Greek National Health System Research Articles

Scenarios for Assessing Leadership Behaviors of Mid-level Managers in the Greek National Health System Through the Lens of Servant Leadership Theory: A Pilot Study in the Hospital Cluster of North Attica.

This study aimed to develop a scenario-based questionnaire for evaluating medium-level leadership behaviors within the Greek National Healthcare System (NHS), drawing upon the principles of servant leadership theory. Data for this pilot study were collected in the first quarter of 2019, using a sample of 33 (22.9% of all medium-level managerial positions) medium-level managers from the Greek NHS hospital cluster located in North Attica. To assess managerial behaviors, an ordinal scale was employed, revealing non-normal data distributions. Consequently, our analysis involved presenting descriptive statistics, utilizing non-parametric tests to explore distinctions in managerial behaviors, and conducting thematic analysis of responses to open-ended questions, with frequencies and relative frequencies of each theme meticulously recorded. Overall, our findings indicate that, in most cases, managers exhibited positive behaviors towardtheir employees, regardless of whether the outcomes were positive, negative, or unknown. Positive behaviors towards the administration were comparatively rare. Significant differences were observed, highlighting that managers were more inclined to exhibit positive behaviors when the outcome was known, particularly in scenarios involving employee management. Within each scenario, behavioral patterns varied, with managers demonstrating a propensity to take credit for employee success in positive outcomes but distancing themselves from negative outcomes when reporting to the administration. Furthermore, the survey responses underscored the prevalence of positive attitudes regarding accountability and stewardship, with stewardship showing a positive correlation with scenario-based behaviors. Finally, our study brought to light several challenges in the management of the Greek NHS, including the absence of comprehensive managerial evaluation, the lack of meritocracy, regulatory deficiencies, and a shortage of leadership skills among current managers. These findings emphasize the importance of scenario-based assessments for Greek hospital managers, as they can help connect managerial behaviors to stewardship, accountability, and skills, ultimately contributing to the enhancement of leadership within the Greek NHS.

Multicenter investigation of moral distress among physicians and its impact on the intention to leave working position

Introduction: The evidence concerning Moral Distress (MD) among physicians is limited, while such data are absent for physicians working in the Greek National Health System (GNHS). The purpose of this study is the investigation of MD among physicians in Greece and the validation Moral Distress Scale-Revised (MDS-R) as a reliable method for the measurement of MD in the Greek language. Methods: This is a multicenter study in which 200 physicians of all specialties and degrees participated. A self-reporting questionnaire was used. The MDS-R questionnaire is constituted of 21 items that describe conditions met in clinical practice, aiming to investigate the frequency and intensity of such cases. The questionnaire was translated and validated in the Greek language. Results: The test-retest procedure was undergone in a sample of 18 physicians and it was found significant and high agreement in all of the MD scale items. Therefore, all 21 items of the MDS-R questionnaire were found suitable for inclusion in the Greek version of MDS-R. A model of four main factors emerged after the analysis of the results with a total variance of 46,8% and all these factors were correlated with each other. MD was detected to a significant degree in more than half participants. The incidence and intensity of MD were higher in physicians who worked in general hospitals compared to those working in cancer hospitals, which is reported for the first time. Conclusions: The Greek version of MDS-R is a valid and reliable instrument for the investigation of MD among Greek physicians. Moral distress impacts the Greek physicians but the degree depends on the working position. Moral distress is also associated with leaving a working position among Greek physicians.

The Greek economic crisis and its impact on the national health system

Abstract The Greek economic crisis produced severe economic and social outcomes. A massive rescue package was conditional on implementing a Memorandum of Economic and Financial Policies agreed upon between the Greek government and the EU, European Central Bank, and the International Monetary Fund. The extremely austere fiscal consolidation and the structural reforms accompanying the Greek Economic Adjustment Programmes reduced the country’s GDP. Implementing the austerity policies on the Greek National Health System, which was already facing structural problems, reduced the quality and availability of public health care services. This paper investigates the impact of the GDP change on public healthcare expenditures (HCE) from 2000 to 2018. The empirical analysis reveals a statistically significant positive correlation between the GDP per capita and public healthcare expenditure (HCE) from 2000 to 2014 while the effect of GDP on HCE after the 2015 remains unchanged. This paper contributes to the field’s literature since it determines the impact of GDP on public HCE, specifically matched with empirical results to derive conclusive answers.

