9 research outputs found
Η επίδραση της οικονομικής κρίσης στην υγεία και τη χρήση υπηρεσιών υγείας των κατοίκων της Ελλάδας
No full textΥπόβαθρο/Σκοπός: Το 2009, η Ελλάδα εισήλθε σε μια παρατεταμένη περίοδο ύφεσης και υιοθέτησε μέτρα λιτότητας, που επηρέασαν σε μεγάλο βαθμό πολλές πτυχές της κοινωνικοοικονομικής ζωής, συμπεριλαμβανομένου του τομέα υγείας. Σκοπός της παρούσας διατριβής ήταν η διερεύνηση της κατάστασης της υγείας και της χρήσης των υπηρεσιών υγείας στον ελληνικό πληθυσμό στο πλαίσιο της κρίσης. Μέθοδοι: Χρησιμοποιήθηκαν τα δεδομένα δύο συγχρονικών ερευνών, που διεξήχθησαν στον πληθυσμό των ενηλίκων της ευρύτερης περιοχής της Αθήνας το 2003 και το 2016, για να διερευνηθούν ενδεχόμενες μεταβολές της Σχετιζόμενης με την Υγεία Ποιότητας Ζωής (ΣΥΠΖ) και να εκτιμηθούν ο ρόλος της οικονομικής κρίσης και άλλων κοινωνικοοικονομικών και δημογραφικών παραγόντων στη διαμόρφωση της ΣΥΠΖ. Επιπλέον, δύο εθνικές έρευνες υγείας, που διεξήχθησαν στον πληθυσμό ηλικίας 15 ετών και άνω το 2009 και το 2014, χρησιμοποιήθηκαν για τη διερεύνηση των τάσεων και των προσδιοριστών του επιπέδου υγείας και της χρήσης της υγειονομικής περίθαλψης. Εφαρμόστηκαν οι στατιστικοί έλεγχοι Mann-Whitney U και χ2 για τη διερεύνηση στατιστικά σημαντικών διαφορών και αναλύσεις παλινδρόμησης για τη διερεύνηση των προσδιοριστών του επιπέδου υγείας και της χρήσης των υπηρεσιών υγείας. Αποτελέσματα: Η συνοπτική κλίμακα της σωματικής υγείας βελτιώθηκε και η συνοπτική κλίμακα ψυχικής υγείας επιδεινώθηκε σε σχέση με τα προ κρίσης επίπεδα. Η ηλικία, το φύλο, η λήψη σύνταξης και το χαμηλό εισόδημα ήταν οι ισχυρότεροι προσδιοριστές για τη σωματική διάσταση, ενώ η ηλικία, το διαζύγιο, η χηρεία και οι συνθήκες οικονομικής κρίσης ήταν οι ισχυρότεροι προσδιοριστές για την ψυχική διάσταση της ΣΥΠΖ. Το 2014 σε σχέση με το 2009, το ποσοστό των συμμετεχόντων με ένα ή περισσότερα χρόνια προβλήματα υγείας αυξήθηκε και το ποσοστό εκείνων με πολύ κακή/κακή/μέτρια κατάσταση υγείας δε μεταβλήθηκε σημαντικά. Οι πιο σημαντικοί προσδιοριστές για το αυτοεκτιμώμενο επίπεδο υγείας ήταν η ηλικία, το εκπαιδευτικό επίπεδο, η λήψη σύνταξης, η νοσηρότητα και η έντονη ενόχληση πόνου, ενώ για τη νοσηρότητα από χρόνια προβλήματα υγείας η ηλικία, το διαζύγιο/χηρεία και η ιδιότητα του συνταξιούχου. Επίσης, το ποσοστό των χρηστών των υπηρεσιών των «ειδικών» ιατρών μειώθηκε, το ποσοστό των εισαχθέντων στο νοσοκομείο για ημερήσια νοσηλεία αυξήθηκε, ενώ τα ποσοστά των νοσηλευθέντων με διανυκτέρευση και των χρηστών των υπηρεσιών των γενικών ιατρών δε μεταβλήθηκαν στατιστικά σημαντικά. Οι ισχυρότεροι προσδιοριστές της χρήσης εξωνοσοκομειακών υπηρεσιών ήταν το αυτοεκτιμώμενο επίπεδο υγείας και ο χρόνος διεξαγωγής της έρευνας ως εκφραστής του γενικότερου πλαισίου και των συνθηκών κρίσης, ενώ τη μεγαλύτερη προβλεπτική αξία για τη χρήση ενδονοσοκομειακών υπηρεσιών είχαν κυρίως οι σχετιζόμενοι με την υγειονομική ανάγκη παράγοντες. Συμπεράσματα: