the southernmost entrance to the european health systems

Área de gestión sanitaria del Campo de Gibraltar

The southernmost entrance to the European Health systems

The experience at Hospital “Punta de Europa”, Algeciras, Cádiz SPAIN



1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

TOTAL 18551 19539 16686 35616 57195 99122 330881 394048 443085 429524

Europa 6696 6456 6004 15921 25735 40327 85994 112619 154589 165037

Africa 4704 5027 4672 8389 13118 20248 54241 55797 55156 58807

Asia 1737 1722 1280 1945 2549 3587 10127 11041 11559 13915

América 5394 6304 4706 9323 15724 34863 180316 214349 221580 191577

Oceanía 20 30 24 38 69 97 203 242 201 188

-Fuente: Estadística de Variaciones Residenciales. INE.



0

50000

100000

150000

200000

250000

300000

350000

400000

450000

500000

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

TOTAL

Europa

Africa

Asia

América

Oceanía


MFH EU NETWORK

Kaiser-Franz-Josef-Spital, Vienna, AustriaImmanuel-Krankenhaus GmbH, Rheumaklinik Berlin-Wannsee, Berlin, GermanyKolding Hospital, Velje-Kolding, DenmarkHospital ”Spiliopoulio Agia Eleni”, Athens, GreeceHospital Punta de Europa, Algeciras-Cádiz, SpainTurku University Hospital, Turku, Finland Hôptial Avicenne, Paris, FranceJames Connolly Memorial Hospital, Dublin, IrelandPresidio Ospedaliero della Provincia di Reggio Emilia, Reggio Emilia, ItalyAcademic Medical Center, Amsterdam, The NetherlandsHospital Nossa Senhora do Rosário (HNSR) Barreiro/Lisbon, PortugalUppsala University Hospital, Psychiatric Centre, Uppsala, SwedenBradford Hospitals NHS Trust , Bradford, U.K.

AT

DE

DK

EL

ES

FI

FR

IT

NL

PT

SV

UK

IR


Common issues

differences in hospital's ownershipdifferences in demography of the clienteledifferences in degree of settlement of populations...Some areas were common concern all over the EU


Problem Areas

Communication

Austria

Denmark

Finland

France

Germany

Greece

Ireland

Italy

Portugal

Spain

Sweden

The Netherlands

United Kingdom


Problem Areas

Understanding cultural differences

Austria

Finland

France

Germany

Ireland

Italy

Portugal

Spain

Sweden


Problem Areas

Lack of structures for migrant health

Austria

Denmark

Finland

Germany

Greece

Italy

Sweden

The Netherlands


Problem Areas

Lack of adequate patient information

Austria

Denmark

Finland

Germany

Greece

Ireland

Portugal

Spain

Sweden


The southernmost entrance to the European Health systemsOur health authority district

•Geography234,000 inhabs.Two hospitals10 primary health care 10 primary health care centers centers Located at the very south of Located at the very south of EuropeEuropeAt only 18 Km from AfricaAt only 18 Km from Africa


The southernmost entrance to the European Health systemsOur Health authority district

•demographyWe attend more than 120,000 emergencies/yeartwo million people cross the Strait of gibraltar from Spain to Morocco and backwards.

We attend people that irregularly entered our country

• Population in transit

• Population with irregular entrance

• Settled population



Why did we get involved in MFH?answers to the challenge of a growing diversity in clinical settingsservice must be sensitive to the demands of social forcesadapted to the population it serves



WHAT OBSTACLES WILL HAVE TO BE OVERCOME IN ORDER TO MEET THE NEEDS OF THESE PATIENTS?



EQUITABLE IS NOT ALWAYS EQUAL



LANGUAGECULTURALKNOWLEDGEORGANIZATION


The southernmost entrance to the European Health systemsin addressing this issue, have in mind

•The responseManagerialStaffClientele

• National

• non nationals


The southernmost entrance to the European Health systemsin addressing this issue, have in mind

•Local policieshospital ownership

• integrate within the political framework of the health system on equality, diversity and access to it

• equality in access

• public ownership

• free health care -even in irregular entrance



EQUITABLE IS NOT ALWAYS EQUAL



Different geographical contextadministrative situationslanguage CultureReligioneconomic situationDemographygeographical distribution


WHAT IS (ARE) YOUR LOCAL POPULATION(S) LIKE?



