Health Tourism and Challenges For India: Mrs. Christy Solomon Dr. Acharyulu G.V.R.K

EXCEL International Journal of Multidisciplinary Management Studies
Vol.2 Issue 4, April 2012, ISSN 2249 8834 Online available at http://zenithresearch.org.in/
HEALTH TOURISM AND CHALLENGES FOR INDIA

MRS. CHRISTY SOLOMON*; DR. ACHARYULU G.V.R.K**
*School of Management Studies, University of Hyderabad, Gachibowli, Hyderabad - 500046, Andhra Pradesh, India. **Reader, Operations & Supply Chain, Coordinator MBA, Health Care & Hospital Management, PO Central University Campus, Hyderabad 500046, India.
ABSTRACT Medical tourism is a booming industry in India. Studies on the patients visiting India revealed that three quarters of the over 1.5 million international patients as of January 2007 came from the United States and the United Kingdom. The medical tourism market has a potential to generate up to 2 billion USD by 2012. Health tourism or global health care also refers to medical tourism today. Medical tourism benefits the government, the hospital, the doctor, the entrepreneur and the patients and is the most cost effective method of obtaining immediate care for most of the patients in terms of cost of travel, accommodation food, insurance, transportation and other costs. However, hospitals which deviate quality standards also manage to attract foreign patients by providing attractive package, affecting the image of the growing medical tourism industry. Issues of equity, cost of care and quality standards are to be addressed to reap the benefits of global health care. This paper attempts to document the management challenges associated with medical tourism within India and its impact on the global economy. KEYWORDS: medical tourism, health care, quality standard, cost-effective. ______________________________________________________________________________ 1.0 INTRODUCTION Global health care, health tourism, medical outsourcing, medical travel, wellness tourism are common terminologies used for medical tourism today. The foreigners rising demand for health care from India has set a new standard of health care in terms of quality of staff and infrastructure. Many health care institutions are striving hard to meet the quality standards and meet the growing demands of the medical tourism industry. A number of health intermediaries or entrepreneurs who mediate between the foreign patient and the hospital have emerged as an essential link in facilitating the process of medical tourism. Foreign patients from other countries are attracted to Indian institutions, promising high quality of service, using standard treatment procedures, by specialists trained internationally and meeting accreditation standards at a low cost. Medical tourism benefits the government (by stimulation of the economy and development of world class facilities), the hospital (high revenue from foreign patients, assured returns on investment), the doctor (high quality profile, personal income improved skills), the entrepreneur
145
www.zenithresearch.org.in

(create a new market or industry) and the patients (access to quality services, affordability, access and reduced waiting times). Medical tourism is the most cost effective method of obtaining immediate care for most of the patients considering the cost of travel accommodation food insurance transportation and other costs. In developed countries surgeries are done priority wise and hence the patients are required to wait from a zero waiting time if critical, to some times years for cases not considered as clinically urgent. Patients prefer to travel to places other than their home country where the costs are low, quality of care are of international standards and where there is a package of services that provides an excellent tourist vacation which fulfils their health needs as well as the time for recovery. Medical tourism on the flip side has many challenges for the patient as well as the host country. The major challenge being lack of insurance to cover foreign patients and the challenge is intense in the event of post operative complications and additional expenses that have to be borne by the foreign patient. Sometimes, the follow up of such patients who have complications need to be done by the doctors in the patients home country who are required to attend to side effects and emergency care if any. Some hospitals which have a low standard also manage to attract foreign patients by providing attractive package, affecting the image of the growing medical tourism industry. When errors occur in treatment of patients, either at the home country or in a host country, it has inevitable adverse effects on the medical tourism industry especially in countries where data collection and recording of details of events are not adequately documented. 2.0 GROWTH OF MEDICAL TOURISM According to CB Venkatakrishna Prasad (2008), travelling to a different place for health is not new and dates back to thousands of years, when in ancient Greece, patients from all over the Mediterranean came to the healing god asklepios at Epidaurus. Health resorts in North Africa were visited by wealthy Europeans in the 18th century. But in the recent past there is a steep rise in the movement of patients providing a great business opportunity for nations that have resources in terms of technology, skilled manpower, infrastructure and the like. www.zenithresearch.org.in Service sector is a key engine of growth in todays leading global economies according to Basole and Rouse (2008). There are many reasons for the growth of the services sector: increasing competition in a global economy, pressure to innovate and changing customer demands. This has led to more complex environments, markets, product and service offerings, and stakeholder relationships. According to Devon et al (2008), global competition is emerging in the health care industry. Earlier only wealthy patients from developing countries travelled to developed countries for high quality medical care. This has been reversed by the fact that patients unable to seek care in their home country seek treatment of high quality at an affordable price from the once called third world countries including India. Approximately 500000 Americans travelled abroad for treatment in 2005 to Mexico, Latin American Countries, Singapore, India and Thailand.
146

