2013

I.

1.
2.
3.
4.
5.

5
7
7
10
10

II.

12

III.

22

1.

22

1.1.
1.1.1.
1.2.

22
22
28

2. -

31

2.1.
2.2.

31
40

3.

42

3.1.
3.2.
3.3.
3.4.

42
44
48
49

4.

50

4.1.
4.2.
4.3.

50
50
51

5.

52

5.1.
5.2.
5.2.
5.3.

52
56
56
66

6.

68

6.1.
6.2.
6.3.

68
68
70

7.

71

7.1.
7.2.
7.3.

71
71
73

8.

75

8.1.
8.2.
8.3.

75
76
76

9.

77

9.1.
9.2.
9.3.

77
77
78

10.

80

10.1.
10.2.
10.3.
10.4.

80
96
97
99

11. -

100

11.1.
11.2.
11.3.

100
100
105

12. -

106

12.1
12.2.
12.3.

106
106
109

13.

111

13.1.
13.2.
13.3.

111
111
115

14.

117

14.1.
14.2.

117
124

IV.

128

V.

137

1.

2.

3.

143
145

VI.

151

138

1.
, 2012
2. :
:

(), 2012
3. :

, , 2013
4. TASK FORCE:
A FUTURE FOR PRIMARY CARE FOR THE GREEK POPULATION, 2013

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Delivery of Primary Health Care Services in New Brunswick. Discussion Paper, November
2010 (http://www.gnb.ca/0053/phc/pdf/2011/PrimaryHealthCareDiscussionPaper.pdf)

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available at http://www.who.int/whr/2008/whr08_en.pdf.
24

( 1).

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: World Health Organization, 2008.

( )
:11

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[First-contact care],

[Continuous (ongoing) care],

[Coordinated care],

[Comprehensive care].

Johns Hopkins School of Public Health, Measurement of Primary Care: Report on the Johns
Hopkins Primary Care Assessment Tool, December 2012.
25

[Family-centered care],

[Community-oriented care],

[Culturally competent care].

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Economou C. Greece. Health system review. Health Systems in Transition 2010, 12(7):1-180
Mossialos E, Allin S, Davaki K. Analysing the Greek health system: a tale of fragmentation
and inertia. Health Econ. 2005;14:S151-68.
28

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care. Geneva, 1978) : WHO, The World Health
Report, Primary Health Care: Now more than ever 2008, available at
http://www.who.int/whr/2008/whr08_en.pdf.

14

. : Johns Hopkins School of Public Health, Measurement of

Primary Care: Report on the Johns Hopkins Primary Care Assessment Tool, December 2012.
29

,
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5

Source: European Commission: Report on health inequalities in the European Union,

September 2013.
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. : Starfield, B. (1998). Primary care: Balancing health needs, services

and technology. New York: Oxford University Press.
31

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2011-2013 50% ( 2).

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18

(),

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. : World Health Organisation (WHO), Guidelines for the

psychosocially assisted pharmacological treatment of opioid dependence, 2009, www.
who.int/substance_abuse/activities/treatment_opioid_dependence/en/index.html,
WHO
32

2:
1984-2013

: (), 2013.

, :

,
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and UNODC Joint Programme on drug dependence treatment and care, Vienna, May 2009,
UNODC, Treatnet, Working towards evidence-based drug dependence treatment and care,
April 2010, EMCDDA and ECDC, Joint EMCDDA and ECDC rapid risk assessment, HIV in
injecting drug users in the EU/EEA, following a reported increase of cases in Greece and
Romania, November 2011 ECDC, Technical report, Risk assessment on HIV in Greece,
Stockholm, November 2012.
,
.
33

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3.
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: Boerma and Dubois, 2006.

21

Boerma, W.G.W. (2006), Coordination and integration in European primary care, in:
Primary care in the drivers seat? Organizational reform in European primary care, edited by
Richard B. Saltman, Ana Rico and Wienke G. W. Boerma, European Observatory on Health
Systems and Policies Series, Open University Press, UK.
42

,
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4:
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: OECD Health Data 2013.

22

Boerma W., Dubois CA., Mapping primary care across Europe in Primary Care in the
Drivers Seat? Organizational Reform in the European primary care. in: Saltman RB., Rico A.,
Boerma W.(eds), European Observatory on Health Systems and Policies, London: Open
University Press/ McGraw-Hill Education, 2006.
43

5:
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: OECD Health Data 2013.

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: Souliotis K., et . al., Barriers to accessing biologic treatment for rheumatoid

arthritis in Greece: the unseen impact of the fiscal crisisthe Health Outcomes
Patient Environment (HOPE) study, Rheumatol Int, DOI 10.1007/s00296-013-2866-1.

45

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Integrated Health Care System in Greece: A Primary Care Perspective, Journal of Medical
Systems, Vol. 18, No 6, 2004.

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Athanasakis K., Souliotis K., Kyriopoulos E.J., Loukidou E., Kritikou P., Kyriopoulos J.,
Inequalities in access to cancer treatment: an analysis of cross-regional patient mobility in
Greece, Supportive Care in Cancer, Mar;20(3):455-60, 2012.

