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23-Jul-2021
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Arch Hellen Med, 38(4), July-August 2021, 524-530 ORIGINAL PAPER Primary health care: The Greek case, in the perspective of reform S. Karakolias,1 D. Batzokas,2 N. Polyzos1 |
OBJECTIVE Τo describe the current situation and to formulate reform proposals for the Greek Primary Health Care (PHC) system, with emphasis on issues related to family doctors (FDs).
METHOD Aggregated data for 2019 were collected from the Greek Ministry of Health concerning the geographical distribution of FDs and the utilization of their services by patients. Combined with population data, this information was used to construct density and work-load indicators.
RESULTS Data analysis showed that each self-employed FD contracted with the National Organization for Healthcare Provision (EOPYY) had an average of 874 patients on his(her) list, with the average of pediatricians (4,569 patients/doctor) being many times that of general practitioners (GPs) (1,081 patients/doctor). Similar findings emerged for the FDs employed in the National Health System (ESY) units, but their average patient list was clearly less burdened (129 patients/doctor). The common denominator includes the significant geographical differences in the number of patients per doctor, along with the fact that only 10% of the total population of the country was found to be registered with either EOPYY or ESY FDs. In parallel, the use of the services provided by the ESY FDs was more intense (901 visits/doctor, 4 visits/patient) than those provided by self-employed FDs (103 visits/doctor, 2.8 visits/ patient), with a remarkable service excess at the local health units (TOMYs) compared with health centers and their regional medical units (KY-PI), according to prescriptions in urban areas.
CONCLUSIONS To date, the FD institution in Greece is under-functioning, with a shortage of doctors, irrational geographical distribution, and significant differences in the burden of the patient lists and in the doctors' workload. This situation requires further reform, in the form of interventions to create financial incentives for FDs, and unification of the organization and operation of PHC units, starting with the use of modern information technologies.
Key words: Family doctor, Geographical distribution, Primary health care, Reform, Service utilization.
