open access
Health status of patients who suffer from acute and chronic respiratory diseases in Greece in the era of economic crisis
open access
Abstract
Introduction: In Greece, the last decade, the harsh austerity measures, that were enacted, had a huge impact on patients’ suffering from chronic diseases. The aim of the current study was to assess the financial ability of the patients suffering from an acute or chronic respiratory disease hospitalized in an urban pulmonary university clinic in central Greece and to explore the correlation of their health status with their financial ability.
Material and methods: An anonymous and self completed questionnaire was administered in the Greek language. It included the SF-36 and the EQ-5D-3L scale that are validated in the Greek language and a new scale (Financial Ability Scale, FAS) that has been developed and validated.
Results: Half of the patients (55%) suffered from a chronic respiratory disease (64% COPD and 36% asthma) while 45% from an acute respiratory disease (pneumonia). Those suffering from COPD were mainly males (88.7%), over 65 years old (74.6%), with primary education or some primary (83.1%), covered by public health insurance (95.8%) and living with their families (91.5%). With the exception of anxiety/depression, the more the problems with mobility, self-care, usual activities and pain/discomfort, the worse the financial ability of the participants. Those > 65 years old, with fewer years of education, suffering from a chronic disease and those having a better experience from the current hospitalization, had a statistically significant lower VAS. Those aged > 65 years old reported a lower financial ability (26.00 ± 9.41
vs 29.24 ± 10.63) as well as those with a chronic respiratory disease (24.18 ± 7.90 vs 30.57 ± 11.98). The years lived with the disease correlated statistically and negatively (r = -0.232; p = 0.001) with the total financial ability score.
Conclusion: Economic crisis in Greece, affected COPD burden in terms of financial ability, and quality of life.
Abstract
Introduction: In Greece, the last decade, the harsh austerity measures, that were enacted, had a huge impact on patients’ suffering from chronic diseases. The aim of the current study was to assess the financial ability of the patients suffering from an acute or chronic respiratory disease hospitalized in an urban pulmonary university clinic in central Greece and to explore the correlation of their health status with their financial ability.
Material and methods: An anonymous and self completed questionnaire was administered in the Greek language. It included the SF-36 and the EQ-5D-3L scale that are validated in the Greek language and a new scale (Financial Ability Scale, FAS) that has been developed and validated.
Results: Half of the patients (55%) suffered from a chronic respiratory disease (64% COPD and 36% asthma) while 45% from an acute respiratory disease (pneumonia). Those suffering from COPD were mainly males (88.7%), over 65 years old (74.6%), with primary education or some primary (83.1%), covered by public health insurance (95.8%) and living with their families (91.5%). With the exception of anxiety/depression, the more the problems with mobility, self-care, usual activities and pain/discomfort, the worse the financial ability of the participants. Those > 65 years old, with fewer years of education, suffering from a chronic disease and those having a better experience from the current hospitalization, had a statistically significant lower VAS. Those aged > 65 years old reported a lower financial ability (26.00 ± 9.41
vs 29.24 ± 10.63) as well as those with a chronic respiratory disease (24.18 ± 7.90 vs 30.57 ± 11.98). The years lived with the disease correlated statistically and negatively (r = -0.232; p = 0.001) with the total financial ability score.
Conclusion: Economic crisis in Greece, affected COPD burden in terms of financial ability, and quality of life.
Keywords
COPD, economic crisis, COPD burden, ΕQ-5D-3L


Title
Health status of patients who suffer from acute and chronic respiratory diseases in Greece in the era of economic crisis
Journal
Advances in Respiratory Medicine
Issue
Pages
167-174
Published online
2019-06-28
DOI
10.5603/ARM.2019.0028
Pubmed
Bibliographic record
Adv Respir Med 2019;87(3):167-174.
Keywords
COPD
economic crisis
COPD burden
ΕQ-5D-3L
Authors
Panagiota Koutsimpou
Konstantinos Gourgoulianis
Athena Economou
Vasilios Raftopoulos


- Blanco I, Diego I, Bueno P, et al. Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique. Int J Chron Obstruct Pulmon Dis. 2018; 13: 57–67.
- Yin P, Zhang M, Li Y, et al. Prevalence of COPD and its association with socioeconomic status in China: findings from China Chronic Disease Risk Factor Surveillance 2007. BMC Public Health. 2011; 11: 586.
- Grigsby M, Siddharthan T, Chowdhury MAh, et al. Socioeconomic status and COPD among low- and middle-income countries. Int J Chron Obstruct Pulmon Dis. 2016; 11: 2497–2507.
- Jones PW, Gelhorn H, Wilson H, et al. Socioeconomic status as a determinant of health status treatment response in COPD trials. Chronic Obstr Pulm Dis. 2017; 4(2): 150–158.