32

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Boerma, W.G.W. (2006), Coordination and integration in European primary care, in:
Primary care in the drivers seat? Organizational reform in European primary care, edited by
Richard B. Saltman, Ana Rico and Wienke G. W. Boerma, European Observatory on Health
Systems and Policies Series, Open University Press, UK.
52

-
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. : Souliotis K, Lionis C., Creating an Integrated Health Care System in Greece:

A Primary Care Perspective, Journal of Medical Systems, Vol. 18, No 6, 2004.
56

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38

. : Psaltopoulou T, Orfanos P, Naska A, Lenas D, Trichopoulos D, Trichopoulou

A. Prevalence, awareness, treatment and control of hypertension in a general population
sample of 26,913 adults in the Greek EPIC study. Int J Epidemiol. 2004 Dec;33(6):1345-52,
Panagiotakos DB, Pitsavos C, Chrysohoou C, Skoumas I, Stefanadis C. Prevalence and fiveyear incidence (2001-2006) of cardiovascular disease risk factors in a Greek sample: the
ATTICA study. Hellenic J Cardiol. 2009 Sep-Oct;50(5):388-95, Minas M, Koukosias N, Zintzaras
E, Kostikas K, Gourgoulianis KI. Prevalence of chronic diseases and morbidity in primary
health care in central Greece: an epidemiological study. BMC Health Serv Res. 2010 Aug
28;10:252 Athanasakis K, Ollandezos M, Angeli A, Gregoriou A, Geitona M, Kyriopoulos J.
Estimating the direct cost of Type 2 diabetes in Greece: the effects of blood glucose
regulation on patient cost. Diabet Med. 2010 Jun;27(6):679-84.
61

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Christos Lionis Ch., Tsiraki M., Bardis V., Philalithis A., Seeking Quality Improvement in
Primary Care in Crete, Greece: the First Actions, Croatian Medical Journal, 45(5):599-603,
2004.
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Community Services, Long Term Care and Community Support Services Strategy, Association
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. 1:24-30, Kalokairinou A., Frounta M., Karagiannis J. et al. (2004), Home
Health in Greece. ICUS NURS WEB J, 17:1-9, Jan-March, Danielson E., Krogerus-Therman I.,
Sivertsen B., Sourtzi P. (2005) Nursing and public health in Europe a new continuous
education programme. International Nursing Review, 52: 3238 Kemp, L.A., Harris, E.
and Comino, E. (2005) Changes in community nursing in Australia: 19952000. Journal of
Advanced Nursing, 49(3): 30714.
101

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. : WHO (1974) Community Health Nursing. World Health Organisation

(WHO), Geneva, Kalokairinou A., Frounta M., Karagiannis J. et al. (2004), Home Health in
Greece. ICUS NURS WEB J, 17:1-9, Jan-March, Danielson E., Krogerus-Therman I., Sivertsen
B., Sourtzi P. (2005) Nursing and public health in Europe a new continuous education
programme. International Nursing Review, 52: 3238 Kemp, L.A., Harris, E. and Comino,
E. (2005) Changes in community nursing in Australia: 19952000. Journal of Advanced
Nursing, 49(3): 30714, Smith J. (2000) Community nursing and health care in the twentyfirst century. Australian Health Review, 23: 114121, Tablot, L., and Verrinder, G. (2005)
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Lionis Ch., Petelos E., The impact of the financial crisis on the quality of care in primary care:
an issue that requires a prompt attention, Quality in Primary Care 2013;21:26973.
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. :: Pink, D. et al (2002) Principles for Best Practice in Clinical Audit. 2002

National Institute for Clinical Excellence. Radcliffe Medical Press Ltd, Organization for
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112

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137

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<140/90 mmHg >65
<130/85 mmHg
<130/85 mmHg

: , , ,
,

: , ,
,


,

138

-

BMI<25
(
) <250 mg/dl

( ) 12


( )

139

, >18

HbA1c<8%

LDL-
LDL-<100
mg/dl
<130/85
mmHg
-

( )


HbA1c LDL- : HbA1c<8%, LDL<100 mg/dl, .. <130/85 mmHg

HbA1c
6

12

12

( ) 12
140

12

( )
12

>20%

-

BMI<25
<140/90
mmHg
<190 mg/dl
LDL-<115
mg/dl
DL->39
mg/dl >43 mg/dl

75 mg
141

(DMF & dmf)

6, 9, 12 15
(UNT)
-

142

2.

1.1.1.1.1.1.1
(.. ..
)

..


( ,
, )

- ,

- /1000
/
- Test Pap/1000
/
- /1000
/
- MMR/1000 12-15
/
- /1000/

143

- / 1000
/
- /1000
- /1000
- /1000
-

(
)

1.1.1.1.1.1.2

( ,
)

1.1.1.1.1.1.3

( ,
)

144

3.

:
:

.:

. 1 :

:
:
/ -:

. :
:

()

/
-/ :
:

()
()
()
()

:
1). :

(Alzheimers)
Parkinsons

.
. .

...

.
. C

.

2). :
(kgr)

(/2)

(cm)

3). :
). :
:
:
:
--./:

). :
:
:
/:

:
:

145

4). :

5). / :

6). :
1 :
...:
:
:
:
:
( ), ( ), ( ), ( ), ( )
:
:
:
: ( ), ( ), ( ), ( )
( ), ( ), ( ), ( )
:
:

:
/min:
..(mmHg):
...:
/min:
FEV1/P.E.F.:

146

/oC :
Ro :

:
-:

147

. (mmHg):
...

/min:

/ C:

-:

ICPC-2

148

ICD-10

:
:

.:

. :

. 1 :

. :
:
/ :
:
:
/ -:

:
:
. :
:

()

-/ :

/
/

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:
1). :
ICPC-2
ICD-10

( , , tics)
(, )

/Rhesus

2). :

G.6.P.D.:

DTP
OPV/IPV
MMR

BCG
HBV

149

1 .

3). :
(kgr)

(/2)

(cm)

4). :
). :
:

/.:

). (/) :
:
:

:
:

:
:

:
:

5). :

6). / :

7). :
1 :
...
:
:
:
:
( ), ( ), ( ), ( ), ( )
:

(Alzheimers)

.
. C

( )
( )

150

:
/min:
..(mmHg):
:

FEV1/PEF:

-:
:
( , ):
:
(, ):
:
(/ , , ):

( , , ):

151

VI.

152