Nearly half of surveyed Portuguese adults fall into the most vulnerable health profile

Three patient profiles

A study released on Thursday, 5 November, by the Ordem dos Médicos sorts respondents into three health profiles: 'Vulneráveis' (vulnerable), 'Episódicos' (episodic) and 'Integrados' (integrated). The vulnerable group is the largest, at 48% of respondents, and is marked by worse perceived health and a heavier disease burden. Its members are mostly older people who use health services more out of necessity, yet they find it hardest to keep up continuous follow-up. The episodic profile accounts for 34%, made up of younger people who rate their health better and use services less, but who have weak continuity of care and irregular prevention habits. The integrated group, at 18%, reports intermediate health, regular service use, strong follow-up and better preventive practices.

Vulneráveis (vulnerable)48%

Episódicos (episodic)34%

Integrados (integrated)18%

Vulneráveis (vulnerable)

48 %

Episódicos (episodic)

34 %

Integrados (integrated)

18 %

Data from the article text

Study coordinator Tiago Correia summed up the paradox in one sentence.

“They are the people who need the most and the people who have the greatest difficulty keeping up the circuit in the health system in light of their needs.”

Access and waiting times

Nearly three in ten respondents (29.9%) said they had not received care within an adequate period in the previous 12 months, because of booking difficulties or waiting lists. More than a third (36.3%) rated access to the national health service (SNS) in their area of residence as difficult or very difficult. In contrast, 40% rated that access as easy or very easy. Correia told DN that the waiting-time figure is the most frequently reported access problem in the study, and that it rests on official indicators of the maximum guaranteed response time, which he said are rising. He added that the most affected are the most vulnerable, including people aged 65 or over.

Did not get timely care29.9%

Rate SNS access difficult or very difficult36.3%

Rate SNS access easy or very easy40%

Did not get timely care

29.9 %

Rate SNS access difficult or very difficult

36.3 %

Rate SNS access easy or very easy

40 %

Data from the article text

Informal caregivers

The study found that 14.7% of respondents regularly care for someone with long-term health problems. Of those carers, 34% spend 20 or more hours a week on that task. More than 40% of informal carers said the Informal Caregiver Statute, approved in 2019, has had no positive effect on their mental health or income, and nearly half describe themselves as struggling both mentally and financially. Correia noted that European health systems rely heavily on informal care, a role that carries a gender dimension and tends to fall on women. He argued that the model keeps carers out of the labour market and limits their life autonomy, and posed three questions: whether the statute is being properly implemented, whether support must be expanded, or whether the home-based model itself needs rethinking.

One Health and antibiotics

Almost 84% (83.9%) of respondents consider cooperation between doctors, veterinarians, environmental specialists and policymakers essential to prevent outbreaks and respond to public health threats. Knowledge gaps remain, however. Some 12% admitted taking antibiotics without a prescription, between a quarter and a fifth disagree that antibiotic use in animal production can affect human health, and nearly 20% say they do not know the link exists. About a fifth of people who eat meat from their own or family farms do not know the hygiene conditions in which the animals were raised or slaughtered. Correia said much work remains on integrating human, animal and environmental health, and stressed that food choices matter as much as medical care.

“It is not only about our health. It has to do with how we produce food and animals, and how we make informed choices, for example, in the supermarket.”

Study design

The study, titled 'Retrato da Saúde em Portugal no Pós-Pandemia', was promoted by the Ordem dos Médicos and carried out by the Instituto de Higiene e Medicina Tropical of Universidade NOVA de Lisboa, with support from the WHO Collaborating Centre for Health Workforce Policy and Planning. It draws on 700 telephone interviews with adult residents of mainland Portugal and the islands. The project also includes the views of doctors and medical students. Bastonário Carlos Cortes said the results could help underpin the deep reform the SNS needs.