目标:政治,经济,沟通和文化边界仍然限制了患者获得急性医疗服务的机会,因此他们经常不得不接受更长的距离才能前往自己国家的下一个提供者。在本文中,我们分析了边界和边界开放对医院和边境地区患者的急性医疗服务的影响。
方法:我们开发了跨境医疗保健的概念框架模型,并将其应用于波兰-德国边境地区。该模型结合了距离衰减效应,集水区分析,规模经济和学习曲线。
结果:边界对医院和患者的急性医疗护理有重大影响。设定新的边界将减少患者获得保健设施的机会,或者需要建立新的医院。重新开放边界可能会引发恶性循环,导致医院破产,这可能会导致某些患者的健康状况恶化。
结论:应大力克服政治和文化边界,以改善边境地区人口的健康状况。同样,必须在农村卫生和农村周边地区小型乡村医院的特殊情况下看待增加跨境急性医疗保健。
OBJECTIVE: Political, economic, communicative and cultural borders still limit the accessibility of acute healthcare services for patients so that they frequently have to accept longer distances to travel to the next provider within their own country. In this paper, we analyze the impact of borders and opening of borders on acute medical care in hospitals and on patients in
border regions.
METHODS: We develop a conceptual framework model of cross-
border healthcare and apply it to the Polish-German
border area. The model combines the distance decay effect, a catchment area analysis, economies of scale and the learning curve.
RESULTS: Borders have a major impact on acute medical care in hospitals and on patients. Setting of new borders will reduce the accessibility of health facilities for patients or require the establishment of new hospitals. Reopening borders might induce a vicious circle leading to the insolvency of a hospital which might result in poorer health for some patients.
CONCLUSIONS: Strong effort should be invested to overcome political and cultural borders to improve the health of the population in
border regions. Similarly, increased cross-
border acute healthcare must be seen in the context of rural health and the special situation of small rural hospitals in rural peripheral areas.