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Title: The impact of medical tourism on the domestic economy and private health system : a case study of Thailand
Author: Noree, T.
ISNI:       0000 0004 5363 834X
Awarding Body: London School of Hygiene and Tropical Medicine (University of London)
Current Institution: London School of Hygiene and Tropical Medicine (University of London)
Date of Award: 2015
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In the 21st century, medical tourism has emerged as a prosperous industry. Its growth has been fostered by increasing healthcare costs, long waiting lists for nonemergency operations and a lack of service availability in many developed countries. This has resulted in a reverse phenomenon of patients travelling from developed countries to developing ones to seek affordable healthcare and prompt services. Developing countries in particular have established a variety of strategies to benefit from this profitable market. However, the negative implications of the cross-border movement of services have raised concerns. Quality of services and continuity of care for patients are key concerns in source countries, and inequity, in terms of access to services, rising healthcare costs and the ‘internal brain drain’ of healthcare personnel are concerns in destination countries. It is widely believed that there are substantial economic benefits to be gained from medical tourism, but this belief is not based on a firm empirical foundation. Similarly, there is a lack of empirical evidence concerning the impacts on the health systems of destination countries. The divergence of views and overall lack of evidence affords the potential for policy incoherence between trade and health. This study intends to address this gap in the literature through an empirical assessment of both medical tourism and the healthcare profiles of medical tourists. The overall aim of the study is to assess the impact of medical tourism on the Thai economy and domestic private health system. Thailand was selected as a appropriate country for a case study due to its significant medical tourism industry. This study presents the most extensive and detailed research on medical tourism and its effects on the private health system to date, by drawing on 324,906 patient records in the five largest private hospitals in the country. The key findings are that medical tourists in Thailand are non-homogenous. Comparisons present differences between them and non-medical tourists and Thai private patients in terms of demography and service profiles. The majority are likely to be opportunistic tourists, especially patients who use out-patient departments. Furthermore, the actual number of medical tourists is far fewer than is generally suggested, although they and their companions contribute disproportionately to the Thai economy in terms of medical and tourism-related spending. In terms of medical services, there is no difference between the critical aspects of care given to Thai and foreign patients. Hospitals make use of spare capacity to serve the demand of foreigners. However, foreign patients might be partially responsible for a shortage of high calibre doctors in public hospitals. Hence, if it wishes to continue with its “Medical hub” policy, there is an evident need for the Thai government to consider carefully the overall “cost” of this policy.
Supervisor: Smith, R. Sponsor: International Health Policy Program, Thailand
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral