M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1
Medical Tourism Climate
Survey 2011
Conducted for the Euro...
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Contents
1. Contents ........................................
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1. Executive summary
 This is the second Medical Tourism ...
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months. This figure was over 50% in 2010.
 Respondents ar...
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2. Methodology
Those who were invited to attend the Europe...
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3. About the respondents and their organisation
Location o...
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Services provided by the organisation
Dental treatment, co...
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Size of business
The survey reflects the fragmented and “s...
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Number of medical tourists handled
Over one third of the r...
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4. Medical tourism facilitators
The following questions ...
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5. Services provided to medical tourists
Range of servic...
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Information provided to patients
The majority of respond...
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6. Trends in the organisation’s business
Number of medic...
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Source of patients
The top ten sources of medical touris...
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Future business situation
Only one respondent thinks the...
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7. The medical tourism market
Historic market trends
17%...
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Where will market growth occur?
Respondents are most opt...
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Section 9 provides a list of additional comments on prob...
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Factors believed to be important to medical tourists in ...
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8. European issues
Understanding of the European Union D...
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Key tasks and role for the European Cross-Border Healthc...
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9. Detailed results
For questions where detailed data is...
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Spain 3.1%
Sweden 0.5%
Switzerland 1.0%
Syria 0.5%
Taiwa...
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Questions for medical tourism facilitators and agents on...
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Zimbabwe 2
Bahamas 1
Czech Republic 1
France 1
Ireland 1...
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United Kingdom 3
Uruguay 3
El Salvador 2
Saudi Arabia 2
...
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Accreditation and codes of practice
25% of the responden...
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Argentina 5
Libyan Arab Jamahiriya 5
New Zealand 5
Alban...
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The medical tourism market
Growth by sector
How do you t...
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 Direct business between patients & hospitals
 The rea...
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adversity Political intervention Would be professional a...
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 The market will rationalize and de-layer as it matures...
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 Marketing of new medical technologies, minimize the pr...
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Factors important to medical tourists
What factors do yo...
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Malaysia 12
United Kingdom 12
China 10
Spain 10
Russian ...
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Organisations completing the survey
AC Lotus Spa
Adana H...
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Green Tourism Limited Saudi Commission for Tourism & Ant...
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10. Who to contact
For further information about Interna...
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Medical Toursim survey report final

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Medical Toursim survey report final

  1. 1. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 Medical Tourism Climate Survey 2011 Conducted for the European Medical Travel Conference 2011 Barcelona, Spain 27th - 29th April 2011 www.imtj.com © Intuition Communication Ltd 2011
  2. 2. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 Contents 1. Contents .................................................................................................................................................... 1 2. Executive summary.................................................................................................................................... 3 3. Methodology ............................................................................................................................................. 5 4. About the respondents and their organisation......................................................................................... 6 5. Medical tourism facilitators..................................................................................................................... 10 6. Services provided to medical tourists ..................................................................................................... 11 7. Trends in the organisation’s business ..................................................................................................... 13 8. The medical tourism market ................................................................................................................... 16 9. European issues....................................................................................................................................... 20 10. Detailed results........................................................................................................................................ 22 About the respondent’s organisation................................................................................................. 22 Questions for medical tourism facilitators and agents only............................................................... 24 The organisation’s business: Source of business................................................................................ 27 The medical tourism market............................................................................................................... 29 Problems and challenges: Other comments....................................................................................... 29 11. Who to contact..................................................................................................................................... 38
