EUCBCC

EUropean Cross Border Care Collaborations Short Title: CrossEurope

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 Obiettivo del progetto (Objective)

'EUCBCC aims to facilitate a process whereby Europe's citizens can make informed choices about whether to seek health care in another Member State and, if they so choose, to ensure that the admin and clinical processes are straightforward and ensure continuity of care. It takes as its starting point the recent draft Directive on Patients' Rights, augmented by the existing body of research on cross-border care. It then focuses on those areas where the necessary information is incomplete and seeks to fill the gaps. It is equally important to state what it does not do. It does not seek to quantify the scale of movement because our earlier research reveals this to be a dynamic area where data are often unavailable and rapidly become out of date. EUCBCC firstly examines five aspects of health care delivery where it will be necessary for procedures to be compatible if patients are to be assured that the care they receive is safe, of adequate quality, and capable of providing continuity where some parts of the overall care process are provided in different Member States. These are: provisions with regard to the continuing quality health professionals; treatment pathways; public reporting of quality; content and scope of medical records; and medical prescribing. Secondly, it looks at three areas where there is already cross-border collaboration, to identify practical issues that have arisen and how they have (not) addressed. These areas of practice are collaborations between hospitals in border areas, telemedicine, and dentistry. The research on the first set of topics generally takes place on two levels. The first involves a series of pan-European surveys to identify the nature of the phenomenon in, as far as possible, all Member States. The second involves focused studies in key areas geographical of subject areas that capture important issues. The methods used are both quantitative and qualitative and involve contributions from a broad range of disciplines.'

Introduzione (Teaser)

Providing health care to patients across European borders is difficult. An EU-funded project explored where it is working and what barriers prevent more widespread use.

Descrizione progetto (Article)

The project 'European cross border care collaborations short title: CrossEurope' (http://www.ecabeurope.eu (EUCBCC)) examined nine aspects of cross-border health care: quality of health professionals, treatment pathways, the content and scope of medical records, medical prescribing, reporting quality in both health and long-term care, hospital collaboration, telemedicine, dentistry and media reporting. The study also looked at existing cross-border collaborations to identify practical issues and concerns.

Researchers used a variety of quantitative and qualitative models to gather information. These included surveys, a Delphi exercise, mystery interviews and focus groups. Experts from 13 partner institutions from 11 countries conducted the research.

Findings showed that relatively few patients or those who seek care cross borders for health services. Even well-developed arrangements, such as those for dentists in Hungary serving patients from Hungary and Austria, serve limited numbers of patients. This is also true for French women choosing to give birth in Belgium and tourists receiving dialysis treatment in Italy. Although patient satisfaction was high, lack of data made it difficult to quantify the scale of these events.

In contrast, there was significant movement of health professionals across borders. Variability in training standards across countries, however, has been problematic.

Variability in guidelines was also identified as a problematic area. For example, although all participating countries have clinical guidelines, there is no systematic process for data collection. As a result, it is difficult to determine how frequently the guidelines are used.

An area where processes are working well is patient safety in dispensing of prescriptions. The limited amount of dispensed prescriptions allow pharmacists to find the right one. In other areas, further improvements in the legal framework are needed for cross-border care to take place and to be effective. For instance, for telemedicine to work, legislation and regulation at the EU level are needed. There also should be agreement on minimum data requirements in hospital discharge summaries.

This project was the first comprehensive overview of current patient and professional mobility across Europe. Its findings will have a major impact on public policy decisions.