The question of cross-border access to healthcare in the European Union has long surpassed the idea of merely encouraging the movement of workers across borders. Nevertheless, remnants of the ...nation-state-based discourses have retained their grip on certain member states, making access to cross-border healthcare less effective. This article will perform a genealogical analysis of the regulatory aspects of cross-border access to healthcare. On the one hand, an ethical need for increasing inclusivity will be emphasized. To retain the quality of public healthcare, this has to be balanced with realist considerations, taking into account economic and other social factors.
Background and objective
Political, economic, communicative and cultural borders still limit the accessibility of acute healthcare services for patients so that they frequently have to accept longer ...distances to travel to the next provider within their own country. In this paper, we analyze the impact of borders and opening of borders on acute medical care in hospitals and on patients in border regions.
Methods
We develop a conceptual framework model of cross-border healthcare and apply it to the Polish–German border area. The model combines the distance decay effect, a catchment area analysis, economies of scale and the learning curve.
Results
Borders have a major impact on acute medical care in hospitals and on patients. Setting of new borders will reduce the accessibility of health facilities for patients or require the establishment of new hospitals. Reopening borders might induce a vicious circle leading to the insolvency of a hospital which might result in poorer health for some patients.
Conclusion
Strong effort should be invested to overcome political and cultural borders to improve the health of the population in border regions. Similarly, increased cross-border acute healthcare must be seen in the context of rural health and the special situation of small rural hospitals in rural peripheral areas.
E-health, a priority for governments worldwide, involves multiple stakeholders and requires a complex framework designed for interoperability on legal, organizational, technical, and semantic levels, ...as the Croatian National Healthcare System exemplifies. Successful implementation suggests a model for e-government more broadly. The first Web extra at http://youtu.be/oB0_80AKUXc is an audio podcast in which Tina Miteko from Tech Talks Central speaks with Benoit Abeloos, Research Program Officer, eHealth for the European Commission, about the progress in eHealth that has been made so far in Europe; the obstacles that need to be surpassed; EU data protection policies; and initiatives that foster entrepreneurship and job growth. Shared via Creative Commons http://creativecommons.org/licenses/by-nc-sa/3.0/legalcode. The second Web extra at http://youtu.be/iN_QscJdMTI is a video in which Ettore Turra and Benoit Abeloos report their vision on e-health in Trentino and in Europe during the First National Workshop: From Personal Notepad to Personal Health Record, held in Trentino on 20-21 March 2014. For more info please visit: https://www.fbk.eu/events/personal-notepad-personal-health-records.
The issue at stake in Case C-243/19 A v. Veselības ministrija is whether a personal choice on the part of a patient, based on religious beliefs, must be considered when assessing the need for ...cross-border healthcare. The Court of Justice of the European Union holds that the Charter of Fundamental Rights of the European Union is applicable and the right to freedom of religion can be invoked, in addition to medical criteria. However, the sustainability of the healthcare system can be an objective justification for refusal to grant authorisation for cross-border healthcare. Furthermore, the case clarifies – to a certain extent – the parallel tracks for claiming cross-border healthcare.
In Denmark, immigrants have been found to have a higher use of healthcare services abroad. Since this use may have an impact on both the individual patient and the healthcare system in the country of ...residence, research into underlying reasons is of increasing relevance. This study therefore investigates what motives patients with an immigrant background have for seeking healthcare services in their region of origin.
The study was based on 10 semi-structured interviews with 10 patients who had an immigrant background, primarily originating from Turkey and the Middle East, recruited at a clinic of immigrant medicine in Denmark. The interviews were analysed thematically to elucidate motives for seeking healthcare services abroad, with focus on identifying push and pull factors.
Four motives for seeking healthcare in the region of origin were salient in the material: the perception of availability, in terms of quantity and access; familiarity, conceptualised as feeling comfortable within the healthcare system; perception of quality of services; and finally, the perceived need for a second opinion. All motives emerged simultaneously as push factors, motivating immigrants to explore healthcare services abroad, and pull factors, attracting them to their country of origin. Affordability did not emerge as an independent motive but influenced the other factors.
