Medical tourism refers to people traveling to countries other than their own for medical treatment. In the past this usually refers to those who travel from less developed countries to major medical centers in developed countries for treatments that are not available at home. However, in recent years this may be similar to those from developed countries who travel to developing countries for lower-priced medical care. Motivation may also be for medical services not available or illegal in the country of origin.
The most frequent medical tourism is for surgery (cosmetics or other) or similar treatments, although people also travel for dental tourism or fertility tourism. People with rare conditions can travel to countries where care is better understood. However, almost all types of health care are available, including psychiatry, alternative medicine, healing treatments, and even funeral services.
Health tourism is a broader term for travel that focuses on medical care and the use of health care services. It covers a broad field of health-oriented, tourism ranging from preventive and health-conductive care to rehabilitation and curative forms of travel. Health tourism is a related field.
Video Medical tourism
Histori
The first recorded example of people traveling for medical care has been around for thousands of years when Greek pilgrims traveled from the eastern Mediterranean to a small area of ​​the Saronic Gulf called Epidauria. This region is a refuge for the god of healing Asklepios.
The city's spa and sanitaria are the earliest forms of medical tourism. In the 18th century, European patients visited spas as they were places with mineral water that were supposed to provide health, cure diseases from gout to liver disorders and bronchitis.
Maps Medical tourism
Description
Factors that have led to the rising popularity of medical travel include high health care costs, long waiting times for certain procedures, the ease and affordability of international travel, and improved technology and maintenance standards in many countries. The avoidance of waiting times is a major factor for medical tourism from the UK, whereas in the US, the main reason is cheaper prices abroad.
Many surgical procedures performed at medical tourist destinations spend a fraction of the price they do in other countries. For example, in the United States, a liver transplant that might cost $ 300,000 USD, will typically cost about $ 91,000 USD in Taiwan. The great attraction for medical travel is comfort and speed. Countries that operate public health care systems often wait a long time for certain operations, for example, an estimated 782,936 Canadian patients spent an average waiting period of 9.4 weeks on a waiting list in 2005. Canada also sets a waiting time limit for non-urgent medical procedures, including a 26-week waiting period for hip replacement and waiting 16 weeks for cataract surgery.
In First World countries such as the United States, medical tourism has large growth prospects and potentially destabilizing implications. Estimates by Deloitte Consulting published in August 2008 projected that medical tourism originating in the US can 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 estimates that 1.5 million will seek healthcare outside the US in 2008. Growth in medical tourism has the potential to burden US health care providers billions of dollars in revenues missing.
Authority at Harvard Business School stated that "promoted medical tourism is much heavier in the UK than in the United States".
In addition, some patients in some First World countries find that insurance does not cover orthopedic surgery (such as knee or hip replacements) or limit the choice of facilities, surgeons, or prosthetics to be used.
Popular medical travel destinations around the world include: Canada, Costa Rica, Ecuador, India, Israel, Jordan, Malaysia, Mexico, Singapore, South Korea, Taiwan, Thailand, Turkey, United States.
Popular destinations for cosmetic surgery include: Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Ecuador, Mexico, Turkey, Thailand, and Ukraine. According to "Sociedad Boliviana de Cirugia Plastica y Reconstructiva", more than 70% of middle and upper class women in this country have some form of plastic surgery. Other destinations include Belgium, Poland, Slovakia and South Africa.
Some people travel to help with pregnancy, such as in-vitro fertilization, or surrogacy, or frozen embryos for retro production.
However, the perception of medical tourism is not always positive. In places like the US, which have high quality standards, medical tourism is viewed as risky. In some parts of the world, wider political issues may affect where medical travelers will choose to seek health care.
Health tourism providers have been developed as an intermediary that brings together potential medical travelers with hospital providers and other organizations. Companies that focus on medical value travel typically provide nurse managers to help patients with medical problems before and after travel. They can also help provide resources for follow-up care for the patient's return.
