Medical Tourism

Ravi Rohilla
Junior Resident
Community Medicine

CONTENTS
Tourism
Medical Tourism
Scope of Medical
Tourism
Components
Accreditation
Medical Tourism
Provider

Indian Scenario
SWOT analysis
Role of Government
and Private
Innovations

Tourism
Tourism comprises of the activities of persons
traveling to and staying in place outside their
usual environment for leisure, business and
other purposes.
Tourists are the people who "travel to and stay
in places outside their usual environment for
not more than one consecutive year for leisure,
business and other purposes not related to the
exercise of an activity remunerated from within
the place visited.
-World Tourism Organisation

Types of Tourism
United Nations classified three forms of
tourism in its Recommendations on
Tourism Statistics (1994).

Domestic tourism, involving residents of

the given country travelling only within the
country.
Inbound tourism, involving non-residents
travelling in the given country.
Outbound tourism, involving residents
travelling in another country

Medical Tourism
Medical tourism is a term involving
people who travel to a different place to
receive treatment for a disease,
ailment, or condition, and who are
seeking lower cost of care, higher
quality of care, better access to care, or
different care than they could receive at
home.
-Global Spa Summit 2011

Why Medical
Tourism?
Healthcare and Tourism industries are the
fastest growing industries in the world.
Medical Tourism is being promoted as a Fusion
product of these industries.
Various countries like Thailand, Malaysia,
India, etc are promoting Medical Tourism
aggressively.
Medical tourism has tremendously generated
services and revenues across the globe and
numerous possibilities still remain unexplored.

Reasons for Medical

Tourism

Cost Effectiveness
Availability of services
Expertise
Absence of waiting lists

Scope of Medical
Tourism
Healthcare industry

World's largest industry

Total revenue of approximately US$2.8 Trillion.

In India

Healthcare industry has emerged as one of

the largest service sectors
Estimated revenue of around US$30 billion
constituting 5% of GDP and offering
employment to around 4 million people

Scope of Medical Tourism in

India
Medical tourism market is valued to be worth
over $310 million with foreign patients coming
by 100,000 every year, and the market is
predicted to grow to $2 billion by 2012.
An estimated 180,000 medical tourists were
treated at Indian facilities in 2004 (up from
10,000 in year 2000), and the number has
been growing at 25-30% annually.
-

CII-McKinsey report 2008

Scope of Medical
Tourism
There are various kinds of services that
are provided under medical tourism

Service Delivery Medical services

Travel Services (Airlines & Hotels)
Shopping & Entertainment for tourists and
their family members
Insurance Coverage towards the risks
involved during the treatment
Websites providing information, booking
facilities and promotions

Countries currently offering

International Medical Tourism
healthcare services.
Argentina
Australia
Bahrain
Bangladesh
Barbados
Belgium
Brazil
India
Lebanon
Lithuania
Malaysia

Canada
Cayman Islands
Chile
Costa Rica
Cuba
Cyprus
Switzerland
Taiwan
Thailand
Turkey

Healthcare
& Medical
Tourism

Component
s

Treatment of Illnesses

Joint replacements
Heart surgery
Cancer treatment,
Neurosurgery,
Transplants(Liver and Bone marrow)
Dental treatment.

Enhancement
Enhancement procedures are carried
out mainly for aesthetic purposes(much
of this work is non-disease related
unless disfigurement is caused by
disease). These are:

All cosmetic surgeries

Breast surgeries
Facelifts,
liposuction and cosmetic dental work.

Wellness(Spa/Alternate
therapies)
The wellness segment of medical and
healthcare tourism promotes healthier
lifestyles. These products can include:

Treatment in spas
Thermal and water treatment
Acupuncture and Aromatherapy
Beauty care, facials, exercise and diet
Herbal healing, homeopathy, massage
Yoga and naturopathy.

Reproduction(Fertility)
Under this component, there are
patients who seek fertility-related
treatments such as in vitro and in vivo
fertilization and other similar
procedures.
At times, potential parents travel for the
purposes of adopting children because
the legislation and supply of babies for
adoption is easier in host countries.

