Medical Tourism

It is confidentially predicted It is confidentially predicted that over the next decade, that over the next decade, Asia will have one of the Asia will have one of the fastest growing tourist fastest growing tourist population in the world…population in the world…

It is confidentially predicted It is confidentially predicted that over the next decade, that over the next decade, Asia will have one of the Asia will have one of the fastest growing tourist fastest growing tourist population in the world…population in the world…

KAZEMI Dec. 2007Lulea University of Technology

1. travel for pleasure: the activity of traveling

for pleasure2. travel business: the business of arranging

travel and travel services for people

3. travel to obtain service: travel to benefit

from a particular service or activity that is unavailable at home (usually used in combination) •health tourism

Microsoft® Encarta® 2007. © 1993-2006 Microsoft Corporation. All rights reserved.

tour·ism [toor ìzzəm]noun

tour·ism [toor ìzzəm]noun

www.yellowpages-cambodia.com/images/maps/Southeastasia

PHILIPPINESPHILIPPINES

THAILANDTHAILANDINDIAINDIA

SINGAPORESINGAPORE

MALAYSIAMALAYSIA

The Booming MEDICAL TOURISMIn ASIA

Medical tourism in AsiaMedical tourism in Asia is relatively is relatively new brought on in the aftermath new brought on in the aftermath of the Asian Financial Crisis that of the Asian Financial Crisis that led first private hospitals in some led first private hospitals in some Asian countries to seek alternative Asian countries to seek alternative revenue sources…revenue sources…

Medical tourism in AsiaMedical tourism in Asia is relatively is relatively new brought on in the aftermath new brought on in the aftermath of the Asian Financial Crisis that of the Asian Financial Crisis that led first private hospitals in some led first private hospitals in some Asian countries to seek alternative Asian countries to seek alternative revenue sources…revenue sources…

KAZEMI Dec. 2007Lulea University of Technology

Asia represents the most potential Asia represents the most potential medical tourism market in the medical tourism market in the world. In 2007, the region world. In 2007, the region generated revenues worth US$ generated revenues worth US$ 3.4 Billion, accounting for nearly 3.4 Billion, accounting for nearly 12.7% of the global market 12.7% of the global market

Asia represents the most potential Asia represents the most potential medical tourism market in the medical tourism market in the world. In 2007, the region world. In 2007, the region generated revenues worth US$ generated revenues worth US$ 3.4 Billion, accounting for nearly 3.4 Billion, accounting for nearly 12.7% of the global market 12.7% of the global market

“Asian Medical Tourism Analysis (2008-2012)” Bharatbook June 2008

MEDICAL TOURISM, Defined

• Popular mass culture where people travel often long distances to overseas destinations to obtain medical, dental and surgical care while simultaneously being holiday makers in a more conventional sense

Connell 2006


•Provision of cost-effective private medical care in collaboration with the tourism industry for patients needing surgical and other forms of specialized treatment.

India Medical Care, 2007

Medical TreatmentAlternative & Complimentary Medicine

Medical TourismWellness Tourism

MEDICAL TOURISM, Structure

Jabarri, 2007

Health Tourism

COMPLIMENTARY & ALTERNATIVE MEDICINE

Any help and treatment that is beyond the Any help and treatment that is beyond the usage of Western Medicine usage of Western Medicine (Avijgan, 2007)(Avijgan, 2007)

Dietary supplements, mega dose vitamins, Dietary supplements, mega dose vitamins, herbal preparations, massage therapy, herbal preparations, massage therapy, magnet therapy, spiritual healing and magnet therapy, spiritual healing and meditationmeditation

Complimentary medicine-Complimentary medicine- used together used together with conventionalwith conventional

Alternative medicine-Alternative medicine- used in place of used in place of conventionalconventional

Medical Surgical(Cosmetic, Non-Cosmetic)

Dental Reproductive: (Fertility, Birth, Sex Change)

Medical Treatment

Medical TourismWellness Tourism

Alternative & Complimentary Medicine

MEDICAL TOURISM, Structure

Jabarri, 2007

Health Tourism


MEDICALTOURISM

Consumer Consumer BenifitBenifit

Social IssuesSocial Issues BrandingBranding

ProductProduct

InfrastructureInfrastructureCommunication Communication ChannelChannel

LegalLegal FrameworkFramework

OperatorsOperators

Caballero, Danell & Mugomba, 2006

MEDICAL TOURISM, What’s at stake?

