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Medical Tourism Turkey(cost, quality, succes): IVF case study poster

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Competitive advantages of Turkey in medical tourism is presented with a case study about IVF transaction. Cost, quality, succes and safety components are compared between USA and Turkey in that point.

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Medical Tourism Turkey(cost, quality, succes): IVF case study poster

  1. 1. Turkey as a medical tourism destination: Cost-advantage, specialization and subsequent quality improvement in medical tourism hubs M.Said Yildiz, M.Mahmud Khan , PhD, N.Hikmet, PhD University of South Carolina Background Medical tourism has become an important mechanism of obtaining medical care services and it is estimated that total value of medical tourism is going to increase in various reports and studies. Turkey’s market share in medical tourism is increasing with its competitiveness in different aspects. Generally Turkey is known as a competitive country in medical tourism with low cost and high quality service, advanced technology usage in medical care, minimum waiting times, well trained doctors and high number of JCI accredited hospitals. IVF is highly available to medical tourism in terms of lower malpractice risk, lesser hospital visit essentiality and lesser continues care requirement. Turkey is known as one of the most important destinations of IVF treatments. Egg donation, surrogacy and sex selection is officially prohibited in Turkey. So Turkey is an IVF medical tourism destination due to other reasons like cost, convenience, success rate and quality. IVF can be considered as mutually beneficial type of medical tourism with minimum concern of reducing access to health care for the destination country’s citizens. (There is enough -more than 100- IVF laboratories in Turkey. So access to IVF services is not a problem) Also medical tourism for IVF doesn’t increase cost of treatment for Turkish citizens. First and second cycles of IVF is paid by governmental social security agency in Turkey. Study Objective The purpose of this study is to better understand the factors associated with increased popularity of medical tourism in Turkey with a case study of a JCI accredited hospital’s medical tourism efforts and accomplishment in IVF treatment. Competitiveness (Cost comparison between Southeast USA – Turkey) Turkey Southeast USA daVinci Prostatectomy 17,250 102,400 Heart Bypass (CABGx4) 12,250 144,317 Health Valve Replacement 13,750 177,665 Hip Replacement 12,000 100,047 Hysterectomy(Vaginal) 5,000 31,474 Knee Replacement 11,500 IVF Market (Global and Turkey) 65,918 Spinal Fusion 18,000 IVF Cost comparison with other countries IVF cost (per cycle) 103,761 Italy Source: http://www.companionglobalhealthcare.com/employers/comparecosts.aspx Competitiveness (comparison of treatment choices: country-abroad) Anadolu Medical Center It is estimated that at least 20,000 couples receive in vitro fertilization (IVF) care abroad each year. (Peter Kovacs. Seeking IVF Abroad: Medical Tourism for Infertile Couples Medscape. Jun 14, 2010.) Turkey is 7th in IVF market. Total number of baby born with IVF is 44.000. Total number of Assisted Reproduction Centers is more than 120. (2010) In a report(2008), the fertility industry was being seen to be slated to bring in additional revenue of $1-2 billion by 2012 (http://www.geneticsandsociety.org/article.php?id=4241) Hospital in United States IVF (Medical Cost) 2500 12000 Airfare (15-20 percent Turkish airlines discount for medical tourism patient) Hotel (located in hospital campus / IVF package) Other (Trip expenses 100 USD for a day) 2500 - TOTAL 8500 1500 - 2000 $5,504 Spain $5,600 Norway $4,523 Sweden $5,300 Canada $5,766 USA $12,146 Turkey $2,500 - TURKEY COST INCLUDES Monitoring, Ultrasonography Exams, Medical Fees. Egg Retrieval, Anesthesia, IVF. Embryology Laboratory Services, Assisted Hatching, IMSI, Blastocyst, Embryo Transfer. Airport/hospital or hotel/hospital ground transportation. Hotel and trip arrangements. 