The comparable costs for India and the US are very crucial to understand the concept of medical tourism. For example: Cardiac surgery costs USD 4000 and knee replacement costs USD 12000 in India where as the same costs USD 30000 each in the US. Accreditation by the Joint Commission International (JCI) of more than 125 facilities in 24 countries, and the International Organization of Standardization provides a useful point of reference for patients selecting offshore medical facilities according to Horowitz (2007). Some of the medical tourism destinations in the world are given in the table below. Asia America Europe Africa China, India, Malaysia, Singapore, South Korea, Philippines, Taiwan and Turkey. Argentina, Canada, Colombia, Costa Rica, Ecuador, Mexico, United States. Belgium, Czech Republic, Germany, Hungary, Italy, Latvia, Lithuania, Poland, Portugal, Romania, Russia and Spain South Africa and Tunisia
Patients who are not familiar with specific medical facilities abroad can coordinate their treatment through medical travel intermediaries. These services work like specialised travel agents. They investigate health care providers to ensure quality and screen customers to assess those who are physically well enough to travel. They often have doctors and nurses on staff to assess the medical efficacy of procedures and help patients select physicians and hospitals. Medical tourism is only one aspect of the way globalisation is changing the US health care system. Apart from patient travel, many medical tasks can be outsourced to skilled include interpretation of diagnostic tests and long distance international collaboration particularly in case management and disease management programs because of the availability of information technology. Patient Safety is now widely accepted as being fundamental to all aspects of health care. The need for improved public awareness and education about the considerations inherent in medical tourism the introduction of more stringent regulations for international centers was given by Reza Nassab et al. (2009). Eric Ford and Grant concluded that the patient safety goals of reducing medical errors while maximising health outcomes draws upon the tenets of evidence based medicine ( EBM) as well as the managerial theories of human relations. 3.0 ISSUES IN MEDICAL TOURISM According to P Terry Nicholas (2007), hospitals are hampered by immigration policies when they seek to overcome physician shortages. Patients are denied access to drugs or treatments that are cheaper across nearby borders. Health care is becoming more global in ways that patients and even some providers do not realise. The rise of medical tourism emphasises the privatisation of health care, the growing dependence on technology, uneven access to health resources and the
147

