Economic crisis and primary healthcare in Greece: ‘disaster’ or ‘blessing’?

Fragkoulis, Evangelos

doi:10.7861/clinmedicine.12-6-607

Cited by 4 publications

(3 citation statements)

References 1 publication

(2 reference statements)

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“…Taking this into account and considering the increasing health care expenditure and tight health budget, this the right time to introduce reforms in the Greek health care system to integrate care for chronic diseases [ 62 ]. Optimists would argue that Greece should see the crisis as a blessing to reform care rather than as disaster of health care [ 14 ]. However, even they would agree that this is not an easy task.…”

Section: Discussionmentioning

confidence: 99%

“…Further budget cuts without structural reforms would lead to the collapse of the health care and health protection system [ 14 ] threatening, therefore, the overall sustainability of the Greek economy. This would be undesirable for Greece and the Greek debt holders (i.e., International Monetary Fund, European Union and European Central Bank).…”

Section: Introductionmentioning

confidence: 99%

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

Tsiachristas¹,

Lionis²,

Yfantopoulos

2015

Int J Integr Care

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Tsiachristas¹,

Lionis²,

Yfantopoulos

2015

Int J Integr Care

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“…Lack of integration can result in fragmentation of care and poor health outcomes, [ 16 ] as well as in problems related to funding, planning, effectiveness and operation of the healthcare system[ 17 ]. Substantial healthcare budget cuts and prolonged delay of major reform are jeopardising the NHS, putting it at risk of becoming unsustainable and ultimately, obsolete [ 18 ]. Failing to achieve immediate policy and structural changes to this direction, could increase the risk of potential NHS collapse with numerous adverse consequences [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Operational integration in primary health care: patient encounters and workflows

Sifaki-Pistolla

Chatzea

Markaki

et al. 2017

BMC Health Serv Res

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BackgroundDespite several countrywide attempts to strengthen and standardise the primary healthcare (PHC) system, Greece is still lacking a sustainable, policy-based model of integrated services. The aim of our study was to identify operational integration levels through existing patient care pathways and to recommend an alternative PHC model for optimum integration.MethodsThe study was part of a large state-funded project, which included 22 randomly selected PHC units located across two health regions of Greece. Dimensions of operational integration in PHC were selected based on the work of Kringos and colleagues. A five-point Likert-type scale, coupled with an algorithm, was used to capture and transform theoretical framework features into measurable attributes. PHC services were grouped under the main categories of chronic care, urgent/acute care, preventive care, and home care. A web-based platform was used to assess patient pathways, evaluate integration levels and propose improvement actions. Analysis relied on a comparison of actual pathways versus optimal, the latter ones having been identified through literature review.ResultsOverall integration varied among units. The majority (57%) of units corresponded to a basic level. Integration by type of PHC service ranged as follows: basic (86%) or poor (14%) for chronic care units, poor (78%) or basic (22%) for urgent/acute care units, basic (50%) for preventive care units, and partial or basic (50%) for home care units. The actual pathways across all four categories of PHC services differed from those captured in the optimum integration model. Certain similarities were observed in the operational flows between chronic care management and urgent/acute care management. Such similarities were present at the highest level of abstraction, but also in common steps along the operational flows.ConclusionsExisting patient care pathways were mapped and analysed, and recommendations for an optimum integration PHC model were made. The developed web platform, based on a strong theoretical framework, can serve as a robust integration evaluation tool. This could be a first step towards restructuring and improving PHC services within a financially restrained environment.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2702-5) contains supplementary material, which is available to authorized users.

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Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: A systematic review

Simou¹,

2014

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Economic crisis and primary healthcare in Greece: ‘disaster’ or ‘blessing’?

Cited by 4 publications

References 1 publication

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

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

Operational integration in primary health care: patient encounters and workflows

Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: A systematic review

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