Advantages and constraints for health tourism · 2016. 11. 21. · "secret" of that intervenon. 14...

1 of31

Advantagesandconstraintsforhealthtourism

DelićdrMarina

2 [email protected]

SavaIlića5Igalo,MontenegroPhone+38231658555

Health

As a state of complete physical, mental, and social well-being and notmerely the absence of disease or infirmity.(WHO,1948.)

„Healthisadynamiccondi1onthatisiden1fiablebyaphysicaland mental state that allows a person to pursue his or hergoals,givenasetofacceptedcircumstances(WHO1984.)

3 [email protected]


Tourism is defined as the ac1vi1es ofpersons iden1fied as visitors. A visitor issomeone who is making a visit to amaindes1na1on outs ide h i s /her usua lenvironment for less than a year for anymain purpose [including] holidays, leisureandrecrea1on,business,health,educa1onor other purposes….This scope is muchwider than the tradi1onal percep1on oftourists, which included only thosetravelling for leisure. [UNWTO sta0s0csGuidelines:2010]Travelling ... is either an escape or adiscovery(RosieThomas)

4 [email protected]


10MegatrendsinTourism

Thefirstfivetrendswillhaveamajorinfluenceondemandinthetourismsectorbutwillalsoimpactthesecondsetoftrends,whichconcernschangingsupply.Together,theyrepresentforceswhichwillshapethefutureoftourism..

5 [email protected]


Healthtourism

Theage-oldtendencyofpeopletothelongerstayhealthy,youngandbeau0fulgrowingwithprosperityofresidents.Therefore, especially in developed countries, there aredifferent facili0es of tourist offer that seek to respondappropriatelytoallprofiledmarketdemands.Health/wellnesstourismisconsideredoneofthefastestgrowingsegmentsoftourismdemand.Itisatypeoftourismthatweknowundervariousnames(health,medical,healthcare,spa,wellnesstourism).

6 [email protected]


Health tourism refers to travel for any kind of medicaltreatment.Terminological ambiguity o_en accompanied byuncertain0esrelatedtodemandcharacteris0cs.Regardingthis,itisnecessarytodrawa`en0ontothefactthat the demand for this type of tourism can be brokendownintonumeroussub-segmentsofthemarket.

7 [email protected]

SavaIlića5Igalo,MontenegroTel:+38231658555

Health tourism in the world, recorded ahugegrowthinthelastdecadeandisoneofthemanifesta0onsofglobaliza0on.Hismarket in global terms, is growing atanannualrateof19-25%andpredicteditsfurthergrowthinthecomingyears(WTO).Healthtourismisasuccessfulcombina0onof medical treatment, hospitals, hotelsand other services in the touristdes0na0on.Today it is a lucra0ve bisnis whichdevelopsrapidincreaseinmanycountriesoftheworld.

8 [email protected]

SavaIlića5Igalo,MontenegroTel:+38231658555

There are a number of significant driversof heath tourism.One of these drivers iscost. The ability to receive comparabletreatmentsatlowercostsmo0vatessomepeopletotravel.Anotherkeydriveristhatit is some0mes necessary to travel inorder to obtain state-of-the-art medicaltreatments.“The best healthcare solu0on to apar0cular problem is o_en not found inthe localmedical centerorhealthsystemanditsuspectthatchallengewillprobablygetworsebeforeitgetsbe`er.”

Theop0mal goal shouldnotbe to accessthebesthightechcarebutrathertoneverexperienceaseriousmedicalproblemlikeahearta`ackorcancer.T o d a y t h i s i s d o n e b ycrea0ng a plan that combines yourpersonal risk with ongoing ac0vepreven0ontomi0gatethatrisk.

9 [email protected]


10 [email protected]


During the XIXth and the first half of XXth centuries, thethermaltourismhadaremarkabledevelopmentandbecameaccessible to thewell-to-dosocialclasses. In thesecondhalfof XXth s, this tourism of health develops and allows themiddleclassestoreachit.Atthesame0me,theotherformsoftourismrelatedwiththehealthappear,asthe"an0-aging"medicine, the "Medical Spa" and theMedical Tourism (MT)allowing the access to new treatments, fruits of theremarkable scien0fic and technological development in themedicaldomain.

We need to dis0nguish Thermal/cura0ve and wellnesstourismwhich takescareof the"well-being" (thermalbaths,thalassotherapyandbalneotherapy), of theMedical Tourism(MT)wherethe"medicaltourist"(Mt)plansaloneorwithhisregular doctor, the medical or surgical protocol the mostadapted tomake abroad. Therefore, theMT concernsmorehealththantourism.



