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跨境医疗保健指令:评估波兰和葡萄牙利益相关者的观点。

Cross-border healthcare directive: Assessing stakeholders' perspectives in Poland and Portugal.

作者信息

Helena Ricardo

机构信息

MPH, University of Sheffield, UK; MSc in Health Economics and Governance of Health Systems, Jagiellonian University of Krakow, Poland.

出版信息

Health Policy. 2016 Apr;120(4):369-76. doi: 10.1016/j.healthpol.2016.02.009. Epub 2016 Mar 3.

DOI:10.1016/j.healthpol.2016.02.009
PMID:26948704
Abstract

Within the context of the EU, a succession of rulings from the European Court of Justice addressed the gap of specific healthcare legislation. These rulings shook the member states assumption of health provision autonomy and led the European Commission to produce a specific directive concerning cross-border healthcare. In spite of different viewpoints of member states, including Poland and Portugal, the directive was approved and expected to be implemented by October 2013. The objective of this study was to analyse stakeholders' perspective towards the directive, unveiling the factors that supported a different viewpoint, and to identify challenges and assess the expected impact associated with the directive implementation on Poland and Portugal, using the WHO health systems conceptual framework. Information was collected through a literature review, identifying potential stakeholders. Primary qualitative analysis was conducted through the dissemination of open-ended questionnaires. Content and critical analysis was performed considering the available literature intertwined with the WHO health systems conceptual framework. The directive appears to be positive regarding patient rights, increased transparency, and potential to set new information technologies and healthcare networks. However, it also seems to potentially generate access inequalities between home and foreign patients, and increase healthcare costs due to the short-term investments needed.

摘要

在欧盟范围内,欧洲法院的一系列裁决解决了特定医疗保健立法的空白问题。这些裁决动摇了成员国对医疗保健供应自主权的假设,并促使欧盟委员会出台了一项关于跨境医疗保健的具体指令。尽管包括波兰和葡萄牙在内的成员国存在不同观点,但该指令仍获批准,并预计于2013年10月实施。本研究的目的是利用世界卫生组织卫生系统概念框架,分析利益相关者对该指令的看法,揭示支持不同观点的因素,并确定挑战,评估该指令在波兰和葡萄牙实施可能产生的影响。通过文献综述收集信息,确定潜在的利益相关者。通过发放开放式问卷进行初步定性分析。结合现有文献和世界卫生组织卫生系统概念框架进行内容和批判性分析。该指令在患者权利、提高透明度以及建立新信息技术和医疗保健网络的潜力方面似乎是积极的。然而,它也可能在本国患者和外国患者之间造成获得医疗服务的不平等,并因所需的短期投资而增加医疗成本。

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