accelerated globalisation of both health care and tourism which was assessed by Connell John (2005). World watch online discussion held in May 2003 states that, the economic divide has widened not only in poor countries and those struggling in transition from communist to capitalist economic systems but also in many industrial nations. Its impact on essentials such as health and education lends even more urgency to reducing the gap between the worlds haves and have nots wherever they live. The US in fact has one of the most inequitable income distribution of all industrialised countries over 30 percent of the income is in the hands of the 10 percent rich and 1.8 percent is in the hands of the poorest 10 percent. This is not a sustainable trend and is tied to many other social inequities such as reduced access to basic education and health care. 4.0 MEDICAL TOURISM IN INDIA Medical tourism is simply the process of travelling abroad to a specific destination to obtain certain medical procedures. Canadians and Europeans have been travelling outside their regions for years to obtain medical procedures due to the long waiting periods associated with socialised medicine. Now they have an opportunity to seek top quality procedures where they can recover in anonymity and luxury at more affordable rates. The clinical outcomes are at par with the worlds best centres having internationally qualified and experience doctors. Costs of the medical procedures in India are approximately 1/5th of the costs in the West. This is because doctors in US pay high medical malpractice insurance to the tune of $100000 when compared to the other doctors who pay less than $4000 annually. This cost differential enables a patient to have a vacation in an exotic country and recover in a 4 to 5 star resort in complete anonymity and then return home having spent less than the procedure alone in the parent country. There is no waiting time for any surgical procedures. India receives patients from over 50 countries across the world. The reasons are (1) cost of medical care in India is very low when compared to that in many western countries.(2) A vast reservoir of skilled doctors,(3) Doctors who have proven their mettle return to India and establish hospitals in India. Entrepreneurs or intermediaries link up patients abroad to doctors in India by detailing them on the procedures and choices in a package of service that includes travel stay food and medical care. Anil Maini, the president of the India-based Apollo Hospitals Group estimates that ten Americans per month undergo surgery in Apollo Hospitals and an additional forty to fifty schedule eye exams, dental work, and computed axial tomography (CAT) scans, among other procedures. Apollo Hospitals also receives approximately 100 treatment inquiries per day, the majority of which come from the United States. Vishal Bali, the Chief Executive Officer of Wockhardt Hospitals, India, observes that what started as a low-cost, low-value medical care destination is today turning into a super speciality zone. According to Gluck(2008), the emergence of a one-stop shopping approach to medical tourism coupled with the Western medicine and Indias traditional healing arts, are driven by
148

Indias efforts to develop a distinctive brand of medical tourism in the face of stiff regional competition. Tamilnadu is the hub of health care in India. The Apollo Group, Sankara Nethralaya, Madras Medical Mission and Miot group have pioneered medical treatment and they attract overseas patients quite regularly. Naturopathy, aromatherapy, herbal therapies all have become popular among the medical tourists. Corporate hospitals in Chennai lure foreign patients by providing a good package medical expertise, nursing care, priority treatment at a reasonable cost. 5.0 ISSUES & CHALLENGES The following are the issues of medical tourism that needs to be addressed in India. 1. The local patients interests are marginalised and thus the issue of equity is widened because of medical tourism. 2. The boom in the medical tourism in India has earned huge benefits to the Indian economy but systems and rules need to become more stringent to avoid hospital infections and medical blunders. 3. The report on super bug and naming it as NDM 1 (New Delhi Metallo-1) can have a negative impact and should be adequately addressed. 4. Research points out that patients and their expectations have not been largely considered in designing benchmarking systems in most economies(Guven-Uslu,2005). 5. A health business model is proposed to maximise the benefits of medical tourism in India which calls for integration of efforts across stakeholders. Based on the analysis of the tourism industy review an alternative health business model is proposed for the effective promotion of medical tourism in India which can overcome the existing issues and challenges. This includes all the stakeholders who influence the medical tourism Industry. Effective coordination and cooperation between these agencies would enhance the quality of services leading to sustainable growth of the medical tourism industry in India. www.zenithresearch.org.in
149

6.0 CONCLUSION Medical Tourism in India is a booming industry which is very lucrative not only for the health personnel and hospitals but for entrepreneurs and economists as it can contribute tremendously to the Indian economy by maximising the benefits and minimising medical errors. However, care should be taken to cater to local needs and the issues of equity and quality of care. India has all the advantages to excel in the health sector due to its expertise and skill in the medical industry. Coordination, collaboration and commitment across sectors can build Indian economy to unimaginable levels along with patient safety measures to harness the benefits of globalisation in health care. 7.0 REFERENCES 1. C Segouin, B Hodges and PH Brechat, Globalization in health care: is international standardization of quality a step toward outsourcing?, Int J Qual Health Care 17 (2005), pp. 277279 2. Conceptualisation and empirical investigation. IBM Systems Journal,47, 53-70. 3. Eric W. Ford & Grant T. Savage, patient Safety: State of the Art in Health Care Management and Future Directions Patient Safety and Health Care Management,
150

