The accessibility of vulnerable groups to health services in Greece: a Delphi study on the perceptions of health professionals

Karamitri, Ioanna; Bellali, Thalia; Galanis, Petros; Καϊτελίδου, Δάφνη

doi:10.1002/hpm.2115

Cited by 13 publications

(17 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Though PITC was deliberately initiated to tackle high prevalence of HIV/AIDS amongst the SAMs population, physicians were reluctant to encourage their patients to undertake HIV/AIDS testing (unless patients themselves requested) owing to a fear of being accused of racism. A survey of the opinions of health experts in Greece failed to reach a consensus on whether or not establishing a separate ward for migrants would increase the efficiency of healthcare service delivery, this resulted from fears that it might emphasise the perception of racial inequity [ 68 ]. This is something Worth et al [ 61 ] called the ‘fear of making cultural blunder’ in health practitioners.…”

Section: Discussionmentioning

confidence: 99%

Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens

Suphanchaimat

Kantamaturapoj

Putthasri

et al. 2015

BMC Health Serv Res

228

191

View full text Add to dashboard Cite

BackgroundIn recent years, cross-border migration has gained significant attention in high-level policy dialogues in numerous countries. While there exists some literature describing the health status of migrants, and exploring migrants’ perceptions of service utilisation in receiving countries, there is still little evidence that examines the issue of health services for migrants through the lens of providers. This study therefore aims to systematically review the latest literature, which investigated perceptions and attitudes of healthcare providers in managing care for migrants, as well as examining the challenges and barriers faced in their practices.MethodsA systematic review was performed by gathering evidence from three main online databases: Medline, Embase and Scopus, plus a purposive search from the World Health Organization’s website and grey literature sources. The articles, published in English since 2000, were reviewed according to the following topics: (1) how healthcare providers interacted with individual migrant patients, (2) how workplace factors shaped services for migrants, and (3) how the external environment, specifically laws and professional norms influenced their practices. Key message of the articles were analysed by thematic analysis.ResultsThirty seven articles were recruited for the final review. Key findings of the selected articles were synthesised and presented in the data extraction form. Quality of retrieved articles varied substantially. Almost all the selected articles had congruent findings regarding language andcultural challenges, and a lack of knowledge of a host country's health system amongst migrant patients. Most respondents expressed concerns over in-house constraints resulting from heavy workloads and the inadequacy of human resources. Professional norms strongly influenced the behaviours and attitudes of healthcare providers despite conflicting with laws that limited right to health services access for illegal migrants.DiscussionThe perceptions, attitudes and practices of practitioners in the provision of healthcare services for migrants were mainly influenced by: (1) diverse cultural beliefs and language differences, (2) limited institutional capacity, in terms of time and/or resource constraints, (3) the contradiction between professional ethics and laws that limited migrants’ right to health care. Nevertheless, healthcare providers addressedsuch problems by partially ignoring the immigrants’precarious legal status, and using numerous tactics, including seeking help from civil society groups, to support their clinical practice.ConclusionIt was evident that healthcare providers faced several challenges in managing care for migrants, which included not only language and cultural barriers, but also resource constraints within their workplaces, and disharmony between the law and their professional norms. Further studies, which explore health care management for migrants in countries with different health insurance models, are recommended.Electronic supplementary mater...

show abstract

Section: Discussionmentioning

confidence: 99%

Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens

Suphanchaimat

Kantamaturapoj

Putthasri

et al. 2015

BMC Health Serv Res

228

191

View full text Add to dashboard Cite

show abstract

“…A qualitative study [12] was conducted prior to this one, in order to construct the quantitative questionnaire of our study. A pilot quantitative study with 30 immigrants was carried out, in order to improve the comprehensibility of the questionnaire.…”

Section: Methodsmentioning

confidence: 99%

Public health services knowledge and utilization among immigrants in Greece: a cross-sectional study

