Introduction

Medical tourism is a colloquial term for the cross-border use of medical treatment. Depending on the type of treatment procedure, the stay may last a few days or a few months. Reasons for such tourism include lack of treatment options in the patient’s country, avoidance of waiting times in the home country or cost savings. [1] Medical tourism is considered a global trend and is one of the consequences of increasing globalization. Every year, only 20 million patients worldwide travel abroad. The annual volume of medical tourism is around 80 billion euros (as of 2019). [2] About 40 countries are actively recruiting patients from abroad, including the United States, Germany, Switzerland, Mexico, Costa Rica, Israel, India, Thailand, South Korea, and Singapore.

Two-thirds of all medical travel is within Asia. India, Thailand, Singapore, Malaysia, South Korea and the Philippines treat hundreds of thousands of patients from abroad every year. These, mostly outpatients, come from neighboring countries as well as the United States, Europe or the Arab Gulf states, with an increasing trend of about 15 percent per year. Germany is also considered a preferred destination for medical tourists, particularly from the EU, Commonwealth of Independent States and Arab countries. Another target group is US citizens who do not have health insurance and are increasingly traveling to Asia for necessary operations. In 2007, 750,000 Americans travelled abroad for medical treatment; In 2017 there were about 1.7 million.
There are now a large number of tourism companies and patient brokers worldwide who specialize in medical tourism. Recently, Turkey has also been actively recruiting patients from abroad, partly with the support of the Ministry of Tourism. In 2013, 360,000 people travelled to the country for medical procedures.
From the point of view of origin or patient flow of medical tourists, a distinction must be made between two forms: the so-called outbound and inbound medical tourism. In Germany, both forms have become highly economically relevant in recent years. Outbound medical tourism refers to the flow of patients from within the country who visit medical tourism destinations abroad and receive treatment there. The term incoming medical tourism, on the other hand, describes tourists from abroad who come to the country with the primary goal of medical treatment.

Objectives of Medical Tourism

Medical tourists have a variety of purposes for medical treatment abroad. Depending on the origin of the patient, a distinction can be made between the following types of medical tourism:
Patients worldwide are looking for the best treatment options
Patients who are looking for a better treatment option than in their home country
Patients who have to wait for treatment in their country
Those who are treated abroad are cheaper
Medical emergency
Patients who have emigrated in old age and use medical care in their home country
Patients in border areas
Patients who, due to legal restrictions or ethical reasons, can only receive certain treatments in clinics abroad
Check up on patients
Medical wellness tourists
Patients who require health-promoting natural infrastructure
Hierarchy and boundaries
The term medical tourism is not clearly defined in science and is sometimes disputed among experts. Depending on the perspective, approach and nature of the subject, numerous synonyms have emerged in the literature (e.g. clinical tourism, patient tourism, cross-border healthcare, etc.). However, as the term suggests, the term consists of two elements: medicine and tourism.

Concept

The codification of medical travel is often found within the tourism industry and with the general term “health”. The World Health Organization (WHO) defines the term as follows:
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. “Furthermore, the World Tourism Organization defines a “tourist” as a person who travels to a place outside their natural environment and stays there for no more than one year for leisure or business. In so-called medical tourism describes a trend towards health and medically motivated travel, which combines both touristic and medical features in one offer, due to cost savings and avoidance of waiting times. Medical tourism can be understood as a form of health tourism – alongside the classic spa tourism and wellness tourism. At the same time, it serves as a general term for other sub-fields (Figure 1: “Systematic classification of medical tourism in different tourism categories”). The categories “Prevention Tourism”, “Surgical Tourism” and “Rehabilitation Tourism” form a sub-category of medical tourism.

Unlike the other two forms of health tourism – spa and wellness tourism – medical tourism has a higher degree and intensity of desired medical applications. Accordingly, a tourist who is already chronically or acutely ill travels as a patient to a country outside his home country to receive targeted treatment. The motivation for a medical trip comes from a previous diagnosis or a clinically manifested illness of the patient in his home country, for which he expects better quality, faster or cheaper treatment abroad for various reasons. Medically directed health travel usually includes an inpatient or outpatient stay at a medical facility. For acutely ill (emergency) patients, a medical trip is often associated with high treatment risk and possible complications during therapy. The terms “foreign patient”, “international patient” or “medical tourist” are used synonymously in the literature to refer to tourists who undertake specifically medical trips. Specialists do not include people who do not travel abroad with the primary aim of treatment, but who become patients there unintentionally (eg by accident). Patients from abroad include both individual patients and groups of patients.

Advantage of medical tourism

Reduce cost

The most well-known advantage of medical tourism is that it can be achieved at low cost. Medical expenses have risen so much that complex surgeries cost more than travel, treatment and accommodation in famous medical tourism destinations. It turns out that medical tourists can save 25% to 90% on medical expenses, which mainly depends on the procedure they undergo and the country they travel to. There are several factors that influence this.

Decision Making:

Medical tourism plays an important role in empowering patients to make decisions. It helps to analyze the pros and cons of medical tourism. People underserve their healthcare.

Culture and Language

It is often seen that various immigrants prefer to have treatments and procedures carried out in their own countries, considering how much language barriers can affect the quality of care they receive. Many people choose to receive treatment in their home country because it allows them to be close to family, friends and caregivers who can help them in their recovery process. This acts as one of the main advantages and outweighs all the advantages and disadvantages of medical tourism.

Immediate Treatment

People can seek immediate treatment in medical tourism without any further delay. Some hospitals also offer post-operative care. Discovering a new country is also a great experience and patients have enough privacy to opt for alternative surgeries such as fat reduction and butt augmentation.

Disadvantages of Medical Tourism

After a good overview of the benefits of medical tourism, let’s discuss the disadvantages of improving health equity that medical tourism lags behind

Misinformation

Misinformation on various topics can lead to unfavorable, inefficient treatment and waste of time, money and health. Additionally, operative and postoperative care is not available in several hospitals abroad. Often, the cost of the entire trip exceeds the actual amount and patients face financial losses.

Poorly trained surgeons:

Every country has both good and bad surgeons. Regardless of the procedure you’re having or where you’re having it, you should always check with your surgeon or doctor beforehand.

Lack of ethical standards:

Lack of ethical standards and malpractice laws increase the risks of medical travel in several developing countries. In addition, patients in clinics and hospitals are not adequately informed about the risks and potential treatment outcomes. Therefore, such problems in ethical standards reduce the growth of medical tourism.