Rostrum of Asclepius Vol 18, No. 4 (2019): October - December 2019

Most of the current knowledge about the management of human resources derive from the field of business and enterprises. It appears that despite the wide spectrum of capabilities of the employees, the financial crisis has caused many obstacles in its substantial development. This phenomenon has a direct impact on the effectiveness and efficiency of our health system. A meticulous research was conducted in various online databases (Medline, PubMed, Scopus) using the following keywords: human resourses, management of working force, health organization, productivity, effectivenes, development, management of healthcare systems, design, financial crisis. The effective management of the available human resources is multifactorial. The management of employees in a health organization calls should aim in maximizing the productivity and accomplishing the main aims of the organization. The efficiency and productivity of employees is inextricably correlated with the prospect of development, motivation, good working environment, continuous education and the overall satisfaction of each employee.

Keywords: Management of working force, productivity, effectiveness, management of healthcare systems

Οbesity is a cοmplex disease that has unfavοrable impacts fοr all ethnic pοpulatiοns in wοrldwide. Genetics, envirοnment and lifestyle are sοme οf the aetiοlοgical factοrs οf this disease. Genetic cοntributiοn related tο this disease, is generally classified intο 2 types: mοnοgenic syndrοmes that display severe οbesity, and the pοlygenic mοdel οf cοmmοn οbesity. Single-gene mutatiοns can cause severe οbesity resulting frοm alteratiοn in central and peripheral appetite cοntrοl mechanisms. Candidate gene and genοme-wide assοciatiοn studies have led tο the identificatiοn οf nine lοci assοciated with Mendelian fοrms οf οbesity and 58 lοci cοntributing tο pοlygenic οbesity. These lοci explain a small fractiοn οf the heritability fοr οbesity and many genes remain tο be identified. The interactiοn οf several pοlymοrphisms and epigenetic mοdificatiοns οpen a new research field fοr cοmmοn οbesity. Hοwever, further research still needs tο be held in οrder that safe cοnclusiοn be drawn.

Keywords: Genetics, οbesity, bοdy mass index, gene

Stroke care comes increasingly difficult where there is austerity due to poor resource allocation and the demanding nature of the condition itself. This places special demands for updated clinical excellence and optimum organisation of scarce care services. Stroke remains a leading cause of mortality, as well as of subsequent serious long-term physical and mental morbidity. Thus, many western countries have developed and implemented public informative strategies. This cannot be easily ‘translated’ in Greece due to special features on the hospital administration system such as a unique rotation system for acute admissions. New policy decisions are needed to improve stroke services but these are deferred due to lack of funding and the technical knowhow required. Currently, Greece is not in a position to host a sophisticated Comprehensive Stroke Center, offering the highest level of specialized stroke prevention and stroke care. Yet, by creating short-term solutions as in the case of stroke bays, local experts would be able to provide the highest level of care from the second the patient is admitted to the emergency room through to his/her stroke recovery. Still, despite the adverse conditions, clinicians within the Greek health care system have been exceeding themselves in their attempt to provide optimum care outcomes.

Keywords: Stroke care, stroke units, nursing, austerity

The demand inducement for health services refers to the tendency of physicians to prescribe higher cost of treatment and higher quantity of health services than the patient would have chosen if he had the knowledge of the doctor. Therefore, this is due to information asymmetry and the agency relationship between doctors and their patients, leading to waste of resources and increased costs as a result of overconsumption of health services beyond the 'Pareto Optimum' (allocative efficiency). Typical examples in Greece are the large proportion of cesarean sections and the increased pharmaceutical expenditure, which is twice as high as the OECD average. During the years of the financial crisis, a variety of fiscal policy measures have been taken, emerged as a field of resource-saving policies, with representative examples the system of e-Prescribing medicines and control system based on therapeutic protocols, the promotion of generics in order to address over-prescription and the implementation of Diagnostic Related Groups (DRGs) as a method of reimbursement in hospitals. Despite the initial spectacular declining numbers of health expenditure, the results were ambiguous necessitating redefinition and new goal setting as well as the mixture of health policies.

Keywords: Demand inducement, health services, measures of health policies, Greece, pharmaceutical expenditure, DRGs

Introduction: The recent socioeconomic crisis created an imperative need to empower the non-hospital structures that provide care services to the elderly. In Greece, the programs “Helping Elderly at Home” and “Social Care” are the most widespread kind of non-institutional care services. Aim: To investigate user satisfaction with the services provided by a provincial care program “Helping Elderly at Home” and its determinants. Material and Method: A cross-sectional study was conducted during March and April 2017 and the study population consisted of 138 elderly people from 65 to 90 years old. Data were collected by means of two anonymous questionnaires that were completed voluntarily by the participants. Results: The level of complete satisfaction was quite high (4,05 on a measuring scale 1-5). Among demographic factors found to be significantly correlated with overall satisfaction, participants of greater age and those who had more frequent visits by the personnel reported higher satisfaction. Furthermore, longer participation at the program and increased frequency of visits were correlated with higher satisfaction by the personnel, higher satisfaction by the participants’ socioeconomic condition and higher satisfaction by the program effectiveness. Conclusions: The empowerment of the program “Helping Elderly at Home”, in the context of applying preventive and health promotion actions, could improve the quality of life of the elderly, acting as a compensatory factor to the Greek socioeconomic crisis.

Keywords: Help at home, satisfaction, quality of life, health level