Evaluating National Health Systems: The Case of the General Health System of Cyprus Through a Survey

Abstract

Background and Aims: A medical health system (MHS) comprises organizations, professionals, and resources working together to maintain and improve health at both individual and societal levels. Evaluating MHS performance is essential to ensure quality, equity, and sustainability. This study attempts an initial assessment of Cypriots' views on the newly developed General Health System (GHS) of Cyprus, a national MHS. Methods: First, a literature-based review was performed on national MHSs in relation to their features and performance. Next, the GHS schedule and implementation were discussed. The literature review informed the design of a structured questionnaire, covering six constructs: satisfaction, trust, reliability, expectations, improvement factors, and comparison of the MHS before and after GHS implementation. A total of 445 responses were collected through stratified sampling across Cyprus. Descriptive statistics (means, standard deviations) and reliability analysis (Cronbach's α) were conducted. Results: Key measures such as Satisfaction (Mean [M] = 2.589), Trust (M = 2.406), and Reliability (M = 2.328) were below neutral (M = 3.0), suggesting negative perceptions. By contrast, Expectations were high (M = 4.256), indicating that citizens anticipate significant improvements from GHS. No significant variation was observed across gender, age, district, income, or work sector. Cronbach's α values confirmed strong internal consistency (0.80–0.93). Findings indicate moderately low levels of satisfaction, trust, and reliability in the GHS despite high public expectations. Conclusion: These results are consistent with prior national MHS surveys and highlight systemic rather than subgroup-specific challenges. This study contributes the first nationwide assessment of the Cyprus GHS, offering evidence-based insights for healthcare policy and service improvement.