PHP141 In Search of Reform for the Greek Health Care System: Depicting the Key Opinion Leaders' Views

Abstract

Financial crisis in Greece raised the need for more efficient use of resources in the health care sector. A number of policies have been proposed for this purpose. The aim of this study was to investigate the views of healthcare Key Opinion Leaders (KOLs) on the proposed interventions. Seventy-two KOLs were invited to participate in an expert panel survey. For the purpose of the study a closed questionnaire was developed comprising of six sections based on the proposed policies i.e. audit, economic evaluation, financial management, pricing, health care funding and procurement system. During the meeting KOLs were asked to select the answers that best represented their views on the appropriateness/feasibility of each policy under study and express their opinion in an open discussion that followed. Forty experts (55.5%) accepted the invitation. The majority of participants argued that audit is necessary in the health sector but half of them believed that at present it is not feasible. They thought that a certified public institution should be responsible for the audit process. The indicators and targets should be set nationally but can be differentiated locally. Very important was the finding that the audit report should be a criterion for each institution's (hospital) funding and if results are negative then a penalty should be applied. Implementation of economic evaluation in decision-making was considered extremely important. A reform in the hospital's financing was reported as necessary and the most suitable reimbursement technique is a combination of global budget and DRG system. Physicians should be reimbursed based on qualitative criteria. Finally, procurement system should and can be reformed immediately according to the expert panel. All proposed interventions were evaluated positively but experts considered that there is a greater need for an audit mechanism and reform of the procurement system to be implemented first.