Προβλήματα αιχμής στη δημόσια διοίκηση: η περίπτωση της πρωτοβάθμιας φροντίδας υγείας
Critical issues in public administration: the case of primary health care
KeywordsΠρωτοβάθμια φροντίδα υγείας ; Μοντέλο πρόβλεψης ζήτησης υπηρεσιών υγείας ; Primary health care ; Health demand model
This thesis presents problems that have been identified with regard to the organisation and operation of the Greek Primary Health Care System and indicates and addresses the following organizational issues: o Assessment of health needs and forecasting demand (based on historical data) for primary health services in Greece. o The unequal distribution of the health workforce in the Greek Territory. o The lack of providing preventive care. The first chapter mentions the aim and the specific objectives of the dissertation. Research questions that are related to the purpose of the study are developed and articulated. The second chapter provides a literature review and presents the domestic and international experience regarding the organization of the Primary Health Care System. The third chapter gives an outline of research methods and contains the findings of the research in the following issues: • Αssessment of the primary care access and distribution of human resources. is carried out. • The financial contribution that patients are required to make when they use health care services is compared to the average disposal income. • A comparison is made between the doctor's remuneration methods and the average national wage. • The availability of radiological and diagnostic laboratory facilities to general practitioners is presented in relation to the available number of doctors. • Α comparative analysis is carried out among countries which show the income of the beneficiaries as a criterion for the nursing home care subsidy in relation to the income of the average pensioner. • A survey was conducted for the period 01/12/2017-31/12/2017 on the electronic eRDV platform for setting up appointments with a general practitioner/internist at the national Primary Care Network or the Primary Health Center. It was calculated the elapsed time between when demand for primary health services is initiated and supply is applied, all in units of time. • Explore the distribution of General Practitioners/internists per capita at Municipality level and per square kilometre of the Municipality. Furthermore, the general practitioners were allocated by the following methods: a) current utilization of health care services, b) the implementation of the gatekeeping and (c) the proximity of health services at the place of residence. • The focus for preventive actions is presented by calculating the total number of staff required to advise the Greek Population on proper nutrition and smoking cessation. • Calculate the total number of referrals for screening cancers required for the total population of the country for one year. The fourth chapter presents a summary of the findings in this research and proposals for the reorganization of Primary Health Care provision in Greece.