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Global Partnership of Asian Colleges
University of Economics and Business, VNU
VIETNAM MATIONAL UNIVERSITY, HANOI UNIVERSITY OF ECONOMICS AND BUSINESS -------------------------------------------
Topic: Medical tourism a new approach to treatment benefits and disadvantages, a new role for nurses the trend of Medical Tourism in Asia
Supervisor: Dr. Phm Th Li , M!A Dep". #roup: V Th $o% &Le%'er( N)u* Th H ) ) Th Ph ) Tho D ) Th Th+* ,-%ss: .H/001 E 2TN 3 #r%'u%"e
-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)
ACKNOWLEDGEMENT
This study would not have been completed without the cooperation of Dr. Pham Thi Lien, a teacher of Master of Business Administration Department, Business, "ietnam #ational niversity of !conomics and niversity, $anoi. %esearchers would li&e to show 'ratitude to
Dr. Lien for her cooperation and helps to accomplish this study. (he 'ave us useful and practical advice and worthy remar&s. Moreover, this is the first time researchers have dealt with an economic research topic and especially for the purpose of discussin' them with e)cellent students from some Asian countries in *lobal Partnership of Asian +olle'es, therefore, it appeared to be a difficult tas& to some aspects but eventually, with her helps and researchers- efforts, it was accomplished successfully to some e)tent. .ithout her help and willin'ness to participate, this study would never have happened.
ABSTRACT
/n the period of chan'es and development of the world economy, Medical is more and more concerned to provide best 0ualified treatments for human. Medical also ma&es a hu'e contribution to the world livin' standard in terms of economic factor. Therefore, many services emer'e with medical basis. /n the flow of development, Medical tourism emer'ed and now is developin' speedily in all over the world for the two main purposes above. /t now is bein' e)ploited as a ma1or factor of economic 'rowth by many countries, especially /ndia, Thailand, (in'apore, some countries in !urope li&e The (, in America li&e the (, Me)ico, +anada, etc. /n Asian countries, especially, there is fast development of Medical tourisms than&s to the benefits and economic contributions it brin's althou'h there still e)ist some disadvanta'es. This paper e)plored the main benefits as well as disadvanta'es of Medical tourism, new role2s3 of nurses, its contribution to the world economy, especially concernin' with four case studies of /ndia, Thailand, (in'apore and "ietnam the countries have been 'ainin' reputation for Medical tourism and have potentials for development of Medical tourism.
TABLE OF CONTENT
ACKNOWLEGDMENT.................................................................................................2 ABSTRACT.....................................................................................................................2 Table of content.................................................................................................................4 List of tables, chart and fi'ures ........................................................................................5 CHAPTER 1: INTRODUCTION I. Bac& 'round of the research............................................................................6 II. III. IV. V. VI. Aim and ob1ectives, and scope of the research................................................6 %esearch 0uestions..........................................................................................6 (tructure of the research..................................................................................7 Data collection instruments and procedures....................................................7 Data analysis procedures.................................................................................7
CHAPTER 2: LITERATURE REVIEW I. Definition of medical tourism...........................................................................8 II. III. $istory..............................................................................................................8 %elated researches............................................................................................9 1. Benefits of Medical tourism.......................................................................9 2. Disadvanta'es of Medical tourism...........................................................:; 3. %ole2s3 of nurses.......................................................................................:5 4. +ontribution to the world *DP................................................................:7 CHAPTER 3: RESULTS AND DISCUSSION: CASE STUDIES +urrent situation of Medical tourism Trend in the world.........................................................................................:< Medical tourism in Asia................................................................................;: 1. +ase study := Medical tourism in /ndia...................................................;7 2. +ase study ;= Medical tourism in Thailand.............................................;< 3. +ase study 4= Medical tourism in (in'apore...........................................4; 4. +ase study 5= Medical tourism in "ietnam.............................................45 CHAPTER 4: CONCLUSION I. Ma1or findin's...............................................................................................48 II. Limitations.....................................................................................................48 III. +ontribution of the study...............................................................................49 /". (u''estions for further studies......................................................................49 APPENDICES................................................................................................................39 REFERENCES..............................................................................................................43
I. II.
LIST OF TABLES, FIGURES a ! GRAPHS Ta"#$% Table := The international price comparisons F&'()$% >i'ure := people travel abroad each year for health care >i'ure ;.:= +omparisons in term of costs amon' countries between ( and /ndia, Thailand, (in'apore >i'ure ;.;= +omparisons in term of costs amon' countries G)a*+% *raph := /nternational tourist arrivals, traditional and emer'in' mar&ets ;??8 *raph ;= Mappin' the 'rowth path of /ndia Medical tourism
CHAPTER 1: INTRODUCTION
I. Ba,- ').( ! ./ 0+$ )$%$a),+ #owadays, medical tourism is becomin' more and more popular worldwide. /t has been promoted by most of the nations owin' to the fact that it brin's them many benefits. >or individuals, it is the availability of media that offers people more choices of destinations so that they can ma)imi@e their benefits and minimi@e their cost. Therefore, medical tourism is not only a useful but also an economic way for people to en1oy their vacation and receive health treatment at the same time. >or businesses and 'overnment, medical travel is seen as a A'reen industryA to increase the revenues or boost *DP. Amon' the mar&ets, Asian countries 2includin' "ietnam3 are considered to be the most potential for developin' medical tourism since these countries have beautiful si'htseein' and 'ood 0uality service with lower price. Than&s to the low labor cost, customers can save 6? or up to 9? percent as they under'o a medical treatment in Asian countries in comparison with that of nited (tates or a !uropean country. $ence, there are hordes of tourists come for medical tourism in Asian countries every year. /t is the revenues from this type of industry that help these countries prove their livin' standard remar&ably. II. A&1 a ! ."2$,0&3$% ./ 0+$ )$%$a),+, %,.*$ ./ 0+$ )$%$a),+ >or all of the reasons above, the 'roup would li&e to 'ive inBdept information about medical tourism in order to provide people some useful information of this topic. At the same time, the research aims to raise peopleCs awareness about the contributions of medical tourism to the 'rowth of economy as well as the trend for developin' this industry in the future. $owever, due to the limitation of the paper, the researchers only cover several aspects of medical travel such as its definition, advanta'es, disadvanta'es, and new roles for nurses as well as its development in some &ey Asian countries. III. R$%$a),+ 4($%0&. % Accordin'ly, the research focuses on answerin' the 0uestions= 1. What are the benefits as well as the disadvantages that Medical can bring? Do the nurses have the new role(s)? What can Medical tourism contribute to the world economy? 2. What are the real cases of some key sian countries! where Medical tourism is currently "romoted and develo"ed? IV. S0)(,0()$ ./ 0+$ )$%$a),+ The research is comprised of five chapters as follows= +hapter : is the introduction to the thesis. +hapter ; provides readers with the review of previous studies related to the present research. +hapter 4 presents the methods used in present research and
the process of data analysis. +hapter 5 is the discussions of the findin's as well as analyses of the trends as well as contributions of medical tourism to economy of some Asian countries. +hapter 6 summari@es the main points of the study and offers some advices for tourists to have the best option as they travel abroad for medical treatment. The remains are references and appendices. V. Da0a ,.##$,0&. & %0)(1$ 0% a ! *).,$!()$% /n order to address to the research, a caseBstudy method was employed. (tudied cases were often the ones which were e)plored and studied by the previous researchers or even scientists and scholars. >irstly, the researchers found those studied cases throu'h boo&s and other sources but mostly the internet. All of the materials only provided the readers with the bac&'round &nowled'e of medical tourism in some Asian countries such as /ndia, Thailand, (in'apore and so on. After referrin' to the previous studies, all of the characteristics, the trends as well as the contributions of medical tourism to the economy of each nation were pointed out. VI. Da0a a a#5%&% *).,$!()$% The researchers used the data analysis method 'iven by #unan 2:<<;3 in which the data were reconstructed so that they were systematic and lo'ical. >irst of all, the collected findin's were cate'ori@ed into 'roups in terms of its content such as the benefits, roles of nurses or disadvanta'es of medical tourism. Then some of data was summari@ed into tables and charts to facilitate the synthesis and 'enerali@ation of the data. Lastly, they would be compared with what have been found in the previous studies. These results, combined with the researchers- understandin' of medical tourism are the basis for the final conclusion of the research.
