Filenews 21 November 2025
From 55% of patients who receive a referral to a specialist doctor, we fell to 33%, while the percentage of urgent referrals issued by personal to specialist doctors is limited to 2.5% with 85% of patients being served within ten days. At the same time, the percentage of correctly completed discharges issued by GHS hospitals doubled and rose from 33% to 65% over a two-year period.
All the above data, together with the process of adaptation and implementation of the first six clinical guidelines that were included in the General Health System, were presented by the Health Insurance Organization, at the European Public Health Congress held in the previous days after it was judged, at the European level, that the evaluation models used by the HIO yield substantial results and ensure the quality of the services provided.
The main objective of the conference is "the promotion of public health in Europe through the development and dissemination of scientific knowledge, the formulation and strengthening of data-driven health policies and the discussion for the development of sustainable, resilient health systems" and is attended by scientists and public health professionals, academics, international organizations as well as public authorities and policy makers.
In the context of the conference, representatives of the HIO together with the University of Cyprus, presented three different sections which concerned the way of evaluating services and health service providers, while at the same time citing the positive results of the methodology followed by the Organization in each of the specific topics.
2.5% are urgent with 90% or more being justified
The evaluation of the personal doctors of the System, in terms of the criterion of issuing referrals to specialist doctors, was the first of the issues analyzed by the HIO.
As the senior official of the Organization, Petros Neophytou, explained to "F", "for the qualitative evaluation of referrals, we use three basic criteria. The first concerns the actions taken by the doctor before the issuance of the referral, the second the reasons for the referral to a specialist doctor and the categorization of the referral and the third whether the guidelines applied within the GHS were followed."
The control of referrals issued by personal doctors to specialist doctors began three years ago "and gradually the model used has been strengthened and is scientifically structured".
Based on the results of this audit, three years ago the percentage of referrals to specialist doctors concerned 55% of visits to personal doctors. That is, one in two beneficiaries who visited an adult personal doctor received a referral for a specialist doctor. Now, said Mr. Neophytou, "we see that we have fallen to 33% with the reduction being considered very significant, although of course there is still room for improvement."
As far as paediatricians are concerned, three years ago the percentage of referrals was 28%, i.e. about one in three children received a referral for a specialist doctor and now it is at 18%. "So we see a significant reduction in the case of paediatricians as well."
Regarding the categorization of referrals by personal doctors, according to HIO data, they constitute only 2.5% of all referrals issued.
From the evaluation of these referrals by the specialist doctors as to whether the designation of "emergency" was justified, it appears that more than 90% of the emergency referrals concern real emergencies.
In addition and based on data, 85% of emergencies are served by specialist doctors within the 10-day timeframe set by the Health Insurance Organization.
The percentage of correct discharges doubled
The HIO also presented at this conference the model used for the qualitative evaluation of discharges issued by GHS hospitals. As the Organization's senior officer, Dr. Monica Kyriakou, explained to "F", "the importance of correctly filling in discharges is particularly important since the information that must be included in a discharge is intended to facilitate both the patient himself and the doctors he will visit afterwards for the smooth and more effective continuation of care".
The process of evaluating and grading discharges, said Dr. Kyriakou, "is done in collaboration with external experts" and based on the criteria applied, "discharges must include the services offered during hospitalization, the tests the patient underwent, the medications administered, the next appointments and in general the actions that the patient must take after leaving the hospital".
The evaluation so far, which is done on a sample basis in the discharges issued by GHS hospitals every six months, shows a "significant improvement".
"The hospitals that appear to be correctly completing their discharges by 75% or more, when the process began, constituted 33% of the hospitals that had been evaluated. Now this percentage has risen to 65%."
Compliance with the implementation of clinical guidelines
The last initiative presented by the HIO during the conference in the form of a laboratory concerned the implementation of the six clinical guidelines that the Organization prepared in collaboration with the University of Cyprus, the Pancyprian Medical Association and the NICE organization and included in the GHS, as well as the quality indicators used to control the implementation of these guidelines.
The goal, said Dr. Kyriakou, "is certainly to upgrade the level of services provided to citizens and in this case it is also monitored whether the clinical guidelines are implemented by our doctors."
Already, "we have issued the evaluation of the directive on atrial fibrillation and this audit has given us data that has led to the promotion of concrete measures for further improvements".
It is recalled that the evaluation of this Directive found that the percentage of patients with atrial fibrillation admitted for stroke and receiving anticoagulant treatment in Cyprus was 58% in 2023 and increased to 69% in 2024 after the introduction of the Directive.
As the senior official of the HIO pointed out, anticoagulant therapy, according to international recommendations, is given to patients without contraindications, as it reduces the risk of stroke and we observed that "despite the improvement recorded, there is still room to further increase patient coverage".
In addition, the index concerning the regular monitoring of renal function, creatinine clearance, general blood and liver function in patients receiving anticoagulants was completed and it was found that only 68% of patients were checked as planned, both in the reference period and in the comparison period.
"This percentage is considered low, which demonstrates the need for significant efforts to fully implement the recommendations of the Directive and enhance patient safety."
This is followed, said Dr. Kyriakou, "the evaluation of the Clinical Guidelines concerning chronic kidney disease and thyroid cancer".
