Result card

  • LEG6: Do laws/ binding rules require appropriate processes or resources to guarantee equal access to Structured telephone support (STS) for adult patients with chronic heart failure?
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Do laws/ binding rules require appropriate processes or resources to guarantee equal access to Structured telephone support (STS) for adult patients with chronic heart failure?

Authors: Ingrid Wilbacher, Valentina Prevolnik Rupel

Internal reviewers: Ingrid Rosian

The allocation of (limited) resources needs to select the most benefiting patients without discrimination. In case of structured telephone support for patients with chronic heart failure the decision process is to be made transparently and to follow objective indicators like regional distance, compliance, absence of relatives, etc. – despite the medicinal criteria.

The allocation of (limited) resources needs to select the most benefiting patients without discrimination. In case of structured telephone support for patients with chronic heart failure the decision process is to be made transparently and to follow objective indicators like regional distance, compliance, absence of relatives, etc. – despite the medicinal criteria.

  • Convention for the Protection of Human Rights and Fundamental Freedoms {12}, Article 14 – Prohibition of discrimination:

“The enjoyment of the rights and freedoms set forth in this Convention shall be secured without discrimination on any ground such as sex, race, colour, language, religion, political or other opinion, national or social origin, association with a national minority, property, birth or other status.” {12}

  • Everybody has the basic right to health care at the state of the art ("best care"). It can be discussed whether “structured telephone support” counts as “state of the art”
  • There are no exclusions/ special protection declarations for gender equality, prisoners, disabled, regional equalities {13,14,15,16,17,18,19}
  • The level of quality is included into the right of good care, but there is a need of legal regulation about a minimum defined quality level to provide equal preconditions for everyone
  • Limited access to structured telephone support as a telemonitoring service for special persons are based on the balance between evidence of best outcome rates, economic calculations for the costs and reduction of possible disadvantages due to i.e. lack of compliance. The decision for inclusion/ exclusion into a structured telephone support service has to be transparent ({12}, Article 14 – Prohibition of discrimination

There are several regulations and statements on EU- and international level for securing equal access to health care in Europe.{13,14,15,16,17,18,19} It implements that usual care for all persons is provided.

The limits of healthcare should be implemented in a balance between the right of access and the patients' right for human dignity, right to life, right to the integrity of the person, prohibition of torture and inhuman or degrading treatment or punishment; and respect for private and family Life. Transparency is one method to provide prohibition of discrimination as required in the Convention for the Protection of Human Rights {12}.

Especially in the field of e-health It is essential to discuss, among others, aspects relating to safety and confidentiality; professional accountability; technical standards relating to digital recording, storage, and transmission of clinical data; copyright; authorization from professional regulatory bodies; and licensing for the remote practice of medicine. (Rezende 2010) {20}

Responsibility:

Legal issues can be solved easily when responsibilities of parties concerned have been established and documented. Loeber 2008 {21}

Important
Wilbacher I, Rupel V Result Card LEG6 In: Wilbacher I, Rupel V Legal aspects In: Jefferson T, Cerbo M, Vicari N [eds.]. Structured telephone support (STS) for adult patients with chronic heart failure [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 3 October 2022]. Available from: http://corehta.info/ViewCover.aspx?id=305

References