{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:08:47Z","timestamp":1760058527021,"version":"build-2065373602"},"reference-count":51,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: The Portuguese NHS has embarked on an administrative restructuring aimed at enabling healthcare professionals, particularly family doctors, to focus on direct patient care and improve overall healthcare outcomes. This article details these measures, their initial benefits for patients and professionals, and explores future strategies to further integrate levels of care and leverage technology to enhance efficiency, patient-centeredness, and ultimately, population health. Methods: Each measure was evaluated to estimate its potential impact on the four pillars of the value-based healthcare (VBHC) framework. Results: We found that most measures aimed at reducing bureaucracy had an estimated impact on more than two of the four pillars. Conclusions: Thus, we conclude that the reduction in bureaucracy will tend to address several of the pillars of the VBHC framework and should be considered as a steppingstone in the process of increasing VBHC.<\/jats:p>","DOI":"10.3390\/healthcare13070821","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T14:59:57Z","timestamp":1743778797000},"page":"821","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Addressing Bureaucratic Burdens on the Portuguese National Health Service: A Simplification Experience Aiming for Value-Based Healthcare"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2055-6906","authenticated-orcid":false,"given":"Francisco","family":"Goiana-da-Silva","sequence":"first","affiliation":[{"name":"Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London W2 1NY, UK"},{"name":"Nova Medical School, Travessa de Est\u00eav\u00e3o Pinto\u2014Campus de Campolide, Universidade Nova de Lisboa, 1099-085 Lisbon, Portugal"},{"name":"Faculdade de Ci\u00eancias da Sa\u00fade, Universidade da Beira Interior, 6200-506 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5702-8843","authenticated-orcid":false,"given":"Raisa","family":"Guedes","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Filipa","family":"Malcata","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Juliana","family":"S\u00e1","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias da Sa\u00fade, Universidade da Beira Interior, 6200-506 Covilh\u00e3, Portugal"},{"name":"Unidade Local De Sa\u00fade Santo Ant\u00f3nio, 4099-001 Porto, Portugal"}]},{"given":"Miguel","family":"Cabral","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Rafael","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Unidade Local De Sa\u00fade Regi\u00e3o de Leiria, 2410-197 Leiria, Portugal"}]},{"given":"Soraia","family":"Costa","sequence":"additional","affiliation":[{"name":"Unidade Local De Sa\u00fade P\u00f3voa de Varzim\/Vila do Conde, 4490-421 P\u00f3voa de Varzim, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4431-9470","authenticated-orcid":false,"given":"In\u00eas","family":"Morais-Vila\u00e7a","sequence":"additional","affiliation":[{"name":"Unidade Local De Sa\u00fade Gaia\/Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Lara","family":"Pinheiro-Guedes","sequence":"additional","affiliation":[{"name":"Unidade Local De Sa\u00fade T\u00e2mega e Sousa, 4560-136 Penafiel, Portugal"}]},{"given":"Jo\u00e3o","family":"Sarmento","sequence":"additional","affiliation":[{"name":"Public Health Research Center, Nova National School of Public Health, Universidade Nova de Lisboa, 1600-560 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9060-8025","authenticated-orcid":false,"given":"Filipe","family":"Costa","sequence":"additional","affiliation":[{"name":"Nova School of Business and Economics, Travessa de Est\u00eav\u00e3o Pinto\u2014Campus de Campolide, Universidade Nova de Lisboa, 1099-085 Lisbon, Portugal"}]},{"given":"Rita","family":"Moreira","sequence":"additional","affiliation":[{"name":"Unidade Local De Sa\u00fade Santo Ant\u00f3nio, 4099-001 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7350-8584","authenticated-orcid":false,"given":"F\u00e1tima","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Unidade Local De Sa\u00fade Regi\u00e3o de Aveiro, 3814-501 Aveiro, Portugal"}]},{"given":"Jaime","family":"Alves","sequence":"additional","affiliation":[{"name":"Minist\u00e9rio das Finan\u00e7as, Governo de Portugal, 1149-009 Lisbon, Portugal"}]},{"given":"Marisa","family":"Miraldo","sequence":"additional","affiliation":[{"name":"Department of Economics and Public Policy, Centre for Health Economics and Policy Innovation Imperial College Business School, South Kensington Campus, Imperial College London, London SW7 2AZ, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6808-7769","authenticated-orcid":false,"given":"Alexandre Morais","family":"Nunes","sequence":"additional","affiliation":[{"name":"Centre for Public Administration and Public Policies, Institute of Social and Political Sciences, University of Lisbon, 1300-663 Lisbon, Portugal"}]},{"given":"Hutan","family":"Ashrafian","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London W2 1NY, UK"},{"name":"Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London W12 0NN, UK"}]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London W2 1NY, UK"},{"name":"Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London W12 0NN, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6471-5564","authenticated-orcid":false,"given":"Fernando","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"unstructured":"(2024, February 01). 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