Formerly London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1 7HT, UK.
Cardiff University, School of Healthcare Sciences, Eastgate House, Newport Road 35-43, Cardiff, CF24 0AB, UK.
BMC Health Serv Res. 2021 Jul 1;21(1):628. doi: 10.1186/s12913-021-06678-9.
Between 2010 and 2018, Greece implemented an Economic Adjustment Programme and underwent a series of extensive reforms, including in the health sector. We conducted a scoping review to examine whether the Primary Health Care reforms during that period assisted the country in moving towards Universal Health Coverage.
We performed a review of the literature on the following databases: Scopus, PubMed, Epistemonikos, Web of Science, and Google Scholar, including published research articles and grey literature. Findings were synthesised thematically, using the World Health Organization Universal Health Coverage dimensions: population coverage, service coverage, and financial protection.
Forty-four documents were included in this review. Out of these, thirty-eight were research-based (thirty-three qualitative, two quantitative, and three mixed design studies), two grey literature, and four legislative bills. The evidence suggests that despite the systemic interventions addressing longstanding distortions, population coverage, service coverage and financial protection have not significantly improved.
This review suggests that Primary Health Care reforms in Greece have not managed to substantially improve Universal Health Coverage, although some positive steps towards that direction have taken place with the establishment of community-based multidisciplinary health teams. Before further interventions are implemented, an evidence-based monitoring and evaluation mechanism is necessary in order to clearly evaluate their effectiveness and progress.
2010 年至 2018 年期间，希腊实施了经济调整计划，并进行了一系列广泛的改革，包括医疗保健领域。我们进行了范围综述，以研究这一时期的初级卫生保健改革是否有助于该国向全民健康覆盖迈进。
我们在以下数据库中对文献进行了综述：Scopus、PubMed、Epistemonikos、Web of Science 和 Google Scholar，包括已发表的研究文章和灰色文献。使用世界卫生组织全民健康覆盖的四个维度（人口覆盖、服务覆盖和财务保护）对研究结果进行了主题综合。
本综述共纳入 44 篇文献。其中 38 篇是基于研究的（33 篇定性研究、2 篇定量研究和 3 篇混合设计研究），2 篇灰色文献，4 篇立法法案。证据表明，尽管进行了系统性干预以解决长期存在的扭曲问题，但人口覆盖、服务覆盖和财务保护并未得到显著改善。
本综述表明，希腊的初级卫生保健改革并未成功显著改善全民健康覆盖，尽管在建立以社区为基础的多学科卫生团队方面已经朝着这个方向迈出了一些积极的步伐。在进一步干预之前，需要建立一个基于证据的监测和评估机制，以明确评估其效果和进展。