Medical TourismMedical Tourism

A business that: A business that: ––creates value within the tourism and creates value within the tourism and healthcare healthcare ––attracts foreign exchange and investment attracts foreign exchange and investment capitalcapital––creates supply and demand for high creates supply and demand for high skilled labor poolskilled labor pool––generates the highest revenue per visit of generates the highest revenue per visit of any tourist category any tourist category

Who are Who are medical touristsmedical tourists??

Asian Medical & Hospital Center

Initially, medical tourists were composed Initially, medical tourists were composed of only the affluent and well-to-do people of only the affluent and well-to-do people from all over the world, who could afford from all over the world, who could afford to travel abroad to receive the best to travel abroad to receive the best medical attention. medical attention.

medical tourists now also consist of medical tourists now also consist of average earning individuals.average earning individuals.

Initially, medical tourists were composed Initially, medical tourists were composed of only the affluent and well-to-do people of only the affluent and well-to-do people from all over the world, who could afford from all over the world, who could afford to travel abroad to receive the best to travel abroad to receive the best medical attention. medical attention.

medical tourists now also consist of medical tourists now also consist of average earning individuals.average earning individuals.

Why would someone travel halfway across Why would someone travel halfway across the world to a foreign country for these the world to a foreign country for these

health care?health care?

Even if these procedures are available in the home country. What

are the significant reasons?….

Earliest medical tourism centersEarliest medical tourism centers 2000 BC – (Bronze Age) hill tribes near present 2000 BC – (Bronze Age) hill tribes near present

day St. Moritz,day St. Moritz, Switzerland Switzerland gathered around to gathered around to drink & bathe in the iron rich mineral springs of drink & bathe in the iron rich mineral springs of the regionthe region

4000 BC – 4000 BC – SumeriansSumerians constructed the earliest constructed the earliest known health complexes alongside mineral water known health complexes alongside mineral water springs that included elevated temples and springs that included elevated temples and flowing poolsflowing pools

GREEKSGREEKS – first laid the foundation for a – first laid the foundation for a comprehensive health tourism systemcomprehensive health tourism system

Health Medical Tourism, 2005

MEDICAL TOURISM, HISTORY

Wikipeda, 2007

The rise of Greek medical tourismThe rise of Greek medical tourism Asclepia Asclepia templestemples – earliest healing centers, where – earliest healing centers, where

patients from around the region congregated for patients from around the region congregated for therapeutic purposestherapeutic purposes

Greek mythology – Asclepius, the God of Greek mythology – Asclepius, the God of Medicine, mentored by Chiron, the master of Medicine, mentored by Chiron, the master of MedicineMedicine

44thth Century BC – Asclepian healing temples had Century BC – Asclepian healing temples had been constructed throughout the length and been constructed throughout the length and breadth of the Grecian world.breadth of the Grecian world.



The rise of Greek medical tourismThe rise of Greek medical tourism Epidaurus Asclepia Temple ComplexEpidaurus Asclepia Temple Complex

flourished well until 4flourished well until 4thth century AD century AD Included:Included:

• Bathing springsBathing springs• Dream templeDream temple• GymnasiunGymnasiun• Palaestra (exercise area)Palaestra (exercise area)• Snake farmSnake farm


Ancient Roman medical tourismAncient Roman medical tourism ThermaeThermae (hot water baths) – not only used for (hot water baths) – not only used for

obvious medicinal purposes but served as obvious medicinal purposes but served as important social networking venues for some of important social networking venues for some of the Europe’s most privileged elitethe Europe’s most privileged elite ((Health Medical Tourism, 2005)

Because of active trade, Thermae expansion included the following:• Ayurvedic massage• Chinese medicine• Aspects of Buddhist spiritual healing (Health

Medical Industry, 2005)



Early Islamic civilizationEarly Islamic civilization

Mansuri Hospital in Mansuri Hospital in CairoCairo (erected 1210 AD)(erected 1210 AD)• In patient capacity 8000 peopleIn patient capacity 8000 people• Largest hospital of the timeLargest hospital of the time• Most advanced health care facilityMost advanced health care facility



Medieval JapanMedieval Japan

OnsenOnsen – hot mineral springs with healing – hot mineral springs with healing properties enriched by the surrounding volcanic properties enriched by the surrounding volcanic soil.soil.

