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The European Journal of Public Health 1997 7(Supplement 3):33-41; doi:10.1093/eurpub/7.suppl_3.33
© 1997 by European Journal of Public Health
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A comparative study on cross-border hospital care in the Euregio Meuse–Rhine

Bert Starmans1, Reiner Leidl2 and Grant Rhodes1

1 Department of Health Organization, Policy and Economics, University Maastricht The Netherlands
2 Department of Health Economics, University of Ulm Germany

Correspondence: B. Starmans, Department of Health Organization, Policy and Economics, University Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands, tel. +31 43 3881727, fax +31 43 3670960

Received May 7, 1996 , accepted September 19, 1996

Using data and examples from 3 academic hospitals and 1 general hospital in the Euregio Meuse–Rhine, this paper illustrates the opportunities for and obstacles to cross-border in-patient care in the European Union (EU). It defines 2 concepts of cross-border care, one related to the country of residence of the patient and the other to the country of insurance. A number of possible determinants of cross-border in-patient hospital care in the Euregio are discussed as well as the actual evidence of this type of care in the study hospitals. In a number of cases, the level of cross-border care measured in this region exceeds the average level estimated for the EU. However, it is quite low: a share of the total hospital admissions of patients admitted from a directly neighbouring member state above 1% has been found to be extraordinarily high. On the one hand, a number of factors seem to have encouraged the cross-border in-patient care in this region: short distances between the patients' residences and foreign hospitals, small language differences, lower levels of patient charges in the foreign hospitals, the presence of special knowledge in the foreign hospitals and waiting lists in the domestic hospitals. On the other hand, regulations for cross-border care at the EU level generally constrain this type of care for publicly insured patients; privately insured patients may face less constraints. National rules may even extend the possibilities of cross-border care. The initiation of cooperation between both providers and insurers across borders, at the regional level, may alter the current state of cross-border care in the future.

Keywords: cross-border care, hospital care, European Union, regional analysis


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