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在当前财政紧缩时期探讨初级保健背景下的健康促进与研究问题:来自希腊两个地区的探索性分析。

Discussing issues of health promotion and research in the context of primary care during the ongoing austerity period: an exploratory analysis from two regions in Greece.

作者信息

Sbarouni Vicky, Petelos Elena, Kamekis Apostolos, Tzagkarakis Stylianos Ioannis, Symvoulakis Emmanouil K, Lionis Christos

机构信息

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

Department of Political Science, University of Crete, Rethymno, Crete, Greece.

出版信息

Med Pharm Rep. 2020 Jan;93(1):69-74. doi: 10.15386/mpr-1346. Epub 2020 Jan 31.

Abstract

BACKGROUND

In Greece, both Primary Health Care (PHC) system and National Health System (NHS) in general, were plagued by several inefficiencies even prior to the financial crisis; the imposed austerity measures dramatically worsened the level of health provision and access, especially for vulnerable social groups, resulting in an exacerbation of existing disparities and access gaps.

AIM AND METHODS

The current branch study was conducted in two regions of Greece, namely Crete and Epirus, with the main aim of eliciting responses to gather baseline information regarding crucial PHC-related aspects, using questionnaires with dichotomous questions. Directors or managers (physicians who have been assigned administrative/governance duties), of the Primary Health Care Centres (PHCCs) in two Greek geographic and administrative regions of Crete and Epirus, were invited to participate and to contribute to the investigation of issues on the provision of prevention and health promotion services, e-health topics and primary care research. Thirty directors/managers were approached and twenty-eight agreed to participate. Data processing and analysis of the responses was performed for the completed questionnaires.

RESULTS

Data analysis did not demonstrate a surprisingly substantial deviation in the average score of positive responses of directors/managers in the PHCCs of Crete in comparison to those of directors/managers in the PHCCs of Epirus. The findings show that several gaps exist in terms of prevention and health promotion resources and activities in both regions, while e-health, electronic health record (EHR) and telemedicine services are poorly developed.

CONCLUSION

The study confirms that the Greek PHC is characterized by several inefficiencies, which may affect the quality of the services provided. An overall deficit has been emerged for PHCCs in both regions, a fact that indicates crucial points lacking in terms of overall PHC provision, thus adversely impacting upon living conditions, health quality and prevention.

摘要

背景

在希腊,甚至在金融危机之前,初级卫生保健(PHC)系统和整个国家卫生系统(NHS)就一直受到多种低效率问题的困扰;实施的紧缩措施极大地恶化了卫生服务提供水平和可及性,尤其是对弱势群体而言,导致现有差距和可及性缺口进一步加剧。

目的与方法

当前的分支研究在希腊的两个地区进行,即克里特岛和伊庇鲁斯,主要目的是通过使用带有二分法问题的问卷来收集关于关键的初级卫生保健相关方面的基线信息,以获取反馈。邀请了希腊克里特岛和伊庇鲁斯两个地理和行政区的初级卫生保健中心(PHCCs)的主任或管理人员(被赋予行政/管理职责的医生)参与并协助调查预防和健康促进服务提供、电子健康主题以及初级保健研究等问题。共联系了30位主任/管理人员,其中28位同意参与。对完成的问卷进行了数据处理和分析。

结果

数据分析表明,克里特岛PHCCs的主任/管理人员的肯定回答平均得分与伊庇鲁斯PHCCs的主任/管理人员相比,并无惊人的显著差异。研究结果表明,两个地区在预防和健康促进资源及活动方面均存在若干差距,而电子健康、电子健康记录(EHR)和远程医疗服务发展不佳。

结论

该研究证实希腊的初级卫生保健存在多种低效率问题,这可能会影响所提供服务的质量。两个地区的PHCCs均出现了总体不足的情况,这一事实表明在初级卫生保健的整体提供方面存在关键缺失点,从而对生活条件、健康质量和预防产生不利影响。

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本文引用的文献

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Economic crisis, austerity and the Greek public health system.经济危机、财政紧缩与希腊公共卫生系统
Eur J Public Health. 2012 Feb;22(1):4-5. doi: 10.1093/eurpub/ckr190. Epub 2011 Dec 23.

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