- discovered later by elderly farmers and - discovered later by elderly farmers and hunters to be effective treatment for arthritic hunters to be effective treatment for arthritic aches, and by warriors to alleviate pain, heal aches, and by warriors to alleviate pain, heal wounds and recuperatewounds and recuperate


Connel, 2006

Indian Medical TourismIndian Medical Tourism

India’s alternative medicine and yoga (5000 yrs India’s alternative medicine and yoga (5000 yrs ago) – made India the epicenter of Eastern ago) – made India the epicenter of Eastern cultural, spiritual, and medicinal progresscultural, spiritual, and medicinal progress

Remained to be a veritable Mecca for all Remained to be a veritable Mecca for all practitioners of alternative medicinepractitioners of alternative medicine

The world’s oldest medical tourism destination The world’s oldest medical tourism destination and now, one of the world’s popular onesand now, one of the world’s popular ones



European Medical TourismEuropean Medical Tourism 1616thth Century –Europeans discovered the Roman Century –Europeans discovered the Roman

bathsbaths

Spa towns sprung up, notably, Bath or Aquae Spa towns sprung up, notably, Bath or Aquae Sulis (Sulis Minerva-water Goddess)Sulis (Sulis Minerva-water Goddess)

Bath- became anointed as fashionable wellness Bath- became anointed as fashionable wellness and recreation playground for the rich and the and recreation playground for the rich and the famous.famous.



Health Tourism in the new worldHealth Tourism in the new world

1600s – English and Dutch colonists in the newly 1600s – English and Dutch colonists in the newly discovered America constructed log cabins near discovered America constructed log cabins near mineral springs that were rich in medicinal mineral springs that were rich in medicinal properties.properties.

Health Tourism in the new worldHealth Tourism in the new world

1600s – English and Dutch colonists in the newly 1600s – English and Dutch colonists in the newly discovered America constructed log cabins near discovered America constructed log cabins near mineral springs that were rich in medicinal mineral springs that were rich in medicinal properties.properties.


Gupta 2007

The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia

Asian countries can now attract a Asian countries can now attract a combined 1.3 million medical tourists per combined 1.3 million medical tourists per year and is increasing annually.year and is increasing annually.

Asia alone will be projected to generate Asia alone will be projected to generate more than USD4 billion by 2012more than USD4 billion by 2012


Asian countries can now attract a Asian countries can now attract a combined 1.3 million medical tourists per combined 1.3 million medical tourists per year and is increasing annually.year and is increasing annually.

Asia alone will be projected to generate Asia alone will be projected to generate more than USD4 billion by 2012more than USD4 billion by 2012


Connel, 2006


1970’s- 1970’s- Thailand Thailand became known as a destination became known as a destination for medical tourism because of sex change for medical tourism because of sex change operations, and later, cosmetic surgeryoperations, and later, cosmetic surgery

After 1998 in the wake of Asian economic crisis After 1998 in the wake of Asian economic crisis and the need for economic diversificationand the need for economic diversification, , MalaysiaMalaysia entered medical tourism entered medical tourism


1970’s- 1970’s- Thailand Thailand became known as a destination became known as a destination for medical tourism because of sex change for medical tourism because of sex change operations, and later, cosmetic surgeryoperations, and later, cosmetic surgery

After 1998 in the wake of Asian economic crisis After 1998 in the wake of Asian economic crisis and the need for economic diversificationand the need for economic diversification, , MalaysiaMalaysia entered medical tourism entered medical tourism




Mid 1990’s – Mid 1990’s – India,India, regarded as regarded as contemporary global center for medical contemporary global center for medical tourism advertises itself as offering tourism advertises itself as offering everything from alternative Ayurvedic everything from alternative Ayurvedic therapy to coronary bypasses and therapy to coronary bypasses and cosmetic surgerycosmetic surgery


Mid 1990’s – Mid 1990’s – India,India, regarded as regarded as contemporary global center for medical contemporary global center for medical tourism advertises itself as offering tourism advertises itself as offering everything from alternative Ayurvedic everything from alternative Ayurvedic therapy to coronary bypasses and therapy to coronary bypasses and cosmetic surgerycosmetic surgery

Connel, 2006

MEDICAL TOURISM, HISTORYThe Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia

2001 – successful separation of 10 mo. old 2001 – successful separation of 10 mo. old Nepalese conjoined twins put Nepalese conjoined twins put SingaporeSingapore’s medical ’s medical expertise into headlines around the world.expertise into headlines around the world. (Wikipeda, 2007)(Wikipeda, 2007)

2006 – Joint Commission International 2006 – Joint Commission International (JCI)(JCI) set up set up its Asia Pacific office in Singapore. The country its Asia Pacific office in Singapore. The country has 9 hospitals & 2 medical centers accredited by has 9 hospitals & 2 medical centers accredited by the said commissionthe said commission..((Connel, 2006)