Healthtourism

Health tourusm(HT)hasservedasagateway forpa0ents toreceive affordable and quality medical care by crossingborders. Savings from medical tourism can be 15 to 85percentinsomecases

People are crossing borders to seek healthcare services inanothercountryandthisinterna0onalphenomenonistermedashealthtourism.It isa`ainingpopularityamongurbanandsub-urbanresidentstodevelopedcountries.Everynewthingis ques0oned or doubted and it is happening with healthtourism.Itisalsobeinganalyzedandcri0cized.

.



Medical tourism (MT) involves interna0onal travel with theintent of addressingmedical care needs of the traveler thatoccurs outside of arranged cross-border care. Such medicalcareisusuallypaidforout-of-pocket.Theprac0ceofmedicaltourismraisesimportantques0onsforthesafetyofpa0ents,createsuncertain0esaboutimpactsonpa0ents’ home countries and des0na0on countries, andcreatesethicalissuesbothforpeoplewhohaveandhavenotpar0cipatedinmedicaltourism.Weshallapproachnowtheadvantagesandthedisadvantagesof theMT,atfirst for themedical tourists (Mt), thenfor thecountry supplier of these Mt and finally, for the receivingcountryofMt(CanadianCenterofScienceandEduca1on)..



AdvantagesoftheMTfortheMt•  Thecostproposedby theofferof thecareabroad,plus thoseof the tripand thestay, islowerthanthecostofonlythecarerealizedinthecountryoforigin,takingintoaccountthepossiblerefundsofthehealthinsurance.

•  Whentherequiredtreatmentisnotavailable,ornottakencare,orisnotpar0allycoveredbythehealthinsuranceofthecountryoforigin,itisbe`ertobetreatedabroad.

•  The quality/price ra0o is more favourable abroad: many foreign hospitals and foreignprivateclinicsemploydoctorstrainedandqualifiedinthewesterncountries.

•  The possibility of associa0ng "body care" and "tourism" but also "to join the useful andunpleasant,withthepleasant"andallowing"toswallowthepill"moreeasily,becauseoftheforeign exo0cism which will allow the Mt to integrate the unpleasant memories with thepleasantones.

•  Achangeofscenery(changeofplaceandmaybecountry,changeofclimateandculture)andtheleisureac0vi0esassociatedwithtourism,oraconvalescenceinaluxuryhotel,wouldallowhimtosurmountmoreeasilyitssufferingsbeforeanda_ertheapplica0onofthecare,bycompensa0ngathingwithotherone.

•  Beableto"mask"aninterven0on,forexampleofplas0csurgery,underatouristjourney,because the treatment concerns the domain of the in0macy; it thus allows to keep the"secret"ofthatinterven0on.



Accordingtothena0onalityofthemedicaltouristorthetypeofenvisagedmedicaltreatment,otheraddi0onalbenefitsarepossible:

•  toreachquicklythecareandnotbeforcedtostayonawai0nglistduringsomemonthsinthecountryoforigin,

•  tobelookedbythemostfamousdoctors,•  to be able to follow the fashion of canons of beauty: plas0csurgery(bosoms,face,belly,bu`ocks,etc.),

•  tohavetheopportunitytoreachthesecares,•  tobeproudtohavemanagedtobelookedabroad,•  to have the possibility to choose freely the most convenientmoment to leave home to be treated abroad because it is notforcedbyapreciseperiodoftheyearsuchasthatoftheholidays,relatedtothecalendarsofeverycountry.



EU

If the journey takes place inside the Schengen area, there is aEuropean legal frame that allows to benefit fromquality care inanotherEuropeancountry (freecircula0onofEuropeanci0zens),by choosing freely the clinic and the doctors to be looked. Itspecifiestherightsofthepa0entsandthedu0es(responsibili0es)of the suppliers of health care, in a general frame of medicalethics.TheEuropeanlegisla0onestablishedtheequalityofaccess,of treatment and care, of safety and appeal of the na0onal andforeignpa0entshavingundergonedamages.Thislegisla0oncompletesthena0onaloneofeverycountryoftheEUandsuggestsagreatersurveillanceofallthepublicandprivateactorsinhealthfields.Theserightsareframedbyprocedures(UE/EU,2008,2011)whereareinvolvedtheSocialSecuri0esofbothcountries;theEuropeanpa0ent has to respect them if he will claim to benefit fromreimbursements of medical expenses as if he had stayed in hiscountryoforigin.



