Qual Saf Health Care 18:i15-i21 doi:10.1136/qshc.2008.028837
  • Supplement

Quality requirements for cross-border care in Europe: a qualitative study of patients’, professionals’ and healthcare financiers’ views

Open Access
  1. O Groene1,
  2. P Poletti2,
  3. P Vallejo3,
  4. C Cucic4,
  5. N Klazinga5,
  6. R Suñol1
  1. 1
    Avedis Donabedian Institute, Autonomous University of Barcelona, and CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain
  2. 2
    Centre for Research and Development, Padua, Italy
  3. 3
    Avedis Donabedian Institute, Madrid Office, Autonomous University of Barcelona, and CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain
  4. 4
    The Dutch Institute for Health Care Improvement, the Netherlands
  5. 5
    University of Amsterdam, Amsterdam, the Netherlands
  1. O Groene, Avedis Donabedian Institute, Autonomous University of Barcelona, Provenza 293 Pral, 08037 Barcelona, Spain; ogroene{at}
  • Accepted 22 October 2008


Background: In the past decade the issue of patient mobility has emerged on the European health policy agenda. Although the volume of patients crossing borders to obtain healthcare is low, it is increasing continuously and, due to its legal, financial and medical implications, has generated considerable interest among health policy and other decision makers. However, there is little information available on the safety and patient-centredness of cross-border care and neither governments nor citizens have an explicit basis for comparing healthcare delivery in Europe.

Methods: This study investigated the viewpoints of patients, professionals and healthcare financiers on the safety and patient-centredness of cross-border care. Qualitative interviews were carried out during 2005 and early 2006 with 40 patients, 30 professionals (doctors, nurses and managers) and 3 healthcare-financing bodies.

Results: Although cross-border care has become a common issue in many European countries, there remain uncertainties on the side of each of the parties addressed—patients, professionals and financiers—with regard to the provision of cross-border care. One of the most striking results of this project is the current lack of research on systematic knowledge on the quality of cross-border care.

Conclusion: Many of the issues identified through this research may have a potential impact on the quality and safety of cross-border care and will support further investigation and help shape the health policy agenda on patients crossing borders in European Union countries.


  • Funding: This research was funded by the European Commission through its “Scientific Support to Policies” action under the Sixth Framework Programme for Research for the research project “Methods of Assessing Response to Quality Improvement Strategies (MARQuIS)” (SP21-CT-2004-513712).

  • Competing interests: None declared.

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