Data gathered and analyzed in this manner provided a novel evaluation and monitoring system for Greece, which can assist decision-makers, healthcare professionals, and patients in Greece to retrieve relevant information, with the long-term goal to improve quality in care in the GNHS hospital sector.

Data have indicated that countries with a strong system of Primary Health Care (PHC) are more likely to have efficient health systems and better health outcomes than countries that focus strongly on hospital services. The aim of the article was to systematically review implemented quality projects used for evaluation of quality in PHC services. A systematic literature review was conducted via MEDLINE to identify papers referring to international or national PHC quality assessment projects, published in English from 1990 to 2010. Projects were included if they had been implemented, had a holistic approach, and reported specifications of the quality indicators used. Sixteen publications were considered eligible for further analyses, referring to 10 relevant projects and a total of 556 indicators. Number and content of indicators and their domains varied across projects. Regarding raw data, lack of standardization of collection tools between projects could lead to invalid comparisons. In areas that international projects operate in parallel to national initiatives, there may be problems regarding expenses and burden of data collection, which might create competing interests and low quality of information. Further actions for alignment of quality projects on primary health care are required, for future results to become comparable.

The findings pointed that PHC absorbs a very limited part of the national health system's workforce. Important inequalities in the numerical and geographical allocation of the PHC health workforce specialties across the country in favor of the medical profession and to the detriment of rural areas and the islands were identified, raising concerns about the policymakers' ability to meet the emerging needs of the population, as the retrospective study of the health-care workforce, since 2010, reveals that the numerical and per type allocations remained almost unchanged. These results were in line with previous studies showcasing the lack of holistic approach for PHC questioning the restrictive spending policy (ie, salary and benefit cuts for the health-care professionals, important discharges and nonrenewal of the personnel) adopted in the public health-care sector.

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