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

Apostolos Tsiachristas,John Yfantopoulos,Christos Lionis

doi:10.5334/ijic.2228

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.

Highlights

Chronic diseases pose a major threat to population health and sustainability of health care systems and economies worldwide
This study showed that chronic diseases are poorly addressed in Greece and integrated care is in embryonic stage
The action plan provided in this paper could support policy makers to make the first serious step to face this challenge

Summary

Introduction

Chronic diseases pose a major threat to population health and sustainability of health care systems and economies worldwide. With regard to the economic impact, it is estimated that over the 20 years, chronic diseases will cost more than 48% of the global gross domestic product in 2010 [6] They account for a large extent of the increasing health care expenditure [7] because their direct and indirect costs in health care are a sizeable share of a country’s gross domestic product. Chronic diseases constitute a great challenge to economies and a threat to the sustainability of health care systems worldwide This challenge is even greater when considering that chronic diseases have long-term macroeconomic impact on consumption, capital accumulation, labour productivity and labour supply [3]. Integrated care is the most promising concept in redesigning care to tackle the increasing threat of chronic diseases It refers to a ‘range of approaches deployed to increase coordination, cooperation, continuity, collaboration, and networking across different components of health service delivery’ [18]. Busse et al (2008) stated that integrated care aims to: (1) improve quality of care delivery, (2) ensure professional adherence to disease-specific protocols and guidelines, (3) reduce unnecessary hospital utilisation by strengthening the primary care sector, (4) share financial responsibility with other stakeholders, and in the long-term, (5) contain the increasing chronic care expenditure [26]

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Discussion

Conclusion