Probably the major limiting factor on the growth of medical tourism, about which I have posted multiple previous notes, is the question of the quality of the services that are delivered in the overseas hospitals, particularly for surgical patients. I believe it's possible that the best hospitals in. say, Singapore or India are actually superior to some of the hospitals in the U.S. However, it's also necessary for them to provide tangible evidence of this fact. In order to respond to this quality issue, many of the hospitals abroad have sought certification from the Joint Commission International, a non-profit U.S. hospital accreditation body. My sense is that this is a good first step.
A recent op-ed piece in the New York Times focused on medical tourism and offshore surgery (see: Overseas, Under the Knife) described the need for comparing the postoperative surgical outcomes of overseas hospitals with those of U.S. hospitals. Below is an excerpt from it with boldface emphasis mine:
- ...[W]e must adopt a uniform way for American hospitals and surgeons to report on the frequency of short-term surgical complications. Medicare could do this by requiring that all participating hospitals and surgeons count pre-surgical risk factors and post-surgical complications during hospitalization and for 30 days afterward, when most short-term problems become evident....
- Patients and their surgeons also need comparable measurements of long-term success. Medicare should lead by adopting Sweden’s method of monitoring hip joint replacement outcomes. It tracks, for example, a patient’s ability to walk without pain six years after surgery.
- ...Medicare should invite accredited offshore hospitals and their affiliated doctors to participate in all of its comparative performance reporting systems. Beyond informing Americans contemplating treatment abroad, such comparisons would allow us to learn if our care is the world’s best — and to accelerate our improvement efforts if it is not.
You can obtain detailed information on the web in minutes comparing the quality and performance of various automobiles or PCs. Unfortunately, you can't perform the same task when seeking a surgeon in whose hands you may be putting your life. I don't buy the line of reasoning that the outcomes of a hip replacement are too complex to measure or outcomes can't be compared from hospital to hospital. If it can be done in Sweden, it can be done here.
I have noted in previous notes that one of the positive aspects of medical tourism and overseas surgery is that it establishes more quality and price competition for U.S. hospitals (see: Business Risks of Medical Tourism, Reduced Cost of Offshore Surgical Procedures Puts Pressure on U.S. Hospitals to Compete). Note the reference in the NYT article above to the fact that overseas surgery provides "a modest way to make American health care more affordable." From the quality perspective, I suspect that the better offshore facilities like Bumrungrad Hospital in Bangkok will jump at the chance of providing post-operative outcomes data. U.S. hospitals will then be forced to provide comparable data to prove that they are better and we will learn, as noted above, "if our care is the world's best."
By the way and as an example of price transparency, the Bumrungrad Hospital web site provides a "How much will it cost?" web page with data based on the actual invoices patients paid upon leaving the hospital, including surgical fees, doctor’s fees, lab tests, drugs prices, and room fees. I suspect that comparable data would be very hard to obtain for comparable American hospitals.
Comments