define health tourism

What is health tourism and why is it growing?

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Health tourism is a growing trend around the world. But what is health tourism and why is it so popular? Read on to find out…

What is health tourism?

The growth of health tourism, why is health tourism important, health tourism activities, health tourism- further reading.

Health tourism is a tricky one to define. It is more of an umbrella term, encompassing both wellness tourism and medical tourism. These two types of tourism may seem quite different, but they both fundamentally have health at their core. So, health tourism can be defined as follows:

Health tourism covers those types of tourism which have as a primary motivation, the contribution to physical, mental and/or spiritual health through medical and wellness-based activities which increase the capacity of individuals to satisfy their own needs and function better as individuals in their environment and society.

This definition comes from an executive summary published by the World Tourism Organization and the European Travel Commission in 2018. As you can see, the exploration of health tourism in itself is a relatively new idea. The two organisations also provided the following definitions of wellness and medical tourism respectively:

Wellness tourism is a type of tourism activity which aims to improve and balance all of the main domains of human life including physical, mental, emotional, occupational, intellectual and spiritual. The primary motivation for the wellness tourist is to engage in preventive, proactive, lifestyle enhancing activities such as fitness, healthy eating, relaxation, pampering and healing treatments.

Medical tourism is a type of tourism activity which involves the use of evidence-based medical healing resources and services (both invasive and non-invasive). This may include diagnosis, treatment, cure, prevention and rehabilitation.

There are many reasons as to why health tourism as an industry is growing. People are keener than ever to put their health and wellbeing first – especially now we are 2 years into a global pandemic. As a population , we are more aware now than ever before how our health can hang in the balance. And just knowing this, coupled with all of the other changes brought about by the pandemic as well as the general ease of accessing information, mean that life is generally more stressful. So it is no wonder that we are looking for wellness trips to calm and soothe ourselves – and to affordable and accessible medical procedures that may be unavailable at home…

The UK sees health tourism as a distinct and negative phenomenon. The media uses the term to refer to people who travel to the UK deliberately in order to access free medical treatment from the National Health Service. This is seen as leeching off the state, and as you can imagine is particularly frowned upon by many in the country. However, reports show that the government estimates ‘health tourism’ costs the NHS only £300m annually – or 0.3% of their budget! But due to this, new laws are in place to charge people who do not ‘ordinarily reside’ in the UK if they use the NHS.

Health tourism is important for many reasons. Looking at it from an economical point of view, it provides a boost to local economies when people travel to a destination for any reason. So heading to a summer yoga retreat in Santorini or getting some dental work done in Turkey is contributing to the local economy. And it’s not just the cost of your treatment or stay – you will also purchase food and drink, maybe even souvenirs. You might extend your trip and do some sightseeing with local tour companies too. All of these things mean a cash injection for the area and its inhabitants.

Linked to this is that health tourism often provides a cheaper opportunity to do something you were going to do at home. Travelling for optional surgery or going to a small spa in a remote village might be much cheaper than doing so in your home country. In this way, health tourism actually provides people with a way to save money.

Health tourism is also important as it is a reflection of my earlier point – people are taking more of an interest in their health. Regardless of whether it’s wellness tourism or medical tourism, health tourists are travelling with the primary focus of improving their mind, body or life in some way. This is obviously a positive factor for society.

As health tourism combines wellness and medical tourism, the activities it involves are anything which falls under these categories. Essentially, anything you do as a tourist which is aimed at improving your health is classed as health tourism. See a list of activities below:

Dental/dentistry
Orthopedics
Cosmetic/plastic surgery
Bariatric surgery
Fertility treatment
Eye surgery
Ears, nose and throat
Organ transplants
Rehabilitation
Alternative medication access
Yoga retreats
Writing retreats
Meditation centres
Weight loss or healthy eating retreats
Sensory deprivation

Popular health tourism destinations

There are many destinations you can visit as a health tourist. Your home country may also be a health tourism location for people from other countries. It is all contextual and subjective, depending on what exactly you are looking to get out of your trip…

This is a popular place for health tourism – particularly when it comes to wellness. With its geothermal pools, breathtaking scenery, infinity pools and mountain hiking areas the options are endless! A very popular part of Iceland for wellness activities is Myvatn Nature Baths, where the alkaline in the water has a lot of minerals and is incredibly beneficial for the treatment of skin conditions. Because of this, it can also be seen as a destination which works for medical purposes – making it a dead cert for health tourism.

Ever heard of the saying ‘Turkey teeth’? It doesn’t come from nowhere! The reason this term exists is because many people (particularly younger people, celebrities, and influencers) flock to Turkey to have dental treatment done for cosmetic purposes. They want straighter, whiter and brighter teeth. Something like this might cost double or triple in the UK, for example, than what it would in Turkey. Plus, visitors get to combine their trip with sun, sea and sand!

India is a big one for health tourism as it has a big wellness tourism industry combined with many options for medical tourists to have cheaper procedures done. Being such a spiritual country, it is no wonder that people come here for wellness purposes. The Indian government readily promotes the country as a hub for yoga, Sidha, naturopathy and Ayurveda – citing the ‘spiritual philosophy that has been integral to the Indian way of life’. There are retreats right across the country, particularly in countryside areas but also in the bustling cities which mean it works for both primary AND secondary wellness tourism.

Primary wellness tourism is when someone’s whole trip is focused on wellness; it is their sole reason for travel, and the major component of their trip. Every aspect of their holiday is tailored to wellness. Secondary wellness tourism is when general tourists incorporate some aspect of wellness (a massage on the beach during an all-inclusive Mexican vacation) into their holiday.

India is also a huge destination when it comes to medical tourism. Locations such as Chennai, Maharashtra and Kerala are really popular for medical procedures, with costs being about one tenth of those in either the UK or the USA. Medical tourists travel to India for alternative medicine, cardiac procedures, bone-marrow transplants, eye surgery and hip replacements in particular.

Beautiful Hawaii is like one big spa in itself. Primary wellness tourists visit here in droves to experience the therapeutic salt water, the laid back atmosphere, the glorious sunshine and the traditional practices of omilomi massage and pohaku (hot stone treatment). With scenery that will leave you lost for words, it is one of the most relaxing places in the world which is why wellness tourism is so big here – and so, by extension, is health tourism.

This stunning country has cutting edge technology and beautiful spaces to relax – making it ideal for health tourism encompassing both wellness and medical tourism. People tend to head here for small elective surgeries, choosing to get the procedure done for a lower price and recover somewhere beautiful! And there are so many options for wellness tourists, too. From Thai massage parlours to serene meditation retreats on beaches where the sunsets are bright pink and shiny gold, you couldn’t ask for somewhere more suited to a relaxing wellness trip.

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UN Tourism | Bringing the world closer

All Regions
20 Dec 2018

UNWTO/ETC Launch Report on Health Tourism

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PR No. : PR 18100

Madrid, Spain, 27 December 2018 – The World Tourism Organization (UNWTO), together with the European Travel Commission (ETC) launched a new report on health tourism. Part of their joint research programme, the study is the first attempt to set a coherent conceptualization of health tourism and define the motivations behind travellers looking for health-related services.

‘Exploring Health Tourism’ proposes a comprehensive taxonomy with a consistent terminology to define and describe the intricate system of travelling for health purposes and provides a practical toolkit for National Tourism Organizations (NTOs) and Destination Management Organizations (DMOs) wanting to develop health tourism.

As defined in the report, health tourism covers those types of tourism which have as a primary motivation the contribution to physical, mental and/or spiritual health through medical and wellness-based activities.

The report sheds light on the factors shaping health tourism such as technological developments, personal health, data protection and urbanization. It also explores the market, the demand and the supply of health tourism and provides examples of marketing management. Finally, the study proposes a set of recommendations ranging from improved data collection and more accurate measurement to more accessible and sustainable health tourism calling for further partnerships.

Useful links:

Exploring Health Tourism Report

Exploring Health Tourism Report- Executive Summary

UNWTO Communications Department

Tel: (+34) 91 567 8100 / Fax: +34 91 567 8218 / [email protected]

Why Patients Are Turning to Medical Tourism

Statistics, Benefits, and Risks

Planning Ahead

Frequently asked questions.

Medical tourism is a term that refers to traveling to another country to get a medical or dental procedure. In some instances, medical tourists travel abroad seeking alternative treatments that are not approved in the United States.

Medical tourism is successful for millions of people each year, and it is on the rise for a variety of reasons, including increasing healthcare costs in the United States, lack of health insurance, specialist-driven procedures, high-quality facilities, and the opportunity to travel before or after a medical procedure.

According to a New York Times article from January 2021, pent-up demand for nonessential surgeries, as well as the fact that many Americans lost their health insurance during the coronavirus pandemic led to a surge in medical tourism once other countries re-opened.