Ο προσδιορισμός της προκυκλικής ή αντικυκλικής φύσης και συμπεριφοράς των μεταβλητών του επιπέδου υγείας και της χρήσης της υγειονομικής περίθαλψης, αλλά και των προσδιοριστών τους, αποτελεί σημαντική προτεραιότητα προκειμένου να βελτιωθεί η πρόσβαση στο σύστημα υγείας και να προωθηθεί η ισότητα στην υγεία.Background/Aim: In 2009, Greece entered a prolonged recession period and adopted austerity measures, which have profoundly affected many aspects of social sector, including health sector. The objective of this study was to investigate health status and health services utilization in the Greek population in the context of the crisis and its determinants. Methods: Two cross-sectional surveys of the adult residents of Athens conducted in 2003 and 2016 surveys were used to analyze possible changes in Health-related Quality of Life and estimate the role of the economic crisis and other demographic and socio-economic factors. Additionally, two National Health Surveys of the population aged 15 and over, conducted in 2009 and 2014 were used to investigate trends in healthcare utilization and its determinants. Mann–Whitney tests and chi-square tests were applied to estimate possible statistically significant differences and regression analyses were performed to identify significant determinants of health status and healthcare utilization. Results: Physical component summary score (PCS) has improved and Mental Component Summary score (MCS) has deteriorated. The most important determinants of PCS were age, gender, being retired and low income and of MCS age, being divorced or widowed and financial crisis conditions (survey year was used as a proxy measure of crisis). Between 2009 and 2014, the percentage of participants who reported one or more chronic health problems increased and the percentage of those with very bad/bad/fair health status did not change significantly. The most important predictors of self-rated health status were age, educational attainment, being retired, morbidity and experiencing pain and regarding self-reported morbidity, age, being divorced/widowed and retired had the strongest impact. Additionally, the share of those who had visited a specialist decreased, the share of same-day patients increased, whereas that of those who had visited a general practitioner or had been hospitalized did not change significantly. The strongest predictors of outpatient healthcare utilization were self-rated health and being surveyed in 2014, while concerning inpatient care, need-related factors had the strongest effect. Conclusions: Identifying the procyclical or counter-cyclical nature of health status and healthcare utilization and the association with their determinants is an important priority in order to improve access and promote health equity
Health services utilization and its determinants in the context of recession: evidence from Greece.