CHAPTER 2: LITERATURE REVIEW

I. D$/& &0&. ./ 1$!&,a# 0.()&%1 Medical tourism is defined as the practice of travelin' to another country in order to receive medical attention. /ts forms can be varied from a minor sur'ery to a complicated one such as heart sur'ery, breast implants, a hip replacement or dental wor&. Due to the differences in terms of location and procedure, a medical vacation can cost 6?D, 4?D or even :?D of what a person pays at home. Besides, it is necessary for people to distin'uish between the two terms Amedical tourismA and Amedical travelA. Accordin' to the .$ECs statistics, most of patients who travel abroad primarily because of medical reasons fall into the cate'ory of medical travel. /n contrast, some patients also come for medical service since it is incidental to their trip to another country 2medical treatment is not their primary purpose3. These people belon' to the cate'ory of medical tourism. . #ormally, they 'o in for elective, cosmetic or minimally invasive procedures such as dermatolo'y, dental, 'eneral health screenin' and AaestheticA procedures. II. H&%0.)5 /t is widely believed that medical tourism is not a new concept. /t has been practiced around the word for years. $owever, nowadays, more and more people find it advanta'eous to practice and cheaper to access this &ind of medical treatment. /n ancient time, there e)isted a stron' lin& between reli'ion and healthcare which dated bac& for thousands of years. At that time, the *ree&s showed their honor to their *od of medicineB Asclepius by erectin' the Asclepia Temples. Then, this place became one of the wordCs first health centers to which people often travel to see& for their ailments. As a result, the *ree&s were considered to be the first to lay a foundation for a comprehensive medical tourism networ&. /n the followin' years, other therapeutic temples flourished under the *ree& domain with a variety of services li&e a 'ymnasium, a sna&e farm, a dream temple, and thermal baths. (ince the :6??s, in /ndia, people be'an ac&nowled'in' about medical tourism with the popularity of yo'a and Ayurvedic medicine. As early as 6??? years a'o, constant streams of medical travelers and spiritual students came to /ndia to see& the benefits of these alternativeBhealin' methods. /n the :9th and :<th centuries, !uropeans and Americans floc&ed to health spas and sanitariums, sometimes in remote places, in the hope that they would obtain relief from their disablin' conditions, such as tuberculosis, 'out, bronchitis, or liver diseases.
/n the ;:st century, medical tourism is becomin' more and more popular, especially in Asian countries ascribed to relatively lowBcost 1et travel. #owadays, it is said to be a millionBdollar industry which is promoted by the 'overnments and businesses in many parts all over the world. This is proven by the fact that hordes of Americans 2nearly half a million3 visit Asia, Me)ico, and (outh America each year to see& hi'h 0uality yet cheap medical treatment, combined with e)otic vacations in the destination country. *eneral spea&in', health travel used to be restricted either to the wealthy or truly desperate, however, in today-s flattenin' 'lobal economy, the physical, economic, and cultural barriers that once separated nations from one another are dissolvin'. /nternational travel and more lenient trade policies ma&e it possible for those with modest means to en1oy the benefits of worldBclass health care at some of the most popular medical tourism destinations around the 'lobe. !http"##$$$%health tourism%com#medical tourism#history#& R$#a0$! )$%$a),+$% 1. B$ $/&0% ./ M$!&,a# 0.()&%1 &. L.6 ,.%0: The cost effectiveness is the number one reason why people choose to 'o offshore for medical treatment. The savin's ran'e between 4?D and 9?D of the cost that patients would normally pay in the (A. >or many procedures, it is more e)pensive for a patient to receive treatment at home than it is to purchase a plane tic&et, boo& a hotel, and pay for all medical e)penses out of poc&et in a forei'n country. This is especially true in popular medical tourism destinations such as /ndia, Thailand, and (in'apore. Due to the low prices of medical procedures and sur'ery abroad, some people worry that medical tourism mi'ht be fraud or a scam, but it is not true. The main reason for the low prices of medical treatment abroad is the low cost of labor in the popular medical tourism destinations. Besides, hi'h competitive prices and ade0uate malpractice insurance also lead to the reduction in the e)penses for medical treatment. !http"##$$$%health tourism%com#medical tourism#benefits#& !http"##$$$%articlesnatch%com#Article#'he 'op ( Benefits )f *edical 'ourism#+,-.+(& Low labor cost Lower labor costs help e)plain why medical tourism procedures are cheaper. $ourly wa'es in countries li&e /ndia, Thailand, and Ar'entina are usually lower than they are in countries li&e the nited (tates, !n'land, or Fapan. $owever, this does not mean that these labors here are uns&illful
III.
and dis0ualified. /n most cases sur'ical procedures are performed by well trained e)perts who are usin' top notch technolo'y. !http"##$$$%health tourism%com#medical tourism#benefits#& !http"##$$$%articlesnatch%com#Article#'he 'op ( Benefits )f *edical 'ourism#+,-.+(& !http"##$$$%healism%com#medical/tourism#overvie$#advantages/of/medical/tourism#& Malpractice insurance Ma#*)a,0&,$ (%(a##5 &% 70 a% +&'+ a% &0 &% & 0+$ US. This is not to say that the safety and 0uality of medical treatments are inferior. /tCs 1ust that hospitals can afford to lower their prices since they themselves donCt have to pay as much to their insurance companies. This also means that a patient will not necessarily receive lar'e balloon payments if he or she sues a hospital and win in the event of a botched sur'ery. $i'h competitive price /t is the competitive price that attracts more and more tourist from !urope, especially from the (A to 'et medical treatment in Asian countries. The price for a medical procedure in Asia is sometimes only ;? to 4? percent of that in the nited (tates or nited Gin'dom. This cost differential to'ether with sophisticated travel industry ensurin' ease and affordability of travel provides the bac&bone of medical tourism. /n order to illustrate for this ideas, letCs a have loo& at the table which shows the cost comparison between the ( and some Asian countries below= >i'ures are estimated, are in S()'$)5 Pa)0&a# +&* )$*#a,$1$ 0 /ndia H5,6?? .(. H:9,??? F(## +&* )$*#a,$1$ 0 /ndia H4,??? .(. H4<,??? O)0+.*$!&, %()'$)5 /ndia H5,6?? .(. H:9,??? Ca)!&a, %()'$)5 /ndia H5,???B H<,??? or I7,??? .(. H4?,???B H6?,??? .G. 2Private care3 I4?,??? K $$ %()'$)5 /ndia I9,??? .G. 2Private care3 I;?,??? Ga## "#a!!$) %()'$)5 /ndia H8,6?? .(. H7?,??? T..0+ $80)a,0&. Thailand H4? .(. H46? 9 .(. dollars or .G. pounds, fi'ures vary due to prices char'ed by different medical centres and patient profile and do not include travel and accommodation costs
T6. !$ 0a# ")&!'$% $un'ary H<<? .(. H6,;?? F&##& ' /ndia H;? to H5? P).,$!()$ H$a)0 B5*a%% H$a)0 Va#3$ A '&.*#a%05 H&* R$*#a,$1$ 0 H5%0$)$,0.15 K $$ R$*#a,$1$ 0 S*& a# F(%&. US :;?,??? :76,??? 66,??? 9?,??? ;:,??? 76,??? 76,??? I !&a :?,??? <,??? ::,??? <,??? 4,??? 9,6?? 6,6??