However, there are specific risks that come with traveling overseas for surgery. If you're thinking of pursuing a medical procedure in another country, here's what to know about the benefits and the risks.

Medical Tourism Benefits

The most common procedures Americans go abroad for include dental care, cosmetic procedures , fertility treatments, organ transplants , and cancer treatment.

This is not to be confused with having an unplanned procedure in a foreign country due to an unexpected illness or injury.

Among the reasons a person might choose to go abroad for a medical procedure are:

Lower Costs

Medical tourists can save anywhere from 25% to 90% in medical bills, depending on the procedure they get and the country they travel to. There are several factors that play into this:

The cost of diagnostic testing and medications is particularly expensive in the United States.
The cost of pre- and post-procedure labor is often dramatically lower overseas. This includes labor costs for nurses , aides, surgeons , pharmacists, physical therapists , and more.
High cost of malpractice insurance—the insurance that protects medical professionals against lawsuits—in the United States.
Hospital stays cost far less in many overseas countries compared to the United States. In other words, quality care, hospital meals, and rehabilitation are far more affordable abroad for many people.

For someone who doesn't have insurance , or someone having a procedure that is not covered by insurance , the difference can be enormous.

Popular Countries for Medical Tourism

Dominican Republic

South Korea

Culture and Language

Many immigrants prefer to have treatments and procedures done in their country of origin—a sensible decision, considering just how much language barriers alone can affect the quality of their care.

Furthermore, at least 25% of immigrants and noncitizen residents in the United States are uninsured, compared to 9% of American citizens. Children with at least one noncitizen parent are also more likely to be uninsured.

Practicalities aside, many people choose to have their procedure done in their country of origin simply because it allows them to be close to family, friends, and caretakers who can assist them through their recovery .

Insurance Incentives

Some insurance companies have started promoting medical tourism. The reason behind this is simple: savings for the insured means savings for the insurance provider and vice versa.

Several insurance providers, including Aetna have programs specifically geared at promoting safe medical tourism. Some insurance providers even offer financial incentives for medical tourism, like discounts on medical bills .

That said, many insurance companies will not pay for surgery performed outside of the country unless it is an emergency.

Luxury and Privacy

Medical tourism is a lucrative business for many countries, and much of the money brought in by medical tourists is reinvested into the local economy and health infrastructure.

The effect of this is apparent in the spa-like luxury that some foreign hospitals offer, providing medical tourists the opportunity to be pampered during their stay for a fraction of the cost they would pay at home.

Some facilities offer hospital rooms that are more like a hotel suite than a traditional hospital room. Other hospitals offer one-on-one private nursing care, which is far more generous and attentive than the staffing ratios that most hospitals allow.

Medical tourists who seek that added layer of privacy can find it abroad. Many can return home from their "vacation" without anyone knowing they had a procedure at all.

Vacation in a Foreign Country

Medical tourists often take advantage of their stay in a foreign country to travel for pleasure by scheduling a vacation before or after their procedure.

This is an especially inexpensive way to travel to a foreign country, especially if their insurance provider is paying for the flight and the cost of staying is low.

While it seems logical to recover on a beach or in a chalet by the mountains, keep in mind that it's important not to jeopardize your recovery.

Swimming isn't recommended until your incisions are completely closed. You may not feel up to doing much more than napping in the days following your procedure, either.

Don't let your vacation disrupt your recovery. Any time you have a procedure done, especially a surgery, it's important to listen to your body, take your medications as directed, and follow your doctor's recommendations closely.

Bypassing Rules and Regulations

Some travelers seek surgery abroad to bypass rules that are set in place by their own government, insurance company , or hospital. These rules are typically in place to protect the patient from harm, so getting around them isn't always the best idea.

For example, a patient may be told that their weight is too low to qualify for weight loss surgery . A surgeon in a foreign country may have a different standard for who qualifies for weight loss surgery, so the patient may qualify overseas for the procedure they want.

Talented Surgeons

Surgeons in certain countries are known for their talent in a specific area of surgery. For example, Brazilian surgeons are often touted for their strong plastic surgery skills .

Whereas in the United States, insurance companies might only cover cosmetic procedures if it is medically necessary, cosmetic surgery is often free or low-cost in Brazil's public hospitals—giving cosmetic surgeons there ample practice.

Thailand is reported to be the primary medical tourism destination for individuals seeking gender reassignment . It is often easier to qualify for surgery and the cost is significantly reduced. Surgeons are performing the procedures frequently, and as a result, many have become quite specialized in them.

It is often surprising to many medical tourists that their physician was trained in the United States. Not all physicians are, of course, but a surprisingly high percentage of them working in surgery abroad are trained in English-speaking medical schools and residency programs and then return to their home country. These physicians often speak multiple languages and may be board certified in their home country and a foreign country, such as the United States.

Medical tourism isn’t limited to countries outside of the United States, either. Many people travel to the United States for medical care due to the country's cutting-edge technology, prescription medication supply, and the general safety of healthcare.

Medical Tourism Risks

The financial and practical benefits of medical tourism are well known, and you may even know someone who had a great experience. Nonetheless, the downsides of medical tourism can be just as great if not greater. Sometimes, they can even be deadly.

If you are considering a trip abroad for your procedure, you should know that medical tourism isn't entirely without obstacle and risks. These include:

Poorly Trained Surgeons

In any country—the United States included—there will be good surgeons and bad. And just as there are great surgeons abroad, there are also some surgeons who are less talented, less trained, and less experienced.

Regardless of what procedure you are getting or where, you should always do some preliminary research into the surgeon or physician who will be treating you as well as the hospital you will be treated at.

In the United States, it is fairly easy to obtain information about malpractice lawsuits , sanctions by medical boards, and other disciplinary actions against a physician.

Performing this research from afar can be challenging, especially if you don't speak the local language. Yet countless people take the risk anyway, without knowing whether the physicians who will treat them are reputable.

A physician should be trained in the specific area of medicine that is appropriate for your procedure. For example, you should not be having plastic surgery from a surgeon who was trained to be a heart doctor. It isn’t good enough to be a physician, the physician must be trained in the specialty .

Prior to agreeing to surgery, you should also know your surgeon’s credentials : where they studied, where they trained, and in what specialty(s) they are board-certified. Do not rely on testimonials from previous patients; these are easily made up for a website and even if they are correct, one good surgery doesn’t mean they will all be successful.

Quality of Staff

Nurses are a very important part of healthcare, and the care they provide can mean the difference between a great outcome and a terrible one.

A well-trained nurse can identify a potential problem and fix it before it truly becomes an issue. A poorly trained nurse may not identify a problem until it is too late. The quality of the nursing staff will have a direct impact on your care.

Once again, it's important to research the hospital staff where you will be having your procedure done. Read the reviews but don't trust them blindly. If you can, seek out a recommendation from someone who can vouch for the medical staff where you will be going.

Quality of the Facility

While researching healthcare facilities for your procedure, you want to learn not just about the quality of the facilities themselves, but about the country's healthcare system as a whole.

In some countries, there is a marked distinction between public hospitals and private hospitals. In Turkey, for example, private hospitals are considered on-par with hospitals in the states, while many locals will advise you to steer clear of public hospitals if you can.

You will also want to seek out facilities that are internationally accredited. In the United States, the Joint Commission evaluates hospitals and certifies those that provide safe, quality care. The international division does the same for hospitals outside the United States.

Once you have a few options for potential facilities, you can start to investigate specifics. For one, you should find as many pictures and reviews of the facility as you can. Ask yourself whether the facility is state of the art or whether it seems dirty and outdated.

You will also need to find out if the facility has ICU level care available, in case something goes wrong. If not, there should be a major hospital nearby so that you can be transferred quickly.

To learn more about a healthcare facility, consider joining expat groups on social media for the city or country you will be traveling to. Ask the group for recommendations, or inquire about any positive or negative experiences they may have had at a particular facility.

Flying Home After Surgery

Any surgery comes with risks, including infection and blood clots . Flying home increases the risk of blood clots, especially on long-haul flights that are longer than four hours.

Try to avoid flying home in the days immediately after surgery; waiting a week will decrease the chances of developing a blood clot or another serious complication during the flight.

For longer flights, plan on getting up and walking up and down the aisles each hour to improve blood flow in your legs. You might also benefit from wearing compression socks with your doctor's approval.

If you are taking blood thinners or are at-risk of blood clots , be sure to talk to your doctor about how you can reduce your risk of blood clots after your procedure and while traveling.

Furthermore, you should know the symptoms of blood clots and stay alert.

Unplanned Illness

Any time you travel abroad, you run the risk of catching an illness that you have never been exposed to or that your body is not prepared to fight off. This is especially a concern when spending time in a foreign hospital.

If you have a sensitive stomach, you may also want to think long and hard about having surgery abroad. The food is often very different in foreign hospitals, and in some areas, there is a risk that even the water will be upsetting to your body.

