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'Medical Tourism' - the phenomenon of people travelling abroad to access medical treatment - has received increasing attention in academic and popular media. This paper reports findings from a study examining effect of inbound and outbound medical tourism on the UK NHS, by estimating volume of medical tourism and associated costs and benefits. A mixed methods study it includes analysis of the UK International Passenger Survey (IPS); interviews with 77 returning UK medical tourists, 63 policymakers, NHS managers and medical tourism industry actors policymakers, and a review of published literature. These informed costing of three types of treatments for which patients commonly travel abroad: fertility treatment, cosmetic and bariatric surgery. Costing of inbound tourism relied on data obtained through 28 Freedom-of-Information requests to NHS Foundation Trusts. Findings demonstrate that contrary to some popular media reports, far from being a net importer of patients, the UK is now a clear net exporter of medical travellers. In 2010, an estimated 63,000 UK residents travelled for treatment, while around 52,000 patients sought treatment in the UK. Inbound medical tourists treated as private patients within NHS facilities may be especially profitable when compared to UK private patients, yielding close to a quarter of revenue from only 7% of volume in the data examined. Costs arise where patients travel abroad and return with complications. Analysis also indicates possible savings especially in future health care and social costs averted. These are likely to be specific to procedures and conditions treated. UK medical tourism is a growing phenomenon that presents risks and opportunities to the NHS. To fully understand its implications and guide policy on issues such as NHS global activities and patient safety will require investment in further research and monitoring. Results point to likely impact of medical tourism in other universal public health systems.

To investigate the magnitude and characteristics of medical tourism in Thailand and the impact of such tourism on the Thai health system and economy. In 2010, we checked the records of all visits to five private hospitals that are estimated to cover 63% of all foreign patients. We reviewed hospital records of foreign patients and obtained data on their countries of origin, diagnoses and interventions. We surveyed 293 medical tourists to collect demographic characteristics and information on their expenditure and travelling companions. To help understand the impact of medical tourism on the Thai health system, we also interviewed 15 hospital executives and 28 service providers from the private hospitals. We obtained 911,913 records of hospital visits, of which 324,906 came from 104,830 medical tourists. We estimated that there were 167,000 medical tourists in Thailand in 2010. Of the medical tourists who attended our study hospitals, 67,987 (64.8%) came from the eastern Mediterranean region or Asia and 109,509 (34%) of them were treated for simple and uncomplicated conditions - i.e. general check-ups and medical consultations. The mean self-reported non-medical expenditure was 2750 United States dollars. According to the hospital staff interviewed, medical tourism in 2010 brought benefits to - and apparently had no negative impacts on - the Thai health system and economy. We estimate that the total number of medical tourists visiting Thailand is about 10% of previous national government estimates of 1.2 million. Such tourists appear to bring economic benefits to Thailand and to have negligible effects on the health system.

At an understaffed and underresourced urban African training hospital, Malawian medical students learn to be doctors while foreign medical students, visiting Malawi as clinical tourists on short-term électives, learn about \"global health.\" Scientific ideas circulate fast there; clinical tourists circulate readily from outside to Malawi but not the reverse; medical technologies circulate slowly, erratically, and sometimes not at all. Medicine's uneven globalization is on full display. I extend scholarship on moral imaginations and medical imaginaries to propose that students map these wards variously as places in which—or from which—they seek a better medicine. Clinical tourists, enacting their own moral maps, also become representatives of medicine \"out there\": points on the maps of others. Ethnographic data show that for Malawians, clinical tourists are colleagues, foils against whom they construct ideas about a superior and distinctly Malawian medicine and visions of possible alternative futures for themselves. In einem unterbesetzten, unterfinanzierten afrikanischen Lehrkrankenhaus werden malawische Medizinstudenten zu Ärzten ausgebildet. Auch ausländische Medizinstudenten studieren dort; sie besuchen Malawi als \"klinische Touristen\" für kurzfristige Aufenthalte, bei denen sie Wahlfächer belegen und etwas über \"globale Gesundheit\" lernen. Wissenschaftliche Ideen zirkulieren dort schnell. Medizinische Technologien verbreiten sich langsam, unregelmäßig, und manchmal überhaupt nicht: die ungleiche Globalisierung der Medizin ist unübersehbar, ich erweitere die Literatur über moralische und medizinische Imaginationen und argumentiere, dass die Studenten sich diese Krankenhausabteilungen auf \"moralischen Karten\" vorstellen, entweder als Orte wo—oder von wo aus—sie eine \"bessere Medizin\" anstreben. Klinische Touristen (die ihren eigenen moralischen Karten folgen) repräsentieren außerdem die Medizin \"da draußen\": Sie werden zu Punkten auf den \"moralischen Karten\" Anderer. Für malawische Medizinstudenten sind diese ausländischen klinischen Touristen Kollegen, ein Hintergrund, vor dem sie Ideen einer überlegenen und spezifisch malawischen Medizin und alternative Zukunftsvisionen für sich selbst konstruieren. Dans un hôpital d'enseignement africain, en sous-effectif et manquant de ressources, les étudiants malawiens apprennent à être médecins alors que les étudiants étrangers, « touristes cliniques » en visite au Malawi, s'informent sur la « santé publique mondiale ». Les idées scientifiques circulent rapidement; les touristes circulent facilement de l'étranger au Malawi mais pas vice-versa; quand les technologies médicales circulent, c'est lentement. La mondialisation inégale de la médecine est exposée. J'accrois la recherche sur les imaginations morales et imaginaires médicaux, argumentant que les étudiants dépeignent cette expérience comme étant un lieu où, et par l'intermédiaire duquel, ils recherchent une médecine meilleure. Les touristes affichent leur scheme moral et représentent également la médecine de « là-bas »: des repères pour les autres. Les données ethnographiques démontrent que pour les Malawiens, les touristes sont des collègues à travers qui ils construisent les concepts d'une médecine malawienne supérieure et d'un avenir différent.

