Trade in health services in the ASEAN region

Arunanondchai, Jutamas; Fink, Carsten

doi:10.1093/heapro/dal052

Cited by 56 publications

(57 citation statements)

References 3 publications

(4 reference statements)

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“…This benefits the destination countries via the inward flow of funds into the economy, allowing them to upgrade health care infrastructure and technologies and increase employment of health personnel. Conversely, unless properly managed, this model has the potential to widen the gap between private health care providers focusing on foreign patients and wealthy nationals - who can afford technologically-advanced and high-quality health care - and the rest of the health care providers available to the general public [2–6]. …”

Section: Introductionmentioning

confidence: 99%

“…Thailand is the largest exporter of health services via consumption abroad in Southeast Asia [6] with 1.4 million foreign patients in 2013 [7], owing to the efforts of private hospitals to develop a new customer base in cooperation with the government’s medical hub policy. The medical hub policy is the government’s overall strategy for ensuring that Thailand becomes medical hub of Asia.…”

Section: Introductionmentioning

confidence: 99%

“…The largest group of foreign patients are Japanese [6, 7], most of whom are expatriates [8]. Currently there are few medical tourists from Japan since the Japanese universal health insurance scheme allows Japanese to get quality health care in Japan at a moderate price.…”

Section: Introductionmentioning

confidence: 99%

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Cross-border movement of older patients: a descriptive study on health service use of Japanese retirees in Thailand

et al. 2017

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BackgroundThailand’s policy to promote long-stay tourism encourages Japanese retirees to relocate to Thailand. One concern of such an influx is the impact of these elderly foreign residents on the Thai health system. This study aims to reveal the current use of and needs for health services amongst Japanese retirees residing in various locations in Thailand.MethodsIn collaboration with nine Japanese self-help clubs in Bangkok, Chiang Mai, Chiang Rai, and Phuket, questionnaire surveys of Japanese long-stay retirees were conducted from January to March 2015. The inclusion criteria were being ≥ 50 years of age and staying in Thailand for ≥30 days in the previous 12 months while the main exclusion criteria included relocation by company, relocation due to marriage, or working migrants.ResultsThe mean age of the 237 eligible participants was 68.8, with 79.3% of them being male, 57.8% having stayed in Thailand for ≥5 years, 63.3% having stayed in Thailand for ≥300 days in the previous 12 months and 33% suffering from chronic diseases or sequelae. Of the 143 who had health check-ups in the previous 12 months, 48.3% did so in Thailand. The top 3 diseases treated either in Thailand or Japan in the previous 12 months were dental diseases (50 patients), hypertension (44 patients), and musculoskeletal disorders (41 patients), with the rate of treatment in Thailand standing at 46.0, 47.7, and 65.9%, respectively. Of the 106 who saw a doctor in Thailand in the same period, 70.8% did so less than once a month. Only 23.2% of the participants preferred to receive medical treatment for serious conditions in Thailand. However, this number rose to 32.9% for long-term care (LTC) use.ConclusionThe usage of Thai health services amongst Japanese long-stay retirees is currently limited as they prefer going back to Japan for health screenings and treatment of chronic or serious diseases. However, the number of Japanese residents requiring health services including LTC and end-of-life care is expected to increase. The potential impact of promoting long-stay tourism on the Thai public health should be acknowledged and investigated by the Thai government, including the tourism authority.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cross-border movement of older patients: a descriptive study on health service use of Japanese retirees in Thailand

et al. 2017

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“…It is thus not surprising that certain travel-based factors may actually serve as motivations for ultimately deciding on medical tourism, including on the destination location. Such motivators are thought to be the increasing ease and affordability of international travel, the frequency of flights to major destinations, and the streamlining of visa procedures and expediting of applications for international patients [47,74-77]. The availability of facilitators/brokers to assist with making detailed arrangements, corresponding with doctors, and planning after care in certain departure countries (e.g., in Canada it is reported that there are at least 20 different facilitators/brokers) can serve as a motivator for those reluctant to have to make their own plans and bookings [6,29,36,72].…”

Section: Resultsmentioning

confidence: 99%

What is known about the patient's experience of medical tourism? A scoping review

