Σύστημα Υγείας

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S?S???? ?G???S Health care system Health
system

• ???S??S
• ??a ?esµ??? ???a??µ??? s?st?µa ??a ??a? ded?µ???
  p????sµ?, t?? ?p???? ? ???µat?d?t?s?, ?
  d?????s?, ? ap?st??? ?a? ?? ep?µ????? ?p??es?e?,
  ?a???????ta? µ?s? t?? ??µ??es?a? ?a? ?????
  ep?s?µ?? ?e?µ???? ?a? d?at??e??. ?? s?st?µa
  d?asfa???e? ?p??es?e? ?? ?p??e? ap?s??p??? st??
  ße?t??s? t?? ??e?a? ?a? pa?????ta? st?? p????sµ?,
  se s???e???µ????? ??????, ?p?? ?at ?????, se
  a?ad?µa??? ?d??µata, e??as?a???? ??????,
  d?µ?s???? ??????, st?? ?????t?ta, se ??s???µe?a
  ?a? ????????. ???? WHO, 1998a

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?a st???e?a t?? s?st?µat??

• ??S???S S?S??????S
• ???????S?? ??????G?S??S/????S??????S???
• ?????S
• ??????S??S ??????????F???S?S (Feedback)

• ??S???S
• ??????G?S??-????????S?
• Feedback
• ?????S

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?a?a?t???st??? s?st?µ?t??

• ???????/????S?? S?S??????
• ????????????/S??????????
• ?????????????
• S????G???
• ????????

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? ??G??OS? OS S?S?????
??
?S
??
?
?
??
S
S

• ??T?O??? ???????G??
• ????????? ??????????
• ?????F????S ?G????S??S??S
• G?OS??S ??O??S ???S
• ??????G?S??-????????S?
• FEEDBACK

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• ??S???S ???????S?? ?????S
• INPUTS PROCESS OUTPUTS
• ?????p???? p???? -??e???? -?????e?a
• ??????µ???? p???? -??????s? ??s??e?a?
• ?????te????? ?p?d?µ? -Te?ape?a -????µ?? ?a?
• ?a? e??p??sµ?? -?p??at?stas? e?d?? epeµß?se??
• 
  ???ast???a???
• e?et?se??

???????S???? --?e?t??s? ?p?p?d??
??e?a? -?e?t??s? ?p?p?d?? e??µe??a? ?a?
p???t?ta? ????
??????S??S IMPACTS -?e??s? ???s?µ?t?ta? -?e??s? ?
?s???t?ta?
??ad??as?a a?at??f?d?t?s??
??ad??as?a a?at??f?d?t?s??
?? S?st?µa ??e?a? ?? pa?a?????? d?ad??as?a
???? Te?d???? ?a? s??. 1995
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S?S???? ??????S F??????O? ?G???SHealth care
(delivery) system

• ?? s?st?µa ??e?a? af??? ?p??es?e? pa?????
  f???t?d?? ??e?a?, ?? ?p??e? p??sf????ta? se
  p??t?ß??µ??, de?te??ß??µ?? ?a? t??t?ß??µ??
  ep?ped?, e??a? t? s?st?µa t? ?p??? as???e?ta? µe
  ?at????? ?a? ?e?ape?t???? d?ad??as?e? ?? ?p??e?
  ap?s??p??? st?? d?asf???s? ? t?? ße?t??s? t??
  ?at?stas?? t?? ??e?a? e??? as?e??.
• ???? (WHO, 2000b).

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?????S??S ?G???S

• ???? e??a? t? p?????
• ????? e??a? ? pe??t??
• ???a e??a? ta ep???µ?t? ap?te??sµata
• ??s? e??µe??µ???? e??a? ? pe??t??

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? pe??t?? e??a? t? ?t?µ? ? ta ?t?µa ??a t??
e??p???t?s? t?? ?p???? ?p???e? ??a? ???a??sµ??

• ? ??????S e??a? ? p??ta?????? pe??t?? t??
  S?st?µat?? ??e?a?

• ? ?ST???S e??a? ? p??ta?????? pe??t?? t??
  ??s???µe???

Health System The aim of a health care system is
to ensure good health and good health care for
all members of a given population
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? pe??t?? t?? S?st?µat?? ??e?a?

• ???s?µ?p??e? t?? ?p??es?e? ap? a????? ?a? ??? ap?
  ep?????.
• ??e? p??? µ???? d??at?t?ta ep??????
• ? ??at??? ap?fas??e? s?et??? µe t??
  a????????µe?? a????/a?t?µet?p?s?.

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?? S?S?????? ?G???S

• ????????????? ???
• ????????S
• ?S??????S
• ??????S????S
• ??????G???S
• ??? ????S
• ??????????S

• ??? ???????????? ?? ??S? ??? ?????
• ??G??OS?S
• ???????????S?S
• ????GOG?S
• ???????S ?O? ?????S?O? ?G???S

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??a???se?? S?st?µ?t?? ??e?a?