WHAT CHANGES IN WORK ROUTINE WILL BE NECESSARY?



BAD NEWS!there are no “magic recipes”, tailor to your local situation



GOOD NEWS!!LEARN WERE YOU ARELEARN FROM THE EXPERIENCESINCLUDE CULTURAL DIVERSITY AS A TOPIC TO BE ADDRESSEDOVERCOME THE BARRIERSLOOK FOR AN ORGANISATIONAL CHANGEDEVELOP PARTNERSHIP STRATEGIESDEVELOP A SUPPORTING GROUP



Part A: MF characteristics of serviceGeneral resources to facilitate communication and information Accessibility, pre-entry and entry into hospitalWhilst in hospital

Hotel services Medical / nursing treatment

Discharge MF patient education / health promotion / empowerment



Part B: MF Support System General quality system in hospitalDoes your hospital have a written MF policy ?MF budgetIs a specific MF management structure in place?Involvement of migrant representatives in organisational changeMarketing of MF

internal marketing of MF (at the hospital) External marketing of MF (to the public)

MF training and education for staff


The southernmost entrance to the European Health systemsPart B: MF Support System Monitoring of migrant clientele Monitoring of migrant-specific service outcomes Method/approach used for monitoring migrant dataMonitoring of MF impact on organisational qualityReporting system on MF activities and impactPartnerships and partner alliances



GOOD NEWS!!LEARN WERE YOU ARELEARN FROM THE EXPERIENCESINCLUDE CULTURAL DIVERSITY AS A TOPIC TO BE ADDRESSEDOVERCOME THE BARRIERSLOOK FOR AN ORGANISATIONAL CHANGEDEVELOP PARTNERSHIP STRATEGIESDEVELOP A SUPPORTING GROUP


MFH EU NETWORK

Kaiser-Franz-Josef-Spital, Vienna, AustriaImmanuel-Krankenhaus GmbH, Rheumaklinik Berlin-Wannsee, Berlin, GermanyKolding Hospital, Velje-Kolding, DenmarkHospital ”Spiliopoulio Agia Eleni”, Athens, GreeceHospital Punta de Europa, Algeciras-Cádiz, SpainTurku University Hospital, Turku, Finland Hôptial Avicenne, Paris, FranceJames Connolly Memorial Hospital, Dublin, IrelandPresidio Ospedaliero della Provincia di Reggio Emilia, Reggio Emilia, ItalyAcademic Medical Center, Amsterdam, The NetherlandsHospital Nossa Senhora do Rosário (HNSR) Barreiro/Lisbon, PortugalUppsala University Hospital, Psychiatric Centre, Uppsala, SwedenBradford Hospitals NHS Trust , Bradford, U.K.

AT

DE

DK

EL

ES

FI

FR

IT

NL

PT

SV

UK

IR


Common issues

differences in hospital's ownershipdifferences in demography of the clienteledifferences in degree of settlement of populations...Some areas were common concern all over the EU


The 5 most frequent problem areas

8

8

8

9

13

0 5 10 15

Communication

Cultural differences

Lack of structures for migrant health

Lack of documentation + research

Lack ofadequate patient information

number of mentions in all interviews

(n=97, including multiple mentions)


The Amsterdam declaration –December ‘04

The Amsterdam declaration

“Towards migrant friendly hospitals in an ethno-culturally diverse Europe”


The Amsterdam declaration –December ‘04

www.mfh-eu.net/conf/downloads/AmsterdamDeclaration2004.pdf



WHAT BENEFITS CAN BE EXPECTED FOR PATIENTS?



Increased quality of service•For staff•For patients•For the organisation



For staff Reduce staff workload

• Increase staff skills to manage congflict

• Reduce the stress of staff during cross cultural encounters

• Reduce the opportunities to malpractice

Increase level of comfort Increase level of knowledge



For patients•A more person oriented service•Reduce the opportunities of inadequate use of service•Increase the level of comfort during hospital stay



For the organisations•Integrate the hospital in a networking process•Increase effectiveness•Send a clear message to all stakeholders•A less expensive and more sustainable health system



IN SHORT…•LEARN•NETWORK•MARKETING



THANK YOU!.

the southernmost entrance to the european health systems

Documents