Jesús Díez-Manglano, Sociedad Española de Medicina Interna, Madrid, Spain João Araújo-Correia, Sociedade Portuguesa de Medicina Interna, Lisboa, Portugal Ricardo Gómez-Huelgas, Sociedad Española de Medicina Interna, Madrid, Spain Lèlita Santos, Sociedade Portuguesa de Medicina Interna, Lisboa, Portugal María Montserrat Chimeno-Viñas, Sociedad Española de Medicina Interna, Madrid, Spain Luís Duarte-Costa, Sociedade Portuguesa de Medicina Interna, Lisboa, Portugal María Dolores Martín-Escalante, Sociedad Española de Medicina Interna, Madrid, Spain Jorge Crespo, Sociedade Portuguesa de Medicina Interna, Lisboa, Portugal Luis Manzano-Espinosa, Sociedad Española de Medicina Interna, Madrid, Spain Luís Campos, Sociedade Portuguesa de Medicina Interna, Lisboa, Portugal J. Vasco Barreto, Sociedade Portuguesa de Medicina Interna, Lisboa, Portugal Juana Carretero-Gómez, Sociedad Española de Medicina Interna, Madrid, Spain


The evolution of society has led to big challenges for health-care systems. Sociological, demographic, epidemiological, healthcare, environmental, technological, and economic factors along with the development of innovative health-care technology make it necessary to rethink the model of providing healthcare and organizing hospitals. This consensus, called The Oporto Consensus, statement reflects the societies’ views on the principal changes in hospital organization that will be necessary in upcoming years, especially changes in which internal medicine can and must play an important role. These changes could lead over 10 general principles that incorporate the changes related to the active incorporation of patients, climate change, the prevention of pandemics or alternatives to conventional hospitalization, or the existence of sufficient public funding. In the other hand, changes are necessary in the current model of organization of the health system, based on the integration of the different care levels, focused on processes, and patient-centered multidisciplinary teams, avoiding conventional hospitalization and promoting the use of new technologies in health care, among other. Hence, this document identifies the main challenges that health-care systems currently face and makes proposals for changes in hospital organization to respond to them. Both Spain and Portugal have seen good examples of innovative healthcare adapted to the populations’ needs that take advantage of scientific advances and current technology. These proposals provide a starting point for discussions about how to better organize the health-care system to meet the population’s changing health needs while guaranteeing equitable and sustainable care.



Keywords: Hospital organization. Internal medicine. Portugal. Societies. Medical. Spain.