Wspólnotowy Serwis Informacyjny Badan i Rozwoju - CORDIS


EUROPE FOR PATIENTS Streszczenie raportu

Project ID: 501586
Źródło dofinansowania: FP6-POLICIES
Kraj: Spain

Final Report Summary - EUROPE FOR PATIENTS (The future for Patients in Europe)

An increasingly integrated Europe offers potential benefits to patients through, among other things, greater access to centres of excellence and actions that overcome existing trans-frontier imbalances between demand and supply. However, for these benefits to be realised, there is still much to be done in terms of coordination of legal, contractual, regulatory issues, and in the provision of enhanced information to patients and care providers. These actions, in turn, require a better understanding of differences in how health systems operate on a daily basis and of the practical obstacles to greater harmonisation.

The EUROPE FOR PATIENTS project concludes that the mobility of patients across Europe's borders is somewhat marginal, as most patients prefer to be treated as near to home as possible, close to their friends and relatives. Nevertheless, patient mobility can be an important phenomenon in certain areas and contexts, such as tourist areas and border regions, and where providers have developed specific strategies to attract foreign patients. The project distinguishes between patients who go abroad because they need healthcare and patients who are abroad the moment they need healthcare. For the second group, the project analysed two main categories: temporary visitors abroad and long-term residents retiring to other countries. The patients who go abroad because they need care can be divided in three groups: people living in border areas; people referred abroad by their health systems; and people seeking treatment abroad on their own initiative. Examples of each of those are to be found in the case studies and in the material gathered throughout the project. The specific characteristics of each of these categories; their needs and expectations have been analysed. The nature of the challenges might differ for each category of patient mobility. The EUROPE FOR PATIENTS project also analysed different types of arrangements through which patients can have access to care abroad. An array of access procedures, patient pathways, payment methods etc. exist. These funding and management arrangements have also been grouped and the potential differences in the impact of the different arrangements for the patients, the actors involved in healthcare delivery and the healthcare systems have been analysed.

Although patients are on the whole very satisfied on the care they received abroad, when their care is properly managed, patients often experience a lack of information, bureaucratic hurdles, and problems with continuity of care. Problems with access to medical information and uncertainty surrounding the legal and administrative framework are weak points experienced by all the stakeholders. An important conclusion of the project is that the available data are fragmentary. Data are often not collected, not processed, unreliable, incomplete and incomparable.

The evidence gathered confirmed that where there is a right to free movement of people and services, health care cannot be limited to national boundaries. Even though the numbers involved still seem to be very small (whilst not forgetting a probable high number of unreported cases), there is a potential for increased numbers of patients asserting their right to obtain care abroad. Where care with prior authorisation is concerned, the establishment of prices by the providing system might cause problems for the originating country; and where no prior authorisation is required, costs might represent considerable uncertainty for patients.

Other future challenges include access to medical information: there is little inter-operability of health systems, because electronic cards and electronic patient records are not compatible.

Patient 'mobilities' need legal certainty. Some cases are straightforward, requiring clarification on the application of legal principles to health care, and involve issues such as liability and cross-border contracts. On other issues, political consensus is needed on the role of the market in the provision of health care, and market mechanisms are managed to ensure the citizens have equitable access to a balanced package of health services.

In conclusion, the results of this project and the ongoing discussions show that there is still a large open agenda on patient mobility: a new European Union (EU) health services instrument might be needed; then, building on current legislation, unresolved areas should be clarified, such as mechanisms developed at national level for defining undue delay, or systems for ensuring minimum standards for safety and quality of care provided. Patient mobility needs to be managed, and in some cases EU citizens should accept that prior authorisation is needed for certain types of treatment. Management and transparency will be the most important aspects of dealing with patient mobility in the future. Further research will be needed to clarify many of the open questions.

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