Detecting Stroke at the Emergency Department by a Point of Care Device: A Multicenter Feasibility Study.

To evaluate if the Strokefinder MD 100 by Medfield Diagnostics AB can be used as a point of care device in overcrowded Emergency Departments (ED). We used the strokefinder MD 100 by Medfield Diagnostics AB in two Greek National Health System (NHS) Hospitals Emergency Departments. Our research protocol was approved by local scientific and ethics committees. We prospectively enrolled 71 adult patients from two NHS emergency departments in whom stroke was included as a differential diagnosis after triage. The feasibility of using the Strokefinder MD 100 by Medfield Diagnostics AB in various emergency department settings was evaluated through a structured questionnaire. The strokefinder MD 100 was used on 71 patients in various settings in the Emergency Department. In every case, the test was completed at the patient bedside without interfering with other ongoing and diagnostic and resuscitation procedures. There was no additional delay to patient care caused by performing the test when compared with current local Emergency Department practice and protocol. In almost 90% of the cases, a clear result was produced by the device. The Strokefinder MD 100 can be safely used as a point of care device by all trained healthcare professionals, in the most overcrowded emergency department, in various ED locations. Point of Care Systems, Cerebrovascular Stroke, Proof of Concept Study.

The Impact of Change Management in the Greek National Health System: A Quantitative Study.

Serious changes took place in Greece due to the economic crisis of 2008, which led to significant changes in Greece's health sector. The reforms and changes that were made to the National Health System (NHS) aimed to improve it, provide quality services to its users, and adapt it to Greece's new external environment. The aim of this study was to assess the management of these changes by the leadership of the NHS and to examine their effectiveness. The survey was based on quantitative research methods, using a questionnaire as a research tool. The sample population comprised employees of a tertiary-care public hospital in northern Greece. We recruited a sample size of 100 participants for the survey. The questionnaire's Cronbach's alpha was equal to 0.724. The overall change management was moderate, and Greece's NHS did not follow a specific change-management model that provided principles facilitating the success of the effort. The most serious problems identified by using the questionnaire were the following: the changes were not structured and clear, the management set unrealistic goals and objectives, the changes to the NHS were made without the appropriate financial support, and there is uncertainty about the future of health care in Greece. The present study showed that changes cannot be made randomly; rather, they require careful planning and organization. Further changes, continuous feedback, and development are required to improve the status of Greece's healthcare system.

The health professionals and SARS-Cov-2 pandemic. Occupational performance and mental health

Introduction: World Health Organization has designated 2021 as the International Year of Health Care Workers, recognizing the impact of the pandemic on their mental and physical health. Purpose: Investigating the impact of Covid-19 pandemic on mental health and professional performance of Greek National Health System health professionals. Material and Method: Online non-experimental quantitative cross-sectional study of 203 health care workers with a questionnaire that included a) the Health Worker’s Perception Survey on Covid-19 b) the Fear of Covid-19 questionnaire and c) the e-health questionnaire. Statistical analysis was carried out by SPSS – version 25, parametric t-test and one-way ANOVA tests were used while the level of statistical significance was set at 0.05. Results: Continuous information and the provision of Personal Protective Equipment had significant role in the performance of health professionals. The results did not show high levels of stress (M.T.=1.40) and fear (M.T.=1.14). Women presented higher levels of stress and fear compared to men (p =0.001), while health professionals who deal exclusively with the care of Covid-19 patients, had higher levels of stress (p=0.039). Also, respondents with ≥10 years of work showed greater levels of fear (p=0.014) and stress (p=0.044) than those with ≤10 years. Conclusions: Information, availability of Personal Protective Equipment and the observance of protection measures, are some important factors that during pandemic, have a decisive effect on health care workers’ efficiency and levels of fear and stress.

Epidemiological Features of the Molecular Surveillance of SARS-CoV-2 in Northern Greece: The Experience of a Regional Hospital

