Greeks, in general, benefit from good health, with statistics showcasing low infant and child mortality, and life-expectancy that is at the same level of other European countries. However, chronic diseases in our country, as all around the world, constitute severe problems for our citizens.
For all those citizens affected by them, and for their family members, chronic diseases are often associated with premature death. Chronic diseases put a strain on our economic and social development because they impede productivity in our society – which is particularly problematic for Greece in its current situation where growth is highly desirable. As in all European Union member states, the management of chronic diseases is one of the most significant burdens on our health systems.
Most chronic diseases – cardiovascular and respiratory diseases, metabolic diseases including diabetes, mental and neurological diseases including dementia, cancer, and functional impairment after injuries – become more frequent as we grow older. But chronic diseases are also a reality for many children and young people. Management of chronic diseases in young people is partly different from its management in older age groups. With a strong emphasis not only on prevention and treatment, but also on rehabilitation, the management of chronic diseases aims to achieve a quality of life that is as high as possible.
"Even though physical and mental capabilities decrease during the late ageing process, chronic diseases are not compulsory companions to the inevitable end of human life"
Even though physical and mental capabilities decrease during the late ageing process, chronic diseases are not compulsory companions to the inevitable end of human life. On the contrary, an active life in working age, followed by physical and social activities at later ages, allow an increased chance to avoid chronic diseases until the very last few years of life. If such an active life is combined with healthy lifestyles, such as healthy nutrition, the possibilities of contracting premature chronic diseases decrease even further.
Although the individual human being, through their way of life, can make a great difference to their health and that of their family, chronic diseases strike unequally hard on underprivileged population groups. Our common commitment – as EU and national policymakers in the health arena – is to ensure access to high quality healthcare. This applies not only to healthcare, but to the application of ‘health in all policies’. Schools, the transport system, laws against smoking, protection against crime and other law offences and food security mitigate the risk of chronic diseases.
The Greek financial crisis is well known to all fellow Europeans. It was inevitable that the effects of the crisis would also strike our health systems, not because of the low economic budget, but because of the bad managerial decisions of the past. That is why our reforms had to point to self-restraint and self-sufficiency. Still, efforts had to be made to protect vulnerable groups against the negative effects of the crisis.
However, the strain put on the Greek health system has simultaneously created opportunities for long needed change – needs that have been recognised by Greek society, politicians and the academic community for decades, but which were not sufficiently acted upon. Greece entered a path that leads to reforms throughout our health system. Obviously the ageing of our population and the advances in health technology will call for more resources rather than less. But the overall idea is that reforms – in health as in many other socioeconomic subsystems – can optimise system design, achieving better results with the same resources. In a severe crisis, it may even be temporarily necessary to accept similar levels of results, but with fewer resources.
Greece’s health reforms include a public health programme driven by evidence-based and cost-effective prevention. The core of the reforms is the establishment of comprehensive primary healthcare structures. This allows community prevention of health threats that often lead to chronic diseases, and continuity of care for those already suffering from one or several chronic diseases. However, chronic disease treatment will increasingly include advanced diagnostic and therapeutic procedures, and, in order to make up-to-date care possible competence-wise and financially, our hospitals will benefit from management reforms. The financing of hospitals will be through a more elaborate diagnosis-related group system, including the improvement incentives that go with such systems.
Additionally, the provision and financing of pharmaceuticals, one of the key factors in disease management, are undergoing major changes. ICT systems, known as eHealth, are already needed for basic healthcare management, but also for quality development in healthcare. And most importantly, the development of human resources for health is increasingly vital, in particular with a stronger emphasis on teamwork among many health professionals and specialists.
All the above mentioned actions, which form the core of the Greek health sector reorganisation, could easily be described as the basis of an improved management of chronic diseases in our country. We are convinced that it is possible for Greece to achieve major changes even under the strain of perhaps the worst crisis in Europe for many decades.