Traveling tour is also a medical tourism area that has grown. Traveling is a journey to access legal medical services in the destination country but is illegal in the country of origin. This may include trips to unapproved fertility treatments in home country, abortion, and physician-assisted suicide. Abortion tours can be found most commonly in Europe, where travel between countries is relatively simple. Ireland and Poland, two European countries with very strict abortion laws, have the highest level of circumvention tourism. Particularly in Poland, it is estimated that every year nearly 7,000 women travel to the UK, where free abortion services go through the National Health Service. There are also efforts by independent organizations and doctors, such as Women on Waves, to help women avoid cruel laws to access medical services. With Women on Waves, organizations use mobile clinics aboard for medical abortions in international waters, where the flag-raising state law applies.
International health care accreditation
International health care accreditation is a process of quality level certification for healthcare providers and programs in many countries. The international healthcare accreditation organization declares various health care programs such as hospitals, primary care centers, medical transport, and outpatient care services. There are a number of accreditation schemes available in a number of different countries around the world.
The oldest international accrediting body is Canadian Accreditation, formerly known as the Canadian Council on Health Services Accreditation, which accredited Bermuda Hospital Board soon after 1968. Since then, it has accredited hospitals and healthcare organizations in ten other countries.
In the United States, the Joint Commission International (JCI) accreditation group was formed in 1994 to provide international client education and consulting services. Many international hospitals today look to gain international accreditation as a way to attract American patients.
The Joint Commission International is the brother of the Joint Commission in the United States. Both are US independent private sector nonprofit 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 accrediting hospitals that meet standards.
The UK Scheme, QHA Trent Accreditation, is an active, independent holistic accreditation scheme, and GCR.org monitors success and standards metrics from nearly 500,000 medical clinics around the world.
Various international health care accreditation schemes vary in quality, size, cost, purpose, and skills and their marketing intensity. They also vary in cost to hospitals and health institutions that use them.
Increasingly, some hospitals seek double international accreditation, may have both JCI to cover potential US clients, and Canadian Accreditation or QHA Trent. As a result of competition between clinics for American medical tourists, there are initiatives to rank hospitals based on patient reported metrics.
Risk
Medical tourism carries some of the risks that local medical care provides does not carry or bring to a much lower level.
Some countries, such as South Africa, or Thailand have a very different epidemiology related to infectious diseases to Europe and North America. Exposure to diseases without building natural immunity can be a hazard for weak individuals, particularly those associated with gastrointestinal diseases (eg hepatitis A, amoebic dysentery, paratyphoid) that can weaken progress and expose patients to transmitted diseases through mosquitoes, influenza and tuberculosis. However, because in poor tropical countries the disease runs entirely, doctors seem to be more open to the possibility of considering infectious diseases, including HIV, TB, and typhoid, while there are cases in the West where patients have been consistently misdiagnosed for years due to illness as it is considered "rare" in the West.
The quality of post-operative care can also vary dramatically, depending on the hospital and country, and may differ from US or European standards. Also, traveling long distances immediately after surgery may increase the risk of complications. Long flight and decreased mobility associated with windowless seats can be one cause of proliferation of deep vein thrombosis and potentially pulmonary embolism. Other holiday activities can also cause problems - for example, the scars can become darker and more visible if they are sunburned when healing.
Also, healthcare facilities that treat medical travelers may not have adequate complaint policies to deal fairly and fairly with complaints made by dissatisfied patients.
The standard difference of health care providers worldwide has been recognized by the World Health Organization, and in 2004 launched the World Alliance for Patient Safety. It assists hospitals and governments around the world in establishing patient safety policies and practices that can be highly relevant when providing medical tourism services.
If there are complications, patients may need to stay in a foreign country longer than planned or if they have returned home, will not have easy access to follow-up care.
Patients sometimes travel to other countries to obtain medical procedures that doctors in their home country refuse to perform because they believe that the risk of the procedure is greater than the benefits. Such patients may have difficulty obtaining insurance (either public or private) to cover medical follow-up costs if the dreaded complications do occur.