Having diarrhea or postoperative nausea and vomiting makes for a miserable recovery experience, especially if you do not have a friend or family member nearby who can help you through it.

Before you travel abroad, check with your doctor to see if you need any vaccines to travel to your destination or if there are any foreign illnesses you should be aware of. Picking up an illness abroad, particularly after your surgery, can potentially be life-threatening.

Language Barriers

If you are having surgery in a country where English is not the primary language, you will need to make preparations in order to be able to communicate with the staff.

You may be pleasantly surprised to learn that the staff speaks your primary language well. If not, then you will need to consider how you will make your wishes and needs known to the surgeon, the staff, and others you will meet.

Whether you are at home or abroad, remember to speak up and advocate for yourself to make sure your needs are met. If you don't speak the local language, download a language translation app on your smartphone and don't hesitate to use it to communicate your needs. Hiring a translator is another option.

A Word About Transplant Tourism

Transplant tourism is one area of medical tourism that is strongly discouraged by organ and tissue transplant professionals in multiple countries. Most international transplants are considered “black market” surgeries that are not only poor in quality, but ethically and morally wrong.

China, for example, the country that is believed to perform more international kidney transplants than any other country, is widely believed to take organs from political prisoners after their execution.

In India, living donors are often promised large sums of money for their kidney donation, only to find out they have been scammed and never receive payment. Selling an organ in India is illegal, as it is in most areas of the world, so there is little recourse for the donor.

Then there is the final outcome: how well the organ works after the surgery is complete. With black market transplants, less care is often taken with matching the donor and recipient, which leads to high levels of rejection and a greater risk of death. Furthermore, the new organ may not have been screened for diseases such as cytomegalovirus , tuberculosis , hepatitis B , and hepatitis C . It is often the new disease that leads to death, rather than the organ rejection itself.

Finally, transplant surgeons are often reluctant to care for a patient who intentionally circumvented the donor process in the United States and received their transplant from an unknown physician.

It is important to arrange your follow-up care prior to leaving your home country.

Many physicians and surgeons are hesitant to take care of a patient who received care outside the country, as they are often unfamiliar with medical tourism and have concerns about the quality of care overseas.

Arranging for follow-up care before you leave will make it easier to transition to care at home without the stress of trying to find a physician after surgery .

Just be sure to inform your follow-up care physician where you are having your procedure done. After you return, they will also want to know what prescription medications you were given, if any.

What are popular countries for medical tourism?

Mexico, India, Costa Rica, Turkey, Singapore, Canada, and Thailand are among the many countries that are popular for medical tourism.

How safe is medical tourism?

Medical tourism is generally considered safe, but it's critical to research the quality of care, physician training, and surgical specialties of each country. There are several medical tourism organizations that specialize in evaluating popular destinations for this purpose.

What countries have free healthcare?

Countries with free healthcare include England, Canada, Thailand, Mexico, India, Sweden, South Korea, Israel, and many others.

A Word From Verywell

If you are considering medical tourism, discuss the risks and benefits with your doctor, and consider working with your insurance provider to arrange a trip that balances financial savings with safety. (Also, before you embark on a trip overseas for your procedure, make sure you are financially prepared for unexpected events and emergencies. Don't go abroad if you don't have enough money to get yourself home in a crisis.)

A medical tourism organization such as Patients Without Borders can help you evaluate the quality and trustworthiness of healthcare in various countries. Making sure a high level of care is readily available will lead to a safer, more relaxing experience.

Centers For Disease Control and Prevention. Medical Tourism: Getting medical care in another country . Updated October 23, 2017.

University of the Incarnate Word. Center for Medical Tourism Research .

Patients Beyond Borders. Facts and figures .

Kaiser Family Foundation. Health coverage of immigrants . Published July 2021.

Paul DP 3rd, Barker T, Watts AL, Messinger A, Coustasse A. Insurance companies adapting to trends by adopting medical tourism . Health Care Manag (Frederick). 2017 Oct/Dec;36(4):326-333. doi: 10.1097/HCM.0000000000000179

Batista BN. State of plastic surgery in Brazil . Plast Reconstr Surg Glob Open . 2017 Dec;5(12):1627. doi:10.1097/GOX.0000000000001627

Johns Hopkins Bloomberg School of Public Health - Global Health Now. Brazilians' risky right to beauty . Published May 2018.

Chokrungvaranont P, Selvaggi G, Jindarak S, et al. The development of sex reassignment surgery in Thailand: a social perspective . Sci World J . 2014 Mar;2014(1):1-5. doi:10.1155/2014/182981

The Joint Commission. For consumers .

Centers for Disease Control and Prevention. Blood clots and travel: what you need to know . Reviewed February 2021.

Hurley R. China harvested organs from political prisoners on substantial scale, says tribunal . BMJ . 2018 Dec;363(1):5250. doi:10.1136/bmj.k5250

Ambagtsheer F, Van Balen L. I'm not Sherlock Holmes: suspicions, secrecy, and silence of transplant professionals in the human organ trade . Euro J Criminol . 2019 Jan;17(6):764-783. doi:10.1177/1477370818825331

Centers for Disease Control and Prevention. Transplant Surgery. Key facts . Reviewed January 2019.

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

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What Do We Know About Medical Tourism? A Review of the Literature With Discussion of Its Implications for the UK National Health Service as an Example of a Public Health Care System

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Johanna Hanefeld, Richard Smith, Daniel Horsfall, Neil Lunt, What Do We Know About Medical Tourism? A Review of the Literature With Discussion of Its Implications for the UK National Health Service as an Example of a Public Health Care System, Journal of Travel Medicine , Volume 21, Issue 6, 1 November 2014, Pages 410–417, https://doi.org/10.1111/jtm.12147

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Medical tourism is a growing phenomenon. This review of the literature maps current knowledge and discusses findings with reference to the UK National Health Service (NHS).

Databases were systematically searched between September 2011 and March 2012 and 100 papers were selected for review.

The literature shows specific types of tourism depending on treatment, eg, dentistry, cosmetic, or fertility. Patient motivation is complex and while further research is needed, factors beyond cost, including availability and distance, are clearly important. The provision of medical tourism varies. Volume of patient travel, economic cost and benefit were established for 13 countries. It highlights contributions not only to recipient countries' economies but also to a possible growth in health systems' inequities. Evidence suggests that UK patients travel abroad to receive treatment, complications arise and are treated by the NHS, indicating costs from medical travel for originating health systems.

It demonstrates the importance of quality standards and holds lessons as the UK and other EU countries implement the EU Directive on cross‐border care. Lifting the private‐patient‐cap for NHS hospitals increases potential for growth in inbound medical tourism; yet no research exists on this. Research is required on volume, cost, patient motivation, industry, and on long‐term health outcomes in medical tourists.

Medical tourism—people traveling abroad with the expressed purpose of accessing medical treatment—is a growing phenomenon associated with globalization. 1 This includes cheaper and more widely available air travel and cross‐border communication through the Internet, which allows medical providers from one country to market themselves to patients in another. 2 At the same time, increased movement of health workers for education means doctors providing care in middle‐ and low‐income countries have in many cases the same qualifications as those in the high‐income countries in Western Europe and the United States. This has been coupled with an increase in foreign direct investment in health care providers in destination countries. 3 The increasing acceptance of health care portability is evident in Europe where greater patient mobility led to an EU Directive on cross‐border health care. 4 Together with a rise in out‐of‐pocket expenditures for health in many high‐income countries at a time of economic crisis, this conspires to form a perfect storm for medical tourism.

Yet, understanding of medical travel is limited. 5 Little is known as to which patients choose to travel and why, when others do not. Details of the volume of patient flows and resources spent remain uncertain. 3 This has hampered efforts to understand the economic costs and benefits to countries experiencing inflows and outflows of patients. Similarly, for the medical tourism industry, the role of private providers and brokers and marketing remain a “black box.” 1 While interest in the issue has grown over the past decade, effects on patients and health systems are not fully understood.

This review of the literature seeks to outline the current level of knowledge on medical tourism. Specifically, it aims to better understand (1) patient motivation, (2) the medical tourism industry, (3) volume of medical travel, and (4) effects of medical travel on originating health systems. Results are reported and discussed, paying specific attention to evidence of impact and lessons for the UK National Health Service (NHS) as an example of how medical tourism affects even universal public health systems. The authors conclude on current levels of knowledge, critical gaps, and future research priorities on medical travel.

