National health policy in Greece : regulations or reforms? The Sisyphus myth

This paper attempts an evaluation of health care reforms and regulations in Greece. The main findings indicate that the existing Conservative Government has kept but not developed some previous Social-democrats’ major reforms concerning decentralisation and hospital management arrangements. The government also announced new regulations concerning the pharmaceutical sector and the procurement procedures of the national health units. On the other hand, precedent regulations for primary health care were to be postponed and the fundamental financing issue of the system has been neglected. In addition, this paper intends to take parallel account that terms such as globalisation and enlargement are still within the European perspective of the country. Overall, the Greek NHS seems to be developed and enlarged, besides the lack of strong political will to consider reforms and even regulations, into a continuous managerial process, assessment and public dialogue. In this sense, there is a continuing gap between - on the one hand - principles and goals and - on the other hand - rational planning, political issues and implementation process, all resulting in a never-ending reform scenario.peer-reviewe

Regional differences in mortality in Greece (1984–2004): The case of Thrace

<p>Abstract</p> <p>Background</p> <p>Mortality differences at national level can generate hypothesis on possible causal association that could be further investigated. The aim of the present study was to identify regions with high mortality rates in Greece.</p> <p>Methods</p> <p>Age adjusted specific mortality rates by gender were calculated in each of the 10 regions of Greece during the period 1984–2004. Moreover standardized mortality rates (SMR) were also calculated by using population census data of years 1981, 1991, 2001. The mortality rates were examined in relation to GDP per capita, the ratio of hospital beds, and doctors per population for each region.</p> <p>Results</p> <p>During the study period, the region of Thrace recorded the highest mortality rate at almost all age groups in both sexes among the ten Greek regions. Thrace had one of the lowest GDP per capita (11 123 Euro) and recorded low ratios of Physicians (284) per 100 000 inhabitants in comparison to the national ratios. Moreover the ratio of hospital beds per population was in Thrace very low (268/100 000) in comparison to the national ratio (470/100 000). Thrace is the Greek region with the highest percentage of Muslim population (33%). Multivariate analysis revealed that GDP and doctors/100000 inhabitants were associated with increased mortality in Thrace.</p> <p>Conclusion</p> <p>Thrace is the region with the highest mortality rate in Greece. Further research is needed to assess the contribution of each possible risk factor to the increased mortality rate of Thrace which could have important public health implications.</p

Alcohol Use and Mental Health Status Among University Students in Greece

Alcohol abuse is a common incident in college student’s communities. The purpose of this research study was to evaluate the rates of alcohol use among university students in Greece and to search if there is a relation between alcohol use disorders and mental health status (depression, anxiety, stress)

Economic Crisis Impact and Social Determinants of Perinatal Outcomes and Infant Mortality in Greece

(1) Background: To explore the effects of the 2008 economic crisis on maternal, perinatal and infant mortality in Greece and the socio-economic determinants associated with them; (2) Methods: The annual rates of stillbirth (SBR), perinatal mortality (PMR), infant mortality (IMR), neonatal mortality (NNMR), post-neonatal mortality (PNMR), low birth weight (LBW), and maternal mortality (MMR) were calculated for the years 2000–2016. Average Annual Percent Changes (AAPC) were calculated by the period before and after 2008. The expected rates of 2009–2016 and the observed-to-expected rate ratios (RR) were calculated. Correlation and multiple linear regression analyses were used to test the impact of socio-economic variables on health outcomes; (3) Results: A reverse in downwards trends of PNM, IMR, and NNMR is observed since 2009. All observed values of 2009–2016 were found significantly higher than the expected ones by 12–34%. All indicators except SBR were found negatively correlated with GDP and DHI. A positive correlation was found between IMR, NNMR, and LBW and long-term unemployment, and no association with public health expenditure; (4) Conclusions: Economic crisis was associated with remarkable adverse effects on perinatal outcomes and infant mortality, mainly determined by long-term unemployment and income reduction. The findings stress a need for interventions to protect maternity and child health during crises

Use of amenable mortality indicators to evaluate the impact of financial crisis on health system performance in Greece

Background: Greece experienced the largest reduction in its health care budget of any European country during the economic crisis of 2008-15. Here, we test the hypothesis that budget reductions worsened health system performance in Greece, using the concept of Amenable Mortality to capture deaths which should not occur in the presence of effective and timely health care. Methods: Amenable mortality was calculated from national mortality statistics, using age-standardized deaths from 34 conditions amenable to medical intervention in Greece during 2000-16, with further analysis by sex, age, region and cause. Mortality rate ratios and their 95% CI were also computed. Interrupted time series analyses were performed to compare trends prior to austerity measures (2001-10) with those after (2011-16), adjusting for historical trends. Results: Prior to austerity measures, amenable mortality rates were declining. After 2011, coinciding with the inception of budget reductions, the slope of decline diminished significantly. The average annual percent of change in standardized death rates was 2.65% in 2001-10, falling to 1.60% in 2011-6. In 10 of 34 conditions, the SDR increased significantly after the crisis onset, and in five more conditions the long-term decline reversed, to increasing after 2011. The age-specific mortality rates observed in 2011-16 were significantly higher than those expected at ages 0-4 and 65-74 but not significantly higher in all other age groups. Conclusions: Health system performance in Greece worsened in association with austerity measures, leading to a deceleration of the decline in amenable mortality and increased mortality from several conditions amenable to medical interventions

National Health Policy In Greece: Regulations Or Reforms ? The Sisyphus Myth

This paper attempts an evaluation of health care reforms and regulations in Greece. The main findings indicate that the existing Conservative Government has kept but not developed some previous Social-democrats’ major reforms concerning decentralisation and hospital management arrangements. The government also announced new regulations concerning the pharmaceutical sector and the procurement procedures of the national health units. On the other hand, precedent regulations for primary health care were to be postponed and the fundamental financing issue of the system has been neglected. In addition, this paper intends to take parallel account that terms such as globalisation and enlargement are still within the European perspective of the country. Overall, the Greek NHS seems to be developed and enlarged, besides the lack of strong political will to consider reforms and even regulations, into a continuous managerial process, assessment and public dialogue. In this sense, there is a continuing gap between - on the one hand - principles and goals and - on the other hand - rational planning, political issues and implementation process, all resulting in a never-ending reform scenario.health policy, health care reform, regulations, globalization, enlargement