Legal issues
Receiving medical treatment abroad can subject medical tourists to unknown legal issues. The limited nature of litigation in different countries is the reason for the accessibility of care abroad. While some countries today present themselves as an attractive medical tourism destination providing some form of legal restoration to medical malpractice, this legal path may be of no interest to medical travelers. If a problem arises, the patient may not be covered by adequate personal insurance or may not be able to request compensation through malpractice lawsuits. Hospitals and/or physicians in some countries may not be able to pay the financial compensation provided by the court to patients who have sued them, because hospitals and/or doctors do not have appropriate insurance coverage and/or medical damages.
Problems can also arise for patients seeking illegal services in their home country. In this case, some countries have jurisdiction to prosecute their citizens as soon as they return home, or in extreme cases of externalitarian capture and prosecution. In Ireland, in particular, in the 1980s of the 90s there were cases of young rape victims who were prohibited from traveling to Europe to obtain legal abortions. Ultimately, the Irish Supreme Court overturned the ban; they and many other countries have since created an "right to travel" amendment.
Ethical issues
There may be major ethical issues surrounding medical tourism. For example, illegally purchasing organs and networks for transplantation has been systematically documented and studied in countries such as India, China, Colombia and the Philippines. The Istanbul Declaration distinguishes between ethically problematic "transplant travel" and "travel for transplantation".
Medical tourism can lead to wider ethical issues for the countries in which it is promoted. For example, in India, some argue that the "policy" of medical tourism for the class and the health mission for the masses will lead to deepening of injustice "already embedded in the health care system.In Thailand, in 2008 it was stated that," Doctors in Thailand have so busy with foreigners that Thai patients find it difficult to get treatment. "Medical tourism centered on new technologies, such as stem cell treatments, is often criticized on the basis of fraud, lack of scientific and patient safety reasons, but when pioneering advanced technology, 'unproven' therapy to patients outside routine clinical trials, it is often difficult to distinguish between acceptable medical innovations and unacceptable exploitation of patients.
Company-sponsored health care in the US
Some US businessmen have begun to explore travel medical programs as a way to cut employee health care costs. Such proposals have sparked a heated debate between employers and trade unions representing workers, with one union claiming that he regrets a "surprising new approach" that offers treatment to employees abroad in return for a share of the company's savings. Unions also raise the issue of legal liability if anything goes wrong, and the potential for job losses in the US health care industry if treatment is outsourced.
Employers can offer incentives such as paying for air travel and waiving out-of-pocket costs for treatment outside the US. For example, in January 2008, Hannaford Bros., a supermarket chain based in Maine, began paying medical bills for employees to travel to Singapore for hip and knee replacements, including trips for patients and escorts. Medical travel packages can integrate with all types of health insurance, including limited benefit plans, selected provider organizations and a reduced health plan.
In 2000, the Blue Shield of California initiated the first cross-border health plan of the United States. Patients in California can travel to one of three certified hospitals in Mexico for treatment under California Blue Shield. In 2007, BlueCross BlueSross's subsidiary of South Carolina, Companion Global Healthcare, worked with hospitals in Thailand, Singapore, Turkey, Ireland, Costa Rica and India. A 2008 article in Fast Company discusses the globalization of health care and explains how various players in the US health care market have begun to explore it.
Destination
Africa and Middle East
Jordan
Jordan, through their Private Hospital Association, attracted 250,000 international patients accompanied by over 500,000 colleagues by 2012, with total revenues exceeding 1 billion US $. Jordan won the Medical Destination of the year award in 2014 at the IMTJ Medical Travel Awards.
