Rostrum of Asclepius Vol 3, No. 1 (2004): January - March 2004

The current trend defining the supply of Health Services, like cost, administration and quality focus in illness prevention, health promotion and rehabilitation. These targets are achieved by Primary Health £are services as Alma-Ata has ordered. Nursing takes a large piece of the pie (percentage) and offers valuable services in Primary Health £are. In USA, nursing participation in prevention, health promotion and rehabilitation is important and respectable. £ommunity needs have pushed nurses towards specialization in public health (public health nurse). In addition the high cost of illness and disability has created rehabilitation nursing. In Europe, in countries where Primary Health care is established, nursing participation in prevention is a fact. Nurses cooperate with other health care professionals and are divided in fields as determined by the primary health care via health centres, of rural or urban type. In Greece, even though the legal and organizational frame exists (number 15 of LI397/83) stating that nursing participation is unexceptional, in fact nursing participation is poor. In national level predefined targets have not been achieved and nursing has failed to take its place in prevention in the community. The solution is to get the plan activated. That demands social sensitisation and maturity of the state but also efforts by the nurses. Only by specialization in public health, community and rehabilitation nursing we could be dynamically present in the community showing not only scientific but a humanistic profile as well.

Keywords: Prevention, primary health care, public health Nursing, community Nursing

The current trend defining the supply of Health Services, like cost, administration and quality focus in illness prevention, health promotion and rehabilitation. These targets are achieved by Primary Health £are services as Alma-Ata has ordered. Nursing takes a large piece of the pie (percentage) and offers valuable services in Primary Health £are. In USA, nursing participation in prevention, health promotion and rehabilitation is important and respectable. £ommunity needs have pushed nurses towards specialization in public health (public health nurse). In addition the high cost of illness and disability has created rehabilitation nursing. In Europe, in countries where Primary Health care is established, nursing participation in prevention is a fact. Nurses cooperate with other health care professionals and are divided in fields as determined by the primary health care via health centres, of rural or urban type. In Greece, even though the legal and organizational frame exists (number 15 of LI397/83) stating that nursing participation is unexceptional, in fact nursing participation is poor. In national level predefined targets have not been achieved and nursing has failed to take its place in prevention in the community. The solution is to get the plan activated. That demands social sensitisation and maturity of the state but also efforts by the nurses. Only by specialization in public health, community and rehabilitation nursing we could be dynamically present in the community showing not only scientific but a humanistic profile as well.

Keywords: Prevention, primary health care, public health Nursing, community Nursing

This article reviews hand-hygiene practices of healthcare workers (HCWs), levels of adherence of personnel to recommended handwashing practices and factors adversery affecting adherence, in addition, it summarizes the new studies of the in vivo efficacy of alcohol-based hand rubbing and the low incidence of dermatitis associated with its use. Finally, it is stressed the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubbing in improving hand-hygiene practices.

Keywords: Hand-hygiene, alcohol- based hand rubbing

A review is presented on the evolutions in European Union in the field of Complementary Medicine as well as an evaluation of the data. Special reference is being directed on the present status of Complementary Medicine in Greece in relation to countries with well-established regulations in the field from long ago on the basis of sensitivity and interest for prevention and primary health care, like Great Britain. Also, the relation of Complementary Medicine with Nursing and Midwifery in the British model is investigated and suggestions are set out for the relevant adjustment of our country in matters of training and practice.

Keywords: Complementary Medicine, European Union, Nursing

The purpose of this study was to calculate the cost of the X-ray diagnostic examinations in the Argos General Hospital. Up until today, the national health service has not had a complete system applied to account for the cost of the health services (examinations, surgical treatments, etc.) as a result of which we do not know the actual cost of the services provided. All the cost groups have been allocated to the following examinations: simple X-rays (chest X-rays, ischium X-rays, etc.), radioscopies (pyelography, etc.), ultrasounds, mammograms and X-rays taken on the portable X-ray machines. Material-Method Methodologically, this is a prospective study of analyzing and accounting for the cost of the examinations. This has been done taking into consideration the cost groups that play a part in sharing the price of each examination and which are: cost of the equipment's purchase and maintenance, personnel payments, disposable material, cost for rooms and rooms adjustment, general expenses (telephone services, electric power, etc.)» indirect expenses (administrative and assistant personal payments, etc.). The material for this study has been the patients of the X-ray diagnostic department from 1/1/01 to 31/12/01, which come to 30,652 people (in- and outpatients). For every cost group the allocation criterion has been different. For example, the allocation of the cost for the maintenance and repairing of the equipment during the examinations has been based on how long the equipment s lamp was on. Results The study has shown that the cost for each examination is as follows: 8.73 € for a simple X-ray, 18.64 € for a mammogram, 72.68 € for a pyelography, 18.00 € for an ultrasound and 22.00 € for an X-ray using the portable radiological machines. Comparing the prices for the examinations in this study to the governmental rates has made clear the vast variation of the tow. The governmental rates set the cost of the simple X-ray at 4.05 € whereas the cost for the Argos General Hospital is 215.5% higher. Likewise, mammograms are 116.4% more expensive, pyelography 359%, ultrasound 217.4 % and the X-ray from the portable machines 545.2% more expensive than the prices set by the presidential enactment 157. Finally, we tried a comparison of the prices of this study to the prices charged by the private clinics for imaging tests. This comparison has also shown the vast variation between the tow rates. Indicatively, the hospitals “Ygeia” and “Metropolitan” charge 49.28 € for a chest X-ray whereas the governmental rates set its cost at 4.05 € and its actual cost for Argos General Hospital is 8.73 €. Conclusions The discrepancy between the actual cost of the examinations and the governmental rates confirms the need of readjusting the latter on the basis of more rational criteria. This will result in reducing the hospitals' deficit.

Keywords: Cost, radiodiagnostic test, X-ray, mammography, pyelography, ultrasound