Open Access BASE2018

The burden of disease in Greece, health loss, risk factors, and health financing, 2000-16 : an analysis of the Global Burden of Disease Study 2016

In: The Lancet Public Health--2468-2667 Vol. 3 Issue. 8 pp: E395-E406

Tyrovolas, Stefanos; Kassebaum, Nicholas J; Stergachis, Andy; Abraha, Haftom N; Alla, Francois; Androudi, Sofia; Car, Mate; Chrepa, Vanessa; Furst, Thomas; Fullman, Nancy; Haro, Josep M; Hay, Simon I; Jakovljevic, Mihajlo B; Jonas, Jost B; Khalil, Ibrahim A; Kopec, Jacek A; Manguerra, Helena; Martopullo, Ira; Mokdad, Ali H; Monasta, Lorenzo; Nichols, Emma; Olsen, Helen E; Rawaf, Salman; Reiner, Robert; Renzaho, Andre M. N. (R17978); Ronfani, Luca; Sanchez-Nino, Maria; Sartorius, Benn; Sawhney, Monika; Alves, Silveira; Stathopoulou, Vasiliki; Vollset, Stein E; Stroumpoulis, Konstantinos; Topor-Madry, Roman; Topouzis, Fotis; Tortajada-Girbes, Miguel; Tsilimbaris, Miltiadis; Tsilimparis, Nikolaos; Valsamidis, Dimitrios; Van Boven, Job F; Violante, Francesco S; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A; Wolfe, Charles D; Younis, Mustafa Z; Kotsakis, Georgios A

Zugriff(Open Access)

Abstract

Background: Following the economic crisis in Greece in 2010, the country's ongoing austerity measures include a substantial contraction of health-care expenditure, with reports of subsequent negative health consequences. A comprehensive evaluation of mortality and morbidity is required to understand the current challenges of public health in Greece. Methods: We used the results of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 to describe the patterns of death and disability among those living in Greece from 2000 to 2010 (pre-austerity) and 2010 to 2016 (post-austerity), and compared trends in health outcomes and health expenditure to those in Cyprus and western Europe. We estimated all-cause mortality from vital registration data, and we calculated cause-specific deaths and years of life lost. Age-standardised mortality rates were compared using the annualised rate of change (ARC). Mortality risk factors were assessed using a comparative risk assessment framework for 84 risk factors and clusters to calculative summary exposure values and population attributable fraction statistics. We assessed the association between trends in total, government, out-of-pocket, and prepaid public health expenditure and all-cause mortality with a segmented correlation analysis.