.(. H4?? to H5?? R..0 ,a a# /ndia H;?? to H5?? .(. H4,6??
T+a&#a ! :?,??? <,??? :;,??? ::,??? 5,??? <,??? 8,???
S& 'a*.)$ :9,6?? :;,6?? :4,??? :;,??? 7,??? :4,??? <,???
'able ," 'he international price comparisons
!http"##$$$%health tourism%com#medical tourism#benefits#& !http"##$$$%articlesnatch%com#Article#'he 'op ( Benefits )f *edical 'ourism#+,-.+(& &&. S+.)0 6a&0& ' 0&1$ Another ma1or benefit is 0+$ %*$$! a0 6+&,+ %.1$ %()'&,a# *).,$!()$% ,a "$ ,.1*#$0$!. This is especially true for tourists who come from countries with public health care systems with no or little re'ulatory paperwor& and bureaucratic red tape. /n this case, they will have unusually lon' waitin' times whereas medical tourism offers them the chance to be placed on the priority list. The waitin' period for a hip replacement in Britain, for e)ample, can be up to a year or more whereas a patient can have the procedure done almost immediately if they fly to fly to /ndia, Thailand, Malaysia or the Philippines. $owever, it can be seen that a lon' waitin'Blist is not an option when a personCs health is at sta&e. As a result, countries such as !n'land have actually be'un encoura'in' their citi@ens to receive medical attention abroad due to the shorter waitin' times and lower costs. 2http"##$$$%discovermedicaltourism%com#benefits#&
&&&. B$00$) 4(a#&05
Many people have doubted about the 0uality of medical travel with the lower cost but this is not true. Based on the recent reports of as wellBtrained staff as followin's= #.$E, the 0uality of medical service is sometimes superior to what a person could find bac& home. This can be proven by the stateBof BtheBart facilities as well
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B$00$) a ! *)./$%%&. a# %*$,&a#&%0% a !
()%$%= .ith lower labor costs, medical tourism
facilities can often hire more support staff than a comparable facility in the .est can. /t can be proven by hi'her ratios of nurseBtoBpatient and the rela)in' atmosphere that a patient can en1oy as they under'o a medical treatment. Many of these patients admit that their e)periences are more li&e hotel stays than typical hospital visits B$00$) a ! a!3a ,$! /a,&#&0&$%= #owadays, there is also a 'rowin' phenomenon that many hospitals are rated J6Bstar- around the 'lobe in such farBflun' places as Ban'&o&, (in'apore, Manila, Gerala and Dubai. They operate in a hi'hly competitive mar&et and are run alon' the lines of 6Bstar hotels. Many hospitals in (outh !ast Asia, especially in Malaysia, Thailand, (in'apore, have adopted and invested in the latest medical technolo'y to provide stateBof BtheBart care for patients. >or instance, these hospitals often employ ( or !uropeanB trained physicians and care team or use clinical information technolo'ies for treatment. They also claim to offer the firstBrate and modern facilities and a wide ran'e of speciali@ed medical and dia'nostic services coverin' all medical disciplines, while 'uaranteein' more affordable and hi'h 0uality care for patients.
!http"##$$$%healism%com#fa0s#fa0s/about/medical/tourism#medical/tourism/fa0s/about/medical/tourism#& &3. M.)$ .*0&. %
F.) #a,-9( a3a&#a"&#&05 ./ )$1$!5 a0 +.1$ ,.( 0)5 Ebviously, medical tourism sometimes offers patients a chance to access to procedures that are not available in their home countries. /n some cases, these patients have difficulty in dealin' with their health matters since their home countries heavily re'ulate 2or even ban3 certain elective procedures or complicated sur'eries. /n contrast, they are able to access these procedures very easily in another country with the support of medical tourism, even with a lower price. >or e)ample, hip resurfacin' was only recently approved by the ( >ood and Dru' Administration, despite its widespread use and success rate at many popular medical tourism destinations around the world F.) )$*#a,& ' .0:'..! )$1$!5 a0 +.1$ ,.( 0)5 /t is the flourish and popularity of medical services that 'ive people a lot of options to be treated with the best 0uality and the lowest price. /n order to attract as many tourists as possible, the most popular medical destinations actively do everythin' they can to provide patients with options and ensure optimal care. /n ;??6, for e)ample, lu)ury medical facility, Bumrun'rad /nternational $ospital in Thailand, treated 66,??? patients from the nited (tates alone. !http"##$$$%healism%com#medical/tourism#overvie$#advantages/of/medical/tourism#&
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3. T.()&%1
.hile the primary motivation for most of patients is affordable sur'ery, the opportunity to visit e)otic destinations is also an additional draw for some of them. (everal medical tourists decide to spend a few days si'htseein' before their procedures whereas the others en1oy the same while recuperatin'. /t is a fact that most of people have a plan to spend holidays yearly and sometimes need to under'o medical treatment. Besides, a patient should be aware of the fact that visitin' e)otic places will speed up the healin' process. Therefore, a wise decision is to combine between dealin' with health matters and en1oyin' holidays abroad because it helps these people receive less e)pensive but more effective healthcare as well as have opportunity to travel to 'reat si'htseein' all over the world. !http"##$$$%health tourism%com#medical tourism#benefits#& 2. D&%a!3a 0a'$% ./ M$!&,a# 0.()&%1 Medical tourism is a personal choice because there are many decisions that must be addressed before considerin' healthcare services abroad. As mentioned, a tourist can be obtained many benefits from travelin' abroad for healthcare treatment, however, that is not to say that medical travel does not cause them any troubles or ris&s. /t is important for these people to &eep in mind that all medical treatments incur some de'ree of ris&, and that there is an unavoidable inherent dan'er associated with all medical procedure. Most of the ris&s are related to the unfamiliarity with the local conditions. There are two &inds of dan'ers that tourists often encounter as they 'o for medical treatment as followin's= &. R&%- ./ 1a#*)a,0&,$: I +$)$ 0 !a '$)= /t is important to ac&nowled'e that inherent dan'ers may occur in any medical treatment, no matter where people receive it. /t is estimated that nearly :??,??? people die every year in American hospitals because of preventable medical errors. (o no matter where a person decides to receive his or her
treatment, understand that he or she can face certain ris&s. U $8*$,0$! !a '$)%: Durin' the procedure of medical treatment, patients can encounter several une)pected dan'ers such as food poisonin', in1ury, culture shoc&, and countless other potential KthreatsL.
!http"##$$$%healism%com#medical/tourism#overvie$#disadvantages/of/medical/tourism#& &&. L$'a# ,. ,$) :

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Due to the lac& of available le'al recourse, medical tourists may have difficulty in see&in' for redress in cases of ne'li'ence, misdia'noses, or incompetence. Ebviously, insurance laws are various from re'ions to re'ions in terms of types of insurance and types of procedures protected. Therefore, a patient probably e)periences a preventable, adverse event as a result of receivin' care overseas and has the limits to the compensation that they can receive. /n such case, hospital staff would be protected whereas patients suffer from dama'e with no le'al recourse or financial compensation. Besides, receivin' medical care abroad may sub1ect medical tourists to unfamiliar le'al issues. /t is the limited nature of liti'ation in various countries that helps to reduce the cost of care overseas. As a result, as some problems arise, patients mi'ht not be covered by ade0uate personal insurance or mi'ht be unable to see& compensation via malpractice lawsuits. $ospitals andMor doctors in some countries may be unable to pay the financial dama'es awarded by a court to a patient who has sued them, owin' to the hospital andMor the doctor not possessin' appropriate insurance cover andMor medical indemnity. !http"##$$$%business in asia%com#asia#medical/tourism%html& &&&. E0+&,a# ,. ,$)
Despite the benefits of lower cost and decreased waitin' periods for medical tourists, ethical dilemmas associated with this tourism must be ac&nowled'ed. >irst of all, domestic customers may have difficulty in dealin' with healthcare in their home country. As usual, forei'n customers are often in priority as they 'o to medical centers. #ormally, doctors pay more attention to them and offer them the best conditions of treatment. /n some cases, these doctors have become so busy with forei'ners that domestic patients are 'oin' trouble 'ettin' care. >urthermore, medical tourism is often critici@ed on 'rounds of fraud, blatant lac& of scientific rationale and patient safety. $owever, it is often challen'in' to differentiate between acceptable medical innovation and unacceptable patient e)ploitation when a healthcare center or a hospital pioneers advanced technolo'ies, such as providin' CunprovenC therapies to patients outside of re'ular clinical trials. !http"##$$$%business in asia%com#asia#medical/tourism%html& iv. La '(a'$ a ! ,(#0()$ "a))&$)% 13
/t is said that lan'ua'e and cultural problems sometimes prevent patients from en1oyin' their vacation or receivin' healthcare in another country. >irstly, !n'lish is considered to be the international lan'ua'e for people from different countries to communicate with one another. Therefore, 'ood !n'lish is e)pected from both hospital staff and tourists. $owever, some tourists may find it difficult to e)press their opinions because they &now no or little !n'lish and vice versa. /t is these lan'ua'e barriers that may cause some re'retful misunderstandin' between doctors and customers. >or instance, Thais in the tourism sector 'enerally spea& !n'lish well and the service is e)cellent with forei'n restaurants and a 'enuine attempt to please, however, !n'lish is 0uite poor outside the tourism sector. +ulture shoc& is also a typical problem that tourists often encounter as they travel for medical treatment, especially for those who have little e)perience travelin' abroad. >or e)ample, /ndia, Thailand and (in'apore 'enerally lead the medical tourism hubs but all have ma1or failin's in terms of lan'ua'e and cultural barriers. /ndians tend to spea& better !n'lish, but are much less accommodatin' culturally and while the lan'ua'e barrier is lower the cultural barrier is much hi'her. $ence, as tourists come to such countries, it is advisable for them to brin' an a'ent boo& or boo& a pac&a'e holiday so that they can limit the interaction with local people and avoid several troubles. !http"##$$$%business in asia%com#asia#medical/tourism%html& 3. R.#$;%< ./ ()%$% &. R$a%. % /.) ,+a '$% & ).#$;%< ./ ()%$%: There are several reasons for the chan'es in the roles of nurses when medical tourism is becomin' more and more popular. >or lon' recovery, postoperative arran'ement >or many procedures, itCs customary to chec& in with your physician or dentist from time to time as you recuperate. $owever, by receivin' treatment abroad, it becomes prohibitively e)pensive to consult with whatever doctor or dentist provided you with primary care. This is one reason why many medical tourists decide to recuperate while they are still abroad. As a result, many medical tourism destinations have e)cellent facilities to care for and entertain recoverin' patients. /tCs not uncommon to find medical tourists rela)in' on the beaches as they recuperate. But for procedures re0uirin' lon'er recovery periods, youCll need to ma&e postoperative arran'ements on
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your own. This usually re0uires consultin' a local physician or dentist in your hometown, in addition to whatever forei'n health care provider supervised the ori'inal treatment. >or removin' potential and inherent dan'ers To ta&e advanta'e of this demand, forei'n clinics are increasin'ly vyin' for reco'nition from the Foint +ommission /nternational, the leadin' .(.Bbased hospital accreditation body. Applicants must meet a strin'ent set of criteria, includin' havin' a competently trained medical staff who understands forei'n lan'ua'es and cultures, an honest admission and price policy, and performance re0uirements in ;? other specific areas. KThe ris&s for patients in travelin' far distances for care can be si'nificantL says F+/-s president and +!E, Garen $. Timmons. KPatients need assurance that their physician and healthBcare provider have the ri'ht 0ualifications and credentials. Patients must also understand the le'al redress available to them.L &&. C+a '$% & ).#$% ./ ()%$%.
/t is difficult to precisely define the full 'amut of responsibilities covered by the 'eneral term, J#ursin'-. A nurse-s duties are many. T)a!&0&. a##5, nurses play a role of careB'ivers. They are responsible for the wellbein' of patients entrusted to their care. Their duties therefore, e)tend from establishin' relationships with beside chores that ensure that the patients are clean and comfortable durin' their illness and convalesce, to assistin' the physician, &eepin' accurate records, administerin' medication and helpin' durin' e)aminations and operations. #ormally, every nurse, on each duty round, is 'iven the care of a set number of patients. A nurse-s duties in this area include assessin', discussin' and plannin' for each individual patient-s needs, puttin' these plans into operation, monitorin' their pro'ress, and if necessary chan'in' them. They have also to &eep detailed notes to ensure continuity, as collea'ues often have to ta&e over when the patient-s own nurse is off duty. #urses are also re0uired to be present when consultants visit their patient, and to follow up on the treatment prescribed. They are e)pected to display a calm, perceptive approach durin' crises that are only to be e)pected in hospitals. Most importantly, the nurse, bein' more in contact with the patient than any other member of the hospital staff, should be able to create a bond between the patient and the medical fraternity in order to facilitate recovery. I 1$!&,a# 0.()&%1, nurses ta&e more roles in order to meet the demand of the 1ob. .hat are the new roles for nursesN /n addition to the role of providin' care to the clients, nurses in 'rowin' medical tourism industry period are re0uired to enhance their &nowled'e base and s&ills in business and mana'ement because medical tourism is essentially a business. Moreover, it is necessary for nurses to build up a stron' bac&'round in transcultural nursin' since there are a 'reat number of forei'n patients comin' to receive care. Apart from learnin' their professional s&ills such as ------------------------------------------------------------------------------------------------------------------------------ 15
Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)
in1ectin' or carin' for people who are ill or in1ured, nurses now have to broaden their mind in some other fields which have been mentioned 2business, culture, etc.3 and bein' clients- coordinator. /n other words, they are e)pected to 'uide clients to the appropriate medical tourism-s destinations, be aware of potential medicalMethicalMle'al issues previously cited and warn clients of these ris&s. !http"##$$$%aarogya%com#health resources#career opportunities#1(-1 role of nurse%html& !http"##$$$%medscape%com#vie$article#23.32(/(& 4. C. 0)&"(0&. 0. 0+$ 6.)#! GDP Accordin' to the .orld Travel and Tourism +ouncil 2.TT+3, tourism is a &ey driver of ;:st century-s economic activity and is the lar'est creator of 1obs, wealth and investment around the world. As illustration, the ( alone contributes (H 4.6 trillion to the world-s *DP and (H :.; trillion to its *DP. /t is also the world-s lar'est e)port earner with forei'n currency receipts from international tourism outstrippin' e)ports of petroleum products, motor vehicles, telecommunications e0uipment, te)tiles or any other product or service. /n ;??8, international tourist arrivals rose by 7 per cent reachin' a new record fi'ure of 9<9 million and overta&in' ;??7 fi'ure by over 6; million arrivals. Ene si'nificant feature of ;??8 was the continuin' healthy performance of emer'in' destinations bac&ed up by one of the lon'est periods of sustained economic e)pansion. Medical tourism in Asia is 'rowin' rapidly, far outstrippin' the 5 to 7 per cent 'rowth in 'eneral travel boo&in's predicted for ;??7, with the number of medical tourist visits to many countries swellin' by ;? to 4? per cent a year. Abacus /nternational President and +!E Don Birch says the spinBoffs which e)tend well beyond the medical, travel and tourism sectors have attracted stron' 'overnment interest across Asia, and efforts to woo medical tourists have added further impetus to the 'rowth. Asia-s bur'eonin' medical tourism industry, e)pected to be worth at least (H5 billion by ;?:;, is provin' a windfall for the travel and hospitality sector. &. G).60+ & !(%0)5 & 0)a3$# a ! +.%*&0a#&05 %$,0.) 'ravel#tourism sector" 'raditional and emerging source mar4ets 5332
16
*lobally, world tourism flow shows a si'nificant shift from traditional source mar&ets 2.estern !urope, (A, +anada, Fapan3 to alternative ones 2+entral and !astern !urope, +hina, %epublic of Gorea, (in'apore, Middle !ast, Me)ico, the %ussian >ederation, /ndia etc.3 Tourism 'rowth has been driven by emer'in' destinations in Asia, Pacific, Africa and the Middle !ast, while the more Jmature- re'ions of !urope and the Americas show a more moderate pace.