Crooks

Kingsbury

Snyder

et al. 2010

BMC Health Serv Res

260

262

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BackgroundMedical tourism is understood as travel abroad with the intention of obtaining non-emergency medical services. This practice is the subject of increasing interest, but little is known about its scope.MethodsA comprehensive scoping review of published academic articles, media sources, and grey literature reports was performed to answer the question: what is known about the patient's experience of medical tourism? The review was accomplished in three steps: (1) identifying the question and relevant literature; (2) selecting the literature; (3) charting, collating, and summarizing the information. Overall themes were identified from this process.Results291 sources were identified for review from the databases searched, the majority of which were media pieces (n = 176). A further 57 sources were included for review after hand searching reference lists. Of the 348 sources that were gathered, 216 were ultimately included in this scoping review. Only a small minority of sources reported on empirical studies that involved the collection of primary data (n = 5). The four themes identified via the review were: (1) decision-making (e.g., push and pull factors that operate to shape patients' decisions); (2) motivations (e.g., procedure-, cost-, and travel-based factors motivating patients to seek care abroad); (3) risks (e.g., health and travel risks); and (4) first-hand accounts (e.g., patients' experiential accounts of having gone abroad for medical care). These themes represent the most discussed issues about the patient's experience of medical tourism in the English-language academic, media, and grey literatures.ConclusionsThis review demonstrates the need for additional research on numerous issues, including: (1) understanding how multiple information sources are consulted and evaluated by patients before deciding upon medical tourism; (2) examining how patients understand the risks of care abroad; (3) gathering patients' prospective and retrospective accounts; and (4) the push and pull factors, as well as the motives of patients to participate in medical tourism. The findings from this scoping review and the knowledge gaps it uncovered also demonstrate that there is great potential for new contributions to our understanding of the patient's experience of medical tourism.

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“…The use of public resources for medical tourism also extends to nations' publicly-financed health care services, with countries such as Singapore and Cuba opening public hospitals to privately-financed foreign patients [21,44-47]. A less direct form of public subsidization, the hiring of physicians trained in public education systems by private medical tourism facilities is another example of a potentially inequitable use of public resources [38,48]. Furthermore, physicians in LMICs who might normally practice in resource-poor environments can instead treat high-paying international patients, thereby gaining access to advanced technologies and superior facilities while receiving a higher wage [38,49].…”

Section: Resultsmentioning

confidence: 99%

What is known about the effects of medical tourism in destination and departure countries? A scoping review

Johnston

Crooks

Snyder

et al. 2010

Int J Equity Health

211

202

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BackgroundMedical tourism involves patients intentionally leaving their home country to access non-emergency health care services abroad. Growth in the popularity of this practice has resulted in a significant amount of attention being given to it from researchers, policy-makers, and the media. Yet, there has been little effort to systematically synthesize what is known about the effects of this phenomenon. This article presents the findings of a scoping review examining what is known about the effects of medical tourism in destination and departure countries.MethodsDrawing on academic articles, grey literature, and media sources extracted from18 databases, we follow a widely used scoping review protocol to synthesize what is known about the effects of medical tourism in destination and departure countries. The review design has three main stages: (1) identifying the question and relevant literature; (2) selecting the literature; and (3) charting, collating, and summarizing the data.ResultsThe large majority of the 203 sources accepted into the review offer a perspective of medical tourism from the Global North, focusing on the flow of patients from high income nations to lower and middle income countries. This greatly shapes any discussion of the effects of medical tourism on destination and departure countries. Five interrelated themes that characterize existing discussion of the effects of this practice were extracted from the reviewed sources. These themes frame medical tourism as a: (1) user of public resources; (2) solution to health system problems; (3) revenue generating industry; (4) standard of care; and (5) source of inequity. It is observed that what is currently known about the effects of medical tourism is minimal, unreliable, geographically restricted and mostly based on speculation.ConclusionsGiven its positive and negative effects on the health care systems of departure and destination countries, medical tourism is a highly significant and contested phenomenon. This is especially true given its potential to serve as a powerful force for the inequitable delivery of health care services globally. It is recommended that empirical evidence and other data associated with medical tourism be subjected to clear and coherent definitions, including reports focused on the flows of medical tourists and surgery success rates. Additional primary research on the effects of medical tourism is needed if the industry is to develop in a manner that is beneficial to citizens of both departure and destination countries.

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Trade in health services in the ASEAN region

Cited by 56 publications

References 3 publications

Cross-border movement of older patients: a descriptive study on health service use of Japanese retirees in Thailand

Cross-border movement of older patients: a descriptive study on health service use of Japanese retirees in Thailand

What is known about the patient's experience of medical tourism? A scoping review

What is known about the effects of medical tourism in destination and departure countries? A scoping review

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