Patients’ access to cross-border healthcare : the Maltese perspective

Abstract

Background: The purpose of the present study is to analyse the willingness of Maltese patients to access cross-border healthcare. This study seeks to analyze factors and level of willingness to access cross-border health care by evaluating patients’ behaviours, attitudes, experiences and expectations. The purpose is to include patients who did and did not experience treatment, which could possibly present variants in willingness to access cross-border healthcare. This population provides evidence on sociodemographic issues, financial issues, literacy on cross-border healthcare, patients’ experiences and patients’ expectations which are domains that affect willingness to access cross-border healthcare. This study creates a continuum with recommendations from previous studies such as using patients' experiences via the current arrangements that Malta has with the United Kingdom as research ground Objectives: The objectives of this study are to identify: 1) factors that influence the willingness of Maltese patients to access cross-border healthcare in Malta and 2) the level of willingness to access cross-border healthcare in Malta. Methodology: This study employed a quantitative cross-sectional approach to measure willingness to access cross-border health care by patients in Malta and to identify the factors that are associated with willingness. The target population includes patients from the outpatients department of the public hospital. The fieldwork was implemented in a public hospital, which is an acute general teaching hospital offering a full range of hospital services. The research tool is a self-designed survey which was developed via expert and focus group analysis and piloted prior to the commencement of data collection. The data was collected between January 2015 and March 2015. It was analysed using IBM SPSS Software© and it was analysed via descriptive analysis and non-parametric tests. Results: Age (p-value=0.006), education (p-value=0.008), language literacy (pvalue= 0.000), literacy on cross-border healthcare (p-value=0.000) and financial resources (p-value=0.000) were found to have a significant association with willingness to access cross-border healthcare. Gender, employment status, and occupation were found not to be significantly associated with willingness to access cross-border healthcare. Maltese patients who participated in this study are willing to access treatment abroad. There is no significant difference in willingness to access crossborder healthcare between the respondents who have never received treatment abroad and those who did experience institutionalised exits. Respondents base their decisions to access treatment abroad on the information provided by their specialist and General Practitioner and they access treatment abroad for specialised care. These findings are context specific. Conclusions: The respondents of the study are willing to access cross-border healthcare and are knowledgeable of their cross-border rights as EU/Maltese citizens. They respondents are more likely to access treatment abroad for specialised care rather than to by-pass long waiting times in Malta. The respondents are willing to access foreign care related to the existing arrangements in the Maltese health system. Knowledge on cross-border care needs to be improved in Malta and it is country specific.