  3. 3. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 1. Executive summary  This is the second Medical Tourism Climate Survey run by IMTJ in conjunction with EMTC.  The Medical Tourism Climate Survey 2011 examines current activities, market and business growth, current challenges and opportunities in the medical tourism sector. The research was funded by International Medical Travel Journal and was conducted online using the SurveyMonkey system.  182 individuals completed the survey, representing organisations in 47 different countries. The USA, India, Turkey, UK and Spain were the most highly represented in the sample. A wide variety of organisation types were represented: 34.3% of respondents worked for medical tourism agencies and facilitators, 21.7% for hospitals, and 9.8% for consultancy businesses.  52.9% of respondents have been in business for more than two years. Around 30% have been in business for less than one year – this has increased from around 20% in 2010.  Dental treatment, cosmetic surgery and orthopaedic surgery were the most common services provided by the participating organisations.  The survey sample reflects the fragmented and “small business” nature of the medical tourism sector and its recent development. More than 60% of the organisations employ less than five people. Over one third of the respondents, handled less than 50 medical tourists last year. 15% handle more than 500 medical tourists per year. 52% of the organisations have been in business for more than two years. Around 32% have been in business for less than one year.  According to medical tourism facilitators, the leading destinations for medical tourists are India, Thailand, Costa Rica, Turkey and Mexico, with Costa Rica seeing a notable increase since 2010. Countries considered to provide the best overall service to patients are India, Thailand, Germany, Singapore and Turkey.  The respondents predicted that India, Thailand and Turkey would be the leading destinations in five years time, with Turkey seeing the biggest increase in support from 2010.  Although extensive services are provided for medical tourists in destination countries, pre travel and post treatment follow up is far less common. English, German and French are the most commonly supported languages within the destination countries.  The majority of respondents say that they provide clinician profiles, post discharge questionnaires, and infection rate data to some or all patients. Only 31% provide a written guarantee.  In contrast to last year, nearly two thirds of respondents report growth of over 10% in their medical tourism business over the last 12 months. The figure was just over a third in 2010, so there is some indication of recovery in the sector.  Respondents are more confident about future business prospects. Only 15.4% expect their throughput of medical tourists to decline or remain the same.  The USA, UK and Germany are seen as the leading sources of medical tourists.  Respondents have a much more optimistic view of the current medical tourism market than last year with only 17% believing that the market had declined or remained static over the last twelve
  4. 4. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 4 months. This figure was over 50% in 2010.  Respondents are also optimistic about the next twelve months, with 77.7% believing that the market will grow.  Marketing issues and competition are seen as the major problems facing organisations involved in medical tourism.  Adoption of the European Directive on Cross-border Healthcare, medical tourists making treatment choices based on quality rather than price and major tourism and travel companies entering the medical tourism market are seen as the most significant future trends.  Expertise and qualifications of the doctor/dentist, comments and ratings by other patients, fluency in the patient's language and standard of hospital accommodation are all seen as more important factors in patient choice than low cost, although 82% still this is important or very important.  Respondents have marginally less understanding of the Directive than last year, with 63% saying they have little understanding. Nevertheless 75% of respondents believe the Directive will increase the number of medical tourists.  Cooperating with other international organizations in improving the quality of cross-border healthcare services and assisting in the implementation of quality standards as seen as the most important tasks for the European Cross-Border Healthcare Organization (ECHO), although at least 60% of respondents deemed all of the issues listed as important or very important.
  5. 5. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 5 2. Methodology Those who were invited to attend the European Medical Travel Conference 2011 and subscribers to the e-newsletter for the International Medical Travel Journal (IMTJ) were asked to complete an online medical tourism climate survey to assess their current views on:  Market and business growth  Current challenges  Future opportunities 182 individuals completed the survey. To encourage participation, respondents were offered a free copy of the survey analysis. The survey was conducted online using the SurveyMonkey survey system. The research was funded by International Medical Travel Journal. Results Full details of the results are provided in Section 9 of this document. Sections 2 to 8 provide a summary of the survey results.
  6. 6. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 6 3. About the respondents and their organisation Location of respondents The 257 respondents represented organisations in 55 different countries. The USA (13.6%), India (12.3%), Turkey (5.8%), UK (5.2%) and Spain (4.5%) were the most highly represented in the sample. See Section 9 for the full list of countries represented in the sample. Organisation type A wide variety of organisation types were represented. 34.3% of respondents worked for medical tourism agencies and facilitators, 21.7% for hospitals, and 9.8% for consultancy businesses.
  7. 7. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 7 Services provided by the organisation Dental treatment, cosmetic surgery and orthopaedic surgery were the most common services provided by the participating organisations. Membership of medical tourism associations 19% of the organisations mentioned that they held memberships of various medical tourism associations. See Section 9 for a full breakdown. Time in business 52.9% of respondents have been in business for more than two years. Around 30% have been in business for less than one year – this has increased from around 20% in 2010.
  8. 8. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 8 Size of business The survey reflects the fragmented and “small business” nature of the medical tourism sector, particularly if we exclude from the analysis the hospital facilities where there are large numbers of employees. Number of staff More than 60% of the organisations employ less than five people. Less than 15% of the organisations employ more than 20 people. Amongst medical tourism facilitators, the figure is only 2.1% (9% less than in 2010).
  9. 9. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 9 Number of medical tourists handled Over one third of the respondents, handled less than 50 medical tourists last year. 15% handle more than 500 medical tourists per year (down from 22% in 2010).
  10. 10. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 0 4. Medical tourism facilitators The following questions were asked only of medical tourism facilitators and intermediaries. Most popular destinations for patients via medical tourism facilitators The top ten most popular destinations mentioned by facilitators were as follows. (See Section 9 for scoring methodology and detailed analysis). Country Score India 28 Thailand 23 Costa Rica 19 Mexico 18 Turkey 16 Germany 15 United States 12 United Kingdom 11 Singapore 9 Australia 8 The most notable inclusion in the top ten is Costa Rica which scored only 5 in 2010. Countries providing the best overall service to patients as rated by medical tourism facilitators The top ten countries rated on service level by facilitators were as follows. (See Section 9 for scoring methodology and detailed analysis). Country Score India 37 Thailand 29 Germany 16 United States 15 Singapore 12 Turkey 12 Costa Rica 11 Mexico 11 Cyprus 8 Argentina 6
  11. 11. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 1 5. Services provided to medical tourists Range of services Extensive services are provided in the destination country. Pre travel and post treatment follow up is far less common. Languages supported English, German and French are the most commonly supported languages within the destination countries.
