Integrated PHC NSRF



NSRF Project “Operational integration of PHC facilities”


Project’s full title: “Operationalintegration between bodies of primary health care (PHC)and otherhealthcare bodies using standardized quality processes”

Funding agency: National Strategic Reference Framework (NSRF) 2007-2013

Project number: 337424

Project duration: 06 June 2012 – 07 December 2014

Project carrier: Clinic of Social and Family medicine, Faculty of Medicine, University of Crete

Principal Investigator (PI): Christos Lionis, Professor of General Practice and Primary Health Care

Co-PIs: Ada Markaki, Instructor Primary Health Care

             Yiannis Frangiadakis, Information Technology Director

Project Manager: Dimitra Sifaki-Pistolla, MPH, PhD candidate

Reseach Team: (in alphabetical order)

Bertsias Antonis,

Elfadl Hag Nazik,

Kalantzakis Yiannis,

Kardasis Stamatis,

Kaukalakis Stavros,

Koutis Antonis,

Kritikos Kyriakos,

Milaki Popi,

Petelos Elena,

Philalithis Anastassios,

Plexousakis Demetris,

Thireos Eleftherios,

Trigoni Maria,

Van der Schaaf Hans,

Zampetakis Michalis.


Overall aim: to propose an optimum model of intra-operational integration for the primary health care (PHC) sector in Greece as well as to optimize interoperational integration between PHC facilities and secondary/tertiary care facilities.

PHC units subject of this study are those defined by laws 3235/2004 and 3918/2011, mandated to provide primary health care services to the Greek population. Particular attention will be given to those comprising the National Health Service Organization (EOPYY), expected to provide the bulk of primary care services in the coming years.

The following PHC units meet the study inclusion criteria:

  • Rural Health Centers belonging to NHS, along with their Satellite Clinics
  • NHS Hospital Outpatient Clinics
  • Outpatient Units under the umbrella of health insurance providers IKA - ETAM
  • Private general practice physicians, affiliated with  EOPYY
  • Municipal agencies of PHC services (“Care at Home", Senior Citizen Services, Outpatient Centers for Nursing Care, Municipal Clinics).
  • Other facilities, such as outpatient mental health units, rehabilitation units, ambulatory /community care units.


Tools in the form of a questionnaire and/or a template, containing statements for scoring or assessing the degree of integrated PHC, were sought through systematic literature review. PCAT short version, developed by the Primary Care Policy Center for Underserved Populations at Johns Hopkins University (1998) was identified as the most relevant. Steps were taken towards translation, cultural adaptation and piloting of PCAT. A supplementary questionnaire was also developed by the research team of the Clinic of Social and Family Medicine.

The theoretical underpinning of the operational integration model is based on Barbara Starfield’s (1998) work as well as the Chronic Care Model. The optimum integration model for Greece will be pilot tested in Crete and the Aegean islands, employing educational seminars, training and information diffusion strategies.

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