Medical Tourism Services Available to Residents of the United States
There are growing reports of United States (US) residents traveling overseas for medical care, but empirical data about medical tourism are limited.
To characterize the businesses and business practices of entities promoting medical tourism and the types and costs of procedures being offered.
DESIGN, PARTICIPANTS, AND OUTCOMES
Between June and August 2008, we conducted a telephone survey of all businesses engaged in facilitating overseas medical travel for US residents. We collected information from each company including: the number of employees; number of patients referred overseas; medical records security processes; destinations to which patients were referred; treatments offered; treatment costs; and whether patient outcomes were collected.
We identified 63 medical tourism companies and 45 completed our survey (71%). Companies had a mean of 9.8 employees and had referred an average of 285 patients overseas (a total of approximately 13,500 patients). 35 (79%) companies reported requiring accreditation of foreign providers, 22 (50%) collected patient outcome data, but only 17 (39%) described formal medical records security policies. The most common destinations were India (23 companies, 55%), Costa Rica (14, 33%), and Thailand (12, 29%). The most common types of care included orthopedics (32 companies, 73%), cardiac care (23, 52%), and cosmetic surgery (29, 66%). 20 companies (44%) offered treatments not approved for use in the US – most commonly stem cell therapy. Average costs for common procedures, CABG ($18,600) and knee arthroplasty ($10,800), were similar to previous reports.
The number of Americans traveling overseas for medical care with assistance from medical tourism companies is relatively small. Attention to medical records security and patient outcomes is variable and cost-savings are dependent on US prices. That said, overseas medical care can be a reasonable alternative for price sensitive patients in need of relatively common, elective medical procedures.
KEY WORDSmedical tourism uninsured travel elective surgery
Dr. Reisinger is supported by a Career Development Award from the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (CD1 08-013-1). Dr. Martin is an investigator at the Iowa City VA Medical Center. Dr. Cram was supported by a K23 career development award (RR01997201) from the NCRR at the NIH and the Robert Wood Johnson Physician Faculty Scholars Program. This work is also funded by R01 HL085347-01A1 from NHLBI at the NIH.
Conflicts of Interest
Dr. Reisinger, Dr. Martin and Dr. Cram have no conflicts of interest to disclose. Dr. Horowitz is President of Medical Insights International, a consulting firm specializing in international and domestic medical travel. Dr. Horowitz provided assistance in the development of the study survey, identification of companies for consideration for inclusion of the survey and critical commentary and revision of the manuscript. Dr. Horowitz did not participate in the analysis of the study data or funding of the study. All other authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Mr. Alleman and Ms. Luger are graduate students at the University of Iowa with no financial interests related to this study. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The funding sources had no role in the analyses or drafting of this manuscript.
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