The review was conducted between September 2011 and March 2012 as part of wider research, assessing implications of medical tourism on the UK NHS. Authors developed a search strategy based on the aims set out above. They adapted the strategy used by Smith and colleagues, 5 deemed particularly relevant as it presented a recent review of medical tourism albeit focused on bilateral tourism. It was amended to focus more broadly on medical tourism. Initial papers identified were reviewed for inclusion by J. H. and R. S. according to title and where this proved inconclusive according to the abstract. In line with research objectives, papers with general focus on medical tourism, published in English and German (languages read by authors), and focused on the NHS, were included. The following were excluded: papers on well‐being, news items, commentaries, laws or directives, and conference proceedings; papers focusing on stem cell tourism, travel for assisted suicide, and transplant tourism, given the distinct ethical issues. Three hundred and seventy‐four papers remained as initial sample. References of papers identified were further examined to ensure comprehensiveness and four additional papers were included. The initial selection of papers was then reviewed (abstract or full paper) applying these criteria and focusing more specifically on the aims of the review (as above). Two papers were not accessible and therefore excluded. 6,7 A final list of 100 papers was derived for inclusion in this review. This sample was tested based on the criteria by D. H. The literature search is summarized in the PRISMA flowchart (Figure 1 ).

PRISMA flow diagram for literature review medical tourism.

A rapidly expanding literature over the past 5 years with an “explosion” in 2010 and 2011 is reflected in the dates of publication of papers included in the review—73 were published in 2010 and 2011.

Types of Studies Reviewed

Papers included in the review were classified into the following categories: (1) those based on primary data collection (quantitative and qualitative): interviews, surveys, analysis of datasets collected and obtained by authors, or the calculation of revenue and tourist flows, and case studies of patients; (2) reviews: literature reviews of medical tourism websites or promotional materials; (3) analysis: papers which while drawing on secondary sources, provide substantive new insights or conceptualize it in a new way (a number of papers presented frameworks); and (4) overview articles which gave an introduction to the issue of medical tourism. The results are summarized in Figure 2 .

Type of study reviewed.

Geographic Focus

Papers were grouped according to the region the research investigated (see Figure 3 ), or global where they were general. Europe was the focus of 29 papers, 13 explicitly focus on the UK and a further 11 papers refer to either UK patients or the NHS, thus a total of 24 papers mentioned or focused on the UK.

Countries covered.

Literature reviewed suggests a regional dimension to medical tourism: Japanese companies send their employees to Thailand, 8 or to countries in the Gulf. 9,10 A study of medical tourists in Tunisia found that they were from neighboring countries. 11 Countries are known for specific areas of medicine: Singapore for high‐end procedures, 12 Thailand for cardiac, orthopedic, and gender reassignment surgery, 13 Eastern Europe for dental tourism, 14 and Spain for fertility treatment. 15 While some destinations were recognized as popular with UK patients, eg, Budapest for dental treatment, evidence from literature suggested that proximity alone does explain preference for one destination over another.

Motivation to Travel

Most papers made reference to push and pull factors determining patients' decision to travel. These relate to cost, perceived quality, familiarity, waiting lists or delays in treatment, or the lack of availability of certain treatments in the country of origin. 16 As this list demonstrates, these are often complex and dynamic, 6 and may vary according to the treatment for which a patient travels. Evidence suggests that patients traveling for cosmetic surgery may enjoy the anonymity of a destination far from their country of origin, 17 whereas migrants may prefer to return “home” to feel more comfortable with language or type of care provided. 18 These different factors allow for a division into different subsets of medical tourism.

A number of studies refer to a group of tourists classified as diaspora, documenting the return of recent migrants from India, China, Korea, and Mexico, to access treatment either not available or perceived to be not available in their country of residence, or perceived to be more effective. 9,18–20 While cost plays a part in explaining why, eg, Mexican immigrants to the United States return to Mexico for treatment, trust emerged as the key determining factor. This may partly be linked to language barriers, as a study of Korean immigrants to Australia suggests. 18

Reproductive or fertility travel is comparatively better documented than other forms of medical tourism. 15 Of the 16 papers identified for inclusion in this review, 6 papers focus on equity and ethical issues relating to fertility tourism, highlighting the rights of women in recipient countries and equity concerns where they may be compelled by poverty to donate eggs or act as surrogates. Four papers provide a general overview of the issues relating to fertility tourism. 7,21–23 A review of literature on cross‐border reproductive care 15 finds a consistent gap of empirical research—of 54 papers reviewed only 15 were based on empirical investigation. It noted the absence of evidence about patients' backgrounds and factors motivating their travel, and a gap in research on industry. A specific feature of fertility travel cited across papers reviewed is that availability of treatment (in this case gametes and surrogacy) is a factor in patient decision making. This includes the wish for timely and affordable treatment; in the UK it includes perceptions of the NHS as stressful and less effective. 6 Evidence also highlights health effects of fertility travel on patients, showing an increase in multiple births in a London hospital resulting from fertility treatment received abroad. 24 Combined, these studies show that there is an effect of fertility travel on the health system of the country from which medical tourists originate, in this case the NHS, and that regulation of availability and (perceived) quality of service are factors leading patients to travel.

Dental Tourism, Bariatric and Cosmetic Surgery

Other types of tourism are identifiable, including dental tourism. 25 Three papers 26,27,28 indicated this is likely to be an area of increasing travel by UK citizens, given the high cost of dentistry in the UK private sector, limited availability in the public sector, and lower cost in Eastern Europe. 27 A survey of dental clinics in Western Hungary and Budapest showed the largest group of patients (20.2%) originating from the UK with lower prices cited as main motivating factor. 28 Two papers focused in depth on issues surrounding bariatric surgery, exploring the ethical challenges and a case study of complications experienced by a US patient. 29,30 Papers by Birch and colleagues 31 and Miyagi and colleagues 32 focus on complications from cosmetic tourism in UK patients. Others reported that a poll conducted amongst the members of the UK public found that 92% would consider traveling abroad for cosmetic surgery. 33 The possibility of a large number of UK patients seeking cosmetic surgery abroad appears supported by a survey conducted by the British Association of Plastic, Reconstructive and Aesthetic Surgeons which found that 37% of respondents had seen patients in the NHS with complications from overseas surgery. 31

Risks for patients are covered in 29 papers. But surprisingly only 8 of these papers focus exclusively on the issue, and 10 studies mention longer‐term health outcomes of patients. Three describe the recent outbreak of NDM1 bacteria following patients receiving treatment in India, a fourth describes an outbreak of hepatitis B in a London hospital traced to a patient recently returned from surgery in India, pointing to potential risks of diaspora travel. 34–37

While papers tend to mention regulation, only two 38,39 review this more systematically. Both point to a vacuum in regulation, with no one specific regulator or quality assurance standard in place, but rather a number of private companies offering quality assurance through affiliation, creating a market for quality assurance rather than independent standards.

Effect on Countries

As summarized in Table 1 , 37 papers focused on the effects on recipient country's health system. Issues highlighted include the potential for medical tourism to retain or attract doctors in low‐ and middle‐income countries who may otherwise emigrate, thus preventing or reversing a brain drain, and generating foreign currency. 12 Also considered is the danger of creating a two‐tiered health system, resulting in increasing inequities in access and quality of health care for the local population in destination countries, 40,41 mainly as a result of a rise in price where public health services are not provided for free in recipient countries, and the potentially greater concentration of doctors in the private sector. 42

Issues covered

A total of 34 papers focused on potential effects on originating countries' health system. These referred to factors leading to patients' travel, including rise in costs. Papers documented patients returning with complications. 43 Seven papers specifically highlighted complications dealt with in the NHS. 31 Research highlighted the need for regulation, the lack of quality control of overseas providers, and the cost (potential or real) arising to the originating country from treating such complications. Two papers calculated the potential cost saving and benefits of sending patients abroad. 20,44 Overall, papers focusing on the effects on originating countries' health system concentrate mainly on perceived negative consequences.

Forty‐one papers reviewed focus at least partly on providers of medical tourism. A subset of 22 papers studied the medical tourism industry in a more focused way. These provide evidence of a highly diversified industry, with no clear typology emerging. For example, in Southeast Asia medical tourism is state‐led, with large hospitals targeting foreign patients. In other cases, such as cosmetic or dental tourism, intermediaries organize travel and treatment for patients. Examining the entire literature, it is clear that there is not a uniform model or chain for medical tourism.