No full textBACKGROUND: In 2009, Greece entered a prolonged economic recession and adopted austerity reforms, which have profoundly affected many aspects of health sector, including health services use. The objective of this study was to investigate healthcare utilization in the Greek population in the context of austerity and its determinants. METHODS: Two National Health Surveys of the population aged 15 and over, conducted in 2009 and 2014-before and after the adoption of austerity measures-, were used to analyse possible changes in healthcare utilization and its determinants applying chi-square tests, Mann-Whitney U-tests and generalized linear models. RESULTS: Between 2009 and 2014, the share of those who had visited a specialist decreased, whereas that of those who had visited a general practitioner or had been hospitalized did not change significantly. The number of outpatient consultations decreased and the number of nights spent in hospital did not change significantly. The strongest predictors were self-rated health, presence of chronic diseases and experiencing pain. CONCLUSIONS: Identifying the procyclical or counter-cyclical nature of healthcare utilization and the association between utilization and its determinants in different settings is an important priority in order to improve access and promote health equity
The impact of economic crisis on health status and health services utilization in Greece
No full textBackground/Aim: In 2009, Greece entered a prolonged recession period and adopted austerity measures, which have profoundly affected many aspects of social sector, including health sector. The objective of this study was to investigate health status and health services utilization in the Greek population in the context of the crisis and its determinants. Methods: Two cross-sectional surveys of the adult residents of Athens conducted in 2003 and 2016 surveys were used to analyze possible changes in Health-related Quality of Life and estimate the role of the economic crisis and other demographic and socio-economic factors. Additionally, two National Health Surveys of the population aged 15 and over, conducted in 2009 and 2014 were used to investigate trends in healthcare utilization and its determinants. Mann–Whitney tests and chi-square tests were applied to estimate possible statistically significant differences and regression analyses were performed to identify significant determinants of health status and healthcare utilization. Results: Physical component summary score (PCS) has improved and Mental Component Summary score (MCS) has deteriorated. The most important determinants of PCS were age, gender, being retired and low income and of MCS age, being divorced or widowed and financial crisis conditions (survey year was used as a proxy measure of crisis). Between 2009 and 2014, the percentage of participants who reported one or more chronic health problems increased and the percentage of those with very bad/bad/fair health status did not change significantly. The most important predictors of self-rated health status were age, educational attainment, being retired, morbidity and experiencing pain and regarding self-reported morbidity, age, being divorced/widowed and retired had the strongest impact. Additionally, the share of those who had visited a specialist decreased, the share of same-day patients increased, whereas that of those who had visited a general practitioner or had been hospitalized did not change significantly. The strongest predictors of outpatient healthcare utilization were self-rated health and being surveyed in 2014, while concerning inpatient care, need-related factors had the strongest effect. Conclusions: Identifying the procyclical or counter-cyclical nature of health status and healthcare utilization and the association with their determinants is an important priority in order to improve access and promote health equity.