{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:29:24Z","timestamp":1770985764927,"version":"3.50.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/4255\/2020"],"award-info":[{"award-number":["UIDB\/4255\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"DOI":"10.1186\/s12875-026-03174-z","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T23:45:38Z","timestamp":1768866338000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of exclusive utilisation of scheduled and unscheduled primary care visits: a cross-sectional study in Portugal"],"prefix":"10.1186","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8490-1319","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Carneiro","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2362-5527","authenticated-orcid":false,"given":"Paulo","family":"Santos","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"11","key":"3174_CR1","doi-asserted-by":"publisher","first-page":"e81256","DOI":"10.1371\/journal.pone.0081256","volume":"8","author":"C Martins","year":"2013","unstructured":"Martins C, Azevedo LF, Ribeiro O, Sa L, Santos P, Couto L, et al. A Population-Based nationwide Cross-Sectional study on preventive health services utilization in Portugal-What services (and Frequencies) are deemed necessary by patients? PLoS ONE. 2013;8(11):e81256. https:\/\/doi.org\/10.1371\/journal.pone.0081256.","journal-title":"PLoS ONE"},{"issue":"7","key":"3174_CR2","doi-asserted-by":"publisher","first-page":"e0219262","DOI":"10.1371\/journal.pone.0219262","volume":"14","author":"JVM Rocha","year":"2019","unstructured":"Rocha JVM, Nunes C, Santana R. Avoidable hospitalizations in Brazil and portugal: identifying and comparing critical areas through Spatial analysis. PLoS ONE. 2019;14(7):e0219262. https:\/\/doi.org\/10.1371\/journal.pone.0219262.","journal-title":"PLoS ONE"},{"key":"3174_CR3","doi-asserted-by":"publisher","first-page":"38","DOI":"10.11606\/S1518-8787.2019053000940","volume":"53","author":"TB Vidal","year":"2019","unstructured":"Vidal TB, Rocha SA, Harzheim E, Hauser L, Tesser CD. Scheduling models and primary health care quality: a multilevel and cross-sectional study. Rev Saude Publica. 2019;53:38. https:\/\/doi.org\/10.11606\/S1518-8787.2019053000940.","journal-title":"Rev Saude Publica"},{"issue":"1","key":"3174_CR4","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1186\/s12909-022-03528-y","volume":"22","author":"I Reis","year":"2022","unstructured":"Reis I, Envia G, Santos P. Impact of the primary care residents on the productivity of the ambulatory health centres in portugal: a cross-sectional study. BMC Med Educ. 2022;22(1):465. https:\/\/doi.org\/10.1186\/s12909-022-03528-y.","journal-title":"BMC Med Educ"},{"issue":"9","key":"3174_CR5","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1002\/hec.1046","volume":"14","author":"OD Lourenco","year":"2005","unstructured":"Lourenco OD, Ferreira PL. Utilization of public health centres in portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples. Health Econ. 2005;14(9):939\u201353. https:\/\/doi.org\/10.1002\/hec.1046.","journal-title":"Health Econ"},{"issue":"8","key":"3174_CR6","doi-asserted-by":"publisher","first-page":"e003320","DOI":"10.1136\/bmjopen-2013-003320","volume":"3","author":"Y Wang","year":"2013","unstructured":"Wang Y, Hunt K, Nazareth I, Freemantle N, Petersen I. Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open. 2013;3(8):e003320. https:\/\/doi.org\/10.1136\/bmjopen-2013-003320.","journal-title":"BMJ Open"},{"issue":"1","key":"3174_CR7","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1089\/whr.2021.0088","volume":"3","author":"SJ Khan","year":"2022","unstructured":"Khan SJ, Poole KG, Kling JM, Taylor G. Outpatient primary care practitioner access: Gender-Based preferences. Womens Health Rep (New Rochelle). 2022;3(1):150\u20134. https:\/\/doi.org\/10.1089\/whr.2021.0088.","journal-title":"Womens Health Rep (New Rochelle)"},{"issue":"1","key":"3174_CR8","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s12875-017-0633-1","volume":"18","author":"M Rutten","year":"2017","unstructured":"Rutten M, Vrielink F, Smits M, Giesen P. Patient and care characteristics of self-referrals treated by the general practitioner cooperative at emergency-care-access-points in the Netherlands. BMC Fam Pract. 