Greece: #25 in the 2024 World Index of Healthcare Innovation

Introduction

In the 2024 World Index of Healthcare Innovation, Greece improved its position to 25th, up from 27th in 2022. Despite this improvement, Greece faced challenges, earning  28th place in Quality for the third consecutive year. Fiscal Sustainability also proved problematic, ranking 18th, largely attributed to Greece’s high debt-to-GDP ratio, which exceeds 162 percent. The dimension in which Greece performed best was Choice, ranking 9th.

Background

The foundations of Western medicine trace back to Greece, home of Hippocrates, who was born on the island of Kos around 460 B.C.E. His principles have significantly shaped modern medical ethics and practices, including the Hippocratic oath to, among other things, “do no harm.”

Historically, Greece has featured a robust private health insurance market, similar to that found in Germany and other Bismarckian systems, with a variety of premiums, benefits, and patient cost-sharing models. The financial crisis of 2011 initiated a pivotal shift towards a single-payer system overseen by the National Organization for Healthcare Provision (EOPYY), as part of broader economic stabilization measures.

As of 2024, Greece has 283 hospitals, of which 55 percent are publicly owned. Public hospitals account for two-thirds of all hospital beds—approximately 19,800—and the remaining 45 percent of hospitals are privately owned and provide about one-third of the total beds,  roughly 10,200. This distribution underscores a continued dependence on public healthcare facilities despite substantial private sector participation.

Providing adequate primary care is a challenge in Greece, with noticeable discrepancies between urban and rural healthcare services. Rather, the Greek healthcare system devotes more resources to secondary care.

Economically, Greece now dedicates approximately 9.7 percent of its GDP to health expenditures, a modest increase reflecting ongoing investments in health infrastructure and services. This percentage is similar to the EU average of 9.5 percent. Public financing comprises about 64 percent of healthcare spending through social health insurance and taxes, with private out-of-pocket spending accounting for the remaining 36 percent.

Greece provides universal coverage and is principally managed by EOPYY, with a broad range of preventative and specialized services. The country has increased its investment in digital health technologies, with a significant push towards telemedicine, aiming to bridge the service gap in remote areas. Telemedicine consultations have grown by 20 percent year-over-year, enhancing access and efficiency in healthcare delivery. Furthermore, Greece is integrating electronic health records more broadly, with over 80 percent of primary care providers now utilizing the technology to streamline patient care and data management.

Dimension Performance

Quality

Greece ranked 28th in Quality. The country faced significant challenges, ranking 26th in three of the four elements for the Quality dimension: disease prevention, patient-centered care, and pandemic preparedness and response. These scores were influenced by high rates of chronic conditions; cardiovascular disease and cancer accounted for 65 percent of all deaths, largely attributed to high rates of smoking and obesity. Greece also lacks adequate infrastructure to address these issues (29th). 

Choice

Greece ranked 9th for Choice—its strongest showing in the 2024 WIHI. Freedom to choose healthcare services was one of Greece’s strengths, ranking 6th. But Greece ranked well below the median in access to new treatments (28th), due to both restrictive access to new drugs but also poor access to essential health services.  Greece also struggles to provide affordability of health coverage(25th), with higher rates of household catastrophic health spending than most countries in the Index.

Science and Technology 

Greece holds the 22nd position in the overall Science and Technology dimension. It ranks 20th in medical advances, 23rd in scientific discoveries, and 26th in health digitization. Like many small European countries, Greece does not invest much in R&D for medical technologies, nor is it awarded many patents for such technology. But Greece is also one of the least digitally connected countries in the Index—limiting its ability to take full advantage of electronic health records.

Fiscal Sustainability

Greece secured the 18th position in Fiscal Sustainability in the latest rankings. The country showed commendable control in the growth of public health spending, placing 12th in this category. The restraint in public healthcare spending growth can be attributed to austerity measures implemented post-recession. However, it still struggles to contain the national debt, ranking 31st in national solvency.