In the past few decades, there has been the globalization of the health care market. The free movement of goods and services under the auspices of the World Trade Organization and its General Agreement on Trade in Services (Smith, 2004, Smith et al, 2009b) and to the use of regional and bilateral trade agreements made patients, health professionals, medical technology and knowledge have been shared throughout the globe in the modern times which leads to new patterns of consumption and production of healthcare services.
While the consumption of health care in a foreign land is not new to history, the shifts that are currently underway with regard to medical tourism are quantitatively and qualitatively different from earlier forms of health-related travel. The key difference is the reversal of its flow. During the 20th Century, wealthy people from less developed nations traveled to more developed nations to gain access to high-quality facilities and highly trained medics. However, in the new 21st-century style of medical tourism, larger numbers of people travel for treatment, mostly from developed to less-developed nations driven by low-cost treatments, cheap flights, and internet sources of information.
Medical tourism is when the patient decides to travel across international borders with the intention of receiving some form of medical treatment including dental care, cosmetic surgery, elective surgery, and fertility treatment. However, not all forms would be included within the health trade, as for instance, cosmetic surgery for aesthetic rather than reconstructive reasons would be considered outside the health boundary (OECD, 2010, pp.30-31).
Medical tourism plays an important role in the treatment of illness to both patients and the health care industry. For patients, medical tourism broadens the choice of treatment for the patients, allowing them to receive better care for a cheaper price. Patients could choose any form of treatment that existed in the globe they see fit to their medical conditions could result positively in the treatment of illness, for instance, faster recovery. Although the main reason for choosing to travel to get medical treatment is for financial reasons, it also gives patients a variety of forms of treatment they might require. Medical tourism also broadens the market for the health care industry. The hospital could be providing care for patients from many parts of the world and the hospital would have more chances to experience more variety of cases and improve medical knowledge.
Medical tourism is a global scale industry which has many stakeholders with commercial interests including brokers, health care providers, insurance provision, website providers and conference and media services
Medical tourism is driven by the technological platform of the internet which is providing information and advertisement about medical care from anywhere in the world for the patients as well as offering providers vital new avenues for marketing to reach into non-domestic markets. This makes commercialization the heart of the growth in medical tourism.
In managing medical tourism, there are certain aspects that are needed to be considered. Firstly, they are quality, safety, and risk. Medical tourism adds a new dynamic to this element of risk during the patient’s transportation. Traveling when unwell could lead to further health complications, including the possibility of deep vein thrombosis (Crooks et al., 2010).
Secondly, it is patient satisfaction. Patient satisfaction is an important dimension of healthcare treatment and it is reported that patients are generally highly satisfied with the quality of care received overseas.
Thirdly, there are clinical outcomes. Evidence of clinical outcomes for medical tourist treatments is limited and hard to obtain and verify. Therefore, it is hard to learn about the clinical effectiveness and outcomes for particular treatments, institutions, clinicians, and organizations.
Fourth, it is continuity of care. When medical treatment is operated abroad, the normal continuum of care may be interrupted. The patients usually only stay in the hospital for only a few days or even weeks, when complications, side-effects, and post-operative care then become the responsibility of the healthcare system in the patients’ home country.
Fifthly, they are privacy and confidentiality. According to the World Tourism Organization’s Global Code of Ethics for Tourism (1999), it is expected that tourists and visitors should have the same rights as citizens of destination countries with regard to the confidentiality of their personal data and information, especially when these are stored in electronic formats. Laws and regulations will vary in different parts of the world in relation to medical confidentiality, including the protection of data kept on the computer.
Sixthly, there is an infection and cross-border spread of antimicrobial resistance and dangerous pathogens. Medical travelers may be traveling from home to countries with very different ecosystems and disease profiles. General precautions should be considered and arranged prior to the trip overseas.
Seventhly, it is an external quality assessment. External Quality Assessment (EQA) is the introduction of a trusted third party to assess quality control which contains the potential for increasing both the information flow, especially the exchange of good practice between organizations, and transparency within organizations.
Lastly, accreditation should be considered. Accreditation is a form of EQA where surveying is carried out by a third-party conformity assessment body known as an accreditation scheme, using a combination of self-assessment and external peer review led by a team of external peer reviewers.
Whilst ethical and legal issues, such as informed consent, liability, and legislating for clinical malpractice, arise for all forms of medical care, these are intensified for medical tourism. As the range of treatments and sites offering them expands, there is a need to understand these issues – for patients, surgeons, overseas facilities, and legal systems.
There are a few issues about medical tourism. Firstly, they are medico-legal issues (quality of care, redress, liability, litigation). If the clinical outcome fails, how do patient fare in seeking redress given there is no international regulation of medical tourism? There are complexities regarding who could be subject to legal proceedings and pursuing a legal case overseas brings its own difficulties. Secondly, there are issues for providers, ancillary interests, and third-party funders. There are some important issues relating to the legal context and redress mechanisms available to medical tourists. There are needs to comprehensively review national frameworks and practices in terms of legal redress and to review and analyze the experience of bilateral legal proceedings to date. Thirdly, these are ethical dimensions. Different ethical standards may operate in different parts of the world due to religious and cultural differences. Fourthly, nonmaleficence and beneficence should be counted.
Medical tourism is a rising global scale industry driven by the internet which broadens the choice of health care for patients and the market for the hospital. Medical tourism benefits both financial way and in the treatment of illness. However, there are risks and issues that require an understanding, preparation and precaution.
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