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Medical Tourism
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Medical Tourism

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Medical Tourism

Medical Tourism

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  • 1. It is confidentially predicted that overIt is confidentially predicted that over the next decade, Asia will have one ofthe next decade, Asia will have one of the fastest growing tourist populationthe fastest growing tourist population in the world…in the world… It is confidentially predicted that overIt is confidentially predicted that over the next decade, Asia will have one ofthe next decade, Asia will have one of the fastest growing tourist populationthe fastest growing tourist population in the world…in the world… KAZEMI Dec. 2007 Lulea University of Technology
  • 2. 1 . travel for pleasure: the activity of traveling for pleasure 2 . travel business: the business of arranging travel and travel services for people 3 . travel to obtain service: travel to benefit from a particular service or activity that is unavailable at home (usually used in combination) •health tourism Microsoft® Encarta® 2007. © 1993-2006 Microsoft Corporation. All rights reserved. tour·ism [toor ìzzəm] noun tour·ism [toor ìzzəm] noun
  • 3. www.yellowpages-cambodia.com/images/maps/Southeastasia PHILIPPINESPHILIPPINES THAILANDTHAILANDINDIAINDIA SINGAPORESINGAPORE MALAYSIAMALAYSIA The Booming MEDICAL TOURISM
  • 4. Medical tourism in AsiaMedical tourism in Asia is relatively new broughtis relatively new brought on in the aftermath of the Asian Financialon in the aftermath of the Asian Financial Crisis that led first private hospitals in someCrisis that led first private hospitals in some Asian countries to seek alternative revenueAsian countries to seek alternative revenue sources…sources… Medical tourism in AsiaMedical tourism in Asia is relatively new broughtis relatively new brought on in the aftermath of the Asian Financialon in the aftermath of the Asian Financial Crisis that led first private hospitals in someCrisis that led first private hospitals in some Asian countries to seek alternative revenueAsian countries to seek alternative revenue sources…sources… KAZEMI Dec. 2007 Lulea University of Technology
  • 5. Asia represents the most potential medicalAsia represents the most potential medical tourism market in the world. In 2007, thetourism market in the world. In 2007, the region generated revenues worth US$ 3.4region generated revenues worth US$ 3.4 Billion, accounting for nearly 12.7% of theBillion, accounting for nearly 12.7% of the global marketglobal market Asia represents the most potential medicalAsia represents the most potential medical tourism market in the world. In 2007, thetourism market in the world. In 2007, the region generated revenues worth US$ 3.4region generated revenues worth US$ 3.4 Billion, accounting for nearly 12.7% of theBillion, accounting for nearly 12.7% of the global marketglobal market “Asian Medical Tourism Analysis (2008-2012)” Bharatbook June 2008
  • 6. MEDICAL TOURISM, Defined • Popular mass culture where people travel often long distances to overseas destinations to obtain medical, dental and surgical care while simultaneously being holiday makers in a more conventional sense Connell 2006
  • 7. MEDICAL TOURISM, Defined •Provision of cost-effective private medical care in collaboration with the tourism industry for patients needing surgical and other forms of specialized treatment. India Medical Care, 2007
  • 8. Medical TreatmentAlternative & Complimentary Medicine Medical TourismWellness Tourism MEDICAL TOURISM, Structure Jabarri, 2007 Health Tourism
  • 9. COMPLIMENTARY & ALTERNATIVE MEDICINE  Any help and treatment that is beyond theAny help and treatment that is beyond the usage of Western Medicineusage of Western Medicine (Avijgan, 2007)(Avijgan, 2007)  Dietary supplements, mega dose vitamins,Dietary supplements, mega dose vitamins, herbal preparations, massage therapy,herbal preparations, massage therapy, magnet therapy, spiritual healing andmagnet therapy, spiritual healing and meditationmeditation Complimentary medicine-Complimentary medicine- used togetherused together with conventionalwith conventional Alternative medicine-Alternative medicine- used in place ofused in place of conventionalconventional
  • 10. Medical Surgical (Cosmetic, Non- Cosmetic) Dental Reproductive: (Fertility, Birth, Sex Change) Medical Treatment Medical TourismWellness Tourism Alternative & Complimentary Medicine MEDICAL TOURISM, Structure Jabarri, 2007 Health Tourism
  • 11. MEDICAL TOURISM, Defined MEDICAL TOURISM ConsumerConsumer BenifitBenifit Social IssuesSocial Issues BrandingBranding ProductProduct InfrastructureInfrastructureCommunicationCommunication ChannelChannel LegalLegal FrameworkFramework OperatorsOperators Caballero, Danell & Mugomba, 2006
  • 12. MEDICAL TOURISM, What’s at stake? Medical TourismMedical Tourism A business that:A business that: ––creates value within the tourism andcreates value within the tourism and healthcarehealthcare ––attracts foreign exchange and investmentattracts foreign exchange and investment capitalcapital ––creates supply and demand for highcreates supply and demand for high skilled labor poolskilled labor pool ––generates the highest revenue per visit ofgenerates the highest revenue per visit of any tourist categoryany tourist category
  • 13. Who areWho are medical touristsmedical tourists?? Asian Medical & Hospital Center  Initially, medical tourists were composedInitially, medical tourists were composed of only the affluent and well-to-do peopleof only the affluent and well-to-do people from all over the world, who could affordfrom all over the world, who could afford to travel abroad to receive the bestto travel abroad to receive the best medical attention.medical attention.  medical tourists now also consist ofmedical tourists now also consist of average earning individuals.average earning individuals.  Initially, medical tourists were composedInitially, medical tourists were composed of only the affluent and well-to-do peopleof only the affluent and well-to-do people from all over the world, who could affordfrom all over the world, who could afford to travel abroad to receive the bestto travel abroad to receive the best medical attention.medical attention.  medical tourists now also consist ofmedical tourists now also consist of average earning individuals.average earning individuals.
