Paraskevi Boufounou

Background/Objectives: Efficient resource allocation is essential for the sustainability of public hospitals operating under financial and capacity constraints. This study evaluated the volume-based technical efficiency and productivity of public hospitals within a Greek Health Region and explored associations between efficiency and selected contextual characteristics. Methods: Of 15 public hospitals in the study setting, two were excluded on production-comparability grounds, leaving 13 hospitals analyzed over 2015–2021 using input-oriented Data Envelopment Analysis under constant and variable returns to scale. Bootstrap bias correction was applied to CRS efficiency estimates, while scale efficiency was derived from CRS and VRS scores. Exploratory associations between 2021 bias-corrected efficiency and population ageing, population density, and unemployment were examined using Simar–Wilson double-bootstrap truncated regression. Productivity change was assessed using the Malmquist Productivity Index. Results: Mean bias-corrected CRS efficiency ranged from 0.7486 to 0.8556, and no hospital achieved a bias-corrected score of 1. Mean scale efficiency ranged from 0.8981 to 0.9416. Population ageing, population density, and unemployment were negatively associated with efficiency in the primary second-stage specification, with coefficient directions remaining broadly consistent across sensitivity models. Malmquist analysis indicated an overall decline in productivity, driven predominantly by shifts in the estimated production frontier, with substantial year-to-year variation. Conclusions: Hospital efficiency and productivity varied substantially across hospitals and over time. DEA can support regional performance review, but results should be interpreted alongside case mix, quality, accessibility, population need, and local service responsibilities rather than as stand-alone performance rankings.

The rapid growth of financial technology (FinTech) has introduced significant regulatory challenges for public sectors across the European Union, particularly as digital finance becomes integrated into government operations. The European Union has established a comprehensive regulatory framework, including PSD2, eIDAS, GDPR, and MiCA. However, the transposition of PSD2 (a directive) and the implementation of eIDAS, GDPR, and MiCA (directly applicable regulations) at the national level remain complex and partial. This paper examines the FinTech regulatory landscape in Greece, focusing on its implications for the public sector. The study is based on a theoretical analysis of legal texts, policy documents, and academic literature. The analysis reveals that Greece has transposed PSD2 and implemented eIDAS, GDPR, and MiCA with reasonable timeliness, but implementation lags substantially due to fragmented institutional coordination, limited supervisory capacity, and the digital divide. Recent developments, such as MiCA implementation and the evolution of digital identity systems, further highlight the need for adaptive regulatory strategies. The paper develops a three-criteria analytical framework—regulatory alignment, institutional capacity, and practical application—that can be used to assess FinTech implementation across EU member states. Applying this framework to Greece reveals that while the country achieves full regulatory alignment for PSD2, eIDAS, and GDPR, it demonstrates limited institutional capacity and practical application. For MiCA, while regulatory alignment is achieved, institutional capacity is inadequate and practical application is weak.

The rule of law, a foundational value of the European Union as enshrined in Article 2 of the Treaty on European Union, faces challenges in implementation due to historical and political factors that have evolved over the past decade, particularly within Member States in the administrative domain. While institutional backsliding in countries like Hungary and Poland has drawn significant political attention, less emphasis has been placed on the role of public administrations in upholding or undermining the rule of law on a day-to-day basis. This paper argues that the sustainability of the rule of law in the EU requires more than legal compliance mechanisms. These alone do not address the underlying administrative and cultural factors necessary for effective implementation. Instead, it requires closer attention to how rule-of-law principles are embedded in the everyday functioning of public administrations. This argument is informed by the authors’ systematic examination of recent EU monitoring practices and administrative reform instruments. Adopting a mixed conceptual-empirical methodology, the paper draws on primary data from EU Rule of Law Reports (2020–2024), the EU Justice Scoreboard, the Recovery and Resilience Facility (RRF), and the Technical Support Instrument (TSI), complemented by relevant OECD/SIGMA indicators. Several structural obstacles emerge from the analysis. These include symbolic compliance, whereby organisations adopt formal structures without corresponding behavioural change; weak institutional leadership that fails to drive reform momentum; and the absence of integrated performance metrics, which hampers meaningful accountability. Fragmented ownership of reform agendas, in turn, breeds inconsistency in implementation. These challenges point to the limitations of a technocratic or legalistic approach to rule-of-law governance. Strategic leadership and organisational flexibility emerge from the evidence as preconditions—not merely facilitators—of genuine internalisation, though the relationship is context-dependent. Digitalisation can reinforce these dynamics, yet its contribution depends on whether it is embedded within broader integrity-oriented reforms. The paper advocates for a shift from externalized compliance mechanisms to a model that emphasizes administrative ownership through specific strategies such as developing integrity-based leadership programs and embedding governance practices that prioritize transparency and accountability. It proposes concrete institutional reforms, including performance-linked conditionalities that tie funding to measurable outcomes, ethical leadership academies to train future leaders, integrity audits to ensure accountability, and administrative benchmarking to set clear standards, as tools to foster autonomous, value-driven public institutions capable of adapting to evolving governance challenges while maintaining core democratic values.

