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Tsampouri E, Kapetaniou K, Missiou A, Bakola M, Willems S, Van Poel E, Tatsioni A. Measures during the COVID-19 pandemic in public primary health care in Greece: is there still a missing link to universal health coverage? BMC PRIMARY CARE 2024; 24:287. [PMID: 38760684 PMCID: PMC11100090 DOI: 10.1186/s12875-024-02392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/12/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND The PRICOV-19 study aimed to assess the organization of primary health care (PHC) during the COVID-19 pandemic in 37 European countries and Israel; and its impact on different dimensions of quality of care. In this paper, we described measures taken by public PHC centers in Greece. Additionally, we explored potential differences between rural and non-rural settings. METHODS The study population consisted of the 287 public PHC centers in Greece. A random sample of 100 PHC centers stratified by Health Region was created. The online questionnaire consisted of 53 items, covering six sections: general information on the PHC center, patient flow, infection prevention, information processing, communication to patients, collaboration, and collegiality. RESULTS Seventy-eight PHC centers (78%) - 50 rural and 28 non-rural - responded to the survey. Certain measures were reported by few PHC centers. Specifically, the use of online messages about complaints that can be solved without a visit to the PHC center (21% rural; and 31% non-rural PHC centers), the use of video consultations with patients (12% rural; and 7% non-rural PHC centers), and the use of electronic medical records (EMRs) to systematically identify the list of patients with chronic conditions (5% rural; and 10% non-rural PHC centers) were scarcely reported. Very few PHC centers reported measures to support identifying and reaching out to vulnerable population, including patients that may have experienced domestic violence (8% rural; and 7% non-rural PHC centers), or financial problems (26% rural; and 7% non-rural PHC centers). Providing administrative documents to patients through postal mail (12% rural; and 21% non-rural PHC centers), or regular e-mail (11% rural; and 36% non-rural PHC centers), or through a secured server (8% rural; and 18% non-rural PHC centers) was rarely reported. Finally, providing information in multiple languages through a PHC website (12% rural PHC centers only), or an answering machine (6% rural PHC centers only), or leaflets (3% rural PHC centers only; and for leaflets specifically on COVID-19: 6% rural; and 8% non-rural PHC centers) were lacking in most PHC centers. CONCLUSION Our study captured measures implemented by few PHC centers suggesting potential priority areas of future improvement.
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Affiliation(s)
- Efthalia Tsampouri
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Konstantina Kapetaniou
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Aristea Missiou
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Bakola
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Sara Willems
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Esther Van Poel
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Athina Tatsioni
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
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Xie J, Liu M, Ding S, Zhong Z, Zeng S, Liu A, He S, Zhou J. Attitudes toward depression among rural primary healthcare providers in hunan areas, China: a cross sectional study. BMC MEDICAL EDUCATION 2023; 23:226. [PMID: 37038143 PMCID: PMC10088272 DOI: 10.1186/s12909-023-04197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Mental health services are not sufficient for depression patients in rural areas of China, training in mental health knowledge for primary healthcare providers has been encouraged, but the effect of this encouragement has rarely been reported. METHODS A cross-sectional survey was conducted in primary healthcare facilities that sought to include all the primary healthcare providers (registered physicians and nurses) in two cities in Hunan province, China by administering questionnaires that covered depression symptoms, typical depression cases, and the Revised Depression Attitude Questionnaire. RESULTS In total, 315 primary healthcare providers agreed to participate in the study and finished the questionnaires, of which 12.1% had training in depression. In addition, 62.9% of the rural primary healthcare providers were able to recognize most general depression symptoms, and 8.3% were able to recognize all general depression symptoms. The primary healthcare providers in the survey held a neutral to slightly negative attitude towards depression as indicated by their professional confidence (mean scores 16.51 ± 4.30), therapeutic optimism/pessimism (mean scores 29.02 ± 5.98), and general perspective (mean scores 18.12 ± 3.12) scores. Fewer rural primary healthcare providers knew (28.3%) or applied (2.9%) psychological intervention in the clinic. CONCLUSIONS Our study indicated that primary healthcare providers knew about general depression symptoms, but lacked psychological intervention skills and held low confidence in and pessimistic attitudes toward depression care. We therefore speculate that existing psychological training for primary healthcare providers is insufficient in quantity and quality, making the need to explore more effective types of training urgently.
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Affiliation(s)
- Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Min Liu
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China.
| | - Siqing Ding
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
| | - Zhuqing Zhong
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Sainan Zeng
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
| | - Aizhong Liu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Shiwen He
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China.
| | - Jianda Zhou
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
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Pinaka O, Gioulekas F, Routa E, Delliou A, Stamatiadis E, Dratsiou I, Romanopoulou E, Billinis C. Introducing New Paths towards Public Primary Healthcare Services in Greece: Efforts for Scaling-Up Mental Healthcare Services Addressed to Older Adults. Healthcare (Basel) 2022; 10:healthcare10071230. [PMID: 35885757 PMCID: PMC9320876 DOI: 10.3390/healthcare10071230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/23/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022] Open
Abstract
The exponential growth in the aging population challenges the Primary Care Providers (PCPs) who provide health care services to older adults who are considered highly vulnerable and are in need of specialized healthcare services. The development of new policies and the adoption of appropriate health strategies by PCPs may improve the early detection and prevention of mental disorders in older adults. This reduces both queuing and costs in outpatient clinics while preventing stigma for patients and families. To this end, specialized training for PCPs at the Local Primary Health Care Unit (LPHCU) was provided in order to conduct efficient assessments of older adults (65 and above years old, without previously diagnosed depression or dementia, and willing to participate). The assessment is based on the Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS). Older adults identified with MMSE <20 and GDS >5 were referred to the psychiatric outpatient clinic. The aim of this study is to discuss evidence-informed policymaking in Greece with a focus on advancing mental health practices and scaling up quality primary healthcare services for older adults.
