Comparison of primary health care services between urban and rural settings after the introduction of the first urban health centre in Vyronas, Greece

Alevizos Alevizos,Vassilios Gizlis,Marek Papathanasiou,Theodoros Mariolis-Sapsakos,Dimitris Karanasios,Constantinos Mihas,Bodossakis Merkouris,Konstantinos Marayiannis,Anargiros Mariolis

doi:10.1186/1472-6963-8-124

Abstract

BackgroundDiscrepancies in primary health care (PHC) services between urban and rural settings have already been studied in many countries; however, limited information exists regarding countries, such as Greece, where public Health Centres dedicated to primary care have not been in existence in major cities. The objective of this study was to evaluate points of divergence or convergence between an urban and a rural health centre, in an attempt to underline challenges faced by the introduction of urban health centres in Greece.MethodsA cross-sectional analysis was conducted in the Health Centre of Vyronas, Athens, Greece and in the Health Centre of Nea (New) Madytos, Thessaloniki Prefecture, Greece between February 2004 and February 2006. The profile of the population seeking care, as well as data on the services provided were collected and compared. In addition, the reason for choosing each primary health care unit was also recorded.ResultsMore patients visited the urban centre (145415 vs. 112513), while the pattern of services utilized by the citizens differed significantly (p < 0.001) between the two Health Centres. The frequency of diagnoses made according to ICPC-2 was not similar in the two Health Centres (p < 0.001). The three most frequent reasons for the adults choosing the Health Centre for their problem were low waiting time, proximity to residence and satisfaction with the services provided in previous visits in Vyronas.ConclusionThe results of this study highlight the significant differences regarding PHC services utilization between an urban and a rural population. Urban citizens seem to have different health needs and reasons for choosing a PHC unit than residents of the Greek countryside. Proximity to health services and the public character of the urban health centre seem to be its main advantages.

Highlights

Discrepancies in primary health care (PHC) services between urban and rural settings have already been studied in many countries; limited information exists regarding countries, such as Greece, where public Health Centres dedicated to primary care have not been in existence in major cities
PHC is mainly provided by the Social Insurance Institute (SII) [6] and to a lesser degree by private clinics
The study was based on a cross-sectional analysis of data collected in the Health Centre of Vyronas, Athens, Greece (HCOV) and the Health Centre of Nea (New) Madytos, Thessaloniki Prefecture (HCNM) between February 2004 and February 2006

Summary

Introduction

Discrepancies in primary health care (PHC) services between urban and rural settings have already been studied in many countries; limited information exists regarding countries, such as Greece, where public Health Centres dedicated to primary care have not been in existence in major cities. Primary health care (PHC) is mainly provided by General Practitioners – Family Physicians (GPs) in developed countries [1,2,3] This is not the case in developing countries, where many doctors who are not GPs work in PHC [4]. More than half the medical personnel working in these Centres are GPs. More than half the medical personnel working in these Centres are GPs In rural areas, this type of organization seems well established, since 212 Health Centres exist; on the other hand, in major cities, such as Athens or Thessaloniki, there was not a single primary care dedicated unit till now. Problems frequently arise in these units, since they do not offer 24-7 coverage, patients are self-referred and there is no continuity of care, as the physicians change posts very often in search of better remuneration

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