Managing NHS money in Portugal: who decides?

Purpose: The need to reduce health expenditures raises the discussion on rationing possibilities and there is a growing interest in considering society's perspectives. The aim of this paper was to evaluate Portuguese citizens' opinion regarding the imposition of limits on National Health Service (NHS) spending. We also asked who decides how NHS money is spent, in order to obtain the respondents' views on public involvement. Design/methodology/approach: An online questionnaire was used to collect data. Descriptive and inferential statistics, factorial analysis and a logit model were applied. Findings: Our results showed that most of the respondents believe citizens have low participation on NHS' financial decisions, confirming the lack of public involvement. Health professionals are more likely to agree with limits on NHS spending, which could indicate potential inefficiencies. Practical implications: From a health policy perspective, we have concluded that different stakeholders should be involved before deciding how public spending limits should be implemented. Health professionals' perspectives should be considered, taking advantage of their experience. Originality/value: The main novelty of this paper is the evaluation of whether there should be limits on NHS spending, comparing health professionals and non-health professionals. [ABSTRACT FROM AUTHOR]