Free Movement of Patients in the European Union and Its Impact Upon the National (Social) Health Care Systems

2005 ◽  
Author(s):  
Monika Kawczynska
2020 ◽  
Vol 19 (1) ◽  
pp. 71-80
Author(s):  
Michał Wielechowski ◽  
Łukasz Grzęda

The aim of the paper was to present health care systems and assess the recent trend in health care expenditure in the European Union countries. The data source was the World Bank and European Statistical Office (Eurostat). The adopted research period covered the years 2000–2016, due to data availability. The methodology of the study was based on an analysis of data indicator series related to health care expenditure, which evaluate the national health care system performance. The research results were presented using primarily Japanese candlestick charting. The study showed that health care expenditure represented an ever-increasing burden for all the EU economies, both in absolute values and in relation to GDP. However, substantial differentiations in the amount and structure of health care expenditure were observed at the country level, having roots in the level of a country’s economic development and diverse post-war economic and political evolution. The analysis of health care expenditure structure confirmed that all three types of health care systems (Beveridge, Bismarck and mixed one) were observed in the EU, but the last one had a marginal importance. The form of system did not determine its effectiveness. On average, more than three-fourths of health care expenses were financed by general government expenditure. Out-of-pocket spending varied widely among the analysed EU member states.


Author(s):  
Davor Mucic

In this chapter the author gives the short review over wide range of telepsychiatry applications. Furthermore, describes completely new and innovative approach regarding assessment and/or treatment of asylum seekers, refugees and migrants in Europe. Experiences from both Danish telepsychiatry survey and the first international telepsychiatry collaboration in Europe ever, will be reviewed in this chapter. Numbers of benefits within mental health care systems all over the European Union can be achieved by establishing of an International European Telepsychiatry Network. The chapter ends by suggestions for future development within mental health services in EU.


Health Policy ◽  
2004 ◽  
Vol 69 (3) ◽  
pp. 403-408 ◽  
Author(s):  
Efthimios D Avgerinos ◽  
Sotirios A Koupidis ◽  
Dimitrios K Filippou

1994 ◽  
Vol 9 (3) ◽  
pp. 337-362 ◽  
Author(s):  
Guenther Lueschen ◽  
Fred Stevens ◽  
Jouke van der Zee ◽  
William C. Cockerham ◽  
Jos Diederijks ◽  
...  

2020 ◽  
Vol 13 (11) ◽  
pp. 400
Author(s):  
Arnold G. Vulto ◽  
Jackie Vanderpuye-Orgle ◽  
Martin van der Graaff ◽  
Steven R. A. Simoens ◽  
Lorenzo Dagna ◽  
...  

Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.


2020 ◽  
Vol 161 (49) ◽  
pp. 2059-2071
Author(s):  
Helga Kraxner ◽  
Andor Hirschberg ◽  
Kristóf Nékám

