Medical Tourism: Push and pull factors

People from across the globe and all walks of life are turning to medical tourism (also known as global health) to satisfy their healthcare needs. There are several main factors driving medical tourism. These can be divided into “push” and “pull” factors that are particular to the country of residence of the medical tourist, in the case of the former, and to the destinations they are traveling to in the case of the latter. A push factor involves a force or circumstance which acts to drive (or push) people away from a place, while a pull factor is what draws (or pulls) them to a new location.

In the remainder of this report we will look at several destinations that are prime sources of medical tourists to analyze the push and pull factors influencing their citizens to travel abroad for care.

Canada

Although highly touted in terms of quality, Canada’s socialized healthcare system generates long wait times for certain procedures, making it a prime source market for medical tourists.

Push factors Pull factors
High percentage of baby boomers Quick access to care
High incidence of lifestyle diseases such as diabetes, obesity and cardiovascular conditions Availability of non-FDA approved treatments
Long waiting times for certain treatments[1] Proximity of destination
Unavailability of certain treatment due to government restrictions Ability to combine treatment with a vacation
Availability of higher expertise and technology for certain procedures[2]
Procedures sought: Orthopedics, weight loss surgeries, ophthalmology, CCSVI, dental, cardiology, stem cell, infertility treatments[3]
Destinations sought: United States, Mexico, Costa Rica, India, Thailand

 Saudi Arabia

Saudi Arabian medical tourists seek highly specialized procedures and VIP treatment. Over the last few years the Saudi government has invested heavily in healthcare infrastructure with the goal of stemming the tide of medical tourists leaving the country and at the same time becoming a medical tourism destination.

Push factors Pull factors
High incidence of lifestyle diseases such as diabetes, obesity and cardiovascular conditions Availability of acute and specialized healthcare treatments and technology
Perception of low quality healthcare services Promptness in scheduling treatment
Convenience and VIP healthcare and Concierge services
Procedures sought:  Oncology, organ transplantation, cosmetic surgery[4]
Destinations sought: United States, Germany, Dubai

 Nigeria

According to the Chief Executive Officer of the Nigeria Sovereign Investment Authority, Uche Orji, approximately 30,000 Nigerians travel for medical tourism each year, leaving $1 billion US dollars in potential healthcare revenues outside the country.  The government is looking at ways to improve healthcare services so as to stem the tide of outbound medical travelers.

Push factors Pull factors
Limited availability of quality healthcare services Availability of acute treatment facilities
Long waiting times for certain medical procedures Prompt scheduling of treatments
Availability of lowcost treatments
Procedures sought:  Cardiology, oncology, orthopedics, neurosurgery, organ transplantation, stem cell treatments[5]
Destinations sought: India, Germany, Israel, Egypt[6]

Russia

A lack of confidence in the quality of local healthcare services coupled with increasing wealth among the middle classes is spurring many Russians to seek medical treatments abroad.

Push factors Pull factors
Perception of low quality healthcare services Availability of high quality healthcare services
Limited Access to specialized treatments Convenience and hand-holding (all inclusive medical packages)
Long waiting times for certain procedures Savings
A growing demographic wealthy individuals looking for high quality healthcare treatments Short waiting times for scheduling procedures
Procedures sought: Oncology, cardiology, orthopedics, neurosurgery, gynecology, urology.
Destinations sought: Israel, Germany, Turkey, South Korea[7]

 United States

A long-time source for outbound medical tourists as well as a destination for inbound medical tourists, the U.S. is grappling with the provisions of the recently instituted Affordable Care Act. On the one hand, many of the previously uninsured individuals will have access to insurance, but on the other, insurance premiums have gone up, affecting both individuals as well as employers, which should benefit the adoption of medical tourism.

Push factors Pull factors
High cost of healthcare services Low cost of healthcare
Lack of insurance coverage or deficient coverage Availability of non-FDA approved treatments
A growing demographic of baby boomers Proximity of destination
High incidence of lifestyle diseases such as diabetes, obesity and cardiovascular conditions Ability to combine treatment with a vacation
Unavailability of certain treatment due to government restrictions
Procedures sought:  Orthopedics, Cardiology, spinal, weight loss surgeries, organ transplantation, cosmetic surgery, infertility treatments, dental
Destinations sought: Mexico, Canada, Costa Rica, Thailand, India

[1] Canadians Seeking Health Care Abroad: Why and How Many? Nadeem Esmail, The Fraser Institute. From Presentation at 5th World Medical Tourism & Global Healthcare Congress, Oct. 27, 2012

[2] Canadians Seeking Health Care Abroad: Why and How Many? Nadeem Esmail, The Fraser Institute. From Presentation at 5th World Medical Tourism & Global Healthcare Congress, Oct. 27, 2012

[3] Beyond “medical tourism”: Canadian companies marketing medical travel. Leigh Turner. Globalization and Health. http://www.globalizationandhealth.com/content/8/1/16#B21. Accessed 10/22/2014

[4] Saudi Arabia’s Inbound and Outbound Medical Tourism- Interview with Medical Attaché. Medical Tourism Magazine, June 18, 2012. http://www.medicaltourismmag.com/saudi-arabiaaes-inbound-and-outbound-medical-tourism-interview-with-a-medical-attacha/

[5] http://www.vanguardngr.com/2014/05/nigerian-spends-1bn-annually-medical-tourism/

[6] http://allafrica.com/stories/201301071129.html?viewall=1

[7] Russian medical tourists. Who are they? Dr. Vadym Meyl, presentation at World Medical Tourism & Global Healthcare Congress, Las Vegas, NV, Nov 4th, 2013

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