Den Nya Patientmobiliteten Över Statsgränser

Sammanfattning: Health care access has always preoccupied human societies. Today citizens can travel abroad to obtain timely and/or affordable health care. Cross-border healthcare regulation has been established in the European Union to facilitate patient mobility and safety. Outside the EU medical travel however remains unregulated. This study thereby seeks to compare EU-regional and global patient mobility, and as well aims to identify the risk dimensions that are connected with patient mobility across borders. Two EU-regional cross-border healthcare mobility types were identified. One builds on national citizenship rights, while the other is based on EU-citizenship rights. Public sectors in EU-countries can sometimes send patients to other EU-countries for planned treatment, if such services cannot be provided timely within the domestic healthcare system. Agreements between nation-state public sectors include objective quality and safety evaluations. Secondly, while self-organized EU patient mobility in contrast necessitates independent quality and safety evaluations of clinics abroad, EU-nationals at the same time maintain social rights and can be reimbursed for their treatment abroad. The third patient mobility type is global. This entirely self-reliant consumer practice entails subjective risk calculations in an unregulated global healthcare market. Medical travel across borders can facilitate health care access and independent choice. Health care consumerism however is also bound to several interrelated risk dimensions. National healthcare systems are constituted by variable high security organizational cultures, which depend on familiarity and trust to enable safe and high quality health care provision. Risks include discontinuity of care and medical errors, communication issues and cultural unfamiliarity, and oversight limitations regarding safety and quality standards. While globalization impacts health policy and delivery, this study thus concludes that cross-border healthcare is not a sustainable solution to health care access problems in neither developing nor high-income countries.