Hospital
Accreditation
Accreditation has been defined as "A selfassessment and external peer assessment
process used by health care organisations to
accurately assess their level of performance
in relation to established standards and to
implement ways to continuously improve.
Fundamentally healthcare and hospital
accreditation is about improving how care is
delivered to patients and the quality of the
care they receive.

Accreditation Schemes
Trent Accreditation Scheme (based in UKEurope)
QHA Trent Accreditation, based in the UK
Joint Commission International, or JCI
(based in USA)
Australian Council for Healthcare
Standards International, or ACHSI (based
in Australia)

Accreditation Canada (formerly the

Canadian Council on Health Services
Accreditation or CCHSA -based in Canada)
Accreditation of France (La Haute Autorit
de Sant) based in Paris, France.
NABH(National Accreditation Board for
Hospitals and Health Centres- based in
India)

The Ministry of Health and Family Welfare

has set up a National Accreditation Board
for Hospitals(NABH), under the Quality
Council of India for accreditation of
hospitals
Established in year 2006.
There are 16 JCI accredited and 63 NABH
accredited healthcare providers in India.

Outline of NABH
Standards
Access, Assessment and Continuity of Care
Patient Rights and Education
Care of Patient
Management of Medication
Hospital Infection Control
Continuous Quality Improvement
Responsibility of Management
Facility Management and Safety
Human Resources Management
Information Management System

Medical Tourism
Provider
A Medical Tourism Provider is an
organisation or a company which seeks to
bring together a prospective patient with a
service provider, usually a hospital or a
clinic.
Some such organisations and companies
specialize in certain areas of healthcare,
such as cosmetic surgery, dentistry or
transplant surgery, while others are more
generalised in their approach.

Medical tourism
provider
Medical quality standards vary around the
world, and international accreditation is
relatively new.
For these reasons, Medical tourists look to
health tourism providers to provide
information about
Quality,
Safety and
Legal issues.

Various issues for

Medical
Tourists
Medical issues
Availability of
techniques
Pre-travel health
issues, such as
antimalarial therapy
and relevant
immunisations
Medico-legal issues

Non Medical
issues
Prices and how to pay
Hotels(checking in)
Language issues
Ethics

Various service
providers(India)
http://www.medaccessindia.com/
http://www.recoverdiscover.com/
http://www.medicaltourisminindia.n
et/
http://www.forerunnershealthcare.
com/
http://www.medicalresortindia.com/
http://www.medicaltourism-india.in/
http://www.medicaltourismco.com/

NEJM echoes
The New England Journal of Medicine
detailed an account of a self-employed
carpenter who had an acute mitral-valve
prolapse that required surgery.
Estimated fees at the nearest hospital
approached $200,000, half of which needed
to be paid in advance.
After some more digging around, this patient
was able to find a hospital in Texas that
could perform the procedure for $40,000.

After some more research, the patient

decided to fly to New Delhi, India where
he had the procedure performed for less
than $7,000.
Shortly after returning to North Carolina,
the patient went back to work with a
healthy heart.

To India

Why India?
India has several advantages that make it a
natural choice for Medical treatment.

Cost advantage during treatment as well as

medication
Large pool of good doctors, nurses and paramedics
World-class facilities
High brand value of leading Indian medical
professionals across the globe
Good English speaking population
Vibrant Pharmaceutical industry

Healthcare
Pricing(Comparision)
Procedure
US
UK
Burmungrad
Raffles
Bangkok

Singapore

Max

Healthcare
(India)

Angioplasty

30000

2100027000

4000 - 5000

5000

4000 - 5000

Angiography

2500 3000

2000

1100

800

400

Hip
replacement

19000

1300016000

6600

6000

Knee
replacement

2700032000

1600018000

6000

6000

CABG

30000

9600

6400

Lasik

750

400

22502900

Major Players
Following are major players in the
Medical Tourism industry.

