In the Words of the Medical Tourist: An Analysis of Internet Narratives by Health Travelers to Turkey

Ozan-Rafferty, Margaret E.; Johnson, James Allen; Shah, Gulzar H.; Kursun, Attila

doi:10.2196/jmir.2694

Cited by 27 publications

(41 citation statements)

References 40 publications

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“…The role of narrative on social media sites as a persuasive rhetorical strategy in regard to health care decision making has also been explored, although this important work is largely preliminary [3,13,22,37]. Our work shifts attention away from bursts of activity on sites such as Twitter to a complementary examination of long-term conversations that evolve over many months and even years, with a primary focus on the emerging and endemic narrative frameworks that inform these conversations, aligning with other large-scale studies of attitudes toward health care decisions [38-40]. …”

Section: Discussionmentioning

confidence: 99%

“Mommy Blogs” and the Vaccination Exemption Narrative: Results From A Machine-Learning Approach for Story Aggregation on Parenting Social Media Sites

Tangherlini¹,

Roychowdhury²,

Glenn³

et al. 2016

JMIR Public Health Surveill

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BackgroundSocial media offer an unprecedented opportunity to explore how people talk about health care at a very large scale. Numerous studies have shown the importance of websites with user forums for people seeking information related to health. Parents turn to some of these sites, colloquially referred to as “mommy blogs,” to share concerns about children’s health care, including vaccination. Although substantial work has considered the role of social media, particularly Twitter, in discussions of vaccination and other health care–related issues, there has been little work on describing the underlying structure of these discussions and the role of persuasive storytelling, particularly on sites with no limits on post length. Understanding the role of persuasive storytelling at Internet scale provides useful insight into how people discuss vaccinations, including exemption-seeking behavior, which has been tied to a recent diminution of herd immunity in some communities.ObjectiveTo develop an automated and scalable machine-learning method for story aggregation on social media sites dedicated to discussions of parenting. We wanted to discover the aggregate narrative frameworks to which individuals, through their exchange of experiences and commentary, contribute over time in a particular topic domain. We also wanted to characterize temporal trends in these narrative frameworks on the sites over the study period.MethodsTo ensure that our data capture long-term discussions and not short-term reactions to recent events, we developed a dataset of 1.99 million posts contributed by 40,056 users and viewed 20.12 million times indexed from 2 parenting sites over a period of 105 months. Using probabilistic methods, we determined the topics of discussion on these parenting sites. We developed a generative statistical-mechanical narrative model to automatically extract the underlying stories and story fragments from millions of posts. We aggregated the stories into an overarching narrative framework graph. In our model, stories were represented as network graphs with actants as nodes and their various relationships as edges. We estimated the latent stories circulating on these sites by modeling the posts as a sampling of the hidden narrative framework graph. Temporal trends were examined based on monthly user-poststatistics.ResultsWe discovered that discussions of exemption from vaccination requirements are highly represented. We found a strong narrative framework related to exemption seeking and a culture of distrust of government and medical institutions. Various posts reinforced part of the narrative framework graph in which parents, medical professionals, and religious institutions emerged as key nodes, and exemption seeking emerged as an important edge. In the aggregate story, parents used religion or belief to acquire exemptions to protect their children from vaccines that are required by schools or government institutions, but (allegedly) cause adverse reactions such as autism, pain, compromised immunity, and even dea...

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Section: Discussionmentioning

confidence: 99%

“Mommy Blogs” and the Vaccination Exemption Narrative: Results From A Machine-Learning Approach for Story Aggregation on Parenting Social Media Sites

Tangherlini¹,

Roychowdhury²,

Glenn³

et al. 2016

JMIR Public Health Surveill

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“…In Turkey, in parallel with the Health Transformation Program, health tourism has rapidly developed in the last ten years. [15][16][17] Both public and private hospitals offer high quality services with the latest technology and highly qualified personnel. Forty-nine health care institutions have been accredited by the Joint Commission International (JCI) in Turkey, one of the highest rates in the region.…”

Section: Medical Tourism In Turkeymentioning

confidence: 99%

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

Tiren-Verbeet

Çetın

Alp

et al. 2018

Int J Travel Med Glob Health

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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.

