Neil Lunt

Medical tourism: Assessing the evidence on treatment abroad

The review focuses on one growing dimension of health care globalisation - medical tourism, whereby consumers elect to travel across borders or to overseas destinations to receive their treatment. Such treatments include cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF treatment; and organ and tissue transplantation. The review sought to identify the medical tourist literature for out-of-pocket payments, focusing wherever possible on evidence and experience pertaining to patients in mid-life and beyond. Despite increasing media interest and coverage hard empirical findings pertaining to out-of-pocket medical tourism are rare. Despite a number of countries offering relatively low cost treatments we know very little about many of the numbers and key indicators on medical tourism. The narrative review traverses discussion on medical tourist markets, consumer choice, clinical outcomes, quality and safety, and ethical and legal dimensions. The narrative review draws attention to gaps in research evidence and strengthens the call for more empirical research on the role, process and outcomes of medical tourism. In concluding it makes suggestion for the content of such a strategy.

Nip, tuck and click : medical tourism and the emergence of web-based health information.

An emerging trend is what has become commonly known as ‘Medical Tourism’ where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions. This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making. This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework.

Medical tourism: a cost or benefit to the NHS?

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

Systematic review of web sites for prospective medical tourists

Purpose – A key driver in the medical tourism phenomenon is the platform provided by the internet for gaining access to healthcare information and advertising. Given the pivotal role of web‐based resources, there are important questions about their role and function including: the availability and types of information provided; information provenance and reliability; and privacy protection. This paper aims to address these questions.Design/methodology/approach – The paper provides the first systematic review of medical tourism sites, interrogating them for the range and quality of advice on seeking care.Findings – A typology of sites (industry, media, professional, and consumer sites) was identified and quantitative and qualitative assessment tools were used to explore the content of information and materials.Originality/value – In light of this review, the paper comments on the nature of medical tourism information available and the extent to which information asymmetry – rife in the market for healthcar...

A European perspective on medical tourism: the need for a knowledge base.

Since the early 1990s, medical tourism, whereby individuals choose to travel across national borders or overseas to receive treatments, has been increasingly recognized in the United States and Asia. This article highlights the emergence of medical tourism in the European context. It examines the drivers for such developments and situates medical tourism within the broader context of health globalization and forms of patient mobility in the European Union. In outlining the developments of medical tourism in Europe, the authors distinguish between two types of medical tourist: the citizen and the consumer. The discussion explores the need for greater empirical research on medical tourism in Europe and argues that such research will contribute toward knowledge of patient mobility and the broader theorization of medical tourism. The authors make suggestions about the content of this research agenda, including understanding the development of medical tourist markets, the nature of choice, equity implications, the role of brokers and intermediaries, and general issues for health management.

Disability and employment: towards an understanding of discourse and policy

ABSTRACT This article explores the nature of disability employment policy drawing on evidence from fifteen countries. In line with earlier sociological approaches to disability it describes two ways of framing policy in the area. These two paradigms are developed and used to critically evaluate employment policy under the headings: legislative measures, open employment-financial employment support services and sheltered/supported provision. The dilemmas that may arise during implementation of policy are discussed and the consequences for the construction of an emancipatory employment policy. Finally, the article suggests some themes or dimensions that a coherent disability policy should have.

Patient Mobility in the Global Marketplace: A Multidisciplinary Perspective

There is a growing global market in healthcare and patients. And while there is a small body of evidence emerging around this phenomenon commonly known as medical tourism there remain significant unanswered policy and research questions which need to be addressed. We outline some of the key issues set against the six key disciplinary preoccupations of the journal: epidemiology, health economics, health policy ethics, politics of health, health management, and health policy.

Nested mentoring relationships: reflections on a practice project for mentoring research capacity amongst social work practitioners

• Summary: This article provides a new perspective on mentoring relationships by reflecting on a practice project that involved what we identify as ‘nested mentoring’. The insights emerged from a series of consultations during 2004, followed by developmental work during 2005, and then the project proper, which was funded during 2006—07. • Findings: The authors reflect on the outcomes of unique mentoring relationships between tertiary providers and social service agencies in a project aimed at assisting the development of a culture of practitioner enquiry amongst social workers in social services agencies in New Zealand. This time-limited collaborative project involved bringing together 43 practitioners from eight social service agencies, a practitioner advisor, four academics from two universities, all logistically managed by a programme manager and supported by three funding bodies. Teams of practitioners were supported to conceptualize, design, implement and disseminate their own practice research projects located within their own agencies. The support included two strategies — workshops and mentoring; the latter being the focus of this article. Mentoring was provided by members of the academic and support team at the practitioners’ place of work at regular intervals during the life of the project. • Applications : Our reflections point to sets of emergent mentor relations in a development that goes beyond positing either vertical or horizontal relationships, to a more complicated nesting approach.

From Welfare State to Social Development: Winning the War of Words in New Zealand

This paper examines how ‘welfare state’ and ‘welfare’ have been displaced by a ‘social development’ agenda within New Zealand. The discussion outlines a growing attention to language and the place of vocabulary and discourse as a valid research agenda. The paper then traces the end of welfare and the rise of ‘social development’, assessing the impact on citizenship debates. It suggests reasons why ‘social development’ must be handled carefully given its assumptions around temporality, its elevation of the market, the diminishing of the social, the stunted vision of development and its peculiar view of progress.

Medical tourism: A snapshot of evidence on treatment abroad

The scoping review focuses on medical tourism, whereby consumers elect to travel across borders or to overseas destinations to receive their treatment. Such treatments include: cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF; and organ and tissue transplantation. The review assesses the emerging focus of research evidence post-2010. The narrative review traverses discussion on medical tourism definitions and flows, consumer choice, clinical quality and outcomes, and health systems implications. Attention is drawn to gaps in the research evidence.