SPA IS MORE…

LONG TERM STRATEGY for EUROPEAN SPAS

and HEALTH RESORTS

Janka Zálešáková,

Belek, TURKEY, May 26th, 2011

New Directive 2011/24/EU of the European Parliament

and of the Council

on patients rights in cross-border healthcare

• Establish rules for facilitating access to safe high-quality

cross-border healthcare in the EU

• Ensure patient mobility in accordance with the principles

established by the Court of Justice.

• Should be apply to individual patients who decide

to seek healthcare in a member state other than state of

affilation

It is clear that the obligation to reimburse costs of

cross- border healthcare should be limited to

healthcare to which the insured person is entitled

according to the legislation of the Member State of

affiliation (14)

EU Directive regarding the application of

patients´rights on cross-border healthcare

SPACE FOR COMPETITION IN THE EUROPEAN

MARKET OF HEALTHCARE

Medical

spas

Reha-

clinicsSpecialized

hospital

departments

ESPA

members

No ESPA

members

– Patients should enjoy a guarantee of assumption of the costs of that healthcare at least at the level as would be provided for the same healthcare, had it been provided in the Member State of affiliation. This should fully respect the responsibility of the Member States to determine the extent of the sickness cover available to their citizens and prevent any significant effect on the financing of the national healthcare systems.

– Directive should not apply to those

long- term care services deemed

necessary in order to enable the

person in need of care to live as full

and self- determined a life as

possible. Thus, this Directive should

not apply, for example, to long-term

care services provided by home care

services, in assisted living facilities

and in residential homes or housing

(‘nursing homes’).

CHAPTER III

REIMBURSEMENT OF COSTS OF CROSS-

BORDER HEALTHCARE

Article 7

General principles for reimbursement of

costs

1. Without prejudice to Regulation (EC) No

883/2004 and subject to the provisions of

Articles 8 and 9, the Member State of affiliation

shall ensure the costs incurred by an insured

person who receives cross-border healthcare

are reimbursed, if the healthcare in question is

among the benefits to which the insured

person is entitled in the Member State of

affiliation.

4. The costs of cross-border healthcare shall be reimbursed or paid directly by the

Member State of affiliation up to the level of costs that would have been assumed

by the Member State of affiliation, had this healthcare been provided in its territory

without exceeding the actual costs of healthcare received.

Spas with strong medical background is

especially European fenomenon, only partly in

Asia (e.g. Japan, China...)

Spas and spa facilities are in the most European countries

the part of a health system and spa treatment/healthcare is

paid by social/health insurence.

Cross-border healthcare for traditional spa treatment is

good known many years, mainly by selfpaid patients/clients

in some countries full/partly reimburse (e.g.Germany)

What products of spas can be as cross-board healthcare

paid in other member states

?

MEDICAL SPAS in EU

● License of the state authority providing spa

treatment as part of healthcare

● Natural healing sources/ all treatments

recognised by state authority

● Strong medical background (high qualified

personel, e.g. physicians, physioterapists,

masseurs etc.)

● Implementation of new treatments based on

scientific results and specialized services (e.g.

diagnostics, laboratory tests, health consulting)

● Medical and preventive packages

● Length of stay (more than two weeks)

European spas

Spas and spa facilities are in the most European countries the part of a health system

Inseparable part of a health system and the healthtourism

Conditions necessary for creation

and existence of a Spa in Europe

Local natural healing source (healing water, healing peloids, healing gases, natural healing sources of sea, climatic conditions suitable for healing, acknowledged natural system of cure – Kneipp.

High quality environment

Specific and protected spa place

Medical background for rehabilitation and cure, primary and secondary prevention

Thermal spas

Mineral spas

Peloid spas

Climatic spas

Kniepp spas

Radon spas

Priesnitz spas

Tallasso spas

...

