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Cross-border healthcare data.

van Ginneken E, Busse R
In: Wismar M, Palm W, Figueras J, Ernst K, van Ginneken E (eds.) Cross-Border Healthcare in the EU: Mapping and Analysing Practices and Policies. Copenhagen: WHO on behalf of European Observatory on Health Systems and Policies, S. 289-340





Although most countries seem to collate data on cross-border patient flows, huge national differences exist in terms of what is collected, the system of data collection and by whom the data are collected. The different frameworks under which patient mobility takes place (Council Regulation (EEC) No. 1408/71, cross-border contracts and, especially, the "Kohll/Decker" principle) make it difficult to collect all the data. There is a body of evidence that suggests an underestimation is in many cases the result. As a consequence, the reliability, completeness and the comparability of patient mobility data must be questioned. Data on "cross-border provision of services" and "permanent presence of a foreign service provider" are scarce. What evidence is available is anecdotal and presented in case study form. Data on professional migration are - similarly to patient migration - collected using various national data collection processes, which results in data that are incomplete and far from comparable. Furthermore, the health sector consists of more than nurses, doctors and dentists, but these other health workers are almost impossible to find. It is often difficult to discern patient mobility, service mobility and professional mobility, as overlap between these types of mobility is possible, which complicates the
collection of these data. In general, a solid agreement on who collects which data and how (whether or not facilitated by the European Commission) is essential for acquiring better data and, therefore, a more realistic picture of the size of the phenomenon.