Early health system responses to the COVID-19 pandemic in Mediterranean countries: A tale of successes and challenges.

This paper conducts a comparative review of the (curative) health systems' response taken by Cyprus, Greece, Israel, Italy, Malta, Portugal, and Spain during the first six months of the COVID-19 pandemic. Prior to the COVID-19 pandemic, these Mediterranean countries shared similarities in terms of health system resources, which were low compared to the EU/OECD average. We distill key policy insights regarding the governance tools adopted to manage the pandemic, the means to secure sufficient physical infrastructure and workforce capacity and some financing and coverage aspects. We performed a qualitative analysis of the evidence reported to the 'Health System Response Monitor' platform of the European Observatory by country experts. We found that governance in the early stages of the pandemic was undertaken centrally in all the Mediterranean countries, even in Italy and Spain where regional authorities usually have autonomy over health matters. Stretched public resources prompted countries to deploy "flexible" intensive care unit capacity and health workforce resources as agile solutions. The private sector was also utilized to expand resources and health workforce capacity, through special public-private partnerships. Countries ensured universal coverage for COVID-19-related services, even for groups not usually entitled to free publicly financed health care, such as undocumented migrants. We conclude that flexibility, speed and adaptive management in health policy responses were key to responding to immediate needs during the COVID-19 pandemic. Financial barriers to accessing care as well as potentially higher mortality rates were avoided in most of the countries during the first wave. Yet it is still early to assess to what extent countries were able to maintain essential services without undermining equitable access to high quality care.

The System of The Provision of Oral Healthcare in the Republic of Cyprus and the Effect of the Economic Crisis.

PURPOSE: To investigate recent developments in the provision of oral healthcare in Cyprus and the population's oral health, with special reference to the impact of the recent economic crisis. RESEARCH DESIGN: cross-sectional study. MATERIALS AND METHODS: Data from oral health surveys in Cyprus over the last 30 years were reviewed and analysed together with policy documents. Information regarding oral health behaviour, dental visits and the consequences of the economic crisis on the latter was also obtained with the help of self-completed questionnaires by patients and dentists. RESULTS: Although the overall level of oral health in Cyprus can be considered satisfactory, there were statistically significant variations between districts and different socioeconomic and ethnic groups. Beyond these variations, it seemed that the three-year economic crisis (2013-2016) had negatively affected the behaviour of the population in seeking dental care, reducing the frequency of visits to the dentist, and avoiding costly dental work, especially among those from the lower socioeconomic strata. This change in citizens' behaviour led to a statistically significant decrease in dentists' income in the private sector. CONCLUSIONS: The economic crisis brought about new difficulties and challenges for both the public and the private sectors of oral healthcare, and into the implementation of a new National Health System.

Systems for the provision of oral health care in the black sea countries part 13: cyprus.

This paper describes the health care system in Cyprus and the funding arrangements for oral health care. Some epidemiological data and costs are also presented. Although almost 83% of the population is entitled to free of charge oral health care within the public sector, only 10% make use of it. Most patients prefer to use the private sector, where they pay out of pocket on a fee-for-service basis. Additionally, issues regarding the dental workforce in Cyprus are discussed, including the fact that there is no dental school in Cyprus.

Cyprus health system review.

The health system in Cyprus comprises separate public and private systems of similar size. The public system, which is financed by the state budget, is highly centralized and tightly controlled by the Ministry of Health. Entitlement to receive free health services is based on residency and income level. The private system is almost completely separate from the public system and for the most part is unregulated and largely financed out of pocket. In many ways there is an imbalance between the public and private sectors. The public system suffers from long waiting lists for many services, a situation that has been worsened by the recent economic crisis, while the private sector has an overcapacity of expensive medical technology that is underutilized. To try to address these and other inefficiencies, a new national health insurance scheme funded by taxes and social insurance contributions has been designed to offer universal coverage and introduce competition between the public and private sectors through changes in provider payment methods. However, the scheme has not been implemented due to cost concerns. Despite the low share of economic resources dedicated to health care and access issues for some vulnerable population groups, overall Cypriots enjoy good health comparable to other high-income countries.