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边境对健康的影响：一般性思考及波兰-德国边境案例研究。

Health impact of borders: general reflections and a case study from the Polish-German border.

机构信息

Department of Healthcare Management, University of Greifswald, Friedrich-Loeffler-Strasse 70, 17487, Greifswald, Germany.

Department of Anesthesia, Intensive, Emergency and Pain Medicine, University Medicine of Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany.

出版信息

Eur J Health Econ. 2024 Mar;25(2):281-292. doi: 10.1007/s10198-023-01588-5. Epub 2023 Apr 12.

DOI:10.1007/s10198-023-01588-5
PMID:37046102
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10096107/
Abstract

BACKGROUND AND OBJECTIVE

Political, economic, communicative and cultural borders still limit the accessibility of acute healthcare services for patients so that they frequently have to accept longer distances to travel to the next provider within their own country. In this paper, we analyze the impact of borders and opening of borders on acute medical care in hospitals and on patients in border regions.

METHODS

We develop a conceptual framework model of cross-border healthcare and apply it to the Polish-German border area. The model combines the distance decay effect, a catchment area analysis, economies of scale and the learning curve.

RESULTS

Borders have a major impact on acute medical care in hospitals and on patients. Setting of new borders will reduce the accessibility of health facilities for patients or require the establishment of new hospitals. Reopening borders might induce a vicious circle leading to the insolvency of a hospital which might result in poorer health for some patients.

CONCLUSION

Strong effort should be invested to overcome political and cultural borders to improve the health of the population in border regions. Similarly, increased cross-border acute healthcare must be seen in the context of rural health and the special situation of small rural hospitals in rural peripheral areas.

摘要

背景与目的

政治、经济、沟通和文化等边界仍然限制了患者获得急性医疗服务的机会，使他们经常不得不接受更长的距离，前往本国的下一个医疗服务提供者。本文旨在分析边界和边界开放对医院急性医疗服务和边境地区患者的影响。

方法

我们开发了一个跨境医疗的概念框架模型，并将其应用于波兰-德国边境地区。该模型结合了距离衰减效应、集水区分析、规模经济和学习曲线。

结果

边界对医院的急性医疗服务和患者有重大影响。新边界的设定将降低患者获得医疗设施的便利性，或者需要建立新的医院。重新开放边界可能会导致恶性循环，使医院破产，从而导致一些患者的健康状况恶化。

结论

应大力努力克服政治和文化边界，改善边境地区居民的健康状况。同样，跨境急性医疗服务的增加必须结合农村卫生和农村偏远地区小农村医院的特殊情况来看待。

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