Demographics and Trends for Inbound Medical Tourism in Germany for Orthopedic Patients before and during the COVID-19 Pandemic

Abstract

Medical tourism is a rapidly growing sector of economic growth and diversification. However, data on the demographics and characteristics of the traveling patients are sparse. In this study, we analyzed the common demographic properties and characteristics of the inbound medical tourists seeking orthopedic medical care in Germany for the years 2010 to 2019 compared to a domestic group. At the same time, we examined how the COVID-19 pandemic outbreak of 2020 changed the field of medical tourism in Germany. Calculations were performed using administrative hospital data provided by the Federal Statistical Department of Germany. Data were analyzed from the years 2010 to 2020. A total of six elective orthopedic surgery codes (bone biopsy, knee arthroplasty, foot surgery, osteotomy, hardware removal, and arthrodesis) were identified as key service indicators for medical tourism and further analyzed. Factors including residence, sex, year, and type of elective surgery were modeled using linear regression analysis. Age and sex distributions were compared between patients living inside Germany (DE) or outside Germany (non-DE). Between 2010 and 2020, 6,261,801 orthopedic procedures were coded for the DE group and 27,420 key procedures were identified for the non-DE group. Medical tourists were predominantly male and significantly younger than the domestic population. The linear regression analysis of the OPS codes over the past years showed a significantly different slope between the DE and non-DE groups only for the OPS code “hardware removal”. With the COVID-19 pandemic, an overall decline in performed orthopedic procedures was observed for the non-DE and the DE group. A significant reduction below the 95% prediction bands for the year 2020 could be shown for hardware removal and foot surgery (for DE), and for hardware removal, knee arthroplasty, foot surgery, and osteotomy (for non-DE). This study is the first to quantify inbound medical tourism in elective orthopedic surgery in Germany. The COVID-19 pandemic negatively affected many—but not all—areas of orthopedic surgery. It has to be seen how this negative trend will develop in the future.

Assessing the Potential Growth of Iran’s Hospitals with Regard to the Sustainable Management of Medical Tourism

“…(1) Te main considerable characteristics of the host country and its environment (2) Te quality of healthcare services and the perceived value (3) Te facilities of hospitals, which deserve to be mentioned (4) Presence of qualifed doctors and nurses (5) Public health conditions and the current status of available infrastructure (6) Touristic attractions (7) Safety of the country (8) Economic and social aspects of the host country (9) Weakness and strengths of Iran as a medical tourism destination (10) How to create value by providing a service and managing the patient's experience (11) Te efect of their experience on reputation and referrals…”

“…Numerous studies on medical tourism address various issues and viewpoints, such as the perceived risks involved [7], what should be done to ascertain the public's attitude toward the development of medical tourism [8], as well as the patients' consumption perspective [9], and the impact of country image [10]. Additionally, several academics have worked to suggest some efective tactics by taking into account the pandemic period and its impact on medical tourism [11]. It was crucial to take into account any management issues that might have an impact on a patient's decision from another country [12].…”