  12. 12. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 2 Information provided to patients The majority of respondents say that they provide clinician profiles, post discharge questionnaires, and infection rate data to some or all patients. Only 31% provide a written guarantee. Information Information provided Doctor/clinician profiles 84.0% Post discharge questionnaire 78.3% Infection rate data 65.4% Written treatment guarantee 31. 0% Accreditation and certification standards Respondents were asked “What forms of accreditation and certification does your organisation hold?” and provided with a list of standards related to medical tourism. The vast majority of respondents skipped the question. JCI (55.6%), the Treatment Abroad certification (27.8%) and USA MTA certification (16.7%) were the most commonly mentioned by those who responded. A detailed breakdown is provided in Section 9.
  13. 13. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 3 6. Trends in the organisation’s business Number of medical tourists using their services over the last twelve months In contrast to last year, nearly two thirds of respondents report growth of over 10% in their medical tourism business over the last 12 months. The figure was just over a third in 2010. Around 37.2 have seen no growth or a decline. Number of medical tourists expected over the next twelve months Respondents are confident about future business prospects. Only 15.4% expect their throughput of medical tourists to decline or remain the same.
  14. 14. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 4 Source of patients The top ten sources of medical tourists were ranked as follows. (See Section 9 for scoring methodology and detailed analysis). Country Score United States 98 United Kingdom 90 Germany 38 Russian Federation 32 Canada 25 Iraq 21 Australia 19 Netherlands 14 France 13 Nigeria 12 Current business situation Nearly half of respondents state that their current business situation is good or very good. 39% state that it is satisfactory. 19% consider it to be poor or very poor.
  15. 15. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 5 Future business situation Only one respondent thinks their business situation will deteriorate over the next twelve months. 15% expect it to remain the same. 84% believe it will be better or much better.
  16. 16. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 6 7. The medical tourism market Historic market trends 17% believe that the market has declined over the last twelve months. 20% believe that it has remained static. 63% believe that the market has grown. This is a much more optimistic view than in 2010, where only 44% believed it had grown. Future market trends Respondents are also optimistic about the next twelve months, with 77.7% believing that the market will grow. 7.5% believe that the market will decline over the next twelve months and 14.8% believe it will remain static.
  17. 17. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 7 Where will market growth occur? Respondents are most optimistic about the cosmetic surgery and infertility treatment markets, followed by cardiac surgery and dental treatment. Transplants, rehabilitation and addiction treatment are seen as the least promising markets in terms of growth. (A breakdown of percentages is provided in Section 9). Main problems and challenges facing the organisation Marketing issues and competition are seen as the major problems facing organisations involved in medical tourism.
  18. 18. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 8 Section 9 provides a list of additional comments on problems and challenges facing the organisation. In summary, these embrace:  Increases in local/domestic competition  Lack of sales and marketing expertise  Lack of useful data  Local cultural/political factors Key issues facing the medical tourism sector Verbatim comments were submitted by respondents. A full listing of comments is provided in Section 9. In summary, these comments embrace:  Increasing competition  Lack of coordination and integration within the industry  Lack of quality standards and international standards  Lack of transparency  Lack of understanding of industry by patients  Poor marketing  Product and service differentiation Trends and changes over the next five years Adoption of the European Directive on Cross-border Healthcare, medical tourists making treatment choices based on quality rather than price and major tourism and travel companies entering the medical tourism market are seen as the most significant future trends. (A breakdown of percentages is provided in Section 9).
  19. 19. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 1 9 Factors believed to be important to medical tourists in service choice Expertise and qualifications of the doctor/dentist, comments and ratings by other patients, fluency in the patient's language and standard of hospital accommodation are all seen as more important factors in patient choice than low cost, although 82% still this is important or very important. (A breakdown of percentages is provided in Section 9). The leading destinations in five years time The respondents identified the following countries as the top ten destinations in five years time. (See Section 9 for scoring methodology and detailed analysis). The top 10 is mostly the same as last year with the addition of Turkey, which scored only 17 in 2010. Country Score India 100 Thailand 66 Turkey 37 United States 37 Singapore 32 Germany 30 Hungary 30 Costa Rica 29 Mexico 23 Poland 16
  20. 20. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 0 8. European issues Understanding of the European Union Directive on Patient Mobility Respondents have marginally less understanding of the Directive than last year, with 63% saying they have little understanding. Impact of the European Union Directive Despite the lack of understanding, 75% of respondents believe the Directive will increase the number of medical tourists – up from 63% in 2010.
  21. 21. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 1 Key tasks and role for the European Cross-Border Healthcare Organization (ECHO) Cooperating with other international organizations in improving the quality of cross-border healthcare services and assisting in the implementation of quality standards as seen as the most important tasks for ECHO, although at least 60% of respondents deemed all of the issues listed as important or very important.
