Handbook on Medical Tourism and Patient Mobility
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Handbook on Medical Tourism and Patient Mobility

Edited by Neil Lunt, Daniel Horsfall and Johanna Hanefeld

The growth of international travel for purposes of medical treatment has been accompanied by increased academic research and analysis. This Handbook explores the emergence of medical travel and patient mobility and the implications for patients and health systems. Bringing together leading scholars and analysts from across the globe, this unprecedented Handbook examines the regional and national experiences of medical tourism, including coverage of the Americas, Europe, Africa, the Middle East, and Asia. The chapters explore topics on issues of risk, law and ethics; and include treatment-focused discussions which highlight patient decision-making, patient experience and treatment outcomes for cosmetic, transplantation, dentil, fertility and bariatric treatment.
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Chapter 7: Health systems and medical tourism

Pedro P. Barros

Abstract

Medical tourism has implications for the equilibrium of health systems. The challenges medical tourism poses will be different across health systems, depending on their particular institutional features, on health insurance protection and on how provision of health care is organized. Health systems decisions influence both outbound and incoming medical tourism flows. By defining health insurance coverage for patients looking for health care in another country, health systems influence outbound flows. For incoming patients, in a country with difficult access to health care (reflected in the existence of waiting lists, for example), treating medical tourists on preferential terms may present political difficulties. Health systems with public providers participating in medical tourism initiatives will face challenges regarding differential prices and qualities between domestic and foreign patients. Engaging in medical tourism may work as a strategy by a health system in order to avoid medical brain drain. System-wide effects on quality of care are less clear. The existence of competition in quality may lead to more quality improvements. On the other hand, aftercare externalities may require carefully crafted payment systems. The way in which health systems are affected by medical tourism and how they adjust remains an important research area, both for theory and empirical work.

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