More doctors but less in hospitals
In 2020, there were 5.6 doctors in Portugal per 100 thousand inhabitants, 0.2 more per 1000 inhabitants than in 2019. An increasing trend that has been observed since 2004. Data from the National Statistics Institute (INE) released yesterday, within the scope of World Health Day, reveal that, in 2020, 57,198 professionals were registered with the Portuguese Medical Association, of which 55,094 on the mainland, 912 on the Azores and 1,202 on Madeira.
The regions of Alentejo. The Azores and Madeira have a number of professionals lower than the national average, respectively 3.2, 3.7 and 4.7 doctors per 1,000 inhabitants. However, when we compare these numbers with those of the European Union of 27, Portugal was the country that had the biggest increase in the number of professionals from 2014 to 2019: 18.9%, an average annual growth of around 3.5%, while in the EU-27 this increase was 8.3%, an increase of 1.6% per year. In these 20 years, the picture of the medical profession has also changed significantly. From 81.4 women per 100 men in 2000, it rose to 128.6 women per 100 men in 2020, above the average recorded in the EU-27, which is 103.8 women per 100 men.
INE data also reveal that 60% of professionals enrolled in the OM are specialists (34,836). The areas of General and Family Medicine, Pediatrics, Internal Medicine and Anesthesiology are preferred, although General and Family Medicine does not have even one doctor per 1000 inhabitants (0.9). In 2020, there was also a noticeable trend that has been worsening for 20 years, while in 2000, 58.2% of doctors enrolled in the OM worked in hospitals, in 2020 this percentage was 46%.
Hospitals added to the SNS were the ones that hired more nurses
The trend towards an increase in the number of nurses in our country has been consistent, around 2.9% per year since 2017. In 2020, 77,984 professionals were enrolled in the Ordem dos Enfermeiros, which represents 7.6 nurses per 1,000 inhabitants and an increase of 0.2 nurses per 1000 inhabitants compared to 2019, when there was a ratio of 7.4 nurses per 1000 inhabitants.
In relation to this class, the number of professionals per 1000 inhabitants is higher in the autonomous regions, with 9.3 and 9.4 nurses per 1000 inhabitants in the Azores and Madeira. As 20 years ago, women continue to represent more than 80% of professionals, with an increase of up to 1% in the female-male ratio compared to 2000 (461.3 to 465.1). Unlike doctors, the overwhelming majority of professionals perform generalist functions, 73.9%, only 26.1% are specialists. Of these, 22.1% have the specialty of rehabilitation and 21.8% medical-surgical.
Most nurses work in hospitals, 61.9%. In fact, hospitals added to the SNS, public or public-private partnership, were the ones that contributed most to the growth of employment in the class between 2015 and 2020 (78.1% of the overall increase). The contribution was even greater in 2020, around 91%.
Fewer public and more private hospitals
In 2020, there were 241 hospitals in Portugal, 113 from the SNS, a number that has remained stable since 2016, although with a decrease of 14 hospitals compared to 2010. The ratio of hospitals added to the SNS (public or public-private partnership) by 100 thousand inhabitants was 1.1 in 2020, as in the previous year.
In 2020, 128 private hospitals were in operation, 26 more than in 2010, a growth felt mainly from 2016 onwards. Around 74% of the existing hospitals in 2020 were general hospitals and 62 were specialized, of which 23 were for Psychiatry. This year, there were 36,300 beds in hospitals for immediate hospitalization, 230 more than in 2019, which corresponded to 3.5 inpatient beds per 1,000 inhabitants.
Of the total number of beds, 67.2% were from hospitals linked to the SNS, although there has been a reduction in these, in the order of 5.1%, since 1999.
Fewer admissions than in the last 20 years
The year 2020 was the year in which about 987.2 thousand admissions were registered in Portuguese hospitals and 9.4 million days of hospitalization, which is the lowest value recorded in the series started in 1999. For the first time, the number of admissions did not reach one million and the number of days spent in hospital was below 10 million. This results from the fact that there were 162,900 fewer hospitalizations and 968,400 fewer days of hospitalization than in 2019.
Public hospitals or public-private partnership hospitals ensured around 739 thousand hospitalizations (74.9% of the total) and 6.7 million days of hospitalization (71.1% of the total). These values mean a reduction of approximately 124 thousand hospitalizations and 821 thousand days of hospitalization, 14.3% less and 10.9% less compared to the activity in 2019. (-13.6%) and less than 148 thousand days of hospitalization (5.1%).
Of the total admissions in 2020, 77.5% occupied ward beds, especially in Internal Medicine, General Surgery and Obstetrics Gynecology, respectively 25.2%, 14.2% and 13.0% of the total admissions. The Infectious Diseases specialty represented less than 2% of hospitalizations that occurred in the ward in 2020, but stood out for having had an increase of more than 10,000 hospitalizations, due to covid, more than double the number recorded in this specialty in the previous year.
2.4 million fewer emergencies in 2020
In all, there were 5.7 million visits to hospital emergency services, 2.4 million less than in 2019. The lowest value recorded since 1999 and a drop of 29.6% compared to 2019. In hospitals In the public sector, there were 4.8 million visits in 2020, 2 million fewer than in 2019. In private hospitals, 964 thousand visits were made in 2020, 447 thousand less than in the previous year. This is the lowest number since 2014. Public hospitals or hospitals in public-private partnerships provided 83.2% of all emergency room visits and private hospitals 16.8%.
2.7 million fewer consultations in hospitals
In 2020, around 18.4 million medical consultations were carried out in hospitals, 2.7 million less than in the previous year. But it was the private hospitals that felt the most, a decrease of 1.4 million consultations compared to 2019. In public public hospitals, 1.2 million fewer consultations were performed. Regarding the surgical activity, there were 176 thousand fewer surgeries in operating theaters and 55.2 thousand less minor surgeries. Hospitals in the public and private sectors suffered drops of 17.7% and 15.4%, respectively. The specialties of Ophthalmology, General Surgery and Orthopedics registered the greatest reduction in surgeries in operating theaters, 47 thousand fewer, 33 thousand fewer and 28 thousand fewer surgeries.
19.6 million fewer diagnostic tests
In Portuguese hospitals, in 2020, 162.6 million complementary procedures, tests necessary for a diagnosis or acts intended to provide curative care after diagnosis and therapeutic prescription were carried out, 19.6 million less than in the previous year . Of this negative balance, 14.3 million relate to public sector hospitals, which represents a drop of 9.2% in the activity of these establishments between 2019 and 2020. Private hospitals performed 5.3 million fewer complementary diagnostic and / or therapy, meaning a reduction of 20.6% compared to 2019. On the other hand, there was an increase in the number of complementary Pulmonology procedures performed in public sector hospitals (170,400 more, equivalent to 7.3% more ) and complementary Gynecology procedures performed in private hospitals (31,100 more, equivalent to 19.3% more).