health-tourism

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HEALTH TOURISM

The broad definition of health tourism refers to people seeking medical attention, as well as health care services, in a country other than their place of residence. Health tourism was defined by the International Union of Tourist Organizations (IUTO), the forerunner to the United Nations World Tourism Organization, as ‘‘the provision of health facilities utilizing the natural resources of the country, in particular mineral water and climate’’. Goeldner in a review of the health tourism literature, defined health tourism as ‘‘staying away from home, with health [as the] most important motive, and done in a leisure setting.’’ Goodrich defined health tourism in terms of the narrower concept of health‐care tourism as:

“The attempt  on  the  part  of  a  tourist  facility  (e.g. hotel)  or  destination  (e.g. Algarve,  Portugal)  to attract tourists by deliberately promoting its health care services and facilities, in addition to its regular tourist amenities.”

Goeldner recognized five components of the health tourism market, each of these identifies a more specific market segment which can have categories of health‐related tourism attached to it:

1. Sun and fun activities (leisure tourism).

2. Engaging in healthy activities, but health is not the central motive (outdoor recreation, adventure tourism, sports tourism, and wellness tourism).

3. Principle motive for travel is health (e.g. a sea cruise or travel to a different climate/health tourism and wellness tourism).

4. Travel for sauna, massage, and other health activities (spa tourism and wellness tourism).

5. Medical treatment (medical tourism and dental tourism).

While  the  above  classification  is  useful  for  identifying  elements  of   the  demand  for  health  and  spa tourism, it fails to acknowledge the importance that those health products and spas play in destination or attraction  marketing  and  promotion  or  as  a  component  of  tourism  development  strategies.

Therefore, Hall, in seeking to provide a definition, consistent with official definitions of tourism, suggested that health tourism be defined as:

“A commercial phenomenon of industrial society which involves a person travelling overnight away from the normal  home environment  for  the  express  benefit  of  maintaining  or  improving  health,  and      the  supply  and promotion  of  facilities  and  destinations  which  seek  to  provide  such  benefits.”

What makes health tourism different from medical tourism is that health tourism covers a wide range of services from preventive and health‐conductive to rehabilitation and curative, while medical tourism usually only covers surgeries or similar treatments.

These kinds of travels, motivated by health matters, date back to the time when Greek pilgrims traveled to  the  sanctuary  of  the  healing  god  Asklepios.  Spas  and  mineral  water  springs  have  been  and  still  are forms of medical tourism as they are known to treat diseases from gout to liver disorders and bronchitis. These places are the destination of  many  travelers  these  days.

Travels  due  to  health  tourism    have  been  usually  made  by  people  from  under‐developed  countries  seeking better  quality  health  services  in  well‐known  health  centers  in  highly  developed  countries.  However,  lately,  citizens  of  developed  countries  have  been  referring  to  less‐developed   countries  to  benefit from cheaper health services. Several demographic, economic, and lifestyle factors are driving such tourisms (Handszuh and  Waters 1997; Ross  2001). Particularities  of  healthcare  systems  such  as long waiting lists, high costs, lack of insurance, unavailable or non‐licensed services and under insurement are causing some to go abroad to seek medical care. This is a major drive of demand from     offshore  sources  when  local  health  systems  cannot  provide appropriate  or  timely  options.

Sometimes  people  with  rare  conditions  even  travel  for  a  better  understanding  of  their  treatment and traveling motives usually differ for each country.  For an example, the leading factor for health tourism in UK is the   avoidance  of  waiting  times,  while Americans  mostly  travel  for  lower‐priced quality  treatments.

Basically,  convenience  and  speed  are  the  main  reasons  for  such   travels.  This  is seen  as well as an  opportunity to develop an economic sector, and as a problem in some national healthcare systems (Borman 2004).

Despite these forces, there are numerous constraints to trade in health services (Chanda 2001) such as the restrictions on entry and practice by foreign health service providers, restrictions on foreign direct investment in health and other related sectors, regulations in insurance, education and telecommunications, domestic, regulatory, infrastructural and capacity related constraints. Other than what  mentioned  above  it is  known  that health  tourism  carries  some  risks.  For example,  if  you’re considering a medical travel to South Africa or Thailand, which is well‐known for everything from open‐ heart  surgery  to  fertility  treatments,   you  should  be aware  that  these  countries  have  very  different  infectious  disease‐related  epidemiology to Europe and North America

 So a question arises: Is health tourism a cure or a threat for global public health?

