The effectiveness of primary health care reforms in Greece towards achieving universal health coverage: a scoping review

Abstract

Introduction Between 2010 and 2018, Greece implemented an Economic Adjustment Programme and underwent a series of extensive reforms, including in the health sector. We conducted a scoping review to examine whether the Primary Health Care reforms during that period assisted the country in moving towards Universal Health Coverage. Methods We performed a review of the literature on the following databases: Scopus, PubMed, Epistemonikos, Web of Science, and Google Scholar, including published research articles and grey literature. Findings were synthesised thematically, using the World Health Organization Universal Health Coverage dimensions: population coverage, service coverage, and financial protection. Results Forty-four documents were included in this review. Out of these, thirty-eight were research-based (thirty-three qualitative, two quantitative, and three mixed design studies), two grey literature, and four legislative bills. The evidence suggests that despite the systemic interventions addressing longstanding distortions, population coverage, service coverage and financial protection have not significantly improved. Conclusions This review suggests that Primary Health Care reforms in Greece have not managed to substantially improve Universal Health Coverage, although some positive steps towards that direction have taken place with the establishment of community-based multidisciplinary health teams. Before further interventions are implemented, an evidence-based monitoring and evaluation mechanism is necessary in order to clearly evaluate their effectiveness and progress.

A Survey of Greek Primary Care Physicians on Their Likeability in Treating Migraines and Other Common Diseases

“…Participating primary care physicians were asked to respond to the statement "I like to treat patients with this disease or symptom" with the use of a five-point Likert scale (1: strongly disagree; 2: disagree; 3: neutral; 4: agree; 5: strongly agree). This methodology is considered generally appropriate for a survey [8], while for comparison purposes we used the same set of disorders and symptoms as those used in the only previously published survey by Evans et al [11].…”

“…According to the available evidence, there is a lack of key characteristics for a strong primary care organization in the current Greek healthcare system, and as such, there is a need for major reforms to strengthen it [8]. Among other actions, this could be accomplished by providing a more comprehensive education curriculum to general practitioners during their residency training in various fields, especially in diseases affecting the nervous system.…”

A Comparison between Greek and Danish Citizens' Perceptions of the Nursing Uniform and the Impact on Patients’ Health

“…Nowadays, Greek hospitals are mainly funded by the government. Hospitals are the cornerstone of the health care system offering secondary and tertiary health care by providing medical and nursing services [21] . The private sector consists of hospitals, diagnostic centres, laboratories, and private doctors and is financed by direct patient payments and to a lesser extent by private health insurances.…”

Exploring Inpatients’ Perspective: A Cross-Sectional Survey on Satisfaction and Experiences in Greek Hospitals

“…Negative gaps in these dimensions indicate deeper problems with hospital quality of care [ 17 , 18 , 19 , 20 , 21 , 22 ]. Hence, Greece has one of the lowest overall response rates for inpatient services among OECD countries and the healthcare system has been strongly hospital-centered due to transformations and reforms in the primary care system during 2011–2018 [ 23 , 24 , 25 ]. In this light, and since patient satisfaction is not a static indicator as it is affected by changes in the external environment, this study aims to provide valuable insights, identify areas that require attention, assess the challenges associated with enhancing patient satisfaction, and bring to the forefront key concepts that could enhance the quality of care in hospital settings.…”