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Thelen ST, Yoo B. The impact of country image and patient cosmopolitanism on medical tourism. Health Mark Q 2023; 40:98-118. [PMID: 36651293 DOI: 10.1080/07359683.2023.2167260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The purpose of this research is to examine the impact affective/cognitive country image, cosmopolitanism, and satisfaction with insurance have on patient willingness to go abroad for surgery. Patients are presented a scenario where they select having knee replacement surgery domestically, having to pay all co-pays and deductibles, or abroad (Mexico, India, Israel) for free surgery at a JCI certified hospital. Results indicate cosmopolitanism impacts patient perception of medical tourism whilst affective and cognitive country image exhibit varying levels of significance. This study contributes to the literature by assessing factors that impact patient likelihood to travel abroad for surgery.
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Affiliation(s)
- Shawn T Thelen
- Department of Marketing and International Business, Frank G. Zarb School of Business, Hofstra University, Hempstead, NY, USA
| | - Boonghee Yoo
- Department of Marketing and International Business, Frank G. Zarb School of Business, Hofstra University, Hempstead, NY, USA
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Heinz T, Eidmann A, Jakuscheit A, Laux T, Rudert M, Stratos I. Demographics and Trends for Inbound Medical Tourism in Germany for Orthopedic Patients before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1209. [PMID: 36673964 PMCID: PMC9859416 DOI: 10.3390/ijerph20021209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/28/2022] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Medical tourism is a rapidly growing sector of economic growth and diversification. However, data on the demographics and characteristics of the traveling patients are sparse. In this study, we analyzed the common demographic properties and characteristics of the inbound medical tourists seeking orthopedic medical care in Germany for the years 2010 to 2019 compared to a domestic group. At the same time, we examined how the COVID-19 pandemic outbreak of 2020 changed the field of medical tourism in Germany. Calculations were performed using administrative hospital data provided by the Federal Statistical Department of Germany. Data were analyzed from the years 2010 to 2020. A total of six elective orthopedic surgery codes (bone biopsy, knee arthroplasty, foot surgery, osteotomy, hardware removal, and arthrodesis) were identified as key service indicators for medical tourism and further analyzed. Factors including residence, sex, year, and type of elective surgery were modeled using linear regression analysis. Age and sex distributions were compared between patients living inside Germany (DE) or outside Germany (non-DE). Between 2010 and 2020, 6,261,801 orthopedic procedures were coded for the DE group and 27,420 key procedures were identified for the non-DE group. Medical tourists were predominantly male and significantly younger than the domestic population. The linear regression analysis of the OPS codes over the past years showed a significantly different slope between the DE and non-DE groups only for the OPS code "hardware removal". With the COVID-19 pandemic, an overall decline in performed orthopedic procedures was observed for the non-DE and the DE group. A significant reduction below the 95% prediction bands for the year 2020 could be shown for hardware removal and foot surgery (for DE), and for hardware removal, knee arthroplasty, foot surgery, and osteotomy (for non-DE). This study is the first to quantify inbound medical tourism in elective orthopedic surgery in Germany. The COVID-19 pandemic negatively affected many-but not all-areas of orthopedic surgery. It has to be seen how this negative trend will develop in the future.
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Affiliation(s)
- Tizian Heinz
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
| | - Annette Eidmann
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
| | - Axel Jakuscheit
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
| | - Tino Laux
- Distance and Independent Studies Center, Technical University Kaiserslautern, Erwin-Schroedinger-Straße 57, 67663 Kaiserslautern, Germany
| | - Maximilian Rudert
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
| | - Ioannis Stratos
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
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Amuedo‐Dorantes C, Rivera‐Garrido N, Vall Castelló J. Reforming the provision of cross-border medical care: Evidence from Spain. HEALTH ECONOMICS 2022; 31:859-876. [PMID: 35212071 PMCID: PMC9303968 DOI: 10.1002/hec.4481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 01/13/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Cross-border medical care, defined as care facilitated by a local health provider under pre-established regional agreements, as in the case of European Union (EU) citizens accessing care within EU countries, has been on the rise. Unlike medical tourism, typically sought by patients through their own volition and paid for out-of-pocket, cross-border medical care is often reimbursable or paid for directly by the responsible government. Yet, because nations vary in the extent of health coverage offered to their residents, these expenditures are often only partially reimbursed. The resulting financial burden for some countries can be large and not reciprocal, straining regional and country-level finances. We analyze the effectiveness of a legislative measure adopted by a Spanish region in January 2012 with the purpose of curbing cross-border medical care. Using a comprehensive administrative dataset of all medical procedures performed in the country between 2008 and 2015, we find that the measure led to a drastic drop in the number of foreigners' hospitalizations and a reduction of 4.8 million euros/trimester in costs. Finally, the decrease in hospitalizations did not disproportionally affect patients based on their gender, age, or origin, although it fostered a reduction in readmissions.