- Yfantopoulos J. The Greek version of the EuroQol (EQ-5D) instrument. Archives of Hellenic Medicine. 2001; 18(2): 180–191.
- Pappa E, Kontodimopoulos N, Niakas D. Validating and norming of the Greek SF-36 Health Survey. Qual Life Res. 2005; 14(5): 1433–1438.
- Carr-Hill RA. EuroQol Group. EuroQol — a new facility for the measurement of health-related quality of life. Health Policy. 1990; 16(3): 199–208.
- Minas M, Hatzoglou C, Karetsi E, et al. COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program. Prim Care Respir J. 2010; 19(4): 363–370.
- Papaioannou AI, Bania E, Alexopoulos EC, et al. Sex discrepancies in COPD patients and burden of the disease in females: a nationwide study in Greece (Greek Obstructive Lung Disease Epidemiology and health ecoNomics: GOLDEN study). Int J Chron Obstruct Pulmon Dis. 2014; 9: 203–213.
- Mitsiki E, Bania E, Varounis C, et al. Characteristics of prevalent and new COPD cases in Greece: the GOLDEN study. Int J Chron Obstruct Pulmon Dis. 2015; 10: 1371–1382.
- Alexopoulos, E.C., Malli, F., Mitsiki, E. Frequency and risk factors of COPD exacerbations and hospitalizations: a nationwide study in Greece (Greek Obstructive Lung Disease Epidemiology and health ecoNomics: GOLDEN study), Int J Chron Obstruct Pulmon Dis. 2015; 10: 2665–2674.
- Kotsiou OS, Zouridis S, Kosmopoulos M, et al. Impact of the financial crisis on COPD burden: Greece as a case study. Eur Respir Rev. 2018; 27(147).
- Mitonas G, Juvana A, Daniil Z, et al. COPD patients' medical care and support in Greece during financial crisis. Int J Gen Med. 2016; 9: 401–407.
- Tzanakis N, Anagnostopoulou U, Filaditaki V, et al. COPD group of the Hellenic Thoracic Society. Prevalence of COPD in Greece. Chest. 2004; 125(3): 892–900.
- Sichletidis L, Tsiotsios I, Gavriilidis A, et al. Prevalence of chronic obstructive pulmonary disease and rhinitis in northern Greece. Respiration. 2005; 72(3): 270–277.
- Kanervisto M, Vasankari T, Laitinen T, et al. Low socioeconomic status is associated with chronic obstructive airway diseases. Respir Med. 2011; 105(8): 1140–1146.
- Gershon AS, Dolmage TE, Stephenson A, et al. Chronic obstructive pulmonary disease and socioeconomic status: a systematic review. COPD. 2012; 9(3): 216–226.
- Kington RS, Smith JP. Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases. Am J Public Health. 1997; 87(5): 805–810.
- Sudore RL, Mehta KM, Simonsick EM, et al. Limited literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc. 2006; 54(5): 770–776.
- Devoe JE, Baez A, Angier H, et al. Insurance + access not equal to health care: typology of barriers to health care access for low-income families. Ann Fam Med. 2007; 5(6): 511–518.
- Tsiligianni I, Kocks J, Tzanakis N, et al. Factors that influence disease-specific quality of life or health status in patients with COPD: a review and meta-analysis of Pearson correlations. Prim Care Respir J. 2011; 20(3): 257–268.
- Kwon HY, Kim E. Factors contributing to quality of life in COPD patients in South Korea. Int J Chron Obstruct Pulmon Dis. 2016; 11: 103–109.
- Kyriopoulos II, Zavras D, Skroumpelos A, et al. Barriers in access to healthcare services for chronic patients in times of austerity: an empirical approach in Greece. Int J Equity Health. 2014; 13: 54.
- Skroumpelos A, Pavi E, Mylona K, et al. The Impact of Economic Crisis on Chronic Patients’ Self-Rated Health, Health Expenditures and Health Services Utilization. Diseases. 2014; 2(2): 93–105.
- Souliotis K, Kani C, Papageorgiou M, et al. Using big data to assess prescribing patterns in greece: the case of chronic obstructive pulmonary disease. PLoS One. 2016; 11(5): e0154960.
- Stafyla E, Kerenidi T, Gerogianni I, et al. The pharmacological cost of COPD during Greek economic crisis. Int J Chron Obstruct Pulmon Dis. 2017; 12: 461–466.
- Kentikelenis A, Karanikolos M, Papanicolas I, et al. Health effects of financial crisis: omens of a Greek tragedy. The Lancet. 2011; 378(9801): 1457–1458.
- Eisner MD, Blanc PD, Omachi TA, et al. Socioeconomic status, race and COPD health outcomes. J Epidemiol Community Health. 2011; 65(1): 26–34.