Articles examining communication materials and websites highlight the limited information on follow‐up care and redress in case of complications. 2 They point to an emphasis on testimonies by patients, rather than formal accreditation or qualification of clinicians, a focus on tourism aspects of the destination and on trust—offering services “as good as at home.” 41 These are in addition to low cost used as a selling point. Studies focusing on medical tourism facilitators identify these as a heterogeneous group. 45,46

Papers reviewed mention individual hospitals or a medical tourism provider at the country level to give a flavor of the industry. 8,45 However, only four papers 47–50 report findings of a more systematic assessment of the industry, including focus on the strong state role in the development of medical tourism in Hong Kong, Malaysia, and Singapore, analyzing how these countries have fostered medical tourism, including through tax incentives. Singapore, for example, made a conscious decision to focus on the high‐end complex procedures to have a competitive advantage. 47

Number of People Traveling

The actual volume in flow of medical patients was referred to in many papers but investigated in few 10,11,28,42,51–54 ; all papers provided further estimates or trends. Most papers cited similar figures of patient flows, but often sources were not accessible or based on media reports or other academic papers, which in turn quoted inaccessible sources. Seven papers referred directly to a report by Deloitte Consultancy, and six to McKinsey; the exact ways in which these were calculated remain unclear. Even where these were not referenced, the figures cited suggest these two reports as a source. For example, one paper 33 cites The Economist stating 750,000 US patients traveling abroad for treatment in 2007. This is the figure provided in the report from Deloitte consultancy in 2008.

Eight papers reviewed had either generated or collected own data on patient flows. Only three papers had calculated the total volume of medical tourism for 13 countries, including actual cost and effect on recipient country's health systems. NaRanong and colleagues calculate the contribution of medical tourism to Thai GDP (0.4%), while medical tourists with their higher purchasing power are likely to increase the cost of health services and lessen access in the public sector. 42 This contrasts with Lautier's findings which highlight that export of health services in Tunisia simply makes use of excess capacity in the country's private sector. 11 Siddiqi's 11‐country study in the Middle East showed complex flows within the region. 10 Findings across the different studies suggest that the impact on recipient country's health system depends on the context and capacity, but that there is likely to be a small contribution to overall GDP. How income gained from medical tourism is in turn invested has not been studied.

This review of the literature provides the most comprehensive overview of knowledge on medical tourism to date. The main limitation of the studies is the focus on English (and German) literature, and as set out in the search strategy a narrow definition focused on medical tourism rather than on the inclusion of broader health and well‐being travel literature. This was essential to maintain feasibility of the review, given the large number of papers published.

Main Findings: What We Can Learn From the Literature on Medical Tourism

The literature reviewed clearly indicates that medical tourism is no unified phenomenon. Sub‐types of travel, such as diaspora or fertility travel, travel for bariatric surgery, dental, or cosmetic work, were evident from the review. Decisions by patients to travel are not simply guided by cost considerations or even clinical outcomes. Rather, the literature points to a complex matrix of perceptions of care, waiting times, cost, and others, depending on the type of treatment sought. For example, trust appeared as a motivation for diaspora travelers but not for dental tourists, cost or availability in cosmetic procedures, and regulation in the case of fertility. However, lack of information about patients' characteristics limits deeper understanding of push and pull factors. With very few exceptions, 16,6 the absence of in‐depth interviews with more than one or two patients poses the greatest weakness of the literature reviewed and opens the potential to bias within studies reviewed.

A diverse picture of the medical tourism industry emerges. Some countries have become known for excellence in certain areas of treatment such as Spain for fertility or Hungary or Poland for dental treatment. Yet, this did not appear the case for all medical tourism destinations, eg, while India clearly is a destination for medical tourists, this is for a whole broad spectrum of treatments.

Few studies were able to quantify patient flows and calculate effect on recipient health systems and the economy. Evidence does suggest that the inflow of medical travelers can increase inequities within the recipient country health systems 42 but that depends on the context. 11

Perhaps the most surprising finding was the increase in papers presenting primary research—a shortfall or gap that had been noted by the earlier literature reviews. 5,55,56 The recent publication date of many confirms the increase in research of medical travel.

Implications for the UK NHS

Evidence demonstrates that UK patients travel abroad to receive treatment and return with complications or infections that require follow‐up in the public sector. Based on papers reviewed, cosmetic procedures appear an area of growth for medical travel by UK patients and likely to result in cost to the NHS due to resulting complications, but costs resulting from other types of travel, including fertility and dental tourism, are evident. While complications experienced by UK medical tourists were reported, these were not compared to rates of complications for similar procedures undertaken in the UK, which would have further strengthened such research. However, in individual cases of patients described, these often focused on cases so unusual or extreme that the comparison or lack thereof to the UK was implicit. Case studies also underlined the challenges relating to information and communication, with often limited patient records available for returning medical tourists.

Despite a number of studies focusing on UK patients, overall the evidence presented underlines the need for further research to ascertain the potential impact and costs arising from medical tourism on the NHS. Only one study 42 estimated actual costs arising from complications of returning medical tourists and this was based on a small sample of patients. We found no research calculating the potential savings arising from UK patients traveling abroad for treatment. While research on risks associated with medical travel proved limited, the documented NDM1 outbreak in the UK highlighted the potential of infections that may result from medical travel. 36

Research focused on communication materials and websites highlights the lack of credible information about qualification and an absence of regulation and legal safeguards. This lack of clear information paired with the increasing willingness to travel of the UK public makes a greater numbers of complications a likely scenario.

Considering findings from the literature focused on the UK, these are particularly salient for the NHS at a time of reform. The lifting of the cap on private patients increases the potential for greater earning and marketing of NHS hospitals to foreign private patients. In this context, the lack of evidence on incoming tourists limits the possibility of informed decision making. Moreover, findings about complications of returning medical tourists, which highlight the need of quality control and continuity of care, are likely to mirror some of the policy challenges that will become evident in the implementation of the EU Directive on cross‐border health care implemented from 2013. In this context, it seems opportune for policymakers within the EU to further explore lessons from medical travel.

This review of the literature highlights a growing trend in medical travel that is likely to continue and have an increasing impact on patients, and originating and recipient health systems. It shows a diverse industry and different types of tourism depending on treatment, each with a complex set of patient motivation. Evidence also highlights complications experienced by patients, resulting in health problems and costs to originating health systems. While the review shows an increase in research over the past 2 years, it also clearly identifies limits to current knowledge and areas where the need for further research is evident:

A lack of information about patients' background and numbers of patients traveling abroad for treatment persists. The lack of data also restricts analysis about possible cost and benefits of medical travel.

Limited insights on why some patients travel when others do not.

Little is known about the industry beyond reviews of information materials and websites. Further research is needed to better understand how the sector operates, to ultimately understand impact on health services and outcomes of medical travelers.

Moreover, there is an absence of research examining the long‐term health outcomes of medical tourists when compared to patients treated within their country of residence. As a result, evidence on the comparative effect of treatment received abroad is lacking. Further qualitative and quantitative research beyond immediate clinical outcomes is needed to truly understand the effect of medical travel on patients, and its cost to the health system.

As medical tourism is set to rise, addressing these gaps in the evidence is urgently required to avoid potential harm to patients and health systems by enabling more informed policymaking on aspects of medical tourism.

This is a hospital in Hualien, Taiwan, which has two prominent advertising boards on its front facade promoting the hospital. Taiwan is a hot spot for medical tourism in Asia, attracting thousands of medical tourists mostly from China. Photo Credit: Eric Caumes .

The authors wish to acknowledge the members of the study advisory committee for their input into the review. This project was funded by the National Institute for Health Research Health Services and Delivery Research Programme (project number HSR 09/2001/21). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS, or the Department of Health.

The authors state that they have no conflicts of interest to declare.

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Complementary & Alternative Medicine

Health and wellness tourism today.

According to the World Health Organization (WHO) health is a state of physical mental and social well-being and not merely the complete absence of disease or infirmity. In accordance with this definition wellness can be equated with health. Health and wellness involves several well-being dimensions including physical mental social sexual emotional cultural spiritual educational occupational financial ethical and existential dimensions. ‍

This article represents an attempt to develop an understanding of current health and wellness tourism around the world. The aims are to:

clarify concepts because of the usual incipiency and lack of conceptual rigor regarding health and wellness tourism
qualify procedures and patient safety as crucial factors
importance of destination branding.

Brief History: Health and Wellness

Past ancestors: Ayurvedic Medicine (India 3000 BC) Chinese Medicine (Emperor Sheng Nung 20382698 BC) Thai Traditional Medicine Japanese Onsen Russian Steam Bath Tell el Amarna Therms (Egypt 1350 BC) Greek Thalassa (Hippocrates 460355 BC) Roman Thermae/Balnea Publica (II BCIII AC) Arabian Medicine (8th-15th century Al Razi 850923) Turkish Haman Dead Sea Salts Baths Egyptian Mansuri Hospital (Cairo 1248).

Travellers came from all over the world Native American Sweat Lodge Mexican Temazcalli Australian Aboriginal Steam Baths Mineral Springs in Spa near Liége (14th) Climatotherapy (XVIII/XIX Centuries) in Madeira and Canarias Islands Scientific Medicine (19th century). Recent years: 1959 Inauguration of Golgen Door Spa in California 1987 Official beginning of the Global SPA industry SpaFinder Magazine 1991 International SPA Association ISPA (USA) 1996 European SPA Association. ‍

In health and wellness tourism quality/excellence safety and ethics are deeply connected.

