Medical tourism

Medical tourism is a colloquial term for the office of the transnational receiving medical treatments and surgeries. Depending on the type of medical intervention staying a few days (eg plastic surgical operations ) or more months may take ( oncological treatments or organ transplants ). Reasons for this form of " tourism" are not existing treatment options in the country of origin of the patient, the circumvention of waiting times in the home country or in cost savings. Medical tourism is the worldwide trend and is one of the consequences of advancing globalization. Some 40 countries actively recruit to patients from abroad, including the USA, Germany, Switzerland, Israel, India, Thailand and Singapore.

Two-thirds of all medical trips take place within Asia. India, Thailand, Singapore, Malaysia, South Korea and the Philippines treat each year hundreds of thousands of patients from abroad. These, mostly outpatients come from neighboring states as well as the U.S., Europe or the Arab Gulf states, with an upward trend of about 15 percent per year. Even Germany is the preferred destination of medical tourists, mainly from the EU, the Commonwealth of Independent States and the Arab countries. An interesting target group also constitute U.S. citizens who have no health insurance and travel for necessary operations abroad. 2007 750,000 Americans traveled abroad for medical treatments, 2010, there should already be six million, according to estimates.

Meanwhile, there are a variety of tourism companies and patient recruiters who specialize in medical tourism worldwide. Lately, Turkey, partly with the help of the Ministry of Tourism, very strongly to patients from abroad advertises. Especially Istanbul has really experienced a boom in this industry. On risks to look out for.

Classification and delineation of the medical tourism concept

The term medical tourism is not yet clearly defined in the current scientific knowledge and experts sometimes even controversial. Depending on the approach, perspective and expression of the theme have been described in the literature many synonyms (eg tourism clinic, patients tourism, cross-border healthcare, etc. ) emerged. As the wording, however, suggests, the term is composed of two components: medicine and tourism.

Most often there is the systematization of medical travel in the segments of the tourism industry and in conjunction with the generic term " health". The World Health Organization ( WHO) defines this term as follows: "Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity." Furthermore, the World Tourism Organization describes the "tourists" as a person who travels to places outside their usual environment and stays there for leisure, business and other purposes for not more than one year.

In summary describes the so-called medical tourism, in terms of health and medically-oriented travel for reasons of cost savings and avoid waiting times, a trend that combines with tourism and medicinal properties to an offer. Medical tourism can be understood as a form of health tourism - in addition to the classic spa tourism and wellness tourism. At the same time it acts as a generic term for other sub-regions (Fig. 1: " Scientific classification of medical tourism in the different tourism segments "). The lines of business "Prevention tourism", "Operation tourism" and " tourism rehabilitation " form a subdivision of medicine travel.

In contrast to the two other forms of health tourism - spa and wellness tourism - are the degree and intensity of medical school application process in medical tourism is very high. Thus, travels the already chronic or sick tourist as symptomatic patient in a country outside of his normal place of residence in order to be targeted undergoing medical treatment. The impetus for a medical trip starts with a preliminary diagnosis or clinically manifest disease of the patient in his home, for which he hopes to better quality, faster or cheaper treatment abroad for different reasons. The medically -indicated health travel usually includes one inpatient or outpatient stay in a medical facility. In acutely ill ( emergency ) patients a medical travel is often also associated with a higher risk of treatment and possible complications during the therapy.

The terms " foreign patients ", " International patients " or " medical tourists " are used interchangeably in the literature for those tourists who make the target a medical trip. In professional circles, does not include people who are not traveling with the primary goal of medical treatment abroad but there involuntarily (eg an accident ) are used for patients. Among patients from abroad both individual patients and patient groups to be understood.

Types of medical tourism

From the perspective of the origin or the patient flows of medical tourists is to distinguish between essentially two forms: the so-called outgoing and the incoming medical tourism. In Germany two forms have gained in recent years of high economic relevance.