Υπόβαθρο/Σκοπός: Το 2009, η Ελλάδα εισήλθε σε μια παρατεταμένη περίοδο ύφεσης και υιοθέτησε μέτρα λιτότητας, που επηρέασαν σε μεγάλο βαθμό πολλές πτυχές της κοινωνικοοικονομικής ζωής, συμπεριλαμβανομένου του τομέα υγείας. Σκοπός της παρούσας διατριβής ήταν η διερεύνηση της κατάστασης της υγείας και της χρήσης των υπηρεσιών υγείας στον ελληνικό πληθυσμό στο πλαίσιο της κρίσης. Μέθοδοι: Χρησιμοποιήθηκαν τα δεδομένα δύο συγχρονικών ερευνών, που διεξήχθησαν στον πληθυσμό των ενηλίκων της ευρύτερης περιοχής της Αθήνας το 2003 και το 2016, για να διερευνηθούν ενδεχόμενες μεταβολές της Σχετιζόμενης με την Υγεία Ποιότητας Ζωής (ΣΥΠΖ) και να εκτιμηθούν ο ρόλος της οικονομικής κρίσης και άλλων κοινωνικοοικονομικών και δημογραφικών παραγόντων στη διαμόρφωση της ΣΥΠΖ. Επιπλέον, δύο εθνικές έρευνες υγείας, που διεξήχθησαν στον πληθυσμό ηλικίας 15 ετών και άνω το 2009 και το 2014, χρησιμοποιήθηκαν για τη διερεύνηση των τάσεων και των προσδιοριστών του επιπέδου υγείας και της χρήσης της υγειονομικής περίθαλψης. Εφαρμόστηκαν οι στατιστικοί έλεγχοι Mann-Whitney U και χ2 για τη διερεύνηση στατιστικά σημαντικών διαφορών και αναλύσεις παλινδρόμησης για τη διερεύνηση των προσδιοριστών του επιπέδου υγείας και της χρήσης των υπηρεσιών υγείας. Αποτελέσματα: Η συνοπτική κλίμακα της σωματικής υγείας βελτιώθηκε και η συνοπτική κλίμακα ψυχικής υγείας επιδεινώθηκε σε σχέση με τα προ κρίσης επίπεδα. Η ηλικία, το φύλο, η λήψη σύνταξης και το χαμηλό εισόδημα ήταν οι ισχυρότεροι προσδιοριστές για τη σωματική διάσταση, ενώ η ηλικία, το διαζύγιο, η χηρεία και οι συνθήκες οικονομικής κρίσης ήταν οι ισχυρότεροι προσδιοριστές για την ψυχική διάσταση της ΣΥΠΖ. Το 2014 σε σχέση με το 2009, το ποσοστό των συμμετεχόντων με ένα ή περισσότερα χρόνια προβλήματα υγείας αυξήθηκε και το ποσοστό εκείνων με πολύ κακή/κακή/μέτρια κατάσταση υγείας δε μεταβλήθηκε σημαντικά. Οι πιο σημαντικοί προσδιοριστές για το αυτοεκτιμώμενο επίπεδο υγείας ήταν η ηλικία, το εκπαιδευτικό επίπεδο, η λήψη σύνταξης, η νοσηρότητα και η έντονη ενόχληση πόνου, ενώ για τη νοσηρότητα από χρόνια προβλήματα υγείας η ηλικία, το διαζύγιο/χηρεία και η ιδιότητα του συνταξιούχου. Επίσης, το ποσοστό των χρηστών των υπηρεσιών των «ειδικών» ιατρών μειώθηκε, το ποσοστό των εισαχθέντων στο νοσοκομείο για ημερήσια νοσηλεία αυξήθηκε, ενώ τα ποσοστά των νοσηλευθέντων με διανυκτέρευση και των χρηστών των υπηρεσιών των γενικών ιατρών δε μεταβλήθηκαν στατιστικά σημαντικά. Οι ισχυρότεροι προσδιοριστές της χρήσης εξωνοσοκομειακών υπηρεσιών ήταν το αυτοεκτιμώμενο επίπεδο υγείας και ο χρόνος διεξαγωγής της έρευνας ως εκφραστής του γενικότερου πλαισίου και των συνθηκών κρίσης, ενώ τη μεγαλύτερη προβλεπτική αξία για τη χρήση ενδονοσοκομειακών υπηρεσιών είχαν κυρίως οι σχετιζόμενοι με την υγειονομική ανάγκη παράγοντες. Συμπεράσματα: Ο προσδιορισμός της προκυκλικής ή αντικυκλικής φύσης και συμπεριφοράς των μεταβλητών του επιπέδου υγείας και της χρήσης της υγειονομικής περίθαλψης, αλλά και των προσδιοριστών τους, αποτελεί σημαντική προτεραιότητα προκειμένου να βελτιωθεί η πρόσβαση στο σύστημα υγείας και να προωθηθεί η ισότητα στην υγεία
Gender Differences in Health-Related Quality of Life (HRQL) of Overweight and Obese Adults in a Representative Sample of Greek Urban Population.