  • 14. Why would someone travel halfway acrossWhy would someone travel halfway across the world to a foreign country for thesethe world to a foreign country for these health care?health care? Even if these procedures are available in the home country. What are the significant reasons?….
  • 15. Earliest medical tourism centersEarliest medical tourism centers  2000 BC – (Bronze Age) hill tribes near present2000 BC – (Bronze Age) hill tribes near present day St. Moritz,day St. Moritz, SwitzerlandSwitzerland gathered around togathered around to drink & bathe in the iron rich mineral springs ofdrink & bathe in the iron rich mineral springs of the regionthe region  4000 BC –4000 BC – SumeriansSumerians constructed the earliestconstructed the earliest known health complexes alongside mineral waterknown health complexes alongside mineral water springs that included elevated temples andsprings that included elevated temples and flowing poolsflowing pools  GREEKSGREEKS – first laid the foundation for a– first laid the foundation for a comprehensive health tourism systemcomprehensive health tourism system Health Medical Tourism, 2005 MEDICAL TOURISM, HISTORY
  • 16. Wikipeda, 2007 The rise of Greek medical tourismThe rise of Greek medical tourism  AsclepiaAsclepia templestemples – earliest healing centers, where– earliest healing centers, where patients from around the region congregated forpatients from around the region congregated for therapeutic purposestherapeutic purposes  Greek mythology – Asclepius, the God ofGreek mythology – Asclepius, the God of Medicine, mentored by Chiron, the master ofMedicine, mentored by Chiron, the master of MedicineMedicine  44thth Century BC – Asclepian healing temples hadCentury BC – Asclepian healing temples had been constructed throughout the length andbeen constructed throughout the length and breadth of the Grecian world.breadth of the Grecian world. MEDICAL TOURISM, HISTORY
  • 17. Health Medical Tourism, 2007 The rise of Greek medical tourismThe rise of Greek medical tourism  Epidaurus Asclepia Temple ComplexEpidaurus Asclepia Temple Complex flourished well until 4flourished well until 4thth century ADcentury AD  Included:Included: • Bathing springsBathing springs • Dream templeDream temple • GymnasiunGymnasiun • Palaestra (exercise area)Palaestra (exercise area) • Snake farmSnake farm MEDICAL TOURISM, HISTORY
  • 18. Ancient Roman medical tourismAncient Roman medical tourism  ThermaeThermae (hot water baths) – not only used for(hot water baths) – not only used for obvious medicinal purposes but served asobvious medicinal purposes but served as important social networking venues for some ofimportant social networking venues for some of the Europe’s most privileged elitethe Europe’s most privileged elite ((Health Medical Tourism, 2005)  Because of active trade, Thermae expansion included the following: • Ayurvedic massage • Chinese medicine • Aspects of Buddhist spiritual healing (Health Medical Industry, 2005) MEDICAL TOURISM, HISTORY
  • 19. Health Medical Tourism, 2007 Early Islamic civilizationEarly Islamic civilization  Mansuri Hospital inMansuri Hospital in CairoCairo (erected 1210 AD)(erected 1210 AD) • In patient capacity 8000 peopleIn patient capacity 8000 people • Largest hospital of the timeLargest hospital of the time • Most advanced health care facilityMost advanced health care facility MEDICAL TOURISM, HISTORY
  • 20. Health Medical Tourism, 2007 Medieval JapanMedieval Japan  OnsenOnsen – hot mineral springs with healing– hot mineral springs with healing properties enriched by the surrounding volcanicproperties enriched by the surrounding volcanic soil.soil. - discovered later by elderly farmers and- discovered later by elderly farmers and hunters to be effective treatment for arthritichunters to be effective treatment for arthritic aches, and by warriors to alleviate pain, healaches, and by warriors to alleviate pain, heal wounds and recuperatewounds and recuperate MEDICAL TOURISM, HISTORY
  • 21. Connel, 2006 Indian Medical TourismIndian Medical Tourism  India’s alternative medicine and yoga (5000 yrsIndia’s alternative medicine and yoga (5000 yrs ago) – made India the epicenter of Easternago) – made India the epicenter of Eastern cultural, spiritual, and medicinal progresscultural, spiritual, and medicinal progress  Remained to be a veritable Mecca for allRemained to be a veritable Mecca for all practitioners of alternative medicinepractitioners of alternative medicine  The world’s oldest medical tourism destinationThe world’s oldest medical tourism destination and now, one of the world’s popular onesand now, one of the world’s popular ones MEDICAL TOURISM, HISTORY
  • 22. Health Medical Tourism, 2005 European Medical TourismEuropean Medical Tourism  1616thth Century –Europeans discovered the RomanCentury –Europeans discovered the Roman bathsbaths  Spa towns sprung up, notably, Bath or AquaeSpa towns sprung up, notably, Bath or Aquae Sulis (Sulis Minerva-water Goddess)Sulis (Sulis Minerva-water Goddess)  Bath- became anointed as fashionable wellnessBath- became anointed as fashionable wellness and recreation playground for the rich and theand recreation playground for the rich and the famous.famous. MEDICAL TOURISM, HISTORY
