Application of an organizational assessment tool of primary health care

OBJECTIVE Application of an organizational assessment tool for the evaluation of primary health care (PHC) in a specific geographic area of Greece. METHOD The Greek version of the International Family Practice Maturity Matrix tool (IFPMM) was implemented, which evaluates seven organizational dimensions of PHC units. The assessment was conducted in the context of the current organizational structure and culture, with a view to creating the necessary conditions for improvement of the quality of the services provided. The survey was conducted in the five Primary National Health Network (PEDY) units of the prefecture of Evros, by means of semi-structured personal interviews with the staff of the units. Primary data were collected and analysed qualitatively. RESULTS The analysis highlighted significant underdevelopment at the organizational level of the units, and particularly in the area of staff management, and also in listening to patients. The organizational differences among the health centers and former units of the National Organization for Healthcare Provision (EOPYY) are of note. The divergences range from issues concerning payroll, information systems and working hours, to interconnection with senior authorities and distribution of the staff by specialty. However, differences were also revealed within health centers, confirming the high degree of fragmentation and heterogeneity of the Greek PHC services. CONCLUSIONS The main conclusion is that the PHC units of the Greek National Health System are characterized by moderate to low organizational "maturity", resulting in systemic weaknesses which limit attempts to improve the quality of the services. The PEDY units need to converge with international standards in order to better meet the health needs of the population. This could be effected using tools such as the IFPMM, which creates the basis for assessment and comparisons, leading towards an integrated organizational structure and culture.