Mια ενθαρρυντική άποψη της κοινής γνώμης (ή ίσως κυρίως του Ιατρικού κόσμου) σχετικά με την κινητοποίηση του Ιατρικού σώματος αποτυπώνεται στο γκάλοπ:
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[/tabl This pattern of healthcare utilization is attributed primarily to inadequacies in rural primary care services. The services delivered are unilaterally oriented towards acute health problems, and rarely engage in prevention, health promotion, social care and rehabilitation4. Moreover, chronic disease management is usually performed in a fragmented way, with the main focus being on prescribing. Consequently, a stable, personal long-term relation between the patient and provider is rarely established. Under these circumstances, it is not surprising that rural populations are highly dissatisfied with delivered healthcare services2. Obviously, the Greek rural population does not have the same opportunities in health care as the urban population. On one hand, rural citizens have fewer healthcare options; they are mostly insured by the OGA insurance fund, which does not have its own healthcare network nor does it provide free access to private doctors, as do other social funds. On the other hand, the lack of satisfactory rural healthcare services means that rural patients often have to travel long distances to find the necessary care, thus incurring large time and travelling costs. Quite often they are forced to seek private care, which may be expensive and burdensome for a limited family budget3. Indeed, rural residents are more likely to consult private doctors or clinics than urban residents (p = 0.006) (Table 1). Countries with strong primary-care systems are generally associated with better outcomes and lower inequalities5. Hopefully, the Greek health authorities will realise the necessity to head towards an integrated, team-based primary care system that will ensure continuity and coordination of care. Adequate investments in human resources and infrastructure are critical in establishing effective rural health services, and these need to be accompanied by structural reforms and updated organizational policies. Nikolaos Oikonomou, MD and Yannis Tountas, MD, PhD Centre for Health Services Research Medical School, University of Athens Athens, Greece References 1. Mossialos E, Allin S, Davaki K. Analysing the Greek health system: a tale of fragmentation and inertia. Health Economics 2005; 14: S151-S168. 2. Tountas Y, Karnaki P, Pavi E, Souliotis K. The “unexpected” growth of the private health sector in Greece. Health Policy 2005; 74: 167-180. 3. Tountas Y, Oikonomou N, Pallikarona G, Dimitrakaki C, Tzavara C, Souliotis K et al. Sociodemographic and socioeconomic determinants of health services utilisation in Greece: the Hellas Health I study. Health Service Management Research 2011; 24(1): 8-18. 4. Oikonomou N, Mariolis A. How is Greece conforming to Alma-Ata's principles in the middle of its biggest financial crisis? British Journal of General Practice 2010; 60(575): 456-457. 5. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. The Milbank Quarterly 2005; 83(3): 457-502. © Nikolaos Oikonomou, Yannis Tountas 2011 A licence to publish this material has been given to James Cook University, http://www.jcu.edu.au This article has been viewed 97 times since February 11, 2011. Article No. 1661 CONTACT US | COPYRIGHT AND DISCLAIMER | ADMIN ONLY |