Israel
Israel is a popular destination for medical tourism. Many medical tourists to Israel come from Europe, especially the former Soviet Union, as well as the United States, Australia, Cyprus, and South Africa. Medical tourists come to Israel for various surgical procedures and therapies, including bone marrow transplant, cardiac surgery and catheterization, oncology and neurological treatments, orthopedic procedures, car accident rehabilitation, and in-vitro fertilization. The popularity of Israel as a medical tourism destination stems from its status as a developed country with a high level of medical care, while at the same time having lower medical costs than many other developed countries. Israel is very popular as a destination for bone marrow transplantation among Cypriots, because its procedure is not available in Cyprus, and for orthopedic procedures among Americans, as the cost of orthopedic procedures in Israel is about half that of the United States. Israel is a very popular destination for people looking for IFV treatments. Medical tourists in Israel use public and private hospitals, and all major Israeli hospitals offer medical tour packages that are usually much cheaper than comparable procedures than elsewhere with the same high standard of care. By 2014, it is estimated that about 50,000 medical tourists come to Israel each year. There are reports that medical tourists are getting special care, thus harming local patients. In addition, some people came to Israel to visit the health resorts of the Dead Sea, and at Lake Kinneret.
Iran
In 2012, 30,000 people come to Iran to receive medical treatment. By 2015, it is estimated that between 150,000 and 200,000 health tourists come to Iran, and this figure is expected to increase to 500,000 per year.
Iran has low endemicity for hepatitis B virus and hepatitis C virus infection and there is a unique experience controlling this infection that can be presented to people in Middle Eastern countries. Pharmaceutical companies in Iran produce the drugs needed to control HCV and HBV infections such as Tenopovir disoproxil, Peg Interferon, Sofosbuvir/daclatasvir and Ledipasvir at very low prices and high efficacy. Sadeghi F, Salehi-Vaziri M, Almasi-Hashiani A, Gholami-Fesharaki M, Pakzad R, Alavian SM. Prevalence of Hepatitis C Virus Genotypes Among Patients in Countries of the WHO Eastern Regional Office (EMRO): Systematic Review and Meta-Analysis. Hepat Mon. 2016; 16 (4): e35558.
South Africa
South Africa is the first country in Africa to emerge as a medical tourist destination.
United Arab Emirates
United Arab Emirates, especially Dubai, Abu Dhabi, Ras Al Khaimah is a popular destination for medical tourism. Dubai Health Authority has pioneered medical tourism to the UAE, particularly Dubai. However, hospitals that provide medical tourism are spread across seven emirates. The UAE has the distinction of having the maximum number of JCI accredited hospitals (under various heads). UAE has incoming medical tourism as well as people going out for medical treatment. Inbound tours are usually from African countries such as Nigeria, Kenya, Uganda, Rwanda, etc. Outbond can be categorized into two segments - local people (UAE citizens) and expatriates. Locals prefer to go to European destinations like England, Germany, etc. The expatriates prefer to return to their home country for treatment.
America
Brazil
In Brazil, Albert Einstein Hospital at SÃÆ'Â £ Paulo is the first facility accredited by JCI outside the US, and more than a dozen Brazilian medical facilities have also been accredited.
Canada
Compared to US healthcare costs, patients can save 30 to 60 percent on healthcare costs in Canada.
In the early 1990s, Americans illegally using Canada's fake, borrowed, or counterfeit health insurance cards to obtain free health care in Canada became a serious problem because of the high fees imposed.
Costa Rica
In Costa Rica, there are two Joint Commission International accredited (JCI) hospitals. Both are in San Jose, Costa Rica. When the World Health Organization (WHO) ranked the world health system in 2000, Costa Rica was ranked no. 26, which is higher than the US, and together with Dominica dominates the list among Central American countries.
The Deloitte Center for Health Solutions reports an average cost savings of between 30-70% of US prices.
