Measuring intra-hospital clinic efficiency and productivity : an application to a Greek university general hospital

In this paper we use Data Envelopment Analysis and the Malmquist Productivity Index and its decompositions to assess the productive efficiency and productivity of the in-patient clinics of a large Greek University General Hospital. Clinics are represented by means of a simple model whereby they use inputs (labor and capital) to produce outputs (in-patient days and patient discharges). The efficiency model is input oriented and assumes constant returns to scale. Model validation analyses showed that this model appears to be externally valid. The framework proposed here is a simple and useful tool for informing intra-hospital management decisions.peer-reviewe

Health care services performance measurement : theory, methods and empirical evidence

Despite the growing international literature in the field of efficiency and productivity measurement there are very limited Greek applications partly due to inadequate and incomplete datasets. The aim of this article is to illustrate the main methodologies for health care services efficiency and productivity measurement, to present their strengths and weaknesses and to discuss the existing evidence from applications in other countries. Notwithstanding the fact that the related methodologies have been recently developed these methods may help practitioners and health care decisions makers in improving health care management in Greece.peer-reviewe

Measuring across hospital efficiency and productivity : the case of second regional health authority of Attica

The purpose of the study is to investigate technical efficiency and productivity change of a sample of Greek Hospitals over the period 1998 - 2005. Efficiency and productivity measurement became a crucial issue in Greece after the launching of health reforms in 2001, with the legislative Act No. 2889, aiming at cost containment and improvements in hospital efficiency. Applying the linear programming method of Data Envelopment Analysis we investigate how efficiently the hospital resources are used to obtain the maximum possible outcome, before and after the reforms. Hospital output is modelled in terms of interventions, laboratory examinations, outpatient and inpatient cases. Inputs considered include beds, doctors, nurses and rest personnel and operational expenses. The analysis indicates that the reforms have generated efficiency gains when only input and output quantities are considered. During the period 1998- 2002 an overall efficiency regress is observed followed by an upturn, after the launching of managerial reforms. However, when the running costs of the hospitals are considered, then the sample experiences significant regress, implying relatively higher production costs over time. We conclude that DEA is a useful technique to assess relative efficiency and optimum hospital performance across hospitals.peer-reviewe

Results of the COVID-19 mental health international for the general population (COMET-G) study.

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them

Informal payments for maternity health services in public hospitals in Greece

Background: Private health expenditure for consuming maternity health services has been identified as an issue within public hospitals. Aim: To estimate level of private health expenditure, in the form of informal payments, for maternal services in public hospitals in Greece. Methods: The study population consisted of 160 women who had recently given birth in three provincial general hospitals and one general hospital in Athens. A three-part questionnaire was developed in order to collect financial information regarding the use of public obstetrics services in Greece. Results: The mean age of respondents was 29.5 (±5.6) years. There was a high rate of informal payments with 74.4% of women involved in informal transactions. Mean total private payments were €1549 (±992), representing 7.9% of the mean annual per capita income in Greece. Mean informal payment was €848 (±714). For 56.3% of the respondents, it was at the obstetrician's request, on top of formal payment of €701 (±1351). Total informal payments were higher for women who gave birth in Athens (p < 0.001), for Greek women compared to non Greek (p < 0.001) and for deliveries that were conducted by women's personal obstetrician (p = 0.001). Conclusion: There is a large black economy in the field of obstetric services, as 74.4% of women who used public maternity services had to pay under-the-table payments corresponding approximately to the net salary of an intern physician. There is a need for the state to adopt innovative strategies and mechanisms in order to reduce informal payments for obstetric services in the public sector. © 2012 Elsevier Ireland Ltd. All rights reserved

Factors Associated with Healthcare Workers’ (HCWs) Acceptance of COVID-19 Vaccinations and Indications of a Role Model towards Population Vaccinations from a Cross-Sectional Survey in Greece, May 2021

A Knowledge, Attitudes and Practices (KAP) study was conducted at the end of May 2021 engaging 1456 healthcare workers (HCWs) from 20 hospitals throughout Greece. Acceptance of vaccination against coronavirus disease 2019 (COVID-19) was estimated at 77.7%, with lower vaccine acceptance identified in nurses compared to physicians. Fears related to vaccine safety, lack of information and general knowledge about vaccinations, influenza vaccine acceptance, education level and years of practice were among the factors independently associated with vaccine acceptance. A strong association was identified between vaccination of HCWs in each health region and the population coverage, indicating that HCWs may be role models for the general population. Information campaigns should continue despite decisions taken regarding mandatory vaccinations

Factors Associated with Healthcare Workers&apos; (HCWs) Acceptance of COVID-19 Vaccinations and Indications of a Role Model towards Population Vaccinations from a Cross-Sectional Survey in Greece, May 2021

A Knowledge, Attitudes and Practices (KAP) study was conducted at the end of May 2021 engaging 1456 healthcare workers (HCWs) from 20 hospitals throughout Greece. Acceptance of vaccination against coronavirus disease 2019 (COVID-19) was estimated at 77.7%, with lower vaccine acceptance identified in nurses compared to physicians. Fears related to vaccine safety, lack of information and general knowledge about vaccinations, influenza vaccine acceptance, education level and years of practice were among the factors independently associated with vaccine acceptance. A strong association was identified between vaccination of HCWs in each health region and the population coverage, indicating that HCWs may be role models for the general population. Information campaigns should continue despite decisions taken regarding mandatory vaccinations.&lt;/p&gt

Mental health and conspirasism in health care professionals during the spring 2020 COVID-19 lockdown in Greece

Introduction: The aim of the study was to investigate mental health and conspiracy theory beliefs concerning COVID-19 among Health Care Professionals (HCPs). Material and Methods: During lockdown, an online questionnaire gathered data from 507 HCPs (432 females aged 33.86±8.63 and 75 males aged 39.09±9.54). Statistical Analysis: A post-stratification method to transform the study sample was used; descriptive statistics were calculated. Results: Anxiety and probable depression were increased 1.5-2-fold and were higher in females and nurses. Previous history of depression was the main risk factor. The rates of the believing in conspiracy theories concerning the COVID-19 were alarming with the majority of individuals (especially females) following some theory to at least some extend. Conclusions: The current paper reports high rates of depression, distress and suicidal thoughts in the HCPs during the lockdown, with a high prevalence of beliefs in conspiracy theories. Female gender and previous history of depression acted as risk factors while the belief in conspiracy theories might act as a protective factor. The results should be considered with caution due to the nature of the data (online survey on a self-selected but stratified sample

Results of the COVID-19 mental health international for the health professionals (COMET-HP) study: depression, suicidal tendencies and conspiracism.

INTRODUCTION: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. MATERIALS AND METHODS: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Clinical depression was detected in 13.16% with male doctors and 'non-binary genders' having the lowest rates (7.89 and 5.88% respectively) and 'non-binary gender' nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). CONCLUSIONS: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable