Increased Demand for Outpatient Surgery as Driver for Outbound Medical Tourism

I recently came across a report by Deloitte focusing on medical tourism (see: Medical Tourism: Updates and Implications). This is a topic that has been of great interest to me in the past. One section of it lists the most important growth drivers for outbound medical tourism, defined in the report as U.S. citizens traveling to other countries for medical care. It describes the increased demand for outpatient surgery as one such driver. Below are more details copied from the report:

The number of outpatient surgical procedures performed in the United States has tripled from 1996 to 2006. In 2006 alone, almost 35 million patients had outpatient surgery. This growth has been due, in part, to enhanced technology that allows many patients to go home just several hours after a procedure, rather than days later. The increase in patient demand for these surgeries has been accompanied by the growth of outpatient surgical centers and freestanding facilities. Since outpatient surgeries comprise almost 75 percent of medical tourism procedures and, for many of these, consumer out-of-pocket payments are high, the option of medical tourism will be attractive

This is a very interesting point and one that I had not considered previously. Inpatient hospital beds are expensive to build -- it's much less expensive to build freestanding ambulatory care facilities. Similarly, most patients would rather spend the night at home or in a comfortable hotel room rather than in a hospital. Also and from the perspective of infection, a hospital is not a safe place to be. This continuing movement toward outpatient care can only act as a stimulus for the growth of outbound medical tourism.

It's inevitable that outbound medical tourism will progress from the current emphasis on dental and cosmetic surgery to more complex surgical procedures. Total hip and knee replacements come to mind as examples of such procedures that are both common and expensive in the U.S. I have no idea what will be considered as routine "outpatient procedures" several years from now. It's possible, with new technologies and operative procedures, that joint replacement may fall into this category. Medical tourism seems to combine medical care with a quasi-vacation, sometimes in an exotic location. The combination of outpatient surgery with lodging in a nearby resort-like hotel for recuperation takes this idea to a new level.

By the way, the Deloitte medical tourism report refers to inbound and intrabound medical tourism in addition  to the outbound variety. These two terms refer to foreign tourists traveling to the U.S. for care and U.S. patients traveling domestically. These types of patients, to use the common term in the U.S., are participating in what are called destination hospital programs  (see: "Destination Programs" at Large Medical Centers).

Comments

[L Needham]

It's an interesting addition the 'puzzle' of medical tourism...and likely one that will not only increase in frequency due in part to the stated reasons. However, in harkening back to a recent post on this topic, the most curious thing about the practice is (as you mentioned) how U.S. based insurance companies view/ cover any subsequent complications from such procedures. Perhaps there's a reader in a different country (non-U.S) can explain how these matters are currently handled by payers in their home countries? What if the complication rate increases, and is covered by stateside insurances (the sequelae)...what then? we (the public) are presumably held to an even greater financial burden in order to 'pay' for these procedures and results when the procedure's weren't performed in the U.S. nor by U.S. trained/ based physicians? the Question / area in general quickly becomes a Pandora's Box!!! What about procedures or therapies that aren't approved in the U.S.? how are they handled (by insurance)?
Another possible pitfall, alluded to in this post, is what happens when, as use and foreign methods increase, these procedures do progress to incorporate joint replacements and the like? What happens/ who is held responsible if in-flight/transit issues arise, including, but certainly not limited to, expedited returns to home countries that contradict typical practices regarding safe time post-procedure to avoid VTE's?

It's an interesting realm to discuss...and hypothesize, and, in thinking of it more, know little of how matters are currently handled, only raising the stakes as time moves forward!