ESPA (Brussels) 1998 Guide of the 100 Best SPAS of the World 2003 Spa Asia Magazine 2007 Medical Tourism Association MTA USA 2007 I Congress on Medical Tourism Worldwide Munich 2008 I International Health Tourism Congress Turkey Association of Improving Health Tourism 2008 onward -- Congress took place in different cities in Turkey 2008 First Annual World Medical Tourism Association Congress 2008 onward.

Congress took place in different cities in USA 2010/2012 Annual European Medical Travel Conference (EMTC) Venice Barcelona Berlin 2012 I International Conference on Health and Tourism Faro Portugal 2013 International Medical Travel Exhibition and Conference Monaco 2014 II International Congress on Health and Tourism Albufeira Portugal. ‍

Emergent Paradigms on Health and Medicine

Preventive Medicine promotes healthy lifestyles and diets stress management intellectual stimulation and fitness with a focus on wellness assessments versus illness. ‍

‍ Predictive Medicine individual health promotion based on diagnostics of genetic and environmental determinants. ‍

‍ Holistic Medicine whole-being meaning physical well-being mental awareness and wisdom spiritual harmony and equilibrium. ‍

Integrative Medicine brings together orthodox Western medicine/Allopathic and other Eastern holistic medicines Chinese Ayurvedic and Indigenous knowledge and environmental consciousness. Integrative medicine emphasizes wellness wholeness and a preventive approach to health. Western medicine is based on an illness model concerned with treating disease rather than enhancing wellness. ‍

‍ Anti-Aging medicine that combines all those preceding paradigms. ‍

Definition: Health and Wellness Tourism

Health and wellness tourism includes travelling both nationally and internationally to places and facilities such as hospitals clinics thermae thalasso wellness SPAs and fitness centers and wellness resorts. ‍

In 2012 it was estimated that a million medical tourists travelled around the world for outbound/ inbound medical tourism.

The purpose of health and wellness tourism is medical care and health beauty relaxation recovery and rehabilitation treatments. There are more than a hundred-million health and wellness tourists around the world each year. Health and wellness tourism includes medical tourism elderly age tourism disability tourism thermal tourism and thalasso-therapy tourism. ‍

Wellness Tourism

Wellness tourism includes consumers who travel to maintain their well-being and life satisfaction through the experiences of healthy treatments. Wellness has to do with quality of life. In a holistic approach to health (Chinese ayurvedic and integrative medicines) wellness treatments and therapies restore the vital balance among bodies mind and spirit toward equilibrium and health harmony. This harmony re-balances and restores the energy flow bringing about overall well-being. ‍

Health Tourism

Health tourism refers to patients who travel nationally or internationally for healing therapies in hospitals and clinics. Health tourism includes medical tourism aesthetical/plastic tourism thermal tourism and thalassotherapy tourism. ‍

Medical Tourism

Medical tourism involves travel to hospitals and clinics for medical treatments in different areas including cardiology gynaecology neurology ophthalmology oncology orthopaedic transplants preventive medicine artificial insemination anti-aging medicine and plastic reconstructive medicine.

Medical tourism is also known as medical travel health tourism health travel healthcare tourism healthcare abroad medical overseas and overseas medical.Medical tourism has two components: inbound and outbound. In 2012 it was estimated that a million medical tourists travelled around the world for outbound/inbound medical tourism.

Medical tourism is a $100 billion global industry. The most important destinations include Argentina Austria Belgium Bolivia Brazil Chile Colombia Costa Rica Cuba Cyprus Czech Republic Dubai El Salvador France Germany Greece Guatemala Hungary India Israel Jordan Malaysia Mexico Philippines Poland Singapore South Africa South Korea Spain Sir Lanka Thailand Tunisia Turkey United Arab Emirates Venezuela and Vietnam. ‍

Aesthetical Tourism

Aesthetical tourism includes aesthetic surgery and treatments. In aesthetic/plastic tourism the most important countries are the United States and Brazil. Other destinations are Argentina Austria Belgium Bolivia Costa Rica Cuba France Germany Greece Hungary Italy Poland South Africa Spain Tunisia Turkey United Arab Emirates and Venezuela. ‍

Quality/Excellence and Safety

Within the scope of healthcare the quality of procedures and patient/client safety is strongly connected. Quality is the level of excellence ensured by a continuous managerial system.Safety is the condition/state of being secure from hurt/ injury and aims to prevent accidents and contagious diseases. It includes protective devices to prevent hazardous accidents and nosokomeion diseases. ‍

Quality/Excellence and Main Safety Components

Safe Environment air quality water quality reduced noise and visual pollution free of radiation pollution (magnetic electric nuclear) natural or recreated pleasant landscape - healthy trees bushes and flowers.

‍ Architectonic Requirements Modern and pleasant-looking healthcare facilities that enable the fast physical mental and spiritual well-being of patients and that makes their relatives and visitors rest and relax.

The main architectonic requirements are operating rooms located in sterilized areas lounges designed as living rooms and libraries assuring safety patient well-being and reduced time in integrated examination rooms on the same floor special architectural design that allows optimization of patient flow within the hospital and aims to prevent infections floors walls and ceiling materials must be easy to clean and disinfect walls painted with soft colors such as blue green and pink natural lighting and ventilation and healthy plants. ‍

Medical tourism hospitals must have a specialized staff which can speak different languages fluently namely the official voice of the patient's country.

A new generation of healthcare facilities is emerging that is very different from familiar institutional models. Based on patient-centered care and healing the whole person these health centers are spiritual sanctuaries with gardens fountains natural light art and music. Research is learning how human emotions are linked to disease and that healing is promoted by surroundings that reduce stress and engage the senses in therapeutic ways. Jain Malkin ‍

Hotel Structure and Services

The hospital (hospital like a hotel) requires healthcare humanization beautiful lounges several restaurants and cafeterias shops exhibition galleries musical concerts conference halls containing simultaneous translation systems and catering and laundry facilities specializing in the healthcare sector. A hospital is primarily a hotel in which health services are provided. Acibadem Turkey ‍

Technological Accuracy/Modern Technology

The latest international technology is put into service including accurate diagnosis equipment a fully equipped digital radiology department accurate radiotherapy treatments cyber-knife robotic surgery systems advanced cardiology ophthalmology and orthopaedics diagnosis treatment equipment and organ transplants. ‍

Professional Healthcare Qualifications: Surgeons Doctors and Others

Professional staff includes a high-qualified board of internationally certified surgeons and doctors specialized in different medical fields highly qualified anaesthesiologists qualified nurses and others health professionals. ‍

Multi-Language Staff Communicating Skills

Medical tourism hospitals must have a specialized staff which can speak different languages fluently namely the official voice of the patient's country. Good communication is very important to the safety and well-being of patients and their relatives. ‍

Scientific Affiliation

Hospitals and clinics develop protocols with universities/ colleges and research centers. Turkey Acibadem is affiliated with Harvard Medical International and Anadolu Health Center with John Hopkins Hospital. ‍

Healthcare Humanization

It is very important that patient-centered healthcare include a warm and tender environment attention to each individual patient's needs respect of cultural roots alimentary traditions and religious beliefs and patient participation in musical and theatrical groups. ‍

Accreditation and Certification

In medical/aesthetical tourism it is important to attest to the excellence and safety of healthcare services for clients from other countries. The most important international accreditation institutions are the Joint Commission International (JCI) Canadian Council on Health Services (CCHSA) Deutche Akkreditierrungasstelle Chemie (GMBH) Commission on Laboratory Accreditation of the College of American Pathologists Clinical Laboratory Accreditation Certificate ISO 15189 and ISSO 9001:2000 Medical Tourism Association (MTA Certification) International Society for Quality in Healthcare (ISQUA) European Society for Quality in Healthcare (ESQH) International Organization for standardization (ISO) Trent Accreditation Schemes (TAS) King's Fund Health Quality Services (KFHQS) and International Society of Aesthetic Plastic Surgery (ISAPS). ‍

High Standard of Ethical and Professional Deontology

In health and wellness tourism quality/excellence safety and ethics are deeply connected. The aesthetical surgeons must avoid making several surgical operations while informing the client/patient of the dangers of multiple aesthetical surgeries. ‍

Importance of Branding Destinations

Health and wellness brand destination becomes more important to promote the image of high-quality healthcare in a location (city region country). Seeking to attract international patients from around the world partners and stakeholders should work together to develop network synergies health and wellness clusters. Hotels and resorts become healthcare facilities for prior and post-surgery medical travellers. ‍

Attractive and Competitive Advantage of a Destination

The attractiveness and competitive advantage of medical/ aesthetical tourism are competitive prices on a global scale international accessibility and proximity international accreditation/certification and excellence.

