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 obstetrician's 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 women's 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.

Understanding the oversupply of physicians in Greece: the role of human resources planning, financing policy, and physician power.

Planning of the workforce has emerged as a critical issue in European health policy, as the need for human resources for health is changing in light of demographic, epidemiological, and socio-cultural trends and patterns of supply and demand in service provision. Greece represents a country with an oversupply of physicians, having the highest concentration of physicians among European Union countries. The study aims to analyze the factors influencing the high number of physicians in Greece and make policy recommendations. The analysis was conducted through international literature review and database searches. Neither the demography of the physician population in terms of age, gender composition, and geographic dispersion, nor the epidemiology of the Greek population, can explain the relatively high number of physicians in Greece. Despite the physician surplus, Greece faces serious geographical inequities regarding the distribution of physicians. There are also imbalances within the specialist category, with certain specialists (e.g., cardiologists) being in oversupply compared to other European countries, while others (e.g., general practitioners) remain weakly represented. Inadequate planning of human resources for health, inadequate health financing policy regarding primary care, gatekeeping mechanisms, and medical power constitute the primary themes explaining the trends of physicians' population in Greece.

The cost of home care for patients with malignant neoplasms.

A microeconomic study evaluated the health sector cost of home care in Greece for patients with malignant neoplasms. A cost-identification analysis was performed from the home care service's perspective. According to the results of the study, the cost varies among the main categories of malignant neoplasms because of a fluctuation in the cost of drugs, whereas the main cost-driver factor is the cost of laboratory tests. In comparison with the corresponding cost of in-hospital care, the cost of home care for patients with malignant neoplasms is significantly lower, which also is confirmed by the results of other international studies.