DisadvantagesoftheMTfortheMt

•  Main disadvantage of medical tourism is that the pa0ent andtheir familymembers are not sure about the qualifica0ons of thedoctors.

•  Any medical interven0on is risked: the possible post-opera0vecomplica0ons can increase the invoice if it is necessary to remainabroad to treat them. Complica0ons can appear at the 0me ofreturntothehomecountry,dueto,amongothers,atrauma0smora secondary infec0on during the journey. Therefore, the careabroad can then turn out less profitable than a caremade in thehomecountry.•  O_en accompanying medical services (clinical analysislaboratories, centres of radiology, medical imaging andinterpreta0on)areoflowerqualitythaninthehomecountry.



•  Themedicalfollow-upcannotbemaintainedabroadbythemedicalteam,whichprac0cedtheinterven0ons,unlesscomingagain.•  Themedicalfollow-upa_ertheinterven0onhastocon0nueinthecountryoforigin,athisexpensesorinapublicins0tu0onthatagreestotakecareofhim.•  It isnotcertainthattheforeigndoctormakesacommitmenttorepairthedamagesofhissurgicalact.Thus,theMTisinterestedintakingoutanaddi0onalinsurances,eventhoughthatwill increase the final invoice, to make sure of the good progress during his hospital andtouris0cstay.

•  Thereisapossibilityofcontrac0ngahospital-bornediseaseduetothelackofasepsisorofhygiene in foreinghospitals, orof contrac0nganendemicor seasonaldisease (chikungunya,malaria,SRAS)intheforeigncountryandabsentinthecountryoforigin.



AdvantagesfortheCountrySupplierofMt•  The development of the MT allowed the medical industry ofdeveloped countries to export their products and their know-how(installa0ons,organiza0onandpharmaceu0cal industry)towardstheemergentcountriesthathopetodevelopMT,socontribu0ngtotheexportsandtoimprovetheirbalanceofpayments.•  The inter-European MT is going to grow and poles of speciality(dental,aesthe0corcardiacsurgeries,cancerresearch,etc.)arebeingdevelopedinsomecountries.•  The MT allows the health organiza0ons to dispose of financialsourcesbesidesthepublicfinancing.

•  Thewesterncountriesand inpar0cular theEUwillbe confrontedwith the financial consequences of the ageing of the popula0on.Perhaps,olderpa0entswillbe facedeither toaccepta reduc0onofthemedicalservicesortodecidebelookedabroad(outoftheEU),toreduce their expenses and to relieve at the same0me the na0onalbudgetofthehealth.



•  But it is as well possible that they lead to a development policy of the services ofGeriatricstosa0sfy,notonlytheneedsofhealthofEuropeanpa0entsbutalsoofforeignseniorswhichinthisway,canbringacomplementtofinancingthehealthsector.•  In addi0on, the new technologies applied to the medical care, in par0cular thosecentredontelemedicine,cancons0tuteanimportantfactorinthegrowthofMT,becausetheyallowEuropeandoctorstofollowremotelyanalreadylookedMt,andtheycontributetothegoodrealiza0onofsurgeriesabroadbydoctorswhowillcan,incaseofemergencyorcomplica0ons,appealthebestspecialistsofthedevelopedcountries.Thesenewmethodsofworkwillbepossiblethanksto:-theuseofremoteautomatedandremote-controlledmedicalequipments,-theconsulta0onsandthesurgicalopera0onsbyvideoconferencing,- the remotely interpreta0on of medical analyses or radiological examina0ons (e.g.scanners),- the TV-monitoring (permanent remote control of the health of the pa0ent stayed athome).



DisadvantagesfortheCountrySupplierofMt

•  Developed countries have financial losses because of thedevelopment of theMT and the HT out of borders. For theEuropean countries, as far as theMT and theHT takeplaceinside theEuropeanUnion, they contribute to redistribute acertainwealthamongthevariousEuropeanpartners.

•  TheMTandtheHTtowardstherichcountriesalsodevelopedwhat confirms the global aspect of these flows of Mt. Atpresent, thefinancial contribu0onof the foreignpa0entsdoesnotcompensatethefinancial lossesof thena0onals that leaveabroad,becausetheirnumberismuchlower.•  Certainly there will be an increase of the interna0onalmobility of the medical and paramedical staff towards placeswhere they can exercise their profession in good condi0ons(recogni0onoftheirabili0esandprofitofagoodsalary).



•  TheMTcontributestopandemics.Themovementofpersonsandgoodsforcommercialortouris0creasonscausedintheworldanaccelera0onofthe transmission of diseases (SRAS, H1N1) and the hospital-borneinfec0ons.