2001 – successful separation of 10 mo. old 2001 – successful separation of 10 mo. old Nepalese conjoined twins put Nepalese conjoined twins put SingaporeSingapore’s medical ’s medical expertise into headlines around the world.expertise into headlines around the world. (Wikipeda, 2007)(Wikipeda, 2007)

2006 – Joint Commission International 2006 – Joint Commission International (JCI)(JCI) set up set up its Asia Pacific office in Singapore. The country its Asia Pacific office in Singapore. The country has 9 hospitals & 2 medical centers accredited by has 9 hospitals & 2 medical centers accredited by the said commissionthe said commission..((Connel, 2006)



October 2004 – Philippine Medical Tourism October 2004 – Philippine Medical Tourism Program Program (PMTP)(PMTP) was created through was created through Executive Order No. 372 by President Executive Order No. 372 by President Gloria Macapagal-ArroyoGloria Macapagal-Arroyo

Nov., 2006 -"Only in the Philippines: Nov., 2006 -"Only in the Philippines: Tender Loving (Health)CareTender Loving (Health)Care," the very first ," the very first Philippine Medical Tourism Congress, Expo Philippine Medical Tourism Congress, Expo and Launchand Launch


October 2004 – Philippine Medical Tourism October 2004 – Philippine Medical Tourism Program Program (PMTP)(PMTP) was created through was created through Executive Order No. 372 by President Executive Order No. 372 by President Gloria Macapagal-ArroyoGloria Macapagal-Arroyo

Nov., 2006 -"Only in the Philippines: Nov., 2006 -"Only in the Philippines: Tender Loving (Health)CareTender Loving (Health)Care," the very first ," the very first Philippine Medical Tourism Congress, Expo Philippine Medical Tourism Congress, Expo and Launchand Launch

History of Curative & Wellness Tourism Which are Used & Named to Each Decade

Jabbari, 2007

Neolithic & Bronze Neolithic & Bronze Age-Age-

Mineral & Hot Springs Mineral & Hot Springs VisitsVisits

Middle Ages - Middle Ages - SpringsSprings

1616thth century - century - Fountain of YouthFountain of Youth

1717thth, 18, 18thth century - century - SpaSpa

1919thth Century - Century - Sea & Mountain Air (TB Sea & Mountain Air (TB sanitarium)sanitarium)

2020thth Century - Century - Health Farms & Fat FarmsHealth Farms & Fat Farms

1991 - 1991 - Formation of International Formation of International Spa AssociationSpa Association

TODAY - TODAY - Hospitals are more like Hospitals are more like spas & Spas are more like spas & Spas are more like hospitalshospitals

Why would someone travel halfway across the Why would someone travel halfway across the world to a foreign country for wellness?world to a foreign country for wellness?

The shifting in consumer valuesThe shifting in consumer values Increased stress & workloadIncreased stress & workload Older populationOlder population Health care costs are escalatingHealth care costs are escalating New attitude towards mental & spiritual New attitude towards mental & spiritual

activitiesactivities The emergence of environmentalistsThe emergence of environmentalists

The shifting in consumer valuesThe shifting in consumer values Increased stress & workloadIncreased stress & workload Older populationOlder population Health care costs are escalatingHealth care costs are escalating New attitude towards mental & spiritual New attitude towards mental & spiritual

activitiesactivities The emergence of environmentalistsThe emergence of environmentalists

Jabbari, 2007

Exhorbitant cost of treatment in the home Exhorbitant cost of treatment in the home countrycountry

Treatment or surgeries not covered by Treatment or surgeries not covered by health insurance in home countryhealth insurance in home country

Long waiting periods ( in “rationed” health Long waiting periods ( in “rationed” health care in home country)care in home country)

No or minimal insurance coverageNo or minimal insurance coverage Privacy (Anonymity)Privacy (Anonymity) Lack of facilities in the home countryLack of facilities in the home country Possibility of a holiday with health carePossibility of a holiday with health care

Exhorbitant cost of treatment in the home Exhorbitant cost of treatment in the home countrycountry

Treatment or surgeries not covered by Treatment or surgeries not covered by health insurance in home countryhealth insurance in home country

Long waiting periods ( in “rationed” health Long waiting periods ( in “rationed” health care in home country)care in home country)

No or minimal insurance coverageNo or minimal insurance coverage Privacy (Anonymity)Privacy (Anonymity) Lack of facilities in the home countryLack of facilities in the home country Possibility of a holiday with health carePossibility of a holiday with health care

Why would someone travel halfway across the Why would someone travel halfway across the world to a foreign country for treatment?world to a foreign country for treatment?

