Sick by Appointment? - Health Science Journals

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Health Science Journal
ISSN 1791-809X
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‘Sick by Appointment?’
2015
Vol. 9 No. 1:1
Dimitris Theofanidis
Lecturer, Nursing Department,
Alexandreio Educational Institute of
Thessaloniki, Greece
Corresponding Author:
Dimitris Theofanidis

Abstract
Pharmacogenetics explores heritable genetic polymorphisms that can effect
responses to drug therapy. Many studies have focused on several genetic
polymorphisms, which are involved in cholesterol metabolism, trying to
define their contribution to a potential genotype-guided treatment against
dyslipidemia.adult.
dimitrisnoni@yahoo.gr
Lecturer, Nursing Department, Alexandreio
Educational Institute of Thessaloniki,
Greece
Keywords: Statins; Pharmacogenetics; Gene polymorphism
The Greek healthcare system was ranked 14th worldwide in the
overall assessment by the World Health Organization, placing
Greece above other European countries such as the UK and
Germany [1]. For the past four decades, governments have put
strong emphasis on public health care which is essentially free of
charge at the point of delivery [2].
The health care sector bloomed during the late 1970s as the
country was returning from the 7 year military junta to democracy
and by 1983, the new Greek National Health System (NHS) was
introduced.
At its peak, the Greek NHS was comprised of more than 200
hundred hospitals and 40.000 beds which were considered rather
excessive for its 10m inhabitants. Currently, the country has been
under heavy recession for the last 6 years and now resulting
minimum staff so services are stretched to the limit.
However, the Greek NHS’s problems started long before the
recession. The centralized infrastructure of the health care
system, the oversupply of hospital-based physicians, the absence
of a referral system and a growing public demand for equal rights
and free access to health for all, has led the tertiary health care
sector in particular to grow out of proportion [3,4].
As a result, a unique-to-Greece rota system for hospital
emergencies evolved, by modifying the notion of the rota-based
system for 24-hour pharmacies. Essentially, this means that
hospitals rotate to be on 24-hour duty for admitting new cases.
Each designated hospital operates alone, or in pairs depending
on the city size.
© Copyright iMedPub | This article is available in: www.hsj.gr/archive
So the designated hospital’s Accident & Emergencies (A&E)
department would accept all incoming patients for a 24-hour
period at a time. The rest of the city’s hospitals would not accept
new cases but only offer continuing care to in-patients.
This arrangement creates numerous logistic problems as every
so often the hospital has to face a pressure on bed availability
and other resources, resulting often in early discharges in order
to free beds in anticipation of an influx with the next rota on-call
period [5].
By law, the A&E department is not permitted to admit cases when
not on-call, unless a major event takes place right outside the
premises. In such a case, the hospital staff is obliged to stabilize
the patient and transfer him to the appropriate on-call hospital.
Patients arriving for emergency treatment at a hospital which
is not open to emergencies are redirected to the rota allocated
hospital regardless of how serious the condition may be. Yet, this
can cause unnecessary and unwanted delays for treatment which
may affect outcomes as valuable time is lost.
Criticisms of the rota system with typical examples include:
•
Unnecessary delays, e.g. patients are not always
aware of which hospital is on-call, often ending up to
a hospital which is not admitting for the day, or having
to call ambulance services in order to get quick access.
•
Underuse of all available resources
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ISSN 1698-9465
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e.g. a medium sized Greek city may have three
hospitals, working on a rota basis instead of a major
hospital with concentrated services steadily servicing
the city.
2
•
Expertise is not fully used, e.g. sophisticated services
and specialized units found in one particular hospital
may only be available for new admissions until the
next time this particular hospital is on call.
•
Some patient follow unwanted health behaviour
patterns, e.g. there are reports whereby patients may
even postpone an urgently needed visit to the A&E in
2015
Vol. 9 No. 1:1
order to wait until a particular hospital of their choice
is on-call, based on proximity to their home, or the
hospital’s perceived status.
•
Due to the rota system, it can be argued that health
care resources are not readily available to everyone.
Overall, it is evident that despite great past success
in improving health care services of the population,
the Greek health care system is now facing serious
structural problems concerning adequate financing,
sensible resource allocation, skilled organization,
efficient management and proper delivery of services.
This article is available in: www.hsj.gr/archive
ARCHIVOS
DE MEDICINA
Health Science
Journal
ISSN 1698-9465
1791-809X
References
1 Economou C (2010) Greece: Health system review. Health Systems in
Transition 12: 1-177.
2 Boutsioli Z (2010) The Greek hospital sector and its cost efficiency
problems in relation to unexpected hospital demand: A policymaking perspective. Rev Eur Studies 2: 170-187.
3 Karamanoli E (2012) Greece’s financial crisis dries up drug supply.
© Under License of Creative Commons Attribution 3.0 License
2015
Vol. 9 No. 1:1
Lancet 379: 302.
4 Kentikelenis A, Karanikolos M, Reeves A, McKee M, Stuckler D (2014)
Greece’s health crisis: from austerity to denialism. Lancet 383: 748753.
5 Karapanayiotides T, Piechowski-Jozwiak B, van Melle, Bogousslavsky
S, Devugst G (2004) Stroke patterns, aetiology, and prognosis in
patients with diabetes mellitus. Neurology 62: 1558–1562.
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