A Survey

of
Medical Tourism Service Providers

Christina R. Peters & Katherine M. Sauer

Metropolitan State College of Denver

March 25th, 2010 MBAA – ABE Annual Conference Chicago, IL

 Outline:

I. Introduction
II.Survey Methodology
III.Results
IV.Potential Impacts / Future Research
I. Introduction
The practice of traveling to obtain health care is known
by several different names…
medical tourism medial travel
health tourism health travel

Medical or health travel are probably the most accurate

terms.

Medical tourism seems to be the most widely used term.

From a US perspective, there are three general types of
medical tourism:
patients traveling outside the US for care
patients traveling to the US for care
patients traveling within the US for care.

Today’s focus will be US patients traveling abroad for

medical care.
Estimates on the number of Americans traveling abroad
for medical care range from 50,000 to
1 million people per year.

A 2009 Deloitte Center report states that 1% of

respondents have traveled abroad for medical care.
We seek to get some concrete data on the industry
by surveying medical tourism service providers.
II. Survey Methodology

Our interest is in US patients traveling abroad.

- survey medical tourism service providers who
cater to US patients

- OnlineMedicalTourism.com provides information

on service providers, procedures, insurance, and
accreditation.
- 130 firms listed as “full service” providers
- visited all websites
- chose ones who were marketing to US
patients
Found 91 firms to be our population.
- 62 internationally based (India 11)
- 19 US based (CA, FL, NJ 13)

A total of 57 destinations were offered.

- max number of destinations 23
- average number of destinations 3.4
- two-thirds of firms offer 1 destination

India is most frequently offered destination (38).

Costa Rica, Thailand, Singapore, and Turkey make up
the rest of the top 5 offered destinations.
A 30 item questionnaire is constructed and approved by
the MSCD Institutional Research Board.

Pre-notification letters and emails are sent.

A follow up email with the link to our on-line survey is

sent.

Paper copies of the survey are sent to non-responders.

III. Survey Results

18 responses, 16 usable responses

17.6% response rate

9 domestic firms, 7 international firms

Respondents were asked what their job title is and how

long they’ve been with the firm.
- CEO, managers, presidents
- average of 3.2 years with the firm
Respondents were asked how long the firm has been in
business.
81% of firms opened in 2005 or later
63% of firms opened in 2006 or later
54% of firms opened in 2007 or later
13% of firms opened in 2008 or later
Table 1: Frequently Offered Destinations
  Survey Sample   Population
  n = 16   N = 91
Percentage
Number Percentage Number of
  of
of Firms of Sample Firms
Destination Population
India 8 50% 38 42%
Costa Rica 6 38% 20 22%
Turkey 5 31% 17 19%
Brazil 5 31%
Mexico 4 25%
Thailand 19 21%
Singapore         17 19%

average 4.5 countries

 Table 2: Available Procedures
Percentage of
Number of Firms
Procedure Sample
Hip Surgery 16 100%
Knee Surgery 16 100%
Heart Surgery 15 94%
General Surgery 14 88%
Laparoscopic Surgery 14 88%
Obesity Surgery 14 88%
Dental Surgery/Treatment 13 81%
Infertility Treatment 13 81%
Scans/Investigations 12 75%
Cosmetic Surgery 11 69%
Cancer Treatment 11 69%
Neurosurgery 11 69%
Spinal Fusion 11 69%
Transplants 10 63%
Eye Surgery 8 50%
Therapeutic or Medical Spa
Treatment 4 25%
 Figure 1: Travel Trends

Average length of trip: 18 days

Median length of trip: 12 days
 Table 3: Influences on Decision to Seek Medical
Treatment Abroad
Importance to Clients When Making Decision to
Seek Medical Treatment Abroad
 

Very Important or Slightly Not at all

Important Important Important

Factor
Percentage of Respondents:

Experience & Reputation of a Particular Overseas Medical Provider 100% 0% 0%

Medical Care Abroad is Cheaper than Domestic Care 94% 0% 6%

Length of Waiting Time for Domestic Treatment 75% 19% 6%

Client has Inadequate Domestic Health Insurance 69% 19% 13%

Client’s Health Insurance Covers Treatment Abroad, or Offers Incentives 69% 31% 0%

Treatment is Available Abroad that is Unavailable Domestically 69% 25% 6%

Anonymity of Treatment 32% 56% 13%

Combining Medical Treatment with Vacation 20% 40% 40%

On average 17% of clients had insurance coverage for
their procedure domestically.

