The data comes from a study by the Health Regulatory Authority (HRA) on immigrants' access to primary healthcare (PHC), which concluded that, in the last three years, 88.8% of units registered an increase in demand.

According to the regulator, among the more than 844 thousand immigrants registered in the PH in 2023, only around 419 thousand (49.7%) had a family doctor assigned, a rate considerably lower than the 83.5% of all users registered nationwide.

According to the study, which excluded specific situations from this analysis, such as access by tourists or those covered by international agreements, medical consultations for immigrant users represented 6.5% of the total number of primary care consultations and nursing services provided to immigrants corresponded to 7.6% of the total number carried out in PHCs.

Consultations due to cases of acute illness and maternal and child care are the most sought-after health care services and were considered very frequent by 51.9% and 49.2% of primary care functional units (FU).

According to the HRA, most units identified significant differences in demand between immigrants in regular and irregular situations, with registration in the PH (82.6%) and the assignment of a family doctor (76.5%) being the main factors contributing to these differences.

The FUs also reported that the main obstacles that immigrants face in accessing health care include those related to legal issues (89.9%), language barriers (63.8%) and administrative constraints (48.8%).

In the case of immigrants in a regular situation, they highlighted the constraints associated with registration in information systems (59.2%), followed by the insufficiency or dispersion of guidelines on the regulatory framework and rules in force (52.5%).

In the case of immigrants in an irregular situation, the main constraints identified by providers were the lack of documentation on the part of the citizen (85.7%) and the difficulties associated with registration in information systems (63.8%).

The HRA justified its decision to focus the analysis on PHCs with their importance for access to more specialised health care, but also with the unavailability of complete and stabilised data from the Central Administration of the Health System (CAHS), which would allow an accurate portrayal of the demand for hospital health care in recent years.

In view of these conclusions, the HRA emphasises the recommendation already issued to the CAHS, for an effective improvement in the registration, processing and monitoring of data and information on each foreign citizen who accesses healthcare in the SNS.

The HRA also put forward a draft recommendation to Local Health Units, which will be open for public consultation until May 6, with the aim of ensuring the correct registration in the National User Registry (NUR) of foreign citizens and, consequently, respect for their right to access health care.

Between 2018 and 2020, the HRA initiated and concluded 10 investigations related to difficulties in accessing health care by immigrants.

The regulator also assured that it will continue to monitor access to healthcare by foreign citizens in the SNS, considering the impact of legislative changes planned for 2025.

According to data sent by CAHS to HRA, on 31 December 2023, there were 1,785,490 users registered with NNU with foreign nationality, an increase of around 19% compared to 2022, a trend that has been recorded since 2020.