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Analysing the Greek health system: a tale of fragmentation and inertia

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Author Info

  • Elias Mossialos

    (London School of Economics and Political Science, LSE Health and Social Care, UK)

  • Sara Allin

    (London School of Economics and Political Science, LSE Health and Social Care, UK)

  • Konstantina Davaki

    (London School of Economics and Political Science, LSE Health and Social Care, UK)

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    Abstract

    The Greek health system does not yet offer universal coverage and has fragmented funding and delivery. Funding is regressive, with a reliance on informal payments, and there are inequities in access, supply and quality of services. Inefficiencies arise from an over reliance on relatively expensive inputs, as evidenced by the oversupply of specialists and undersupply of nurses. Resource allocation mechanisms are historical and political with no relation to performance or output, therefore providers have little incentive to improve productivity. Some options for future health system reform include focusing on coordinating funding by developing a monopsony purchaser with the aim of improving quality of services and efficiency in the health system and changing provider incentives to improve productivity. Copyright © 2005 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.1033
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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 14 (2005)
    Issue (Month): S1 ()
    Pages: S151-S168

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    Handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s151-s168

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    References

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    1. Schneider, Friedrich, 2002. "The Size and Development of the Shadow Economies of 22 Transition and 21 OECD Countries," IZA Discussion Papers 514, Institute for the Study of Labor (IZA).
    2. Giokas, Dimitris I., 2001. "Greek hospitals: how well their resources are used," Omega, Elsevier, vol. 29(1), pages 73-83, February.
    3. Polyzos, Nicholas M., 2002. "Striving towards efficiency in the Greek hospitals by reviewing case mix classifications," Health Policy, Elsevier, vol. 61(3), pages 305-328, September.
    4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    5. Huisman, Martijn & Kunst, Anton E. & Mackenbach, Johan P., 2003. "Socioeconomic inequalities in morbidity among the elderly; a European overview," Social Science & Medicine, Elsevier, vol. 57(5), pages 861-873, September.
    6. Athanassopoulos, Antreas & Gounaris, Chrysostomos, 2001. "Assessing the technical and allocative efficiency of hospital operations in Greece and its resource allocation implications," European Journal of Operational Research, Elsevier, vol. 133(2), pages 416-431, January.
    7. Liaropoulos, Lycurgus L., 1995. "Health services financing in Greece: a role for private health insurance," Health Policy, Elsevier, vol. 34(1), pages 53-62, October.
    8. Chiara Bronchi, 2001. "Options for Reforming The Tax System in Greece," OECD Economics Department Working Papers 291, OECD Publishing.
    9. Adam Wagstaff, 2002. "Reflections on and alternatives to WHO's fairness of financial contribution index," Health Economics, John Wiley & Sons, Ltd., vol. 11(2), pages 103-115.
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    Citations

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    Cited by:
    1. Polyzos, Nikolaos & Karanikas, Haralampos & Thireos, Eleftherios & Kastanioti, Catherine & Kontodimopoulos, Nick, 2013. "Reforming reimbursement of public hospitals in Greece during the economic crisis: Implementation of a DRG system," Health Policy, Elsevier, vol. 109(1), pages 14-22.
    2. Manos Matsaganis & Theodore Mitrakos & Panos Tsakloglou, 2009. "Modelling health expenditure at the household level in Greece," The European Journal of Health Economics, Springer, vol. 10(3), pages 329-336, July.
    3. Teresa Bago d’Uva & Andrew M. Jones, 2006. "Health care utilisation in Europe: new evidence from the ECHP," Health, Econometrics and Data Group (HEDG) Working Papers 06/09, HEDG, c/o Department of Economics, University of York.
    4. Kristian Bolin & Anna Lindgren & Bjorn Lindgren & Petter Lundborg, 2008. "Utilisation of Physician Services in the 50+ Population. The Relative Importance of Individual versus Institutional Factors in 10 European Countries," NBER Working Papers 14096, National Bureau of Economic Research, Inc.
    5. Manos Matsaganis & Theodore Mitrakos & Panos Tsakloglou, 2008. "Modelling Household Expenditure on Health Care in Greece," Working Papers 68, Bank of Greece.
    6. Siskou, Olga & Kaitelidou, Daphne & Papakonstantinou, Vasiliki & Liaropoulos, Lycourgos, 2008. "Private health expenditure in the Greek health care system: Where truth ends and the myth begins," Health Policy, Elsevier, vol. 88(2-3), pages 282-293, December.
    7. Katsimi, Margarita & Moutos, Thomas, 2010. "EMU and the Greek crisis: The political-economy perspective," European Journal of Political Economy, Elsevier, vol. 26(4), pages 568-576, December.
    8. Stamatiadis, Filippos & Eriotis, Nikolaos, 2011. "Evolution of the Governmental Accounting Reform implementation in Greek Public Hospitals: Testing the institutional framework," MPRA Paper 28816, University Library of Munich, Germany.
    9. Aletras, Vassilios & Kontodimopoulos, Nick & Zagouldoudis, Athanasios & Niakas, Dimitris, 2007. "The short-term effect on technical and scale efficiency of establishing regional health systems and general management in Greek NHS hospitals," Health Policy, Elsevier, vol. 83(2-3), pages 236-245, October.

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