Health services utilization and its determinants in the context of recession: evidence from Greece.

Abstract

In 2009, Greece entered a prolonged economic recession and adopted austerity reforms, which have profoundly affected many aspects of health sector, including health services use. The objective of this study was to investigate healthcare utilization in the Greek population in the context of austerity and its determinants. Two National Health Surveys of the population aged 15 and over, conducted in 2009 and 2014-before and after the adoption of austerity measures-, were used to analyse possible changes in healthcare utilization and its determinants applying chi-square tests, Mann-Whitney U-tests and generalized linear models. Between 2009 and 2014, the share of those who had visited a specialist decreased, whereas that of those who had visited a general practitioner or had been hospitalized did not change significantly. The number of outpatient consultations decreased and the number of nights spent in hospital did not change significantly. The strongest predictors were self-rated health, presence of chronic diseases and experiencing pain. Identifying the procyclical or counter-cyclical nature of healthcare utilization and the association between utilization and its determinants in different settings is an important priority in order to improve access and promote health equity.