Malaysia had big plans for its medical tourism industry in 2020—only for the pandemic to hit. Megan Tatum reports on a sector full of profit and promise that is now full of uncertainty.

Background There is a growing recognition of the significance of the diasporic dimension of medical travel. Explanations of medical tourism are increasingly presented in a wider context of transnationalism, diaspora and migration. Yet diaspora and cross-border travellers rarely get through the broader narrative of medical travel. Objective Our aim in this scoping review was to extend the current knowledge on the emerging subject of diasporic travels for medical purposes. Specifically, we reviewed the existing literature on what is known about the determinants and motivational factors of diasporic medical tourism; its geographic scope and its quantitative estimation. Methods Using a scoping review methodology, we conducted the search in seven electronic databases. It resulted in 210 records retrieved. Ultimately, 28 research papers and 6 non-research papers (published between 2002 and 2019) met the following criteria: 1) focus on healthcare and health-related practices, 2) transnational perspective, 3) healthcare consumption in the country of origin (homeland) while being a resident of another country, 4) published in English. Results The findings from our review highlighted the importance of diasporic medical patients who had been researched and analysed on four continents. Even though quantitative evidence has been scarce, the data analysed in the scoping review pointed to the existence of non-negligible level of diasporic medical tourism in Northern America, and in Europe. Various motivational factors were enumerated with their frequency of occurrence: medical culture (12), time availability (“by the way of being home”) (9), communication (6), dissatisfaction with the current system (6), healthcare insurance status (5), quality of healthcare (5), second opinion (3), and value for money (3). Conclusion Diasporic medical tourists constitute an attractive segment of consumers that is still not well understood and targeted. They are part of transnational communities that cultivate the links between the two nations. They simultaneously participate in bi-lateral healthcare systems via return visits which impact the health systems of sending and receiving countries in a substantial way. In the current globalised, connected and migratory context, transnationalism seems to represent an answer to many local healthcare-related barriers. Sending and receiving countries have put in place an array of programmes and policies addressed to the diasporic medical travellers.

This study focuses on diasporic medical tourism (DMT), an offshoot of migration-led tourism and medical tourism. There has been growing recognition of the significance of a diasporic dimension of medical tourism worldwide, yet little is known about these travellers, especially quantitatively. This paper examines the antecedents and behavioural intention of the DMT by applying the extended Theory of Planned Behaviour. A cross-sectional survey was conducted in three European countries (Belgium, the Netherlands, and Luxembourg) among the Polish diaspora (N=i,288), which constitutes one of the largest migrant populations in Europe. The results analysed via PLS-SEM demonstrated that the model explained 53 % of the variance (R2= 0.527, Q2= 0.392), indicating a good model fit. Constructs of Attitude (ß = 0.329), Subjective Norms (ß = 0.277), Perceived Behavioural Control (ß = 0.112), and Past Behaviour (ß = 0.302) were all statistically significant. The caring/affective/trusting relationship with doctors, familiarity with the system, second opinion, encouragement/recommendation from referents, and facilitating factors influenced the decisions to undertake the DMT. 'Committed' and 'Contended' travellers accounted for 76% of all surveyed diasporic medical travellers, indicating the significant potential of those 'hidden' medical travellers. Diasporic medical tourism was compared to foreign medical tourism. This study provides theoretical/practical implications and contributes to the research on medical tourism, diaspora tourism and the interrelation between tourism and migration, specifically in the European context.