The COVID-19 pandemic has been a huge challenge for the Greek National Health System. Real-time reverse transcription PCR (rtRT-PCR) remains the reference method for early diagnosis, contact tracing, and containment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study is the documentation of the epidemiological features of SARS-CoV-2 laboratory surveillance with rtRT-PCR in the population residing in the Pieria province of Greece. Of the 15,486 nasopharyngeal and oropharyngeal samples tested with real-time reverse transcription PCR for the presence of SARS-CoV-2 RNA, 8,051 (52%) were from females and 7,435 (48%) from males, aged 7 days–103 years, with 69.9% coming from the age group of >40 years. The 4,616 out of 15,486 (29.8%) samples came from hospitalised patients. There were 3,771 positive samples out of 15,486 (24.3%); 1,890 (50.8%) males and 1,881 (49.2%) females, with the age group of 40–59 years being dominant (29.9%). Those diagnosed for the first time made up 3,352 out of 3,771 (88.9%) of positive samples. The monthly positivity rate ranged from 6.24–15.69% during the B.1.1.7 variant wave, 17.38–52.89% during the B.1.617.2 variant wave, and 59.76% during the first month of the B.1.1.529 variant wave. Absence of detection of the spike protein gene target was observed in 1,371 (36.4%) of positive samples. Cycle threshold values <20, indicative of higher viral load, had 43.2% of positive samples during the B.1.1.7, 70.0% during the B.1.617, and 92.0% during the first month of the B.1.1.529 wave. The positivity and distribution of variants in the study population was in accordance with the respective results announced by official government authorities for the Pieria region.

Follitropin Alpha for assisted reproduction: an analysis based on a non-interventional study in Greece

Objective To conduct an economic evaluation estimating the cost per live birth after controlled ovarian stimulation (COS) using Follitropin Alpha (Gonal-F), in the Greek National Health System setting. A secondary objective was to predict the live birth rateof the In Vitro Fertilization (IVF) procedure. Methods A single arm, multi-center, prospective, non-interventional study was conducted on which economic, efficacy and safety data were collected by six of the largest IVF centers. The participants were 350 female patients. Three statistical methods were employed for the analysis of the study outcomes, namely (a) Generalized Linear Modeling for the estimation of the costs of IVF treatment, (b) multivariable logistic regression and (c) an Artificial Neural Network (ANN) model for live birth prediction. Results The mean total cost of IVF therapy per patient was estimated at €3728 (95% CI: €3679–€3780), while the total cost per live birth was €14,872 (95% CI: €12,441–€17,951). The live birth rate after 3 complete IVF cycles was estimated at 22.9%, while the percentage of those suffering from OHSS was limited at 0.57%. In logistic regression, the Ovarian Sensitivity Index (OSI) was a factor found to be positively associated with live birth (OR 7.39, 95% CI: 1.84–29.71). For the ANN, important predictors included number of gestational sacs and the duration of infertility. Conclusion The present study constitutes the largest single-arm study based on real data in Greece to date. The cost of IVF treatment and the cost per live birth are not insignificant in this NHS setting. The live birth rate, cost per oocyte, and the cost per live birth are in line with literature. OSI was a main contributing factor to the accurate prediction of the live birth rate, while age and BMI were found to be negatively correlated.

Medical Students’ Engagement in the Fight Against the COVID-19 Pandemic: Remote Monitoring of Home-Quarantined Patients and Vaccination Teams. Reflections on the Experience and the Learning Outcomes

Multiple student initiatives were developed in the Medical School of the Aristotle University of Thessaloniki, under the guidance of the Laboratory of Primary Health Care, General Practice, and Health Services Research, as an answer to the increasing needs of the Greek National Health System during the pandemic. In one group, students were responsible for the phone call communication with patients of certain areas to book an appointment for a rapid test, announce the results of the test, monitor the symptoms and the health condition of patients with mild COVID-19 and inform the GPs of the health centers. At around the same time, in another group, senior medical students were enlisted as volunteers, and they were distributed to seven vaccination centers in two different Health Districts of Northern Greece. The vaccination process was significantly facilitated by the support of students in the initial data collection and recording of the personal medical history of the incoming citizens. Supporting the medical staff to accelerate the process, helping to raise public awareness about vaccination, keeping in touch with clinical life and patients, and further training in vaccination and communication skills were cited as critical expectations by the volunteer students, which were largely met. Other schools could implement similar strategies of including medical students in community health projects and promote initiatives that support primary health care.