Cayman Islands
Cuban
United States
A McKinsey and Co. report from 2008 found that between 60,000 and 85,000 medical travelers traveled to the United States for the purpose of receiving inpatient medical treatment. The same McKinsey study estimated that 750,000 American medical tourists traveled from the United States to another country in 2007 (up from 500,000 in 2006). The availability of advanced medical technology and advanced physician training are referred to as driving motivation for the growth of foreigners traveling to the US for medical treatment, while low-cost for hospital care and large/complex procedures at Western accredited medical facilities abroad is cited as the main motivator for American travelers. In addition, the decline in US dollar values ​​between 2007 and 2013 is used to offer additional incentives for overseas travel to the US, although the cost difference between the US and many locations in Asia is greater than any currency fluctuations.
Some major medical centers and teaching hospitals offer international patient centers serving patients from foreign countries seeking medical care in the US. Many of these organizations offer service coordinators to assist international patients with arrangements for medical care, accommodation, finance and transportation including air ambulance services.
Asia and the Pacific Islands
China
The 2016 Online Medical Tourism report on Ctrip shows that the number of tourists enrolling in overseas medical tourism through its platform increased fivefold compared to the previous year, and more than 500,000 Chinese visitors are expected to go to medical tourism. The top ten medical tourism destinations are Japan, Korea, US, Taiwan, Germany, Singapore, Malaysia, Sweden, Thailand, and India. Routine healthcare is the largest part of China's medical tourism by 2016, representing more than 50% of all medical travel for tourists from China.
Hong Kong
All twelve Hong Kong private hospitals have been surveyed and accredited by the UK Trent Accreditation Scheme since early 2001.
India
Medical tourism is a growing sector in India. India became the second medical tourist destination after Thailand. Chennai is considered the "Indian Health City" because it attracts 45% of health tourists visiting India and 40% of domestic health tourists.
India's medical tourism sector is expected to experience an annual growth rate of 30% from 2012, making it a $ 2 billion industry by 2015. As the cost of medical care in a balloon developing country - with the United States leading the way - more and more Westerners are discovering the prospect of international travel for medical treatment more attractive. An estimated 150,000 of these trips to India for cheap health care procedures each year. Cosmetic surgery, bariatric surgery, knee replacement stamps, liver transplants, and cancer treatments are some of the most sought-after medical procedures selected by foreigners.
Malaysia
New Zealand
In 2008, it was estimated that New Zealand's average surgical costs were about 15 to 20% the cost of similar surgical procedures in the US.
Pakistan
Singapore
Singapore has a dozen hospitals and medical centers with JCI accreditation. In 2013, medical expenditures resulting from medical tourists, most of the more complex medical procedures, such as cardiac surgery, were S $ 832 million, a 25% reduction from S $ 1.11 billion in 2012, as hospitals face more much competition from neighboring countries for less complex work.. Singapore is the most popular destination for medical tourism because of its expertise in complex surgical procedures, the demand for medical tourism is also soaring in other parts of Asia, according to research analysts Future Market Insights
Thai
Thailand has 39 hospitals that are accredited by JCI. In 1994, the Thai Dental Council was established and is a premier dentist's practice in Thailand, and has now formulated a uniform requirement of competence for dental practitioners, which directly affects medical and dental teaching programs. The Ministry of Public Health plays an important role in developing health services to promote scientific-based education. In addition, the Thai government has placed a more important role in public health programs for its citizens. Foreigners seeking treatment for everything from open heart surgery to gender assignment have made Thailand a popular destination for medical tourism, attracting some 2.81 million patients by 2015, up 10.2 percent. In 2013, medical tourists pumped as much as $ 4.7 billion into the Thai economy, according to government statistics. Development of Thailand's sex change operation has expanded the country's medical tourism industry over the years. Through Kathoey's portrayal of transgender women, represented in the media, Thailand has become one of the leading countries with increasing number of medical tours per year.
Europe
In 2006, it was decided that under the conditions of the European health scheme E112, UK health authorities would have to pay bills if one of their patients could establish an urgent medical reason for seeking treatment sooner in other European united states.
The European directive on the application of patient rights for cross-border health care is approved in 2011.
