DETERMINANTS OF HEALTH CARE EXPENDITURE IN GREECE: CAN PRIMARY HEALTH CARE IMPACT ON THEIR EVOLUTION?

This paper identifies and analyzes the determinants of public and private health care expenditure in Greece over the period 1970-2004 to assess its relationship with the lack of an integrated Primary Health Care System. The determinants assessed are those commonly stated in international literature as influencing health expenditure growth, i.e. per capita GDP-Gross Domestic Product- (income), demographic ageing and induced demand, expressed through the number of physicians. Several multiple linear regression models were developed and selected through stepwise entry and backward elimination. Dependent variables were per capita public and private health care expenditure. According to the results, the most important determinant, for both public and private health care expenditure, is population ageing. Per capita GDP is strongly and positively related to public health care expenditure, as well as to private health care expenditure, the latter, however, in a non-statistically significant form. The development of an Integrated Primary Health Care System in Greece has been constantly under discussion and review for the past two decades. Nonetheless, the lack of gatekeeping mechanisms as well as patient monitoring and general population prevention programmes have led to significant and consistent increases in both public and private expenditure.