A Portuguese health authority, the Inspeção-Geral das Atividades em Saúde (IGAS), initiated an audit in March of this year into the care provided to non-resident foreigners in the emergency services at Unidade Local de Saúde de São José. The report was submitted to the Health Minister’s office on October 30 and is awaiting approval.
The report indicates that between 2023 and 2024, a total of 27,703 people were treated in emergency services, accounting for 31,803 episodes.
The growth rate of people assisted was 16.5%, with approximately half of these covered by bilateral agreements for health protection.
In 2023, there were 14,513 recorded emergency episodes, which rose to 17,290 in 2024, showing an increase of 19.1%.
The report highlights a 126% rise in the number of births among non-resident foreign women from 2023 to 2024, compared to a 17.3% increase for all users of the obstetrics and gynecology emergency service.
These patients accounted for about 21.3% of the total increase in birth episodes. “Though they form a minority of the total patients, they contributed to the overall growth,” the IGAS report concludes.
The document, initially disclosed by a national newspaper, shows that the relative weight of non-resident foreign patients nearly doubled, rising from 2.9% to 5.6% of the total birth episodes resulting from emergency admissions.
“This trend indicates not only an absolute increase but also a faster growth than that of the overall attended population,” it emphasizes.
IGAS compiled a “Top 5” list of regions most represented by episode numbers, with 39.1% in 2023 corresponding to individuals from South America (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela) and Western Europe (Germany, Austria, Belgium, France, Luxembourg, Netherlands, and Switzerland), decreasing to 37.7% in 2024.
In the multipurpose and pediatric emergency services, South America and Western Europe occupied the top two positions in both years.
In obstetrics and gynecology emergencies, South Asia (Afghanistan, Bangladesh, Burundi, India, Iran, Nepal, Pakistan, and Sri Lanka) ranked first in both years.
In 2024, South Asia was fifth in the pediatric emergency ranking, with IGAS noting its lesser presence in general multipurpose and pediatric emergency services.
The disparity in pediatric emergency demand by South Asian citizens, as opposed to obstetric and gynecology emergencies, is because, under Portuguese nationality rules, babies born to mothers from this region are Portuguese citizens, excluding them from the audit’s scope.
In this biennium, the majority of non-resident patients in the general multipurpose emergency were from Brazil, France, the United States, and Germany.
In pediatric emergencies, Brazil, France, São Tomé and Príncipe, Angola, and Spain were the top-represented countries.
In obstetrics and gynecology emergencies, Brazil, São Tomé and Príncipe, Angola, and Bangladesh were consistently noted over the two years.
Bangladesh ranked second in obstetrics and gynecology for 2023 and 2024, though it placed 11th in pediatric emergencies across both years.
Brazil stood out as the most represented country across all three emergency services, maintaining the top position in each.
The “illness” category was the predominant reason that non-resident foreigners sought general multipurpose and pediatric emergency services (over 70%).
The “personal accident/fall” category ranked second, with approximately 12% in 2023 and 10% in 2024 in general multipurpose emergencies and around 6% in pediatric emergencies in both years.
In obstetrics and gynecology emergencies, “pregnant women and parturients” was a significantly more common reason than “illness,” with 68% in 2023 and 83% in 2024.
The IGAS audit covered 39 Local Health Units (ULS) and followed a December 2024 report, outside an inspection action, which noted that over 102,000 non-residents received emergency care in the National Health Service (SNS) in 2023, with around 92,000 treated between January and September 2024.
[Updated at 16:18]
