The data comes from an analysis by researchers Carolina Santos and Pedro Pita Barros, from Nova SBE, which found that 14.1% of adults used a private family doctor last year, and of these, approximately 70% have a family doctor assigned by the National Health Service.

The data shows that “the main facts underlying the use of a family doctor in the private sector in Portugal is not the absence of a family doctor in the SNS, but rather coverage by private health insurance or another form of dual coverage.”

Seeking private healthcare without a family doctor

According to the analysis “Family Doctors in the Private Sector in Portugal: Current Situation,” only 4.2% of the total population resorts to private healthcare because they do not have a family doctor in the National Health Service (SNS), and approximately 10% of the population has dual coverage (family doctor in the SNS and in the private sector).

The study shows that having a health insurance plan increases the likelihood of seeking a family doctor in the private sector by about 39 percentage points, also showing a significant increase when analysing beneficiaries of private health subsystems: 24.5 percentage points across all private subsystems, 15.2 percentage points in the case of ADSE (a public health insurance scheme for civil servants), and 10.8 percentage points among ADM (a private health insurance scheme for civil servants) beneficiaries (including PSP and GNR).

“In contrast, not having a family doctor in the SNS only increases this probability by 6.3 percentage points (an impact about four times smaller than that associated with private health insurance),” it points out.

Although the loss of access, the increase in family doctor use in the SNS leads to a moderate increase in private healthcare: the predicted probability of resorting to private healthcare is 13.4% for those who maintain a doctor in the SNS, rising only to 18.7% if that access is lost.

Higher rates of private healthcare use

Algarve and Greater Lisbon (19.3% and 16.8%, respectively) have the highest rates of private healthcare use, followed by Greater Porto (13.6%) and the North Coast (11.5%).

“Interestingly, regions with high public coverage, such as the North Coast (94.6%) and Greater Porto (93.1%), also register significant levels of dual use (10.9% and 12.6%, respectively), suggesting that the recourse to private healthcare does not stem exclusively from SNS coverage failures,” it points out.

Acquiring health insurance

According to the analysis, the probability of acquiring private health insurance rises sharply with increasing socioeconomic status.

“This pattern highlights that Private health insurance is highly sensitive to economic vulnerability, even after considering the roles of education, profession, and region of residence,” he emphasises.

On the other hand, self-reported health status has a limited impact on the decision to seek private care, suggesting that access to private care is more influenced by financial coverage and socioeconomic resources than by immediate clinical need.

The researchers conclude that “the growth of private health insurance, in terms of people covered, will be boosting the development of a habit of using family doctors in the private sector that is not a unique, or even predominant, result of the lack of overall coverage by family doctors in SNS.”

“There is presumably an element of personal preference, the more detailed knowledge of which should motivate the work of generating additional knowledge,” they argue.

For the researchers, “the importance of these results for the Portuguese health system is that it is not to be expected that greater coverage of family doctors in the SNS will significantly reduce the work of family doctors in the private sector.”

The analysis was developed within the scope of the Equity Initiative. Social, a partnership between the “la Caixa” Foundation, BPI and Nova SBE, was based on data from the Baseline Survey of the Healthcare Access Report (2023 and 2025).