{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:10:53Z","timestamp":1767373853695,"version":"build-2065373602"},"reference-count":51,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,1,26]],"date-time":"2024-01-26T00:00:00Z","timestamp":1706227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sustainability"],"abstract":"<jats:p>The performances of public corporate hospital units are being influenced by user behaviour, delayed service responses, and sustainability risks. Consequently, there is a need for these units to adopt a different approach to user care in order to attain overall success and mitigate discontent arising from delays and waiting lists. The faults within the public system are becoming increasingly apparent as a result of the growing emphasis on the transparency and authenticity of information. The reform of the Portuguese health system aims to enhance coordination among public, private, and social services. Additionally, it prioritises the integration of various levels of care within the Portuguese National Health Service, specifically by promoting the amalgamation of hospital business entities with primary care under single organisations known as Local Health Units. The objective of this study was to utilise the SWOT framework to examine the reform from the standpoint of citizens, as they are the focal point of the system and its long-term sustainability. The study revealed several benefits associated with the reform. However, it is crucial to address potential risks and opportunities in order to achieve the intended outcomes. If health managers and policy-makers effectively utilise the available opportunities, it can be inferred that there exists a favourable circumstance to implement a Local Health Unit model that seeks to integrate comprehensive care. This approach, by addressing the health issues of citizens, will create a larger scope for improvement and enhance citizen contentment. Moreover, it will ensure the long-term viability, ethical conduct, transparency, and genuineness of health outcomes.<\/jats:p>","DOI":"10.3390\/su16031078","type":"journal-article","created":{"date-parts":[[2024,1,26]],"date-time":"2024-01-26T08:56:01Z","timestamp":1706259361000},"page":"1078","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Vertical Integration in Healthcare and Patient Satisfaction: An Exploratory Analysis of Portuguese Reforms"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6808-7769","authenticated-orcid":false,"given":"Alexandre","family":"Nunes","sequence":"first","affiliation":[{"name":"Centre for Public Administration and Public Policies, Institute of Social and Political Sciences, Universidade de Lisboa, Rua Almerindo Lessa, 1300-663 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1111\/itor.12713","article-title":"Optimizing payments based on efficiency, quality, complexity, and heterogeneity: The case of hospital funding","volume":"27","author":"Ferreira","year":"2019","journal-title":"Int. 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