The role of the 2011 patients' rights in cross-border health care directive in shaping seven national health systems: Looking beyond patient mobility. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Azzopardi-Muscat, Natasha; Baeten, Rita; Clemens, Timo; Habicht, Triin; Keskimäki, Ilmo; Kowalska-Bobko, Iwona; Sagan, Anna; van Ginneken, Ewout
• Is Part Of: Health policy. Volume 122:Issue 3(2018)
• Page Start: 279
• Page End: 283
• Publication Date: 2018-03
• Subjects: Cross-border health care -- European union -- Patients' rights -- Health system -- Health policy; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2017.12.010
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Some countries had adopted ECJ case law on patient mobility before the directive became effective. In these countries, including Belgium, Estonia, Germany, and the Netherlands, the directive had little impact. In Poland, Malta, and Finland, more substantial reforms were needed to adapt to the directive. The Directive increased pressure to reimburse care from domestic private (non-contracted) providers. Abstract: Reports on the implementation of the Directive on the application of Patients' Rights in Cross-border Healthcare indicate that it had little impact on the numbers of patients seeking care abroad. We set out to explore the effects of this directive on health systems in seven EU Member States. Key informants in Belgium, Estonia, Finland, Germany, Malta, Poland and The Netherlands filled out a structured questionnaire. Findings indicate that the impact of the directive varied between countries and was smaller in countries where a large degree of adaptation had already taken place in response to the European Court of Justice Rulings. The main reforms reported include a heightened emphasis on patient rights and the adoption of explicit benefits packages and tariffs. Countries may be facing increased pressure to treat patients within a medically justifiable time limit. The implementation of professional liability insurance, in countries where this did not previously exist, may also bring benefits for patients. Lowering of reimbursement tariffs to dissuade patients from seeking treatment abroad has been reported in Poland. The issue of discrimination against non-contracted domestic private providers in Estonia, Finland, Malta and The Netherlands remains largely unresolved. We conclude that evidence showing that patients using domestic health systems have actually benefitted from the directive remains scarce and further monitoring over a longer period of time is recommended.