到國外治療：更多的選擇，更大的風險

Treatment abroad: Greater choice, greater risk

18 November 2011 Last updated at08:25 GMT

Source: By Dr Stephanie Bown Medical Protection Society

Dr Stephanie Bown 醫療保護協會

  

Recuperating on the beach could appeal to some

在海灘上休養可能吸引某些人

Jetting off to the sunny climes of the Cote d'Azur for a hip replacement may seem like a good way of combining much needed treatment with a relaxing holiday.

遠離塵囂到陽光明媚的蔚藍海岸置換髖關節的，可能看起來像一個急需治療和輕鬆假期相結合的一個好辦法。

It conjures up images of lying by the pool afterwards and maybe enjoying some excellent cuisine - but in this week's Scrubbing Up, Dr Stephanie Bown of the Medical Protection Society warns patients should think carefully before going abroad for treatment.

想像手術完躺在水池邊的悠閑畫面，也許事後還可享受一些精緻美食 - 但這想像在這星期將全盤重整，Dr Stephanie Bown的醫療保障協會警告患者出國治療前應仔細考慮。

A new directive on cross-border healthcare adopted by the European Commission earlier this year will give citizens greater choice and access to medical treatment anywhere in the EU.

But new choices may bring new risks.

今年早些時候一個跨境醫療採用由歐盟委員會通過的新指令賦予公民在歐盟任何地方更多的選擇和獲得醫療處置。

但新的選擇，可能會帶來新的風險。

'Hidden costs'

 “隱藏性成本”

The directive enables UK patients to receive treatment abroad which they would have been entitled to under the NHS, provided they obtain prior authorisation through their GP.

But, as with any medical treatment, people need to do their research before taking that step.

The standard, culture and quality of care differs from country to country.

  

該指引使英國的病人有權根據 NHS，只要通過他們的家庭醫生獲得事先批准，可到國外接受治療。

PS: NHS National Health Service (英國)國家衛生事業局

但是，在進行任何治療，人們採取這一步驟之前，需要做他們的研究。

護理質量標準，文化等各國是不同。

It is intended that each member state will eventually have a 'national contact point' holding all relevant information about healthcare providers to enable patients to make an informed choice.

它的目的是，每個會員國最終將有一個“國際接觸點”可保持所有醫療服務提供者的相關信息，讓患者作出明智的選擇。

In the meantime patients will have to take a 'caveat emptor' approach and do their homework, to check that the service provider has the appropriate qualifications, indemnity and expertise to carry out their treatment.

There may also be hidden costs for patients.

在此期間，患者將不得不採取了“買者自負”的方式做功課，確認檢查服務的供應商有相應的資質，賠款和專業知識，以承載他們的治療。

他們也有可能對病人隱藏應負的成本。

Although they will be able to claim reimbursement of the cost of treatment up to the cost of receiving that healthcare on the NHS, there are other factors such as travel, accommodation, travelling companions and the possibility that treatment may be more expensive or take longer than anticipated - leaving the question of whether the true cost of treatment abroad is equal to that at home.

雖然他們將能夠要求宣稱治療的成本決定於接受NHS的醫療費用，還有其他因素，如旅遊，膳宿，旅伴的可能性，治療可能比預期更昂貴或需要更長的時間- 及離開國外治療的真實成本是否等於在家治療等的問題。

Extra pressure

額外的壓力 

There are also likely to be difficulties arising from language and cultural differences.

也有可能是語言和文化差異而產生的困難。

Those with an idealistic viewpoint of combining treatment with a holiday should look before they leap ”

那些想將假期和治療的觀點相結合的人應該三思而後行“

For example, what language will the prescription or medical records be written in? Will the patient, pharmacist or their GP at home be able to read it? Will they feel comfortable and safe being treated by people that are speaking another language?

例如，處方或醫療記錄用什麼樣的語言被寫入？病人，藥劑師或家庭醫生將能夠理解它嗎？當他們讓講另一種語言的人治療會感到舒適和安全嗎？

There is also the extra pressure this may put on GPs, if they have to conduct their own research to ensure the treatment is right for their patient and liaise with the service provider abroad where necessary.

在GPS普通開業醫生上可能也有額外的壓力，如果他們要進行自己的研究，以確保治療是正確的，為他們的病人聯絡國外的服務供應商是必要的。

GPs are already extremely stretched, with many feeling challenged to manage their patient lists and needs, but they may also now have to be prepared for the possibility of urgent and unexpected requests, for example, a service provider may ask for additional information if a problem arises with one of their patients during treatment abroad.

GPS已經非常捉襟見肘，他們面臨的挑戰是管理他們的病人名單和需求，且他們也要準備緊急的可能和無法預期的要求，例如，如果他們的病人之一在國外治療出了問題，服務提供商可能會要求更多的信息，。

Once patients return home after treatment, they may require further follow-up and aftercare. And what if something goes wrong once they are back on home soil?

The patients may not necessarily be able to return to where they received the treatment. Complaints will be dealt with under the system, if any, in operation in the country of treatment.
 

一旦患者回家治療後，它們可能需要進一步的後續行動和善後。且如果是一旦回到家鄉後才滋長的問題呢?

患者未必能夠返回到他們接受治療的地方。，如果有的話，將在投訴處理制度下處理國際間的運作。

Similarly, negligence claims are usually brought in the jurisdiction in which the treatment was provided and are therefore subject to the civil law procedures in that country.

Although this may not be something people want to think about before receiving treatment, it could present practical difficulties for a potential claimant, and they should certainly check that the clinic or doctor providing the treatment holds appropriate indemnity.

同樣，在提供治療時的疏忽其索償的要求通常帶來的司法審判，因此該國的民法程序是一課題。

雖然這可能不是人們所認為接受治療前約希望，它可能顯示潛在要求者目前實際的困難，他們當然應該檢查診所或醫生提供的治療承受適當的賠償。

Although the EU Directive is a step forward in terms of offering more choice and greater accessibility, the healthcare systems of the 27 countries involved are of differing sophistication and there are a lot of details to be clarified.

雖然歐盟指令為提供更多的選擇和無障礙方面向前邁進一步，但涉及27個國家的衛生保健複雜系統是不同的，有很多細節須加以澄清。

For doctors, it will be a case of managing another task and set of expectations, and raising awareness of the directive, in an already busy clinical setting.

For UK citizens living and working abroad the new directive may make it easier to access treatment, but for those with an idealistic viewpoint of combining treatment with a holiday, they should look before they leap.

對醫生而言，在繁忙的臨床處置下，這將是管理的另一項任務和期望設置，需提高對指令的警覺。

對於那些在國外生活和工作的英國公民，新指令可能使其更容易獲得治療，但對於那些有想將假期和治療相結合觀點的人而言，他們應該三思而後行。

參考資料:

台灣國際醫療網

20111230Aircafe Break