Bridging knowledge to develop an action plan for integrated care for chronic diseases in Greece

Abstract

The health, social and economic impact of chronic diseases is well documented in Europe. However, chronic diseases threaten relatively more the ‘memorandum and peripheral’ Eurozone countries (i.e., Greece, Spain, Portugal and Ireland), which were under heavy recession after the economic crisis in 2009. Especially in Greece, where the crisis was the most severe across Europe, the austerity measures affected mainly people with chronic diseases. As a result, the urgency to tackle the threat of chronic diseases in Greece by promoting public health and providing effective chronic care while flattening the rising health care expenditure is eminent. In many European countries, integrated care is seen as a means to achieve this.The aim of this paper was to support Greek health policy makers to develop an action plan from 2015 onwards, to integrate care by bridging local policy context and needs with knowledge and experience from other European countries. To achieve this aim, we adopted a conceptual framework developed by the World Health Organization on one hand to analyse the status of integrated care in Greece, and on the other to develop an action plan for reform. The action plan was based on an analysis of the Greek health care system regarding prerequisite conditions to integrate care, a clear understanding of its context and successful examples of integrated care from other European countries. This study showed that chronic diseases are poorly addressed in Greece and integrated care is in embryonic stage.Greek policy makers have to realise that this is the opportunity to make substantial reforms in chronic care. Failing to reform towards integrated care would lead to the significant risk of collapse of the Greek health care system with all associated negative consequences. The action plan provided in this paper could support policy makers to make the first serious step to face this challenge. The details and specifications of the action plan can only be decided by Greek policy makers in close cooperation with other health and social care partners. This is the appropriate time for doing so.

Performing Economic Evaluation of Integrated Care: Highway to Hell or Stairway to Heaven?

“…As a result, these theories and methods should be further explored in the future in order to systematize their inclusion in the economic evaluation of integrated care. In addition, health economics should support policy makers in Eastern and South European countries, where action plans to integrate care have been recently published to support policy makers in taking the first serious steps towards that direction [9596]. A thorough economic evaluation should be integral part of their implementation to inform decision making.…”

Home health nursing care services in Greece during an economic crisis

“…), and of PHC (Tsiachristas et al. ) seems to be a necessity for the Greek healthcare system. The nurse's job is also varied (Johansen & Fagerström ; Van Eenoo et al.…”

“…This scheme does not provide incentives for the improvement of quality of care (Tsiachristas et al. ). Clients’ co‐payment of 5€ for the care they receive in PHC has been abolished (Ministerial decision 23754/GG/B’/490/01.04.2015).…”

“…The method of reimbursement in human resources in the public HHC services is the salary (Economou 2010). This scheme does not provide incentives for the improvement of quality of care (Tsiachristas et al 2015). Clients' co-payment of 5€ for the care they receive in PHC has been abolished (Ministerial decision 23754/GG/B'/490/01.04.2015).…”

“…Although there are a variety of caregivers, there is no official collaboration and coordination of them (Tsiachristas et al 2015).…”