Jabbari, 2007

MEDICAL TOURISM, Today…

In the past, health travel was restricted either to the wealthy or

truly desperate.

In the past, health travel was restricted either to the wealthy or

truly desperate.

Today, with flattening global Today, with flattening global economy, international travel, economy, international travel, mass communication and more mass communication and more lenient trade policies make it lenient trade policies make it

possible for those with modest possible for those with modest means to enjoy the benefits of means to enjoy the benefits of world-class health care in the world-class health care in the

form of medical tourism.form of medical tourism.

Today, with flattening global Today, with flattening global economy, international travel, economy, international travel, mass communication and more mass communication and more lenient trade policies make it lenient trade policies make it

possible for those with modest possible for those with modest means to enjoy the benefits of means to enjoy the benefits of world-class health care in the world-class health care in the

form of medical tourism.form of medical tourism.KAZEMI, 2007

Objectives of Medical TravelIndustrial Medical Industrial Medical

Tourism (Past)Tourism (Past)Health Medical

Tourism (Present) Self-paying client from Self-paying client from

the Middle East, Asia or the Middle East, Asia or Latin America seeking Latin America seeking care in the USA or care in the USA or Western Europe.Western Europe.

Specialists Targeted: Specialists Targeted: quality care not quality care not available in home available in home countries i.e. cardiac or countries i.e. cardiac or plastic surgeriesplastic surgeries

Need for emergency Need for emergency care not available in care not available in home countries.home countries.

Elective procedures: they are wait-listed in home country: UK & Canada

Opportunity for high quality interventions

Competitive prices

Desirable environment

Combination of treatment and tour.

KAZEMI Dec. 2007

vsvs

Jabarri, 2007

Trend of Medical Tourism Concept (1st International Conference of Health Tourism in Iran)

19971997 Health TourismHealth Tourism

1997-1997-20012001

TransitionTransition

2001-2001-20072007

Medical TourismMedical Tourism

2006-2006-20072007

Medical Medical OutsourcingOutsourcing

Sociological Aspects of Medical Outsourcing to Asia

Langham, Richmond, Rubin, 2006

Monetary benefit to nationMonetary benefit to nation

Savings passed on to other needs Savings passed on to other needs

Additional income revenue Additional income revenue

Lower CostsLower Costs

Country Receiving Patients


Country Sending Patients


ECONOMICECONOMIC

Sociological Aspects of Medical Outsourcing


More tourism promotion in effect

Opportunity for family to visit abroad

Increased cultural exchanges

Greater respect to host nationals

Opportunity to encounter others

Appreciation given host nation



SOCIAL



Internationalization of practices

Potential for redefining of malpractice suits

Greater international legal ties

Promote development of agreements



LEGAL



Inspections by international medical regulatory boards

Concerns for medical standards

Reputation importance Questions of safety in follow up

Raise issues of international medical ethics

Less control of medical practices

Increased prestige in medicine for host nation

Increased contacts in exchange of people and information

Country Receiving Patients Country Sending Patients

MEDICAL

ADVERTISEMENTADVERTISEMENTADVERTISEMENTADVERTISEMENT

TechnologyTechnologyTechnologyTechnology

QualityQualityReliabilityReliabilityQualityQuality

ReliabilityReliability

Overseas Overseas TrainingTraining

Overseas Overseas TrainingTraining

KAZEMI, 2007

PROMOTIONAL EXPERIENCES OF ASIAN COUNTRIES

THAILANDTHAILAND

Inter-sectoral coordinationInter-sectoral coordination

Effective marketingEffective marketing

Focus on hospitalityFocus on hospitality

Building InfrastructureBuilding Infrastructure

THAILANDTHAILAND

Inter-sectoral coordinationInter-sectoral coordination


Focus on hospitalityFocus on hospitality

Building InfrastructureBuilding Infrastructure

KAZEMI, 2007


INDIAINDIA

Low-cost treatmentLow-cost treatment


Indian companies having negotiation with Indian companies having negotiation with National Health Service (NHS) about out-sourcing National Health Service (NHS) about out-sourcing the treatment of British patients to Indiathe treatment of British patients to India

INDIAINDIA

Low-cost treatmentLow-cost treatment


Indian companies having negotiation with Indian companies having negotiation with National Health Service (NHS) about out-sourcing National Health Service (NHS) about out-sourcing the treatment of British patients to Indiathe treatment of British patients to India

KAZEMI, 2007


MALAYSIAMALAYSIA

Government effort to promote medical tourism Government effort to promote medical tourism promotional plans.promotional plans.