Finnish
On December 9, 2013 the City of Helsinki ruled that all minors under 18 years and all expectant mothers living in Helsinki without a valid visa or residence permit, are entitled to the same health care and at the same price as all citizens of the city. This service will be available around early 2014. Volunteer doctors from Global Clinic have tried to help these people, who are only available acute care. This means that the Finnish health care system is open to all people coming outside the EU. This service includes special child health care, maternity clinics, and specialist medical care, etc. For free. It remains unclear whether this will improve the so-called health-care tour, because all you have to do is come to Helsinki as a tourist and let the visa expire.
The Global Clinic in Turku offers healthcare to all immigrants without documents for free.
French
The NHS UK patients have been offered treatments in France to reduce waiting lists for hip, knee and cataract surgeries since 2002. France is a popular tourist destination but also the world's leading health care system ranking by the World Health Organization. The European Court says that the National Health Service (UK) must pay back British patients.
The number of patients is growing, and by 2016, France is ranked # 7 in the Medical Tourism Index.
Serbian
Serbia has various clinics serving medical tourists in the areas of cosmetic surgery, dental care, fertility treatments and weight loss procedures. The country is also a major international center for sex change operations.
Turkish
The cost of medical care in Turkey is quite affordable compared to Western European countries. Therefore, thousands of people each year travel to Turkey for their medical care. Turkey is primarily a center for hair transplant surgery. In February 2018 it was reported that the country was the worst place for a failed plastic surgery operation on the British people with Dr. Mehmet Kaya of Marmaris selected for criticism. The president of the British Association of Aesthetic Plastic Surgeons says surgery is done on people who are not fit for surgery, and that unscrupulous practitioners have jeopardized their health for profit.
United Kingdom
The National Health Service is publicly owned. This attracts medical tourism especially to specialist centers in London. Some private hospitals and clinics in the UK are medical tourism destinations. Very few British private hospitals have been through independent international accreditation (they have mandatory registration with British supervisor, Quality Care Commission), so they have not measured themselves against the best clinics and hospitals elsewhere in the world.
It is said that health tourists in the UK often target the NHS for free treatment at the treatment site, which allegedly harms the NHS to Ã, Â £ 200 million. A study in 2013 concluded that Britain is a net tourist exporter of medical tourists, with 63,000 Britons traveling abroad for treatment and about 52,000 patients getting treatment in the UK. Medical travelers who are treated as private patients by NHS trusts are more profitable than British private patients, generating almost a quarter of income from only 7% of the case volume. British dental patients mostly go to Hungary and Poland. Most fertility tourists travel to Eastern Europe, Cyprus and Spain.
In the summer of 2015 the immigration officers from the Border Force are stationed at the St George NHS Foundation Trust University Hospital to train staff to identify "potentially costly patients". In October 2016, the trust announced that they planned to request a photo identification document or proof of their right to remain in the UK such as an asylum or visa status for a pregnant woman. Those who can not provide satisfactory documents will be sent to a team of overseas patient confidence "for screening of special documents, in connection with the UK Border Agency and Home Office." It is estimated that £ 4.6 million a year is spent on caring for unqualified patients. The pilot scheme to check whether patients are entitled to free NHS care at 18 NHS trusts, 11 in London, for two months in 2017 requires 8,894 people for two forms of ID before non-emergency treatment. Only 50 are not eligible for free NHS treatment. The campaigners claim this is "part of the Government's unfriendly environmental policy", and that at Newham hospital "you will see great signs that say you may not be eligible for free NHS treatment".
See also Immigration health surcharges
See also
- Health tour
- Import consumer prescription drugs
Note
References
- Business Can Move Overseas Health Care (Washington Post)
- CBC news about "Medical tourism: Need operation, will travel"
- A Cut Below: Americans Looking Overseas for Health Care (ABC News)
- Medical Tour, 60 Minutes (CBS News)
External links
- List of medical tourism websites - Open Directory Project
Source of the article : Wikipedia
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