Gatekeeping or Provider Choice for Sustainable Health Systems? A Literature Review on Their Impact on Efficiency, Access, and Quality of Services.

As early as 1978, the World Health Organization set primary healthcare as the basis on which health systems should be built worldwide. However, the health systems of the different countries show considerable variations in terms of the implementation of gatekeeping from primary to secondary healthcare and direct access to specialists and hospital care. This literature review attempts to present the gatekeeping system with references to the UK, Sweden, the Netherlands, and Germany compared to the situation in Greece, where no gatekeeping system exists.

Cost Analysis of End-Stage Renal Disease in Pediatric Patients in Greece.

Background/objectives: The cost resulting from peritoneal dialysis (PD), conventional hemodialysis (HD) and online hemodiafiltration (OL-HDF) in pediatric patients with end-stage renal disease (ESRD) has not been estimated to date in Greece. The present single-center retrospective study aimed to estimate the mean annual cost of the above methods, as well as the individual components of this cost.

Methods: Twenty pediatric patients undergoing the three different methods of renal replacement therapy were included in this study.

Achieving Robust Medical Coding in DRGs Systems: Innovative Actions Adopted in Greece.

The purpose of this study is to evaluate and illustrate the effectiveness of a specialized digital platform developed to improve the accuracy of medical coding during the full implementation of Greece's new DRG system, and to highlight innovative actions for achieving and/or improving accurate medical coding. Already grouped DRG cases recorded in the first DRG implementation year in the region of Crete were examined. A sample of 133,922 cases was analyzed and audited, through a process consisting of three stages: (i) digitalization, (ii) auditor training, and (iii) control and consultation.

Sustainable medical tourism in the global competitive environment: The case of Cyprus.

Background: The aim of this study is to examine the perceptions of Cypriot medical tourism experts regarding the phenomenon of medical tourism, as well as to emphasise the benefits and opportunities for Cyprus to become a highly competitive global healthcare destination.

Methods: A Delphi study was conducted in Cyprus, with the participation of 20 experts in the field of medical tourism. At first, 20 experts took part in semi-structured interviews.

Relationship between profitability and financial factors of hospitals after a period of austerity and health care reforms: evidence from Greece.

Purpose: The reduction of government expenditure in the healthcare system, the difficulty of finding new sources of funding and the reduction in disposable income per capita are the most important problems of the healthcare system in Greece over the last decade. Therefore, studying the profitability of health structures is a crucial factor in making decisions about their solvency and corporate sustainability. The aim of this study is to investigate the effect of economic liquidity, debt and business size on profitability for the Greek general hospitals (GHs) during the period 2016-2018.

The Association between Fear of COVID-19 and Health-Related Quality of Life: A Cross-Sectional Study in the Greek General Population.

The aim of this cross-sectional study was to assess the level of fear related to the SARS-CoV-2 virus and the association of fear, and of sociodemographic and clinical characteristics, with health-related quality of life (HRQoL). A large sample of the Greek general population (N = 583) completed the validated versions of the Fear of COVID-19 scale (FCV-19s) and the 12-item Short Form (SF-12), and provided data on socio-demographic status, health history and COVID-19 protective behaviors. Variables were compared with Mann-Whitney and Kruskal-Wallis tests and associations with Spearman’s correlations.

Does bullying in the hospital affect the health-related quality of life of health professionals?

Background: This study investigates workplace harassment among Greek NHS employees and its impact on Health Related Quality of Life (HRQoL).

Objectives: In the present study, we highlight that the consequences of workplace harassment and the concomitant damaged satisfaction can negatively affect health-related quality of life in Public Hospitals.

Methods: A sample of 343 employees from five Athens-based hospitals, including doctors, nurses, administrative and technical personnel, completed the Greek versions of the Leymann Inventory of Psychological Terrorization (LIPT) and the Short Form-36 (SF-36).

A Comparison of EQ-5D-3L, EQ-5D-5L, and SF-6D Utilities of Patients with Musculoskeletal Disorders of Different Severity: A Health-Related Quality of Life Approach.