The use of healthcare services abroad by patients with an immigrant background constitutes active health-seeking behaviours shaped by a range of factors perceived to be limiting access to high-quality services in Denmark. Further research, including quantitative studies, should be initiated to investigate the importance of these motives among larger, more diverse immigrant groups, consequences for treatment regimes, and the healthcare professionals' perspective on the use of healthcare in the region of origin among immigrant patients.
Highlights • This cross-sectional study explored potential pitfalls in the medical travel process. • Health records were not always transferred abroad, especially not in advance. • Provision of ...follow-up care in the home country can be problematic. • Even after the implementation of the PRD, reimbursement issues were experienced. • Member states are recommended to update their policies for safe medical travel.
Objectives:
To analyze the current situation of cross-border access to clinical trials in the EU with an overview of stakeholders' real-life experience, and to identify the needs, challenges, and ...potential for facilitation of cross-border access.
Methods:
We employed a mixed methods design. Semi-structured interviews and an online survey were conducted with a wide range of stakeholders: patient representatives, investigators/physicians, policy and regulatory experts, academic and commercial sponsor representatives, ethics committee members. Interviews underwent a framework analysis. The survey was analyzed descriptively.
Results:
Three hundred ninety six individuals responded to the survey. The majority were investigators/physicians (46%) and patient representatives (33%). Thirty eight individuals were interviewed. The majority were investigators/physicians (29%) and patient representatives (29%). All European regions were represented in the study. The highest response rate was received from residents of Western European countries (38% of survey respondents, 45% of interviewees), the lowest from Eastern Europe (9% of survey respondents, 5% of interviewees). The study suggested that cross-border participation in clinical trials occurs in practice, however very rarely. Ninety two percentage of survey respondents and the majority of interviewees perceived as needed the possibility to access clinical trials abroad. However, most interviewees also opined that patients ideally should not have to travel in order to access experimental treatment. The lack of access to treatment in the home country of the patient was described as the main motivation to participate in a clinical trial in another country. The logistical and financial burden for patients was perceived as the biggest challenge. Different stakeholders expressed diverging opinions regarding the allocation of financial and organizational responsibility for enabling cross-border access to clinical trials. Participants provided a number of proposals for improving the current system, which were carefully evaluated by the research team and informed future recommendations.
Conclusions:
Participation in clinical trials abroad is happening rarely but should be facilitated. There was a consensus on the need for reliable and accessible information regarding practical aspects, as well as multi-stakeholder, multi-national recommendations on existing options and best practice on cross-border access to clinical trials. Broader interdisciplinary research is recommended before discussing options in the EU legislative framework to enable clearly defined conditions for cross-border access to clinical trials.
While policy attention is understandably diverted to COVID-19, the end of the UK's post-Brexit ‘transition period’ remains 31 December 2020. All forms of future EU−UK relationship are worse for ...health than EU membership, but analysis of the negotiating texts shows some forms are better than others. The likely outcomes involve major negative effects for NHS staffing, funding for health and social care, and capital financing for the NHS; and for UK global leadership and influence. We expect minor negative effects for cross border healthcare (except in Northern Ireland); research collaboration; and data sharing, such as the Early Warning and Response System for health threats. Despite political narratives, the legal texts show that the UK seeks de facto continuity in selected key areas for pharmaceuticals, medical devices, and equipment including personal protective equipment (PPE), especially clinical trials, pharmacovigilance, and batch-testing. The UK will be excluded from economies of scale of EU membership, e.g. joint procurement programmes as used recently for PPE. Above all, there is a major risk of reaching an agreement with significant adverse effects for health, without meaningful oversight by or input from the UK Parliament, or other health policy stakeholders.
Over the past 50 years, although categorized as the "Information Age" or "Digital Age," the vast amounts of digitized data have been sorely underutilized. Only recently, in response to the COVID-19 ...pandemic, efforts have accelerated to harness these data using blockchain technology as it pertains to healthcare. Today, through the blockchain infrastructure and its tokenization applications, we are able to leverage healthcare data effectively into more efficient business processes. In addition, we can secure better patient engagement and outcomes, while generating new revenue streams for an array of healthcare stakeholders. It is in the application of blockchain technology to compile these stockpiled data into new, compliant business models that we can reap the full potential of the blockchain. Here are predictions by members of the BHTY editorial board members on how we might further advance the role of blockchain in healthcare in 2023.
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