  • 23. Health Medical Tourism, 2007 Health Tourism in the new worldHealth Tourism in the new world  1600s – English and Dutch colonists in the newly1600s – English and Dutch colonists in the newly discovered America constructed log cabins neardiscovered America constructed log cabins near mineral springs that were rich in medicinalmineral springs that were rich in medicinal properties.properties. Health Tourism in the new worldHealth Tourism in the new world  1600s – English and Dutch colonists in the newly1600s – English and Dutch colonists in the newly discovered America constructed log cabins neardiscovered America constructed log cabins near mineral springs that were rich in medicinalmineral springs that were rich in medicinal properties.properties. MEDICAL TOURISM, HISTORY
  • 24. Gupta 2007 The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  Asian countries can now attract aAsian countries can now attract a combined 1.3 million medical tourists percombined 1.3 million medical tourists per year and is increasing annually.year and is increasing annually.  Asia alone will be projected to generateAsia alone will be projected to generate more than USD4 billion by 2012more than USD4 billion by 2012 The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  Asian countries can now attract aAsian countries can now attract a combined 1.3 million medical tourists percombined 1.3 million medical tourists per year and is increasing annually.year and is increasing annually.  Asia alone will be projected to generateAsia alone will be projected to generate more than USD4 billion by 2012more than USD4 billion by 2012 MEDICAL TOURISM, HISTORY
  • 25. Connel, 2006 The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  1970’s-1970’s- ThailandThailand became known as a destinationbecame known as a destination for medical tourism because of sex changefor medical tourism because of sex change operations, and later, cosmetic surgeryoperations, and later, cosmetic surgery  After 1998 in the wake of Asian economic crisisAfter 1998 in the wake of Asian economic crisis and the need for economic diversificationand the need for economic diversification,, MalaysiaMalaysia entered medical tourismentered medical tourism The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  1970’s-1970’s- ThailandThailand became known as a destinationbecame known as a destination for medical tourism because of sex changefor medical tourism because of sex change operations, and later, cosmetic surgeryoperations, and later, cosmetic surgery  After 1998 in the wake of Asian economic crisisAfter 1998 in the wake of Asian economic crisis and the need for economic diversificationand the need for economic diversification,, MalaysiaMalaysia entered medical tourismentered medical tourism MEDICAL TOURISM, HISTORY
  • 26. MEDICAL TOURISM, HISTORY The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  Mid 1990’s –Mid 1990’s – India,India, regarded asregarded as contemporary global center for medicalcontemporary global center for medical tourism advertises itself as offeringtourism advertises itself as offering everything from alternative Ayurvediceverything from alternative Ayurvedic therapy to coronary bypasses andtherapy to coronary bypasses and cosmetic surgerycosmetic surgery The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  Mid 1990’s –Mid 1990’s – India,India, regarded asregarded as contemporary global center for medicalcontemporary global center for medical tourism advertises itself as offeringtourism advertises itself as offering everything from alternative Ayurvediceverything from alternative Ayurvedic therapy to coronary bypasses andtherapy to coronary bypasses and cosmetic surgerycosmetic surgery Connel, 2006
  • 27. MEDICAL TOURISM, HISTORY The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  2001 – successful separation of 10 mo. old2001 – successful separation of 10 mo. old Nepalese conjoined twins putNepalese conjoined twins put SingaporeSingapore’s medical’s medical expertise into headlines around the world.expertise into headlines around the world. (Wikipeda, 2007)(Wikipeda, 2007)  2006 – Joint Commission International2006 – Joint Commission International (JCI)(JCI) setset up its Asia Pacific office in Singapore. Theup its Asia Pacific office in Singapore. The country has 9 hospitals & 2 medical centerscountry has 9 hospitals & 2 medical centers accredited by the said commissionaccredited by the said commission..((Connel, 2006) The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  2001 – successful separation of 10 mo. old2001 – successful separation of 10 mo. old Nepalese conjoined twins putNepalese conjoined twins put SingaporeSingapore’s medical’s medical expertise into headlines around the world.expertise into headlines around the world. (Wikipeda, 2007)(Wikipeda, 2007)  2006 – Joint Commission International2006 – Joint Commission International (JCI)(JCI) setset up its Asia Pacific office in Singapore. Theup its Asia Pacific office in Singapore. The country has 9 hospitals & 2 medical centerscountry has 9 hospitals & 2 medical centers accredited by the said commissionaccredited by the said commission..((Connel, 2006)
