Bridging knowledge to develop an action plan for integrated care for chronic diseases in Greece

Abstract

The health, social and economic impact of chronic diseases is well documented in Europe. However, chronic diseases threaten relatively more the 'memorandum and peripheral' Eurozone countries (i.e., Greece, Spain, Portugal and Ireland), which were under heavy recession after the economic crisis in 2009. Especially in Greece, where the crisis was the most severe across Europe, the austerity measures affected mainly people with chronic diseases. As a result, the urgency to tackle the threat of chronic diseases in Greece by promoting public health and providing effective chronic care while flattening the rising health care expenditure is eminent. In many European countries, integrated care is seen as a means to achieve this. The aim of this paper was to support Greek health policy makers to develop an action plan from 2015 onwards, to integrate care by bridging local policy context and needs with knowledge and experience from other European countries. To achieve this aim, we adopted a conceptual framework developed by the World Health Organization on one hand to analyse the status of integrated care in Greece, and on the other to develop an action plan for reform. The action plan was based on an analysis of the Greek health care system regarding prerequisite conditions to integrate care, a clear understanding of its context and successful examples of integrated care from other European countries. This study showed that chronic diseases are poorly addressed in Greece and integrated care is in embryonic stage. Greek policy makers have to realise that this is the opportunity to make substantial reforms in chronic care. Failing to reform towards integrated care would lead to the significant risk of collapse of the Greek health care system with all associated negative consequences. The action plan provided in this paper could support policy makers to make the first serious step to face this challenge. The details and specifications of the action plan can only be decided by Greek policy makers in close cooperation with other health and social care partners. This is the appropriate time for doing so.

Keywords: Greece; chronic diseases; economic crisis; integrated care; policy reforms.

Figure 1.

Gross domestic product growth and unemployment trends in Greece (2007–2015). Data source: World Economic Outlook Database [13]

Figure 2.

Percentage of total health expenditure spent on hospital care: Year 2012 or nearest year. Source: OECD Health Statistics 2015 [21]

Figure 3.

The Innovative Care for Chronic Conditions Framework. Source: Innovative Care for Chronic Conditions: Building Blocks for Action, Geneva, Switzerland, World Health Organization, 2002, pp. 65). Copyright 2002, World Health Organization. Reprinted with permission. [22]

Figure 4.

Annual rate of growth of health expenditure 2007–2011. Source: Health at a Glance 2014 [70]

Figure 5.

Patient satisfaction with the provision of health services. Source: OECD 2014 Society at a Glance [70]