24/7 translator assistance. IVF succes comparison (Anadolu Hospital and USA avarage) 80 12000 70 Competitiveness (comparison of quality indicators) Data sources and Limitations Some data like IVF succes, IVF cost and quality indicators for case study hospital were taken directy from Anadolu Medical Center. Different sources were used for comparison to USA and world data. Difficulties of reaching same data of same year limited the study. Foreign Visitors for Medical Purpose to Turkey (Tourist declared health reasons in custom) 60 CLINIC QUALITY INDICATOR USA DATA Urinary Tract Infections (UTI) (per 1000 catheter days) Medical Major Teaching hospitals pooled mean(1) (lower is better) Catheter related blood stream infections (per 1000 catheter days) Medical Major Teaching hospitals pooled mean(2) (lower is better) Patient Falls (Per 1000 Inpatient Days) mean in hospitals over 500 beds in 2007, Massachusetts(3) (lower is better) Pressure Ulcer (Per 1000 Inpatient Days) Among community hospitals in the Healthcare Cost and Utilization Project, the riskadjusted rate of this indicator(4) (lower is better) Prophylactic Antibiotic Selection for Surgical Patients in US National data (April 2011-March 2012) (higher is better) Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision (higher is better) Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time (higher is better) 2,4 ANADOLU HOSPITAL DATA (2011) 2,2 Competitiveness (accredited and affiliated high quality hospitals) •Hospitals with high quality levels has significant cost advantages •Turkey has the highest number of JCI accredited hospitals in the world. (28 hospitals, 3 Genetics Diagnostic Centers, independent laboratories, over 4.000 inpatient beds and 957 ICU beds, 179 operating theaters and 2.000 physicians employed) •Affiliations and collaborations with prestigious medical centers like; Harvard Medical International, Johns Hopkins Medicine International, Mayo Clinic, Houston Memorial, Sloan-Kettering Cancer Centre… •Turkey has capabilities & Expertise in high level medicine including Liver, Kidney and Pancreas Transplantations, Robotic Surgery, Bone Marrow Transplantations, Cardiology and Cardiovascular Surgery… Anadolu 40 1,8 USA 0,7 30 4,76 5.18 0,6 0,6 20 10 . 0 < 35 age 98 35-37 years 38-40 years 41-42 years > 42 years 100 Source: SART https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0 98 99,4 Conclusion 97 97,3 (1, 2) http://www.cdc.gov/nhsn/PDFs/dataStat/NHSN-Report_2010-Data-Summary.pdf (3) http://www.qualitymeasures.ahrq.gov/content.aspx?id=27680 (4) http://www.qualitymeasures.ahrq.gov/content.aspx?id=38513 (5, 6, 7) http://www.baptisthealthmadisonville.com/quality-indicators-data Source: Turkey Statistics Agency – TUIK Data Bank http://www.tuik.gov.tr/ 50 Cost of medical services in Turkey is only about 30% of the costs in Western Europe and the USA but the high demand for IVF services is not due to cost-advantage only; the success rate of IVF is found to be higher in Turkey than in the USA. Therefore, after correcting for the success rate, the cost-advantage per successful case becomes even higher. Over the last few years, quality indicators of Turkish hospitals (especially accredited ones) are showing significant improvements implying that Turkey is moving towards creating significant comparative advantage in medical tourism. Competitiveness of Anadolu Hospital (case study) •209 bed, 59 ICU bed capacity, •136 doctors (internationally experienced and English speaking) 384 nurses. •36.336 total inpatient, 136.997 outpatient visit, 3358 surgeries (2011), •On campus hotel for medical tourism patients and dedicated International Patient Department, •Joint Commission International (JCI) accredited and Johns Hopkins Medicine affilied •ESMO-European Society for Medical Oncology (Certificate of Excellence) •Integrated Management System ISO 9001-2008, ISO 14001-2004, OHSAS 18001-2007, An embryology lab with advanced technologies. Chief of IVF department is an American Board of Obstetrics and Gynecology certificated and USA IVF licenced Yale University professor. Team is composed of experienced and English speaking members.) References BIRDAL, Erginer, Medical Tourism Research 2011, Ministry of Health of Turkey, 2011 INHORN M.C, GÜRTIN Z.B, Infertility and Assisted Reproduction in the Muslim Middle East: Social, Religious, and Resource Considerations FVV in ObGyn, 2012, MOnOGraph: 24-29 KOVACS P, Seeking IVF Abroad: Medical Tourism for Infertile Couples. Medscape. Jun 14, 2010.) SAROJINI N, MARWAH V, SHENOI A, Globalisation of birth markets: a case study of assisted reproductive technologies in India Globalization and Health 2011, 7:27 TRAM Tourism Research and Marketing Report on Medical Tourism (http://www.tramresearch.com/MedicalTourism.PDF) (06.12.2012) YILDIRIM, R Turkish Accredited Hospital Association Presentation, Medical Tourism in Turkey, March 1213, 2010 – Chicago, http://www.medicaltourisminturkey.org/docs/Day1S2RusenYildirim.pdf (06.12.2012)

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