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衔接知识以制定希腊慢性病综合护理行动计划。

Bridging knowledge to develop an action plan for integrated care for chronic diseases in Greece.

作者信息

Tsiachristas Apostolos, Lionis Christos, Yfantopoulos John

机构信息

Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK.

Clinic of Social and Family Medicine, Medical School, University of Crete, Greece.

出版信息

Int J Integr Care. 2015 Oct 22;15:e040. doi: 10.5334/ijic.2228. eCollection 2015 Oct-Dec.

Abstract

The health, social and economic impact of chronic diseases is well documented in Europe. However, chronic diseases threaten relatively more the 'memorandum and peripheral' Eurozone countries (i.e., Greece, Spain, Portugal and Ireland), which were under heavy recession after the economic crisis in 2009. Especially in Greece, where the crisis was the most severe across Europe, the austerity measures affected mainly people with chronic diseases. As a result, the urgency to tackle the threat of chronic diseases in Greece by promoting public health and providing effective chronic care while flattening the rising health care expenditure is eminent. In many European countries, integrated care is seen as a means to achieve this. The aim of this paper was to support Greek health policy makers to develop an action plan from 2015 onwards, to integrate care by bridging local policy context and needs with knowledge and experience from other European countries. To achieve this aim, we adopted a conceptual framework developed by the World Health Organization on one hand to analyse the status of integrated care in Greece, and on the other to develop an action plan for reform. The action plan was based on an analysis of the Greek health care system regarding prerequisite conditions to integrate care, a clear understanding of its context and successful examples of integrated care from other European countries. This study showed that chronic diseases are poorly addressed in Greece and integrated care is in embryonic stage. Greek policy makers have to realise that this is the opportunity to make substantial reforms in chronic care. Failing to reform towards integrated care would lead to the significant risk of collapse of the Greek health care system with all associated negative consequences. The action plan provided in this paper could support policy makers to make the first serious step to face this challenge. The details and specifications of the action plan can only be decided by Greek policy makers in close cooperation with other health and social care partners. This is the appropriate time for doing so.

摘要

慢性病对欧洲的健康、社会和经济影响已有充分记录。然而,慢性病对“备忘录国家和外围”欧元区国家(即希腊、西班牙、葡萄牙和爱尔兰)的威胁相对更大,这些国家在2009年经济危机后陷入严重衰退。特别是在希腊,该国危机在欧洲最为严重,紧缩措施主要影响了慢性病患者。因此,在希腊,通过促进公共卫生和提供有效的慢性病护理来应对慢性病威胁,同时抑制不断上涨的医疗保健支出,已成为当务之急。在许多欧洲国家,综合护理被视为实现这一目标的一种手段。本文的目的是支持希腊卫生政策制定者制定2015年起的行动计划,通过将地方政策背景和需求与其他欧洲国家的知识和经验相结合来实现护理整合。为实现这一目标,我们一方面采用了世界卫生组织制定的概念框架来分析希腊综合护理的现状,另一方面制定改革行动计划。该行动计划基于对希腊医疗保健系统的分析,包括护理整合的前提条件、对其背景的清晰理解以及其他欧洲国家综合护理的成功案例。这项研究表明,希腊对慢性病的应对不力,综合护理尚处于萌芽阶段。希腊政策制定者必须认识到,这是在慢性病护理方面进行重大改革的契机。未能朝着综合护理方向进行改革将导致希腊医疗保健系统崩溃的重大风险以及所有相关的负面后果。本文提供的行动计划可支持政策制定者迈出应对这一挑战的重要第一步。行动计划的细节和规格只能由希腊政策制定者与其他卫生和社会护理伙伴密切合作来决定。现在正是这样做的合适时机。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a109/4843177/37a724f1f538/IJIC-15-2015040-g001.jpg

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