Clinicians’, policy makers’ and patients’ views of pediatric cross-border care between Malta and the UK

Saliba, Vanessa; Muscat, Natasha Azzopardi; Vella, Mairi; Montalto, Simon Attard; Fenech, Charlene; Knai, Cécile

doi:10.1177/1355819614521408

Cited by 12 publications

(13 citation statements)

References 7 publications

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“…The 13 articles analyzed revealed that health actions exist that provided for integration among countries, which took form in the model of international agreements. The data on the governmental policies for the integration of healthcare in international border regions permitted their organization in themes that address the scenarios of health integration agreements, particularly European countries, (11)(12)(13)(14)(15) Asian (16)(17)(18)(19) and South American countries. (20)(21)(22)(23) In these scenarios, the types and goals of the integration agreements could be identified.…”

Section: Resultsmentioning

confidence: 99%

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A integração de saúde entre fronteiras internacionais: uma revisão integrativa

2018

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Objective: Evidence the types and goal of the healthcare integration agreements in international border regions. Methods: Integrative literature review, in which studies published between 2006 and 2015 were selected that were indexed in the electronic databases CINAHL, Clinics Collection, LILACS, MEDLINE, PubMed, Scopus and SocINDEX. Thirteen studies were included. Results: The results demonstrate that formal and informal integration agreements exist in border regions, formalized by federal governments or international laws. The prevalent goals of these agreements are monitoring, disease detection and control in border regions. Conclusion: The agreements studied aim for cooperation to cope with regional diffi culties. The integration actions tend to minimize the health asymmetries of border populations. ResumoObjetivo: Evidenciar os tipos e a fi nalidade dos acordos de integração de atenção à saúde que ocorrem em regiões de fronteiras internacionais. Métodos: Revisão integrativa de literatura, na qual foram selecionados estudos publicados entre 2006 a 2015, indexados nas bases eletrônicas CINAHL, Clinics Collection, LILACS, MEDLINE, PubMed, Scopus e SocINDEX. Foram incluídos 13 estudos. Resultados: Demonstram que os acordos de integração em regiões de fronteiras entre países são dos tipos formais e informais, formalizadas por governos federais ou legislações internacionais. Como fi nalidade destes acordos, prevalecem os de monitoramento, detecção e controle de doenças em regiões fronteiriças. Conclusão: Os acordos estudados objetivam a cooperação para o enfrentamento de difi culdades regionais. As ações de integração tendem a minimizar as assimetrias de saúde das populações fronteiriças. ResumenObjetivo: Evidenciar los tipos y fi nalidad de los acuerdos de integración de atención de salud existentes en zonas de frontera internacionales. Método: Revisión integrativa de literatura, en la que fueron seleccionados estudios publicados de 2006 a 2015, indexados en las bases CINAHL. Clinics Collection, LILACS, MEDLINE, PubMed, Scopus y SocINDEX. Fueron incluidos 13 estudios. Resultados: Demostraron que los acuerdos de integración en zonas de fronteras entre países responden a los tipos formales e informales, respaldados por gobiernos federales o por la legislación internacional. Como fi n de estos acuerdos, prevalecen los de monitoreo, detección y control de enfermedades en regiones fronterizas. Conclusión: Los acuerdos estudiados apuntan a la cooperación para enfrentar las difi cultades regionales. Las acciones de integración tienden a minimizar las asimetrías sanitarias de las poblaciones fronterizas.

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Section: Resultsmentioning

confidence: 99%

“…The research methods employed were case studies with qualitative approaches (12,(14)(15)(16)20) or simply described as qualitative. (11,13) Four studies used quantitative methods (17)(18)(19)21) and two followed the mixed method. (22,23) A synthesis of the themes addressed is displayed in chart 1.…”

Section: Resultsmentioning

confidence: 99%

A integração de saúde entre fronteiras internacionais: uma revisão integrativa

2018

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“…It is based on a quota of Maltese patients who go to the UK to treat rare diseases and specialties and, in exchange, British residents who are temporarily in Malta receive free health care. (14) Managers who work in border regions serve foreign patients who seek urgency and emergency services in Brazil, and care in basic health and specialized units. In Study 2 of this review, health secretaries report that bilateral cooperation between countries could ensure comprehensive care for Brazilians and foreigners.…”

