Aim: The pilot project for the development
of a cross-border health region Lörrach-Basel
was implemented to reduce the border effect
with respect to the health care sector for the
citizens of the Trinational Eurodistrict Basel.
Emphasis is placed on the monitoring of the
quality of care, as patient mobility across the
borders calls for trust in the medical services
of the neighbouring country. Systematic comparisons
of the health care sectors in the participating
countries are not available. A survey
of the quality of care within the framework of
this pilot project is intended to contribute to
cross-border transparency of the quality assurance
efforts of the providers participating
in the project and to show whether, and if so
to what extent, treatment in the neighboring
country bears an increased risk.
Methods: A separate survey module, which
aims to answer the central questions around
the research topic “patient safety”, includes
a questionnaire for the collection of information
about the extent to which the institutions
involved take part in the external
comparative quality assurance and whether
internal quality management is established
in all participating institutions. In addition,
eight guideline-based expert interviews
(Mayring methodology) with representatives
of German social health insurance companies,
German and Swiss hospitals and with
medical professionals of the Lörrach region
were carried out.
Results: In 2008 6 German and 21 Swiss
statutory health insurance companies and
11 German and 6 Swiss institutions for acute
hospital-care and rehabilitation participated
in the project. For the second project year
structured in-house reports were made available
by 83% of the participating institutions
(90% of the German, 71% of the Swiss participants).
These in-house reports and interviews
yielded no evidence that medical quality
management efforts were absent or inadequate
in one of the partner countries. In both
countries all participants have made quality a
part of their institutional policy, have quality
management officers and 87% are currently
involved in quality projects. Serious incidents
during cross-border treatment were not reported.
Further measures of internal and/or
external quality management are planned
by 74% of the responding institutions, on the
Swiss side by 100%.
Discussion: The efforts for quality assurance
and management are advanced in both
countries. The results allow a first assessment
of the status of cross-border quality monitoring
and analysis, and reflection about their
function. Efforts towards quality assurance,
quality management measures and a positive
communication culture serve primarily
to build confidence.
Conclusions: Therefore the pilot project
concept relies on the high potential for datautilization
for reflection, orientation and
planning concepts involving closely the data
owners. The high response rate to the survey
on quality management in both participating
countries suggests good acceptance of this
approach in the region.
