The effect of financial crisis on the profile of the patients examined at the surgical emergencies of an academic institution in Greece

Kontos, Michael C.; Moris, Demetrios; Davakis, Spyridon; Schizas, Dimitrios; Pikoulis, Emmanouil; Liakakos, Theodore

doi:10.21037/atm.2017.02.33

Cited by 3 publications

(3 citation statements)

References 19 publications

(27 reference statements)

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“…EDs offer whole-day, free of charge, preventive, curative services responsive to emergencies as well as rehabilitation services—mainly to urban and semi-urban populations [ 27 ]. On the other hand, in primary care facilities, uninsured patients have to pay their medical bills for most care visits.…”

Section: Impact Of the Economic Recession On Ems Functionmentioning

confidence: 99%

“…This increase is exacerbated by a hospital’s organisational problems, for instance, shortages of staff, laboratory, and admission delays. Accordingly, an ED becomes overcrowded, with inevitable consequences [ 14 , 27 , 30 ]. However, the extent of the workload currently has not been thoroughly evaluated in Greece, as patient data are not regularly recorded.…”

Section: Impact Of the Economic Recession On Ems Functionmentioning

confidence: 99%

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The Emergency Medical System in Greece: Opening Aeolus’ Bag of Winds

Kotsiou

Srivastava

Kotsios

et al. 2018

IJERPH

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An Emergency Medical Service (EMS) system must encompass a spectrum of care, with dedicated pre-hospital and in-hospital medical facilities. It has to be organised in such a way as to include all necessary services—such as triage accurate initial assessment, prompt resuscitation, efficient management of emergency cases, and transport to definitive care. The global economic downturn has had a direct effect on the health sector and poses additional threats to the healthcare system. Greece is one of the hardest-hit countries. This manuscript aims to present the structure of the Greek EMS system and the impact of the current economic recession on it. Nowadays, primary care suffers major shortages in crucial equipment, unmet health needs, and ineffective central coordination. Patients are also facing economic limitations that lead to difficulties in using healthcare services. The multi-factorial problem of in-hospital EMS overcrowding is also evident and has been linked with potentially poorer clinical outcomes. Furthermore, the ongoing refugee crisis challenges the national EMS. Adoption of a triage scale, expansion of the primary care network, and an effective primary–hospital continuum of care are urgently needed in Greece to provide comprehensive, culturally competent, and high-quality health care.

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Section: Impact Of the Economic Recession On Ems Functionmentioning

confidence: 99%

Section: Impact Of the Economic Recession On Ems Functionmentioning

confidence: 99%

The Emergency Medical System in Greece: Opening Aeolus’ Bag of Winds

Kotsiou

Srivastava

Kotsios

et al. 2018

IJERPH

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“…Recent literature has shown that the number of the patients seeking medical help during the crisis has increased while their profile and reason for attendance has shifted (4). The effects on public and private Healthcare sectors should be different due to the different funding resources and probably due to different socio-economic populations they might serve.…”

Section: Introductionmentioning

confidence: 99%

The profile of patients receiving public and private surgical services in Greece during the economic crisis: a comparative study

Schizas¹,

Michalinos²,

Kanavidis³

et al. 2019

Ann. Transl. Med

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Background: International experience has shown that deterioration of healthcare services is a common consequence of socioeconomic crises. Exact mechanism of this deterioration varies with respect to particularities of each healthcare system, government and administrative policies and local epidemiological conditions. The aim of the present study was to evaluate the effect of Greek economic crisis on the profile and the satisfaction rates of patients seeking surgical services in public and private hospitals. Methods: A questionnaire-based survey concerning healthcare quality and patients' satisfaction was conducted at a private and a public (university) hospital. Patient demographics alongside with patient satisfaction before and after treatment were quantified and compared. Results: Significant differences between private and public sector patients were found concerning nationality, socioeconomic status and medical conditions. Private sector patients are younger, of a higher socioeconomic status and admitted for elective rather than urgent medical conditions. Patient expectations before treatment are lower for public sector concerning a variety of markers but patient satisfaction is similar. Conclusions: Even in the years of financial crisis, Greek patients seem to be satisfied by the quality of the healthcare services in both public and private hospitals. Despite the limitations of our study regarding the selection of the population, we believe that the findings might generate more meticulous research on the field hoping that juxtaposed discussions will sensitize policy makers.

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Esophageal cancer surgery in Greece during the era of the financial crisis

Schizas

Mylonas

Hasemaki

et al. 2020

Diseases of the Esophagus

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Summary The aim of this study is to describe outcomes of esophageal cancer surgery in a quaternary upper gastrointestinal (GI) center in Athens during the era of the Greek financial crisis. We performed a retrospective analysis of patients that underwent esophagectomy for esophageal or gastroesophageal junction (GEJ) cancer at an upper GI unit of the University of Athens, during the period January 2004–June 2019. Time-to-event analyses were performed to explore trends in survival and recurrence. A total of 146 patients were identified. Nearly half of the patients (49.3%) underwent surgery during the last 4 years of the financial crisis (2015–2018). Mean age at the time of surgery was 62.3 ± 10.3 years, and patients did not present at older ages during the recession (P = 0.50). Most patients were stage III at the time of surgery both prior to the recession (35%) and during the financial crisis (39.8%, P = 0.17). Ivor–Lewis was the most commonly performed procedure (67.1%) across all eras (P = 0.06). Gastric conduit was the most common form of GI reconstruction (95.9%) following all types of surgery (P < 0.001). Pre-recession anastomoses were usually performed using a circular stapler (65%). Both during (88.1%) and following the recession (100%), the vast majority of anastomoses were hand-sewn. R0 resection was achieved in 142 (97.9%) patients. Anastomosis technique did not affect postoperative leak (P = 0.3) or morbidity rates (P = 0.1). Morbidity rates were not significantly different prior to (25%), during (46.9%), and after (62.5%) the financial crisis, P = 0.16. Utilization of neoadjuvant chemotherapy (26.9%, P = 0.90) or radiation (8.4%, P = 0.44) as well as adjuvant chemotherapy (54.8%, P = 0.85) and irradiation (13.7%, P = 0.49) was the same across all eras. Disease-free survival (DFS) and all-cause mortality rates were 41.2 and 47.3%, respectively. Median DFS and observed survival (OS) were 11.3 and 22.7 months, respectively. The financial crisis did not influence relapse (P = 0.17) and survival rates (P = 0.91). The establishment of capital controls also had no impact on recurrence (P = 0.18) and survival (P = 0.94). Austerity measures during the Greek financial crisis did not influence long-term esophageal cancer outcomes. Therefore, achieving international standards in esophagectomy may be possible in resource-limited countries when centralizing care.

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The effect of financial crisis on the profile of the patients examined at the surgical emergencies of an academic institution in Greece

Abstract: Financial crisis seems to have a multivariable effect on epidemiology and clinical diversity of patients being examined in the ER.

Cited by 3 publications

References 19 publications

The Emergency Medical System in Greece: Opening Aeolus’ Bag of Winds

The Emergency Medical System in Greece: Opening Aeolus’ Bag of Winds

The profile of patients receiving public and private surgical services in Greece during the economic crisis: a comparative study

Esophageal cancer surgery in Greece during the era of the financial crisis

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