  • 28. MEDICAL TOURISM, HISTORY The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  October 2004 – Philippine Medical TourismOctober 2004 – Philippine Medical Tourism ProgramProgram (PMTP)(PMTP) was created throughwas created through Executive Order No. 372 by PresidentExecutive Order No. 372 by President Gloria Macapagal-ArroyoGloria Macapagal-Arroyo  Nov., 2006 -"Only in the Philippines:Nov., 2006 -"Only in the Philippines: Tender Loving (Health)CareTender Loving (Health)Care," the very first," the very first Philippine Medical Tourism Congress, ExpoPhilippine Medical Tourism Congress, Expo and Launchand Launch The Rise of Medical Tourism in AsiaThe Rise of Medical Tourism in Asia  October 2004 – Philippine Medical TourismOctober 2004 – Philippine Medical Tourism ProgramProgram (PMTP)(PMTP) was created throughwas created through Executive Order No. 372 by PresidentExecutive Order No. 372 by President Gloria Macapagal-ArroyoGloria Macapagal-Arroyo  Nov., 2006 -"Only in the Philippines:Nov., 2006 -"Only in the Philippines: Tender Loving (Health)CareTender Loving (Health)Care," the very first," the very first Philippine Medical Tourism Congress, ExpoPhilippine Medical Tourism Congress, Expo and Launchand Launch
  • 29. History of Curative & Wellness Tourism Which are Used & Named to Each Decade Jabbari, 2007 Neolithic & BronzeNeolithic & Bronze Age-Age- Mineral & Hot SpringsMineral & Hot Springs VisitsVisits Middle Ages -Middle Ages - SpringsSprings 1616thth century -century - Fountain of YouthFountain of Youth 1717thth , 18, 18thth century -century - SpaSpa 1919thth Century -Century - Sea & Mountain Air (TBSea & Mountain Air (TB sanitarium)sanitarium) 2020thth Century -Century - Health Farms & Fat FarmsHealth Farms & Fat Farms 1991 -1991 - Formation of InternationalFormation of International Spa AssociationSpa Association TODAY -TODAY - Hospitals are more likeHospitals are more like spas & Spas are more likespas & Spas are more like hospitalshospitals
  • 30. Why would someone travel halfway across theWhy would someone travel halfway across the world to a foreign country for wellness?world to a foreign country for wellness?  The shifting in consumer valuesThe shifting in consumer values  Increased stress & workloadIncreased stress & workload  Older populationOlder population  Health care costs are escalatingHealth care costs are escalating  New attitude towards mental & spiritualNew attitude towards mental & spiritual activitiesactivities  The emergence of environmentalistsThe emergence of environmentalists  The shifting in consumer valuesThe shifting in consumer values  Increased stress & workloadIncreased stress & workload  Older populationOlder population  Health care costs are escalatingHealth care costs are escalating  New attitude towards mental & spiritualNew attitude towards mental & spiritual activitiesactivities  The emergence of environmentalistsThe emergence of environmentalists Jabbari, 2007
  • 31.  Exhorbitant cost of treatment in the homeExhorbitant cost of treatment in the home countrycountry  Treatment or surgeries not covered byTreatment or surgeries not covered by health insurance in home countryhealth insurance in home country  Long waiting periods ( in “rationed” healthLong waiting periods ( in “rationed” health care in home country)care in home country)  No or minimal insurance coverageNo or minimal insurance coverage  Privacy (Anonymity)Privacy (Anonymity)  Lack of facilities in the home countryLack of facilities in the home country  Possibility of a holiday with health carePossibility of a holiday with health care  Exhorbitant cost of treatment in the homeExhorbitant cost of treatment in the home countrycountry  Treatment or surgeries not covered byTreatment or surgeries not covered by health insurance in home countryhealth insurance in home country  Long waiting periods ( in “rationed” healthLong waiting periods ( in “rationed” health care in home country)care in home country)  No or minimal insurance coverageNo or minimal insurance coverage  Privacy (Anonymity)Privacy (Anonymity)  Lack of facilities in the home countryLack of facilities in the home country  Possibility of a holiday with health carePossibility of a holiday with health care Why would someone travel halfway across theWhy would someone travel halfway across the world to a foreign country for treatment?world to a foreign country for treatment? Jabbari, 2007
