According to the report “Access to healthcare – Citizens' choices 2020”, released today, the situation has improved and between 2017 and 2020 the proportion of people who it stopped buying the drugs they needed at least once a year went down, but socioeconomic inequalities meant the percentage increased from 11 percent to 15 percent in the lowest socioeconomic class. The same happened regarding people who stopped going to a medical appointment or having an exam due to lack of money, with an increase from 7 percent (2017) to 10 percent (2019) in the lower socioeconomic class. "Despite the effort that has been made in terms of public policies to lower drug prices, the truth is that it continues to be the central element of people's expenses when they go to the doctor, in terms of direct payments (...) and there is this aspect of ending up being much heavier in families with lower incomes, which is natural”, the author of the report, Pedro Pita Barros, told Lusa.
The study, which results from a partnership between Fundação “la Caixa” and BPI and Nova SBE, states that, despite the existence of socioeconomic inequalities in disease, access to the health system is similar for the entire population and that the decision to first contact has few access barriers. The report also shows that there was no “leakage” from the NHS to the private sector, but rather “a reconfiguration within each sector in recent years”. “The only escape we found in the last year was people leaving the emergency room and choosing another form of treatment. (…) What we have is a reconfiguration within the choices of health systems, which is something that the State has been present over the last decade”, said the author of the report.
In 2020, there was a shift from hospital emergencies, public and private, to another point of treatment within the medical sector, as there was less demand for emergency care for fear of the pandemic. The proportion of people who mentioned hospital emergency as their first point of contact with the health system fell from 41.1 percent in 2019 to 32.2 percent in 2020 in the public sector and from 5 percent to 2.1 percent in the private sector, indicates the report. “What we've found over the last eight to 10 years is a clear split situation in people going more public or more private, but it hasn't changed radically. And this is obviously different from situations that occur when people are on a waiting list already in the public sector and decide to go to the private sector because they do not want to be on the waiting list any longer”, explained Pita Barros. “These situations occur after people are already in the health system, after they have had their first contact. Here we are trying to look [at the system] before that first contact (…) and there is no escape in that direction”, he added.
The pandemic brought two new "access barriers" to the NHS: the fear of going to the health system because of Covid-19, mentioned to by 15 percent of people surveyed in the study, and the cancellation of an appointment by the hospital or doctor, pointed out by 20 percent of respondents. Older people and lower socioeconomic classes indicated greater fear.