“There continues to be a downward trend in the percentage of users with a family doctor assigned, and great heterogeneities at the regional level, with an impact on indicators of access to healthcare provided in primary healthcare units (PHC)”, 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.

ERS monitoring of access to CSPs indicates that last year, 24.6% of users enrolled 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, in Alentejo, there was the largest percentage increase in people without a family doctor – eight percentage points -, rising from 9.4% in 2021 to 17.3% in 2023.

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

The North region stands out positively in this indicator, as only 2.3% of users registered in health centers did not have a family doctor in the last year, a slight increase compared to 1.9% in 2021 and 2. 2% in 2022.

At the end of 2023, 83.5% of users enrolled in the CSP had a family doctor assigned in mainland Portugal, continuing to see a downward trend of 2.1 points compared to 2022 and 5.3 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 figure drops to around 70%.

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

“Comparing the percentages of users with family doctors with the rates of use of consultations, it is highlighted that the LVT and Algarve regions exhibited the lowest rates in all years under analysis in these indicators, which suggests that the availability of family doctor represents an important factor promoting access to PHC 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 lower in number than those recorded in 2019 (20,715,482).

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

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, favoring non-face-to-face nursing consultations, compared to face-to-face ones ”, indicates the regulatory entity.

Regarding screenings for oncological diseases, with the exception of mammograms, which registered a decrease in 2023, the remaining population-based screenings analyzed (colpocytology and colon and rectal cancer) increased, all of which registered higher values than in 2019.

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

Regarding the resumption of care activities, 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), consultations doctors at home, percentage of newborns with nursing homes up to 15 days of age and consultations due to flu.