Keywords: Crisis events; Social determinants of health; macroeconomic policies; health inequalities

"The impact of the Great Recession and Fiscal policy on the effectiveness and accessibility of the Portuguese public National Health Service and its most vulnerable users – Demand for the improvement of healthcare system’s resilience in light of upcoming crisis events"

This study examined the impact of the Great Recession and government policies on the efficiency and accessibility of the Portuguese public health service and its most vulnerable users to shed light on the need to improve the resilience of European health systems in the face of upcoming crisis events, such as the current crisis. Portugal was used as an example of a European Member State that allowed a complete overview of the public component of its health care system while comparing it to other European countries to draw lessons for European decision-makers. The self-generated framework enabled the recognition that the path between equity and equality is key to reducing health disparities at the individual and cross-national population levels. This research confirmed that healthcare systems' resilience can only be ensured by considering the specific outcomes of three interrelated characteristics: Effectiveness, Accessibility, and Resilience. Improving resilience requires the next policy steps in providing research opportunities by improving participation and encouraging the linkage of datasets linkage for research while maintaining privacy and data security.

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