Lycourgos Liaropoulos

Greek economic crisis: not a tragedy for health.

Despite the stories of doom, cuts to healthcare spending in Greece will not necessarily be all bad for patient care, argues Lycourgos Liaropoulos

Health care financing and the sustainability of health systems.

The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to “traditional” issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability.

Economic Evaluation of Home Care Versus Hospital Care for Patients With Terminal-Stage Malignant Neoplasms

Home care is implemented internationally on a large scale. However, in Greece, home care services are underdeveloped, especially in public sector. The economic evaluation of home care for patients with terminal-stage malignant neoplasms and the comparison with the cost of hospital care. A socioeconomic evaluation was conducted comparing the cost of home care with the cost of hospital care for patients with terminal-stage malignant neoplasms. The study population included 66 patients in home care group and 64 patients in hospital care group. Both medical cost of care and carers’ lost productivity were evaluated. The 3-month medical cost of home care was estimated at €2424.3 per patient, while the corresponding cost in hospital care group was €6665.4. The monthly carers’ lost productivity in home care group was estimated at €523.9 per patient (6.7 days out of work), while in hospital care group it was €1071.3 (13.7 days out of work). Home care provides services at lower cost compared to hospital care and contributes in cost containment of public health expenditure.