Georgios Sfakianakis, Nikolaos Grigorakis, Georgios Galyfianakis and Maria Katharaki
Because of the 2008 global financial crisis aftermaths, economic downturn and prolonged recession, several OECD countries have adopted an austerity compound by significantly…
Abstract
Purpose
Because of the 2008 global financial crisis aftermaths, economic downturn and prolonged recession, several OECD countries have adopted an austerity compound by significantly reducing public health expenditure (PHE) for dealing with their fiscal pressure and sovereign-debt challenges. Against this backdrop, this study aims to examine the responsiveness of PHE to macro-fiscal determinants, demography, as well to private health insurance (PHI) financing.
Design/methodology/approach
The authors gather annual panel data from four international organizations databases for the total of OECD countries from a period lasting from 2000 to 2017. The authors apply static and dynamic econometric methodology to deal with panel data and assess the impact of several parameters on PHE.
Findings
The authors’ findings indicate that gross domestic product, fiscal capacity, tax revenues and population aging have a positive effect on PHE. Further, the authors find that both unemployment rate and voluntary private health insurance financing present a negative statistically significant impact on our estimated outcome variable. Different specifications and sample periods applied in the regression models reveal how inseparably associated are PHE and OECD's economies compliance on macro-fiscal policies for offsetting public finances derailment.
Practical implications
Providing more evidence on the responsiveness of PHE to several macro-fiscal drivers, it can be a helpful tool for governments to reconsider their persistence on fiscal adjustments measures and rank public health financing to the top of their political agenda. Health systems policies for meeting Universal Health Coverage (UHC) objectives, they should also take into consideration the voluntary PHI institution, especially for economies with insufficient fiscal capacity to raise public health financing.
Originality/value
To the best of knowledge, the impact of unemployment and voluntary PHI funding on public health financing, apart from other macro-fiscal and demographical parameters effect, remains unnoticed in the existing published studies on the topic.
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Stelios Terzoudis, Nikolaos Kontodimopoulos and John Fanourgiakis
The reduction of government expenditure in the healthcare system, the difficulty of finding new sources of funding and the reduction in disposable income per capita are the most…
Abstract
Purpose
The reduction of government expenditure in the healthcare system, the difficulty of finding new sources of funding and the reduction in disposable income per capita are the most important problems of the healthcare system in Greece over the last decade. Therefore, studying the profitability of health structures is a crucial factor in making decisions about their solvency and corporate sustainability. The aim of this study is to investigate the effect of economic liquidity, debt and business size on profitability for the Greek general hospitals (GHs) during the period 2016–2018.
Design/methodology/approach
Financial statements (balance sheets and income statements) of 84 general hospitals (GHs), 52 public and 32 private, over a three-year period (2016–2018), were analyzed. Spearman’s Rs correlation was carried out on two samples.
Findings
The results revealed that there is a positive relationship between the investigated determinants (liquidity, size) and profitability for both public and private GHs. It was also shown that debt has a negative effect on profitability only for private GHs.
Practical implications
Increasing the turnover of private hospitals through interventions such as expanding private health insurance and adopting modern financial management techniques in public hospitals would have a positive effect both on profitability and the efficient use of limited resources.
Originality/value
These results, in conjunction with the findings of the low profitability of private hospitals and the excess liquidity of public hospitals, can shape the appropriate framework to guide hospital administrators and government policymakers.
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Despite numerous studies on the separate health consequences of economic crises and post-migration difficulties, very little is known about the processes through which the…
Abstract
Purpose
Despite numerous studies on the separate health consequences of economic crises and post-migration difficulties, very little is known about the processes through which the intersection of economic crisis and post-migration adversity contribute to migrants’ health vulnerabilities. The purpose of this paper is to examine existing literature about how newly arrived and long-term migrants’ health and well-being are affected by the economic crisis in Greece.
Design/methodology/approach
The ongoing economic recession in Greece, combined with the recent migration crisis, provided an adequate context for investigating migrants’ health and well-being. A narrative literature review was performed on whether and how migrants’ health and well-being are affected by the economic and the migration crises in the particular case of Greece. Papers published between January 2010 and December 2017 were selected based on review of titles and abstracts, followed by a full text review.
