世界卫生组织2006年通过的关于国际贸易和卫生的决议敦促会员国了解国际贸易和贸易协定对卫生的影响,并应对政策和法规带来的任何挑战。马尔代夫政府是医疗服务的进口国(有外出的医疗旅客),通过为其人民提供全面的全民医疗保健方案,其中包括在国外为该国无法获得的服务提供补贴治疗。到该计划的第一年结束时,马尔代夫政府已花费了约1160万美元来治疗国外的患者。在这项研究中,负担能力,我们从医疗旅行者的角度评估了这种护理的连续性和质量,从而为更安全,更具成本效益的医疗旅行政策提供建议.
尽管全民医保,相当比例的马尔代夫旅行者没有获得政府补贴,三分之一的人报告说没有足够的资金用于国外的治疗。在这项研究中访问最多的五家医院中,在研究期间,没有JCI获得认证,只有3名来自印度的印度医院国家认可委员会(NABH)获得认证。旅行者对接受治疗的满意度很高,但对护理连续性的关注非常高,超过三分之一的患者经历了海外治疗引起的并发症。
来源国可以利用其在医疗服务贸易中的议价能力,为医疗旅行者提供更全面的套餐。拥有主要由公共资助的卫生系统的来源国需要确保医疗旅行真正负担得起和普及,采取质量控制措施,例如使用经认可的外国医院使其更安全,并采取确保旅行者护理连续性的措施。
The resolution adopted in 2006 by the World Health Organization on international trade and health urges Member States to understand the implications of international trade and trade agreements for health and to address any challenges arising through policies and regulations. The government of Maldives is an importer of health services (with outgoing medical travelers), through offering a comprehensive universal health care package for its people that includes subsidized treatment abroad for services unavailable in the country. By the end of the first year of the scheme approximately US$11.6 m had been spent by the government of Maldives to treat patients abroad. In this
study, affordability, continuity and quality of this care were assessed from the perspective of the medical traveler to provide recommendations for safer and more cost effective medical travel policy.
Despite universal health care, a substantial proportion of Maldivian travelers have not accessed the government subsidy, and a third reported not having sufficient funds for the treatment episode abroad. Among the five most visited hospitals in this
study, none were JCI accredited at the time of the
study period and only three from India had undergone the National Accreditation Board for Hospitals (NABH) in India. Satisfaction with treatment received was high amongst travelers but concern for the continuity of care was very high, and more than a third of the patients had experienced complications arising from the treatment overseas.
Source countries can use their bargaining power in the trade of health services to offer a more comprehensive package for medical travelers. Source countries with largely public funded health systems need to ensure that medical travel is truly affordable and universal, with measures for quality control such as the use of accredited foreign hospitals to make it safer and to impose measures that ensure the continuity of care for travelers.