| Abstract |
INTRODUCTION: Primary Health Care (PHC) is a key component of all health systems. The absence of operational integration of PHC units is a major issue in the case of Greece. Particularly during the times of austerity, there is a clear need for structural changes that will lead to reduction of health costs and effectiveness of the health system. This project aims to assess the current status of integration levels of PHC units in Greece, in the context of comprehensive care with the use of common processes and quality standards.
METHODS: A literature review were conducted in three scientific databases (PubMed, Cochrane Library, Google scholar) jointly with desk research to find greek programmes or studies aiming to operational integration of PHC units. No studies were found apart from two projects: one national funded (NSRF, MIS 337 424 OP "Administrative Reform 2007-2013", Social Medicine Clinic of the University of Crete) and a European FP7 project entitled QUALICOPC (Quality and costs of Primary Care in Europe). A synthesis of the results of QUALICOPC project into the main results of the NSRF project was attempted. The identified from the literature review theoretical framework was the one of Kringos et al., which combines the fundamental PHC principles of B.Starfield and the chronic disease management model. The main evaluation tool was the «Primary Care Assessment Tool (PCAT) - Short Version». This questionnaire along with an accompanying questionnaire was applied to the selected PHC units (stratified random sampling). The collected data
Δημόσια Υγεία & Διοίκηση Υπηρεσιών Υγείας
Σχολή Ιατρικής – Πανεπιστήμιο Κρήτης
6
were analyzed with the help of an algorhythm that gave different mathematical weights and integrated the Kringos et al., dimensions with their characteristics and each item of the questionnaire. A 5likert-scale reflected the final assessment, grouping the PHC units based on their integration levels, as follows: absent, poor, basic, medium and maximum integration.
RESULTS: PHC units in Greece proved to be of different integration and quality level, depending on the type of unit rather than units of the same type. However, the two dimensions that require major improvement in the total sample are the “economic conditions of the PHC System” and the “Service Quality of PHC”. The 73% of the units were evaluated of poor integration mainly due to the “system of compensation of the PHC workforce”. As far as the dimension of “quality” is concerned, the most vulnerable characteristic (80% of the units) was the “prescription practices of primary care providers”. Overall, integration of PHC structures in Greece was evaluated to be at a basic or medium level.
CONCLUSIONS: Substantial restructure of the PHC system could be achieved by targeted actions towards vulnerable dimensions and characteristics. These actions will promote quality of PHC services and operational integration of the PHC system.
|
Λειτουργική διασύνδεση φορέων Πρωτοβάθμιας Φροντίδας Υγείας με τις μονάδες υγείας με τη χρήση ενιαίων προτύπων ποιότητας-διαδικασιών
