Health Review | September – December 2022

Oral health is an integral part of overall human health. However, the reduction of public dental funding and chronic weaknesses of the Greek Health System has exacerbated inequalities in access to dental care. In this paper, we aim to uncover the current situation in Greece, regarding the provision of dental care and detect the necessary actions for adopting the historic World Health Organization (WHO) Resolution on Oral Health (May 2021), which mandates the universal coverage of oral health. Qualitative research was conducted, involving sixteen(16) health system experts, public health officials, as well as representatives of the wider dental community, and patients, who were invited to answer an eleven(11)-item questionnaire, through semi-structured in-depth interviews. The validity of the results was confirmed with the method of triangulation, using multiple data sources. A review of the literature and a search for statistical data in reliable databases were also performed. Low prioritization of oral health, understaffing of National Health System (NHS) dental departments, almost zero public dental funding, wide and deep inequalities, and exclusions of access to dental care were found. A National Oral Health Strategy as well as full integration of Dentistry into the Health System, the adoption of a minimum guaranteed share of public health funding dedicated to oral health, and the creation of an Observatory of Inequalities and Oral Health Policies are considered necessary actions for the significant improvement of the oral health status of the Greek population. The WHO Resolution on Oral Health is a call for action toward a modern, universal, effective, efficient, comprehensive, and human centered health system that gives dental care the place it deserves. Political will, a minimum guaranteed percentage of public health funding dedicated to oral health, and a National Strategy emerge as the pillars of this imperative reform.

The trend for quality, efficient, and productive financing of health service providers, especially Intensive Care Units (ICUs), has become increasingly evident in recent decades. In this study, we investigate the prospective reimbursement method, per case of hospitalization in the ICU, according to the Diagnostic Related Groups (DRGs), in the OECD countries, as well as the appropriateness of using the method, in the particular environment of the ICU. A systematic review of papers published up until July 2022 was conducted. The search was performed on PubMed, Medline, Scopus, ScienceDirect, and Google Scholar. The criteria for inclusion in this review were the calculation by researchers of the appropriateness of using DRGs in the ICU, as a method of reimbursement, through comparison with the actual cost of hospitalization of patients in the ICU. Only sixteen(16) of the scientific papers retrieved met the criteria for inclusion in this review. Ten(10) studies assessed the appropriateness of applying DRGs as a reimbursement method in adult ICUs and six(6) assessed the appropriateness of applying DRGs as a reimbursement method in Neonatal Intensive Care Units and pediatric ICUs. Discrepancies were observed between the actual cost of hospitalization and the reimbursement amount in all categories of ICUs. Finding the right DRG system, combined with other financing methods, would be a useful policy tool to help manage finances, contain costs, and provide quality health services.

Administrative staff of Hospitals was exposed to stressors that exacerbated negative emotions and exhaustion during the SARS-CoV-2 period. The purpose of the study is to determine the degree of occupational burnout of the administrative staff in a CoViD-19 Reference Hospital in Attica, and to analyze the effect of socio-demographic characteristics on the aforementioned variable. A quantitative synchronous approach has been used. As the research instrument, the Maslach Burnout Inventory was used to measure burnout levels in terms of the dimensions of emotional exhaustion, depersonalization, and personal accomplishment. T-test, analysis of variance (ANOVA), as well as non-parametric tests of Mann Whitney U and Kruskal Wallis tests, were applied. The level of statistical significance was set at 0.05. In this study, 69 women (72.6%) and 26 men (27.4%) participated. The age of majority is 45-55 years (58.95%), University/ATEI graduates (30.5%), and with 15-25 years of service (56.8%). The occupational burnout of administrators is high. High levels of emotional exhaustion are observed with moderate degree of depersonalization and moderate degree of personal achievement. A statistically significant difference between gender and burnout is found, with women exhibiting higher levels of emotional exhaustion (p

The long-term social and economic consequences of CoViD-19 are uncertain. But, how do we count the cost of a pandemic, including millions of deaths, reduced life expectancy, and long-lasting health impacts? The pandemic, undoubtedly, has put health systems under extreme stress. We have had to adapt to changing circumstances while continuing to provide high-quality health care. Countries across all socioeconomic and development categories have struggled to implement effective national responses. Despite all the challenges, the CoViD-19 emergency has provided opportunities in developing more resilient health systems. The "Health Review", holding open an invitation to healthcare decision-makers and CEOs of the European Association of Hospital Managers (EAHM), shared content that responds to the pressing matters of 5 countries' capacities to prevent, detect, respond, and ensure proactive, coordinated action to both existing and emerging public health threats. We would like to express our sincere gratitude to our colleagues Nikolaus KOLLER (President of the Association of Austrian Hospital Managers), Prof. Pascal VERDONCK (Board member of the Belgian and European Association of Hospital Managers), Philippe BLUA (past President of the European Association of Hospital Managers), Marc HASTERT (Secretary General of the European Association of Hospital Managers, Luxembourg), and Xavier BARRETO (President of the Portuguese Association of Hospital Managers), who generously shared their time, experiences, and insights with us. Response strategies and a comparison of the different national prevention, control, and response strategies can pinpoint lessons that could help strengthen countries’ preparedness and reaction to future health challenges. Therefore, we explore the similarities and differences between the countries Austria, Belgium, France, Luxembourg, and Portugal, adding the Greek experience, regarding the response to CoViD-19 and strategies to reset health systems.