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- Four decades of changing health systems in Southern Europe: a comparative analysis centered on the Portuguese casePublication . Jacquinet, Marc; Curado, Henrique; Gomes, Paulo Sérgio Machado Veloso; Caetano, João RelvãoHealthcare systems have undergone a wide and deep transformation that is only partly reflected in the growth of the per capita spending relative to GDP. Much more transformations are to be explained. Southern European countries are usually considered as a relatively homogeneous group with similar social trends in their health care system. Is it really so and to what extent? Are their more than three or four European models and are European societies – with regard to health policies and systems – converging? What are the specificities of Southern European countries? Our comparative analysis encompasses European countries from the EU and some other countries of the OECD. The data explored are the Health statistics from the OECD and country analysis and data. The Portuguese case serves as a yardstick to get a point of reference. Policy measures and trends will be compared. The results can be summarized at two or three levels: (1) the changes in demography with ageing population all over Europe, (2) the reorientations of health policies and (3) the new social practices around those health national systems. Some specificities of the different counties or group of countries are to be highlighted. The picture is one of complex change: neither a simple convergence nor clear divergences.
- Management of tacit knowledge and the issue of empowerment of patients and stakeholders in the health care sectorPublication . Jacquinet, Marc; Nobre, Ângela Lacerda; Curado, Henrique; Martins, António Eduardo Pais Falcão Barbosa; Arraya, Marco; Sousa, Maria; Pimenta, RuiThere is a growing literature on health and health care dedicated to empowerment of patients; but there is still a gap in the literature to conceptualize knowledge, to extend the discussion of the empowerment of the patients to the stakeholders. The discussion is at the level of managerial processes of empowerment and knowledge management related to health care. The present chapter starts with a review on empowerment, especially focused on the health sector. The following sections will develop a critical analysis of empowerment, mainly around the concept of tacit knowledge (Polanyi) and knowledge management. One key variable is the proximity of the actors involved in the empowerment process. This key variable is very much related to the tacitness issue of knowledge production and flows. The chapter extends the discussion of the empowerment of the patients to that of the stakeholders and the general debate about health literacy. A model is briefly described for the purpose of illustrating the learning process in a knowledge management implemented in health care.