Supervisors info:
Δάφνη Καϊτελίδου, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Όλγα Σίσκου, Επίκουρη Καθηγήτρια, Τμήμα Τουρισμού, Πανεπιστήμιο Πειραιώς
Πέτρος Γαλάνης, Εξωτερικός Συνεργάτης, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Aim: In order for a country to address and limit the spread of covid-19, the role of the national health system was pivotal, while exceptional mobilization was required across a wide range of complex challenges. The aim of this paper was twofold. On the one hand, the investigation of the factors influencing the formation of European countries’ NHS expenses related to covid-19 pandemic, as well as the policies implemented for their financing. On the other hand, to identify the total amount of covid-19 expenses for the Greek NHS, along with their financing mechanisms.
Methods: The methodology went through two pillars: The first pillar followed a) a review of the international literature, on healthcare systems covid-19 related expenditure and relevant financing policies and b) data analysis for 11 European countries, through COVID-19 Health System Response Monitor platform of the European Observatory. The second pillar mainly based on the analysis of primary quantitative data, requested by the Greek Ministry of Health.
Results: The health systems, in order to cope with the increased and urgent needs for the management of the pandemic, had to take a variety of actions to strengthen their infrastructure/spaces, staff and supplies of medical equipment, creating extraordinary expenses. Expenditure reached levels that could not be financed by current health budgets, requiring additional funding. To cope with that, European countries made adjustments to their payment systems and mobilized mechanisms for their financing. The responses of the countries were mostly common, with differences observed in certain characteristics. In addition, the response of international organizations, mainly WHO and OECD, as well as the European Union, was immediate and substantial, through the issuance of specific recommendations, the establishment of various measures, and the activation of financing mechanisms. The challenge of supplying the necessary biomedical material turned out to be particularly critical and complex to deal with, having mobilized significant changes and actions at national and European levels. EU total amount of approved financing available for the health sector was estimated at €5.5 billion. However, a complete overview of the amount of covid-19 expenses for the European healthcare systems was not achievable through the present study, nor therefore a comparative quantitative comparison. Concerning the Greek NHS, the amount of the incurred expenses was calculated at €870m, an amount that corresponds to 22% of the annual pro-covid State Budget limit for the Ministry of Health. The main source of financing came through extraordinary grants from the State Budget, while part of covid-19 related payroll costs was financed through projects from European programs. On top, a unprecedent amount of funding has been directed to the Ministry of Health through cash and in-kind donations, totaling to €150 million.
Conclusions: To the best of our knowledge at the time of the writing, this paper contributes to the limited existing literature related to the cost of the pandemic for the Greek NHS, from the perspective of expenses, and their financing. Moreover, the present study concludes that, in order for the effective management of the pandemic, increased and urgent needs in staff, infrastructure and supplies resulted in additional expenses for the European healthcare systems. Covid-19 expenses, but also the concurrent and common among the countries observed financial challenges - mainly the supply of face masks and other biomedical material - reached levels that could not be addressed at national level or financed by existing resources. They required a rapid mobilization of multifaceted measures, a consistent coordination and close cooperation, highlighting the crucial importance of solidarity. The solidarity mechanisms triggered by the pandemic consist a legacy for the future and further triggered the establishment of an EU funding framework, aiming towards the recovery and resilience of the health systems and the EU economies in general.
Keywords:
Covid-19, Impact, Expenditure, Healthcare system, NHS, Hospitals, Financing, European countries