Excellence is defined as a high-level of holistic quality (several levels and parameters) which exceed expectations including accredited hospitals qualified doctors certified surgeons qualified anaesthesiologists qualified nurses and others professionals advanced technologies efficacious therapeutic procedures faster medical services affiliation with universities and research centres humanization of healthcare beautiful hospitals hospitality/hotel structure linguistically competent teams healing climate pleasant environment/ landscapes healthy gastronomy and partnership with luxury hotels and resorts. ‍

About the Authors

João Viegas Fernandes is a founder and president of the Associação Portuguesa de Turismo de Saúde e Bem Estar APTSBE (Health and Wellness Tourism Portuguese Association). He is also the architect and advisor to Algarve Region Health & Wellness Tourism Cluster and Destination Branding. He is considered a visionary pioneer and expert in health and wellness in Portugal.

As a professor he conceptualized a discipline in health and wellness tourism which he teaches in the School of Management Hospitality and Tourism of Algarve University. He has lectured in various universities in Portugal Spain and Brazil and is researching health and wellness tourism around the world.

Fernandes is a consultant in this area both nationally and internationally. Fernandes has spoken at several conferences in Portugal Spain Brazil Turkey Cape Verde and Monaco on sustainable health and wellness tourism. He is the author of the book ThalassaThermae SPA-Salute Per Aqua (Lisboa Portugal 2006).

He also is co-author of several articles and books including SPAS Centros Talasso e Termas: Turismo de Saúde e Bem-Estar (Lisboa Portugal 2008) and Turismo de Saúde e Bem-Estar no Mundo: Ética Excelência Segurança e Sustentabilidade (São Paulo Brazil 2011).

Fernandes was the chairperson of the I International Conference on Health and Tourism (Faro Portugal 2012) and the II International Congress on Health and Tourism (Albufeira Portugal 2014). He is an advocate of increased cooperation in health and wellness tourism among the eight countries which speak Portuguese. ‍

Filomena Maurício Viegas Fernandes is a medical doctor and specialist in public health. She was the health delegate in several municipalities in the Algarve region and has been responsible for a number of programs on public health.

She has delivered presentations at various international conferences and is considered an expert in health and wellness tourism. Fernandes has been researching and teaching health and wellness tourism in the School of Management Hospitality and Tourism at Algarve University.

She is the co-author of several articles and books including SPAS Centros Talasso e Termas: Turismo de Saúde e Bem-Estar (Lisboa Portugal 2008) and Turismo de Saúde e Bem-Estar no Mundo. Ética Excelência Segurança e Sustentabilidade (São Paulo Brazil 2011).

Fernandes was a member of the organizing committee of the I International Conference on Health and Tourism (Faro Portugal 2012) and is coordinating the II International Congress on Health and Tourism in Albufeira Algarve Portugal in 2014.

Korea: Turning the Focus to an Emerging Global Leader in Medical Tourism

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The Medical Tourism Magazine (MTM), known as the “voice” of the medical tourism industry, provides members and key industry experts with the opportunity to share important developments, initiatives, themes, topics and trends that make the medical tourism industry the booming market it is today.

DESTINATION

1. Overview

Brief introduction to the country and its reputation in medical tourism.

Russia, the world’s largest country by land area, offers a unique blend of history, culture, and cutting-edge technology. While Russia may not be the first destination that comes to mind when considering medical tourism, it has been gaining traction in this field. With substantial investments in healthcare infrastructure and medical research, Russia is slowly but steadily becoming a destination worth considering for various medical procedures. The country has a growing reputation for offering state-of-the-art medical treatments, often at a fraction of the cost you might pay in Western Europe or North America.

Historical and Cultural Significance in Medicine

Russia has a long-standing history of medical research and innovation. From the times of renowned scientists like Ivan Pavlov to contemporary achievements in cardiology and neurology, the country has been instrumental in contributing to global medical science. Russian medical institutions have also been engaged in pioneering work in fields like radiology, organ transplantation, and aerospace medicine, reflecting a cultural emphasis on scientific inquiry and innovation.

The Medical Landscape

The Russian healthcare system is a mix of public and private institutions, providing an array of treatments ranging from general medicine to specialized surgeries. While public healthcare is generally available to citizens, the growing private healthcare sector caters to both local and international patients, often providing services that match global standards.

What Draws Medical Tourists to Russia?

Medical tourists often find Russia appealing due to its advanced technology, specialized treatments, and relatively lower costs. Moreover, the prospect of combining medical treatment with a cultural experience is another attractive feature. Known for its grand architecture, vibrant arts scene, and rich history, Russia offers an all-around travel experience alongside high-quality medical care.

2. Popular Medical Procedures

List and brief descriptions of procedures.

Cosmetic Surgery : Including procedures like rhinoplasty, liposuction, and breast augmentation, Russia is increasingly becoming a destination for cosmetic surgery.
Dental Treatments : Dental implants, crowns, and veneers are some of the sought-after treatments.
Cardiac Surgery : With advanced technology, cardiac procedures like bypass surgeries and angioplasties are performed at specialized centers.
Orthopedic Surgeries : Hip and knee replacements are commonly done here with a high success rate.

Specializations or Pioneering Treatments

Russia is becoming known for its cancer treatments, including specialized radiation therapies and immunotherapy treatments. Additionally, the country has been involved in research and treatment of neurological conditions, offering specialized services in this domain.

3. Top Hospitals & Clinics

Renowned hospitals and clinics.

Almazov National Medical Research Centre, St. Petersburg
European Medical Center, Moscow
Moscow City Clinical Hospital

Accreditation and Affiliation

Most top hospitals are accredited by Russian healthcare authorities and some even possess international accreditations. These hospitals often collaborate with international medical institutions for research and training purposes.

Special Features, Awards, or Recognitions

Many hospitals have received awards for medical excellence and innovations in treatments. They also offer features like English-speaking staff, modern facilities, and state-of-the-art medical equipment.

4. Cost Comparison

Comparative data.

On average, medical procedures in Russia can cost 30-70% less than in Western Europe or North America. For instance, a dental implant that might cost upwards of $3,000 in the United States could be available for around $1,000 in Russia.

Price Ranges

Costs can vary based on the facility, location, and type of procedure. Always get multiple quotes and consult with healthcare providers to get a more accurate picture.

5. Quality & Safety

Medical standards and practices.

Russia is committed to ensuring high standards of medical care, supported by its educational system that produces skilled doctors and medical professionals. While there might be variations in quality between rural and urban centers, most metropolitan areas have hospitals and clinics equipped with modern technology and well-trained staff.

Accreditation Systems and Regulatory Bodies

In Russia, medical facilities are generally regulated by the Ministry of Health. While not all hospitals may have international accreditations, most top institutions meet or exceed global healthcare standards.

Quality Checks and Patient Safety Protocols

Russian healthcare providers employ a variety of safety measures such as pre-surgical consultations, sterilization protocols, and rigorous post-operative care. They also tend to follow internationally recognized best practices to ensure patient safety.

Patient Rights

Patients have the right to quality healthcare, the right to choose their physician, and the right to confidentiality. These are enshrined in Russian medical law and are generally adhered to by healthcare providers.

6. Medical Visa Information

Guidelines and requirements.

To obtain a medical visa, you generally need a formal invitation from the Russian medical institution where you plan to receive treatment. Proof of financial stability and medical insurance are often required.

Duration, Documentation, and Application Process

The visa can be valid for up to 90 days, with possible extensions in case of medical necessity. Documentation usually includes your passport, invitation letter, visa application form, and photographs. Applications are typically processed within 10 to 20 business days, although expedited services are available for an additional fee.

Travel-related Advisories or Restrictions

It’s advisable to keep an eye on travel advisories and consult your home country's embassy or consulate for the most current information.

7. Cultural Considerations

Local customs and etiquette.

While Russia is generally welcoming to tourists, being aware of local customs and etiquette can enrich your experience. A basic understanding of Russian manners, such as greetings and proper attire, can be beneficial.

Language and Communication

While the primary language is Russian, English is often spoken in large hospitals and medical centers. Nonetheless, it's advisable to confirm the availability of English-speaking staff or interpreters.

Dietary Considerations

Russia offers a variety of cuisine options, though traditional foods might be heavy in meat and dairy. Vegetarian and vegan options are increasingly available, particularly in larger cities.

8. Travel & Accommodation

Popular areas to stay.

Moscow and St. Petersburg are popular destinations with proximity to top medical facilities. Both cities offer a range of lodging options, from luxury hotels to budget-friendly hostels.

Proximity to Medical Facilities

Medical centers are often well-connected by public transportation or are just a short drive away from popular accommodation areas.

Transportation and Infrastructure

Russia has an extensive public transportation network, including subways, buses, and taxis. Apps like Uber are also widely used.

Post-procedure Relaxation and Recuperation Spots

Russia is rich in natural beauty, from the beaches of Sochi to the serene landscapes of Siberia, offering plenty of options for post-procedure relaxation.