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Affiliation(s)
- Ourania Pinaka
- 4th Local Primary Healthcare Unit of Ampelokipi Larissa, 5th Regional Health Authority of Thessaly & Sterea, 5–7 Myron, 41447 Larissa, Greece; (E.R.); (A.D.)
- Faculty of Public and One Health, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece;
- Correspondence: ; Tel.: +30-241-0534-235
| | - Fotios Gioulekas
- 5th Regional Health Authority of Thessaly & Sterea, Mezourlo Area, 41110 Larissa, Greece; (F.G.); (E.S.)
| | - Evlampia Routa
- 4th Local Primary Healthcare Unit of Ampelokipi Larissa, 5th Regional Health Authority of Thessaly & Sterea, 5–7 Myron, 41447 Larissa, Greece; (E.R.); (A.D.)
| | - Aikaterini Delliou
- 4th Local Primary Healthcare Unit of Ampelokipi Larissa, 5th Regional Health Authority of Thessaly & Sterea, 5–7 Myron, 41447 Larissa, Greece; (E.R.); (A.D.)
| | - Evangelos Stamatiadis
- 5th Regional Health Authority of Thessaly & Sterea, Mezourlo Area, 41110 Larissa, Greece; (F.G.); (E.S.)
| | - Ioanna Dratsiou
- Medical Physics Laboratory, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (I.D.); (E.R.)
| | - Evangelia Romanopoulou
- Medical Physics Laboratory, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (I.D.); (E.R.)
| | - Charalambos Billinis
- Faculty of Public and One Health, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece;
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Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units. PSYCH 2022. [DOI: 10.3390/psych4020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Almost a decade ago, an article published in the official journal of the Hellenic Psychiatric Association, concerning the state of Greek mental health reform, referred to the significant shortages of mental health staff and services in rural areas of the country [...]
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Peritogiannis V, Rousoudi S, Vorvolakos T, Gioti P, Gogou A, Arre A, Samakouri M. A comparative study of two Mobile Mental Health Units in different catchment rural areas in Greece. Int J Soc Psychiatry 2022; 68:324-333. [PMID: 33472480 DOI: 10.1177/0020764020985896] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mental healthcare service delivery in rural and remote areas in Greece is challenging due to socioeconomic and geographical reasons, and distant facilities. To address the needs of the underserved areas, the Greek state has launched a number of Mobile Mental Health Units (MMHUs). AIM The objective of the present study was to explore the differences among two MMHUs, one being run by a university general hospital (MMHU UHA) and the other being run by a nongovernmental organization (MMHU I-T). METHODS The two MMHUs deliver services in rural areas of northeast and northwest Greece, respectively. Both MMHUs use the infrastructures of the primary healthcare system and have the potential for domiciliary visits. RESULTS Medical and nursing staff is much more in the MMHU UHA, whereas MMHU I-T has more psychologists, social workers and health visitors. Patients attended the MMHU I-T were significantly older than the patients attended the MMHU UHA (mean age 64.5 vs. 55.3 years) and the percentage of the elderly patients in treatment with the MMHU I-T (56.5%) is significantly higher than the corresponding percentage of the MMHU UHA (20%). The proportion of patients that received home-based care by the two MMHUs was almost identical. The percentage of patients with schizophrenia spectrum disorders that attended the MMHU UHA was significantly higher. Patients with affective disorders, anxiety disorders and organic brain disorders that attended the MMHU I-T were significantly more. CONCLUSIONS Despite the similarities among the MMHUs in rural Greece, this study recorded some important differences. The differences in staffing may be accounted for by the availability of resources. The differences in the patients' population may be explained by the fact that the MMHU UHA was designed from its beginning to treat patients with severe mental illnesses, mainly psychoses, and it accepts loss of referrals within the general hospital's network of psychiatric services. The MMHU I-T is an independent, locally based service that may be better perceived as an expansion of the primary care system. The results of the study could inform service practice and mental health policy.
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Affiliation(s)
- Vaios Peritogiannis
- Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece
| | - Sofia Rousoudi
- Postgraduate Program in Social Psychiatry, Democritus University of Thrace, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagiota Gioti
- Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece
| | - Afroditi Gogou
- Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece
| | - Argiri Arre
- Postgraduate Program in Social Psychiatry, Democritus University of Thrace, Alexandroupolis, Greece.,Department of Psychiatry, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Maria Samakouri
- Department of Psychiatry, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.,Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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