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.