Postacute rehabilitation

Chronic diseases- secondary prevention

> Medical Spa Stays

Prevention - primary

Recuperation

> Regeneration Spa

Relax

Wellness

Weekend Breaks

> Relaxation Stays

Main products of European Spas

HEALTHCARE

Health

Groups of diseases treated in European spas

• diseases of the locomotor apparatus – 70 %

• diseases of cardiovascular system – 12 %

• diseases of the respiratory tract

• skin diseases

• disorders of nourishment and metabolism

• neurological diseases

• psychological problems

• gynecological diseases

• urogenital diseases

• recovery after oncological treatment

indications according natural healing source

– Systematic and continuous

efforts should be made to ensure

that quality and safety standards

are improved in line with the

Council Conclusions and taking

into account advances in

international medical science and

generally recognised good

medical practices as well as

taking into account new health

technologies.

QUALITY and SAFETY

- indication spectrum according local healing sources

- all medical treatments must be recognised

- qualification of staff

- safety for clients and staff in all places

-etc. ......

NEED OF RECOGNISED EUROPEAN CERTIFICATION

EUROPEAN TOURISM STAKEHOLDER

CONFERENCE BUDAPEST MAY 12th-13th, 2011

On 12th – health tourism

Mr. Andrzej Rys, Director for health system and

products EC – need cooperation of MS on

standards and guidelines on quality and safety

ofcross-border healthcare

Mr. Helmut Heckenstaller, chief advisor of the

CEO Techniker Krankenkasse – EUROPESpa

med

Mr. Teofilo Leite, president of UEHP

Guarantee of quality: European standards as

base for european accreditation

Mr. Alfred Hackl, gen. Director of Spa Sarvar –

goodbye pampering – hello prevention and

healthcare

• very low equity

• door for quackery is widely open

• different standards and regulations witin EU

• lack of well trained therapist

NEEDS

• International comparability – EU standards

Products in common european market in

spa-healthcare

SPA rehabilitation (Anschlussheilbehandlung) more and more after high-tech. operations, direct conections with specialised clinics

Products of secondary prevention for chronicaly ill patients

Products of primary prevention for risk groups of population with specific program

Primary prevention with education in healthy lifestyle – young people

Quality in medical spas...

QUALITY - different things for different people

another requirements for quality in different products

EUROPESPA® med

Target of prevention in Spas

Healthy nutrition → prevention of cancer,

cardiovascular diseases, DM, obesity

Physical activity → prevention of cancer,

cardiovascular diseases, osteoporosis, OA, obesity

No smoking →prevention of certain types of cancer,

cardiovascular diseases

No drugs → prevention mental and physical

disorders

Lack of stress → prevention of depression

Positive thinking → stimulation of all body systems

NEW QUALITY OF LIFE STYLE

SPA STAY

Changes in Lifestyle

Smoking

∟ Cardiovascular diseases

∟ Cancer

∟ Respiratory diseases

Nutrition (lack of fruits and vegetables, excess of

fat and sugar in fast food)

∟ Overweight and obesity (risk for cancer, DM, CDV)

∟ Cancer

Lack of physical activity

∟ OA, OP, CVD

∟ Obesity

∟ Cancer

Stress psyco-social determinants

Alcohol harmful abusus, and other drugs

PREVENTION IN SPA

Future of European Spas linked with health needs

Preventive programmes directed at changing of

life style and as a prevention of common diseases

– aim for Europe and Spas

Old age of Europeans (increased number of

seniors) – programmes directed at keeping the

quality of life in old age

Classic spa treatment mainly for diseases of

locomotory apparatus, psychiatric diseases -

depresive stage, cardiovascular diseases

Research and investigation in spa treatments and

services/evidence based spa medicine

Balneological Research Institute

Universities and High schools with

pregradual and postgradual education in field

balneology

Insurance companies – studies on economical

benefits of spa treatment

Spa facilities – objectification of own health

products and own natural healing sources

Professional associations (Kneippverband,

ESPA ?)

Tourist research institutions (ETI in Trier)

In comparison with other medical fields less money (no interest of pharmaceutical companies)

In future existence of spa health resorts without research and investigation is endanger

THANK YOU FOR YOUR ATTENTION