  • 32. MEDICAL TOURISM, Today… In the past, health travel was restricted either to the wealthy or truly desperate. In the past, health travel was restricted either to the wealthy or truly desperate. Today, with flattening global economy,Today, with flattening global economy, international travel, mass communicationinternational travel, mass communication and more lenient trade policies make itand more lenient trade policies make it possible for those with modest means topossible for those with modest means to enjoy the benefits of world-class health careenjoy the benefits of world-class health care in the form of medical tourism.in the form of medical tourism. Today, with flattening global economy,Today, with flattening global economy, international travel, mass communicationinternational travel, mass communication and more lenient trade policies make itand more lenient trade policies make it possible for those with modest means topossible for those with modest means to enjoy the benefits of world-class health careenjoy the benefits of world-class health care in the form of medical tourism.in the form of medical tourism. KAZEMI, 2007
  • 33. Objectives of Medical Travel Industrial MedicalIndustrial Medical Tourism (Past)Tourism (Past) Health Medical Tourism (Present)  Self-paying client fromSelf-paying client from the Middle East, Asia orthe Middle East, Asia or Latin America seekingLatin America seeking care in the USA orcare in the USA or Western Europe.Western Europe.  Specialists Targeted:Specialists Targeted: quality care notquality care not available in homeavailable in home countries i.e. cardiac orcountries i.e. cardiac or plastic surgeriesplastic surgeries  Need for emergencyNeed for emergency care not available incare not available in home countries.home countries.  Elective procedures: they are wait-listed in home country: UK & Canada  Opportunity for high quality interventions  Competitive prices  Desirable environment  Combination of treatment and tour. KAZEMI Dec. 2007 vsvs
  • 34. Jabarri, 2007 Trend of Medical Tourism Concept (1st International Conference of Health Tourism in Iran) 19971997 Health TourismHealth Tourism 1997-1997- 20012001 TransitionTransition 2001-2001- 20072007 Medical TourismMedical Tourism 2006-2006- 20072007 MedicalMedical OutsourcingOutsourcing
  • 35. Sociological Aspects of Medical Outsourcing to Asia Langham, Richmond, Rubin, 2006 Monetary benefit to nation Monetary benefit to nation Savings passed on to other needs Savings passed on to other needs Additional income revenue Additional income revenue Lower CostsLower Costs Country Receiving Patients Country Receiving Patients Country Sending Patients Country Sending Patients ECONOMICECONOMIC
  • 36. Sociological Aspects of Medical Outsourcing Langham, Richmond, Rubin, 2006 More tourism promotion in effect Opportunity for family to visit abroad Increased cultural exchanges Greater respect to host nationals Opportunity to encounter others Appreciation given host nation Country Receiving Patients Country Sending Patients SOCIAL
  • 37. Sociological Aspects of Medical Outsourcing Langham, Richmond, Rubin, 2006 Internationalization of practices Potential for redefining of malpractice suits Greater international legal ties Promote development of agreements Country Receiving Patients Country Sending Patients LEGAL
  • 38. Sociological Aspects of Medical Outsourcing Langham, Richmond, Rubin, 2006 Inspections by international medical regulatory boards Concerns for medical standards Reputation importanceQuestions of safety in follow up Raise issues of international medical ethics Less control of medical practices Increased prestige in medicine for host nation Increased contacts in exchange of people and information Country Receiving PatientsCountry Sending Patients MEDICAL
  • 39. ADVERTISEMENTADVERTISEMENTADVERTISEMENTADVERTISEMENT TechnologyTechnologyTechnologyTechnology QualityQuality ReliabilityReliability QualityQuality ReliabilityReliability OverseasOverseas TrainingTraining OverseasOverseas TrainingTraining KAZEMI, 2007
  • 40. PROMOTIONAL EXPERIENCES OF ASIAN COUNTRIES THAILANDTHAILAND  Inter-sectoral coordinationInter-sectoral coordination  Effective marketingEffective marketing  Focus on hospitalityFocus on hospitality  Building InfrastructureBuilding Infrastructure THAILANDTHAILAND  Inter-sectoral coordinationInter-sectoral coordination  Effective marketingEffective marketing  Focus on hospitalityFocus on hospitality  Building InfrastructureBuilding Infrastructure KAZEMI, 2007
  • 41. PROMOTIONAL EXPERIENCES OF ASIAN COUNTRIES INDIAINDIA  Low-cost treatmentLow-cost treatment  Effective marketingEffective marketing  Indian companies having negotiation withIndian companies having negotiation with National Health Service (NHS) about out-sourcingNational Health Service (NHS) about out-sourcing the treatment of British patients to Indiathe treatment of British patients to India INDIAINDIA  Low-cost treatmentLow-cost treatment  Effective marketingEffective marketing  Indian companies having negotiation withIndian companies having negotiation with National Health Service (NHS) about out-sourcingNational Health Service (NHS) about out-sourcing the treatment of British patients to Indiathe treatment of British patients to India KAZEMI, 2007
