Mapping Health Services Access: National and Cross-Border Issues
(HealthACCESS)
Final Report, November 2006
EU Commission - Directorate General for Health and Consumer Protection
Reinhard Busse*, Markus Wörz*, Thomas Foubister**, Elias Mossialos** and Philip Berman***
*Dept. Health Care Management,
**LSE Health and Social Care,
***European Health Management Association (EHMA),
Available online as PDF file [53p.] at: http://ec.europa.eu/health/ph_projects/2003/action1/docs/2003_1_22_frep_en.pdf
“…..According to the EU Charter of Fundamental Rights, ‘Everyone has the right of access to preventive health care and
the right to benefit from medical treatment under the conditions established by national laws and practices’.
The Health ACCESS project has examined whether any of six hurdles:
- population covered for health insurance,
- benefits covered,
- cost-sharing arrangements,
- geographical barriers,
- organisational barriers and
- utilization of accessible services make it harder or even impossible to access health care within 10 EU countries, and whether cross-border arrangements between actors of different countries can effectively alleviate such problems. European integration has the potential to alleviate some but not all access barriers. However, it can also make access more problematic….”
Content
Summary and Policy Recommendations
Introduction
Access to health care within countries
The use of cross-border arrangements to enhance access
I. Access to health care within countries
Six hurdles to access health care services
Hurdle 1: The proportion of the population covered for health care
Hurdle 2: Benefits covered by health care systems
Hurdle 3: Cost-sharing arrangements
Hurdle 4: Geographical barriers to access
Hurdle 5: Organisational barriers to access
Hurdle 6: Utilization of accessible services
II. Cross-border arrangements and European patient mobility
Background
Cross border arrangements promoting access to health care
Types of arrangement and actors involved
Patient flows in cross-border arrangements
Access hurdles and other reasons for cross-border arrangements
Individual patient mobility
“European Centres of Reference”
III. Analysis of cross border arrangements and cross border movement
Types of cross-border arrangements
Localism/ local agency
Why are cross-border numbers so different? The relative importance of factors
Other features of cross-border arrangements
Conclusion
References
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