Escorts
Apollo Hospital
Max Healthcare
Indraprastha Apollo Hospital
Hinduja Hospital
Jaslok Hospital
Fortis
Wockhardt

Competition
Thailand, Singapore, Malaysia, India
and Philippines are the major destinations
in the Asian medical tourism market.
Thailand is more popular among Western
European medical tourists for cosmetic
surgery.
Singapore and India specialize in complex
procedures with India having a cost
advantage and Singapore a technology
advantage.

Brand India
Medical Treatment in USA
=

A tour to India + Medical

Treatment + Savings

First World Services at Third

World Cost.

Medical Tourism : SWOT

approach
Business/service firms undertake SWOT
analysis to understand their external
and internal environments.
Through such an analysis, the Strengths
and Weaknesses existing within the
medical tourism can be matched with
the Opportunities and Threats operating
in the Indian environment so that an
effective strategy can be formulated.

Strengths
A strength is an inherent capacity which an
organization can use to gain strategic
advantage.

Quality and Range of Services

Affordable costs
Vast supply of qualified doctors:
Strong presence in advanced health care
International Reputation of hospitals and Doctors.
Diversity of tourism destinations and experiences

Weakness
A weakness is an inherent limitation or
constraint which creates strategic
disadvantages.

No strong government support/initiative to promote

medical tourism.
Low coordination between the various players in
the industry- airline operators, hotels, and
hospitals.
Lack of uniform pricing policies across hospitals.
Customer Perception as an unhygienic country
Political problems etc

Opportunities
An opportunity is a favorable condition in
the service industry which enables it to
consolidate and strengthen its position

Increased demand for healthcare services from

countries with aging population (US, UK)
Fast-paced life style increases demand for
wellness tourism and alternative cures.
Shortage of supply in National Health Systems
in countries like UK, Canada.

Opportunities

Demand from countries with

underdeveloped healthcare facilities.
Demand for retirement homes for elderly
people especially Japanese.
Personal touch by the doctors in India.
Traffic system is well developed and easy to
go from one country to another country.
Medicines and lab-our cost is low as
compared to developed countries.

Threats
A threat is an unfavourable condition in the
industrys environment which creates a
risk for, or causes damage to, the industry.

Strong competition from countries like

Thailand, Malaysia and Singapore.
Lack of international accreditaion a major
inhibitor.
Overseas medical care not covered by
insurance providers.
Under investment in health infrastructure.

Threats

Exploitation of tourists by illegal money

changers.
Terrorism
Rise of Resistant strains (NDM-1)

Role of Government
The role of Indian Government for success
in medical tourism is two-fold:
Acting as a Regulator to institute a
uniform grading and accreditation system
for hospitals to build consumers trust.
Acting as a Facilitator for encouraging
private investment in medical
infrastructure and policymaking for
improving medical tourism.

Governments Role
Investment facilitator:
Recognize healthcare as an infrastructure
sector, and extend the benefits under sec
80-IA of the IT Act.
Should actively promote FDI in healthcare
sector
Providing low interest rate loans, reducing
import/excise duty for medical equipment
Facilitating clearances and certification

Governments Role
Tourism facilitator:

Reduce hassles in visa process(MVisa)

Follow an Open-Sky policy to increase
inflow of flights into India
Create Medical Attachs to Indian
embassies that promote health
services to prospective Indian visitors

Private Sector Role

1. Increased participation in building
infrastructure

2. Integrate Horizontally
3. Joint Ventures / Alliances

Innovation Through
MEDICITIES
Software industry-Establishment
of Export Oriented Software
Technology Parks
Medical tourism industryMedicities

MEDICITY
MEDICITY-A self-sustained
healthcare hub with

Super specialty hospitals of international

standards
Ancillary facilities
Research institutions
Health resort
Rehabilitation centers and residential
apartments.

References
World Tourism Organisation, unwto.org/
Ministry of Tourism, India,
tourism.gov.in/
Incredible India,
www.incredibleindia.org/
NABH, www.nabh.co/
CII-McKinsey Report

THANK
S