This study compares EQ-5D-3L, EQ-5D-5L, and SF-6D utilities in patients with different musculoskeletal (MSK) disorders, also differing in disease severity as defined by valid clinical indexes. Utilities were measured from a cross-sectional sample of rheumatoid arthritis (N = 114), psoriatic arthritis (N = 57), ankylosing spondylitis (N = 49), and osteopenia/osteoporosis (N = 95) patients. For the first three groups, disease activity (severity) was measured with the DAS-28, DAPSA, and BASDAI clinical indexes, respectively.

The association between social development and population health: a cross-sectional study across countries of different economic growth.

Background: Social Determinants of Health (SDH) are important in explaining why some countries enjoy better health than others. This empirical study highlights controversies in the literature on the relationship between socioeconomic development and health, and investigates how the relationship might vary in countries with different economic growth.

Methods: The sample consists of 172 countries, and recent cross-sectional data was collected from the World Bank's "Data Bank".

Psychometric evaluation of the Overactive Bladder Questionnaire (OAB-q) for measuring quality of life and clinical implications in Greek patients with overactive bladder.

Introduction And Hypothesis: The Overactive Bladder Questionnaire (OAB-q) measures overactive bladder patients' severity of symptoms and their impact on health-related quality of life (HRQoL). The aim of this study was to validate the OAB-q in Greek patients with overactive bladder and report clinical implications of the disease.

Methods: In total, 107 patients were recruited consecutively in our clinic.

Disease activity and sleep quality in rheumatoid arthritis: a deeper look into the relationship.

: This study looks deeper into the relationship between rheumatoid arthritis (RA) disease activity and distinct dimensions of sleep quality. : The Pittsburgh Sleep Quality Index (PSQI) was administered to a cohort of 147 RA patients. Health-related quality of life (HRQoL) and fatigue were measured with the SF-12 and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) instruments, respectively, whereas RA activity was determined with the Disease Activity Score 28 joints (DAS28).

Willingness to pay and quality of life in patients with pruritic skin disorders.

Pruritic dermatosis is a frequent and burdensome disease. The objectives of this study were (1) to assess the willingness to pay (WTP) and the health-related quality of life (HRQoL) in patients with pruritic dermatoses and (2) to compare the results with data on socio-demographic data, and clinical features/symptoms of the patients. One hundred and three patients with pruritic dermatosis had participated in a non-interventional, cross-sectional study.

Are condition-specific utilities more valid than generic preference-based ones in asthma? Evidence from a study comparing EQ-5D-3L and SF-6D with AQL-5D.

Background: Systematic discrepancies have been shown in utility values derived from different instruments. This study compares utilities from the condition-specific AQL-5D and the generic EQ-5D-3L and SF-6D in an asthmatic population with heterogeneous health-related quality of life (HRQoL), disease severity, and control status.

Methods: A consecutive sample of 104 patients diagnosed with asthma completed a survey containing the Greek versions of SF-36, EQ-5D-3L, and AQLQ(s).

Comparison of health-related quality of Life (HRQOL) among patients with pre-diabetes, diabetes and normal glucose tolerance, using the 15D-HRQOL questionnaire in Greece: the DEPLAN study.

Background: Diabetes mellitus is usually preceded by a pre-diabetic stage before the clinical presentation of the disease, the influence of which on persons' quality of life is not adequately elucidated. The purpose of this study was to compare the Health-Related Quality of Life (HRQOL) of persons with pre-diabetes with that of diabetes or normal glucose tolerance (NGT), using the validated HRQOL-15D questionnaire.

Methods: The HRQOL-15D scores of 172 people with pre-diabetes (108 with Impaired Fasting Glucose [IFG], 64 with Impaired Glucose Tolerance [IGT], aged 58.

Children's and parents' perspectives of health-related quality of life in newly diagnosed adolescent idiopathic scoliosis.

The aim of this study is to compare child and parent perceptions of health-related quality of life in Adolescent Idiopathic Scoliosis. The scoliosis-specific SRS-22 and the generic KIDSCREEN-52 were administered to newly diagnosed patients and the latter also to a parent. Strong correlations (r > 0.