Section: Discussionmentioning

confidence: 99%

“…One of the selected studies showed how the bi-national specialized health agreement between Malta and the United Kingdom in the European Union works in an effective way. (14) In the Brazilian context, the government program reported in the studies was SIS-Fronteira, one of the solutions found by Brazil to solve the problem of the border population. It is an exclusively national program with no help from its neighboring countries and definition of the role of health managers.…”

mentioning

confidence: 99%

Papel do gestor de saúde pública em região de fronteira: scoping review

et al. 2019

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Objective: To examine and map scientifi c evidence on the role of public health managers in a border region. Methods: Scoping Review, based on the procedures recommended by the Joanna Briggs Institute. This method aims at mapping the main concepts, clarifying and identifying knowledge gaps, and achieving the signifi cance and adequacy of the health care practice. Based on these perspectives, the guiding question was: "What is the scientifi c evidence on the role of managers towards the management of public health in border regions?". Eight national and international databases were searched for papers published by August 2017. Of the 188 studies found, 13 were selected for their full reading, resulting in a fi nal sample of seven studies analyzed. Results: The seven publications analyzed were published from 2005 to 2017. Selected studies on the subject are national and international and of quantitative, qualitative or quali-quantitative approaches. The subjects of the studies were similar, considering most of them covered cross-border patient care and increased public health expenditures in these regions. Conclusion:The results of this review showed a shortage of national and international studies on the role of managers in health in border regions. The relevance of the theme and its complexity evidence the need for research on managers in these regions. ResumoObjetivo: Examinar e mapear as evidências científi cas sobre o papel do gestor de saúde pública em região de fronteira. Métodos: Scoping Review, baseado nos procedimentos recomendados pelo Instituto Joanna Briggs. Este método visa mapear os principais conceitos, clarifi car e identifi car lacunas do conhecimento, e obter a signifi cância e a adequação da prática dos cuidados de saúde. Com base nestas perspectivas, estabeleceu-se a pergunta norteadora: "Quais são as evidências científi cas sobre o papel do gestor na gestão em saúde pública nas regiões de fronteira ?". Foram realizadas buscas em oito bases de dados nacionais e internacionais, sobre trabalhos publicados até agosto de 2017. Dos 188 estudos encontrados, 13 foram selecionados para leitura na íntegra, resultando em uma amostra fi nal de sete estudos analisados. Resultados: As sete publicações analisadas foram publicadas de 2005 a 2017. Os estudos selecionados sobre a temática são de âmbito nacional e internacional e de abordagens quantitativa, qualitativa ou qualiquantitativa. Os objetos dos estudos foram semelhantes, uma vez que a maioria retratava sobre o atendimento ao paciente transfronteiriço e o aumento dos gastos públicos em saúde nestas regiões. Conclusão: Os resultados desta revisão mostraram uma escassez de estudos nacionais e internacionais sobre o papel do gestor em saúde na fronteira. A relevância do tema e sua complexidade evidenciam a necessidade de pesquisas sobre o gestor nestas regiões. ResumenObjetivo: Examinar y mapear las evidencias científi cas sobre el papel del gestor de salud pública en regiones de frontera. Métodos: Scoping Review, basado en los procedimientos recomendados...

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“…MS with systems that fit less well with EU legislation may be expected to experience larger adaptations [9,10]. MS with national health service type systems would have to undergo more significant changes in order to align their health care systems with the requirements of the crossborder care directive [11][12][13]. The impact assessment of the Commission's proposal for a directive had highlighted the fact that small MS are [8] likely to face a greater financial impact as a result of cross-border care [14].…”

Section: Introductionmentioning

confidence: 99%

The impact of the EU Directive on patients’ rights and cross border health care in Malta

et al. 2015

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The patients' rights and cross-border health care directive was implemented in Malta in 2013. Malta's transposition of the directive used the discretionary elements allowable to retain national control on cross-border care to the fullest extent. This paper seeks to analyse the underlying dynamics of this directive on the Maltese health care system through the lens of key health system stakeholders. Thirty-three interviews were conducted. Qualitative content analysis of the interviews reveals six key themes: fear from the potential impact of increased patient mobility, strategies employed for damage control, opportunities exploited for health system reform, moderate enhancement of patients' rights, negligible additional patient mobility and unforeseen health system reforms. The findings indicate that local stakeholders expected the directive to have significant negative effects and adopted measures to minimise these effects. In practice the directive has not affected patient mobility in Malta in the first months following its implementation. Government appears to have instrumentalised the implementation of the directive to implement certain reforms including legislation on patients' rights, a health benefits package and compulsory indemnity insurance. Whilst the Maltese geo-demographic situation precludes automatic generalisation of the conclusions from this case study to other Member States, the findings serve to advance our understanding of the mechanisms through which European legislation on health services is influencing health systems, particularly in small EU Member States.

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Clinicians’, policy makers’ and patients’ views of pediatric cross-border care between Malta and the UK

Abstract: Cross-border care pathways can successfully support access to high quality specialized care that is acceptable to health professionals and patients.

Cited by 12 publications

References 7 publications

A integração de saúde entre fronteiras internacionais: uma revisão integrativa

A integração de saúde entre fronteiras internacionais: uma revisão integrativa

Papel do gestor de saúde pública em região de fronteira: scoping review

The impact of the EU Directive on patients’ rights and cross border health care in Malta

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