No full textBACKGROUND: The main objective was to investigate the relationship between Health-Related Quality of Life (HRQL) and Body Mass Index (BMI) status according to gender in a representative sample of Greek urban population. METHODS: In this cross-sectional study, data were collected from 1060 participants (mean age 47.10 yr, 95%CI 46.09-48.07, 52.7% females) in a stratified sample of representative urban population during 1-20 Apr 2016 in Athens, Greece. Socio-demographic characteristics and medical history were involved. BMI (kg/m(2)) was calculated, based on reported height and weight. HRQL was assessed by using the Greek version of SF36. Parametric tests and multiple logistic regression analysis were applied to identify whether socio-demographic characteristics differed across BMI groups. Mann-Whitney test was used to detect significant differences in SF36 scales between men and women across different BMI and age groups. Multivariate stepwise linear regression analyses were performed to investigate the influence of sociodemographic variables on HRQL. RESULTS: The effect of being overweight or obese differs by age and gender and that this negative impact in HRQL was greater in women than in men. More vulnerable were overweight young and obese middle-aged woman both in terms of physical and mental health. On the other hand, HRQL of normal weight men and women did not differ in almost all age groups. CONCLUSION: Gender differences on HRQL observed in the general population were mediated by the different way that the two genders affected by increases in body weight
Quality of Life of Donors After Living Kidney Transplantation: A Cross-Sectional Study
No full textLiving kidney transplantation yields better outcomes for recipients than deceased donation, though it may present long-term challenges for donors. This study assessed the quality of life (QoL) of living kidney donors in Greece using the SF-36 questionnaire and examined associated sociodemographic and clinical factors. This cross-sectional study included 242 clinically stable kidney donors from Laiko General Hospital’s Kidney Donor Outpatient Clinic in Athens. Data on demographics, comorbidities, laboratory parameters, and QoL were collected. Spearman’s correlation coefficients were used to identify associations between QoL scores and influencing factors. The majority of donors were female (73.55%). Donors reported high QoL, with median PCS and MCS scores of 55.27 (49.08–57.73) and 54.17 (46.64–59.93), respectively. Male donors had higher PCS and MCS scores than females (p = 0.028 and p = 0.004). Laparoscopic nephrectomy was associated with better mental health and physical outcomes compared to open surgery (p < 0.001). Higher education and eGFR correlated with better PCS scores, while older age negatively affected QoL (p < 0.05). Living kidney donors reported a satisfactory level of overall QoL post-donation. Lower QoL scores were correlated with the female gender, older age, and open nephrectomy. These findings may further reinforce support for our current organ donation policy. Non-modifiable factors appear to influence donor quality of life. These findings reinforce the current organ donation policy while emphasizing the need for careful pre-transplant counseling and ongoing monitoring post-donation. © 2025 by the authors
Increased body mass index and hypertension: An unbreakable bond
No full textBackground: Adherence with lifestyle recommendations is low among hypertensive patients. The main objective of this study was to assess the prevalence of diagnosed hypertension among the Greek urban population and to examine how lifestyle and sociodemographic characteristics differ between already known hypertensive and the rest of the population. Methods: In this cross-sectional survey, data were collected from 1,060 participants (mean age 47.1 +/- 16.9 (mean +/- 1standard deviation), 52.7% females). Sociodemographic characteristics, health risk factors, and medical history were involved. Body mass index (BMI) (kg/m2) was calculated, according to reported height and weight. Parametric tests and multiple logistic regression analysis were applied to identify whether socio-demographic characteristics and health risk factors differed between known hypertensive and the rest of the population. Results: Already known hypertensives were 179 (101 females-78 males). The prevalence of known hypertension was 16.9% (18.1% in females and 15.6% in males). In multivariate analysis, known hypertensives were more likely to have advanced age (P < 0,001, OR = 1.101, 95%CI 1.081-1.121) and increased BMI (P < 0,001, OR = 1.138, 95%CI 1.085-1.194). Moreover, they had a higher probability of suffering from other cardiovascular diseases or sharing other risk factors for cardiovascular diseases. Conclusions: Among Greek urban population, almost one to six adults knows to suffer from hypertension. In spite the recommendations, patients who were aware of their illness have increased BMI compared with the rest of the population
