Palliative care and the Portuguese health system.

We are currently witnessing the decline of acute diseases and the emergence of chronic degenerative diseases. In Portugal, the cumulative effect of the reduction in mortality and birth rates has resulted in an ageing population. The ageing population will create in the medium term a new dynamic of recruitment in various sectors, including health. With increased life expectancy, the care of chronically ill has become an important area in the context of health services, since they need to be increasingly more focused on the need to provide palliative rather than curative care. Rationalization of resources must be a goal so that waste is minimized. The present model of palliative care ceases to respond to the pressing needs. What to do, to adapt to the changes brought by demographic change and by innovation? What models should be adopted for better resource optimization in palliative care? A literature review was carried out, including articles that compared the main differences between hospital and home care. Portugal has a multi-sectoral palliative care model, in light of what happens in reference countries, however, a better rationalization of resources will be required in order to ensure optimization in the distribution of patients. We also conclude that there is a gap between the patient's will and what is recommended. To respect the individual preferences of the patient, it is necessary to develop quality home-based palliative care services, focusing on training and the expansion of field teams.