Medical Tourism

1. Medical Tourism
Dr Manish Prabhakar

2. Frame Work
• Tourism
• Medical Tourism
• Scope of Medical
Tourism
• Components
• Accreditation
• Medical Tourism
Provider
• Indian Scenario
• SWOT analysis
• Role of Government
and Private
• Innovations

3. Introduction
• After Silicon Rush India Considered as a golden spot for
treating patients
• Medical Outsourcing
• Indian National health policy declared that treatment of
foreign patients is legally export.

4. .

10. What is medical tourism?
• Medical tourists elect to travel across international borders to
receive some form of medical treatment
• Treatments may span the full range of medical services
• Most common: dental care, cosmetic surgery, elective surgery,
and fertility treatment – OECD, 2010

11. 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

12. 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

13. 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

14. 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.

15. Reasons for Medical Tourism
 Cost Effectiveness
 Availability of services
 Expertise
 Absence of waiting lists

16. 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

17. 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

18. 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

19. 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

20. Medical and
Healthcare
Tourism
Treatment of
illnesses
(Medical
tourism)
Enhancement
(Cosmetic
surgeries)
Wellness(Spa/Al
ternate
therapies)
Reproduction
(Fertility)
Healthcare &
Medical Tourism
Components

21. Treatment of Illnesses
 Joint replacements
 Heart surgery
 Cancer treatment,
 Neurosurgery,
 Transplants(Liver and Bone marrow)
 Dental treatment.

22. 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.

23. 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.

24. 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.

26. Hospital Accreditation
• Accreditation has been defined as "A self-
assessment 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.

27. Accreditation Schemes
• Trent Accreditation Scheme (based in UK-
Europe)
• 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)

28. • Accreditation Canada (formerly the
Canadian Council on Health Services
Accreditation or CCHSA -based in Canada)
• Accreditation of France (La Haute Autorité
de Santé) based in Paris, France.
• NABH(National Accreditation Board for
Hospitals and Health Centres- based in
India)

29. • 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.

30. 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

31. 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.

32. 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.

33. 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

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

36. 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.

37. • 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

38. 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

39. Healthcare Pricing(Comparision)
Procedure US UK Burmungrad
Bangkok
Raffles
Singapore
Max Healthcare
(India)
Angioplasty 30000 21000-
27000
4000 - 5000 5000 4000 - 5000
Angiography 2500 -
3000
2000 1100 800 400
Hip
replacement
19000 13000-
16000
_ 6600 6000
Knee
replacement
27000-
32000
16000-
18000
_ 6000 6000
CABG 30000 _ 9600 6400
Lasik _ 2250-
2900
750 _ 400

40. 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

42. 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.

43. Brand India
Medical Treatment in USA
=
A tour to India + Medical Treatment + Savings
“First World Services at Third World
Cost”.

44. 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.

45. 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

46. 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

47. 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.

48. 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.

49. Threats
• A threat is an unfavorable condition in the
industry’s environment which creates a
risk for, or causes damage to, the industry.
 Strong competition from countries like
Thailand, Malaysia and Singapore.
 Lack of international accreditation – a major
inhibitor.
 Overseas medical care not covered by
insurance providers.
 Under – investment in health infrastructure.

50. Threats
 Exploitation of tourists by illegal money
changers.
 Terrorism
 Rise of Resistant strains (NDM-1)

51. 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.

52. Government’s 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

53. Government’s Role
• Tourism facilitator:
 Reduce hassles in visa process(M-Visa)
 Follow an Open-Sky policy to increase inflow of flights into India
 Create Medical Attachés to Indian embassies that promote health
services to prospective Indian visitors

54. Private Sector Role
1. Increased participation in building
infrastructure
2. Integrate Horizontally
3. Joint Ventures / Alliances

55. Innovation Through MEDICITIES
• Software industry-Establishment of Export Oriented Software
Technology Parks
• Medical tourism industry-Medicities

56. 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.

57. 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