2017;18(1):62. https:\/\/doi.org\/10.1186\/s12875-017-0633-1.","journal-title":"BMC Fam Pract"},{"issue":"1","key":"3174_CR9","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/s12875-018-0787-5","volume":"19","author":"B Riedl","year":"2018","unstructured":"Riedl B, Kehrer S, Werner CU, Schneider A, Linde K. Do general practice patients with and without appointment differ? Cross-sectional study. BMC Fam Pract. 2018;19(1):101. https:\/\/doi.org\/10.1186\/s12875-018-0787-5.","journal-title":"BMC Fam Pract"},{"key":"3174_CR10","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/2045-4015-3-40","volume":"3","author":"A Bitton","year":"2014","unstructured":"Bitton A, Dugani SB. Characteristics of individuals not visiting their primary care provider. Isr J Health Policy Res. 2014;3:40. https:\/\/doi.org\/10.1186\/2045-4015-3-40.","journal-title":"Isr J Health Policy Res"},{"key":"3174_CR11","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/1472-6963-11-94","volume":"11","author":"C Chmiel","year":"2011","unstructured":"Chmiel C, Huber CA, Rosemann T, Zoller M, Eichler K, Sidler P, et al. Walk-ins seeking treatment at an emergency department or general practitioner out-of-hours service: a cross-sectional comparison. BMC Health Serv Res. 2011;11:94. https:\/\/doi.org\/10.1186\/1472-6963-11-94.","journal-title":"BMC Health Serv Res"},{"key":"3174_CR12","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.2147\/PPA.S51841","volume":"7","author":"D Giunta","year":"2013","unstructured":"Giunta D, Briatore A, Baum A, Luna D, Waisman G, de Quiros FG. Factors associated with nonattendance at clinical medicine scheduled outpatient appointments in a university general hospital. Patient Prefer Adherence. 2013;7:1163\u201370. https:\/\/doi.org\/10.2147\/PPA.S51841.","journal-title":"Patient Prefer Adherence"},{"key":"3174_CR13","doi-asserted-by":"publisher","unstructured":"Pe\u0161ek K, Pe\u0161ek T, Rogini\u0107 S. The importance of risk factors analysis in the prevention of cardiovascular disease. In: Pesek K, editor. Atherosclerotic cardiovascular disease. Place of publication not identified: InTech; 2011. p. 124. https:\/\/doi.org\/10.5772\/24243.","DOI":"10.5772\/24243"},{"issue":"12","key":"3174_CR14","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","volume":"41","author":"G Mancia","year":"2023","unstructured":"Mancia G, Kreutz R, Brunstrom M, Burnier M, Grassi G, Januszewicz A, et al. 2023 ESH guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the European society of hypertension: endorsed by the international society of hypertension (ISH) and the European renal association (ERA). J Hypertens. 2023;41(12):1874\u20132071. https:\/\/doi.org\/10.1097\/HJH.0000000000003480.","journal-title":"J Hypertens"},{"key":"3174_CR15","doi-asserted-by":"publisher","unstructured":"American Diabetes Association Professional Practice C. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2025. Diabetes care. 2025;48(1 Suppl 1):S59-S85. https:\/\/doi.org\/10.2337\/dc25-S004","DOI":"10.2337\/dc25-S004"},{"issue":"3","key":"3174_CR16","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1590\/1413-81232018233.12132016","volume":"23","author":"MDS Barreto","year":"2018","unstructured":"Barreto MDS, Mendonca RD, Pimenta AM, Garcia-Vivar C, Marcon SS. Non-use of primary care routine consultations for individuals with hypertension. Cien Saude Colet. 2018;23(3):795\u2013804. https:\/\/doi.org\/10.1590\/1413-81232018233.12132016.","journal-title":"Cien Saude Colet"},{"key":"3174_CR17","doi-asserted-by":"publisher","unstructured":"Santos P. The role of cardiovascular risk assessment in preventive medicine: A perspective from Portugal primary Health-Care. J Environ Public Health. 2020;2020(1639634). https:\/\/doi.org\/10.1155\/2020\/1639634.","DOI":"10.1155\/2020\/1639634"},{"key":"3174_CR18","unstructured":"Asthma GIf. Global strategy for asthma management and prevention (2024 update). Fontana: Global Initiative for Asthma; 2024. https:\/\/ginasthma.org\/wp-content\/uploads\/2024\/05\/GINA-2024-Strategy-Report-24_05_22_WMS.pdf."},{"issue":"2","key":"3174_CR19","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1164\/ajrccm.165.2.2102127","volume":"165","author":"WM Vollmer","year":"2002","unstructured":"Vollmer WM, Markson LE, O\u2019Connor E, Frazier EA, Berger M, Buist AS. Association of asthma control with health care utilization: a prospective evaluation. Am J Respir Crit Care Med. 2002;165(2):195\u20139. https:\/\/doi.org\/10.1164\/ajrccm.165.2.2102127.","journal-title":"Am J Respir Crit Care Med"},{"key":"3174_CR20","doi-asserted-by":"publisher","unstructured":"Behr JG, Diaz R, Akpinar-Elci M. Health service utilization and poor health reporting in asthma patients. Int J Environ Res Public Health. 