Tax incentivesTax incentives

Lessening import duty on medical equipmentLessening import duty on medical equipment

Enabling supporting infrastructureEnabling supporting infrastructure

Set up 5 Committees to promote health tourismSet up 5 Committees to promote health tourism

MALAYSIAMALAYSIA

Government effort to promote medical tourism Government effort to promote medical tourism promotional plans.promotional plans.

Tax incentivesTax incentives

Lessening import duty on medical equipmentLessening import duty on medical equipment

Enabling supporting infrastructureEnabling supporting infrastructure

Set up 5 Committees to promote health tourismSet up 5 Committees to promote health tourism

KAZEMI, 2007


SINGAPORESINGAPORE

High level of cleanlinessHigh level of cleanliness

World best standard training and World best standard training and professionalismprofessionalism

SINGAPORESINGAPORE

High level of cleanlinessHigh level of cleanliness

World best standard training and World best standard training and professionalismprofessionalism

KAZEMI, 2007



3 BUSINESS MODELS FOR HEALTH3 BUSINESS MODELS FOR HEALTH• Creation of an international zone of health for Creation of an international zone of health for

wellness combining medical tourism , spa, wellness combining medical tourism , spa, health, eco-tourism and retirement villageshealth, eco-tourism and retirement villages

• Health human resources development network Health human resources development network with the top nursing and medical with the top nursing and medical schools/hospitals in the Philippines.schools/hospitals in the Philippines.

• Health crewing for specific health services, Health crewing for specific health services, including Tele-health, medical transcriptionincluding Tele-health, medical transcription


3 BUSINESS MODELS FOR HEALTH3 BUSINESS MODELS FOR HEALTH• Creation of an international zone of health for Creation of an international zone of health for

wellness combining medical tourism , spa, wellness combining medical tourism , spa, health, eco-tourism and retirement villageshealth, eco-tourism and retirement villages

• Health human resources development network Health human resources development network with the top nursing and medical with the top nursing and medical schools/hospitals in the Philippines.schools/hospitals in the Philippines.

• Health crewing for specific health services, Health crewing for specific health services, including Tele-health, medical transcriptionincluding Tele-health, medical transcription

KAZEMI, 2007

MEDICINEMEDICINE

WELLNESSWELLNESS TOURISMTOURISM

PROCESS

Wikipeda, 2008Wikipeda, 2008

PATIENTMedical Tourism

Provider

Certified Medical Doctors or

Consultants

Discussion ofThe Package

Signing of ConsentBonds & Agreements

Recommendation letters for medical visa

From the Embassy

TRAVEL

Medical Tourist is assignedto a Case Executive whotakes care of everything

for the tourist

STANDARDS


International International Health Care Health Care AccreditationAccreditation

Evidence-Evidence-based based

MedicineMedicine

QualityQualityAssuranceAssurance

International Health Care Accreditation

Joint Commission International (JCI)Joint Commission International (JCI)• USAUSA



Trent International Accreditation Trent International Accreditation SchemeScheme• United KingdomUnited Kingdom• HongKongHongKong



The Society for International Health Care The Society for International Health Care Accreditation (SOFIHA)Accreditation (SOFIHA)• Promotion of safe hospital environment for Promotion of safe hospital environment for

patientspatients

Health Care Tourism InternationalHealth Care Tourism International• Accreditation for all major groups involved in Accreditation for all major groups involved in

the health tourism industry:the health tourism industry: HOTELSHOTELS RECOVERY FACILITIESRECOVERY FACILITIES MEDICAL TOURIST BOOKING AGENCIESMEDICAL TOURIST BOOKING AGENCIES

Quality of Care Issues

Health care errors seriously harm 1 Health care errors seriously harm 1 in every 10 patients around the in every 10 patients around the world.world.

Source: World Health Organization (WHO)Source: World Health Organization (WHO)


Quality of Care Issues International Patient Safety Goals

Goal 1 Goal 1 – Identify Patients – Identify Patients CorrectlyCorrectly

Goal 2 Goal 2 – Improve Effective – Improve Effective CommunicationCommunication

Goal 3 Goal 3 – Improve the Safety of – Improve the Safety of High-Alert MedicationsHigh-Alert Medications


Goal 4 Goal 4 – Eliminate Wrong-Site, Wrong-– Eliminate Wrong-Site, Wrong-Patient, Wrong-Procedure SurgeryPatient, Wrong-Procedure Surgery

Goal 5 Goal 5 – Reduce the risk of health – Reduce the risk of health care-acquired infections.care-acquired infections.