9. Legal & Ethical Considerations

Legal rights of patients.

Patients have the right to informed consent, confidentiality, and quality healthcare as per Russian laws.

Medical Malpractice Laws and Patient Recourse

In cases of medical malpractice, patients have the right to legal recourse. However, legal proceedings can be long and complex.

Ethical Considerations

Ethical standards are generally in line with international norms. Issues such as organ transplantation are strictly regulated.

10. Benefits & Risks

Among the benefits are lower costs, high-quality specialized treatments, and the opportunity to explore Russian culture and history.

Potential Risks

Language barriers and variations in quality between rural and urban healthcare centers are some of the risks involved. Always conduct thorough research and consultations before proceeding with any medical treatment.

11. Post-procedure Care

Post-operative care.

Russian medical facilities often offer robust post-operative care programs, including rehabilitation and follow-up appointments.

Availability and Quality of Rehabilitation Centers

Rehabilitation centers, especially in metropolitan areas, are well-equipped and staffed with trained medical professionals.

12. Frequently Asked Questions (FAQs)

Is English widely spoken in Russian hospitals? In major cities and top healthcare centers, yes. However, it's advisable to confirm this before you travel.
How do I pay for medical procedures? Payment methods vary, but most top hospitals accept credit cards and wire transfers.
Is it safe to travel alone? While generally safe, it is always advisable to be cautious and aware of your surroundings, especially in unfamiliar areas.
Is medical insurance necessary? Yes, proof of medical insurance is usually a requirement for obtaining a medical visa.
What is the quality of post-procedure care? High-quality post-procedure care is often available, particularly in specialized medical centers.

Global Provider Members

Russian Ruble

144,500,000

With an area the size of Russia, it is difficult to give any sort of general advice about the climate and weather, except that summers are warm to hot, and winters get very cold in some areas. In general, the climate of Russia can be described as highly continental, with warm-to-hot, dry summers and (very) cold winters with temperatures of -30°C or lower. Heavy snowfall is not uncommon.

Facilitators

Featured treatments.

MedicalTourism.com

MedicalTourism.com is a free, confidential, independent resource for patients and industry providers. Our mission is to provide a central portal where patients, medical tourism providers, hospitals, clinics, employers, and insurance companies can all find the information they need. Our site focuses on patients looking for specific knowledge in the fields of medical tourism, dental tourism, and health tourism.

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activity holiday
air corridor
amenity kit
caravanning
high season
post-holiday
put something up
ranger station
sightseeing
tourist trap
trailer park

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COMMENTS

What is health tourism and why is it growing?
Health tourism is a tricky one to define. It is more of an umbrella term, encompassing both wellness tourism and medical tourism. These two types of tourism may seem quite different, but they both fundamentally have health at their core. So, health tourism can be defined as follows:
Medical tourism
Health tourism is a wider term for travel that focuses on medical treatments and the use of healthcare services. It covers a wide field of health-oriented tourism ranging from preventive and health-conductive treatment to rehabilitational and curative forms of travel. Wellness tourism is a related field.
Exploring Health Tourism
Exploring Health Tourism. The ETC/UNWTO publication on Exploring Health Tourism aims to provide a better understanding of the growing segment of wellness and medical tourism. The study introduces the evolution of health-related tourism products and services from all around the world and provides insights into the current situation of the ...
Exploring Health Tourism
The ETC/UNWTO publication on Exploring Health Tourism aims to provide a better understanding of the growing segment of wellness and medical tourism. The study introduces the evolution of health-related tourism products and services from all around the world and provides insights into the current situation of the industry, as well as the future ...
Medical, Health and Wellness Tourism Research—A Review of the
Another set of authors defined health tourism as a branch of tourism in general in which people aim to receive specific treatments or seek an enhancement to their mental, physical, or spiritual well-being . This systematic literature review assessed the value of destinations' natural resources and related activities for health tourism.
UNWTO/ETC Launch Report on Health Tourism
As defined in the report, health tourism covers those types of tourism which have as a primary motivation the contribution to physical, mental and/or spiritual health through medical and wellness-based activities. The report sheds light on the factors shaping health tourism such as technological developments, personal health, data protection ...
Medical tourism
health care. medical tourism, international travel for the purpose of receiving medical care. Many patients engage in medical tourism because the procedures they seek can be performed in other countries at relatively low cost and without the delay and inconvenience of being placed on a waiting list. In addition, some patients travel to specific ...
Exploring Health Tourism
eISBN: 978-92-844-2020-9 | ISBN: 978-92-844-2019-3. Abstract: The ETC/UNWTO publication on Exploring Health Tourism aims to provide a better understanding of the growing segment of wellness and medical tourism. The study introduces the evolution of health-related tourism products and services from all around the world and provides insights into ...
Medical Tourism Guide: Countries, Benefits, and Risks
Medical tourism is a lucrative business for many countries, and much of the money brought in by medical tourists is reinvested into the local economy and health infrastructure. The effect of this is apparent in the spa-like luxury that some foreign hospitals offer, providing medical tourists the opportunity to be pampered during their stay for ...
What is Medical Tourism?
Medical tourism can be defined as the process of traveling outside the country of residence for the purpose of receiving medical care. Growth in the popularity of medical tourism has captured the ...
What Do We Know About Medical Tourism? A Review of the Literature With
Medical tourism—people traveling abroad with the expressed purpose of accessing medical treatment—is a growing phenomenon associated with globalization. 1 This includes cheaper and more widely available air travel and cross‐border communication through the Internet, which allows medical providers from one country to market themselves to patients in another. 2 At the same time, increased ...
Medical Tourism
Medical tourism is defined as travel primarily for the purpose of receiving health care. Medical tourists may travel for a variety of procedures, including novel or experimental treatments. Medical tourists may also travel to developing or developed countries. Medical tourism represents a growing health care market, and this group of travelers ...
PDF Medical Tourism: Treatments, Markets and Health System ...
role and impact of medical tourism for OECD countries. Whilst there is an increasing amount written on the subject of medical tourism, such material is hardly ever evidence-based. Medical tourism introduces a range of attendant risks and opportunities for patients. This review identifies the key emerging policy
HEALTH TOURISM
HEALTH TOURISM definition: 1. travel to a foreign country for medical treatment, especially because it is less expensive than…. Learn more.
Exploring Health Tourism
The ETC/UNWTO publication on Exploring Health Tourism aims to provide a better understanding of the growing segment of wellness and medical tourism. The study introduces the evolution of health-related tourism products and services from all around the world and provides insights into the current situation of the industry, as well as the future ...
Health and Wellness Tourism Today
Definition: Health and Wellness Tourism. ... In 2012 it was estimated that a million medical tourists travelled around the world for outbound/ inbound medical tourism. The purpose of health and wellness tourism is medical care and health beauty relaxation recovery and rehabilitation treatments. There are more than a hundred-million health and ...
Russia
Explore medical tourism in Russia - a blend of advanced treatments, cultural experiences, and cost savings. Discover sought-after procedures, top hospitals, safety standards, visa info, and more. Medical tourism in Russia, Top hospitals in Russia, Cost-effective treatments Russia, Russian medical procedures, Visa for medical tourism Russia.
HEALTH TOURISM definition
HEALTH TOURISM meaning: 1. travel to a foreign country for medical treatment, especially because it is less expensive than…. Learn more.
Moscow
Moscow - History, Culture, Architecture: In 1703 Peter I began constructing St. Petersburg on the Gulf of Finland, and in 1712 he transferred the capital to his new, "Westernized," and outward-looking city. Members of the nobility were compelled to move to St. Petersburg; many merchants and artisans also moved. Both population growth and new building in Moscow languished for a time, but ...
Table of Contents : Exploring Health Tourism
The ETC/UNWTO publication on Exploring Health Tourism aims to provide a better understanding of the growing segment of wellness and medical tourism. The study introduces the evolution of health-rel...
Moscow
Moscow is the capital and largest city of Russia.The city stands on the Moskva River in Central Russia, with a population estimated at over 13 million residents within the city limits, over 18.8 million residents in the urban area, and over 21.5 million residents in its metropolitan area. The city covers an area of 2,511 square kilometers (970 sq mi), while the urban area covers 5,891 square ...
Exploring Health Tourism
Exploring Health Tourism. The ETC/UNWTO publication on Exploring Health Tourism aims to provide a better understanding of the growing segment of wellness and medical tourism. The study introduces the evolution of health-related tourism products and services from all around the world and provides insights into the current situation of the ...
Discover Moscow About Us
About the portal. A technological tool for effective communication between the leading players in the Moscow tourism market and representatives of the foreign/regional tourism industry through online events. OBJECTIVES: • Building long-term cooperation with foreign/regional representatives. • Raising awareness among foreign/regional ...