The impact of cross-border patient movement on the delivery of healthcare services

Motivated by a recent legislative discussion in the European Union about providing European patients with the freedom to choose the country they receive treatment, we use a queueing framework to analyze a game-theoretic model that captures the interactions among the patients, the providers, and the healthcare funders. We examine the impact of such “free choice” on the healthcare systems of different countries in equilibrium. Under the assumption that each patient will always prefer to receive care at home when the waiting time is below her individual tolerance level, we show that, in the long run, cross-border patient movement can increase patient welfare due to increased access to care. However, it has a mixed effect on waiting times and reimbursement rates. Moreover, the additional costs of increased access to care are disproportionately shared between the participating countries.