Costs associated with measles in healthcare personnel during the 2017-2018 epidemic in Greece: a real-world data cost-of-illness analysis.

Measles represents an occupational risk for healthcare personnel (HCP). A total of 117 cases of measles among HCP were notified in Greece during 2017-2018. We were able to contact 46 of them. Most of those contacted had a serious clinical course with complications, necessitating hospitalization in 67% of cases. All HCP reported absenteeism, for a mean duration of 21.2 working days (range: 3-60 days); 54.3% of HCP reported being at work while symptomatic for a mean duration of 2.3 working days (range: 1-7 days). The average total cost-of-illness was €4,739 per HCP. The total direct and indirect costs of the 117 notified cases among HCP amount to €554,494, which is likely to be an underestimate of the true cost.

Why do generic drugs fail to achieve an adequate market share in Greece? Empirical findings and policy suggestions.

OBJECTIVES: Since 2010, the memoranda of understanding were implemented in Greece as a measure of fiscal adjustment. Public pharmaceutical expenditure was one of the main focuses of this implementation. Numerous policies, targeted on pharma spending, reduced the pharmaceutical budget by 60.5%. Yet, generics' penetration in Greece remained among the lowest among OECD countries. This study aims to highlight the factors that affect the perceptions of the population on generic drugs and to suggest effective policy measures. METHODOLOGY: The empirical analysis is based on a national cross-sectional survey that was conducted through a sample of 2003 individuals, representative of the general population. Two ordinal logistic regression models were constructed in order to identify the determinants that affect the respondents' beliefs on the safety and the effectiveness of generic drugs. FINDINGS: The empirical findings presented a positive and statistically significant correlation with income, bill payment difficulties, safety and effectiveness of drugs, prescription and dispensing preferences and the views toward pharmaceutical companies. Also, age and trust toward medical community have a positive and statistically significant correlation with the perception on the safety of generic drugs. Policy interventions are suggested on the bases of the empirical results on 3 major categories; (a) information campaigns, (b) incentives to doctors and pharmacists and (c) to strengthen the bioequivalence control framework and the dissemination of results.

Social determinants of dental health services utilisation of Greek adults.

OBJECTIVES: To identify the determinants of dental care utilisation among Greek adults, with a particular emphasis on socio-economic determinants. METHODS: Data were collected through a national survey on health and health care services utilisation of a sample of 4,003 Greek adults stratified by geographic region, age and gender. A purpose made questionnaire was used during face-to-face interviews. A 2-stage model was developed to assess the impact of independent variables on dental utilisation likelihood and frequency. RESULTS: 39.6% (1,562) of Greek adults reported having visited a dentist within the last year. Among dental attenders, 32.6% reported prevention as the reason for visit. Statistically significant differences in dental care utilisation were observed in relation to demographic, socioeconomic and lifestyle factors. Logistic regression analysis showed that gender, age, income, education, place of residence, private insurance coverage and self-rated oral health are important determinants of dental services utilisation. Mean number of dental visits within previous year was 1.6. Results from Poisson regression analysis indicated that lower income level correlates to lower number of dental visits, while having visited for treatment (rather than for prevention) correlated to higher number of dental visits. CONCLUSIONS: Greek adults do not exhibit satisfactory dental visiting behaviour. Extent of care sought is associated with need for treatment rather than preventive reasons. The findings confirm the existence of socioeconomic inequalities in dental services utilisation among Greek adults.

Evidence-based medicine and radiology.

In the early 1990's, a group of physician-epidemiologists developed ways of efficiently tracking down and appraising literature and wrote them up in order to help other doctors, with no or with minimal formal epidemiological training. Today Evidence-Based Medicine (EBM) integrates clinical experience and patient values with the best available research information in order to expand research evidence and to provide sensible answers to medical questions in clinical decision making. Although EBM does not provide the answer to every clinical question, it provides us valuable additional evidence helpful in decision making. EBM process includes five steps: answerable questions asking; accessing for the best information; information appraisal for validity and relevance; data application to patient care and finally evaluation of the performance. The purpose of this paper is to help radiologists who have no postgraduate specialist training in research to become familiar with EBM and to find solutions that are based on best current evidence for problems arising in their practice.

The effect of social and personal factors on the utilisation of dental services in Glasgow, Scotland.

This study examined potential mediators of dental attendance among two distinct adult populations who lived in contrasting social environments (deprived and affluent). The aim of the study was to describe and quantify the effect of both the potentially modifiable and the fixed factors which influence use of dental services. A two-stage weighted random sampling technique was used to select 863 participants who were interviewed. Of these participants, 372 lived in 'affluent' areas and 491 in 'deprived' areas. The 45 minute interview explored many aspects of oral health, and related behaviour and attitudes. The results showed a highly significant association between social deprivation and reported dental attendance (P < 0.001). Social environment was also significantly related to asymptomatic dental attendance. Deprived respondents' dental behaviours were significantly affected by life events and yet structural/organisational barriers to attendance had a significantly greater impact on the affluent population's dental visiting patterns than they did on the deprived population's. A regression model indicated that the best predictors of dental attendance were social environment, dental anxiety, perceptions about denture wearers and the value placed upon restored teeth. The study suggests that the barriers to dental attendance experienced by deprived populations are not easily modifiable, but belong instead to a group which relate to the socio-political agenda. The study also demonstrates the importance of accurate and regularly updated community registers for use in population based health services research.

A programme of preventive dentistry in field conditions carried out in Glasgow, Scotland.

A caries-preventive regime comprising fluoride supplementation in age-related doses, three monthly acid-phosphate-fluoride applications, fissure sealing of deciduous and first permanent molars and chair-side dental health education, had been proved cost-effective in a single health centre setting. It was therefore expanded to a community-wide project in the Greater Glasgow area. This study describes the coverage achieved by the scheme, the demographic details of the children involved, and measured the dental health benefits accrued by the participants. The children received an annual dental examination and, to assess the effects of the programme, the records of 310 subjects who had attended three annual examinations were used. The deft and defs reductions ranged from 60 to 6.5 per cent and 58.8 to 9.6 per cent respectively, and equivalent DMFT and DMFS reductions ranged from 11.1 to 0 per cent, and 33.3 to 16.7 per cent respectively. Previously, deft reductions of 63.7 to 86.2 per cent, and defs reductions of 77.6 to 92.6 per cent had been reported (Stephen et al., 1983). In contrast, the corresponding deft and defs reductions achieved in this project were only up to 16.7 and 9.6 per cent respectively. The programme was most beneficial for children who had reached the age of three years after two year's participation in the scheme. The dental health benefits accrued by those receiving the preventive programme appear to be inversely proportional to its size. Therefore it represents an important example of the reduction of a preventive agents' effectiveness when used under field conditions, as opposed to those of controlled clinical trials.