Losses due to continuous care exceeded 300 euros per month per user.

Losses in long-term care units exceeded 300 euros per month per user last year, according to a study by Porto’s Faculty of Economics, which says underfunding continues despite updated figures.

According to a study commissioned by the National Association for Continuing Care (ANCC) and to which Lusa had access, the amount paid by the state is still insufficient due to the increase in the national minimum wage and the need for many units, for more professionals than the law recommends.

The experts from the Faculty of Economics of the University of Porto, in addition to the costs for 2023, considered three scenarios: one that takes into account only the 4.4% increase in average wages expected this year; another that also applies the inflation rate projected for this year (2.5%) in the headings “Direct and indirect costs” and another that, applying the same inflation rate, takes into account the increase in personnel costs of 7.89% as a result of the increase in the national minimum wage.

Analysing the costs of the previous year, the experts came to the conclusion that there are losses in all types of units (recovery, medium-term and long-term), with the greatest losses occurring in long-term and supportive care units (ULDM), where the difference between public costs and funding reaches 10.79 euros/day/user.

“Considering that in this response the institutions analysed provide an average of 31 beds, this means an underfunding by the state of approximately 122 thousand euros per institution during 2023,” the document concludes.

Despite an update to the amounts paid by the state for mid-term care and rehabilitation (UMDR) and ULDM units, aimed at easing the financial difficulties of the National Network for Continuous Care Integrated (RNCCI) partner organisations – “exacerbated by the Covid-19 pandemic and rising inflation as a result of Russia’s invasion of Ukraine” – these values ​​“remain grossly inadequate”, the study says.

“The Minister of Health has already said publicly that she recognizes that there is serious underfunding of continuing care, and we hope that they will now move from words to action,” ANCC President Jose Burden told Luce.

The official stresses that there is “massive underfunding” in both social response and continuous care.

When considering the three scenarios, the experts report that the value set by the state for 2024 in the three response types “remains significantly lower than the costs per user per day borne by institutions”, emphasizing that the difference is “particularly relevant” in the ULDM (-€6.99 in scenario 1, -€7.59 in scenario 2 and -€9.48 in scenario 3) and in the UMDR (-€5.08 in scenario 1, -€5.74 in scenario 2 and -€8.14 in scenario 3).

They also say such underfunding could threaten the quality of care provided by some institutions and even their own survival, deeming it “particularly urgent” to reconsider the state’s involvement in funding the RNPP.

As a result, they also point to “lack of budget, degradation of infrastructure and lack of equipment,” as well as a lack of motivation among specialists.

“Users suffer from lower quality of care and reduced volumes of services,” the experts add, insisting on the need to “ensure institutions a certain profit margin” that will allow them to improve conditions and the care provided, ensuring the sustainability of the system.”

As José Burden told Luce, there were already departments that wrote to the government that they were going to lower the standards of service provided to users, namely by reducing human resources.

The study was prepared using accounting information from 27 facilities, 24 of which are affiliated with the ANCC. These facilities have a total of 1,169 beds, divided into three response types: convalescent units (hospitalization up to 30 days), UMDR (30 to 90 days), and ULDM (more than 90 days).