Jan-Walter De Neve MD, International Services Medical Coordinator for the Anadolu Medical Center in Turkey, provides an overview of some of the research conducted into cross border healthcare within the European Union and looks at the key drivers for patient mobility within the European Union.
Given the rapid integration of EU Member States and the current debate on patient mobility surrounding the European Directive, one would expect a significant amount of intra-European medical travel. The available data however, reveals a relatively low level of cross-border medical travel within the European Union.
A study commissioned by the European Commission in the early nineties to analyze medical travel revealed that, for the 12 member states in existence at the time, the total value of financial tranfers related to cross-border healthcare was 460.5 million Euro in 1989 and 1,102 million Euros in 1993. This amounted to less than 4 Euros per habitant.(1)
The study also revealed the importance of ‘pre-authorized care’ (60%) versusimmediate care in the case of a temporary stay (25%) and cross-border care for frontier workers (15%) of total expenditures in European cross-border healthcare. In the area of pre-authorized care, France was the major destination country (78%), followed by Belgium (11%), The Netherlands (6%) and Germany (4%).Italy made the most use of cross-border care together with Luxemburg, accounting for over 95% of the French activity.(1)
Rita Baeten, a prominent researcher at the Observatoire Social Européen in Brussels, and well known EU policy advisor on healthcare issues, reinforces the above analysis with similar data appearing in a more recent literature review of Patient Mobility in the EU, stating that the overall numbers of medical travel in Europe remain ‘minor’ (2006). Medical travel seems the result of specific circumstances such as waiting times or national bioethical legislations, and predominates in certain areas and contexts such as tourist areas and border regions.(2) Recently, the European Commission also stated that cross-border healthcare is responsible for (only) 1% of public expenditure on healthcare (3) involving an expenditure of US$13.5 billion (Forbes 2009).(4)
The full article will be published in the European Journal of Public Health shortly.
References
1. J Hermesse, H Lewalle, W Palm, “Patient mobility within the European Union”, European Journal of Public Health, 1997, Oxford Univ Press
2. R Baeten, I Glios, “A Literature Review of Cross-Border Patient Mobility in the European Union”, Sept 2006
3. SEC (2008) 2163, 02.07.2008 (p9), European Commission
4. “E.U. Moves Ahead With Medical Mobility Law”, Jul 2009, Forbes http://www.forbes.com/2009/04/06/european-parliament-votes-business-oxford-analytica.html
Profile of the author
Jan-Walter De Neve is International Services Medical Coordinator at the Anadolu Medical Center in Turkey. Prior to this, he was a Research Associate at University Hospital Brussels. He received his medical training at universities in Belgium, Israel, Switzerland and the USA. He is also Chairman of the Board of Directors of NGO The Comrads, a non-profit organsation that raises money for and supports communities affected by HIV and Aids.
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