Data from the Nova School of Business and Economics healthcare access survey indicate that, in 2025, 45.5% of respondents reported at least one episode of illness, up 3.2 percentage points from 2023 and close to the highest recorded in 2015 (46.3%).

Prepared by researchers Pedro Pita Barros and Carolina Santos, the study, which has surveyed 11,122 people since 2013, reports that the proportion of people who report feeling ill has been increasing since the most intense years of the COVID-19 pandemic (2020 and 2021).

“More people reported having experienced at least one episode of illness, and there was a worsening in the younger age group, which we define as between 15 and 29 years old, but with the survey data, we were unable to identify the causes of this increase,” researcher Carolina Santos explained to Lusa.

Alongside this increase, according to the data collected, there was a reduction between 2019 and 2025 in the likelihood of the population having a family doctor assigned to them (from 91% to 79%), as well as in the number of first consultations carried out within an appropriate time frame, showing high barriers to access to healthcare.

“As many of the most disadvantaged populations typically live in regions with a greater shortage of family doctors, according to our analysis, they end up being penalised in this regard as well,” he explained.

The data also show that the most disadvantaged, in addition to experiencing episodes of illness more frequently, also face greater financial and non-financial barriers to accessing healthcare, which the system is unable to counteract.

“The more frequent occurrence of illness among the most disadvantaged classes already shows a dimension of inequality, and the SNS and the health system as a whole are not, in essence, managing to counteract this inequality in the occurrence of illness,” said Carolina Santos.

While acknowledging that some measures have been taken in the meantime – such as the “Call first, save lives” project, in which calling the SNS24 helpline avoids trips to the emergency room, or even the end of most user fees – the researchers stress that the price of medicines remains a financial barrier to access.

“This has worsened,” acknowledges the researcher, pointing out that “while in 2023 the probability of a person from the most disadvantaged economic bracket not purchasing all the necessary medication was 41%, in 2025 this figure rose to 52%.”

Given that expenditure on medicines continues to account for the largest share of expenditure associated with healthcare (primary care or emergency care), “there is a barrier to access for the most vulnerable population,” she added.

At this level, they suggest assessing the feasibility of extending special co-payment schemes to people in economic vulnerability who, unlike elderly beneficiaries of the Solidarity Supplement for the Elderly, are not eligible for the 100% co-payment for prescription medicines.

At the same time, the share of people who, despite being ill, did not seek healthcare increased from 11.26% (2023) to 14.26% (2025).

According to the data, the primary reason for not seeking healthcare was the belief that the case was not serious; however, a significant percentage of respondents reported they did not want to wait to be seen.

In 2025, the percentage of people who chose not to seek help from the healthcare system and decided to self-medicate increased again. Even so, the proportion (76.4%) remained below the pre-pandemic maximum (77.1% in 2019).