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Medical Tourism: Treatments, Markets and Health System Implications: A scoping review

Auteur : Lunt Neil, Smith Richard, Exworthy Mark ...[et al.]
Type : Etude
Thème : Santé

Résumé/Sommaire :

The global growth in the flow of patients and health professionals as well as medical technology, capital funding and regulatory regimes across national borders has given rise to new patterns of consumption and production of healthcare services over recent decades. A significant new element of a growing trade in healthcare has involved the movement of patients across borders in the pursuit of medical treatment and health; a phenomenon commonly termed ‗medical tourism‘. Medical tourism occurs when consumers elect to travel across international borders with the intention of receiving some form of medical treatment. This treatment may span the full range of medical services, but most commonly includes dental care, cosmetic surgery, elective surgery, and fertility treatment. There has been a shift towards patients from richer, more developed nations travelling to less developed countries to access health services, largely driven by the low-cost treatments available in the latter and helped by cheap flights and internet sources of information.

Despite high-profile media interest and coverage, there is a lack of hard research evidence on the role and impact of medical tourism for OECD countries. Whilst there is an increasing amount written on the subject of medical tourism, such material is hardly ever evidence-based. Medical tourism introduces a range of attendant risks and opportunities for patients. This review identifies the key emerging policy issues relating to the rise of medical tourism‘.

The review details what is currently known about the flow of medical tourists between countries and discusses the interaction of the demand for, and supply of, medical tourism services. It highlights the different organisations and groups involved in the industry, including the range of intermediaries and ancillary services that have grown up to service the industry. Treatment processes (including consideration of quality, safety and risk) and system-level implications for countries of origin and destination (financial issues; equity; and the impact on providers and professionals of medical tourism) are highlighted. The review examines harm, liability and redress in medical tourism services with a particular focus on the legal, ethical and quality-of-care considerations.

In light of this, our broad review outlines key health policy considerations, and draws attention to significant gaps in the research evidence. The central conclusion from this review is that there is a lack of systematic data concerning health services trade, both overall and at a disaggregated level in terms of individual modes of delivery, and of specific countries. This is both in terms of the trade itself, as well as its implications. Mechanisms are needed that help us track the balance of trade around medical tourism on a regular basis. The evidence base is scant to enable us to assess who benefits and who loses out at the level of system, programme, organisation and treatment.

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