General Valid to understand are under the outgoing medical tourism that patient flows from the domestic market, seek medical tourism destinations abroad and medical treatment there. The term incoming medical tourism travelers, however, describes patients who come from abroad, with the primary aim of undergoing medical treatment to undergo this country.

Typology of medical tourists

Medical tourists have a variety of motives for treatment abroad. Depending on the origin of the patient can be made between the following medical tourism types:

• Patients seeking world the best treatment option
• Patients who seek a better treatment option compared to their home country
• Patients who have waiting times for treatment in the home country
• Patients whose treatment abroad is cheaper
• Medical Emergencies
• Patients who have emigrated at the age and use medical services in the home country
• Patients in border regions
• Patients who can only be carried out in foreign clinics because of legal restrictions or moral reasons certain treatments
• Check Up - patients
• Medical Wellness - Tourist
• Patients in need of a health-promoting natural infrastructure ( climatic health resorts )

The literature continues to take three additional criteria for a typology of medical tourists:

* Domestic patient, but place of residence away * Alien patient, but close to the border * Alien patient, but close to the border Personal motives * Better quality of medicine than in the home country * Availability of certain medical services * Better medical- technological equipment ( State-of-the-Art-Technologie/High-End Medical ) * Lower latency for certain treatments * Better value for money than at home payers * EU citizens with an EU health insurance certificate * Foreign private patients ( self-pay ) * Patients whose costs the respective embassy, a non-profit institution or a company takes over The main motive of medical tourists is basically ensuring the improvement, or the general review of the health status. The personal motivation for such a trip can be initiated from two overriding reasons: on the one hand by a medical statement (for example an urgent surgery in a cancer patient ) and on the other hand, from the self-motivation (eg, not medically necessary, surgical cosmetic change ) of the patients out.

The target states encourage this form of " tourism" due to lucrative foreign exchange revenues, which already account for a significant share of gross domestic product in many countries. At the same time the target countries can present itself as a medical high performance, which is a factor also for the "normal " tourist.

Incoming Medical tourism to Germany

In 2012, according to data were the Hochschule Bonn -Rhein-Sieg 90 007 (2011: 82 854 ) treated patients from abroad in German hospitals. Which is 8.6 percent more than last year. Because outpatient treatment estimated 134,000 international patients examined at a clinic. Their share in the total number of clinic patients so that is 0.5 percent and well below the accepted by the European Commission value of around two percent. The estimated revenue volume of international patients annually amounts to approximately 1.1 billion euros. Among the predisposing factors for the medicine in Germany include the inefficiency of many health care systems of other countries, where medical and technological excellence and the accessibility to the services is very difficult or impossible.

Source countries of foreign medical tourists

The who have entered Germany in 2012 medical tourists came from 173 different countries of the world. For the first time, Russia was almost 21,000 patients, the most important source market, followed by Germany's neighboring countries. Only a small part of the medical tourists coming from the U.S. or the more distant EU countries. Outside the EU borders are now almost twice as many patients in the CIS countries and the Baltic States as from the GCC States. Are you looking for higher quality treatments in the countries of the industrialized nations, including Germany counts .. 2005 official figures, 350 patients and 864 accompanying persons came alone from Dubai to Germany, from the United Arab Emirates in total there are approximately 2,500 patients per year.

Criticism

The practice of medical tourism is criticized from several sides. " With the boom are of medical tourism in a country like India, (...) a whole range of risks and side effects associated. They include for example the problem of environmentally sound disposal of hospital waste or the illegal trade in organs. While the medical care of the Indian population can be much to be desired, are scarce tax revenues subsidize private clinics for the rich. "

Furthermore, given various medical and economic points of criticism regularly. These include, for example, the preferred treatment of international patients while domestic waiting times for patients have to accept, the spread of multi-resistant germs through medical tourists or defaults in clinics as well as a lack of transparency in billing due to inadequate legal regulations.

Organ trafficking and the preferred treatment of transplant patients from abroad are not only a problem in emerging markets such as China and Colombia, but also appear regularly in German hospitals.

Swell