The Impact of Economic Crisis on Health of Greek Population and National Health System

PURPOSE: In this paper, we investigate the impact of the economic crisis on Greece's National Health System and population health. Also included is a critical assessment of the health policies implemented, as compared with other countries, and positive proposals. ΜETHODS: We used data from international, European, and Greek databases to conduct a literature review and to compile statistics. RESULTS: Greece spent less on health in 2012 than it did in 2007, as money from the health sector was used for another spending. During the period 2010-2015, both the Physical Health Index and the Mental Health Index showed a significant decline. Policy planning for health financing has become increasingly important since the crisis. In some countries, targeted policies are being implemented to protect the poor and avoid adverse employment effects. CONCLUSIONS: A time of financial crisis tends to require more, not less, resources for health systems to meet the greater need for health care and increase reliance on publicly funded services. During the financial crisis, fiscal and health policies differed between countries, reflecting policy decisions. In achieving fiscal balance, it is important not to sacrifice financial protection, access, efficiency, quality, health outcomes, or equality.

Clinical guidelines and clinical autonomy: exploring the missing link

PurposeThis paper aims at understanding how clinical guidelines' use in the labour process relates to clinical autonomy, that is, the self-control medical professionals exercise over medical practice.Design/methodology/approachDrawing on a qualitative case study research strategy, this paper explores how medical professionals use clinical guidelines in the labour process in one public general hospital of the Greek National Health System. Supplemented by an extensive study of documents, semi-structured interviews were conducted with 33 doctors of several specialties.FindingsThe analysis shows (1) how clinical autonomy, as a self-control structure, mediates the use of clinical guidelines as a knowledge tool in the labour process, and (2) how employing clinical guidelines as a means towards coordinating medical work, but also towards regulating and standardising medical practice, is exercising pressure on the individualistic character of clinical autonomy.Originality/valueAdvancing the analytic value of workplace control structures, this paper contributes novel theoretical understanding of emerging tendencies characterising medical work organisation and clinical autonomy, and explains how medical professionals' non-adherence to clinical practice guidelines (CPGs) relates to CPGs' role as a resource to medical practice. Finally, this research proposes a more critical approach to health policy towards addressing the challenges associated with centrally introducing clinical guidelines in healthcare organisations.

Low seropositivity for SARS-CoV-2 antibodies among healthcare workers after the first COVID-19 pandemic wave in Greece

ObjectivesTo estimate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity among healthcare workers (HCWs) in Greece and to identify high-risk groups in healthcare facilities. Study designThe study design used in this study is a nationwide cross-sectional study. MethodsData were collected from 1 June to 9 July 2020. HCWs in the Greek National Health System were offered a free SARS-CoV-2 IgG antibody test, regardless of symptoms. ResultsOverall, 379 of 57,418 HCWs (0.66%, 95% confidence interval [CI]: 0.59–0.73) were positive for SARS-CoV-2 antibodies. The adjusted overall seroprevalence was 0.43% (95% CI: 0.35–0.51). We found that HCWs in non-reference hospitals for COVID-19 (odds ratio [OR]: 1.81, 95% CI: 1.23–2.64; P = 0.002) and reference hospitals for COVID-19 (OR: 1.66, 95% CI: 1.06–2.58; P = 0.03) were more likely to be seropositive than HCWs in primary care centres. Regarding professions, nurses (OR: 1.45, 95% CI: 1.07–1.98; P = 0.02), physicians (OR: 1.43, 95% CI: 1.06–1.93; P = 0.02), and administrative, cleaning and security staff (OR: 1.50, 95% CI: 1.09–2.06; P = 0.01) had a statistically higher chance of having a positive serology than laboratory employees. ConclusionsThe adjusted overall seroprevalence found in this study indicates a very low prevalence of SARS-CoV-2 among HCWs in Greece. This result is in line with the low incidence of COVID-19 during the first wave of the pandemic and is a direct benefit from the early implementation of lockdown.

The Phenomenon of Oncology Nurses’ Tendency to Change Duties in Greek Public Hospitals: A Study of Its Causes and Suggestions

Background: The concept of job satisfaction is of great importance regarding its impact on employees’ productivity and efficiency. Especially for oncology nurses has become apparent over the past decades that job satisfaction is a determinant factor not only for the quality of services they provide but also of their tendency to change duties and resign from workplace. While this phenomenon is vastly described by the literature, no survey that investigates nursing personnel’s tendency to resign from workplace has been conducted in Greece. Objectives: To investigate oncology nurses’ job satisfaction while examining the causes of their dissatisfaction in regard to their tendency to change duties, either by departing from the oncology field or by resigning. Material and Method: Using a structured questionnaire, a survey was conducted in four hospitals in the region of Attica that fall within the Greek National Health System, ESY. The research sample comprised 278 oncology nurses, men and women, with varied work experience. The data were analyzed using the SPSS software, applying descriptive statistics, inferential statistics, and Principal Component Analysis. Results: Our findings concerning participants’ job satisfaction were mainly positive. Most of the oncology nurses partaking in the study expressed their willingness to remain in their current workplace, as their placements enable them to diffuse in their tasks the knowledge and experience previously acquired. Conclusion: As oncology nurses’ job satisfaction influences their overall performance and dedication in their profession, parameters as working conditions, equal distribution of the workload, independent decision making and seniors’ management recognition of their work, need to be considered as primarily fields of improvement. With this being the first study in Greece that investigates oncology nurses’ job satisfaction in relation to their tendency to change duties, further research is required for the containment of said phenomenon.