Galanis

Sourtzi

Bellali

et al. 2013

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

BackgroundDuring the 90s, Greece has been transformed to a host country for immigrants mostly from the Balkans and Eastern European Countries, who currently constitute approximately 9% of the total population. Despite the increasing number of the immigrants, little is known about their health status and their accessibility to healthcare services. This study aimed to explore the perceived barriers to access and utilization of healthcare services by immigrants in Greece.MethodsA pilot cross-sectional study was conducted from January to April 2012 in Athens, Greece. The study population consisted of 191 immigrants who were living in Greece for less than 10 years. We developed a questionnaire that included information about sociodemographic characteristics, health status, public health services knowledge and utilization and difficulties in health services access. Statistical analysis included Pearson’s ×2 test, ×2 test for trend, Student’s t-test, analysis of variance and Pearson’s correlation coefficient.ResultsOnly 20.4% of the participants reported that they had a good/very good degree of knowledge about public health services in Greece. A considerable percentage (62.3%) of the participants needed at least once to use health services but they could not afford it, during the last year, while 49.7% used public health services in the last 12 months in Greece. Among the most important problems were long waiting times in hospitals, difficulties in communication with health professionals and high cost of health care. Increased ability to speak Greek was associated with increased health services knowledge (p<0.001). Increased family monthly income was also associated with less difficulties in accessing health services (p<0.001).ConclusionsThe empowerment and facilitation of health care access for immigrants in Greece is necessary. Depending on the needs of the migrant population, simple measures such as comprehensive information regarding the available health services and the terms for accessibility is an important step towards enabling better access to needed services.

show abstract

“…In the European Quality of Life survey respondents indicated distance (45 percent of respondents), delay of appointment (67 percent) waiting time to see a doctor (66 percent) and cost (64 percent) as a barriers to access in to healthcare in 2011; in addition there was a 50 percent increase in the reporting of unmet medical need in 2011 relative to 2007. A study by Karamitri et al (2013) looks at the perceptions of health professionals on the accessibility to health services by vulnerable people. Physicians report bureaucratic procedures, the lack of translation of access procedures and medical interpreters, as well as the lack of a link between primary and secondary healthcare, leading to a clustering of vulnerable people in emergency departments, as the main impediments to access.…”

Section: The Greek Health Systemmentioning

confidence: 99%

“…Several authors report on a marked deterioration in accessibility, especially for vulnerable people (uninsured, unemployed, migrants, older people, children etc. ), increases in suicide rates combined with a decrease in the spending for mental health, 40 percent cuts in hospital budgets, shortages in staff and medical supplies, and corruption in procurement and bribes (for example, see Economou et al 2014a, Kentikelenis et al 2011, 2014, Karanikolos et al 2013, Karamitri et al 2013, Kentikelenis and Papanicolas 2012, Karamanoli 2011.…”

Section: Introductionmentioning

confidence: 99%

Greece in Economic Crisis: The Case of Health and Education

Dassiou¹

2015

VJH

View full text Add to dashboard Cite

summary: In 2010 the Greek economy entered a deep economic crisis. This was the result of an accumulation of structural problems in the economy, including overspending and loss of competitiveness during the previous decades, translating into persistently large budget and trade deficits. In 2015, under its third Eu and IMF bailout, Greece has entered a spiral of depression that has led to its economy shrinking by one-third and unemployment skyrocketing to more than 25 percent, both a result of the austerity measures introduced as required to receive bailout funding. As a consequence, the health and education sectors have each experienced a reduction in public spending of more than one-third. We look at these two sectors before the crisis in the early 2000s, finding that a combination of delays, lack of enforcement, and reversals of urgently needed reforms resulted in obvious weaknesses not being corrected. This has prevented these two systems from delivering the social principles of equity in provision, equal opportunities for all, universal coverage, accessibility, and affordability. healthcare and education both lack oversight and evaluation mechanisms to ensure quality of service for its users. Additionally, there are no cost containment/efficiency mechanisms on the procurement side to avoid wasting taxpayers' money and valuable resources. This means that Greece has high cost/low outcome education and health systems. When the economic crisis struck, the ability of these two systems to deliver the above mentioned social objectives further deteriorated, as lower per capita spending on education, health and social protection lowered entitlements, benefits, and outcomes while increasing the burden of out of pocket expenses, user charges etc. We conclude by arguing that there is a need for a radical change in the institutional framework and governance of these two systems, by establishing truly independent regulators or agencies, answerable only to parliament) that can effectively exercise oversight over both the quality and the cost in the provision of health and education.→ JEl Classification: I11, I18, I21, I28

show abstract

The accessibility of vulnerable groups to health services in Greece: a Delphi study on the perceptions of health professionals

Cited by 13 publications

References 28 publications

Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens

Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens

Public health services knowledge and utilization among immigrants in Greece: a cross-sectional study

Greece in Economic Crisis: The Case of Health and Education

Contact Info

Product

Resources

About