"A trend of decrease in the percentage of users with a family doctor assigned continues to be observed, and significant regional heterogeneity, with an impact on the access indicators to healthcare provided in primary healthcare units (CSP)", warns the Health Regulatory Authority (ERS) in a monitoring report released today.

According to data from the National Health Service (SNS) transparency portal consulted by the Lusa agency, at the end of April this year, 1,565,880 users did not have a family doctor in mainland Portugal, 26,658 more than in the previous month.

The ERS monitoring on access to CSP indicates that, in the last year, 24.6% of users registered in LVT did not have a family doctor assigned, a percentage that increased compared to 18.2% in 2021 and 19.2% in 2022.

The Algarve is the second region in mainland Portugal with the most people without access to a general and family medicine specialist, a scenario that has also evolved negatively in the last three years - 15.1% in 2021, 17.6% in 2022 and 20% in 2023.

According to ERS data, Alentejo saw the largest percentage increase in people without a family doctor -- eight percentage points -- going from 9.4% in 2021 to 17.3% in 2023.

In the Center, the number of people registered, but without a family doctor assigned, went from 6% to 12.6% from 2021 to 2023.

The North region stands out positively in this indicator, since only 2.3% of users registered in health centers did not have a family doctor in the last year, a slight growth compared to 1.9% in 2021 and 2.2% in 2022.

At the end of 2023, 83.5% of users registered in CSP had a family doctor assigned in mainland Portugal, with a downward trend of 2.1 percentage points compared to 2022 and 5.3 percentage points compared to 2021.

The North had the highest percentage of registered users with a family doctor assigned (97.6% in 2023), while in LVT this value drops to around 70%.

According to data from the regulatory authority, the rate of use of medical consultations presented, in 2023, a value of 69%, with all regions following this downward trend.

"From the comparison of the percentages of users with family doctors with the rates of use of consultations, it is noteworthy that the LVT and Algarve regions showed the lowest rates in all years analyzed in these indicators, which suggests that the availability of a family doctor represents an important factor in promoting access to CSP in the SNS", warns the ERS.

In 2023, face-to-face medical consultations increased by 3.7%, following the same trend as in 2022, but still in a number lower than those registered in 2019 (20,715,482).

On the other hand, non-face-to-face medical consultations registered a decrease of 6.3% in 2023, compared to 2022, also following the trend of 2022.

The comparison of these data "seems to suggest a change in the way health care is provided, with the reinforcement of face-to-face medical consultations, to the detriment of non-face-to-face consultations, and, on the other hand, privileging non-face-to-face nursing consultations, compared to face-to-face consultations", indicates the regulatory authority.

Regarding the screening of oncological diseases, with the exception of mammograms, which registered a decrease in 2023, the other population-based screenings analyzed (colpocytologies and cancer of the cervix and rectum) increased, all having registered values higher than those of 2019.

According to the ERS, taking into account that the North presents better indicators and that it is the region with the highest percentage of Family Health Units of model B, its "better performance may be associated with the organizational model of these units".

As for the resumption of healthcare activity, the ERS found that "it was not possible to recover the levels of 2019", the year before the covid-19 pandemic, in the indicators of face-to-face consultations (medical and nursing), medical consultations at home, percentage of newborns with a nursing home up to 15 days of life and consultations due to flu.

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