Abstract |
During the 20th century, Greece was confronted with serious problems and
challenges in the health sector that - given the particular social, economic and sanitary
conditions of that period - made necessary the Greek state to plan and implement
integrated and evidence based reforms and regulatory changes in order to improve the
health system's performance and the health of the population as well as to deal with
the malfunctions of the health services.
In these circumstances, an important role was played by academic specialists and
health experts who, with their scientific knowledge and experience in different areas of
health policy, supported the work of the development and modernisation of health
services, through the preparation and drafting of special reports and studies on health
issues that were of particular concern and priority at a national level.
These expert's reports aimed to gather reliable information and data on the
situation and problems of the Greek health system as well as to prepare positions,
proposals and recommendations for evidence-based policy-making that could
contribute to the effective organisational and operational restructuring of health
services and to the improvement of the quality of delivered care.
Moreover, the reports aimed to provide the appropriate interpretative and
diagnostic preparation for the institutionalisation and implementation of the changes
and interventions that the health system needed, taking into account the health needs
of the population, the available resources and the socio-political factors that
influenced, in each period, the decision-making process in the health field. In this context, the research made in the present PhD thesis entitled "Expert
reports on health policy in Greece (1920-2004): social conditions and political reality of
reforms", aims to critically examine the trajectory of health reforms in Greece during
the 20th century and to analyse the most important expert's reports on health policy
issues with ultimate goal to be identified the degree of contribution of these reports to
the formation of the national health policy, to evaluate the systematicity of
preparation and drafting process of the reports, and to highlight the major policy areas
and priorities for the reorganisation of the health system and services, based on the
experts' proposals and findings.
In the theoretical part of this thesis, an overview of the interpretative approaches
and theoretical paradigms for the organisation and operation of health systems, as well
as for the administration, financing and delivery of health services is undertaken, while
particular emphasis is given to the directions and objectives of reforms, in the light of
the contemporary challenges facing health systems and services.
As far as the research part is concerned, an attempt is made to describe the health
policies that have been implemented in Greece since the establishment of the Greek
state, followed by a detailed study and analysis of the expert reports that were
prepared during the period 1920-2000 to support the process of reforming the Greek
health system, which concludes with the presentation and discussion - as a special case
study - of the report of the Health Organization of the League of Nations (1929) for the
sanitary reorganisation of Greece.
The findings and conclusions that emerge in the context of this thesis, highlight the
duration and intensity of reflection on the major problems of health policy in Greece
throughout the 20th century, while at the same time reveal the contribution of expert
reports in promoting the necessary reform initiatives for the reorganization of the
health system and in supporting evidence-based decision making process in the context
of national health policy.
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