C. Michael Hall from the University of Guelph investigated the answer to this question in his review of health tourism. In conclusion,  he states  that  “health  and  medical  tourism  is  a  complex  area  of  study.  Many governments, international agencies, private health providers and  medical practitioners see it  as   a  means  of economic  development  that  may  cross‐subsidies  domestic  health  access  and   provide  a competitive  cure for  the  problems  facing  the  global  health  system.   In  contrast,  others  see  it  as  part   of  a  process  of  marketization   and  economization  of  public  health  services  already  under  pressure  from neo liberal political  agendas;  further  reinforcement  of  the  commoditization  of  the  body;  and  also reinforcing  gaps  between  have  and  have‐nots  both  within  and  between  societies.  Undoubtedly, the  benefits  and  risks attached  to  medical  tourism  both  for  individual  and  collective  public  health  are a significant area for future research. Such research must include contributions, not only from medical and health  research  but  also  from tourism studies.  It  is  hoped  that  this  special  issue  of  Tourism  Review  makes  at  least  a  small  contribution to a better understanding of the field”.

“The  attempt  on  the  part  of  a  tourist  facility  (e.g. hotel)  or  destination  (e.g. Algarve,    Portugal)  to attract tourists by deliberately promoting its health care services and facilities, in addition to its regular tourist  amenities.” Goodrich  uses  these  words  to  define   health  tourism.  In  this  article  we  are  going  to discuss dental tourism, also called dental vacations or commonly known as dental holidays in Europe, which is a subcategory of health tourism. Increasing numbers of patients are crossing national borders and obtaining dental care. Journalists commonly characterize the phenomenon of cross‐border care as ‘dental  tourism’  and  it  applies  to  a person  referring  to  healthcare  systems  in countries  other  than  their  place  of  residence  seeking  dental  care.

Dental tourism commonly occurs along regional pathways rather than global networks. Americans in such Mexican border towns such as the cities of Juarez and Tijuana. Some Americans obtain inexpensive dental care in Argentina, Costa Rica, and Peru. Australian dental tourism companies promote Bangkok and Phuket in Thailand   as  inexpensive  sites  for  dental  treatment.  Americans  can  travel  to  India  or  the  Philippines  for multiple  dental  procedures  but  it  is  only  somewhat  more  expensive  and   far  more  convenient  to  obtain dental care  in  Mexico.  Likewise,  it  is unsurprising   that  most  patients  from  Britain  obtain  dental care  in Portugal rather than the Dominican Republic or Peru. Given the proliferation of dental tourism companies and  their  recognition  that  it  is  possible  to profit  by  selling  low    cost  dental care  to  patients  in regions   where  dental care  is  comparatively  more expensive,  the  number  of  individuals  travelling    for dental care is likely to increase. Marketing initiatives will encourage more individuals to travel for dental care.

Health  tourism  motivations  are  due  to  diverse  reasons  while  dental  tourism  motivations  are  mostly about price/quality ratio considerations as developing countries are providing dental care at significant cost savings when  compared  to their  peers  in  the  developed  world.  Generally,  we  can  explain  the rise  in  patient mobility as a result of five factors.

1.  In some countries private dental care is unaffordable for many patients. The high price of local procedures  drives  individuals  to  find  comparatively  inexpensive  dental  procedures.

2.  Patients  unable  to  obtain  prompt  access  to  local  dental  care  look  beyond  their  communities  in search of timely dental treatment.

3.  Patients unable to access dental specialist close by.  Amongst this, for example, qualified dental implant specialists are scares in the U.K.

4. Patients  understand   that  lower  prices  for  dental  care  need  not  result  in  low   quality  care.  Some patients return home satisfied with the quality of care they receive elsewhere. ‘Word of mouth’ promotion prompts other patients to consider travelling for treatment.

5. Economy air travel makes the cost of transportation considerably less expensive than the price of many dental procedures.

6. The internet plays a powerful role in connecting ‘customers’ to sellers of dental services. Dental clinics around the  world  use  the internet  to  advertise  procedures  to  international  patients. Dental tourism companies, mainstream travel agencies selling health‐related travel packages, and medical tourism companies likewise use the internet to advertise ‘all‐inclusive deals’. These packages include dental procedures with pre‐established prices, hotel rooms, air fare, ground transportation, `VIP treatment´, restaurant reservations, and side trips to popular tourist destinations.

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