Cross-border health care in the European Union: evaluation of different financing arrangements

• Autorzy: Ried W , Rau R. H.

Identyfikatory

DOI

10.1515/emj-2017-0009

• Języki publikacji: EN

Abstrakty

EN

This paper analyses the impact of the financing arrangements for planned cross-border health care within the European Union. A financial arrangement is taken to provide a financial incentive but may also involve payment risks and administrative burden. For the pathways given by the Social Security Regulations (883/2004 and 987/2009) and the EU Directive 2011/24/EU, we investigate how the associated financial arrangements act on providers, patients and on publicly funded health insurance. First, the Regulations can induce cross-border health care that will increase domestic health care expenditure and may threaten national health policy by setting an incentive for patients to go abroad for health care not covered by domestic health insurance. Second, the financial arrangement of the Directive may induce cross-border health care which will lower domestic health care expenditure. However, due to considerable payment risks and administrative burden on both pa-tients and providers, these benefits will not be reaped in full. Moreover, in the presence of national cost containment policies, the Directive may provide an incentive for cross-border health care that is too strong. Finally, due to the requirement to pay upfront, the financial arrangement also suffers from a lack of equity of access to health care provision abroad.

Słowa kluczowe

EN

financing arrangement; cross-border health care; national health policy

PL

układ finansowania; transgraniczna opieka zdrowotna; krajowaj polityka zdrowotna

• Wydawca: Oficyna Wydawnicza Politechniki Białostockiej
• Czasopismo: Engineering Management in Production and Services
• Rocznik: 2017
• Tom: Vol. 9, no. 2
• Strony: 8--20
• Opis fizyczny: Bibliogr. 21 poz., rys.

Twórcy

autor

Ried W

• University of Greifswald, Faculty of Law and Economics, Chair of Public Finance, Germany

autor

Rau R. H.

• University of Greifswald, Faculty of Medicine, Institute of Community Medicine, Germany

Bibliografia

• Blum, K., Löffert, S., Offermanns, M., & Steffen, P. (2015). Krankenhaus Barometer. Umfrage 2015 [Hospital Barometer. Survey 2015]. Düsseldorf, Germany: Deutsches Krankenhausinstitut.
• Busse, R., & Blümel, M. (2014). Germany: health system review. Health Systems in Transition, 16(2), 1-296.
• Busse, R., van Ginneken, E., & Wörz, M. (2011). Access to health care services within and between countries of the European Union. In M. Wismar, W. Palm, J. Figueras, K. Ernst, E. van Ginneken (Eds.), Crossborder health care in the European Union – Mapping and analyzing practices and policies, (pp. 47-90). Copenhagen, Denmark: European Observatory on Health Systems and Policies.
• Chevreul, K., Berg Brigham, K., Durand-Zaleski, I., & Hernández-Quevedo, C. (2015). France: Health system review. Health Systems in Transition, 17(3), 1-218.
• Cylus, J., Richardson, E., Findley, L., Longley, M., O’Neill, C., & Steel, D. (2015). United Kingdom: Health system review. Health Systems in Transition, 17(5), 1-125.
• Department of Health. (2016). Guidance on implementing the overseas visitor hospital charging regulations 2015. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/496951/Overseas_visitor_hospital_charging_accs.pdf
• Directive 2011/24/EU of the European Parliament and of the Council of March 2011 on the application of patients’ rights in cross-border health care 2011 (EU).
• European Commission. (2015a). Evaluative study on the cross-border healthcare Directive (2011/24/EU). Final report. Retrieved from https://ec.europa.eu/health/sites/health/files/cross_border_care/docs/2015_evaluative_study_exsum_en.pdf
• European Commission. (2015b). Commission report on the operation of Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare. Report from the Commission to the European Parliament and the Council. Retrieved from https://ec.europa.eu/health/sites/health/files/cross_border_care/docs/2015_operation_report_dir201124eu_en.pdf
• European Commission. (2016). Member State data on crossborder healthcare following Directive 2011/24/EU. Year 2015. Retrieved from https://ec.europa.eu/health/sites/health/files/cross_border_care/docs/2015_msdata_en.pdf
• European Patients Forum. (2013). EU Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare: Legislation Guidance for Patient Organisations. Retrieved from http://www.eu-patient.eu/globalassets/policy/cross-borderhealthcare/2013-11-18_cbhc_guidance-final.pdf
• European Patients Forum. (2015). Summary Report: CrossBorder Healthcare. Retrieved from http://www.eupatient.eu/globalassets/policy/cross-borderhealthcare/cbhc-summary-report-final_external.pdf
• European Patients Forum. (2016). Directive on patients’ rights in cross-border healthcare. EPF Position State-ment. Retrieved from http://www.eu-patient.eu/globalassets/policy/cross-borderhealthcare/epf_position_statement_cbhc_220416.pdf
• Ferré, F., de Belvis, A.G., Valerio, L., Longhi, S., Lazzari, A., Fattore, G., Ricciardi, W., & Maresso, A. (2014). Italy: Health System Review. Health Systems in Transition, 16(4), 1-168.
• Footman, K., Knai, C., Baeten, R., Glonti, K., & McKee, M. (2014). Cross-border health care in Europe. WHO Regional Office for Europe and European Observatory on Health Systems and Policies. Copenhagen, Denmark: WHO Regional Office for Europe.
• Hartrampf, C. (2016). Towards amplified awareness of EU rights to crossborder care: Stakeholders’ perspectives concerning information on cross-border care [Conference PDF Presentation]. Retrieved from https://ec.europa.eu/health/sites/health/files/cross_border_care/docs/ev_20161024_co01_en.pdf
• Hérault, S. (2012). Grenzüberschreitende Inanspruchnahme von Gesundheitsleistungen in der Europäischen Union. Rück- und Anreizwirkungen im deutschen Gesundheitssystem [Cross-border utilization of health care in the European Union. Feedback and incentive effects for the German health care system] [Disseration]. Heidelberg, Germany: Universität Heidelberg.
• House of Commons, Committee of Public Accounts. (2017). NHS treatment for overseas patients. Thirty-seventh Report of Session 2016-17. Retrieved from https://www.publications.parliament.uk/pa/cm201617/cmselect/cmpubacc/771/771.pdf
• National Audit Office. (2016). Recovering the cost of NHS treatment for overseas visitors. Retrieved from https://www.nao.org.uk/wp-content/uploads/2016/10/Recovering-the-cost-of-NHS-treatment-for-overseasvisitors.pdf
• Ried, W., & Marschall, P. (2016). Potential benefits of crossborder health care: The case of Poland and Germany. Economics & Sociology, 9(3), 14-27.
• Wismar, M., Palm, W., van Ginneken, E., Busse, R., Ernst, & K., Figueras, J. (2011). The Health Service Initiative: supporting the construction of a framework for cross-border health care. In M. Wismar, W. Palm, J. Figue-ras, K. Ernst, E. van Ginneken (Eds.), Crossborder health care in the European Union – Mapping and analyzing practices and policies, (pp. 1-22). Copenhagen, Denmark: European Observatory on Health Systems and Policies.