  22. 22. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 2 9. Detailed results For questions where detailed data is not provided in the previous sections, it is provided here. About the respondent’s organisation Location In what country is your organisation located? Answer Options Response Percent Argentina 0.5% Australia 2.6% Austria 0.5% Belgium 1.0% Brunei 1.0% Bulgaria 0.5% Cambodia 0.5% Canada 0.5% Colombia 0.5% Costa Rica 1.5% Croatia 2.1% Cyprus 0.5% Czech Republic 1.0% Denmark 0.5% Egypt 0.5% Ethiopia 0.5% France 0.5% Germany 3.6% Greece 0.5% Guatemala 0.5% Hong Kong 0.5% Hungary 6.2% Iceland 0.5% India 8.2% Indonesia 0.5% Ireland 0.5% Israel 2.6% Jamaica 0.5% Japan 1.0% Jordan 1.0% Latvia 0.5% Lebanon 1.0% Malaysia 4.6% Mexico 2.1% New Zealand 1.5% Philippines 3.6% Poland 0.5% Portugal 0.5% Saudi Arabia 0.5% Singapore 0.5% South Africa 1.0% South Korea 1.5%
  23. 23. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 3 Spain 3.1% Sweden 0.5% Switzerland 1.0% Syria 0.5% Taiwan 2.6% Thailand 3.6% Turkey 5.7% Ukraine 0.5% United Kingdom 7.2% United States 14.4% Uruguay 0.5% Vietnam 0.5% Yugoslavia 0.5% Membership of organisations Are you a member of an association related to medical tourism: Answer Options Response Percent Yes 19.0% No 81.0% Breakdown of the organisations The following organisations were mentioned by the 29 individuals who claimed membership. Is your organisation a member of any of the following associations and organisations? Answer Options Response Count Asian Medical Tourism Association 9 Association for Medical Tourism Development in Croatia 0 Association of Improving Health Tourism (Turkey) 2 Association of Leading Hungarian Dental Clinics 2 Baja California Medical Tourism Association (BCMTA) 1 Council on the Global Integration of Healthcare 4 European Medical Tourism Alliance EuMTA 6 Indian Medical Travel Association 6 International Medical Spa Association 0 International Spa Association 1 International Wellness and Healthcare Travel Association (IWHTA) 3 Israel Medical Tourism Association 2 Medical Tourism Association (USA) 25 Medical Tourism Association of South Africa 3 Medical Tourism Association of Turkey 1 Medical Travel Quality Alliance 5
  24. 24. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 4 Questions for medical tourism facilitators and agents only Most popular destinations This question was weighted according to ranking as first, second or third preference. Thus a country ranked as first preference, scored 3 points, a country ranked as second preference scored 2 points and a country ranked third scored 1 point. Which three countries are the most popular destinations for your patients? Country Score India 28 Thailand 23 Costa Rica 19 Mexico 18 Turkey 16 Germany 15 United States 12 United Kingdom 11 Singapore 9 Australia 8 Argentina 8 Canada 7 Cyprus 7 South Korea 7 Malaysia 6 Hungary 6 Jordan 4 China 3 Algeria 3 Bangladesh 3 Brazil 3 Colombia 3 Congo, The Democratic Republic of the 3 Iran 3 Latvia 3 Lebanon 3 New Zealand 3 Poland 3 Spain 3 Taiwan 3 Uruguay 3 Bhutan 2 Brunei 2 El Salvador 2 Estonia 2 Finland 2 Greece 2 Morocco 2 Portugal 2 Saudi Arabia 2 South Africa 2
  25. 25. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 5 Zimbabwe 2 Bahamas 1 Czech Republic 1 France 1 Ireland 1 Israel 1 Mozambique 1 Nepal 1 Panama 1 Philippines 1 Sweden 1 United Arab Emirates 1 Destinations with the best service This question was weighted according to ranking as first, second or third preference. Thus a country ranked as first preference, scored 3 points, a country ranked as second preference scored 2 points and a country ranked third scored 1 point. Which three countries overall do you think provide the best OVERALL service for your patients? Country Score India 37 Thailand 29 Germany 16 United States 15 Singapore 12 Turkey 12 Costa Rica 11 Mexico 11 Cyprus 8 Argentina 6 Australia 6 Poland 6 South Africa 6 Jordan 5 Malaysia 5 South Korea 5 Canada 4 Israel 4 Bangladesh 3 Belgium 3 Colombia 3 France 3 Hungary 3 Iran 3 Latvia 3 Lebanon 3 Lithuania 3 Morocco 3 Taiwan 3
  26. 26. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 6 United Kingdom 3 Uruguay 3 El Salvador 2 Saudi Arabia 2 Sri Lanka 2 Bahamas 1 China 1 Czech Republic 1 Dominican Republic 1 Greece 1 Japan 1 Panama 1 Philippines 1 United Arab Emirates 1 Post discharge questionnaire International patients are asked to complete a post charge questionnaire providing feedback on their stay: Answer Options Response Percent Yes 78.3% No 21.7% Provision of doctor profile We provide the patient with a detailed profile or career history of the doctor/surgeon/dentist who will treat them: Answer Options Response Percent Yes 84.0% No 16.0% Information to patients The following information is made available to patients: Answer Options Yes No Hospital/clinic post operative infection rates 65.4% 34.6% Success rates and outcome data 73.1% 26.9% Provision of guarantee to patient Do you provide a written guarantee to patients regarding their surgery or treatment? Answer Options Response Percent Yes 31.0% No 69.0%
