Transforming Public Servants’ Health Care Organization in Greece through the Implementation of an Electronic Referral Project

AbstractObjectiveThe Greek Public Servants’ Health Care Organization aiming to organize, monitor, and enhance the health care services provided to 1,500,000 public servants decided to respond to the national alert of the economic crisis through the reduction of costs caused by diagnostic tests (€300,000,000 claims for 2008), to improve working conditions of contracted physicians and laboratories, and to enhance services provided to insured members. In September 2010, the Greek Public Servants’ Health Care Organization initiated a pilot project that electronically records the prescription process of the diagnostic tests, which is Web-based, is open source, and was provided for free to the contracted physicians and diagnostic centers.MethodsIn this article, we present some interesting findings resulting from the implementation of the pilot electronic referral project by examining a 9-month period.ResultsFifty-eight percent of the physicians had the necessary equipment for the operation of the system, more than 3600 physicians used it, 17,495 public servants had been served through the system, and 178,456 paraclinical examinations had been prescribed with a cost of €1,394,980. In addition, the analysis revealed that the implementation of an electronic referral system could provide significant benefits, such as a faster referral process, valid and coherent information, minimization of the risk of misinterpreting the electronic referral due to illegibility of handwriting, and improvement in quality of services.ConclusionsThe Greek electronic referral system was one of the first attempts toward creating the basis of a society of transparency and cost control. The lessons learnt from this article should not be ignored in the process of redesigning and improving the electronic referral system for Greece

Healthcare access for cancer patients in the era of economic crisis. Results from the HOPE III study

Background: Despite the documentation of addressing healthcare disparities in detection and treatment of cancer and health outcomes for cancer patients, the inequalities persist. Cancer patients of several vulnerable groups suffer disproportionally the effect of economic crisis on health and healthcare

Pharmaceutical pricing policy in Greece: towards a different path.

Background: Affordable, accessible and innovation-promoting pharmaceutical care is essential to the operation of a sustainable health system. External reference pricing (ERP), a common pharmaceutical policy in Europe, suffers today from indigenous weaknesses that may cause market distortions and barriers to care, burdening mostly the weak economies, and hence, raising ethical and political worrying. Objectives and Methods: A non-randomized experiment was conducted, in order to examine the influence of flexible and adaptable to health systems’ affordability ERP structures. Outcomes were assessed by measuring deviations from Greek prices’ level ex ante, as well as effects on pharmaceutical markets affiliated to the European ERP system. Results and Conclusions: Pharmaceutical pricing models that fit prices to income and affordability are better in all aspects, as they produce fairer results, while resulting in low external costs for the European ERP network as a whole. Small sets of reference countries are preferred to large baskets, as they produce similar results, while presenting better qualities by increasing the flexibility of the reimbursement system and the transparency of the market

Data from: Using big data to assess prescribing patterns in Greece: the case of chronic obstructive pulmonary disease

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the top leading causes of death and disability, and its management is focused on reducing risk factors, relieving symptoms, and preventing exacerbations. The study aim was to describe COPD prescribing patterns in Greece by using existing health administrative data for outpatients. Methods: This is a retrospective cross-sectional study based on prescriptions collected by the largest social insurance fund, during the first and last trimester of 2012. Selection criteria were the prescription of specific active substances and a COPD diagnosis. Extracted information included active substance, strength, pharmaceutical form and number of packages prescribed, diagnosis, time of dispensing, as well as insurees' age, gender, percentage of co-payment and social security unique number. Statistical analysis included descriptive statistics and logistic regression. Results: 174,357 patients received medicines for COPD during the study period. Patients were almost equally distributed between male and female, and age above 55 years was strongly correlated with COPD. Most patients received a long-acting beta agonist plus inhaled corticosteroid combination (LABA +ICS), followed by long-acting muscarinic agonist (LAMA). 63% patients belonging in the 35-54 age received LABA+ICS. LAMA was prescribed more frequently among males and was strongly correlated with COPD. Conclusion: The study provides big data analysis of Greek COPD prescribing patterns. It highlights the need for appropriate COPD classification in primary care illustrating the role of electronic prescribing in ensuring appropriate prescribing. Moreover, it indicates possible gender differences in treatment response or disease severity, and the impact of statutory co-payments on prescribing

Access to Care for Multiple Sclerosis in Times of Economic Crisis in Greece – the HOPE II Study

Background While there is currently no cure for multiple sclerosis (MS), treatment with biologic diseasemodifying drugs (bDMDs) can reduce the impact of the condition on the lives of patients. In Greece, the regulatory change in the distribution system of bDMDs, limited their administration through the designated pharmacies of the National Organization for Healthcare Services Provision (EOPYY) or the National Health System (ESY) hospitals, thus potentially impacting access to MS treatment. In this context, the aim of this paper was to assess the barriers to bDMDs, by recording MS patients’ experiences. Methods A survey research was conducted between January and February 2014 in Athens and 5 other major Greek cities with the methods of personal and telephone interview. A structured questionnaire was used to elicit socio-economic and medical information, information related to obstacles in accessing bDMDs and medical treatment, from MS patients that visited EOPYY pharmacies during the study period. Results During the last year 69% of 179 participants reported that the distribution system of bDMDs has improved. Thirteen percent of participants encountered problems in accessing their medication, and 16.9% of participants in accessing their physician, with the obstacles being more pronounced for non-Athens residents. Frequent obstacles to bDMDs were the distance from EOPYY pharmacies and difficulties in obtaining a diagnosis from an EOPYY/ESY physician, while obstacles to medical care were delays in appointment booking and travel difficulties. Conclusion Even though the major weaknesses of the distribution system of bDMDs have improved, further amelioration of the system could be achieved through the home delivery of medicines to patients living in remote areas, and through the development of a national MS registry

Data base of EOPYY insurees' COPD prescriptions

Data base of prescriptions collected by the largest social insurance fund, EOPYY during the first and last trimester of 2012. Extracted information included active substance, strength, pharmaceutical form and number of packages prescribed, diagnosis, time of dispensing, as well as insurees’ age, gender, percentage of co-payment and social security unique number

Characteristics of studied sample.

<p>Characteristics of studied sample.</p

Distribution of COPD patients ((N, (%)) in age groups according to gender and active substance group treatment.

<p>Distribution of COPD patients ((N, (%)) in age groups according to gender and active substance group treatment.</p

Expenditure per therapeutic category, gender and age group.

<p>Expenditure per therapeutic category, gender and age group.</p