Goal 6 Goal 6 – Reduce the risk of patient – Reduce the risk of patient harm resulting from falls.harm resulting from falls.

Quality of Care Issues International Patient Safety Goals


The Outsourcing of Surgical Procedures to Asia:


Note: Angioplasty in Malaysia averages $4,000 - $6,000

$13,000$10,000-$11,000

$9,000-$10,000

$160,000 –$281,000

Heart Valve (single)

$20,000$12,000$4,000-$10,000

$100,000 –$123,000

Coronary Artery Bypass

$13,000$13,000$4,000-$11,000

$35,000 –$83,000

Coronary Angioplasty

SingaporeThailandIndiaUSA

Procedures&

Services

www.pcij.org

Table 1: Comparative Cost of Treatments (in US$)

Source: PIDS

TREATMENT USA$

SINGAPOREIn US$

MALAYSIAIn US$

THAILANDIn US$

PHILIPPINESIn US$

Cataract surgery

2,500-3,000

1,749 1,014 950 1,424

Total knee replacement

5,000 6,207 4,342 5,500 5,639

Liposuction 2,800-5,700

3,221 1,711 1,365 1,400




$10,000$90,000Spinal Disc

$9,000$7,000$5,000-$6,000

$63,000-$91,000Spinal Fusion

$8,000$7,000-$8,000

$4,000-$6,000

$17,000-$20,000

Knee (ACL) Repair

$8,000$8,000$4,000-$7,000

$40,000-$60,000Rotator Cuff

$13,000$10,000$8,000-$9,000

$40,000-$61,000

Knee Replacement

$12,000$12,000$9,000$44,000-$64,000

Hip Replacement

SingaporeThailandIndiaUSAProcedures & Services

RISKS


DIFFERENCE IN DISEASE-RELATED EPIDEMIOLOGY DIFFERENCE IN DISEASE-RELATED EPIDEMIOLOGY BETWEEN HOME COUNTRY & COUNTRY OF BETWEEN HOME COUNTRY & COUNTRY OF DESTINATIONDESTINATION• Hepatitis AHepatitis A• Amoebic DysenteryAmoebic Dysentery• Mosquito-transmitted diseasesMosquito-transmitted diseases• TBTB

DIFFERENCE IN HEALTHCARE PROVIDER DIFFERENCE IN HEALTHCARE PROVIDER STANDARDS AROUND THE WORLDSTANDARDS AROUND THE WORLD• World Alliance for Patient SafetyWorld Alliance for Patient Safety

Assists hospitals and government around the world in setting Assists hospitals and government around the world in setting patient safety policy and practices relevant when providing patient safety policy and practices relevant when providing medical tourism servicesmedical tourism services

QUALITY OF POST-OP CAREQUALITY OF POST-OP CARE• Role of AccreditationRole of Accreditation• Long flights maybe worse for some cases.Long flights maybe worse for some cases.

LEGAL & ETHICAL ISSUES


Medical Malpractice LawsuitsMedical Malpractice Lawsuits

Illegal purchase of organs and Illegal purchase of organs and tissues for transplantationstissues for transplantations

Inequities in health care systemInequities in health care system

GROWTH OF MEDICAL TOURISM IN THE WORLD

Google TrendsGoogle Trends

20042004 20052005 20062006 2007200700

Search VolumeSearch Volume

More than 2.9 Million patients visited More than 2.9 Million patients visited Thailand, India, Singapore, Malaysia and Thailand, India, Singapore, Malaysia and the Philippines for medical tourism in the Philippines for medical tourism in 2007.2007.

Thailand’s low cost and scenic beaches Thailand’s low cost and scenic beaches have enabled it to become the largest have enabled it to become the largest medical tourism market in Asia; however, medical tourism market in Asia; however, an unstable political environment and an unstable political environment and occurrence of another epidemic such as occurrence of another epidemic such as bird flu can restrain its growth.bird flu can restrain its growth.

More than 2.9 Million patients visited More than 2.9 Million patients visited Thailand, India, Singapore, Malaysia and Thailand, India, Singapore, Malaysia and the Philippines for medical tourism in the Philippines for medical tourism in 2007.2007.

