葡萄牙：选定问题

PORTUGAL SELECTED ISSUES This paperonPortugalwas prepared by a staff team of the International Monetary Fundas background documentation for the periodic consultation with the member country.Itis based on the information available at the time it was completed onMay28,2026. Copies of this report are available to the public from International Monetary Fund•Publication ServicesPO Box 92780•Washington, D.C. 20090Telephone: (202) 623-7430•Fax: (202) 623-7201E-mail:publications@imf.org Web:http://www.imf.org International Monetary FundWashington, D.C. PORTUGAL SELECTED ISSUES ApprovedByEuropean DepartmentPrepared ByIppei Shibata(EUR)and Carolina Bloch (FAD). Acronyms_________________________________________________________________________________3 PORTUGAL’S PRODUCTIVITY GAP VIS-À-VIS EUROPE AND THE UNITED STATES:A FIRM-LEVEL ANALYSIS________________________________________________________________4 A.Background and Motivation___________________________________________________________4B.Challenges Faced by Firms to Scale Up in Portugal____________________________________6C.Policy Options to Boost Productivity___________________________________________________9 FIGURES 1. Aggregate Productivity Gap: Portugal vis-à-vis Europe and the United States_________42. European Listed Firms in International Comparison: Productivity, R&D, and EquityIssuance__________________________________________________________________________________53. Firm Dynamics in Portugal_____________________________________________________________64. Gazelles in Portugal____________________________________________________________________85. Portugal’s Innovation Ecosystem______________________________________________________10 ANNEX I.DataSources___________________________________________________________________________11 HEALTH SPENDING EFFICIENCY IN PORTUGAL: DRIVERS, CHALLENGES ANDREFORM PRIORITIES___________________________________________________________________13 A.Introduction__________________________________________________________________________13B.Healthcare Model and Spending Composition________________________________________15C.Input-Related Cost Drivers____________________________________________________________19D.System-Level and Budgeting Reforms and Constraints_______________________________21 PORTUGAL E.Conclusion and Policy Options to Enhance Health Spending Efficiency_______________________23 BOXES 1.Overview of the Portugese Health Sysem_____________________________________________________162.Portugal’s Health Spending Review: Scope and Implementation Constraints__________________23 FIGURES 1. Benchmarking and Recent Trends of Current Health Spending_______________________________142. Health Spending by Financing Schemes and Funding Sources________________________________173. Compositionof Current Health Expenditure in Portugal and EU Countries____________________184. Hospital Spending: Signs of High Costs and Continued Strain________________________________185. Contributions of Main Spending Components to SNS CHE Growth, 2019-2024_______________196. Employment and Compensation of Healthcare Professionals_________________________________207. SNS Spending on Pharmaceuticals: Changes inVolume and Price____________________________21 References_______________________________________________________________________________________25 Acronyms ADMAssistência na Doença aos Militares (Health subsystem for the Armed Forces)ADSEAssistência na Doença aos Servidores do Estado (Health subsystem for civilservants)CHECurrent Health ExpenditureCRICentros de Responsabilidade Integrada (Integrated Responsibility Centers)ECGExcess Cost GrowthINFARMEDAutoridade Nacional do Medicamento e Produtos de Saúde (National Authority ofMedicines and Health Products)LTCLong-Term CareMTEFMedium-Term Expenditure FrameworkPRRPlano de Recuperação e Resiliência (Recovery and Resilience Plan)SNSServiço Nacional de Saúde (National Health System)ULSUnidades Locais de Saúde (Local Health Units)UNPPUnited Nations World Population ProspectsWHOWorld Health Organization PORTUGAL’S PRODUCTIVITY GAP VIS-À-VIS EUROPEAND THE UNITED STATES:A FIRM-LEVEL ANALYSIS1 Portugal’slarge GDP-per-capita gap withthehighest-income euro area economies and the US isprimarily driven by a productivity shortfall. At the EU level,Europeanleading firms, particularly in thetech sector, trail leading global counterparts in productivity and innovation, partly reflecting far lessR&D investment rooted in less reliance on equity.In Portugal, those factors are compounded byabroader lack of dynamism. Firms enter the market small andrarelyscale up, resulting in a muchsmaller economic footprint of young high-growth firmsthanin European peers and—even moreso—the US. Thisrarer occurrence of “gazelles” inPortugalpartly reflects limited access to venturecapital andinadequate human capital, as well as tax and regulatory obstacles to firms’ growth. Takentogether, this comparative la