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Boguszewicz-Kreft M, Kuczamer-Kłopotowska S, Kozłowski A, Ayci A, Abuhashesh M. The Theory of Planned Behaviour in Medical Tourism: International Comparison in the Young Consumer Segment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1626. [PMID: 32138240 PMCID: PMC7084921 DOI: 10.3390/ijerph17051626] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 11/28/2022]
Abstract
The Theory of Planned Behaviour (TPB) assumes the possibility of predicting and explaining humans' behaviour by identifying their intentions. The intentions are shaped by three groups of factors: attitudes towards, social norms and perceived behavioural control over the behaviour. The aim of the research is to examine the applicability of the TPB in medical tourism and to check whether there are differences in predicting the intentions of medical tourists from different countries. The study covered potential medical tourists-521 young consumers from three regionally important markets in medical tourism services: Jordan, Poland and Turkey. The study used a research survey to collect data, which were analysed using the multiple regression and analysis of variance methods. The research showed that the TPB model can be used in medical tourism. The results also show that the consumers' country of origin is a significant factor when predicting their intention to use medical tourism services.
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Affiliation(s)
- Monika Boguszewicz-Kreft
- Department of Marketing, Faculty of Finance and Management, WSB University in Gdańsk, 80-123 Gdańsk, Poland
| | | | - Arkadiusz Kozłowski
- Department of Statistics, Faculty of Management, University of Gdańsk, 81-824 Sopot, Poland;
| | - Ali Ayci
- Small and Medium Enterprises Development Organization of Turkey, Ankara 06050, Turkey;
| | - Mohammd Abuhashesh
- E-Marketing and Social Media Department, Princess Sumaya University for Technology (PSUT), Amman 11941, Jordan;
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Moghadam FN, Masoudi Asl I, Hessam S, Farahani MM. In search a medical tourism marketing pattern in Iran: The case of cultural sensitivities. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2020.1732647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Irvan Masoudi Asl
- Department of healthcare Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Somayeh Hessam
- Department of Health Care Management, South Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mahmoud Mahmoudi Farahani
- Department of Biostatistics, Research Center, Tehran University of Technology, Islamic Azad University, Tehran, Iran
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Critical Success Factors of Medical Tourism: The Case of South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244964. [PMID: 31817698 PMCID: PMC6950601 DOI: 10.3390/ijerph16244964] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/05/2019] [Accepted: 12/05/2019] [Indexed: 12/05/2022]
Abstract
The purpose of this study was to identify the key success factors of medical tourism using the case of South Korea. Medical tourism refers to the phenomenon of travelling across national borders intentionally to access a variety of medical treatments, especially modern medical treatment. Through conducting semi-structure face-to-face in-depth interviews with the service suppliers of Korean medical tourism, it was discovered that Korean medical tourism has been facilitated by the effect of Hallyu and advanced Korean brand power. More importantly, tourism activities for companions and extra support for patients’ convenience are identified as important success factors of Korean medical tourism, suggesting that the medical tourism industry not only includes medical services but also involves tourism perspectives, supporting the patient and their companions to stay in a comfortable and pleasurable environment. This study generated results which are valuable for both academic and industry perspectives, as this is a field which has not been extensively researched. Medical tourism representatives in other countries can consult these findings to develop the industry.
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Malik G. The creation of a medical tourist destination: Exploring determinants of perception. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1677023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Garima Malik
- Department of Marketing & Sales, Amity Business School and XLRI Jamshedpur, Amity University, Noida, India
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Alnakhi WK, Segal JB, Frick KD, Ahmed S, Morlock L. Motivational factors for choosing treatment destinations among the patients treated overseas from the United Arab Emirates: results from the knowledge, attitudes and perceptions survey 2012. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2019; 5:18. [PMID: 31548899 PMCID: PMC6751846 DOI: 10.1186/s40794-019-0093-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 09/02/2019] [Indexed: 01/22/2023]
Abstract
Background Travelling seeking healthcare is becoming common phenomenon. There is limited research to understand factors associated with destinations of choice. Each year the Dubai Health Authority (DHA) spends millions of dollars to cover Emiratis seeking healthcare overseas. The objective of this study is to examine the association of treatment destinations, patients’ characteristics and motivation factors among the patients treated overseas from the UAE during 2009–2012. Method The data from the Knowledge, Attitudes and Perceptions Survey 2012 in Dubai on medical travel. Examining destinations by patients’ characteristics and motivational factors under push and pull factor framework. Modified Poisson regression model was used to identify factors associated with treatment destinations. Results Three hundred thirty-six UAE national families with a member who sought overseas treatment during 2009–2012 were analyzed for this study regarding their most recent trip. The aim of the survey is to explore their knowledge, attitudes and perceptions. The majority of respondents were family members not the patients who had experienced the medical treatment overseas (63%). Germany was the top treatment destination (45%). The top 3 medical conditions for which people traveled overseas were cancer (17%), bone and joint diseases (16%), and heart diseases (15%). However, patients diagnosed with stroke (brain hemorrhage or clot) are more likely to travel to Germany for medical treatment while patients diagnosed with eye diseases are more likely to seek medical treatment at other destinations. Cost was a primary motivational factor for choosing a treatment destination. Conclusion This study addressed knowledge gap related medical travel in the UAE. The results provided evidence about perceptions when choosing treatment destinations. Medical condition and financial factors were main predictors for choosing treatment destination. The result will influence policies related financial coverage by the government. The results suggest understanding patients’ perceptions in-depth related their medical conditions and financial factors for better regulation of overseas treatment strategy in the UAE.