  • 42. PROMOTIONAL EXPERIENCES OF ASIAN COUNTRIES MALAYSIAMALAYSIA  Government effort to promote medical tourismGovernment effort to promote medical tourism promotional plans.promotional plans.  Tax incentivesTax incentives  Lessening import duty on medical equipmentLessening import duty on medical equipment  Enabling supporting infrastructureEnabling supporting infrastructure  Set up 5 Committees to promote health tourismSet up 5 Committees to promote health tourism MALAYSIAMALAYSIA  Government effort to promote medical tourismGovernment effort to promote medical tourism promotional plans.promotional plans.  Tax incentivesTax incentives  Lessening import duty on medical equipmentLessening import duty on medical equipment  Enabling supporting infrastructureEnabling supporting infrastructure  Set up 5 Committees to promote health tourismSet up 5 Committees to promote health tourism KAZEMI, 2007
  • 43. PROMOTIONAL EXPERIENCES OF ASIAN COUNTRIES SINGAPORESINGAPORE  High level of cleanlinessHigh level of cleanliness  World best standard training andWorld best standard training and professionalismprofessionalism SINGAPORESINGAPORE  High level of cleanlinessHigh level of cleanliness  World best standard training andWorld best standard training and professionalismprofessionalism KAZEMI, 2007
  • 44. PROMOTIONAL EXPERIENCES OF ASIAN COUNTRIES PHILIPPINESPHILIPPINES  3 BUSINESS MODELS FOR HEALTH3 BUSINESS MODELS FOR HEALTH • Creation of an international zone of health forCreation of an international zone of health for wellness combining medical tourism , spa,wellness combining medical tourism , spa, health, eco-tourism and retirement villageshealth, eco-tourism and retirement villages • Health human resources development networkHealth human resources development network with the top nursing and medicalwith the top nursing and medical schools/hospitals in the Philippines.schools/hospitals in the Philippines. • Health crewing for specific health services,Health crewing for specific health services, including Tele-health, medical transcriptionincluding Tele-health, medical transcription PHILIPPINESPHILIPPINES  3 BUSINESS MODELS FOR HEALTH3 BUSINESS MODELS FOR HEALTH • Creation of an international zone of health forCreation of an international zone of health for wellness combining medical tourism , spa,wellness combining medical tourism , spa, health, eco-tourism and retirement villageshealth, eco-tourism and retirement villages • Health human resources development networkHealth human resources development network with the top nursing and medicalwith the top nursing and medical schools/hospitals in the Philippines.schools/hospitals in the Philippines. • Health crewing for specific health services,Health crewing for specific health services, including Tele-health, medical transcriptionincluding Tele-health, medical transcription KAZEMI, 2007
  • 45. MEDICINEMEDICINE WELLNESSWELLNESS TOURISMTOURISM
  • 46. PROCESS Wikipeda, 2008Wikipeda, 2008 PATIENT Medical Tourism Provider Certified Medical Doctors or Consultants Discussion of The Package Signing of Consent Bonds & Agreements Recommendation letters for medical visa From the Embassy TRAVEL Medical Tourist is assigned to a Case Executive who takes care of everything for the tourist
  • 47. STANDARDS Wikipeda, 2008Wikipeda, 2008 InternationalInternational Health CareHealth Care AccreditationAccreditation Evidence-Evidence- basedbased MedicineMedicine QualityQuality AssuranceAssurance
  • 48. International Health Care Accreditation  Joint Commission International (JCI)Joint Commission International (JCI) • USAUSA
  • 49. International Health Care Accreditation Wikipeda, 2008Wikipeda, 2008  Trent International AccreditationTrent International Accreditation SchemeScheme • United KingdomUnited Kingdom • HongKongHongKong
  • 50. International Health Care Accreditation Wikipeda, 2008Wikipeda, 2008  The Society for International Health CareThe Society for International Health Care Accreditation (SOFIHA)Accreditation (SOFIHA) • Promotion of safe hospital environment forPromotion of safe hospital environment for patientspatients  Health Care Tourism InternationalHealth Care Tourism International • Accreditation for all major groups involved inAccreditation for all major groups involved in the health tourism industry:the health tourism industry:  HOTELSHOTELS  RECOVERY FACILITIESRECOVERY FACILITIES  MEDICAL TOURIST BOOKING AGENCIESMEDICAL TOURIST BOOKING AGENCIES
  • 51. Quality of Care Issues Health care errors seriously harm 1Health care errors seriously harm 1 in every 10 patients around thein every 10 patients around the world.world. Source: World Health Organization (WHO)Source: World Health Organization (WHO) Langham, Richmond, Rubin, 2006
  • 52. Quality of Care Issues International Patient Safety Goals Goal 1Goal 1 – Identify Patients– Identify Patients CorrectlyCorrectly Goal 2Goal 2 – Improve Effective– Improve Effective CommunicationCommunication Goal 3Goal 3 – Improve the Safety of– Improve the Safety of High-Alert MedicationsHigh-Alert Medications Langham, Richmond, Rubin, 2006
