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- Ελληνικά
Prevention should be applied on the basis of evidence-based clinical practice supported by clinical and epidemiological studies demonstrating the public health benefit. Through prevention, all the measures necessary to reduce the various risk factors for a disease are taken, and at the same time, through prevention, the progression of a disease and/or its complications are slowed down.
More specifically, prevention is divided into several categories, such as prevention applied to healthy people in order to protect them from any disease conditions, prevention applied to people who are ill but asymptomatic with the aim of early diagnosis of the condition, and prevention applied to people who are ill and show symptoms, with the aim of reducing the complications of the disease.
Prevention plays an important role in the philosophy of the General Health System.
Prevention plays an important role in the philosophy of the General Health System. Through the Personal Physician, which is the first point of access to health care services covered by the General Health Insurance Scheme, the Health Insurance Agency establishes as a basic principle the role of the PI as supporting and advising beneficiaries to protect and shield their health. Personal Physicians, among other things, have a duty to suggest ways to discourage habits that may have an adverse impact on the beneficiary's health, such as smoking, excessive alcohol consumption, excessive weight, lack or poor quality of sleep and others. In addition, Personal Physicians have the responsibility to promote the Ministry of Health's population screening programs that relate to public health and fall under level one prevention.
Prevention in the General Health System
The General Health System of Cyprus, until recently, included coverage of preventive examinations for beneficiaries with a hereditary history of morbidity, for diseased asymptomatic persons and for diseased symptomatic persons who were entitled to undergo the necessary examinations in order to monitor the progress of their health or the disease from which they suffer in order to reduce or prevent future consequences.
First-level prevention - with the exception of the Pap test every 2 years - was not included in the services covered by the General Health System, as it is a matter of public health and falls within the competence of the Ministry of Health - a practice that is applied in all Health Systems in the world.
The Health Insurance Organisation, in order to strengthen prevention, always in cooperation with the competent scientific societies and the Pancyprian Medical Association, included in the General Health Insurance Scheme a number of first-level preventive examinations, through specific guidelines that it implemented, for healthy people who have no symptoms.
This list includes important screening tests, such as screening for iron deficiency/iron deficiency anaemia in childhood, developmental hip dysplasia and screening for vision in children.
Recently, and following a study and consultation with the three scientific societies representing GHS Personal Physicians, the OAS also proceeded to include, under certain conditions, routine laboratory tests for adult beneficiaries of the System who are classified as "asymptomatic", a term used to describe healthy individuals who have not been diagnosed with a disease, nor do they have any symptoms or are taking medication.
More specifically. Children are recommended to be examined during routine vision screening by paediatricians at the age of 0 to 6 months every 2 months, from 6 months to 2 years every 6 months and from 6 to 18 years every 3 years. The type of check-up by the paediatrician varies according to the age of the child. In the presence of abnormal findings, when assessed by the paediatrician, the child should be referred to an ophthalmologist. At the age of 3-5 years, universal screening by an ophthalmologist is recommended.
Screening for developmental hip dysplasia is performed by the paediatrician at birth to determine the clinical condition. If the result of the examination is positive, i.e. falls within one of the predefined parameters, then referral to an orthopaedist is recommended. Further examinations are also recommended in the case of a normal clinical picture in an infant who is in the high-risk groups.
Iron deficiency is the most common cause of anaemia in infancy and childhood. For this reason, the Agency has moved to include screening for iron deficiency/iron deficiency anaemia in childhood. On the basis of the guidelines, selective screening for iron deficiency in high-risk groups is recommended.
The Pap test for women who have no symptoms or history, is reimbursed by the GHS every two years until the age of 65 years. However, in cases where there is a history or previous result indicating that the person should have the test at a shorter interval than two years, they may do so again within the Scheme.
Prenatal screening is the set of tests carried out during pregnancy to detect serious, mainly genetic, conditions or other possible abnormalities in the conformation of the foetus. All necessary prenatal imaging screening at predetermined intervals is covered under the GHS, as well as all necessary laboratory tests at predetermined intervals, again in accordance with the guidelines issued by the Agency in this regard.
The most recent addition to the System, made in the context of strengthening prevention, is the routine laboratory tests offered to healthy asymptomatic beneficiaries. Individuals 18-44 years old are given the opportunity to have laboratory tests for prevention purposes every five years, individuals 45-64 years old every two years, and individuals 65 years old and older every year. In line with international guidelines, the OAS has included in these laboratory tests prostate cancer screening tests for men in all age groups and thyroid-stimulating hormone (TSH) testing for men over 60 and women over 50.
Prevention, a cornerstone for any Health System
The prevention services provided within the GHS in no way replace the population/screening programmes of the Ministry of Health, such as mammography or the administration of vaccines for children and adults.
However, since prevention is the cornerstone of any Health System, the General Health System must, within its own framework, promote prevention in all cases.
The Health Insurance Agency, always in collaboration with the competent scientific bodies, seeks to strengthen prevention by increasing the services provided to beneficiaries in a targeted manner, always based on international practices.
Building a relationship of trust and good communication with the Personal Physician are essential prerequisites for the correct guidance of the beneficiary to prevention services.
Finally, it is stressed that one of the priorities of the Agency remains the correct and comprehensive information of beneficiaries and providers on the issue of prevention, in order for beneficiaries to make full use of the relevant services provided by the GHS.
(AF/SX)
Contents of this article including associated images are owned by PIO
Views & opinions expressed are those of the author and/or PIO
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