Graph ," 6nternational tourist arrivals, traditional and emerging mar4ets 5332 !http"##$$$%asianhhm%com#healthcare/management#health/tourism%htm& 7ospitality sector" 'he increasing trend of health tourism The increasin' trends of tourism coupled with health treatments abroad have led to a 'rowth in the health tourism phenomenon. $ealth tourism 2also called medical tourism, medical travel or 'lobal healthcare3 is a term initially coined by travel a'encies and the mass media to describe the rapidly 'rowin' practice of travellin' across international borders to obtain healthcare. (uch services typically include elective procedures as well as more specialised sur'eries such as 1oint replacement 2&nee M hip3, cardiac, dental and cosmetic sur'eries. Travel and leisure aspects typically associated with tourism are now bein' offered in the form of allBinclusive health tourism pac&a'es. &&. O0+$) 0a&#.)$! %$,0.)% = %*& :.//%: /..!, )$,)$a0&. , "(&#!& ', $0,. 17
$otels and resorts want in on the action and have created attractive medical vacation pac&a'es, which offer clinic shuttle service, holistic personal coo&s, and lu)urious accommodations desi'ned for recovery. Abacus /nternational President and +!E Don Birch 2Bumrun'rad /nternational $ospital, Thailand3 says, K/n this competitive landscape, everyone is loo&in' for an ed'e= *overnments are collaboratin' for mutual benefit, hospitals are creatin' incentives to retain their best medical talent, and travel a'ents and hospitality providers are formin' partnerships and offerin' valueBadded pac&a'es. /ncreasin' public awareness of the medical tourism options, 'reater confidence in forei'n hospitals and satisfaction with the tourism elements will be the catalyst for future 'rowth.L !http"##$$$%hotelmar4eting%com#inde8%php#content#article#3+31,3/medical/tourism/asias/gro$th/ industry#&
18
CHAPTER 3: RESULTS AND DISCUSSION: CASE STUDIES

C())$ 0 %&0(a0&. ./ M$!&,a# 0.()&%1 I. T)$ ! & 0+$ 6.)#! Than&s to /nternet technolo'y, more affordable international travel, and ma1or advances in medical science, medical tourism is becomin' less of a novelty and more of a 'lobal trend. >or decades, Americans have &nown they could obtain cheaper health care abroad, and have slipped off to Me)ico for small sur'eries or +anada for prescription dru's. But more and more people now reco'ni@e forei'n hospitals can deliver not only cheap but also hi'hB0uality health care, and are considerin' medical tourism even for serious health problems. .ith spendin' on health care in America toppin' H; trillion, baby boomers a'in' and the pool of uninsured risin' above 54 million, insurers, smaller employers and individual Americans without insurance are loo&in' at overseas care as an alternative for costly treatments, even for comple) procedures li&e heart sur'ery and procedures e)cluded from covera'e in the nited (tates. Already, more than :6?,??? people travel abroad each year for health care.
9igure ," people travel abroad each year for health care 6%,% :oint venture" (everal insurers have proven to be medical tourism pioneers. nited *roup Pro'rams, a >lorida insurance company, now offers plans that reimburse types of overseas care, and wor&s with Apollo, a leadin' hospital in +hennai, /ndia. $ealth #et, another insurer, now offers subscribers in (outhern +alifornia some covera'e at medical facilities across the border in Me)ico.
------------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Tho, Thy, Xoan -leader)
19
/n (outh +alorina, Blue+ross Blue(hield, one of the top brand names, recently si'ned an a'reement with Bumrun'rad, Thailand. Ether ma1or American health insurers are said to be considerin' coverin' some types of offshore medical procedures. The Foint +ommission /nternational, an or'ani@ation that inspects hospitals, now analy@es forei'n medical centers to see if they meet hi'h American standards. !ntrepreneurs are startin' travel companies to brin' Americans to forei'n hospitals O trips that sometimes combine treatment with a short vacation or recovery period, li&e an African safari or a recovery wee&end at a Thai beach. Many of these companies now speciali@e 1ust in one country or re'ion. /n ( $ealth, for e)ample, which is based in #orth +arolina, or'ani@es trips to /ndian hospitals, Planet $ospital, based in #ew Por&, focuses on trips to Me)ico, +entral America and (in'apore. Bumrun'rad has become internationally famous for medical tourism and now treats more than 5??,??? forei'n patients each year. C.( 0)&$% 0+a0 a,0&3$#5 *).1.0$ 1$!&,a# 0.()&%1 include +uba, +osta %ica, $un'ary, /ndia, /srael, Fordan, Lithuania, Malaysia and Thailand. Bel'ium, Poland and (in'apore are now enterin' the field. (outh Africa speciali@es in medical safarisBvisit the country for a safari, with a stopover for plastic sur'ery, a nose 1ob and a chance to see lions and elephants. 6%5% Changes in the ob;ectives of medical tourism The ob1ectives of medical tourism are also chan'in'= movin' far beyond the K'ettin' some wor& doneL type. Trend in the world medical tourism also includes the emer'ency of various countries as medical specialists, for e)amples= +ostal %ica for dentistry, Malaysia for cardiac bypass sur'ery, etc. 6%(% Current *edical 'ourism <estinations Many countries today are see&in' to compete successfully in the medical tourism mar&etplace by advertisin' a wide variety of medical, sur'ical, and dental services in comfortable, modern facilities. (everal countries in +entral and (outh America have developed stron' reputations for cosmetic and plastic sur'ery and dental care 2$ancoc&, ;??7, (chult, ;??7, .oodman, ;??83. (ome destinations in Asia are particularly popular for orthopedic and cardiac sur'eries. Thailand, /ndia, and /srael are wellBestablished medical tourism destinations, attractin' lar'e numbers of forei'n patients and 'eneratin' substantial revenue from the services provided. These countries have lar'e, modern medical facilities that are staffed by wellBtrained physicians who perform comple)
20
procedures, such as minimally invasiveMoffBpump heart sur'ery, correction of con'enital cardiac abnormalities in children, thoracic or'an transplantation, and implantation of mechanical cardiac devices 2Appleby Q (chmidt, ;??7, Lancaster, ;??53. ThailandCs international hospitals have a reputation for havin' modern, hi'hBtech e0uipment, e)cellent 0uality medical care, and superior hospitality services 2$orowit@ et al., ;??8, $orowit@ Q %osenswei', ;??83. /ndia has a reputation for hi'h 0uality care in a number of ma1or hospitals 2+onnell, ;??7, $orowit@ Q %osenswei'3, and /srael has emer'ed as a popular, medical tourism destination due its reputation for the hi'h standards in the care that it offers 2!delheit, ;??9, >ried Q $arris, ;??83. /srael is well situated 'eo'raphically with relatively easy fli'ht access from !urope, Africa, and Asia. Many of /sraelCs facilities maintain re'ular contacts with ma1or medical and scientific research centers abroad, and /srael is fre0uently the host venue for international conferences focusin' on a variety of medical topics 2*radstein, ;??93. (http"##trendsupdates%com#the healthcare traveller) !http"##$$$%imoa4%com#& II. M$!&,a# 0.()&%1 & A%&a