Advances in Health care management, volume7,1-14, 2008,Emerald group Publishing limited. 4. Gary Gardner, Erik Assadourian and Radhika Sarin: World watch Researchers May 30,2003-2 PM EDT. 5. Gluck, Incredible [Accreditable] India:1 Trends In Hospital Accreditation Coexistent With The Growth Of Medical Tourism In India,(2008)492 Saint Louis University Journal Of Health Law & Policy [Vol. 1:459] 6. Guven-Uslu,P(2005), Benchmarking in health services, Benchmarking: An International Journal,Vol.7 No.5,pp.373-88. 7. Health Promotion International,Vol.16, No. 3, 289-297, September, 2001. 8. Herrick, D.M. Medical Tourism: Global Competition in Health Care, NCPA Policy Report No. 304 (November 2007) National Center for Policy Analysis 9. Horowitz Michael D, Rosensweig Jeffrey, Christopher A. Jones, Medical Tourism: Globalization of the Healthcare Marketplace, 2007. 10. John Connell Medical Tourism: Sea, Sun, Sand and Surgery, Tourism Management Volume 27, Issue 6, December 2006 Pages 1093-1100. 11. L.A. Higgins, Medical tourism takes off, but not without debate, Manage Care 16 (4) (2007), pp. 4547. 12. Lori-Ann Richard, Amy K Fehn, Rickard and Associates, St Chaire Shores 2008 prior Determinations- How helpful will they be? 13. Medical tourism Family lmedicine and international health related travel, Canadian family physician, vol.53, pp 1639-41. 14. Michael D. Horowitz, Jeffrey A. Rosensweig, Christopher A. Jones, Medical Tourism: Globalization of the Healthcare Marketplace,Pubmed central, November 13, 2007. 15. Mirror-Singer, Philip, Medical Malpractice Overseas: The Legal Uncertainty Surrendering Medical Tourism.2007 16. Nicholas Pottery, Unregulated Health care phenomena in a flat world: Medical tourism and outsourcing, 2006, pg421. 17. RC Basole & WB Rouse (2008) Complexity of service Value networks: 18. Reza Nasseb,Hamnett Nathan,Kate Nelson,Siramjit kaur,Aesthetic Surgery journal, Dec,2009. The American Society for Aesthetic Plastic Surgery, Inc 2010. www.zenithresearch.org.in
151

19. September,2007, David E. Williams of the health business blogSrivastava, T(2006) Indian Society for Apheresis and apheresis tourism in India- is there a future? Transfusion and Apheresis Science, Vol.34 (2), pp 139-144.The Health Lawyer, Vol.20 (6), pp. 36. 20. Venkata Krishna Prasad C.B., Medical Tourism Industry- Advantage India, 2008, conference organised by Indian Institute of Management, Lucknow and Kerala. 21. www.indianbusiness.nic.in/index.htm 22. http:/hubpages.com/hub/Philippines-medical-tourism.
152

Health Tourism and Challenges For India: Mrs. Christy Solomon Dr. Acharyulu G.V.R.K

Uploaded by

Copyright:

Available Formats

Health Tourism and Challenges For India: Mrs. Christy Solomon Dr. Acharyulu G.V.R.K

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Health Tourism and Challenges For India: Mrs. Christy Solomon Dr. Acharyulu G.V.R.K

Uploaded by

Copyright:

Available Formats

EXCEL International Journal of Multidisciplinary Management Studies