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Affiliation(s)
- Wafa K Alnakhi
- 1Department of Health Policy and Management Bloomberg School of Public Health, Baltimore, USA
| | - Jodi B Segal
- 2School of Medicine Johns Hopkins University, Baltimore, USA
| | - Kevin D Frick
- 3Carey Business School Johns Hopkins University, Baltimore, USA
| | | | - Laura Morlock
- 1Department of Health Policy and Management Bloomberg School of Public Health, Baltimore, USA
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Alnakhi WK, Segal JB, Frick KD, Hussin A, Ahmed S, Morlock L. Treatment destinations and visit frequencies for patients seeking medical treatment overseas from the United Arab Emirates: results from Dubai Health Authority reporting during 2009-2016. Trop Dis Travel Med Vaccines 2019; 5:10. [PMID: 31308954 PMCID: PMC6604140 DOI: 10.1186/s40794-019-0086-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 06/04/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Each year, the Dubai Health Authority (DHA) spends millions of dollars to cover the costs of United Arab Emirates (UAE) nationals seeking healthcare overseas. Patients may travel overseas to seek an array of treatments. It is important to analyze the number of trips and treatment destinations for patients travelling overseas to provide baseline information for the DHA to improve polices and strategies related to overseas treatment for UAE nationals. METHODS Administrative data were obtained from the DHA for UAE nationals who sought medical treatment overseas during 2009-2016. We examined the number of trips and treatment destinations by medical specialty, age, gender, years of travel and travel seasons. Multinomial logistic and negative binomial regression models were used to assess the relationships of the treatment destinations and number of trips, respectively, with the key variables of interest. RESULTS The study included data from 6557 UAE nationals. The top three treatment destinations were Germany (46%), the UK (19%) and Thailand (14%). The most common medical specialties were orthopedic surgery (13%), oncology (13%) and neurosurgery (10%). Oncology had the highest expected number of trips adjusted for a number of covariates (IRR 1.34, 95% CI: 1.24-1.44). Regarding destination variation, patients had a lower relative risk ratio of seeking healthcare in Germany in the winter (RRR 0.68, 95% CI: 0.57-0.80). Endocrinology was the most common medical specialty sought in the UK (RRR 3.36, 95% CI: 2.01-5.60). CONCLUSIONS This is the first study to systematically examine the current practice of medical treatment overseas among UAE nationals. The results demonstrate that treatment destinations, medical specialties for which treatment was sought, age, gender and travel season are significant factors in understanding overseas travel for medical care. The study can guide the DHA in collecting more data for further research that may lead to policy-relevant information about sending patients to the best-quality treatment choices at an optimal cost.
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Affiliation(s)
- Wafa K. Alnakhi
- Department of Health Policy and Management Bloomberg School of Public Health, Baltimore, USA
| | - Jodi B. Segal
- School of Medicine Johns Hopkins University, Baltimore, USA
| | - Kevin D. Frick
- Carey Business School Johns Hopkins University, Baltimore, USA
| | | | - Saifuddin Ahmed
- Department of Population, Family and Reproductive Health Bloomberg School of Public Health, Baltimore, USA
| | - Laura Morlock
- Department of Health Policy and Management Bloomberg School of Public Health, Baltimore, USA
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Pan X, Moreira JP. Outbound medical tourists from China: An update on motivations, deterrents, and needs. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2018. [DOI: 10.1080/20479700.2018.1425277] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Xiaoqing Pan
- School of Foreign Languages, Hangzhou Normal University, Hangzhou, Zhejiang, People's Republic of China
| | - J. Paulo Moreira
- CAPP (Centro Administracao Politicas Publicas), Universidade de Lisboa, Portugal and Atlantica, Oeiras, Portugal
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Medical tourism: A snapshot of evidence on treatment abroad. Maturitas 2016; 88:37-44. [DOI: 10.1016/j.maturitas.2016.03.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 02/25/2016] [Accepted: 03/03/2016] [Indexed: 11/24/2022]
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