European health professionals’ experience of cross-border care through the lens of three common conditions

Introduction: There is growing attention to cross-border health care. This paper seeks to ascertain European health professionals' experience of integrated cross-border health care and their views on continuity of care mechanisms for patients returning to their country of residence, through the lens of three common conditions. Methods: A cross-sectional survey was designed to explore European health professionals' experience of managing three conditions, illustrating the variety of scenarios that might be encountered both by local populations and foreign European nationals: acute myocardial infarction (to represent a potential tourist scenario), acute ketoacidosis in a patient with type 2 diabetes (to represent chronic care needs of pensioners retiring in another country), and hip arthroplasty (to represent elective cross-border care). The survey was made available in Dutch, English, Finnish, French, German, Slovenian and Spanish and disseminated electronically. Results: The survey elicited 345 replies from 14 European countries, with the majority of the respondents from Austria, Finland and Spain. The total number of respondents was relatively high for a study of this type but the large variation in responses by country precluded any analysis of between or within-country differences in care practices. Most respondents were medical specialists currently working in the hospital setting who had previously treated foreign EU nationals. Only 12% of respondents had previously received information on the management of cross-border care patients. Half of respondents (54%) stated that continuity of care was only provided through discharge summaries, while one third of respondents (29%) reported that no mechanisms were in place at all. Conclusions: Harmonizing hospital discharge summaries, making IT systems more compatible and informing health professionals on ways to best support foreign EU national patients could improve continuity and quality of care across Europe. Despite strenuous efforts to obtain representative data, this study can only be considered exploratory in nature. Recommendations are made to improve data collection in future studies on cross-border health care.