L. Liaropoulos

Informal payments for maternity health services in public hospitals in Greece.

BACKGROUND Private health expenditure for consuming maternity health services has been identified as an issue within public hospitals. AIM To estimate level of private health expenditure, in the form of informal payments, for maternal services in public hospitals in Greece. METHODS The study population consisted of 160 women who had recently given birth in three provincial general hospitals and one general hospital in Athens. A three-part questionnaire was developed in order to collect financial information regarding the use of public obstetrics services in Greece. RESULTS The mean age of respondents was 29.5 (±5.6) years. There was a high rate of informal payments with 74.4% of women involved in informal transactions. Mean total private payments were €1549 (±992), representing 7.9% of the mean annual per capita income in Greece. Mean informal payment was €848 (±714). For 56.3% of the respondents, it was at the obstetricians request, on top of formal payment of €701 (±1351). Total informal payments were higher for women who gave birth in Athens (p<0.001), for Greek women compared to non Greek (p<0.001) and for deliveries that were conducted by womens personal obstetrician (p=0.001). CONCLUSION There is a large black economy in the field of obstetric services, as 74.4% of women who used public maternity services had to pay under-the-table payments corresponding approximately to the net salary of an intern physician. There is a need for the state to adopt innovative strategies and mechanisms in order to reduce informal payments for obstetric services in the public sector.

Living with breast cancer: Patients’ journey within the Greek National Health System

Abstract Background: Process mapping (a patient-centred method) and recording the medical, nursing and administrative staff’s views involved in the provision of care help us understand patients’ experience regarding the constraints, delays and bottlenecks of healthcare service processes and identify areas of improvement. Patients and Methods: Time information and data were collected through time and motion study with regard to the path patients with breast cancer follow in two public hospitals (sample of 86 patients) and a semi-structured questionnaire was administered to medical, nursing and administrative staff (sample of 14 employees). Results: The amount of time required in total for the prescription process was increased up to seve7 times compared to the beneficial amount of time, and the longest delays in patients’ waiting time were observed with regard to the process of chemotherapy (more than 2 hours and 40 minutes, in some cases). About 92.3% of the staff of the two hospitals prioritized the malfunctioning of theCcentralIinformationSsystem as the most important factor and more than 75% of the study participants mentioned that several administrative and technical aspects have a negative and significant effect on the time required to prescribe the necessary medicines for the treatment of patients. Conclusions: The lack of understanding of the hospital’s processes and spatial infrastructure by most patients, the lack of an electronic patient record system and central information system are highlighted as the main issues that contribute decisively to the increase in the non-beneficial time that patients with breast cances have to spend nowadays in hospitals of the NHS in Greece.