This study assesses the effect of the COVID-19 pandemic on tourists' preferences and behaviour, drawing on a structured questionnaire completed by 257 residents of the Greek island of Kefalonia, recruited through convenience and snowball sampling. Behaviour was measured across nine constructs (general risks, price, quality, hygiene risks, general attitudes towards travel, travel mode, destination, food and activities) on five-point Likert scales, and analysed with descriptive statistics, non-parametric group-difference tests (Mann-Whitney U, Kruskal-Wallis) and multiple linear regression. Mean scores clustered close to the scale midpoint, indicating moderate and somewhat ambivalent rather than uniformly strong behavioural shifts. Significant differences emerged for a small number of dimensions: men reported more cautious general travel attitudes, while older respondents and those with children scored higher on destination-related concerns. The findings offer practical implications for destination managers and tourism businesses seeking to attract visitors and to strengthen sustainability and resilience in the post-pandemic era.

Earnings management is a constant challenge to the credibility and transparency of financial reporting. Detecting earnings management is crucial for supporting economic growth and maintaining investor confidence, especially in economies dominated by small and medium-sized enterprises like Greece. Although numerous models have been developed to detect such practices, their effectiveness often varies depending on the institutional and economic context in which they are applied. This study provides a comparative assessment of four prominent detection models—the Altman Z-Score model, the Spathis model (S1), the Spathis Z-Score model (S2Z), and the Beneish M-Score model, focusing on companies listed on the Athens Stock Exchange (ASE). Using financial data for 2017–2018 for a sample of 31 companies, the analysis reveals significant differences in the detection results. The Altman model identifies distress rather than manipulation directly, the simplified Spathis model offers a leaner alternative, the Spathis Z-Score incorporates broader financial risk signals, and the Beneish model emphasizes accrual manipulation. All four models indicated a generally low likelihood of earnings misreporting less than 10%, suggesting that large firms increasingly adhere to legal accounting practices that build stakeholder trust. Nevertheless, no single model demonstrated universal reliability. These findings highlight the need for a multimodel analytical approach, particularly in countries such as Greece where regulatory and institutional complexity or structural opacity can mask financial misrepresentation.

This study focuses on the interplay between digital marketing and the F&B industry in Greece during the health crisis of COVID-19 in shaping consumer choices. The theoretical section discusses the most popular digital marketing methods and their importance, particularly during a crisis that confined most citizens to their homes and forced F&B stores to find new ways to attract customers. From an empirical perspective, a survey was conducted utilizing a structured questionnaire, involving 70 consumers in Athens, Greece. Participants expressed their views through closed-ended questions on the criteria for selecting F&B stores, the positive and negative aspects of digital marketing, and their preferences in general, as well as specifically for restaurants, bars, and cafés. The findings highlight that consumer confidence is a key priority (as the most important criterion for selecting F&B stores is the quality of the products) and that digital transformation of the F&B industry is essential as it can bolster resilience and drive growth in the F&B sector amid ongoing challenges.

The rapid evolution of financial technology (fintech), including cryptocurrencies and decentralized finance (DeFi), has transformed how consumers and businesses engage with financial services. This chapter examines the drivers of fintech adoption by extending established technology acceptance models, such as technology acceptance models (TAM), unified theory of acceptance and use of technology (UTAUT), and theory of planned behavior (TPB). A systematic review of 80 articles (2017–2023) identifies key factors influencing adoption, including perceived usefulness, ease of use, social influence, and facilitating conditions. Emerging factors, such as financial literacy, hedonic motivation, and trust, are especially important during crises, such as the COVID-19 pandemic. However, gaps remain in understanding how evolving perceptions of security and trust impact sustained adoption, particularly in decentralized environments, such as blockchain networks and crypto assets, where algorithmic transparency replaces institutional intermediaries. This chapter proposes integrating trust, security, and user perceptions into existing models to create a cohesive framework applicable across fintech services. The findings provide actionable insights for researchers and industry stakeholders to enhance user acceptance and guide future innovation.

The goal of this paper is to provide an overall presentation of corruption as occupational fraud building on the findings of an empirical study conducted in Greece. As uncertainty leads to increased levels of corruption, Greece was chosen due to the prolonged period of uncertainty the county faces, caused by the 2010 financial crisis and followed by the Covid pandemic crisis. 400 questionnaires reviewing corruption perception were gathered and analyzed by gender, age, marital status, education level, position, occupation, and monthly income, as well as urban vs rural area of residence. The findings of the study were compared with and critically evaluated against those of the previous studies for Greece. Respondents in age group 36-49 believe that if appropriate measures are taken it is possible to tackle corruption in the public sector, in contrast to people aged 18-35 who disagree completely. Residents of rural areas do not consider corruption to be a serious problem and are more willing to whistleblowing (in contrast to residents of urban areas). The study findings have important practical implications in the context of designing effective corruption reduction policies.

The chapter aimed to investigate a) whether the Regional Unit of Western Attica-Greece is a robust and smart region in terms of sustainable development policies (studying also its dimensions, i.e., environmental, cultural, economic, and social development) based on its citizens' perspectives and b) the impact of the COVID-19 pandemic on these policies implemented. A specially designed questionnaire was used in a sample of 175 inhabitants in the five Municipalities of the Regional Unit of Western Attica and the findings were studied applying appropriate descriptive and statistical methods. The findings showed that citizens in all Municipalities of the Regional Unit of Western Attica have a generally moderate level of awareness regarding sustainable development, with Municipality of Phyli outperforming the rest of them. Furthermore, it was evidenced that the COVID-19 pandemic had a major influence on the effectiveness of sustainable development policies put in place in all municipalities of the Regional Unit of Western Attica