Összefoglaló. Az allergiás betegségekben szenvedő emberek száma világszerte, köztük Magyarországon is növekszik. Az egészségügyi ellátórendszerek azon dolgoznak, hogy minél hatékonyabban tudják felhasználni a rendelkezésre álló forrásokat. Az Allergic Rhinitis and its Impact on Asthma (ARIA) szervezet célja az allergiás náthában szenvedő betegek ellátásának javítása, szakmai ajánlások készítése, aktualizálása. Ennek egyik módja integrált betegellátási utak kidolgozása. Célunk ezek hazai elérhetővé tétele, az ajánlások széles körű elterjesztése az Európai Unió (EU) többi tagállamához hasonlóan Magyarországon is. Az ARIA más nemzetközi innovatív szervezetek bevonásával olyan integrált betegellátási utakat fejlesztett ki, amelyek allergiás nátha, esetleg társbetegsége, az asztma esetén támogatják a kezelést. Ezeket újgenerációs irányelvek kidolgozása útján alkották, amelyekhez felhasználták a mobiltechnológiából és pollenkamra-vizsgálatokból származó valós evidenciákat is. A gyógyszeres terápia optimalizálásához a vizuális analóg skálán alapuló, úgynevezett Mobil Légúti Figyelő Hálózat algoritmusát digitalizálták, és valós evidenciák felhasználásával tovább finomították. Allergén immunterápiára az ARIA a világon elsőként dolgozott ki integrált betegellátási utakat 2019-ben. A kezelési irányelvekhez való adherenciaszint alacsony, a betegek a tüneteik erőssége alapján módosítják a kezelést. A flutikazon-propionát–azelasztin kombináció hatása erősebb az intranasalis kortikoszteroidokénál, míg az utóbbi hatásosabb az oralis H1-antihisztaminoknál. A mobiltelefonokban tárolt elektronikus napló vagy más ’mobile health’ (mHealth) eszközök használata segíti a betegek kiválasztását allergén immunterápiára. Az ARIA által javasolt algoritmus megfelelőnek mutatkozott az allergiás rhinitis kezelésére, ezért ezek az irányelvek bekerülnek integrált betegellátási utakba, és részét fogják képezni az EU Egészségügyi és Élelmiszer-biztonsági Főigazgatósága digitalizált, személyközpontú gondozási anyagainak. Az allergén immunterápia hatékony az inhalatív allergének által okozott allergiás betegségekben, alkalmazását azonban korlátozni kell gondosan válogatott betegekre. Orv Hetil. 2020; 161(49): 2059–2071. Summary. The number of allergic patients is increasing all over the world, also in Hungary. Delivering effective and cost-effective health care is essential for all health care systems. ARIA (Allergic Rhinitis and its Impact on Asthma) aims to improve the care of patients who suffer from allergic rhinitis by setting up guidelines and updating them. Development of ICPs (integrated care pathways) can play an essential role in attaining this goal. Our aim is to make ICP-s developed by ARIA available also in Hungary, as is already the case in other countries of the European Union (EU). Together with other international initiatives, ARIA has worked out digitally-enabled ICPs to support care in allergic rhinitis and comorbid asthma. ICPs are based on new-generation guidelines using RWE (real-world evidence) from chamber studies and mobile technology. The MASK (Mobile Airways Sentinel NetworK) algorithm – based on visual analogue scale – was digitalized to support pharmacotherapy, and was refined by using RWE. ARIA was the first to develop ICPs for allergen immunotherapy (AIT) in 2019. Based on MASK data, patients did not follow guidelines and their adherence to treatment was poor. Patients would modify their treatments, depending on the disease control. The effect of fluticasone propionate–azelastine combination is superior to intranasal corticosteroids which are superior to oral H1-antihistamines. Electronic diaries obtained from cell phones and other ’mobile health’ (mHealth) devices help select patients for AIT. The ARIA algorithm for AR was found appropriate and no change is necessary. These guidelines will inform ICPs and will be included in the DG Santé digitally-enabled, person-centred care system. AIT is an effective treatment for allergic diseases caused by inhaled allergens. Its use should, however, be restricted to carefully selected patients. Orv Hetil. 2020; 161(49): 2059–2071.


Author(s):  
Margot Horspool ◽  
Matthew Humphreys ◽  
Michael Wells-Greco

This chapter reviews the law on the free movement of services in the European Union. It discusses the service economy and the law on services; non-discrimination and the direct effect of Article 56 of the TFEU; the meaning of services; remuneration; economic services and other activities; services and cross-border activity; the freedom to provide a service; the freedom to receive services; health care provision and the receipt of services; services that move, where the provider and recipient do not; limitations on services freedom; public interest grounds limiting the freedom of Article 56 TFEU; proportionality and limitations on services; illegal services; and the focus on market access and the facilitation of services in the Services Directive.


2003 ◽  
Vol 52 (3) ◽  
Author(s):  
Jörg Jasper ◽  
Ralf Tostmann

AbstractIn this paper we analyze the economic effects of the European Court of Justice’s (CoJ’s) jurisdiction on national health care systems in Europe, especially in Germany. We focus on the CoJ’s decisions concerning European patients’ rights to choose freely among suppliers of medical treatment within the European Union. The results are that national health care systems will face an increasing pressure to comply with the rules of the European Treaty. For Germany, this means that some traditional traits of its regulatory framework, especially the principle of territoriality, will have to undergo a test of “Europe-friendliness”. Unlike these qualitative aspects, we find that quantitative effects will remain more or less negligible for the nearer future and will mostly be confined to the sector of advanced technology medicine.


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