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Health impact of borders: general reflections and a case study from the Polish–German border

Author

Listed:
  • Julia Kuntosch

    (University of Greifswald)

  • Marie-Luise Ruebsam

    (University Medicine of Greifswald)

  • Jakub Orsson

    (University of Greifswald)

  • Dorota Orsson

    (University Medicine of Greifswald)

  • Klaus Hahnenkamp

    (University Medicine of Greifswald)

  • Jörg Hartleib

    (University of Greifswald)

  • Steffen Flessa

    (University of Greifswald)

Abstract

Background and objective Political, economic, communicative and cultural borders still limit the accessibility of acute healthcare services for patients so that they frequently have to accept longer distances to travel to the next provider within their own country. In this paper, we analyze the impact of borders and opening of borders on acute medical care in hospitals and on patients in border regions. Methods We develop a conceptual framework model of cross-border healthcare and apply it to the Polish–German border area. The model combines the distance decay effect, a catchment area analysis, economies of scale and the learning curve. Results Borders have a major impact on acute medical care in hospitals and on patients. Setting of new borders will reduce the accessibility of health facilities for patients or require the establishment of new hospitals. Reopening borders might induce a vicious circle leading to the insolvency of a hospital which might result in poorer health for some patients. Conclusion Strong effort should be invested to overcome political and cultural borders to improve the health of the population in border regions. Similarly, increased cross-border acute healthcare must be seen in the context of rural health and the special situation of small rural hospitals in rural peripheral areas.

Suggested Citation

  • Julia Kuntosch & Marie-Luise Ruebsam & Jakub Orsson & Dorota Orsson & Klaus Hahnenkamp & Jörg Hartleib & Steffen Flessa, 2024. "Health impact of borders: general reflections and a case study from the Polish–German border," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(2), pages 281-292, March.
    • Handle: RePEc:spr:eujhec:v:25:y:2024:i:2:d:10.1007_s10198-023-01588-5
    DOI: 10.1007/s10198-023-01588-5
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    References listed on IDEAS

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    1. Gabriel Felbermayr & Jasmin Gröschl & Thomas Steinwachs, 2018. "The Trade Effects of Border Controls: Evidence from the European Schengen Agreement," Journal of Common Market Studies, Wiley Blackwell, vol. 56(2), pages 335-351, March.
    2. Hynek Böhm & Joanna Kurowska-Pysz, 2019. "Can Cross-Border Healthcare Be Sustainable? An Example from the Czech-Austrian Borderland," Sustainability, MDPI, vol. 11(24), pages 1-14, December.
    3. Kowalska-Bobko, Iwona & Mokrzycka, Anna & Sagan, Anna & Włodarczyk, W. Cezary & Zabdyr-Jamróz, Michał, 2016. "Implementation of the cross-border healthcare directive in Poland: How not to encourage patients to seek care abroad?," Health Policy, Elsevier, vol. 120(11), pages 1233-1239.
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