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“…Similar to the research by Ozan-Rafferty et al [ 9 ], this research assumes that understanding the experiences of medical tourists will benefit the providers who service current and future medical tourists. In addition, the findings from this study can be used to assist in decision making for patients considering health travel in the future, and they may strengthen health administration education by providing insights on medical tourism [ 9 ]. In addition, this study’s outcomes may lead to the development of more online communities focused on improving medical tourism.…”

Section: Introductionmentioning

confidence: 99%

“…This study originated from the recommendations in the further research section in the study by Ozan-Rafferty et al [ 9 ] titled “A qualitative analysis of internet narratives by health travelers to Turkey”. Her study analyzed web-based narratives from health travelers to Turkey and described the themes of their experiences.…”

Section: Introductionmentioning

confidence: 99%

Internet Narratives Focused on Health Travelers’ Experiences in India: Qualitative Analysis

Brown¹,

Johnson²,

Ozan-Rafferty³

et al. 2020

J Med Internet Res

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Background The medical tourism industry is currently popular in India, but there is no confirmation of the common perspectives among the country’s medical travelers. Objective This qualitative research study analyzed web-based narratives from health travelers visiting India and described the themes of their experiences. This study aimed to answer the following primary question: What can we learn about health travelers’ experiences in India from an analysis of their web-based narratives? The secondary questions were as follows: (1) What are the primary health care reasons for which patients in the examined narratives traveled to India? (2) What can be derived from the narratives regarding medical tourists’ satisfaction with the outcome and result of the treatment they received in India? (3) What are some positive and negative factors influencing medical tourists’ perceptions and overall experiences about their health travel to India? (4) What are the characteristics of medical tourists who write web-based narratives regarding their health experiences in India? Methods Publicly available narratives written by medical tourists who visited India were obtained from a Google search. The narratives included blog posts and discussion board posts by medical tourists. The analysis process consisted of initial open coding being conducted on the narratives to create initial codes and identify common themes with a focus on the primary research question and subquestions. Results Although Mumbai, Chennai, and New Delhi were not the only destination cities mentioned, these were the most popular cities patients visited for care. The medical tourists, who stated their origin country, came from one of the following continents: Africa, Europe, North America, and Oceania. Dental care, Ayurveda treatment, and eye care were the most popular types of care that medical tourists sought. The results showed that most of the medical tourists were happy with the overall experience of receiving care in India. The most popular themes with regard to the patients’ satisfaction were low costs, good customer service, and services being offered that were unavailable in their home country. When negative feedback was provided, it was mainly concentrated on the overall environment of India being unorganized and unsanitary. Conclusions Primarily, the study’s findings can benefit health care providers and patients. Providers hosting medical tourists in India can use negative feedback to improve their services; similarly, providers who are losing patients to medical tourism can identify opportunities for improvement (ie, why are we losing patients). Indian providers hosting medical tourists should keep their prices competitive and continue to provide exceptional service; however, they should do their best to lessen the crowdedness of their facilities while making sure they are esthetically pleasing. Providers losing patients to medical tourism need to identify ways to ensure their services match the benefits that their international counterparts are providing, such as competitive pricing and expansion on the services provided.

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In the Words of the Medical Tourist: An Analysis of Internet Narratives by Health Travelers to Turkey

Cited by 27 publications

References 40 publications

“Mommy Blogs” and the Vaccination Exemption Narrative: Results From A Machine-Learning Approach for Story Aggregation on Parenting Social Media Sites

“Mommy Blogs” and the Vaccination Exemption Narrative: Results From A Machine-Learning Approach for Story Aggregation on Parenting Social Media Sites

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

Internet Narratives Focused on Health Travelers’ Experiences in India: Qualitative Analysis

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