  27. 27. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 7 Accreditation and codes of practice 25% of the respondents mentioned one of the accreditation or codes of practice in the suggested list. Here is an analysis of the 36 that claimed membership of one of these: What forms of accreditation and certification does your organisation hold? Tick any that apply. Answer Options Response Percent Joint Commission International 55.6% Treatment Abroad Code of Practice for Medical Tourism 27.8% Medical Tourism Association (USA) Certification 16.7% Australian Council on Healthcare Standards 5.6% CHKS (UK) 2.8% The organisation’s business: Source of business Source of medical tourism patients by country This question was weighted according to ranking as first, second or third largest source of patients. Thus a country ranked first, scored 3 points, a country ranked second preference scored 2 points and a country ranked third scored 1 point. Which three countries are the biggest source of patients for you? Country Score United States 98 United Kingdom 90 Germany 38 Russian Federation 32 Canada 25 Iraq 21 Australia 19 Netherlands 14 France 13 Nigeria 12 Saudi Arabia 12 United Arab Emirates 10 Azerbaijan 9 Indonesia 9 Ireland 9 Italy 9 Austria 8 China 7 Bangladesh 6 Cyprus 6 Lebanon 6 Malaysia 6 Sudan 6 Ukraine 6 Afghanistan 5
  28. 28. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 8 Argentina 5 Libyan Arab Jamahiriya 5 New Zealand 5 Albania 4 Israel 4 Mexico 4 Mongolia 4 Norway 4 Yemen 4 Algeria 3 Brazil 3 Guam 3 India 3 Japan 3 Morocco 3 Romania 3 Spain 3 Swaziland 3 Switzerland 3 Syria 3 Yugoslavia 3 Zimbabwe 3 Bahrain 2 Belgium 2 Bhutan 2 Bulgaria 2 Cayman Islands 2 Chad 2 Congo, The Democratic Republic of the 2 Finland 2 Georgia 2 Hong Kong 2 Hungary 2 Iran 2 Kuwait 2 Malawi 2 Mozambique 2 Oman 2 Singapore 2 Sri Lanka 2 Sweden 2 Thailand 2 Trinidad and Tobago 2 Venezuela 2 Brunei 1 Costa Rica 1 Maldives 1 Namibia 1 Palestine 1 Turks and Caicos Islands 1 Vietnam 1
  29. 29. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 2 9 The medical tourism market Growth by sector How do you think these medical tourism sectors will grow over the next five years, in terms of medical tourist numbers? Answer Options Significant decline Decline No change Growth Significant growth Addiction treatment 0.0% 3.7% 46.9% 43.2% 6.2% Cancer treatment 0.0% 4.3% 22.6% 57.0% 16.1% Cardiac surgery 0.0% 3.3% 14.1% 67.4% 15.2% Cosmetic surgery 0.0% 2.3% 12.5% 54.6% 30.7% Dental treatment 0.0% 2.3% 18.0% 51.7% 28.0% Eye surgery 1.1% 3.4% 27.0% 51.7% 16.9% Infertility treatment 1.1% 0.0% 15.7% 60.7% 22.5% Medical spa treatment 1.2% 3.5% 30.6% 44.7% 20.0% Obesity surgery 2.3% 3.4% 23.9% 54.6% 15.9% Orthopaedic surgery 0.0% 3.3% 30.4% 53.3% 13.0% Rehabilitation 0.0% 9.3% 39.5% 41.9% 9.3% Stem cell treatment 0.0% 1.1% 24.7% 52.8% 21.4% Transplants 1.1% 6.7% 35.6% 41.1% 15.6% Problems and challenges: Other comments  Lack of comparative quality data from a recognized authority on international vs. American hospitals  The market is crowded with providers that are unable to fulfil consumer expectations making for poor reputation, confusing options and poor customer experience. In many nations, the sector has become overly political, with economic development agencies providing poor guidance to the marketing efforts of medical providers. Overall, too much talk, too few real budgetary commitments and ignorance tends to rule the sector. 98% of stakeholders are simply waiting for the revenue flood gates to open, while they have no clue how to create or service demand for the service.  No understanding how to market, no budgets for marketing, weak country brands, political unrest  Medical travel has yet to go mainstream in the US. it's a cultural issue which will change for good, very soon  Finalizing package pricing inclusive of all costs.  You should have included internal price decrease. In the UK prices are not 30-50% lower than 3 years ago. No price gap = no medical tourism  Actionable data.  Lack of a universal accreditation platform  Earthquake  Lack of support from Governments
