Primary health care coverage in Portugal: the promise of a general practitioner for all.

Publisher: BioMed Central Country of Publication: England NLM ID: 101170535 Publication Model: Electronic Cited Medium: Internet ISSN: 1478-4491 (Electronic) Linking ISSN: 14784491 NLM ISO Abbreviation: Hum Resour Health Subsets: MEDLINE

Original Publication: [London] : BioMed Central

Primary Health Care*/organization & administration ; General Practitioners* ; Health Services Accessibility*; Humans ; Portugal ; Workforce

Background: Primary care is an essential pillar of health systems. Many countries have implemented different policies to improve access to primary care. However, persistent challenges remain. This paper offers a critical analysis of the evolution of primary care coverage in Portugal, focusing on the number of patients without an assigned general practitioner (GP).
Methods: We collected and analyzed publicly available data from 2009 to 2023 to decompose primary care coverage in three components: the number of patients enrolled in primary care units (demand-side effect), the number of GPs measured in full-time equivalent (supply-side effect), and the average number of patients on each GP's list (patient-to-GP ratio, capturing a productivity effect). We provide national and local level estimates for these three components.
Results: Between 2009 and 2023, there was an overall decline in the number of patients enrolled in primary health care units. Concurrently, there was also a net decrease of GPs measured in full-time equivalent. Additionally, there was a progressive reduction in the average number of patients on each GP's list. The rise in the number of patients without an assigned GP is attributed not only to a reduction in the number of physicians, but also to a decrease in the patient load per doctor.
Conclusions: Hiring additional GPs may not suffice to enhance coverage. Achieving higher coverage may imply revisiting patient load per doctor or considering alternative care models. Understanding the challenges related to GP coverage is critical for improving the efficiency of primary care.
(© 2024. The Author(s).)

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UIDB/00097/2020 (CEGIST) FCT - Foundation for Science and Technology, I.P.

Keywords: Family doctor; General practice; Patient lists; Portuguese NHS; Primary care

Date Created: 20240809 Date Completed: 20240810 Latest Revision: 20241120

20250114

PMC11316367

10.1186/s12960-024-00936-7

39123226