Quality of Life of Donors After Living Kidney Transplantation: A Cross-Sectional Study
No full textLiving kidney transplantation yields better outcomes for recipients than deceased donation, though it may present long-term challenges for donors. This study assessed the quality of life (QoL) of living kidney donors in Greece using the SF-36 questionnaire and examined associated sociodemographic and clinical factors. This cross-sectional study included 242 clinically stable kidney donors from Laiko General Hospital’s Kidney Donor Outpatient Clinic in Athens. Data on demographics, comorbidities, laboratory parameters, and QoL were collected. Spearman’s correlation coefficients were used to identify associations between QoL scores and influencing factors. The majority of donors were female (73.55%). Donors reported high QoL, with median PCS and MCS scores of 55.27 (49.08–57.73) and 54.17 (46.64–59.93), respectively. Male donors had higher PCS and MCS scores than females (p = 0.028 and p = 0.004). Laparoscopic nephrectomy was associated with better mental health and physical outcomes compared to open surgery (p < 0.001). Higher education and eGFR correlated with better PCS scores, while older age negatively affected QoL (p < 0.05). Living kidney donors reported a satisfactory level of overall QoL post-donation. Lower QoL scores were correlated with the female gender, older age, and open nephrectomy. These findings may further reinforce support for our current organ donation policy. Non-modifiable factors appear to influence donor quality of life. These findings reinforce the current organ donation policy while emphasizing the need for careful pre-transplant counseling and ongoing monitoring post-donation
The Evolution of Living Donor Nephrectomy Program at A Hellenic Transplant Center. Laparoscopic vs. Open Donor Nephrectomy: Single-Center Experience
No full textSince its introduction in 1995, laparoscopic nephrectomy has emerged as the preferred surgical approach for living donor nephrectomy. Given the ubiquity of the surgical procedure and the need for favorable outcomes, as it is an elective operation on otherwise healthy individuals, it is imperative to ensure appropriate preoperative risk stratification and anticipate intraoperative challenges. The aim of the present study was to compare peri-and postoperative outcomes of living kidney donors (LD), who had undergone laparoscopic nephrectomy (LDN), with a control group of those who had undergone open nephrectomy (ODN). Health-related quality of life (QoL) was also assessed using the validated SF-36 questionnaire. Data from 252 LD from a single transplant center from March 2015 to December 2020 were analyzed retrospectively. In total, 117 donors in the LDN and 135 in the ODN groups were assessed. Demographics, type of transplantation, BMI, duration of surgery, length of hospital stay, peri- and postoperative complications, renal function at discharge and QoL were recorded and compared between the two groups using Stata 13.0 software. There was no difference in baseline characteristics, nor in the prevalence of peri-and postoperative complications, with a total complication rate of 16% (mostly minor, Clavien–Dindo grade II) in both groups, while a different pattern of surgical complications was noticed between them. Duration of surgery was significantly longer in the ODN group (median 240 min vs. 160 min in LDN, p < 0.01), warm ischemia time was longer in the LDN group (median 6 min vs.2 min in ODN, p < 0.01) and length of hospital stay shorter in the LDN group (median 3 days vs. 7 days in ODN). Conversion rate from laparoscopic to open surgery was 2.5%. There was a drop in estimated glomerular filtration rate (eGFR) at discharge of 36 mL/min in the LDN and 32 mL/min in the ODN groups, respectively (p = 0.03). No death, readmission or reoperation were recorded. There was a significant difference in favor of LDN group for each one of the eight items of the questionnaire (SF1–SF8). As for the two summary scores, while the total physical component summary (PCS) score was comparable between the two groups (57.87 in the LDN group and 57.07 in the ODN group), the mental component summary (MCS) score was significantly higher (62.14 vs. 45.22, p < 0.001) in the LDN group. This study provides evidence that minimally invasive surgery can be performed safely, with very good short-term outcomes, providing several benefits for the living kidney donor, thereby contributing to expanding the living donor pool, which is essential, especially in countries with deceased-donor organ shortage
