Abstract
In Portugal, family doctors work with a well-defined list of patients to whom they provide healthcare throughout their lives. Several studies showed that larger list sizes are associa- ted with poorer health outcomes and compromise the quality of care. A significant increase in the average list size has been observed in recent years due to the Portuguese unfavorable socioeconomic context and the lack of family doctors. In 2017, the Portuguese Association of General and Fa- mily Medicine (APMGF) developed technical and scientific research that ultimately typified a set of different clinical practice contexts. It considers the geographic and socioeconomic characteristics and a set of population-based indicators, adjusting the list size according to the population's specific needs. Such adjustments ensure health care services with better quality, safety, efficacy, and personalized to their features. In this paper, a brief review is made on this topic, focusing on the work developed by APMGF and its main results.
Highlights
Doctors (GPs) worldwide, in Portugal, work upon a well-defined list of patients, but its size varies significantly across different countries and settings
The work developed by Associação Portuguesa de Medicina Geral e Familiar (APMGF) started with a basic diagnosis of the current PHC context in Portugal, focusing on several aspects, such as population evolution from the sociodemographic viewpoint; PHC use rates; coverage rates of the population enrolled with assigned Family Doctor; the mean patient list size by different regions; the potential needs of GPs; and the organizational model’s development
The innumerable inequalities on the mean number of patients per family doctor were emphasized by the neediest regions (Figure 1)
Summary
Doctors (GPs) worldwide, in Portugal, work upon a well-defined list of patients, but its size varies significantly across different countries and settings. This subject has been a matter of discussion for several years. It is possible to assume the management of patients list considering the sociodemographic context and people’s age This will allow the careful delivery of health care to the population, with more quality, safety, and effectiveness and per the community’s characteristics and complexity. This monograph proposes implementing a new formula, considering the balance between potential retirements of endof-career doctors and the career entry of newly graduated specialists
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