Findings
The review identified a surprisingly limited number of relevant studies. Ultimately five studies were selected and their findings summarised. There was only one study attempting to unravel the specific processes through which the crisis and the post-migration problems impact cumulatively on migrants’ health and well-being and to suggest healthcare improvements. Further research on this topic is urgently needed.
Originality/value
This paper explores existing research looking at how migrants’ health and well-being are affected by the economic and the migration crises in Greece. The emerging dearth of research evidence on the above topic is also critically discussed from a socio-political point of view and recommendations are made related to healthcare practice and services set up for migrants’ health and care.
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A. Karanikolos, P.K. Pantelakis and E.E. Kriezis
The interaction of ELF‐LF electric fields with the human body is examined with a method based on surface charge‐integral equations. The evaluation of the electric field intensity…
Abstract
The interaction of ELF‐LF electric fields with the human body is examined with a method based on surface charge‐integral equations. The evaluation of the electric field intensity on the body surface is performed for a realistic model of the human body. Two examples for different postures of the model are given.
Emilie Robert and Pierre-Marie David
Between 2012 and 2016, the Government of Canada modified health insurance for refugees and asylum seekers. In Quebec, this resulted in refusals of care and uncertainties about…
Abstract
Purpose
Between 2012 and 2016, the Government of Canada modified health insurance for refugees and asylum seekers. In Quebec, this resulted in refusals of care and uncertainties about publicly reimbursed services, despite guaranteed coverage for people with this status under the provincial plan. The Chronic Viral Illness Service (CVIS) at the McGill University Health Centre in Montreal continued to provide care to refugees and asylum seekers living with HIV. The purpose of this paper is to explain how and why challenges brought by this policy change could be overcome.
Design/methodology/approach
A qualitative case study was conducted using interviews with patients and staff members, observation sessions and a review of media, documents and articles. A discussion group validated the interpretation of preliminary results.
Findings
The CVIS provides patient-centered care through a multidisciplinary team. It collectively responds to medical, social and legal issues specific to refugees. Its organizational culture and expertise explain the sustained provision of care. The team’s empathetic view of patients, anchored in the service’s history, care for men who have sex with men and commitment to human rights, is key. A culture of care developed over time thanks to the commitment of exemplary figures. Because they countered the team’s values, changes in refugee healthcare coverage strengthened the service’s culture of care. However, the healthcare system reform launched in 2014 in Quebec is perceived as jeopardizing the culture of care, as it makes, refugee and asylum-seeker patients a non-lucrative venture for providers.
Originality/value
This research analyzes the origin of sustained provision of care to refugees and asylum seekers living with HIV through the lens of culture of care. It considers the historical and political contexts in which this culture developed.
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Enrico Bracci, Christopher Humphrey, Jodie Moll and Ileana Steccolini
The era of austerity that has followed the outbreak of the global financial crisis has posed a myriad of challenges for public services, with demands for major cuts in government…
Abstract
Purpose
The era of austerity that has followed the outbreak of the global financial crisis has posed a myriad of challenges for public services, with demands for major cuts in government spending, the delivery of balanced budgets and zstrategies for deficit reduction. The purpose of this paper is to consider how public sector accounting and accountability systems are implicated in the development and implementation of austerity policies. Also, it pinpoints a range of issues that accounting researchers need to be contemplating on the subject of accounting for austerity.
Design/methodology/approach
Interdisciplinary literature review, coupled with an illustrative discussion of the changing nature of public sector accounting practices under austerity.
Findings
Despite the significance and scale of austerity, public sector accounting research on the topic is in its infancy, with the prominent focus being on how accounting technologies are used to manage austerity. There have been few attempts to debate critically the construction of austerity and to provide alternative accounts of austerity. Accounting for austerity, especially in terms of its implications and consequences, is far too complex and challenging to be categorized as simply seeking to “balance the books”.