Thailand’s low cost and scenic beaches Thailand’s low cost and scenic beaches have enabled it to become the largest have enabled it to become the largest medical tourism market in Asia; however, medical tourism market in Asia; however, an unstable political environment and an unstable political environment and occurrence of another epidemic such as occurrence of another epidemic such as bird flu can restrain its growth.bird flu can restrain its growth.

Asian Medical Tourism Analysis (2008-2012)

Bharatbook, June 2008Bharatbook, June 2008

Asian Medical TourismHOSPITALS

Samitivej Hospital, Thailand Samitivej Hospital, Thailand

Healthcare costs are considerably Healthcare costs are considerably high in high in Singapore Singapore as compared to as compared to other Asian destinations. The other Asian destinations. The country, however, boasts of an country, however, boasts of an infrastructure and resources that in infrastructure and resources that in some cases are even better than some cases are even better than those in the west.those in the west.

Healthcare costs are considerably Healthcare costs are considerably high in high in Singapore Singapore as compared to as compared to other Asian destinations. The other Asian destinations. The country, however, boasts of an country, however, boasts of an infrastructure and resources that in infrastructure and resources that in some cases are even better than some cases are even better than those in the west.those in the west.




Singapore National Eye Centre (SNEC)

India,India, with its low cost advantage with its low cost advantage and emergence of several private and emergence of several private players, represents the fastest players, represents the fastest growing market. The country’s growing market. The country’s questionable sanitary perceptions in questionable sanitary perceptions in the west are, however, a major the west are, however, a major roadblock for growth.roadblock for growth.

India,India, with its low cost advantage with its low cost advantage and emergence of several private and emergence of several private players, represents the fastest players, represents the fastest growing market. The country’s growing market. The country’s questionable sanitary perceptions in questionable sanitary perceptions in the west are, however, a major the west are, however, a major roadblock for growth.roadblock for growth.




LAKESHORE HOSPITAL, INDIALAKESHORE HOSPITAL, INDIA

Malaysia and PhilippinesMalaysia and Philippines, both , both relatively new players in the medical relatively new players in the medical tourism market, are expected to tourism market, are expected to grow strongly in the next five years.grow strongly in the next five years.

Malaysia and PhilippinesMalaysia and Philippines, both , both relatively new players in the medical relatively new players in the medical tourism market, are expected to tourism market, are expected to grow strongly in the next five years.grow strongly in the next five years.




ST. LUKES, MEDICAL CENTER, PhilippinesST. LUKES, MEDICAL CENTER, Philippines


Gleneagles Medical Centre Penang, Malaysia.

A number of employers and health A number of employers and health insurance firms in developed insurance firms in developed countries have now started looking countries have now started looking at medical tourism to reduce their at medical tourism to reduce their surging healthcare expenditure.surging healthcare expenditure.

The Asian medical tourism market is The Asian medical tourism market is expected to grow at a CAGR of expected to grow at a CAGR of 17.6% between 2007 and 201217.6% between 2007 and 2012

A number of employers and health A number of employers and health insurance firms in developed insurance firms in developed countries have now started looking countries have now started looking at medical tourism to reduce their at medical tourism to reduce their surging healthcare expenditure.surging healthcare expenditure.

The Asian medical tourism market is The Asian medical tourism market is expected to grow at a CAGR of expected to grow at a CAGR of 17.6% between 2007 and 201217.6% between 2007 and 2012



Challenges for Health Care Providers in the Promising Industry of Medical Tourism

HEALTHCARE

PROVIDERS

HEALTHCARE

PROVIDERS

Medical Quality Medical Quality of Servicesof Services

Medical Quality Medical Quality of Servicesof Services

Importance of Importance of Non-medical Non-medical Services for Services for

Patient AccessPatient Access

Importance of Importance of Non-medical Non-medical Services for Services for

Patient AccessPatient Access

Marketing Marketing OptionsOptions

Marketing Marketing OptionsOptions

PARTNERSHIP WITH:PARTNERSHIP WITH:

•UniversitiesUniversities•Referring/Competing Referring/Competing HospitalsHospitals•AgentsAgents•GovernmentGovernment•Accommodation & Accommodation & Travel Service Travel Service ProviderProvider

PARTNERSHIP WITH:PARTNERSHIP WITH:

•UniversitiesUniversities•Referring/Competing Referring/Competing HospitalsHospitals•AgentsAgents•GovernmentGovernment•Accommodation & Accommodation & Travel Service Travel Service ProviderProvider

KAZEMI, 2007

Medical Tourism

Health & Medicine

Transcript of Medical Tourism