  30. 30. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 0  Direct business between patients & hospitals  The real issue here is the marketing skills from the medical partners, they are superb in medical services but lack the expertise in marketing and sales.  Increased competition in the health tourism market on behalf of those are unqualified & indign.  Political situation of the country  Jordicure works on getting patients to Jordan; and for western patients, Jordan is mistakenly assumed to be like the rest of the middle east in terms of safety and openness. Future trends What new trends or changes do you think are likely to take place in the medical tourism in the next five years? Answer Options Very Unlikely Unlikely Likely Very likely The European Directive on Cross-border Healthcare will be implemented 2.1% 15.6% 67.7% 14.6% European governments will introduce regulation and licensing of medical travel agencies and facilitators 2.1% 30.9% 56.4% 10.6% Pricing levels in the medical tourism market will fall 4.1% 56.1% 33.7% 6.1% Medical tourists will make treatment choices based on quality rather than price 2.9% 15.4% 61.5% 20.2% Major tourism and travel companies will enter the medical tourism market 2.0% 20.2% 59.6% 18.2% A significant increase in legal cases whereby medical tourists sue healthcare providers in other countries 7.1% 38.4% 46.5% 8.1% The significant adoption of e-health and electronic patient records in medical tourism 5.0% 17.0% 55.0% 23.0% Key issues facing the medical tourism market  Good quality services abroad together with lower prices unique procedures performed abroad better knowledge due to promotion of healthcare providers  Post operative treatment follow-up and pricing.  Good quality service at a reasonable price compared to Europe and the USA  Easy access to all information!  Lack of information -lack of synchronization - uncertainty  Lack of comparative quality data FROM A RECOGNIZED AUTHORITY on international vs. American hospitals  Operator expertise Provider's understanding of the business process Provider's fiscal risk
  31. 31. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 1 adversity Political intervention Would be professional associations that contribute for over rated hype, unreal expectation and zero value  Hospital in India need to gear up for providing much better service standard & cost effective realistic treatment cost packages. The hospitals should be more transparent in terms of billing & information provided to patients pertaining to treatment.  US domestic medical tourism is growing...will impact outbound market  Accreditation  Unprofessional marketing, poor providers giving industry bad reputation, no marketing budget, concentration on conferences only. Too much talk, less action!  Patients have difficulty making a decision due to lack of factual information.  Lack of demand lack of understanding of medical travel  Patients are very price-sensitive, so accreditations don't matter -a lot of unprofessional players are giving it a bad image -US doctors are talking patients against it.  Coordination of providers to provide consistency of care from beginning to end.  Competition  Lack of marketing budgets and lack of sufficient resources for growth.  Legal cases, regulations and licensing  Patient or/and relative of patients are unaware about the medical tourism. People need to be educated about the good and bed things about medical tourism.  Scepticism in the market as to safety and reliability.  Problems with providing guarantees and post services in country of origin Some facilitators do not care about the quality of providers making bad opinion about the industry at the same time  Learning to "sell" services on quality rather than cost. Making sure providers are providing the information patient want rather than what they think they want. Increasing patient safety and corporate transparency.  Lack of regulation. Safety, insurance, protection  Taking about the patient after the surgery in his homeland.  Have real Information about the activity in order to compare same things wherever  Lack of information about the credibility of the medical tourism service providers  Mechanics of major health insurance providers, speed and quality of change (specially in EU) - State/governmental social and health insurance directives - Holistic approach (prevention, treatment and lifestyle awareness programs) - Marketing trust  Perception of low prices = poor quality  Regularisation, licensing, streamlining, auditing, opening up of the sector  The need for positive press and image for high quality services in safe environments.