Thedevelopmentof theMT contributes to spreaddiseasesbut, themostredoubtable is theemergenceofhospital-bornediseasesand importedbyMtpursuingatreatmenta_erastayabroad,ashasalreadyno0cedinsomeEuropeanhospitalcentres.



AdvantagesfortheReceivingCountryofMt

•  TherecentdevelopmentoftheMTledtothatofthemedicalstructures of the emergent countries, not only regardinginfrastructures,medicalequipmentsandinstrumenta0onbutalso professional (seqng up of numerous doctors, nurses,ambulance drivers and other paramedical jobs); quality ofservices, be`er salaries, improvement of the educa0on andthelocalmedicalresearch.Thisallowstofixthemedicalstaffon their country, by avoiding that doctors emigrate toexercise their job more suitably and, at the same 0me, tofacilitate the return of those who had le_ abroad.Addi0onally, MT can help to decrease the "brain drain" atleast in the medical domain. This is an addi0onal asset todeveloptheMT.

•  On the other hand, other countries will take advantage toimprove and develop their health system with the financialgodsend brought by theMt,whatwill allow them to increasethe number of the beneficiaries of the health care of thecountry.



•  Some countries will developmore specific medical ac0vi0es tobecome the best in these domains and, in this way, thwart thecompe00on of the other countries which will then be obliged tospecializeinothermedicalsectors.•  Theycanbenefitfromtheincreaseoftheinterna0onalmobilityofthemedicalandparamedicalstafftowardscountrieswheretheycanexercise their profession in good condi0ons (recogni0on of theirskillsandprofitofagoodsalary).•  ManyemergentcountriesarebeqngonMTtoboostregionalandna0onal tourism to increase the economic fallouts and amelioratetheir labour market (hospitality, restaurants, transports, services,infrastructures,etc.).



DisadvantagesfortheReceivingCountryofMt

•  Numerous doctors of developing countries leave the public hospitals to set up themselvesprivatelyorjoinateamofaprivateclinic,toearnbe`ertheirlivingandhaveabe`erprofessionalrecogni0on.Thus,theeconomicindicator"numberofdoctorsormedicalstaffpercapita"willnothaveanysensebecause its increase will not measure any more an improvement of the living condi0ons in thecountry,becausethesedoctorswilldedicatethemselvestoaforeignclienteleandnottoalocalone.•  Risk of contribu0on to the traffic of organs. Poor people in under developed countries aretemptedtoselltheirownorgansinexchangeofmoneytoamelioratetheirlife.

•  Risk to facilitate the forgery ofmedicines. The search for the reduc0on of the expenses of theinterven0onsabroadcouldfacilitatethedemand,theproduc0onandthedistribu0onoftheforgeryofmedicines.Theforeignpa0entscouldbetemptedtobuythemabroad,outsidetheofficialcircuitstobringthemintheircountryoforigin.

•  Riskof facilita0ng themarke0ngofequipmentsand lower-qualityprosthesesorof forgeries.ToguaranteealessercostfortheMt,someforeignhospitalcentrescouldusethistypeofproducts.



Conclusions

Mostpeople see in theMTonlyadvantages (savingof0meandmoney, excellence of the quality of the services of theprofessionals of health, the possibility of benefi0ng from a fewhoursordaysofsecondarytouris0cac0vi0es).Thus, they o_en forget that the MT can also have a lot ofinconveniences.Thefirstthing,whichitisadvisabletoremind,isthat the zero risk does not exist in Medicine and even less insurgery, independently of the countrywhere the interven0on isrealized.ForcountriessuppliersandforthereceivingcountriesofMt,theMT can bring financial advantages and improvements of theNa0onalHealthService,allowsmarketthesophis0catedmedicalequipmentsandcontributestodeveloptouris0cindustries.Butitcanalsobringfinancialdisadvantages(lesserspendingofhealthinthe country of origin) or risks of contribu0on to the traffic oforgansorfacilitatetheforgeryofmedicines(receivingcountries).



The MT is thus a complex phenomenon, at the momentdifficulttodelimitcompletely.The lackof reliabledataandofficial sta0s0csdoesnotallowtoes0mategloballytheimportanceoftheMT.



THANKYOUFORYOURATTENTION

Advantages and constraints for health tourism · 2016. 11. 21. · "secret" of that intervenon. 14...

Documents

Transcript of Advantages and constraints for health tourism · 2016. 11. 21. · "secret" of that intervenon. 14...