M$!&,a# 0.()&%1 &% %a&! 0. "$ 0+$ %$,. ! 1.%0 *.*(#a) & !(%0)5 .6a!a5%. T+$ & ,)$a%$ & 0+$ (1"$) ./ 1$!&,a# 0.()&%0% $a,+ 5$a) !$ .0$% 0+a0 0+$ 1$!&,a# 0.()&%1 & !(%0)5 6&## %.. "$ . 0+$ "..1. I a,,.)!a ,$ 6&0+ 0+a0 ./ 0+$ 6.)#!, M$!&,a# 0.()&%1 & A%&a &% "..1& '. *rowth pace= KMedical tourism in Asia a H6?? million industry 'rowin' by ;? per cent to 4? per cent a year, e)pected to 'row to H5.5 billion by ;?:;, said Mr. Genneth Mays, mar&etin' director of Bumrum'rad $ospital, /ndia. The number of medical tourist visits is swellin' by ;? to 4? per cent a year. KBut a recent study estimated potential revenues to be much hi'her.L Medical tourism is 'rowin' rapidly, far more than the 5 to 7 per cent 'rowth in 'eneral travel boo&in's predicted for ;??7 The results and e)pectations above stem from the commonest medical treatment such as 1oint replacements, facial and dental sur'eries, heart care and cancer care, barrenness and health chec&up in (in'apore, 'ender reassi'nment sur'ery and health chec&up in Thailand, plastic sur'ery and health chec&up in Malaysia, (ur'ery and disease mana'ement in /ndia, and plastic sur'ery in Gorea. /n Asia, the main characteristics of Medical tourism that attract an enormous number of patients from all over the world are also= low cost supported by advanced technolo'ies, medicine and sur'ery, short waitin' time, treatment procedures- availability providin' more options, wealth of attractions for holiday and vacation. These features of Medical Tourism has already been clarified ------------------------------------------------------------------------------------------------------------------------------ 21
-Medical tourism _ TTXVN (Tho, Thy, Xoan -leader)
in the previous part and also will be specified in details of the most typical and fruitful medical tourism systems in some of Asian countries. !http"##$$$%smarttravelasia%com#*edical'ourism%html http"##business in asia#asia#medical/tourism%html http"##$$$%asianhhm%com#healthcare/management#health/tourism%htm3 The evidence of medical tourism-s flourish in Asia can be drawn from an international comparison in terms of price of the most typical medical procedures between the &nown countries for Medical tourism in Asia. I 0$) a0&. a# P)&,$ C.1*a)&%. %: S$#$,0$! S()'$)&$% P).,$!()$ H$a)0 B5*a%% H$a)0 Va#3$ R$*#a,$1$ 0 A '&.*#a%05 H&* R$*#a,$1$ 0 H5%0$)$,0.15 K $$ R$*#a,$1$ 0 S*& a# F(%&. US C.%0 H:4?,??? H:7?,??? H68,??? H54,??? H;?,??? H5?,??? H7;,??? I !&a H:?,??? H<,??? H::,??? H<,??? H4,??? H9,6?? H6,6?? T+a&#a ! H::,??? H:?,??? H:4,??? H:;,??? H5,6?? H:?,??? H8,??? S& 'a*.)$ H:9,6?? H:;,6?? H:4,??? H:;,??? H7,??? H:4,??? H<,??? ( and most well
'able ," 6nternational price comparisons
!http"##$$$%csmngt%com#medical5%html& .e have presented the numbers in a dia'ram above. >rom the dia'ram, it is easy to see that the savin's can be substantial, ran'in' from 86D to <6D.
22
9igure 5%," Comparisons in term of costs among countries bet$een U= and 6ndia, 'hailand, =ingapore
!http"##$$$%csmngt%com#medical5%html&
The overall comparison can be presented as follow=
23
9igure 5%5" Comparisons in term of costs among countries
!http"##$$$%hhnmag%com#hhnmag/app#;sp#articledisplay%;sp> dcrpath?77N*AG#Article#data#,5<EC533.#3.,577N/=cope/<ataPage@domain?77N*AG& Most of the countries that have less cost in comparison with the ( the nation that has most advanced medical technolo'y and advanced medical treatment are Asian ones with the hi'hest avera'e cost of only 46D of the (, with hu'e numbers of medical tourists travelin' in, especially in Thailand, /ndia, and (in'apore= :,; million, 56?,??? and 5:?,??? respectively. Moreover, the F+/ 2Foint +ommission /nternational3 accreditations certificates of international standards for safe practices achieved by these countries were also remar&able, :4 in (in'apore, :? in /ndia, and 5 in Thailand. !9or details of :C6, see Appendi8 ,&
24
McGinsey also noted in its report that 56D of #orth American medical tourists travel to Asia for care, compared to ;7D to Latin America, ;8D travelin' within #orth America and ;D 'oin' to the Middle !ast. Medical tourism and medical travelin' are proliferatin' around the 'lobe. The trend of medical tourists floodin' to Asia has proved a hu'e contribution to the world economy in 'eneral and Asia economy in particular. Asia-s medical tourism industry is considered as a bur'eonin' industry. /n ;??7, its 'rowth increased by 7D in comparison with ;??6 and e)pected to be worth at least (H5 billion by ;?:; for the reason that The industry in Malaysia, Thailand, (in'apore and /ndia, currently worth around half a billion dollars a year in Asia, is pro1ected to 'enerate more than (H5.5 billion by ;?:;. This is provin' a windfall for the travel and hospitality sector a hi'hly attractive niche for travel a'encies and the hospitality sector. %esearches on this rapidlyB'rowin' business shows a medical tourist spends avera'e compared with the avera'e traveler-s spend of (H:55. /ndia-s medical tourism business is 'rowin' at 4? per cent per year and is forecast to 'enerate at least (H;.; billion a year by ;?:;. (in'apore is tar'etin' to attract one million forei'n patients (H:.7 billion, while Malaysia annually and push the *DP contribution from this sector above (H47; a day,
e)pects medical tourism receipts to be in the re'ion of (H6<? million in five years- time. =pin offs= The development of hospitality sector and travel a'encies boosts the spinBoffs, which e)tend well beyond the medical, travel and tourism sectors. These spinBoffs have attracted stron' 'overnment interest across Asia, and efforts to woo medical tourists have added further impetus to the 'rowth. .hat has been seein' now is an increase in the number of service providers in the industry speciali@in' to meet the needs of this mar&et, with tailored pac&a'es and services, and buildin' partnerships with treatment providers to increase their catchment of customers. Alon'side with the 'rowin' number of sur'ery options from hospitals, many travel a'encies have developed speciali@ed pac&a'es, includin' a broad choice of rehabilitation and leisure activities, which can be inte'rated with the healthcare options. :oint ventures= there appears 1oint ventures between hospitals and travel Rpartners= $ospitals and travel partners are actively wor&in' to'ether to offer customised medical pac&a'es to travellers and their families. (uch opportunities for travel a'ents are on the increase throu'hout Asia, as more
25
patients are loo&in' to travel to safe and trusted locations to ta&e treatments. That-s why it-s important that the medical facilities and travel industry wor& to'ether to create a sin'le, compellin' proposition for customers one which is cost effective, and combines the convenience of air travel with their treatment and a wellBdeserved postBoperation holiday at the same time if that-s what they desire. Then in order to receive attention for the development of both medical and travel industries, health mar&etin' strate'ies are put forwards= versatility of sales strate'ies, 0uality medical services, relative lower medical fees, instant services, health travel brand ima'e creation, etc. #ow, these development strate'ies have helped create Thailand-s uni0ue competitive ed'e in the international travel mar&et, for e)ample. /n the ne)t part, insi'ht loo&s in to /ndia, Thailand and (in'apore will reveal the secret why they are 4 most typical and well &nown countries for medical tourism in Asia. These countries will be discussed in terms of +ost, Main fields of treatment, Suality, KTourismL, +urrent status of Medical tourism Promotion, trend, and +ontribution to !conomy. Also, a small discussion on "ietnam medical tourism state will be shown as a potential mar&et for medical tourism to develop. !$$$%cbc%ca#ne$s#bac4ground#healthtourism%html http"##$$$%aorn%org#Ne$s#:uly533.Ne$s#*edical'ourism#& 1. Ca%$ %0(!5 1: M$!&,a# 0.()&%1 & I !&a
Graph 5" *apping the gro$th path of 6ndia *edical tourism (http"##$$$%financiale8press%com#printer#ne$s#13+5.3#)
26
