Article #10 | Medical Tourism : A vital force of the global healthcare landscape

Dec 05 2018
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Medical Tourism : A vital force of the global healthcare landscape
By Dr Raza Siddiqui, CEO, Arabian Healthcare Group and executive director, RAK Hospital, UAE

One major impact of globalisation which has, in the past few decades, made greater inroads into our lives, is the exponential growth in global medical tourism, a phenomenon that has huge potential to fill the gaps caused by the inequitable delivery of healthcare services globally. The industry, while in no way a new phenomenon, has opened tremendous avenues for people who, for various reasons, choose to seek medical treatment outside their home country. As people around the world are increasingly taking control of their own health, they choose to travel outside the country of residence for the purpose of receiving medical care keeping in mind factors such as high quality of healthcare, affordability, access of care or better availability. While originally, patients from less-developed countries travelled to developed nations for treatments not available in their homeland, today, there is a marked shift in both qualitative and quantitative aspects of patient mobility. The promise of high quality, technologically advanced and competitively priced health
services in less developed nations, the apparent ease of travel and connectivity to destinations around the world, increased regulatory environment including capacity planning, and growth of niche specialities are prompting patients in developed nations also to seek treatments outside their homeland. The rapid growth of global medical tourism can be gauged by the recent report published by Allied Market Research that states the market was valued at USD 61,172 million in 2016. According to the report, this will rise to $165,345 million by 2023, increasing at a CAGR of 15% from 2017 to 2023. Another recent study by VISA and Oxford Economics claims that in the US alone, 1.3 million Americans travelled for medical purposes in 2016, and globally the medical tourism industry is growing at 25 percent a year. While generally, older people make the journey, VISA, found that people between the ages of 18 and 24 are also increasingly travelling for health reasons. The evolution of global medical tourism in recent times has brought about several benefits to all stakeholders associated with global healthcare. First of all, it offers
premium health facilities to patients from all corners of the world. Secondly, in the bid to perform better and with a serious intent to lure more traffic, medical tourism destinations have become far more competitive in terms of services offered and are constantly improving their healthcare tourism infrastructure. They are bringing in cutting-edge technology to improve their technical capabilities and investing in the best possible human resources for both medical practitioners and support staff to augment the quality of services offered as this is a vital element in attracting customers. To further boost the negative images and stereotypes associated with lower income countries and to strengthen the confidence in the quality of healthcare available, emerging medical tourism destinations are opting for quality assessment via accreditation from internationally recognised institutions such as Joint Commission International.

Medical Tourism Hotspots
Based on inbound traffic for medical purposes, healthcare and tourism infrastructure, and quality of healthcare available, Patients Beyond Borders ranks Thailand as the top medical tourism destination globally followed by India, Costa Rica, Israel, Malaysia, Mexico, Singapore, South Korea, Taiwan, Turkey and the US. Other emerging destinations also include Brazil, Columbia and the UAE. These countries are witnessing a prolific growth in the industry, thanks to efforts to boost the regulatory environment and infrastructural capabilities by the government and private sectors. Thailand, for instance, currently sees around 2 million people flying in for medical care, with the number expected to go up considerably year on year, according to the Thailand Investment Review. India is another important case in point, which has emerged as the largest growing medical tourism hub in the region. The country has seen a steady rise in 2016 alone, leading to an impressive 45 per cent increase in the number of medical visas issued, as compared to previous years. Moreover, the industry is predicted to grow from the current USD3 billion to USD8 billion by 2020. Low cost of treatment – around 10 percent of what it would cost in the West – combined with international quality standard compliance, modern technology and range of specialities, have been the driving force behind India’s increasing popularity as a medical tourism destination.

Treatments
The most common procedures that are driving medical tourism trips worldwide include cosmetic surgery, dentistry (general, restorative and cosmetic), and cardiovascular treatments. Other popular sought-after procedures include orthopaedics (joint and spine; sports medicine); cancer (often high-acuity or last resort); reproductive (fertility, IVF, women’s health); and weight loss (LAP-BAND, gastric bypass), amongst several others. The lack of availability of full insurance provisions for issues related to dentistry and cosmetic procedures and the high cost of these treatments is driving patients in western countries to destinations that offer these procedures at more affordable rates. For example, in the US, among the 1.2 million annual outbound medical tourists, 50 percent travel for dental care while 15 percent choose to fly for cosmetic
procedures, as per Patients Beyond Borders. Similarly, circumvention tourism – access to medical services that are legal in the destination country but illegal or unapproved by regulators in the home country – is also very popular. Such patients could also be seeking unproven medical interventions or visits to experts who may have pioneered procedures or specific treatments. These include amongst others, certain types of fertility treatments, stem cell therapies for a range of conditions, highly-specialised cancer treatments, some neurological conditions or digestive diseases.

Why catch the plane?
What exactly do patients look for most when choosing a medical tourism destination? Affordability and the incredible savings it brings about is, of course, one of the biggest determinants, followed by quality healthcare, high levels of medical expertise, personalised services and the absence of waiting time. According to Medical Tourism Association, patients can save up to as much as 90 percent when treated overseas. Countries such as India, Thailand, Singapore and Brazil are among those popular for their inexpensive, yet top quality healthcare that has been attracting increasing inbound traffic. For example, a cardiac bypass that would cost USD123,000 in the US costs only around USD15,000 in Thailand and USD7,900 in India. This means that even after including the costs for travel and other logistical needs, the amount incurred will be less than half. Similarly, hospitals are opening support offices in other countries to provide tertiary care and to coordinate end-to-end travel arrangements, including visas when needed. The trend has been happily picked up by several countries, which now offer attractive value-added services such as affordable accommodation, and leisure tours as part of packages. Countries are clubbing medical tourism with its traditional counterpart and partnering with the hospitality sector to create more pocket-friendly packages. Thailand and the UAE are great examples in this regard, which offer both top-of-the-line healthcare and a plethora of entertainment and leisure activities. Partnerships between healthcare institutions from two different countries and airlines are springing up as well.

The Future
Although the number of people travelling abroad to seek medical treatment has grown in recent years, the industry is still in its growth phase but is clearly heading towards maturity as the multiple stakeholders in the industry are looking to offer dynamic changes in their services and products to ensure sustainable growth.  Amongst the key factors driving the growth of medical tourism are the rise in the ageing population worldwide, increase in degenerative diseases, burgeoning healthcare costs and the fact that many countries do not have adequate quality healthcare services to cater to the soaring needs of their population. In addition, easy access to information on the internet, availability of online consultation and adoption of new technologies that facilitate remote monitoring is enabling the medical tourism industry go mainstream. Having said that, the medical tourism market is still emerging and faces a number of challenges. Tourism destinations need to put more focus on cultural diversity, language barriers, religious sentiments and the knowledge of customs and traditions from across the world in order to create a more welcoming environment for patients. Above all, there needs to be a continuity of care and an evolving practical set up for post-surgical care. Another very important challenge facing the medical tourism industry is the spread of infectious diseases through increasing inbound travellers. Thailand, for example, recently saw a spike in cases of Zika virus in the country, and although the authorities assured that it was no cause for alarm, the issue requires both attention as well as precaution. There is no denying that medical tourism has emerged both as a big part of the current healthcare landscape and an economic force of the traditional tourism industry as well. As cost of care becomes more affordable and accessible in emerging economies, the quality and technology gap is reduced to minimum, and governments ramp up efforts to develop their healthcare and tourism infrastructure and provide a wider choice to patients, the industry will continue to offer valuable solutions to meet the escalating healthcare needs of a growing global population.

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