Research limitations/implications
As an academic community, we need to be developing understanding of public sector accounting research under austerity across different organizational levels and contexts. Also, we should be framing the accounts of austerity in ways that respect and build on a sound understanding of the extensive available interdisciplinary research on this topic. Key research questions to address include: how is accounting shaping constructions of, and impressions, attitudes and behaviors toward, austerity and the status of governments and public service organizations? What do such patterns of development mean for the roles and contributions of public sector accountants under austerity? Are accounting systems destined to be used primarily as vehicles for cost-cutting, or can they be used as engines for growth and for thinking about public service responsibilities in more socially inclusive forms?
Originality/value
Accountings of austerity in the field of public sector accounting research have been worryingly limited. This paper and the papers in this special issue of AAAJ address such failings, revealing a range of critical implications and challenges of austerity policies for public sector accounting research.
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Gustavo Santos, Célia Soares, Raquel Rebelo and Paula Ferreira
While awaiting resolution of their legal process, undocumented migrants (UM) face several challenges, including limited access to public health care. The purpose of this paper is…
Abstract
Purpose
While awaiting resolution of their legal process, undocumented migrants (UM) face several challenges, including limited access to public health care. The purpose of this paper is to survey UM attending a detention centre in Oporto (Portugal) to estimate the prevalence of mental health disorders in this population.
Design/methodology/approach
A retrospective chart review was performed with the relevant sociodemographic and clinical data of all UM in the process of coercive removal from Portuguese territory, observed by Doctors of the World, during three years (2014–2016). The Tenth Version of International Classification of Mental and Behavioural Disorders was used for nosological classification.
Findings
In total, 393 detainees were eligible for the study. Most detainees were male (84 per cent) and 76 months was the mean length of stay in Portugal before detention. In total, 29 per cent of detainees were diagnosed with a mental and behavioural disorder. The most prevalent diagnosis was neurotic, stress-related and somatoform disorders (47 per cent). UM with dual diagnosis (28 per cent) led to the articulation with the integrated centres of drug addiction, which provided and monitored opioid substitution therapy. Female UM were more prone to develop any mental and behavioural disorder when compared to men (χ2=7,017; p<0.05).
Research limitations/implications
In total, 9 per cent of the detainees were excluded from this study due to incomplete data on their medical charts. Some detainees presented oppositional behaviour, hostility towards others and refused to be assessed by the medical team. Both situations could have biased the prevalence of mental disorders. Finally, the appropriateness of the western model of mental health disorders (ICD-10) in the study population is controversial, considering the culture-bound phenomenology and syndromes.
Originality/value
This paper identified the most prevalent mental health disorders in UM detained in Portugal. The most prevalent mental health disorders were either stress-related (associated with the detention itself) or related to previous patterns of substance abuse. Given the study outcomes, it is highly recommended to mobilise human and technical resources to provide specialized mental health care to UM at least while detention policies could not be changed.
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Abstract
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George Koulierakis, Anastasia Dermatis, Nair-Tonia Vassilakou, Elpida Pavi, Dimitris Zavras and John Kyriopoulos
The purpose of this paper is to investigate the key determinants of dietary choices of the Greek population during a period of financial austerity.
Abstract
Purpose
The purpose of this paper is to investigate the key determinants of dietary choices of the Greek population during a period of financial austerity.
Design/methodology/approach
Data from the 2016 “Health and Welfare” Greek national cross-sectional survey, in a representative sample of 2,003 individuals, were examined. The survey was conducted via computer-assisted telephone interviews. Sociodemographic characteristics and diet knowledge were examined as potential determinants of four dietary behaviours (fruit, fish, red meat and fast food consumption).
Findings
Findings showed significant gender differences against men (64.4% were overweight and obese; 57.6% and 18.4% reported red meat and fast food consumption more than twice a week, respectively). Age and financial affordability were the most significant determinants of fruit consumption. Fish consumption was determined by age, financial affordability, and family status (unmarried, living with the parents). Gender, age, family status (unmarried, living alone), employment status (unemployed) and social support affected red meat consumption. Finally, factors influencing fast food consumption were gender, age and employment status (unemployed).
Originality/value
This research incorporates unique and original insight in the determinants of healthy dietary choices during the austerity measures in Greece. Findings could contribute to a better understanding of the main factors that influence healthy eating and help develop policies to encourage healthy dietary lifestyles for the general public.