KMedical Tourism /ndia B .here the entire world meets for the best in $ealth +areL, /ndia is considered the leadin' country promotin' medical tourism, and now it is movin' into a new area of Amedical outsourcin',A where subcontractors provide services to the overburdened medical care systems in western countries. Loo&in' at the 'raphs, it-s reco'ni@ed that the 'reatest impetus for the 'rowth of medical tourism in /ndia is the difference in the cost, the increasin' worldBclass medical facilities available and short waitin' period in here. The typical patients visitin' /ndia on medical tourism are those who lon' for 0uic& and effective cure of the diseases almost from !urope, MiddleB!ast and +anada and all over the world. !http"##$$$%smarttravelasia%com#*edical'ourism%htm& Cost" /n terms of cost, hi'h health care costs in developed countries, has patients loo&in' overseas for medical treatment. Ta&in' advanta'e of this, /ndia is capitali@in' on its low costs and hi'hly trained doctors to appeal to these medical tourists. Medical treatment in /ndia is often only :M6 of the cost in the .est. The reasons can be cheaper airfare and travelin' cost. Add to this the cheap airfare and travelin' cost which means that people in need have the options to combine their medical re0uirements with tourism at practically no e)tra e)pense. !ven considerin' the cost of air travel and lu)ury hotel accommodation 2if re0uired3, the cost savin's comes out to be 5?B9?D of what is in the (A, for e)ample. A simple rhinoplasty costs ;.75 La&h in (, but will only cost around 6?,??? %s in /ndia. Li&ewise a face lift costs 6.;9 La&h in (A but costs only :.6 La&h rupees in /ndia. /f such is the difference then who is not tempted to avail the dual benefit of cure for sure and e)plore for sure. !$$$%cbc%ca#ne$s#bac4ground#healthtourism%html& *ain fields of treatment" Alon' with low cost is a wide ran'e of medical treatment offered. /ndia provides world class medical facilities with hospitals and speciali@ed multi specialty health centers providin' their e)pertise in the areas of +osmetic (ur'ery, Dental care, $eart (ur'eries, +oronary Bypass, $eart +hec& up, "alve replacements, Gnee %eplacements, !ye sur'eries, /ndian traditional treatments li&e Ayurvedic Therapies and much more, practically coverin' every aspect of medicine combinin' modern treatments with traditional e)perience. !http"##$$$%indiahealthvisit%com#health tourism india%htm& Auality" %e'ardin' with 0uality, the improved medical facilities in /ndia prove /ndia to be the best destination for medical tourism /ndia. The best &nown medical doctors and the latest of all medical and health facilities are available in /ndia ma&in' it the favorite choice amon' the countries providin' medical tourism. The 0uality of services found in /ndia is often better than found in nited (tates or nited Gin'dom. /ndia has one of the bi''est private hospitals in the world. Many of them are affiliated with top world medical institutes li&e $arvard Medical and Fohn $op&ins. A
27
number of these hospitals are also accredited by F+/, (A, or /(E. These medical centers have the infrastructure, e)perience and the setup for 0uality conscious medical tourism patients from the .est, latest technolo'y with .estern standard. The country is not only improvin' as a tourist destination but also a medical tourism destination where various medical treatments are performed by 0ualified professionals usin' the latest technolo'y at par with western standards at only a fraction of the price. K$i'h 0ualified team of doctors a mi'hty influence in medicine across the world.L Today /ndian doctors have become a mi'hty influence in medicine across the world B from #orth America and *reat Britain to !ast Africa, Malaysia, and (in'apore. Thus, it is said that the 'rowth of medical tourism in /ndian sector has now alarmed the .(. based hospitals because of the rapid 'rowth of patients comin' to /ndia to accomplish medical treatments by bein' attracted to lower costs and apt services. B'ourismC" /n addition to low cost, hi'h 0uality, one of the factors that ma&e /ndia the most attractive place of medical tourism is its tourism attractions. /ndia is always a point of attraction due to its herita'e and culture and one of the oldest &nown civili@ations to the world and draws a fair number of tourists from around the world. Medical Tourism in /ndia is one of the best options available to people across the 'lobe. Millions come every year to 'et treated and then en1oy their recuperative holidays across /ndia. People from different wal&s of life cut across the entire span of the 'lobe come to /ndia to have their treatments done with peace of mind. /n a recent publication /ndia has been voted as one of the Top Destination from around the world followed by Thailand and /taly. /ndia drawn to the countryCs aweBinspirin' travel scene mar&ed by its Temples, the breathta&in' $imalayas and its rich culture. !http"##$$$%indiahealthvisit%com#health tourism india%htm& Current status of *edical tourism promotion and trend" >or the popularity of medical tourism, the 'overnment has setup Ban'alore $ealth +ity and established MT Department with collaborated efforts of >ederation of /ndian +hambers of +ommerce and (ector, from the base of promotin' private enterprise involvement in the sector since :<<:. #ow, therefore, /ndia is promotin' its healthcare sector as a tourist attraction. As mentioned earlier, it is considered the leadin' country promotin' medical tourism and now it is movin' into a new area of Amedical outsourcin',A where subcontractors provide services to the overburdened medical care systems in western countries. !http"##$$$%tier%org%t$#eng533.#eng/analysis#9=533D31%asp& Contribution to the economy" Accordin'ly, Medical tourism in /ndia has made a hu'e contribution to Asia-s *DP= To promote Medical tourism, /ndia 'overnment is helpin' in issuin' medical visas to the country, which in turn
28
will brin' more and more health tourists. /ts leadership in the industry of medical tourism has led its estimate of 5? percent 'rowth turn into reality this year. /ndia-s medical tourism business is 'rowin' at 4? per cent per year and is forecast to 'enerate at least (H;.; billion a year by ;?:; B by si) times in comparison with (H 4:? million in ;??7 2statistics from *overnment and private sector studies in /ndia3. /ndiaCs #ational $ealth Policy declares that treatment of forei'n patients is le'ally an Ae)portA and deemed Aeli'ible for all fiscal incentives e)tended to e)port earnin's.A $ence, hospitals in /ndia have a very bri'ht future. /ndia is the lar'est democracy in the world, is one of the fastest 'rowin' >or the advanta'es of Medical tourism discussed above, /ndia, as the lar'est democracy in the world is re'arded as the &ey to healthier life. !http"##$$$%indiahealthvisit%com#health tourism india%html& 2. Ca%$ %0(!5 2: M$!&,a# 0.()&%1 & T+a&#a ! As ran&ed by Times Ma'a@ine in the G, Thai land is KThe world-s cheapest medical Q health mar&etL and has been the 'oal for Americans. .hile, so far, /ndia has attracted patients from !urope, the Middle !ast and +anada and initially attracted people who had left that country for the .est, Thailand treated western e)patriates across (outheast Asia. Many of them wor&ed for western companies and had the advanta'e of fle)ible, worldwide medical insurance plans 'eared specifically at the e)patriate and overseas corporate mar&ets. The tourism sector has lon' been Thailand-s ma1or economic development focus. (ince the medical standards are considerably hi'h in Thailand, it became &nown for its 'ender reassi'nment sur'eries since the 8?s. /n recent years, the 'overnment-s active promotion of mar&etin' strate'ies related to inte'rated tourism and medical plannin' has successfully facilitated Thailand-s competitive ed'e in the world travel mar&et. !http"##$$$%smarttravelasia%com#*edical'ourism%html& !http"##$$$%medicaltourismco%com#thailand hospitals#medical tourism 'hailand%php& !http"##$$$%tier%org%t$#eng533.#eng/analysis#9=533D31%asp& Cost" The hospitals in Thailand deliver a AMercedes product at a Toyota priceL. That fact builds up a 'ood reputation for Thailand in terms of cost. >or e)ample, Bladder sur'ery consumin' (H;6,??? in the (A costs only around (H4,??? at Bumrun'rad, the most famous hospital in Thailand. *ain fields of treatment" As reco'ni@ed from over the world, The Main fields that Thailand is famous for are often 'ender reassi'nment sur'eries 28?s3, popular Thai massa'e. Auality"