  32. 32. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 2  The market will rationalize and de-layer as it matures, forcing out smaller, less sophisticated players.  Lack of a universal accreditation platform.  Harmonisation of medical tourism regulation in all countries and insurance involvement in the field.  Disjointed efforts and image perception  Lack of technical promotional activities with a good budget  A lack of professionalism, infrastructure, strategic planning  Legislation  One of the key issues facing medical tourism is the lack of awareness in the developing countries, this is what we journalists writing tourism are trying to correct by educating the people about the importance and where they can get the best treatment in the world  It is still risky for the patients because the lack of standards and follow up circumstances.  Service providers should adopt to greater demand with better services and more comprehensive packages  Cost of travel, safety  Insurance not covered across international boundaries. Most have to come from out of pocket expenses. Need to improve on this as it is a potential area to expand growth in all countries providing health tourism at a larger scale. Need to also set criteria namely hospital that has an international accreditation certification as one of the requirements for insurers to get treatment abroad.  Medical Tourism does exist but it is only a very small industry and does concern only a minority of medical travellers for small medical procedures. What really this industry should be called is Medical Travel because no patient travelling for major procedures such as Orthopaedic, Bariatrics, Plastic, Cardiac etc. is interested in Tourism after their surgery...  Credibility Cohesive Collective Market Proposition Accurate Interpretative Research  At the moment there are too many unprofessional used by the hospitals abroad for marketing their facilities giving some commission, many travel agents guide with no proper knowledge of hospitals or treatment facilities. Many hospitals open up clinics and hospitals to refer patients exclusively to their main hospitals abroad.  Lack of proper understanding (for providers) lack of information (for patients)  Lack of networking  High competition  Pre and post treatment in origin country and e-health, in addition marketing efforts.  International Regulatory Structure and Transparency *in some countries  Cultural issues - ethical issues  Liability insurance
  33. 33. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 3  Marketing of new medical technologies, minimize the procedures (quick service), keep the low price with high quality & maintaining the relationship with partner medical tour agencies  Trust in foreign medical competence.  Good job much better  Marketing  Medical partners are not willing to pay commissions to facilitators, therefor this entire group will struggle and many will disappear. This will only mean a small decline, since facilitators only bring at most 10% of the patients. Too many medical clinics are popping up, resulting in a lower quality services and price. We are glad not to be in this part of the industry any more.  Competition, accreditation of medical tourism providers, indemnification for complications  Need for culture building in the field of pay attention to quality.  Marketing and promotion in the international market  Clear PATIENTS records - enough medical information on PATIENTS situation - prices variation - complication coverage - PATIENTS rights  Reliable information for medical tourists with regards to the assurance of the quality of the service they will receive.
  34. 34. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 4 Factors important to medical tourists What factors do you think are important to medical tourists when they choose a healthcare facility or treatment provider abroad? Answer Options Not at all important Not important Neutral Important Very important Expertise and qualifications of the doctor/dentist 0.00% 2.80% 0.93% 28.04% 68.22% Comments and ratings by other patients 0.00% 0.96% 6.73% 50.00% 42.31% Fluency in the patient's language 0.93% 1.85% 8.33% 57.41% 31.48% Standard of hospital accommodation 0.00% 1.87% 14.95% 61.68% 21.50% Low cost 0.92% 2.75% 14.68% 52.29% 29.36% Distance (Travel time to the destination) 1.82% 3.64% 16.36% 52.73% 25.45% Hospital/clinic accreditation 0.00% 1.87% 22.43% 39.25% 36.45% Clinical outcome data 0.99% 4.95% 20.79% 47.52% 25.74% Provision of concierge services (drivers, patient liaison staff) 0.95% 5.71% 21.90% 55.24% 16.19% Post operative infection rates 1.94% 10.68% 16.50% 50.49% 20.39% Pre –treatment and post-treatment services in the patient's own country 0.94% 3.77% 26.42% 44.34% 24.53% A written guarantee 0.94% 9.43% 40.57% 34.91% 14.15% Leading destinations in next five years Which three countries do you think will be the leading medical tourism destinations in 5 years time? Country Score India 100 Thailand 66 Turkey 37 United States 37 Singapore 32 Germany 30 Hungary 30 Costa Rica 29 Mexico 23 Poland 16 United Arab Emirates 14 Brazil 13