2016;13(7). https:\/\/doi.org\/10.3390\/ijerph13070645.","DOI":"10.3390\/ijerph13070645"},{"issue":"9","key":"3174_CR21","doi-asserted-by":"publisher","first-page":"e558","DOI":"10.1161\/STR.0000000000000382","volume":"52","author":"WN Kernan","year":"2021","unstructured":"Kernan WN, Viera AJ, Billinger SA, Bravata DM, Stark SL, Kasner SE, et al. Primary care of adult patients after stroke: A scientific statement from the American heart association\/American stroke association. Stroke. 2021;52(9):e558\u201371. https:\/\/doi.org\/10.1161\/STR.0000000000000382.","journal-title":"Stroke"},{"key":"3174_CR22","doi-asserted-by":"publisher","unstructured":"Weiller E, Bisserbe JC, Maier W, Lecrubier Y. Prevalence and recognition of anxiety syndromes in five European primary care settings. Br J Psychiatry Supplement. 1998;34:18\u201323. A report from the WHO study on Psychological Problems in General Health Care. https:\/\/doi.org\/10.1192\/S0007125000293471.","DOI":"10.1192\/S0007125000293471"},{"key":"3174_CR23","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1017\/S1463423621000876","volume":"23","author":"C Balsinha","year":"2022","unstructured":"Balsinha C, Iliffe S, Dias S, Freitas A, Barreiros FF, Goncalves-Pereira M. Dementia and primary care teams: Obstacles to the implementation of portugal\u2019s dementia strategy. Prim Health Care Res Dev. 2022;23:e10. https:\/\/doi.org\/10.1017\/S1463423621000876.","journal-title":"Prim Health Care Res Dev"},{"key":"3174_CR24","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/1471-2296-5-17","volume":"5","author":"SA Knox","year":"2004","unstructured":"Knox SA, Britt H. The contribution of demographic and morbidity factors to self-reported visit frequency of patients: a cross-sectional study of general practice patients in Australia. BMC Fam Pract. 2004;5:17. https:\/\/doi.org\/10.1186\/1471-2296-5-17.","journal-title":"BMC Fam Pract"},{"issue":"12","key":"3174_CR25","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1097\/01.mlr.0000185750.18119.fd","volume":"43","author":"MB Stein","year":"2005","unstructured":"Stein MB, Roy-Byrne PP, Craske MG, Bystritsky A, Sullivan G, Pyne JM, et al. Functional impact and health utility of anxiety disorders in primary care outpatients. Med Care. 2005;43(12):1164\u201370. https:\/\/doi.org\/10.1097\/01.mlr.0000185750.18119.fd.","journal-title":"Med Care"},{"key":"3174_CR26","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1186\/1472-6963-11-274","volume":"11","author":"AS Fialho","year":"2011","unstructured":"Fialho AS, Oliveira MD, Sa AB. Using discrete event simulation to compare the performance of family health unit and primary health care centre organizational models in Portugal. BMC Health Serv Res. 2011;11:274. https:\/\/doi.org\/10.1186\/1472-6963-11-274.","journal-title":"BMC Health Serv Res"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-026-03174-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03174-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03174-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T11:54:30Z","timestamp":1770983670000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12875-026-03174-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3174"],"URL":"https:\/\/doi.org\/10.1186\/s12875-026-03174-z","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]},"assertion":[{"value":"28 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ethics Committee of the Local Health Unit of\n                      Entre-Douro-e-Vouga\n                      (Process number 26\/2024, of June 04, 2024) and conducted in accordance with the principles outlined in the Declaration of Helsinki and the Convention of Oviedo. The data were collected from an irreversibly anonymised database. The ethics committee waived the requirement for participants\u2019 individual informed consent, as per Portuguese law (Law n.\u00ba 21\/2014, of April 16, with the alterations introduced by Law n.\u00ba 49\/2018, of August 14, and Law n.\u00ba 73\/2015, of July 27).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"61"}}