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Main results of European Patients' rights monitoring / 5th Patients' rights day

Main results of European Patients' rights monitoring / 5th Patients' rights day

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The main results of the monitoring on Patients' Rights in the European Union, by Rosapaola Metastasio, ACtive citizenship network's staff
The main results of the monitoring on Patients' Rights in the European Union, by Rosapaola Metastasio, ACtive citizenship network's staff

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Published by: Cittadinanzattiva onlus on Apr 11, 2011
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04/11/2011

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The EU Charter of Patients Rights A civic Assessment

PRES Patients Rights Euro Scores
11st April 2011 Rosapaola Metastasio - Cittadinanzattiva

..About this presentation:
1) AN OVERVIEW OF THE RIGHTS focus on the least respected rights for each right, focus on the weakest indicators 2) COLLATERAL RESULTS

An overview of the results

The NOT RESPECTED Rights..
The rights with the lowest scores are same three that resulted worst in the preceding survey:

- patients' time - free choice - access to care

Right to respect of patients time

In sum, problems of: ‡ transparency ‡ organizational issues ‡ wait times

Right to respect of patients time

Right to respect of patients time
Actual conditions of hospital patients 57/100
Worrying indicators: ‡ publicly-available lists of admittance for elective surgery: hospitals of only 3 countries at least ³good´ ‡ publicly-available wait times for in-patients and out-patients: only 6 countries scored ³excellent´ Other bad elements: ‡ a unified contact point for appointments ‡ Interrupted bookings for appointments ‡ wait times for Hip prosthesis and Non-emerg. Head TC Scan

Right to respect of patients time
Alerts from civic organizations - violations concerning: ‡ illness worsened because of a delay in treatment; ‡ illness worsened because of a delay in diagnosis (due to waiting times); ‡ excessively long waiting times for specific exams Frequent or regular violations in 19 countries These indicators emphasize not only the elemental issues concerning time, but also the serious consequences that citizens suffer because of delays in treatment or diagnosis.

Right to free choice
A peculiar assessment: based only on violations detected by civic organizations
Violation of the right to free choice
Countries with violations regularly found 5 Countries with violations frequently found Countries with violations rarely found 11 Countries with violations occasionally found / never found

2 2

Right to free choice
Violations concerning:

‡Incentives to seek treatment in certain hospitals or centres ‡Coverage of supplementary insurance for only some hospitals ‡Difference in fees between public and private hospitals ‡Need to get authorization for some treatments ‡Indigent patients that may only be treated in certain hospitals

Right to free choice
‡ free

choice recognized in principle in all of the countries ‡often actually limited by: organizational procedure; insurance companies; other factors ‡ according to 60% of the civic organizations, administrative authorities and insurers tend to provide incentives for access to determinate hospitals and centres ‡ In sum, what emerges is a ³choice´ that is not in fact very free and that is burdened with many obstacles

Right to access
For a correct evaluation of the right to access, it is necessary to distinguish between: physical access to hospitals (transportation, parking, absence of barriers, etc.): ALMOST RESPECTED (the best score) access to care : the most proper meaning, concerning the access to the needed health care and treatments: NOT RESPECTED

Right to access - to care
Violation of the right to access concerning: Discrimination on the basis of financial resources Place of residence Kind of illness
Countries with violations regularly found 3 4 Countries with violations frequently found Countries with violations rarely found 8 Countries with violations occasionally found / never found

5

Some ³alarm bells´:
information and active citizenship
Both the rights are: ‡ ³hardly respected´ (score 54/100) ‡ these bad results are even more serious, since these rights are particularly relevant from a civic perspective and deal with matters of accountability and transparency of institutions ‡ further aggravating consideration: these can be considered as ³soft rights´.

ight to information
‡ common failure by health authorities to provide information regarding consumer satisfaction about clinical performances. In hospitals: ‡ patient¶ access to free clinical records: only 4 excellent ‡ scarce existence of a free information telephone number ‡ insufficient informative contents of websites (mean score 38) ‡ indicated areas for voluntary and public interest associations: only in 7 countries H attained an assessment at least ³good´ ‡ what deeply lowers the synthetic PRES index is the high frequency of violations denounced by civic organizations.

ight to active citizenship

ight to active citizenship
Unacceptable scores in hospitals:
‡ Periodic consultations of citizens organizations ‡ Common initiatives done in partnership regarding quality

Some worrying indicators (mean score < 35)
RIGHT TO OBSERVANCE OF QUALITY STANDARDS: ‡ List on quality ranking of health services RIGHT TO SAFETY: ‡ Legal protection for people who report an adverse event ‡ Supplementary communication systems for emergency exits (H) RIGHT TO AVOID UNNECESSARY SUFFERING AND PAIN: ‡ Gov. study on national norms concerning the use of pharmaceutical narcotics RIGHT TO PERSONALIZED TREATMENT: ‡ Cultural mediator service available in the hospital or on call RIGHT TO CONSENT: ‡ Specific consent form for appendectomy proper contents

A BASIC VOCABULARY OF PATIENTS RIGHTS
This assessment work didn t produce only scores. During the carrying out of the process, we have discovered something else, collateral results: citizens and civic organizations are often not enough informed about: which their rights exactly are how to demand them If citizens do not know their rights, they cannot stand for them and, above all, exercise them.

This problem of awareness of one¶s own rights has proved that there is a big preliminary work to carry out, for monitoring the respect of patients¶ rights. This commitment can be synthetized in: building a basic vocabulary of patients¶ rights. First step - agreeing on the meaning of terms and concepts for overcoming terminological difficulties Second step ± strengthening active citizenship: mutual support among citizens¶ organizations

Final goal: These steps constitute a process, through which making patients¶ rights easily demandable. demandable

first step - it is necessary to agree on the meaning of terms and concepts, from a civic point of view. It allows to make the rights concrete even in spite of very different contexts. Aim: clarifying the problems that obstruct the real possibility of demanding rights. Focus on: ‡ Clinical record ‡ Informed consent ‡ Active citizenship

second step ± there is a strong need of working for a common and shared awareness of one¶s own rights: some civic organizations have difficulties in playing the role of claiming citizens¶ rights: they need more information, and thus more capacity of training citizens in the local communities. Aim: strengthening active citizenship through mutual support among citizens¶ organizations Keywords for this step: information, training, exchanging best practices.

Thanks for your ³patient´ attention!

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