Budget Impact Analysis of EGFR Mutation Liquid Biopsy for First- and Second-Line Treatment of Metastatic Non-Small Cell Lung Cancer in Greece.

Within the European Union, Greece has the highest incidence of lung cancer among people under 45 years of age. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors are indicated for the treatment of patients with EGFR mutation-positive metastatic non-small cell lung cancer (mNSCLC). Tumor tissue biopsy is the standard method for EGFR mutation detection but is invasive, is resource-intensive, and has risks of complications. The objective of this analysis was to estimate the financial impact on the Greek National Health System of adopting plasma biopsy and to identify the cost-optimal approach for EGFR mutation testing of patients with mNSCLC. We developed a budget impact model to estimate total costs for three EGFR mutation testing approaches: (1) plasma test, (2) combined testing (tissue and plasma test), and (3) reflex testing, compared to the current scenario of tissue biopsy only. One-way sensitivity and scenario analyses were conducted to evaluate the impact of uncertainty and variance of different input parameters on the results. In the first-line (1L) setting, base-case results showed that adopting plasma testing in a combined testing approach identified more EGFR mutation-positive patients and yielded cost savings (−€17 per correctly classified patient) relative to tissue testing alone. The reflex testing approach was the cost-optimal strategy in the second-line (2L) setting as it identified the most EGFR mutation-positive patients with cost savings of −€42 per correctly classified patient relative to tissue testing alone. This analysis suggests that access to both EGFR mutation tissue and plasma testing are important for optimizing mNSCLC treatment decisions in Greece. Inclusion of plasma testing in either a combined or reflex testing approach may be cost optimal for EGFR mutation plasma test implementation.

A cross-sectional study of patient safety culture in acute-care hospitals in Greece

Background The development of a culture of safety can bring about an improvement in patient safety and quality of care. We aimed to investigate patient safety culture within an acute-care hospital setting in Greece. Methods A cross-sectional quantitative study was conducted using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire in two large acute-care hospitals in Greece. We examined questionnaire’s factorial structure using confirmatory and exploratory factor analysis. We assessed scales’ internal consistency, test–retest reliability and construct validity. To assess changes in patient safety culture, we conducted surveys at two points in time (2009 and 2014). Regression analysis examined whether any changes in scale scores could have been due to quality programs implementation or participants’ professional characteristics. Results Six scales with satisfactory psychometric properties emerged, namely ‘Teamwork Across Hospital Units’, ‘Teamwork Within Hospital Units’, ‘Feedback and Communication About Error’, ‘Frequency of Event Reporting’, ‘Supervisor/Manager Expectations and ‘Actions Promoting Safety’, ‘Hospital Management Support for Patient Safety’. Overall ratings of patient safety did not change over time. However, one of the two institutions experienced an increase in reported events. Conclusions The HSOPSC is a valuable tool for assessing patient safety culture in Greece. Moreover, despite the radical reduction in the financing of the Greek National Health System reported between 2009 and 2014, patient safety culture did not deteriorate. A worldwide trend towards increasing patient safety awareness, along with the increasing effort of hospitals’ administration to support patient safety might explain this lack of differences between the two points in time.

Enhanced Public Interest in Response to the Refugee and Healthcare Crises in Greece.

Background: The Greek National Health System (NHS) has been profoundly affected by the synergy of the economic and refugee crises. We aimed at evaluating the public interest regarding refugee and healthcare issues in Greece. Methods: Google Trends was employed to normalize traffic data on a scale from 0 to 100, presented as monthly relative search volume (RSV) for the search term queries: “refugees”, “health”, “diseases”, “hospital”, and “economic crisis” in Greece, from the period 2008 to 2020. Cross-country comparisons in selected European countries were made. Results: The analysis of RSV data showed an upward trend for the keyword “refugee”, in Greece, in the last five years, with two remarkable peaks from 2015 to 2016 and from 2019 to the present. Interest regarding refugees was more prevalent in the Aegean islands compared to the mainland. The mass influx of refugees has been linked to disease-related concerns. The search terms “hospital” and “health” have been the most popular and constantly quested topics since the beginning of the economic crisis in Greece, in 2009. Similar trends existed across Europe. Conclusion: There is an urgent need for effective public awareness of current politico-ethical and social-economic conditions. The patterns of public interest can formulate public policy.

