How the economic crisis in Greece has affected the patient flow between public hospitals and private clinics

Objectives: The economic crisis has devastated the Greek healthcare system, with austerity measures which were introduced by the government resulting in significant budget cuts for hospitals. The Greek hospitals always had trouble with waiting times and lower quality compared to the private clinics, however, the public health system provided free or low-cost care service to residents and their dependents, contributing to the social security. The main goal of this Thesis is to evaluate the impact of economic crisis on the patient flow between public hospitals and private clinics. Data: In order for that goal to be achieved, a dataset which contains the total number of the three surgeries, LAPAROSCOPIC CHOLECYSTECTOMY, SIGMOEIDECTOMY AND TOTAL GASTRECTOMY for the period 2007-2011 for each of the three hospitals and the three clinics accordingly was obtained. Furthermore, it contains the characteristics of each patient who underwent each surgery, which include; age, gender, marital status, sickness fund, cost of surgery, number of hospital days. This kind of dataset has never been obtained before in Greece and this is the most interesting and unique part in this analysis. Methods: First a desk research was conducted to present qualitatively how the Greek health system works and how it has been affected by the economic crisis. Next, using the statistical program Stata, graphs depicting the dataset and the impact of economic crisis on the patient shift between the public and private sector are presented and analyzed. Furthermore, there is an empirical analysis of the dataset, using three logistic regressions for each of the three specific surgeries, where the effect of the economic crisis on the patient flow between the public hospitals and private clinics, as well as which patient characteristics are important is interpreted. Results: The findings suggest that indeed there is an impact of the economic crisis in the healthcare, with the costs of the surgeries decreasing dramatically in the years of 2010 and 2011 compared to the previous years and most importantly, a patient shift from the private clinics to the public hospitals after 2009. However, this Thesis represents only an indication of the potential shift of patients in the public/private healthcare mix. A more concrete data containing also information about the type of the room and the physicians’ fee is needed as well as a qualitative research on patient choice could provide more insight on the matter of the patient choice.