Last update:


Arch Hellen Med, 35(4), July-August 2018, 549-557


Health care reforms and changes in health expenditure in a period of financial crisis

H. Bakola,1 E. Fradelos,1 E. Bakola,2 S. Zyga1
1Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of the Peloponnese, Sparta,
2Health Visitor, Occupational Health Department, Papadopoulos SA, Athens, Greece

Financing of the health sector in Greece has been subject to major changes, which have highlighted its weaknesses and made even more urgent the need for efficient use of resources through health care reform. This study categorized health expenditure in accordance with the System of Health Accounts 2011, in line with OECD methodology. Data analysis demonstrated that the total health funding as a percentage of the GDP fell by -12.8%, and public funding for health fell by -60.6%. In view of this development, and aiming at reduction of health care costs, reforms in hospital care, outpatient care and pharmaceutical policy were proposed and implemented. Among other measures that were introduced were the creation of a compensation scheme for hospitals based on Closed Consolidated Medical Bills (DRGs), and an Association for the Remuneration of Hospitals (ESAN), a Primary National Health Network (PEDY) within the National Organization of Health Care Services (EOPYY), along with an electronic prescribing system and promotion of an increase in the prescription of generic drugs. The effectiveness of these reforms in reducing health spending has been widely debated, stressing the positive and the negative elements, and proposals have been put forward for improving their effectiveness. Innovative ideas with scientific relevance are not missing in the Greek efforts to reduce health costs. The major weakness is in the enforcement and monitoring of the effectiveness of the reforms.

Key words: Financial crisis, Financing health systems reforms, Health expenditures.

© Archives of Hellenic Medicine