‘Neither invisible nor abnormal!’ Exploring the invisibility and pathologisation of LGBT people in the Greek National Health System

This article presents findings from a research study aiming at exploring in-depth experiences of lesbian, gay, bisexual and transgender (LGBT) individuals and communities in the Greek healthcare system. This was the first study of its kind in Greece. Data collected from interviews with LGBT groups and individuals, as well as doctors, suggest that homophobia and transphobia are profound factors of systematic exclusion and restriction from access to good quality healthcare. Our findings suggest that within the healthcare context, LGBT people are routinely invisibilised and/or pathologised. The authors emphasise the urgent need for challenging chronic and institutionalised invisibility experienced by LGBT people as a necessary precondition of social equality and genuine universalism within the Greek Health System.

Work-related musculoskeletal disorders among Greek hospital nursing professionals: A cross-sectional observational study.

The serious shortages of nurses are related to increased risk for musculoskeletal disorders during work. The complexity of patient care places nurses at high-risk for injury and high in the list of occupations with risk for work-related musculoskeletal disorders (WMSD). The current study evaluated the association of personal, professional and health factors with the development of WMSD in the nursing staff of hospitals in the capital of Greece. The study was conducted online with 394 nurses (age: 37.85±7.48 years (mean±SD), 19.54% male and 80.46% female) using a questionnaire based on the Nordic Musculoskeletal Questionnaire, and comparatively examined WMSD across nurses. The prevalence of musculoskeletal disorders in general was 98%, with symptoms reported for the waist (85.3%), neck (71.2%) and back (70.7%). The risk for WMSD was higher for specific RN groups: female nurses had higher risk than males (p-value = 0.000 to 0.022), RNs with 11-20 years of work experience (p-value = 0.008) had higher risk than their younger colleagues, RNs that strain their waist, lift loads, etc faced higher risks (p-value = 0.000 to 0.043). Shift work, age and the body mass index also lead to increased risk. Our study indicated that Greek nurses suffer more frequently from WMSD in comparison to their colleagues internationally and this must alert hospital managers and the Greek National Health System to develop a prevention policy for WMSD in Greek hospitals.

The Problem of Capacity Management in Greek Public Hospitals

<p class="AbstractText">One of the most important problems that the users of Greek National Health System face, is the long waiting lists. Αrather superficial explanationof this phenomenon is usually refer the increasing demand for healthcare services, ignoring that the problem is mainly a problem of capacity management, which is associated with the occupancy rate of specific wards of a hospital, and the average length of stay.</p><p class="AbstractText">The theory of constraints can apply successfully to healthcare organizations, to solve problems of capacity management, reducing the inpatient length of stay and increasing the satisfaction from the offering services as has been proved by international research.</p><p class="AbstractText">In this paper, we study the problem from this point of view. Our qualitative research revealed that there is a bottle-neck in the normal flow of patients, because of the delays in the imaging departments of the hospitals.</p>The increase of the capacity of the imaging departments would offer a feasible solution to the problem.

Ρύθμιση και μεταρρυθμίσεις του εθνικού συστήματος υγείας στην Ελλάδα: συγκρίσεις με την ευρωπαϊκή εμπειρία

<p>The Greek National Health System (ESY) has<br />undergone many attempts for reform. The<br />fi rst one is traced back during the fi rst years<br />after its foundation in 1983 and the last one<br />is dated during 2005. Following a description<br />of the characteristics and the development<br />of the ESY, this study reviews the tendencies<br />of its reforms interpreting them according to<br />criteria which stem from the Greek experience<br />of economic and social development. The<br />comparison of the ESY’s development with<br />the potential outcomes of the national health<br />systems of other European countries, due<br />to recent reforms, is approached from the<br />perspective that these reforms have the<br />tendency to transfer the weight of fi nancing,<br />especially in the case of the public hospital,<br />away from the national budget upon private<br />family budgets.</p>