  • 53. Goal 4Goal 4 – Eliminate Wrong-Site,– Eliminate Wrong-Site, Wrong-Patient, Wrong-ProcedureWrong-Patient, Wrong-Procedure SurgerySurgery Goal 5Goal 5 – Reduce the risk of health– Reduce the risk of health care-acquired infections.care-acquired infections. Goal 6Goal 6 – Reduce the risk of patient– Reduce the risk of patient harm resulting from falls.harm resulting from falls. Quality of Care Issues International Patient Safety Goals Langham, Richmond, Rubin, 2006
  • 54. The Outsourcing of Surgical Procedures to Asia: Langham, Richmond, Rubin, 2006 Note: Angioplasty in Malaysia averages $4,000 - $6,000 $13,000 $10,000- $11,000 $9,000- $10,000 $160,000 – $281,000 Heart Valve (single) $20,000$12,000 $4,000- $10,000 $100,000 – $123,000 Coronary Artery Bypass $13,000$13,000 $4,000- $11,000 $35,000 – $83,000 Coronary Angioplasty SingaporeThailandIndiaUSA Procedures & Services
  • 55. www.pcij.org Table 1: Comparative Cost of Treatments (in US$) Source: PIDS TREATMENT USA $ SINGAPORE In US$ MALAYSIA In US$ THAILAND In US$ PHILIPPINES In US$ Cataract surgery 2,500- 3,000 1,749 1,014 950 1,424 Total knee replacement 5,000 6,207 4,342 5,500 5,639 Liposuction 2,800- 5,700 3,221 1,711 1,365 1,400 The Outsourcing of Surgical Procedures to Asia:
  • 56. The Outsourcing of Surgical Procedures to Asia: Langham, Richmond, Rubin, 2006 $10,000$90,000Spinal Disc $9,000$7,000$5,000-$6,000 $63,000- $91,000Spinal Fusion $8,000$7,000-$8,000$4,000-$6,000 $17,000- $20,000 Knee (ACL) Repair $8,000$8,000$4,000-$7,000 $40,000- $60,000Rotator Cuff $13,000$10,000$8,000-$9,000 $40,000- $61,000 Knee Replacement $12,000$12,000$9,000 $44,000- $64,000 Hip Replacement SingaporeThailandIndiaUSA Procedures & Services
  • 57. RISKS   Wikipeda, 2008Wikipeda, 2008  DIFFERENCE IN DISEASE-RELATED EPIDEMIOLOGY DIFFERENCE IN DISEASE-RELATED EPIDEMIOLOGY  BETWEEN HOME COUNTRY & COUNTRY OF BETWEEN HOME COUNTRY & COUNTRY OF  DESTINATIONDESTINATION • Hepatitis AHepatitis A • Amoebic DysenteryAmoebic Dysentery • Mosquito-transmitted diseasesMosquito-transmitted diseases • TBTB  DIFFERENCE IN HEALTHCARE PROVIDER DIFFERENCE IN HEALTHCARE PROVIDER  STANDARDS AROUND THE WORLDSTANDARDS AROUND THE WORLD • World Alliance for Patient SafetyWorld Alliance for Patient Safety  Assists hospitals and government around the world in settingAssists hospitals and government around the world in setting patient safety policy and practices relevant when providingpatient safety policy and practices relevant when providing medical tourism servicesmedical tourism services  QUALITY OF POST-OP CAREQUALITY OF POST-OP CARE • Role of AccreditationRole of Accreditation • Long flights maybe worse for some cases.Long flights maybe worse for some cases.
  • 58. LEGAL & ETHICAL ISSUES   Wikipeda, 2008Wikipeda, 2008  Medical Malpractice LawsuitsMedical Malpractice Lawsuits  Illegal purchase of organs andIllegal purchase of organs and tissues for transplantationstissues for transplantations  Inequities in health care systemInequities in health care system
  • 59. GROWTH OF MEDICAL TOURISM IN THE  WORLD Google TrendsGoogle Trends 20042004 20052005 20062006 20072007 00 Search VolumeSearch Volume
  • 60.  More than 2.9 Million patients visitedMore than 2.9 Million patients visited Thailand, India, Singapore, Malaysia andThailand, India, Singapore, Malaysia and the Philippines for medical tourism inthe Philippines for medical tourism in 2007.2007.  Thailand’s low cost and scenic beachesThailand’s low cost and scenic beaches have enabled it to become the largesthave enabled it to become the largest medical tourism market in Asia; however,medical tourism market in Asia; however, an unstable political environment andan unstable political environment and occurrence of another epidemic such asoccurrence of another epidemic such as bird flu can restrain its growth.bird flu can restrain its growth.  More than 2.9 Million patients visitedMore than 2.9 Million patients visited Thailand, India, Singapore, Malaysia andThailand, India, Singapore, Malaysia and the Philippines for medical tourism inthe Philippines for medical tourism in 2007.2007.  Thailand’s low cost and scenic beachesThailand’s low cost and scenic beaches have enabled it to become the largesthave enabled it to become the largest medical tourism market in Asia; however,medical tourism market in Asia; however, an unstable political environment andan unstable political environment and occurrence of another epidemic such asoccurrence of another epidemic such as bird flu can restrain its growth.bird flu can restrain its growth. Asian Medical Tourism Analysis  (2008-2012)   Bharatbook, June 2008Bharatbook, June 2008
  • 61. Asian Medical Tourism HOSPITALS Samitivej Hospital, ThailandSamitivej Hospital, Thailand
  • 62. Asian Medical Tourism HOSPITALS
