[Are Socioeconomic Inequalities in the Process of Registration with Family Physicians Decreasing in Portugal?]

Abstract:

INTRODUCTION:The percentage of citizens who were not registered with a family physician in Portugal reached 16.6% in 2011. In 2012 the Ministry of Health implemented several measures aiming at improving access to family physicians. One clear objective was that all individuals would be registered with a family physician by 2014. We evaluate the evolution of the socioeconomic inequalities regarding registration with family physicians in Portugal between 2009 and 2014. MATERIAL AND METHODS:We use data at the primary health care unit level on the number of individuals who are not registered with a family physician and the purchasing power of the population served by each unit. The analysis is done using concentration measures. RESULTS:We find a higher concentration of individuals not registered with a family physician among units serving populations with higher socioeconomic status, although this has been decreasing over the years analyzed. Amongst units serving the most disadvantaged populations, we find a situation close to perfect equality. DISCUSSION:Our results may reflect the fact that populations with higher economic status live in urban areas where there is greater shortage of family physicians. Alternatively, it may be that these populations choose not to have a family physician within the public system, thus relying on private providers. CONCLUSION:Our findings convey a reduction in existing socioeconomic inequalities in terms of registration with a primary care physician, during the period under analysis. This reduction took place among the populations which experienced more inequality. :Introdução: A percentagem de utentes inscritos em unidades da rede de cuidados de saúde primários sem médico de família atribuído atingiu 16,6% em 2011. O Ministro da Saúde do XIX Governo Constitucional, então em funções, adotou em 2012 um conjunto de medidas com vista a que, no final de 2014, toda a população tivesse acesso a médico de família. Neste artigo avaliamos a evolução das desigualdades socioeconómicas na atribuição de médicos de família em Portugal entre 2009 e 2014. Material e Métodos: Utilizamos dados anuais relativos ao número de utentes com e sem médico de família em cada unidade de prestação de cuidados de saúde primários, bem como ao poder de compra médio da população servida por cada unidade. A análise é realizada com recurso a medidas de concentração. Resultados: A maior concentração da proporção de utentes sem acesso a médico de família encontra-se em unidades que servem populações economicamente mais favorecidas, embora a magnitude da mesma se tenha vindo a reduzir ao longo dos anos analisados. Entre as unidades que servem populações mais desfavorecidas, verifica-se uma situação próxima da igualdade. Discussão: Os resultados obtidos podem refletir o facto de populações economicamente mais favorecidas estarem localizadas em zonas urbanas com maior escassez de médicos de família, mas também o facto de estas optarem por não ter médico de família, recorrendo a prestadores privados. Conclusão: Os resultados apontam para uma diminuição das desigualdades socioeconómicas ao longo dos anos em análise, nomeadamente entre as populações em que estas desigualdades eram mais expressivas.

journal_name

Acta Med Port

journal_title

Acta medica portuguesa

authors

Moura A,Barros PP

doi

10.20344/amp.9873

subject

Has Abstract

pub_date

2018-12-28 00:00:00

pages

730-737

issue

12

eissn

0870-399X

issn

1646-0758

journal_volume

31

pub_type

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