Natasha Azzopardi-Muscat1,2,3, Tjede Funk2,3, Sandra C Buttigieg4, Kenneth E Grech4, Helmut Brand2. 1. Department of Health Services Management, Faculty of Health Sciences, University of Malta c/o/Mater Dei Hospital MSD 2080 Msida, Malta natasha.azzopardi-muscat@um.edu.mt. 2. Department of International Health, CAPHRI School for Public Health and Primary Care, Maastricht University, 30 Duboisdomein Maastricht, The Netherlands. 3. Directorate for Health Information and Research, Ministry for Energy and Health, 95 G'Mangia Hill Pieta', Malta. 4. Department of Health Services Management, Faculty of Health Sciences, University of Malta c/o/Mater Dei Hospital MSD 2080 Msida, Malta.
Abstract
BACKGROUND: The EU directive on patients' rights and cross-border care is of particular interest to small states as it reinforces the concept of health system cooperation. An analysis of the challenges faced by small states, as well as a deep evaluation of their health system reform characteristics is timely and justified. This paper identifies areas in which EU level cooperation may bring added value to these countries' health systems. METHOD: Literature search is based primarily on PUBMED and is limited to English-language papers published between January 2000 and September 2014. Results of 76 original research papers appearing in peer-reviewed journals are summarised in a literature map and narrative review. RESULTS: Primary care, health workforce and medicines emerge as the salient themes in the review. Lack of capacity and small market size are found to be the frequently encountered challenges in governance and delivery of services. These constraints appear to also impinge on the ability of small states to effectively implement health system reforms. The EU appears to play a marginal role in supporting small state health systems, albeit the stimulus for reform associated with EU accession. CONCLUSIONS: Small states face common health system challenges which could potentially be addressed through enhanced health system cooperation at EU level. The lessons learned from research on small states may be of relevance to health systems organized at regional level in larger European states.
BACKGROUND: The EU directive on patients' rights and cross-border care is of particular interest to small states as it reinforces the concept of health system cooperation. An analysis of the challenges faced by small states, as well as a deep evaluation of their health system reform characteristics is timely and justified. This paper identifies areas in which EU level cooperation may bring added value to these countries' health systems. METHOD: Literature search is based primarily on PUBMED and is limited to English-language papers published between January 2000 and September 2014. Results of 76 original research papers appearing in peer-reviewed journals are summarised in a literature map and narrative review. RESULTS: Primary care, health workforce and medicines emerge as the salient themes in the review. Lack of capacity and small market size are found to be the frequently encountered challenges in governance and delivery of services. These constraints appear to also impinge on the ability of small states to effectively implement health system reforms. The EU appears to play a marginal role in supporting small state health systems, albeit the stimulus for reform associated with EU accession. CONCLUSIONS: Small states face common health system challenges which could potentially be addressed through enhanced health system cooperation at EU level. The lessons learned from research on small states may be of relevance to health systems organized at regional level in larger European states.
Authors: Ellen Kuhlmann; Ronald Batenburg; Matthias Wismar; Gilles Dussault; Claudia B Maier; Irene A Glinos; Natasha Azzopardi-Muscat; Christine Bond; Viola Burau; Tiago Correia; Peter P Groenewegen; Johan Hansen; David J Hunter; Usman Khan; Hans H Kluge; Marieke Kroezen; Claudia Leone; Milena Santric-Milicevic; Walter Sermeus; Marius Ungureanu Journal: Health Res Policy Syst Date: 2018-06-20
Authors: Robin van Kessel; Rok Hrzic; Katarzyna Czabanowska; Aurélie Baranger; Natasha Azzopardi-Muscat; Nefi Charambalous-Darden; Carol Brayne; Simon Baron-Cohen; Andres Roman-Urrestarazu Journal: Eur J Public Health Date: 2020-12-11 Impact factor: 3.367