  • 63.  Healthcare costs are considerablyHealthcare costs are considerably high inhigh in SingaporeSingapore as compared toas compared to other Asian destinations. Theother Asian destinations. The country, however, boasts of ancountry, however, boasts of an infrastructure and resources that ininfrastructure and resources that in some cases are even better thansome cases are even better than those in the west.those in the west.  Healthcare costs are considerablyHealthcare costs are considerably high inhigh in SingaporeSingapore as compared toas compared to other Asian destinations. Theother Asian destinations. The country, however, boasts of ancountry, however, boasts of an infrastructure and resources that ininfrastructure and resources that in some cases are even better thansome cases are even better than those in the west.those in the west. Asian Medical Tourism Analysis  (2008-2012)   Bharatbook, June 2008Bharatbook, June 2008
  • 64. Asian Medical Tourism HOSPITALS Singapore National Eye Centre (SNEC)
  • 65.  India,India, with its low cost advantagewith its low cost advantage and emergence of several privateand emergence of several private players, represents the fastestplayers, represents the fastest growing market. The country’sgrowing market. The country’s questionable sanitary perceptions inquestionable sanitary perceptions in the west are, however, a majorthe west are, however, a major roadblock for growth.roadblock for growth.  India,India, with its low cost advantagewith its low cost advantage and emergence of several privateand emergence of several private players, represents the fastestplayers, represents the fastest growing market. The country’sgrowing market. The country’s questionable sanitary perceptions inquestionable sanitary perceptions in the west are, however, a majorthe west are, however, a major roadblock for growth.roadblock for growth. Asian Medical Tourism Analysis  (2008-2012)   Bharatbook, June 2008Bharatbook, June 2008
  • 66. Asian Medical Tourism HOSPITALS LAKESHORE HOSPITAL, INDIALAKESHORE HOSPITAL, INDIA
  • 67.  Malaysia and PhilippinesMalaysia and Philippines, both, both relatively new players in the medicalrelatively new players in the medical tourism market, are expected totourism market, are expected to grow strongly in the next five years.grow strongly in the next five years.  Malaysia and PhilippinesMalaysia and Philippines, both, both relatively new players in the medicalrelatively new players in the medical tourism market, are expected totourism market, are expected to grow strongly in the next five years.grow strongly in the next five years. Asian Medical Tourism Analysis  (2008-2012)   Bharatbook, June 2008Bharatbook, June 2008
  • 68. Asian Medical Tourism HOSPITALS ST. LUKES, MEDICAL CENTER, PhilippinesST. LUKES, MEDICAL CENTER, Philippines
  • 69. Asian Medical Tourism HOSPITALS Gleneagles Medical Centre Penang, Malaysia.
  • 70.  A number of employers and healthA number of employers and health insurance firms in developedinsurance firms in developed countries have now started looking atcountries have now started looking at medical tourism to reduce theirmedical tourism to reduce their surging healthcare expenditure.surging healthcare expenditure.  The Asian medical tourism market isThe Asian medical tourism market is expected to grow at a CAGR ofexpected to grow at a CAGR of 17.6% between 2007 and 201217.6% between 2007 and 2012  A number of employers and healthA number of employers and health insurance firms in developedinsurance firms in developed countries have now started looking atcountries have now started looking at medical tourism to reduce theirmedical tourism to reduce their surging healthcare expenditure.surging healthcare expenditure.  The Asian medical tourism market isThe Asian medical tourism market is expected to grow at a CAGR ofexpected to grow at a CAGR of 17.6% between 2007 and 201217.6% between 2007 and 2012 Asian Medical Tourism Analysis  (2008-2012)   Bharatbook, June 2008Bharatbook, June 2008
  • 71. Challenges for Health Care Providers in the Promising Industry of Medical Tourism HEALTH CARE PROVIDERS HEALTH CARE PROVIDERS Medical Quality Medical Quality  of Servicesof Services Medical Quality Medical Quality  of Servicesof Services Importance of Importance of  Non-medical Non-medical  Services for Services for  Patient AccessPatient Access Importance of Importance of  Non-medical Non-medical  Services for Services for  Patient AccessPatient Access Marketing Marketing  OptionsOptions Marketing Marketing  OptionsOptions PARTNERSHIP WITH:PARTNERSHIP WITH: •UniversitiesUniversities •Referring/Competing Referring/Competing  HospitalsHospitals •AgentsAgents •GovernmentGovernment •Accommodation & Accommodation &  Travel Service Travel Service  ProviderProvider PARTNERSHIP WITH:PARTNERSHIP WITH: •UniversitiesUniversities •Referring/Competing Referring/Competing  HospitalsHospitals •AgentsAgents •GovernmentGovernment •Accommodation & Accommodation &  Travel Service Travel Service  ProviderProvider KAZEMI, 2007

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