The document, which outlines the health profile in Portugal and is part of the 2019 report on the Health Situation in the EU, indicates that 2.3% of the Portuguese population reported unfulfilled medical care needs in 2017 due to cost, distance or waiting times.

Unfulfilled needs have decreased since 2014, but remained above the European average (1.8%). Although the rate of unfulfilled needs due to financial difficulties decreased for people in the lowest income bracket between 2014 and 2017, the percentage was double the EU average in 2017 (4.6% compared to 2.3%).

Direct payments play a substantial role in Portugal, accounting for 27.5% of total health expenditure, which substantially exceeds the EU average (15.8%). Around 13% of total direct payments relate to outpatient care and 6.4% to pharmaceuticals (compared to the European averages of 3% and 5.5% respectively), mainly due to subsidies.

The number of hospital beds per 1,000 inhabitants is relatively low (3.4) compared to the EU average (5.1).

Promoting the integration of mental health patients into communities has helped to reduce the number of beds in psychiatric wards.

Some geographical gaps persist in the provision of health care, with specialists and specialised outpatient care concentrated in major cities.

There hasbeen a steady increase in the number of doctors and nurses since 2000 - with five qualified doctors per 1,000 inhabitants in 2017 – this figure seems high compared to the EU average of 3.6, but it includes all qualified doctors, even those who are no longer in the profession.

At the beginning of this year 5.8% of the population (600,000 users) were without a family doctor.