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The issue at stake in Case C-243/19 A v. Vesel��bas ministrija is whether a personal choice on the part of a patient, based on religious beliefs, must be considered when assessing the need for cross-border healthcare. The Court of Justice of the European Union holds that the Charter of Fundamental Rights of the European Union is applicable and the right to freedom of religion can be invoked, in addition to medical criteria. However, the sustainability of the healthcare system can be an objective justification for refusal to grant authorisation for cross-border healthcare. Furthermore, the case clarifies ��� to a certain extent ��� the parallel tracks for claiming cross-border healthcare., Maastricht Journal of European and Comparative Law, vol. 28, no. 6, p. 900

Cross-border healthcare use among elderly Turkish migrants living in Denmark has been of concern in regards to their compliance with Danish healthcare provisions. A qualitative study of 30 elderly Turkish migrants was conducted, and the analysis led to the construction of two types of users: acute and intentional. The acute users respected the authority of the Danish healthcare system and only sought the use of healthcare services in acute situations whilst in Turkey. In contrast, the intentional users planned to consult and buy healthcare services whilst in Turkey. It was concluded that national health authorities should acknowledge and appreciate the benefits of transnational health practices represented by those groups of migrants who, in cooperation with their doctors, are competent users of cross-border healthcare services. The results of this study call attention to scholars of health and migration to be aware of our own ‘concerns’, which may represent spots of blindness hindering important and surprising insights.

In October 29th, 2020, the Court of Justice of the European Union delivered a judgment in case A. vs Ministry of Health, No C-243/19. The Court in the judgment analysed significant legal issues relevant to Latvia. Therefore, the aim of the article is to analyse the main proceedings about the patient’s right to cross-border healthcare when effective hospital treatment is available in the patient’s Member State but the method of treatment used is against the patient’s religious beliefs. The article also aims to analyse whether the principle of objective investigation and prohibition of legal obstruction by institutions and courts in accordance with Administrative Procedure Law have been obeyed. In the article, European Union and national legal framework and scientific literature in the field of patient’s right to receive cross-border healthcare have been analysed. Facts of main proceedings in national court cases and request to Court of Justice of the European Union for preliminary ruling from the Senate of the Supreme Court of the Republic of Latvia have been studied as well. Next, the Advocate General Gerard Hogan’s opinion and judgment of the Court of Justice of the European Union has been analysed. Further, the judgement of the Senate of the Supreme Court of the Republic of Latvia has been investigated. Upon concluding the article, the author draws attention to certain issues of national court’s legal analysis, which could be incompatible with the principle of objective investigation and prohibition of legal obstruction by institutions and courts.

The aim of the article is to assess the access to health services in light of European Union regulatory changes, with particular emphasis on cataract procedures implemented in Poland during the years 2015–2017. Statistical data from the National Health Fund for the years 2015–2017 was analyzed by means of statistical description, graphical and table presentation. For parametric queues, a Student's t-test (α = 0.05) was used. For the number of submitted and paid applications under the directive, the linear trend model and the significance of the directional coefficient (α = 0.05) were used. The waiting queue for cataract surgery from the second quarter of 2015 to the fourth quarter of 2016 had an upward trend. In 2017, a drop in the number of waiting patients was observed, with a simultaneous increase in the number of applications submitted under the directive. At the same time, contract growth was observed, which translated into a decrease in the number of patients waiting for surgery in Poland. Nevertheless, no decreasing trend in the number of patients treated under the cross-border directive was observed.

While policy attention is understandably diverted to COVID-19, the end of the UK's post-Brexit ‘transition period’ remains 31 December 2020. All forms of future EU−UK relationship are worse for health than EU membership, but analysis of the negotiating texts shows some forms are better than others. The likely outcomes involve major negative effects for NHS staffing, funding for health and social care, and capital financing for the NHS; and for UK global leadership and influence. We expect minor negative effects for cross border healthcare (except in Northern Ireland); research collaboration; and data sharing, such as the Early Warning and Response System for health threats. Despite political narratives, the legal texts show that the UK seeks de facto continuity in selected key areas for pharmaceuticals, medical devices, and equipment [including personal protective equipment (PPE)], especially clinical trials, pharmacovigilance, and batch-testing. The UK will be excluded from economies of scale of EU membership, e.g. joint procurement programmes as used recently for PPE. Above all, there is a major risk of reaching an agreement with significant adverse effects for health, without meaningful oversight by or input from the UK Parliament, or other health policy stakeholders.

espanolResumen El presente estudio analiza el impacto de la normativa de desplazamiento de pacientes sobre la dinamica sanitaria intraeuropea a partir de un enfoque mixto. Basado en una perspectiva cualitativa, interpretativa e inferencial de datos secundarios disponibles, se determina la viabilidad del crecimiento del mercado sanitario tanto para paises miembros de la Union Europea como los no miembros. Se encuentra que la normativa vigente no abarca todas las garantias tacitas demandadas por pacientes en cuanto al aseguramiento y cobertura de servicios, medicos generando espacios para la presencia de captadores de pacientes que operan en un entorno de incertidumbre parcial. EnglishAbstract The present study analyzes the impact of the regulation of patient's mobility on intra-European health dynamics from a mixed approach. Based on a qualitative, interpretive and inferential perspective of available secondary data, the growth viability of the health market is determined for both European Union and non-EU countries. It was found that current legislation does not cover all the tacit guarantees demanded by patients in terms of insurance and coverage of medical services generating spaces for the presence of agents that operate in an environment of partial uncertainty.

