Are the issue of cost and quality the only parameter which decides where a patient will go medical tourism? Are these trends of medical tourism, more universal ? Is there any lesson to be learned ?
I recent came across a YouTube video appreciating the health facilities in India, and discussing the difficulty faced by former Pakistan hokey player Mansoor Ahmed to come to India for treatment. It brought me to questions, why had he chose India and what other options he had beside India. A recent report points to the fact large numbers of medical tourists care coming to Asian countries for the treatment , due to cheaper costs and high-quality healthcare services. India holds the second place, after Thailand which is at first.
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Regional trend of medical tourism.
- International medical tourism: We all have heard politicians and film stars going abroad for medical treatment. For last two decades it has become a industry with an estimated business of 50 B US dollars. Americans, Canadians and Europeans are the mostly the patients who travel to India , Thailand, Singapore and other south east Asian countries. Bumrungrad International Hospital , in Thailand is world largest international. It see more than a million patients a year , half of them are foreigners coming from more than 190 countries.India mostly receives patients from Africa and middle east countries. Affluent people from across the world flock to US for treatment as the its standards of healthcare are still the bench mark.
- Medical tourism in India: New Delhi is an epicenter of the healthcare for people residing in north and central Indian states.similarly Hyderabad and Chennai act as similar epicenter for southern states. it is not uncommon to see people coming from Bihar and West Bengal , to AIIMS New Delhi for cardiac and paediatric surgeries.
- Medical tourism within states people from far off districts commonly come to the hospitals in state capitals for surgeries and other modern medical treatment often not available in peripheral districts of a state. all highways coming to any capital cities have clusters of private hospitals in the periphery of cities limits , most of which primarily cater to peripheral patients only.
Specialty destinations of medical tourism.
The movement also follows a trend in the form of the destinations becoming popular for certain type of specialised medical care. Isreal is popular for in-vitro fertilization , Thailand for sex reassignment surgery and India for bariatric surgery and cancer treatments . For cosmetic surgery popular destinations are Argentina, Brazil, Costa Rica, Cuba, Ecuador, Mexico, Turkey, Thailand and Ukraine. In India we all know that Chennai, New Delhi and Hyderabad are very popular destinations for Eye surgeries. Similarly New Delhi and Banguluru are for cardiac surgeries. This pattern of specialty destinations could also be witnessed at state level as well.
Shri Sadguru Seva Sangh Trust, a charity hospital located at a small town named Chitrakoot, in Madhya Pradesh, India is known to operate 1,43724 cataract patients in the year 2015-16. It attract lot of patients from many adjoining district of Uttar Pradesh and Madhya Pradesh and Rajasthan. Similar example can also be seen elsewhere in the country.
Reasons for Migration Of Patients
- Cost of treatment of medical tourism.Probably the most important reason for the international medical tourism is the difference in the cost of the treatment for the similar or comparable quality. It is well known that cost of treatment is very high in US. It is often higher than the combined of traveling and receiving medical care abroad. For example hip replacement surgery cost $40,000 to $65,000 in the USA, whereas it costs about $8,000 to $18,000, abroad, which is including traveling expenses. This is the main reason why patients come to countries like India and south East Asian countries. The comparable prices in India usually vary from 0.25 to one 0.1 of the price of a similar medical procedure in the USA.
- Quality of services in medical tourism.: Many of the specialized medical centers which are popular among patients have developed state-of-the-art facilities that use cutting edge technology and equipment. The doctors in these facilities are trained in good institutions and have excellent skills because of large patient inflow. Bumrungrad International Hospital has 39 speciality subcentre and provide services using cutting technologies like Robotic assisted spine surgery. Shri Sadguru Seva Sangh Trust, has fully developed sub specialies of eye and has Operation Theater Complex having 25 modular OT and a LASIK LASER suite.
- Patient’s affordability in medical tourism: The number of American people seeking treatment abroad is increasing because 1 out of six American is uninsured and there are many medical conditions which are not covered by the medical insurance. It is these types of people who make the bulk of those who travel abroad for treatment and hospitals like Bumrungrad International Hospital offers a good bargain. Shri Sadguru Seva Sangh Trust, offers services to the poor people living in adjoining area and most of the surgeries are done free of cost. Even those opting for the paid services, the rates are very affordable.
- Superior brand value in medical tourism: Majority of foreign patients come to hospitals which have a great reputation in the their field. Bumrungrad International Hospital is the first hospital in Asia to be accredited by the American-based Joint Commission International (JCI), one of the groups providing international healthcare accreditation services. For consecutive three years, from 2004 to 2006, it was featured on CBS’s 60 Minutes and NBC’s Today Show as a leader in medical tourism and International hospitals. Among the patients which receive the treatment there, Shri Sadguru Seva Sangh Trust, enjoys the reputation second to none. The Lion Club International Humanitarian Award, 1993 is to name a one, the actual list is a page long. Former president of india, A P J Abdul kalam has written a testimonial of their mission.
- Patient care in medical tourism: At Bumrungrad International Hospital they take care of each and every possible issue one can face if one is travelling to another place for treatment. That include, food, language, stay before and after hospital, finance, insurance, airport transfer etc. If their website is to be believed they provide cultural support services in as many as 18 languages. Shri Sadguru Seva Sangh Trust, provide free cataract surgical services through eye camps. Obviously the services may not actually match a corporate hospital, but it include transport to and fro from the home, lodging and boarding , food, surgery and post-operative medication. Even those opting for the paid services, patient has to arrange his/her own transport, and pay for the surgery and treatment, which a very much subsided. Services are appreciated by all.
- Connectivity and outreach in medical tourism: Bumrungrad International Hospital has its international offices in 22 counties across the world, even in Iraq and Pakistan. The website of the hospital is comparable to amazon.com in functionality and details. Thailand is a major international tourist destination, which gives it an additional advantage. Shri Sadguru Seva Sangh Trust has simple but functional website which provide all the relevant information. One can have an online appointment. It even provides a contact number for patients to contact in emergency, something amazing for a charity eye hospital. They have 26 visions Centre, in 12 adjoining districts which is the main drainage area for the hospital. Plus it organizes 1500-2000 free screening eye camps to identify patients. Chitrakoot is an important religious tourist destination for adjoining Hindu population.
Lesson from medical tourism.
These migration pattern and underlying reasons offer insight in the way the health services delivery models should be planned. With increasing internet penetration , increasing disposable income , decreasing travel cost and free information flow, physical proximity of the services is not the actual criteria on which a patient access a health facility. This seems to be more valid in case of the public funded health care facilities. Majority of investment goes into construction of facility , manpower hiring and equipment purchase. The intangible qualities like patient care , connectivity , out reach and brand building are often ignored. I could not find a single government funded hospital in UP, in the list of NABH accredited hospitals. It is uncommon to see government hospital having a functional website. If at all there are one, it mostly displays the achievements of the office bearers rather that the services and contact details. It is very difficult to locate the facilities, services and service providers as most of the government hospital do not have anything like patients reception and information system. The patients care is unsatisfactory. All these services and accreditation do warrant an additional financial resources. These facilities continues to be underutilised in spite of significant budgetary outlay. Facilities lacking result oriented corporate work environment could not deliver the services demanded by the patients. Health care being very labour intensive , is difficult to manage in government setting because of administrative inertia.
A health facility is rated not by what it has, but by what it delivers.
What are the issue I failed to identify . Please share your views in the comments below.