To systematically review the literature on women's experiences traveling for abortion and assess how this concept has been explored and operationalized, with a focus on travel distance, cost, delays, and other barriers to receiving services. Increasing limitations on abortion providers and access to care have increased the necessity of travel for abortion services around the world. No systematic examination of women's experiences traveling for abortion has been conducted; this mixed-methods review provides a summary of the qualitative and quantitative literature on this topic. A systematic search was conducted using PubMed, Embase, Web of Science, Popline, and Google Scholar in July 2016 and updated in March 2017 (PROSPERO registration # CRD42016046007). We included original research studies that described women's experiences traveling for abortion. Two reviewers independently performed article screening, data extraction and determination of final inclusion for analysis. Critical appraisal was conducted using CASP, STROBE, and MMAT checklists. We included 59 publications: 46 quantitative studies, 12 qualitative studies, and 1 mixed-methods study. Most studies were published in the last five years, relied on data from the US, and discussed travel as a secondary outcome of interest. In quantitative studies, travel was primarily conceptualized and measured as road or straight-line distance to abortion provider, though some studies also incorporated measures of burdens related to travel, such as financial cost, childcare needs, and unwanted disclosure of their abortion status to others. Qualitative studies explored regional disparities in access to abortion care, with a focus on the burdens related to travel, the impact of travel on abortion method choice, and women's reasons for travel. Studies generally were of high quality, though many studies lacked information on participant recruitment or consideration of potential biases. Standardized measurements of travel, including burdens associated with travel and more nuanced considerations of travel costs, should be implemented in order to facilitate comparison across studies. More research is needed to explore and accurately capture different dimensions of the burden of travel for abortion services on women's lives.

Background Medical tourism is understood as travel abroad with the intention of obtaining non-emergency medical services. This practice is the subject of increasing interest, but little is known about its scope. Methods A comprehensive scoping review of published academic articles, media sources, and grey literature reports was performed to answer the question: what is known about the patient's experience of medical tourism? The review was accomplished in three steps: (1) identifying the question and relevant literature; (2) selecting the literature; (3) charting, collating, and summarizing the information. Overall themes were identified from this process. Results 291 sources were identified for review from the databases searched, the majority of which were media pieces ( n = 176). A further 57 sources were included for review after hand searching reference lists. Of the 348 sources that were gathered, 216 were ultimately included in this scoping review. Only a small minority of sources reported on empirical studies that involved the collection of primary data ( n = 5). The four themes identified via the review were: (1) decision-making (e.g., push and pull factors that operate to shape patients' decisions); (2) motivations (e.g., procedure-, cost-, and travel-based factors motivating patients to seek care abroad); (3) risks (e.g., health and travel risks); and (4) first-hand accounts (e.g., patients' experiential accounts of having gone abroad for medical care). These themes represent the most discussed issues about the patient's experience of medical tourism in the English-language academic, media, and grey literatures. Conclusions This review demonstrates the need for additional research on numerous issues, including: (1) understanding how multiple information sources are consulted and evaluated by patients before deciding upon medical tourism; (2) examining how patients understand the risks of care abroad; (3) gathering patients' prospective and retrospective accounts; and (4) the push and pull factors, as well as the motives of patients to participate in medical tourism. The findings from this scoping review and the knowledge gaps it uncovered also demonstrate that there is great potential for new contributions to our understanding of the patient's experience of medical tourism.

Background Many ethnic minorities in Hong Kong seek medical tourism after encountering inequalities in access to local healthcare because of language barriers and cultural-religious differences. The present study explored the ethnic minorities’ lived experiences of medical tourism and issues arising from cross-border health-seeking relevant to this specific population. Methods Qualitative in-depth interviews with 25 ethnic minority informants from five South Asian countries in 2019. Results The 19 informants out of the 25 have sought assistance from their international networks for home remedies, medical advice and treatments of traditional/Western medicines, for they are more costly or unavailable in Hong Kong and for issues related to racial discrimination, language barriers, transnationalism engagement, cultural insensitivity, and dissatisfaction with healthcare services in Hong Kong. Discussion Medical tourism can relieve the host country’s caring responsibilities from healthcare services, so the government might no longer be hard-pressed to fix the failing healthcare system. Consequently, it could cause public health concerns, such as having patients bear the risks of exposure to new pathogens, the extra cost from postoperative complications, gaps in medical documentation and continuum of care, etc. It also triggers global inequities in health care, exacerbating unequal distribution of resources among the affordable and non-affordable groups. Conclusion Ethnic minorities in Hong Kong sought cross-border healthcare because of structural and cultural-religious issues. The surge of medical tourism from rich and developed countries to poor and developing countries may infringe upon the rights of residents in destination countries. To mitigate such negative impacts, policymakers of host countries should improve hospital infrastructure, as well as train and recruit more culturally sensitive healthcare workers to promote universal health coverage. Healthcare professionals should also strive to enhance their cultural competence to foster effective intercultural communication for ethnic minority groups.