Medical Tourism

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

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

www.yellowpages-cambodia.com/images/maps/Southeastasia
PHILIPPINESPHILIPPINES
THAILANDTHAILANDINDIAINDIA
SINGAPORESINGAPORE
MALAYSIAMALAYSIA
The Booming
MEDICAL
TOURISM

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

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

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

•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

Medical TreatmentAlternative &
Complimentary Medicine
Medical TourismWellness
Tourism
MEDICAL TOURISM, Structure
Jabarri, 2007
Health Tourism

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

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

MEDICAL
TOURISM
ConsumerConsumer
BenifitBenifit
Social IssuesSocial Issues BrandingBranding
ProductProduct
InfrastructureInfrastructureCommunicationCommunication
ChannelChannel
LegalLegal
FrameworkFramework
OperatorsOperators
Caballero, Danell & Mugomba, 2006

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

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.

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?….

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

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.

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

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)

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

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

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

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.

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.

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
 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

Connel, 2006
 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
 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

 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
 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

 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)
 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)

 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
 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

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

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

 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

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

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

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

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

Outsourcing
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

Outsourcing
Internationalization of
practices
Potential for redefining of
malpractice suits
Greater international legal
ties
Promote development of
agreements
Country Receiving
Patients
Country Sending
Patients
LEGAL

Outsourcing
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

ADVERTISEMENTADVERTISEMENTADVERTISEMENTADVERTISEMENT
TechnologyTechnologyTechnologyTechnology
QualityQuality
ReliabilityReliability
QualityQuality
ReliabilityReliability
OverseasOverseas
TrainingTraining
OverseasOverseas
TrainingTraining
KAZEMI, 2007

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
 Focus on hospitalityFocus on hospitality
 Building InfrastructureBuilding Infrastructure
KAZEMI, 2007

ASIAN COUNTRIES
INDIAINDIA
 Low-cost treatmentLow-cost treatment
 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
 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

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

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

ASIAN COUNTRIES
 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
 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

MEDICINEMEDICINE
WELLNESSWELLNESS TOURISMTOURISM

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

STANDARDS
InternationalInternational
Health CareHealth Care
AccreditationAccreditation
Evidence-Evidence-
basedbased
MedicineMedicine
QualityQuality
AssuranceAssurance

International Health Care Accreditation
 Joint Commission International (JCI)Joint Commission International (JCI)
• USAUSA

 Trent International AccreditationTrent International Accreditation
SchemeScheme
• United KingdomUnited Kingdom
• HongKongHongKong

 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

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)

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

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.
International Patient Safety Goals

The Outsourcing of Surgical
Procedures to Asia:
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

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
Procedures to Asia:

Procedures to Asia:
$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

RISKS
 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.

LEGAL & ETHICAL ISSUES
 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

GROWTH OF MEDICAL TOURISM IN THE
WORLD
Google TrendsGoogle Trends
20042004 20052005 20062006 20072007
00
Search VolumeSearch Volume

 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

Asian Medical Tourism
HOSPITALS
Samitivej Hospital, ThailandSamitivej Hospital, Thailand

HOSPITALS

 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.
(2008-2012)

HOSPITALS
Singapore National Eye Centre (SNEC)

 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.
(2008-2012)

HOSPITALS
LAKESHORE HOSPITAL, INDIALAKESHORE HOSPITAL, INDIA

 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.
(2008-2012)

HOSPITALS
ST. LUKES, MEDICAL CENTER, PhilippinesST. LUKES, MEDICAL CENTER, Philippines

HOSPITALS
Gleneagles Medical Centre Penang, Malaysia.

 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
(2008-2012)

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

Medical Tourism

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