Health-Related Quality of Life and Association With Arthropathy in Greek Patients with Hemophilia.

Health-related quality of life (HRQoL) is increasingly implicated in contemporary hemophilia management. This study focuses on the assessment of HRQoL in Greek patients with hemophilia and the comparison with normative data from the general population, as well as on the extent arthropathy may affect the patients' HRQoL. One hundred and nine adult patients completed the Greek social functioning (SF-36) and Haem-A-QoL questionnaires.

Quality of life in children with chronic kidney disease.

Background: Progressive chronic kidney disease (CKD), irrespective of the underlying etiology, affects the quality of life (QoL) of children due to the need for regular follow-up visits, a strict medication program and diet intake.

Methods: The Greek version of the KIDSCREEN-52 multidimensional questionnaire was used in children with CKD, renal transplantation (RT) and in a control group (CG) of healthy children.

Results: Fifty-five patients between 8 and 18 years, with CKD (n = 25), RT (n = 16) and with end-stage renal disease (ESRD) on peritoneal dialysis (PD) (n = 14) were included.

Validity and reliability of the Greek version of the Diabetic Foot Ulcer Scale - Short Form (DFS-SF).

Objective: Diabetic foot ulcer is a critical and costly complication of diabetes mellitus. The aim of this study was to assess the psychometric properties of the Greek version of the diabetic foot ulcer scale - short form (DFS-SF).

Design: A sample of patients with diabetic foot ulcer (N=110) was surveyed with the DFS-SF and various demographic and disease-related questions.

Establishing the Psychometric Properties of the ICOAP Questionnaire through Intra-Articular Treatment of Osteoarthritic Pain: Implementation for the Greek Version.

Objectives. In this prospective study, we intend to establish the psychometric properties of ICOAP for its use in studies involving the Hellenic population. Methods.

Mapping chronic liver disease questionnaire scores onto SF-6D utility values in patients with primary sclerosing cholangitis.

Purpose: The chronic liver disease questionnaire (CLDQ) is a frequently used liver-specific quality of life instrument, but it does not provide information on preference-adjusted health status, which is essential for cost-utility analysis. We aimed to develop a mapping function deriving utilities from the CLDQ in primary sclerosing cholangitis (PSC).

Methods: Short form-6D (SF-6D) utilities were calculated from SF-36 data collected in a recent prospective study in which unselected patients with PSC also completed the CLDQ.

Reengineering NHS Hospitals in Greece: Redistribution Leads to Rational Mergers.

The purpose of this study was to record and evaluate existing public hospital infrastructure of the National Health System (NHS), in terms of clinics and laboratories, as well as the healthcare workforce in each of these units and in every health region in Greece, in an attempt to optimize the allocation of these resources. An extensive analysis of raw data according to supply and performance indicators was performed to serve as a solid and objective scientific baseline for the proposed reengineering of the Greek public hospitals. Suggestions for "reshuffling" clinics and diagnostic laboratories, and their personnel, were made by using a best versus worst outcome indicator approach at a regional and national level.

Do self-perceptions of emotional intelligence predict health-related quality of life? A case study in hospital managers in Greece.

The aim of this study was to examine HRQoL outcome and EI of managers of Health Organizations. We collected data from 120 general managers of Greek public hospitals who completed the Assessing Emotions Scale (AES) and the SF-36 Health Survey. The results showed that male managers generally exhibited better HRQoL and slightly worse EI than females, although differences were not significant throughout.

The potential for a generally applicable mapping model between QLQ-C30 and SF-6D in patients with different cancers: a comparison of regression-based methods.

Purpose: To establish and compare generalized or "global" mapping relationships between QLQ-C30 and SF-6D, applicable across different cancer types.

Methods: Patients (N = 671) with breast, myeloma, colorectal, lymphoma, bone marrow, prostate, lung and gastroenteric cancer were randomly split into estimation (75%) and validation (25%) datasets. SF-6D was estimated from QLQ-C30 scores via ordinary least squares, generalized linear models and median (least-absolute deviations) regression approaches, and with Bayesian additive regression kernels.