This article aims to discuss issues of "Medical tourism" within the European Union countries. The author in his publication presented the trends of medical tourism and considered the cause of this phenomenon. The article makes reference to the history of migration in medical purposes. The role of freedom of movement and freedom to provide services as the base of the economic system of the European Union for the development of medical tourism. The publication presents the basic regulations on this subject in terms of Polish law and European law. The author based on reports and scientific publications tried to in this article to assess after the presentation of both positive and negative effects of this phenomenon, and also provide potential opportunities and threats flowing from it.

Despite the legal authority to confirm, override or modify healthcare insurance decisions made by physicians and government officials, health tribunal decisions have not been empirically analyzed. Using a novel quantitative methodology, all 387 Health Services Appeal and Review Board written and publicly available electronic decisions released over a five-year time period were statistically analyzed with respect to Ontario public health insurance requests for global cross-border healthcare. The statistical results found that patients knew their diagnosis prior to requesting cross-border healthcare, and 84% of patients requested specific northern US facilities for specific treatment. Two specific healthcare facilities in the US were requested for either surgery or assessments. A significant number of patients were seeking cross-border healthcare for pain treatment. This research challenges the assumption that cross-border treatment requests result only from domestic delay when instead patients are seeking specific treatments at specific facilities. This novel quantitative research methodology and data source of written and publicly available electronic Health Services Appeal and Review Board decisions should be used to inform policy decision regarding the utilization and evaluation of Canada's healthcare system and publicly funded healthcare insurance.

Trazer uma reflexão sobre a importância e o potencial impacto da migração pendular na busca por serviços de saúde e, em específico, sobre as peculiaridades dessa mobilidade na região de fronteira. O trabalho descreve o contexto em que a mobilidade pendular se insere na modificação do espaço urbano do século XX, apresenta alguns aspectos legais sobre o tema na área da saúde, ilustrando a partir da realidade da tríplice fronteira Brasil-Argentina-Paraguai, enquanto importante local de migração pendular para uso dos serviços de saúde. São apresentadas hipóteses para possíveis impactos da mobilidade pendular, desfechos em saúde, assim como medidas para aferir a mobilidade pendular, tais como o efeito da distância a ser percorrida da residência ao serviço de saúde, o local de residência (país diferente, com condições de desenvolvimento diferentes) e os aspectos organizacionais da atenção à saúde, como a incerteza relativa ao atendimento em função da mobilidade internacional. Conclui-se que essa forma de mobilidade é muito comum na busca por atenção à saúde, e não apenas, como versa a abordagem tradicional, para trabalho e estudo, e que faz-se de grande importância o estudo de seu impacto na saúde das pessoas e a sua inclusão nos debates sobre a atenção à saúde através da fronteira. This article aims to reflect about the importance and the potential impact of pendulum migration in the pursuance for healthcare, and, specifically, about the peculiarity of this kind of mobility in border areas. It describes the context in which the pendulum migration is inserted for the modification of the urban space in the 20th century, makes initial comments about legal aspects of the theme in health sector, and describes the reality of the Brazil-Argentina-Paraguay triple border as an important location of pendulum migration for the pursuance of healthcare as an illustrative fact. In this way, hypotheses are formulated about the causes of the pendulum migration impact on patient’s health like the effect of the distance covered from home to healthcare facilities, and organizational aspects related to healthcare like the uncertainty about having or not health assistance due to international mobility. It concludes that this kind of mobility is very common in the pursuance of healthcare despite the traditional approach to the theme mentioning only work or study. Besides that, it is very important to study its impact on health and to include this theme on the cross border healthcare debate.

In Swedish law, the notion of ‘science and proven experience’ (in Swedish, vetenskap och beprövad erfarenhet) defines the gold standard for public decision-making and practice, especially in medicine. The notion is notoriously vague but nevertheless plays an important role in the distribution of rights and duties of patients and healthcare workers. For example, failure to provide care in accordance with this standard can lead to penal responsibility. The notion also helps to define Swedish patients’ right to reimbursement for cross-border healthcare. From a legal point of view, the notion is especially intriguing because it appears to import medical standards into the legal conceptual apparatus. The purpose of this article is to explore the mechanisms of this and kindred ‘importing notions’ by investigating the role that the notion of science and proven experience plays in Swedish law and in the transfer of information between the legal and medical fields.

