The Sustainable Health Index is a landmark research-based initiative that has transformed how Portugal monitors and discusses the sustainability of its health system. Developed by researchers at NOVA Information Management School (NOVA IMS) in partnership with AbbVie Portugal and the national newspaper Expresso, the index offers a robust, multidimensional framework for evaluating the system across several pillars: activity, cost, quality/value in health, access to care, and innovation.
Before the creation of the index, Portugal lacked a composite, longitudinal, and publicly visible tool to synthesise health system performance. The Sustainable Health Index addressed this gap by combining primary data gathered among users of health system, secondary data analysis, expert scoring, and stakeholder validation to produce an annual sustainability score that enables year-on-year comparison and fosters transparency.
Since its launch in 2018, the Index has had widespread impact. Policy-makers presently use it as a reference to inform reforms and investment prioritisation. Hospital administrators apply it in internal benchmarking and planning. The media, particularly Expresso, has incorporated the index into national reporting cycles, helping raise public awareness of structural challenges and health system progress. It has been cited in parliamentary committees, public health reports, and expert opinion articles. Furthermore, the methodology has been referenced in academic outputs and adapted for institutional planning by regional health authorities.
What sets this project apart is the sustained and strategic engagement with stakeholders. Every year, the results of the index have been presented and discussed in dedicated public events—particularly during AbbVie’s Sustainable Health Conferences—bringing together leading figures from across the healthcare ecosystem. Key participants in these events have included President of Portugal; Health Ministers, Members of the Parliment, Healthcare Professionals and patient representatives.
These multi-sector debates have enriched the index’s credibility, facilitated policy alignment, and ensured practical relevance. They have also created a platform for translating academic insight into concrete proposals—some of which have informed the design of national strategies for access to innovation and chronic disease management.
The methodology itself was developed by NOVA IMS through a rigorous research process. It combined public data sources (INE, ACSS, PORDATA, OECD,…), performance modelling, primary data collect through a national survey to the population, and expert validation. The scoring model is revised annually to ensure responsiveness to health system changes. AbbVie provided institutional support and stakeholder coordination, while Expresso offered a dissemination channel that bridged science and society.
The key innovation behind the project lies in its ability to convert complex datasets into a policy-relevant, accessible, and mobilising tool. Rather than focusing solely on scientific publications or academic metrics, the index was designed to trigger change—by providing all stakeholders with a common language to assess sustainability and demand improvement.
Since 2018, the index has become a recurring reference in public health dialogue. Its results are published yearly and disseminated through opinion pieces, infographics, and panels. In doing so, it has contributed to a more informed and transparent debate on pressing challenges such as digital health integration, waiting times, workforce pressures, and patient-centred outcomes.
The project’s success stems from its long-term vision and the strength of its cross-sector partnership. It is a case study in how universities can generate public value by collaborating with industry and the media—without compromising scientific independence or methodological rigour. It also illustrates the importance of sustained engagement: the index is not a one-time report, but a living research-based intervention that evolves alongside the healthcare system it evaluates.
In summary, the Sustainable Health Index has influenced policy, empowered public discourse, and helped align diverse actors around the common goal of building a more resilient, equitable, and innovative healthcare system in Portugal. Through data, dialogue, and design, it has become a trusted compass in the search for sustainable health.
By integrating scientific evidence with policy dialogue, the Sustainable Health Index has become a trusted instrument for shaping decisions and priorities in healthcare — a benchmark of how data-driven insight can sustain public value. We are committed to guiding Portugal toward a health system that is not only more efficient, but fair, transparent, and resilient.
Pedro Simões Coelho