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

Abstract

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.

Promoting medical tourism to India: Messages, images, and the marketing of international patient travel

“…The present analysis serves as a useful contribution to addressing knowledge gaps within this literature. For example, health geographers have drawn attention to the need to understand patients' motivations for engaging in international medical travel, as such knowledge can assist with tailoring policy responses (Crooks, Kingsbury et al, 2010;Glinos, Baeten, Helble, & Maarse, in press). The analysis presented herein shows that the motivations commonly discussed in the international literature (e.g., cost savings) cannot be taken at face-value; instead, they need to be empirically examined from multiple stakeholder perspectives in order to be better understood.…”

“…However, current research is hampered by limited empirical analysis of the emergence of a global marketplace in health services (Crooks, Kingsbury et al, 2010;Hopkins, Labonté, Runnels, & Packer, 2010;Lunt & Carrera, 2010). By focusing here on the promotional material developed by destination facilities in India, we hope to make a meaningful contribution to careful, critical, and empirically-informed analyses of the medical tourism industry, the creation of a global market-place for health services, and the rise of India as a leading destination for international patients seeking care.…”

“…The phrase 'medical tourism' is commonly used to describe the practice of patients traveling outside of established cross-border care arrangements to access medical services abroad, which are typically paid for out-of-pocket (Crooks, Kingsbury, Snyder, & Johnston, 2010;Ramirez de Arellano, 2007). Medical tourism does not refer to care given when one happens to have a health emer-gency while abroad, as intent is key: the patient must actually intend to go elsewhere for care.…”

“…In the international literature, two distinct motivations are frequently cited for individuals from high income countries engaging in medical tourism in developing nations specifically (Crooks, Kingsbury et al, 2010). For patients coming from privately funded health systems without universal medical insurance like the United States, cost savings are thought to be a crucial factor in encouraging people to travel long distances in search of affordable medical care, or care that is not available to them in their home jurisdictions (Burkett, 2007;Connell, 2008;Ramirez de Arellano, 2007;Unti, 2009).…”

Caring for Non-residents in Barbados: Examining the Implications of Inbound Transnational Medical Care for Public and Private Health Care

“…Medical tourists are differentiated from ill vacationers or visitors on the basis of intentionality (Crooks et al, 2010). Vacationers who become ill while in Barbados do not travel to the country intending to access medical care, while medical tourists typically do, though aggressive marketing to visitors and/or the availability of inexpensive medical care can sometimes prompt vacationers to intentionally or purposefully access non-emergency medical care while abroad.…”