  35. 35. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 5 Malaysia 12 United Kingdom 12 China 10 Spain 10 Russian Federation 9 Switzerland 9 Argentina 6 South Korea 6 Czech Republic 5 Israel 5 Jordan 5 France 4 Panama 4 South Africa 4 Bangladesh 3 Barbados 3 Belgium 3 Belize 3 Cambodia 3 Cyprus 3 Greece 3 Netherlands 3 Philippines 3 Taiwan 3 Bosnia and Herzegovina 2 Iran 2 Japan 2 Kenya 2 Lebanon 2 Morocco 2 Norway 2 Saudi Arabia 2 Austria 1 Bahamas 1 Cayman Islands 1 Colombia 1 Italy 1 Lithuania 1 Pakistan 1 Qatar 1 Romania 1 Slovakia 1 Sweden 1 Ukraine 1 Uruguay 1 Zimbabwe 1
  36. 36. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 6 Organisations completing the survey AC Lotus Spa Adana Health Tourism Associates Lufthansa AMIL MaksLoyd International Group S.A.L. Angels Global Healthcare Malaysian Society for Quality in Health (MSQH) ARC Europe SA Mansfield Health practice Asiser (Asisa Servicios) Max Healthcare, INDIA Assuta medical center Med and health Sci Ctr, Section Medical Tourism Australia Health Tourism Med2Heal oHG Bangkok Adventist Hospital MediBid Barcelona Medical Center Medical & Wellness Tourism Worldwide Bayındır HealthCare Group Medical Tourism Training Inc. Beverly Hills 6750 Multi-Specialty Aesthetic Institute Medicare Europe Bexleyheath dental Practice MEDICHOL AUSTRALIA BioResMed International MediTour Expo Bonanza Portfolio Ltd MediTravel Solutions Bumrungrad International MediTrip Advisor Canary Surgical Holidays MedRehab Division, Four Seasons Plc. Carolina Medical Center MedSave USA, Inc. CLALIT HEALTH SERVICES Medtral Inc Clínica CIMA Memorial Healthcare Group, Turkey Companion Global Healthcare mhctc Congress Corporation Ministry of Health Cosmetic & Dental Centre Turkey Ministry of Health Turkey Cosmetic&PlasticSurgery MIRAME Natural Dentist CPR Communications MONDIAL ASSISTANCE TURKEY CPR Strategic Marketing Communications Mosfellsbaer Municipality Cracow Medical Tourism/ Trip4Treatment Mpeiria Group Custom Assurance Placements MTA Greece Cyprus Health Services Promotion Board MTA Poland Cyprus Sun Med Connections MyWellcard Pte Ltd De Vere Travelcare NABH delhi medical tourism pvt ltd National Heart Institute, Kuala Lumpur Dental Assistance Hungary National Taiwan Normal University Dental Implant Center Hungary NEWS STAR NEWSPAPER Dental Implant Institute NIR Placement Center, Inc. Dental Palermo NMC Healthcare DENTAN Nordmed Tour ltd DentistAbroad Pantai Hospital Ayer Keroh Department of Health (UK) Pattaya International Hospital Doctors Hospital, Nassau, Bahamas Peritus Assistance Dr Mehta's Hospitals Pillango (Butterfly) Dentistry Dunya Eye Hospital group / World Eye Hospital PKD Hospitals East Town Travel planethospital Ebru Gurel Plenitas FertilityCareSA Prague Fertility Centre First Dr. Asia Previously Angelis, now consultant for Sure Insurance Florida Intl University Prime Consultancy Forest& Ray Dental Practice promed consultancy Fortis Healthcare Limited PT Blue Dot Assistance GIPEIT Reid's Palace Hotel GoAbroad.com (HealthcareAbroad) Rex Clinic Grand Resort Bad Ragaz Salamat Seir Asia Agency
  37. 37. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 7 Green Tourism Limited Saudi Commission for Tourism & Antiquities Health Check Costa Rica scta health devives and consulting Self employed Health Travel Technologies SenaCare LLC healthCare cybernetics L.L.C. Shosholoza Medical Travel & Tourism Healthspan international sikkim manipal Heidelberg Medical Services Sluvin News Hernia Center of Southern California specialty hospital JORDAN Hessischer Heilbäderverband Spine and Pain Institute of Barcelona Holidaylink Corp SSIMS&RC Hospital Británico de Buenos Aires studio dentistico Hospital Particular do Algarve Sunway Medical Centre Hospitality in Health Surgery Getaways Housecoff Travel & Tours Sdn Bhd. T&T Executive SA HTW Target Associates ICRI (INDIA) THAILAND FOR HEALTHCARE ILAN GEVA & FRIENDS The Aga Khan University Implant Expert The Medical City Instituto Bernabeu the specialty hospital INTERNATIONAL BOARD OF MEDICINE AND SURGERY The Well Report INTERNATIONAL STEM CELL TREATMENT CENTERS GROUP Tourism Malaysia International Trigae, LLC Transparent Borders Intuition Communication Ltd Travel and Cultures Group jbara clinic TRAVEL FOR CARE Jordicure for medical tourism Travel Point LLC Jurmala City Council Turkish Airlines KHIDi Uruhealth Health & Tourism in Uruguay King Hussein Cancer Center (KHCC) Velammal Engineering College Konkuk University Medical Center Vinyl Grafik Studio - Roland DG Showroom Le Royal Hotels & Resorts We Care Health Services Leo Juventa Weekly The Industry Longevita Xellum Ltd Lotus Medical International
  38. 38. M E D I C A L T O U R I S M C L I M A T E S U R V E Y 2 0 1 1 3 8 10. Who to contact For further information about International Medical Travel Journal, the Medical Tourism Climate Survey and European Medical Travel Conference: International Medical Travel Journal Call: Keith Pollard on +44 (0)1442 817817 or mobile 07710 229102 Web: www.imtj.com Email sales@imtj.com Write: Intuition Communication Ltd 3 Churchgates Wilderness Berkhamsted Herts HP4 2UB Fax: 01442 817818 European Medical Travel Conference Call: Dr Uwe Klein on +49 89 1011 9222 or mobile +49 151 2120 8495 Write: Health Care Strategy International GmbH Feilitzschstr. 9 80802 Munich, Germany Email: chairman@emtc2011.com Web: www.emtc2011.com

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