title: Facilitating safe and successful cross-border healthcare in the European Union.
abstract: OBJECTIVE
  Even though medical travel is expanding, limited research has identified pitfalls along the full process of medical travel. This study explores the experiences of medical travellers, with a focus on potential issues that may threaten safe and effective medical travel.
  
  
  METHODS
  The experiences of medical travellers were assessed using a cross-sectional questionnaire in the Netherlands in 2014. The questionnaire (n=101) contained 52 items measuring the transfer of records, quality of care abroad, follow-up care, and reimbursement. Additionally, experts provided feedback on the pitfalls identified.
  
  
  RESULTS
  63.1% of medical records were not transferred in advance to the clinic abroad, and for 10.7% of cases these remained unknown during treatment. Although quality of care abroad was rated higher than in the home country, follow-up care was initially refused to 22.2% of patients. Additionally, patients reported problems related to reimbursement.
  
  
  CONCLUSIONS
  More effort is needed to facilitate safe medical travel. Medical professionals should be informed on procedures for medical travellers, especially concerning follow-up care and record transfers. Yet, medical travellers themselves are ultimately responsible for this transfer. Clear information on the necessity of this personal transfer, and clarification on reimbursement options and the authorisation procedure, should be provided by national contact points and third-party payers. Additionally, payment structures to care providers may need adjustments to cover costs of follow-up care.
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229 ER Maastricht, The Netherlands. Electronic address: s.verra@student.maastrichtuniversity.nl.
authors.forename: Sanne Elise
authors.initials: SE
authors.lastname: Verra
authors.affiliation: Department of Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands. Electronic address: kroezerenske@gmail.com.
authors.forename: Renske
authors.initials: R
authors.lastname: Kroeze
authors.affiliation: Engineering Design Centre, Department of Engineering, University of Cambridge, Trumpington Street, Cambridge, CB2 1PZ, UK; Policy Research Group, Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK. Electronic address: Dar56@cam.ac.uk.
authors.forename: Kai
authors.initials: K
authors.lastname: Ruggeri
mesh_terms: D000359:Aftercare / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration; D005062:European Union; D006297:Health Services Accessibility; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008499:Medical Records / Q000592:standards; D057193:Medical Tourism / Q000639:trends*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014850:Waiting Lists
keywords: Cross-border healthcare; European Union; Healthcare quality; Medical travel; Patient mobility; Patient protection