• ???O???? ? F??????T???
• ??????? ? ????S?? (Beveridge)
• S?S???? ????O????S ?SF???S?S (Bismark)
• ????? S?S??????
• ???S ???F?S
• (??? Health Maintenance Organization
• PPO (Preferred Provider Organization)

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??a??s?µ?? ????? ??µ?a ??e?a?
????????? ????t??? ?e??ß?????
???????? ????S??
??G??O??S ??G??O???? ???????S?? ??????G?S??
???????O? ?????GO? ??????F?????S? ????????S
????S??S
?????e? ??e?a? t?? p????sµ??
???????? ?G???S ?????????????S ????????
???O? ????T????? ????S?? ????????S?
??????s? ?p??es??? ??e?a?
?????? ?????S?O? ?G???S
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??????? ? ????S?? (Beveridge)

• S?st?µa ?????????? ?sf???s?? ?a? ??e????µ????
  pe???a???? t? ?p??? p?????e ap? t?? ???es? t??
  Beveridge (Beveridge report) ??a t?? ?????a ?a?
  t?? ??a???a, p?? d?µ?s?e?t??e t? 1943. ? ???es?
  a?t? p??te??e t?? ?????? t?? ??e????µ???? a?a????
  t?? p????sµ??, µ?s? ?e????? f???????a? ?a? t??
  ??at???? p???p?????sµ?? ?a??? ?a? t?? st?????
  t?? p????sµ?? se pe??pt?se?? a?e???a?, as???e?a?
  ?a??? ?a? µet? ap? a?ap???a ? s??ta???d?t?s?.
  ?p?t??esµa ? ?d??s?, t? 1946 µe t?? National
  Health Service Act, e??? e?????? s?st?µat??
  ??e?a? p?? pa???e? d??e?? ?p??es?e? ??a t??
  p??????, d?????s? ?a? ?e?ape?a.
• ???? modified WHO, 1998a.

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??????? ? ????S?? (Beveridge)

• ?????S ?????? ???T?S???
• ???????????S? ??SO G?????S F?????G??S (????????
  ????????G?S???)
• ? ???G??S ?O? ????GOG??O? S??????S?O? ?????? S??
  ?????S
• ?????????S???? ???????G????
• ??t?? ap? t? ???µ??? ?as??e??, ??at??? s?st?µata
  ??e?a?, µe d??e?? pa???? ?p??es??? µ?s? d?µ?s???
  ?p??es??? ?a? f?????, s??a?t?µe st?? S???d?a,
  ?a??a, F??a?d?a ?a? ?ta??a.

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S?S???? ????O????S ?SF???S?S (Bismark)

• ??a s?st?µa e?????? ?????????? asf???s?? ?a?
  asf???s?? ??e?a? t? ?p??? efa?µ?st??e t?? 19?
  a???a st?? Ge?µa??a ap? t?? ?a??e??????
  Bismarck. ?? s?st?µa ßas??eta? st?? ?pa??? t??
  asfa??st???? taµe???, sta ?p??a ? s?µµet??? e??a?
  ?p???e?t???. ?a taµe?a a?t? t??t??, p????t??-
  a?t???? t??? p????? ap? t?? e?sf???? t??
  e???d?t?? ?a? t?? e??a??µ???? ?a? s???? ?a?
  ???µat?d?t?s? ap? t? ???t??- ?a? µe t? se??? t???
  ?a??pt??? t?? dap??e? ??a ?p??es?e? ??e?a? t??
  asfa??sµ???? t???.

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S?S???? ????O????S ?SF???S?S (Bismark)

• ?????S ??????? ?????F??????????? ????T????
• ???????????S? ??? ??SF???S ??G????O? ???
  ??G??????O? ??? S???? ?? ??? ??? ?? ?????S
• ??????O???? ?SF???S? ??? ???T?S??? ???
  ?SF???S?????S ?? ?????S???????S ??G???S???S
• ? ????????? ?O? ??SO? (S??????S?O?) ????GOG?S
  ?????? ?? ????? ????S?? ? ???O????
• ?????????S???? ???????G????
• ??t?? ap? t?? Ge?µa??a s?st?µata ??e?a? p??
  ßas????ta? st?? ????????? asf???s?, s??a?t?µe
  st?? ??st??a, t?? ???a?d?a, t? Ga???a ?a? t?
  ??????.

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???O???? ? F??????T???

• ?? s?st?µa t? ?p??? ?e?t????e? se a?t?st????a µe
  t?? d???µe?? t?? a????? ?a? µe t? µ????te??
  d??at? pa??µßas? e? µ????? t?? ???t???.
• ????T??? ?????G? ??? ???S??-???????O?? ??
  ?????T?? ? ??? S?? S?S????
• ?? ????GOG???? S??????S??S ??????? S? ???O??S
• ? ??????? ? ??G??????? ?????? ??????????????? ???
  ???????S ? ??G???????S ??SF???S
• ?????????S???? ???????G??
• ???

