Bone Marrow Transplantation and Medical Tourism at Erciyes University - A Single Center Experience

Abstract

In its broadest meaning, medical tourism refers to "travel across international borders to receive some form of medical treatment. " 1 Medical tourism emerged in the 1990s when people in developed countries were challenged with high costs and slow service in medical care. As a consequence, people started to look for medical treatment in other countries. 2 Globalization, including cheap and widely available air travel, and easy, cross-border marketing by medical providers accelerated the growth of medical tourism. 3 The terms "medical tourism" and "health tourism" are used interchangeably. 4 "Health tourism" is defined by the World Health Organization (WHO) as the use of services that improve physical or psychological health with the help of mineral water springs, climatic conditions, or medical intervention in an area outside one's place of residence for more than 24 hours and less than one year. 5 Medical tourism is combined with thermal tourism, elderly tourism, and disabled tourism as a part of health tourism. 6 The current review addresses the different aspects of medical tourism in general, describes the development of medical tourism in Turkey, and describes experiences with medical tourism in the Bone Marrow Transplantation Center (BMTC) in Erciyes University, Kayseri. General Considerations on Medical Tourism Several "push" and "pull" factors play roles in the motivation of patients to become a medical tourist. 7-9 The push factors, factors that drive people abroad, are high costs, long waiting periods, and lack of insurance in their homeland. 10 Pull factors, factors that attract people to medical tourism destinations, may include high quality, similar language, and same religion and culture.

Scoping the literature on patient travel abroad for cancer screening, diagnosis and treatment

“…[18][19][20] There are examples of Diasporic travel, including Korean-American travel to Korea for screening [21][22][23][24] and Mexican-Americans returning to Mexico 25 ; flows between places with previous colonial relations with African women travelling to Paris and northern France for cancer treatments 26 ; and flows between smaller states and regional partners such as Tonga to New Zealand within the Pacific, 27 including bilateral health agreements, for example Bahrain to Turkey. 28 Regionalised flows exist within Africa to South Africa 29 ; from Central Asia to India, 14 and between Laos and Thailand 30 ; Bangladesh and Singapore 31 ; and into Malaysia and Thailand 32,33 and into Jordan from neighbouring countries. 34 Canadian, Mexican and South American patients travel to the United States for cancer treatment with Canadians being outsourced by their domestic health care system and most South American patients paying out of pocket.…”

“…surgery 30 ; radiation 30,36,45,47 ; chemotherapy 30,47 ; and transplantation of organs 48,49 and bone marrow 28 but with few discernible patterns (Liver transplantation is a treatment for Hepatocellular carcinoma). Similarly, travel was for all types of cancer sites including: prostate 36 ; breast, 29,37,50 colorectal 21 ; lymphoma 50 ; cervical 23,47 ; and brain.…”

“…Travel decisions involve clinical networks and referral pathways which may include relationships between clinical centres when services are unavailable in one country due to size, cost or lack of specialisation. 28,39,45 Clinicians may also make informal suggestions to patients for further treatment options, drawing on experience of previous clinical residency or overseas connections. 26 Travel decisions may be contra to local clinical advice where domestic clinical teams do not support, and may counsel against, travel abroad by an adult or child patient.…”

“…23 Culturally competent care, 18,35,40,44,53 including language and ability to communicate complex medical issues during treatment, was highlighted as a fundamental concern. 28,35,56 In a survey of overseas cancer patients treated in India 42 nearly 93% of respondents identified issues with language and food. Continuity of care and sharing of medical information was seen as a challenge within treatment pathways whether for screening, surgery or radiography 23,29,36,37,40 including complexity of returning patients back home for palliative care and end of life care given domestic deficiencies in healthcare 53 and an example of end of life care received out of jurisdiction.…”

Establishing Hematopoietic Stem Cell Transplant Unit in Resource Limited Setting: A Critical Analysis of Indian Council of Medical Research 2017 Guidelines

“…State sponsored shifting to other countries for HSCT is a cost effective method. However, by this a lack of science and knowledge will continue [10]. …”