gms | German Medical Science

Background and current state of (inter)national research: Cross-border healthcare gained major attention with the launching of the Directive 2011/24/EU on the right of patients to receive healthcare across EU borders and to receive reimbursement. Yet, the directive is not implemented widely across all border regions. Differences in the organization and legislation of health systems in some regions emerged as barriers. The organization of the Dutch and German healthcare shows striking differences. Although these structural differences have been examined on macro-level, their implications on patients and health professionals have not been broadly examined at a regional level.

The Northern Dutch German (NDG) border has an increasingly aging population and both sides of the border face similar healthcare challenges (e.g. high prevalence of lifestyle risk factors, shortage of healthcare professionals). The lack of healthcare professionals is particularly common in rural areas and contributes to the increasing waiting times and delayed access to health services. The NDG border region is predominantly rural, with a low population density characterized by a low socioeconomic status. Thus, this region can be an excellent setting for a natural experiment to study how healthcare system differences trickle down to healthcare providers and patients.

Research questions and objectives: The Cross-border Institute of Healthcare Systems and Prevention (CBI) as a joint institution of the Universities of Oldenburg and Groningen will be introduced to demonstrate its’ conceptual, strategic and methodological approach to cross-border health services research.

The main goal of the CBI is to promote and coordinate cross-border healthcare research projects aimed at comparing structures, processes and outcomes of the two healthcare systems in the NDG border region.

Methods or hypothesis: The CBI is currently being built up. The first funded research projects will start in the second half of 2020. All developed projects will study current cross-border healthcare challenges and differences between the two healthcare systems from a local regional perspective. Research questions are focused on the identification of differences in treatments and prevention, their consequences for patient and population outcomes, as well as practical barriers to access healthcare services.

Results: The CBI was launched on February 2019 together with a cross-border research fund. A total of 21 cross-border research projects by consortia consisting of researchers from both sides of the border were submitted in two main areas: life-course health and mobility, and prevention of antibiotic resistance. In addition, cross-border research topics were discussed with a large audience in two outreach events at the border.

Discussion: The CBI’s background, vision, current state, and future implications for researching and improving healthcare services in cross-border regions will be discussed with the audience.

Practical implications: We expect the initial research projects will help us to disentangle the differences and similarities in healthcare practice by patients and healthcare professionals in this border region.