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?????????? S?G???S???????S S?S?????O? ?G???S

• ???µ??????e?a e?????? stat?st???? ded?µ????
• ?d??aµ?a a???????s?? t?? ap?d?s?? t?? s?st?µ?t??
  ??e?a?
• ??s????e? µ?t??s?? ?a? p??t?p?p???s?? ded?µ????
• ??s????e? µetaf???? eµpe????? s?et??? µe t??
  p???t??? ??e?a? ap? ???a se ???a.

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?????????S? S?S?????O? ?G???S S??S S?G?????S
S??T???S

• ?s????p??ta? t??? ?????? t?? ???t??? ?a? t??
  a?????.
• ???s????ta? t? ???? t?? ??µ?s?a? ??e?a? ?a?
  efa?µ????ta? d?at?µea??? st?at?????? ?? p??? t???
  e???te???? ???????????, pe??ßa????t????????? ?a?
  s?µpe??f??????? pa?????te? p?? ep???e????? t??
  ??e?a ?a? t? ??s? a?t?st???a
• ??d??aµ????ta? t??? p???te? d??f??a ep?peda t??
  s?st?µat?? ??e?a? µe t?? e??s??s? ?a? t?
  d?e????s? t?? ??µ??es?a? ??a ta d??a??µata t??
  as?e??, µe t?? e?sa???? µ??a??sµ?? s?µµet????
  st?? ?a????sµ? p??te?a??t?t?? ?a? st? d?ad??as?a
  t?? ???????? ap?f?se?? ?a? µe t?? a???s? t??
  ep?????? ???s?? t?? ?p??es???.

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?????????S? S?S?????O? ?G???S S??S S?G?????S
S??T???S

• ?etat?p????ta? µ???? t?? dapa??? st?? p?e??? t??
  ?ata?a??t? e?te µe t?? µ??f? t?? s?µµet???? st??
  dap??e?, e?te µe t?? pe?????sµ? t?? pa????? st??
  p???? a?a??a?e? e?te µe t?? a???s? t??
  s?µp????µat???? ????? t?? ?d??t???? asf???s??.
• ???????ta? t?? ap?te?esµat???t?ta ?a?
  ap?d?t???t?ta t?? ?p??es??? µe d??f??e?
  st?at?????? ?p?? ap??e?t??µ??e? µ??f??
  d?????s??, ? p????µ? µe ß?s? t?? ap?d?s?, ?
  a?ad???????s? t?? ??s???µe?a??? pe???a????, ?
  a??pt??? t?? ????µat?? ??a te?µ????µ??? ?at????
  pe???a??? ?a? ?????? ? a??pt??? t?? ?F?.

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S??????S? ????GOG?S ?G???S

• ??(?1)
• ?p??
• ? ? st??µ? ??e?a? t?? p????sµ?? ? ?? ?p??es?e?
• ?1 ?? s??te?est?? pa?a????? t?? ?p??es??? ??e?a?
• ? t? ???a??t??? p?a?s??, µ?sa st? ?p???
  p?a?µat?p??e?ta? ? d?ad??as?a t?? pa?a?????

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????S? ?????S?O? ?G???S

• ??????-??t?s?
• ?p??es??? ??e?a?
• ?p?s??pt??ta? ??at??/??at????
• ??s????ta? se ??s???µe?a

500 ??t?????
250 ??t?????
????? ???????st?? ??a s?µpt?µa

• ??????-?? ??t?s?
• ?p??es??? ??e?a?
• ??t??e?ape?a, ?d?af???a
• ?????a s?ßa??t?ta?
• ?d??aµ?a p??sßas??
• ???sf??? a????

250 ??t?????
???e??
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?? ??????? ??S ????T????S
p????sµ??
Ge???af??? d?aµ???sµa
gt500.000
?e??f??e?a
???????T???
50.000-500.000
??µa???a
?????????T???
500-50.000
??O????T???
?????t?ta
1-10 ?t?µa
???????e?a
??t?f???t?da
???? Te?d???? ?a? s??. 1995
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??????G??F???S ???F???S

• ?. Te?d????, ?. Sa????, S. S?????. S?st?µata
  ??e?a? ?a? ???????? p?a?µat???t?ta, ??d?s? ?????,
  ????a 1995.
• ?. ??a??p?????, ??????s? ?p??es??? ??e?a?.
  ?a?ep?st?µ?a??? ?a?ad?se??. ?????? ?a?
  ?ap?d?st??a?? ?a?ep?st?µ?? ??????, ?µ?µa
  ??s??e?t????, 1997.
• ?. S????a?. ??????s? ??????s? ?a? ?e?t?????a
  ??s???µe???. ??pa?de?t???? S?µe??se??. ?????? ?a?
  ?ap?d?st??a?? ?a?ep?st?µ?? ??????, ?µ?µa
  ??s??e?t????, ?etapt???a?? ?????aµµa Sp??d?,
  1999.
• G. ????ta? ?a s?st?µata ??e?a? st?? 21? a???a.
  ?at???? 2001, 79(3)215-217.
• European Observatory on Health Care Systems
  www.observatory.dk
• ?p????e?? ??e?a? ??????a? www.ypyp.gr