This chapter aims at providing an insight into some major aspects linked to migration of medical doctors within Europe. The article describes main factors which contribute to doctors’ migration. Further, the current and future mobility trends in Europe are discussed. A major part of this chapter is dedicated to an overview of the EU legal framework impacting healthcare professionals’ mobility, followed by some useful information related to the procedures for recognition of professional qualifications and offices in charge of mobility. Finally, the impacts on healthcare systems and the policy implications of doctor’s mobility are described in context of personalised medicine.

Background The EU Directive on the application of patients’ rights in cross-border healthcare provides rules for facilitating access to cross-border healthcare and promotes cooperation on healthcare between member states, which brings many changes both in the organization and financing of health care. The aim of this paper is to assess whether providers in Poland are prepared to function within the single European market and what may be the impact on the …

European Union (EU) Member States were required to direct their health practices to ensure implementation of ‘Directive on patients’ rights in cross-border healthcare’ which provides the right for EU citizens to seek treatment abroad. This study recruited Maltese patients, consequently it identified and quantified domains constituting willingness to access cross-border healthcare. Via this analytical approach, the results and recommendations were presented to assist cross-border healthcare policy., peer-reviewed

In this commentary, we establish a relationship between medical sociology and the study of medical tourism and cross-border healthcare by introducing Ronald Andersens behavioral model of healthcare use, and linking this model to the recent empirical study of Kovacs et al. on patients travelling to Hungary for orthopedic treatment. Finally, we plead for more measurement in the field of patient mobility.

The 21st century started with some significant efforts globally in the e-health sector. This was mainly pushed as a generic strategy from many nations and international organizations in order to cope with issues such as ageing population, demographic shift, social security limitations, and financial instability. A second reason was the introduction of new technologies such as cloud computing, Web interoperability standards, mobile health, and social media that are steadily changing the way healthcare has been seen in the last decades. In addition to that, globalization, commuting, immigration, and increased mobility raised the issue of cross-border healthcare and the right to access normalized healthcare services anywhere, anytime. In that context, the authors analyze the technological offerings and result of the epSOS (European Patient Smart Open Services) framework and how it has affected strategic decisions in electronic prescription in Greece, thus creating a new useful e-health national application. They prove that by rethinking healthcare, reusing established standards such as HL7 CDA (Health Level Seven Clinical Document Architecture) and IHE (Integrating the Healthcare Enterprise) profiles, it is possible to propose a new innovative system that is in fact based upon new technological propositions such as REST (Representational State Transfer) architecture and cloud computing.

This supplement is focused on the methods, results and recommendations from the research project “Methods of Assessing Response to Quality Improvement Strategies” (MARQuIS). MARQuIS was funded by the Scientific Support to Policies component of the European Union Sixth Framework Research Programme (Contract SP21-CT-2004-513712), and it lasted from January 2004 to June 2008. MARQuIS was coordinated by R Sunol, assisted by P Vallejo, from the Avedis Donabedian University Institute (Autonomous University of Barcelona) in Spain. Some of the European leading organisations in the healthcare quality field participated in this study, with two different roles

A critical problem in providing appropriate compensation for medical accidents in the context of cross-border healthcare is designing and supervising the factfinding processes. Numerous compensation systems in multiple jurisdictions, handling a high volume of cases, must be able to achieve outcome efficiency (neither under-compensating nor over-compensating victims), while also achieving administrative efficiency (low transaction costs). It is impossible to achieve these goals without consistent, accurate, evidence-based factfinding, particularly in an area as factually complex as medical-accident compensation. This paper discusses a framework for producing such factfinding without creating a centralized factfinding institution, and provides examples of general principles, institutional structures, and specific types of legal rules for evidence assessment. It illustrates aspects of this framework using the National Vaccine Injury Compensation Program in the United States. Both the structure of that Program and the cases decided under it provide insights on how factfinding can be transparent, evidence-based, and coordinated, as well as (presumably) accurate, so that all potentially affected parties can be confident that the compensation system is achieving its goals.

Patients will enjoy stronger rights for reimbursable medical treatment in another European Union country under proposals approved by the European parliament’s environment and public health committee. Amendments overwhelmingly endorsed by the committee on 27 October to draft legislation on cross border healthcare would limit the scope for national authorities in the patient’s home country to refuse to pay for the treatment. They would give special rights to people with rare diseases and ensure that anyone contemplating medical care abroad has access to all the relevant information, including the costs involved. The legislation follows a series of rulings by the European Court of Justice in recent years confirming that the public has a right to refundable treatment in another EU …

The Health sector is gaining momentum within the Industry 4.0. National Health Systems are tightly connected to different complex systems, and a wide set of devices. NHSs are processing and managing patients’ data, and they are exchanging sensitive information cross different countries. This paper takes into account legal aspects such as GDPR and it extends the Healthcare Industry architecture reference model, with a set of tools dealing with consent management and data hiding tools A case study illustrates the use of the reference architectural model.