On average 7% of clients had insurance coverage for

their procedure internationally.
 Table 4: Factors Influencing Specific Medical
Tourism Decisions
Importance to Firms When Determining Importance to Clients When Choosing
 
Providers to Recommend Provider and Country
 
Very
Very
Slightly Not at all Important Slightly Not at all
Important or  
Important Important or Important Important
Important
Important
Factor
  Percentage of Respondents:   Percentage of Respondents:
JCI Accreditation 82% 19% 0% 53% 33% 13%
Trent Accreditation 40% 33% 27% 40% 13% 47%
CHSA Accreditation 40% 27% 33% 29% 21% 50%
ACHSI Accreditation 34% 33% 33% 34% 20% 47%
Any Nationally-Recognized Accreditation 76% 13% 13% 60% 13% 27%
Volume of Medical Tourists Served 69% 25% 6% 67% 33% 0%
Experience & Reputation of Medical Provider 100% 0% 0% 100% 0% 0%
Quality of Medical Care 100% 0% 0% 100% 0% 0%
Quality of After-Care 94% 0% 6% 94% 7% 0%
Quality of Facilities 100% 0% 0% 100% 0% 0%
Procedure cost 81% 19% 0% 97% 7% 0%
Distance from Client's Home 44% 44% 13% 53% 33% 13%
Ease of Travel from Client's Home 69% 31% 0% 74% 27% 0%
Ability to Communicate in English 100% 0% 0% 100% 0% 0%
Recommendations from Acquaintances n.a. n.a. n.a. 87% 13% 0%
Desire to Travel and Vacation in That Country n.a. n.a. n.a. 14% 71% 14%
 Table 5: Industry Perceptions and Outlook
  Level of Agreement
Strongly Strongly
Agree Agree Neutral Disagree Disagree
Statement Percentage of Respondents
Medical Tourism patients believe they are getting similar or superior
25% 56% 13% 6% 0%
care abroad when compared to domestic care.
Medical Tourism patients are willing to sacrifice quality to get a
0% 19% 19% 31% 31%
lower price.
For Medical Tourism patients, price is more important than quality
6% 13% 13% 38% 31%
of care.
It is important to direct patients to hospitals/facilities that are
44% 19% 13% 19% 6%
internationally accredited.
US healthcare reform will likely have a significant negative impact
0% 19% 19% 31% 31%
on the number of US patients seeking medical travel abroad.
The Medical Tourism industry has seen a slowdown as the US
60% 44% 19% 25% 6%
economy has slowed down.
The number of US patients seeking medical travel abroad will likely
0% 13% 13% 38% 38%
decrease in 2010.
The outlook for Medical Tourism five years from now is very
44% 44% 13% 0% 0%
promising.
I expect my company’s profits to grow over the next five years.
75% 25% 0% 0% 0%
IV. Potential Implications / Future Research

A. Developing Nations
1. health infrastructure
- built or expanded
- source of foreign investment funds
- tax foreign patients as revenue source for
public health infrastructure
- two-tier system emerges?

2. human capital
- opportunities for advancement domestically
- spillovers into public health
3. local economy effects
- entrepreneurship opportunities
- ground transportation
- lodging
- attractions
- concierge/liaison
- hospital workers spend money

4. growth in export sector

- GATS mode 2 trade in health services
has very few restrictions
- utilize comparative advantage
5. Government Policies
- immigration (medical visas?)
- regulations on foreign investment
- tax policy
- direct promotion
 B. United States

1. affordable health care option

- individuals
- not transform health care industry / costs

2. insurance companies
- pilot programs
- new products

3. US – Foreign partnerships
4. medical issues / follow up care
- continuity
- communication / records

5. legal issues
- can an insurance company force treatment
abroad?
- Medicare?
- malpractice suits on follow up care?
 C. Expanded Survey

- Medical Tourism Association

- conference
 Comments? Questions?

To contact me:
Katherine M. Sauer
Metropolitan State College of Denver
ksauer5@mscd.edu
303-556-3037

March 25th, 2010 MBAA – ABE Annual Conference Chicago, IL