| Abstract |
Objective:
The principal motivation for this dissertation, which was conducted by the University of Crete's
Clinic of Social and Family Medicine in collaboration with the National School of Public Health,
was the lack of available tools for assessing and evaluating the quality of health services offered, in
contrast to international practice. It aspires to help launch a debate on how a better health care
sector and planning can manage existing problems and emerging needs, through an effective and
flexible link between primary health care and public health in Greece. In this context, the main
objective was to evaluate the PHC services provided in rural Greece. This is considered to be the
first step in describing the current conditions, which will allow the transition to a viable and
effective reform of health care provision, particularly during the period of the current new global
crisis.
Study population and methodology:
Data were collected from two geographical and administrative regions representing differences in
economic status and population frequency. Crete and Epirus, at the beginning of the economic
crisis, were the study areas. Data collection was carried out from December 2008 to June 2009 and
was part of a larger ongoing project started by the University of Crete (Clinic of Social and Family
Medicine) in collaboration with the Faculty of Political Sciences of the University of Crete and the
National School of Public Health of Greece, with the general aim of providing a detailed mapping
of the services provided by Primary Health Care Centers in Greece. The study was included 21 Primary Health Care Centers and their reference populations, in the regions of Epirus and Crete, in
Greece.
For this purpose, a methodology with qualitative and quantitative characteristics was used in order
to: a) Record the activities and services provided by the Health Care Centers of the Greek Territory
regarding the basic infrastructure, unit organization, services provided, health education, training,
research, referrals and liaison with the hospital, as well as collaboration with agencies b) record the
needs in electromechanical, hospital hotel and biomedical equipment at the Health Care Centers. (c)
record the various attitudes towards clinical governance and its implementation in CPU units, as
well as the needs for continuing education. (d) measure the clinical effectiveness of Health Care
Centers in selected chronic diseases. (e) assess the quality level in selected areas of the
organization, administration and operation of Health Care Center services and, finally, (g) indirectly
assess the performance of the Health Care Center services. Specifically, the tools used in the study
were a standardized semi-structured questionnaire, quality assessment frameworks and qualitative
research methods.
Results:
Both quantitative and qualitative data were collected. The main ones concern the existing staffing
(nursing, other health professions and administrative staff) of the Health Care Centers which
highlights the shortcomings at the educational level since, as the results show, only 50% of the
reception staff has the training to deal with emergency cases.
The qualitative study of the evaluation of PHC services in the two separate regions of Greece
recorded the relative views of PHC providers and managers. On site interviews showed that primary
care professionals hold varying views as to the quality of services provided, although the vast majority identified similar obstacles to providing high quality PHC services. The positive attitude of
health care providers in the quality assessment research of health care services should be
strengthened by overcoming the identified barriers, while addressing concerns raised about the
future development of private Health Care Centers, in order to avoid a serious decline in services of
state-funded Primary Health Care.
Conclusions:
The methodology used in this study was found to be appropriate for assessing providers' views on
the quality and effectiveness of the provided services and could also be used in other European
countries, where PHC reforms are being implemented or are facing similar challenges.
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Αξιολόγηση της απόδοσης και της ποιότητας των υπηρεσιών υγείας απο τα Κέντρα Υγείας της Ελληνικής επικράτειας
