Medical tourism
Medical tourism is the practice of traveling abroad to obtain medical treatment. In the past, this usually referred to those who traveled from less-developed countries to major medical centers in highly developed countries for treatment unavailable at home. However, in recent years it may equally refer to those from developed countries who travel to developing countries for lower-priced medical treatments. With differences between the medical agencies, such as the Food and Drug Administration or the European Medicines Agency, etc., which decide whether a drug is approved in their country or region, or not, the motivation may be also for medical services unavailable or non-licensed in the home country.
Medical tourism most often is for surgeries or similar treatments, though people also travel for dental tourism or fertility tourism. People with rare conditions may travel to countries where the treatment is better understood. However, almost all types of health care are available, including psychiatry, alternative medicine, convalescent care, and even burial services.
Health tourism is a wider term for travel that focuses on medical treatments and the use of healthcare services. It covers a wide field of health-oriented tourism ranging from preventive and health-conductive treatment to rehabilitational and curative forms of travel. Wellness tourism is a related field.
History
The first recorded instance of people traveling for medical treatment dates back thousands of years to when Greek pilgrims traveled from the eastern Mediterranean to a small area in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios.Spa towns and sanitaria were early forms of medical tourism. In 18th-century Europe patients visited spas because they were places with supposedly health-giving mineral waters, treating diseases from gout to liver disorders and bronchitis.
Description
Factors that have led to the increasing popularity of medical travel include the high cost of health care, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries. The avoidance of waiting times is the leading factor for medical tourism from the UK, whereas in the US, the main reason is cheaper prices abroad. Furthermore, death rates even in the developed countries differ extremely.Many surgical procedures performed in medical tourism destinations cost a fraction of the price they do in other countries. For example, in the United States, a liver transplant that may cost US$300,000, would generally cost about US$91,000 in Taiwan. A large draw to medical travel is convenience and speed. Countries that operate public health-care systems often have long wait times for certain operations, for example, an estimated 782,936 Canadian patients spent an average waiting time of 9.4 weeks on medical waiting lists in 2005. Canada has also set waiting time benchmarks for non-urgent medical procedures, including a 26-week waiting period for a hip replacement and a 16-week wait for cataract surgery.
In developed countries such as the United States, medical tourism has large growth prospects and potentially destabilizing implications. A forecast by Deloitte Consulting published in August 2008 projected that medical tourism originating in the US could jump by a factor of ten over the next decade. An estimated 750,000 Americans went abroad for health care in 2007, and the report estimated that 1.5 million would seek health care outside the US in 2008. The growth in medical tourism has the potential to cost US health care providers billions of dollars in lost revenue.
Manish Chandra, Co founder of Vaidam Health stated that " Medical tourism is a rapidly expanding sector within India's healthcare industry, offering immense potential. Over the years, a significant number of people have traveled across continents seeking medical care due to factors such as cost-effectiveness, faster and more efficient services, specialized healthcare, and advanced treatment options that may not be available in their home countries. Industry reports indicate that India's healthcare industry is projected to reach $280 billion by 2020, which will likely enhance the quality and scope of medical treatment offered by hospitals".
An authority at the Harvard Business School stated that "medical tourism is promoted much more heavily in the United Kingdom than in the United States".
Additionally, some patients in some First World countries are finding that insurance either does not cover orthopedic surgery or limits the choice of the facility, surgeon, or prosthetics to be used.
Popular medical travel worldwide destinations include: Canada, Cuba, Costa Rica, India, Israel, Jordan, Malaysia, Mexico, Singapore, South Korea, Taiwan, Thailand, Turkey, United States.
Among the most popular destinations for cosmetic surgery include: Brazil, Colombia, Costa Rica, Czech Republic, Dominican Republic, Egypt, Greece, Iran, India, Italy, Lebanon, Malaysia, Mexico, Poland, South Korea, Turkey and Thailand.
Some people travel for assisted pregnancy, such as in-vitro fertilization, or surrogacy, or freezing embryos for retro-production.
However, perceptions of medical tourism are not always positive. In places like the US, which has high standards of quality, medical tourism is viewed as risky. In some parts of the world, wider political issues can influence where medical tourists will choose to seek out health care.
Medical tourism providers have developed as intermediaries which unite potential medical tourists with surgeons, provider hospitals and other organizations. In some cases, surgeons from the United States have signed up with medical tourism providers to travel to Mexico to treat American patients. The hope is that using an American surgeon may alleviate concerns about going outside the country, and persuade self-insured American employers to offer this cost-effective option to their workers as a way to save money while still provide high-quality care. Companies that focus on medical value travel typically provide nurse case managers to assist patients with pre- and post-travel medical issues. They may also help provide resources for follow-up care upon the patient's return.
Circumvention tourism is also an area of medical tourism that has grown. Circumvention tourism is travel in order to access medical services that are legal in the destination country but illegal in the home country. This can include travel for fertility treatments that are not yet approved in the home country, abortion, and doctor-assisted suicide. Abortion tourism can be found most commonly in Europe, where travel between countries is relatively simple. Poland, a European country with highly restrictive abortion laws, has one of the highest rates of circumvention tourism, as did Ireland before abortion was made legal in 2018. In Poland especially, it is estimated that each year nearly 7,000 women travel to the UK, where abortion services are free through the National Health Service. There are also efforts being made by independent organizations and doctors, such as with Women on Waves, to help women circumvent laws in order to access medical services. With Women on Waves, the organization uses a mobile clinic aboard a ship to provide medical abortions in international waters, where the law of the country whose flag is flown applies.
Dental tourism is travel for cheaper dentistry or oral surgery. The same porcelain veneer made in a lab in Sweden can be as much as 2500 AUD in Australia, but only 1200 AUD in India. The price difference here is not explainable by reference to the material cost.
International healthcare accreditation
International healthcare accreditation is the process of certifying a level of quality for healthcare providers and programs across multiple countries. International healthcare accreditation organizations certify a wide range of healthcare programs such as hospitals, primary care centers, medical transport, and ambulatory care services. There are a number of accreditation schemes available based in a number of different countries around the world.The oldest international accrediting body is Accreditation Canada, formerly known as the Canadian Council on Health Services Accreditation, which accredited the Bermuda Hospital Board as soon as 1968. Since then, it has accredited hospitals and health service organizations in ten other countries.
In the United States, the accreditation group Joint Commission International was formed in 1994 to provide international clients education and consulting services. Many international hospitals today see obtaining international accreditation as a way to attract American patients.
Joint Commission International is a relative of the Joint Commission in the United States. Both are US-style independent private sector not-for-profit organizations that develop nationally and internationally recognized procedures and standards to help improve patient care and safety. They work with hospitals to help them meet Joint Commission standards for patient care and then accredit those hospitals meeting the standards.
A British scheme, QHA Trent Accreditation, is an active independent holistic accreditation scheme, as well as GCR.org which monitors the success metrics and standards of almost 500,000 medical clinics worldwide.
The different international healthcare accreditation schemes vary in quality, size, cost, intent and the skill and intensity of their marketing. They also vary in terms of cost to hospitals and healthcare institutions making use of them.
Increasingly, some hospitals are looking towards dual international accreditation, perhaps having both JCI to cover potential US clientele, and Accreditation Canada or QHA Trent. As a result of competition between clinics for American medical tourists, there have been initiatives to rank hospitals based on patient-reported metrics.