29
Bimurun'ard $ospital became the first F+/ certified hospital in Asia in ;??;, listed as top :? worldB class tourist spot in #ewswee&. Bumrun'rad is probably the bestBmar&eted hospital in the world. Their fame is well deserved, but their mar&etin' staff and mana'ement have put a tremendous effort in bein' KTheL medical tourist hospital that potential patients in the .estern world have heard of, specifically throu'h news reports on AB+ and +B( as well as multiple appearances in #ewswee&. Moreover, there is construction of travel medical centers in Ban'&o&, Phu&et /sland, and +hian' Mai, promotion of Medical "/P +ard for lifeBtime services, and Ban'&o& $ospital with translators for ;< lan'ua'es. /t-s certainly very difficult to compare the level of s&ill in physicians and nurses for two worldBclass hospitals li&e Bumrun'rad and BM+. They boast similar proportions of forei'nBtrained doctors, especially those trained in the ( and ! . #ursin' staff are professional and abundant in both and interpreters are available in a lar'e number of lan'ua'es. BM+ 'oes a step beyond this by hirin' a physician and nurse from their ma1or patient nationalities 2ie a (audi doctor and nurse for (audi patients3 and havin' si'nificant staff and facilities specially devoted to Fapanese and MiddleB!astern patients, who represent a lar'e proportion of their patient base and are 'enerally very appreciative of services in their native lan'ua'e. En the contrary, Bumrun'rad /nternational says it is a oneBstop medical centre where patients have access to over <?? internationally trained medical specialists under one roof. These facts prove Thailand to have a hi'h 0ualified medical infrastructure. B'ourismC" The most well &nown and 0ualified hospital in Thailand is Ban'&o&-s B(1)( ')a! I 0$) a0&. a# 2www.bumrun'rad.com3. /t has won international acclaim and is Thailand-s bestB&nown facility for health tourism. /t was the first 'enuinely international hospital in Asia to be accredited by the (B based Foint +ommission /nternational. >orei'n patients can find a comfortable lobby, restaurants, coffee and more there. /ndeed it is more hotel than hospital on first loo&s . Patients arrivin' for treatment mi'ht well be 'uests chec&in' in at a fiveBstar hotel= there are concier'eBstyle services on tap and an electronic medicalBrecords system that eliminates paper and waitin', massive columns, hi'h ceilin's and subdued li'htin' at the lobby, "/P waitin' loun'es, bouti0ues and fine dinin' restaurants e)udes a lu)urious. This Ktotal e)perienceL is what attracts clients. !)cept for the occasional presence of nurses in their white uniforms e)itin' the lobbies and orderlies pushin' wheelchairs, one would thin& that they are the lobbies of fiveBstar hotels Thailand is &nown in particular for its stunnin' natural beauty, complete with tropical islands, stunnin' beaches and several .orld $erita'e sites. "isitors have several options to choose from
30
when visitin' the country for medical treatment, ran'in' from vibrant ni'htspots, hu'e shoppin' malls, and sandy beaches to Buddhist temples, national par&s and much more. Apart from all this, medical tourists can also avail the opportunity to indul'e in the popular Thai massa'e, which is sure to re1uvenate your senses. /n addition, the Thai shoppin' e)perience is unmatched, providin' visitors with e)cellent souvenirs to ta&e bac& home, or one of the many lu)ury brands available here. Current status of *' promotion" Thailand setup 6BPear #ational Development Plan Promotion in ;??5, established /nte'ration of tourism stren'th and promotion of medical service sector internationali@ation. (o far, 6 hospitals have received F+/ Accreditations. #ow, Bumrun'rad /nternational is focused on the Aintentional medical traveller, not the accidental travellerA who mi'ht wal& in with a muscle sprain, says the affable Mays, addin' that Athis is usually a doBitByourself &ind of person not covered by social insurance and probably with some connection to Asia.A Li&e other top Asian hospitals, Bumrun'rad wor&s with the travel and tourism industry to promote medical tourism and the hospital has a partnership with Diethelm Travel, Thailand-s lar'est inbound tour operator, which has a travel assistance office in the hospital. #ew Kmedical tourism pac&a'esL are bein' developed and sold by travel a'ents, and the hospital also has a &ios& inside Ban'&o&-s international airport. This partnership has produced very limited results thou'h as leisure travellers are not necessarily medicare see&ers thou'h it is attractive to combine a lowBcost annual company chec&Bup with a few rounds of 'olf. All Bumrun'rad-s doctors are Thai, but more than half have international trainin' or overseas board certification 2includin' ;?? with ( Board certification3. Accordin' to news covera'e of Times Ma'a@ine 2 .G3 Thailand was reputed as JThe world-s cheapest medical Q health mar&et.- The 6Byear #ational Development Plan implemented inte'rated tourism stren'ths in promotin' medical sector internationali@ation. Thailand is e)pected to become the J$ealth Tourism $ub of Asia, .ellness +apital of Asia, and Thai $erbs for $ealth.- The development scope of this plan covers= medical care services, health services, and herbal products. /n the early sta'e of its implementation, the tar'et development areas include= Ban'&o&, +hian' Mai, Phu&et /sland, and (uBMei /sland. Also, ten other provinces will also be developed. Ether than Ministry of Public $ealth-s Dominance in the implementations, respective 'overnment departments will also en'a'e in overall plannin' mar&etin', monitorin' services, and price standardi@ation, certification, re'ulation, biotechnolo'y related %QD, etc. Contribution to the economy"
31
There were :.5 million medical tourists in Thailand in ;??7 and the production value amounted to #TH;?.8 billion e0uivalent to (H74? millionM:.5 million people. /n ;??8, the fi'ure increased to :.65 million with a production value of #TH;5.6 billion :.5 million e0uivalent to (H 85? millionM :.65 million people. Medical tourists are e)pected to reach ; million people by ;?:?. 3. Ca%$ %0(!5 3: M$!&,a# 0.()&%1 & S& 'a*.)$ (in'apore is a state deservin' of its reputation for cleanliness, order and its ultraBhi'h standard of private medical care. .hile it is by no means as cheap as say, /ndia or Thailand, medical staffs here invariably spea& a hi'h standard of !n'lish and the healthcare infrastructure is easily comparable with that of western countries. %ecent years, when Medical Tourism emer'es and proliferates dramatically and speedily, (in'apore is reco'ni@ed as a Ma1or Player in the Asian medical tourism mar&et. This is hardly surprisin', 'iven the city state-s reputation for sophisticated facilities and advanced technolo'y, not to mention safety and efficiency. /n ;??4, (in'apore created S& 'a*.)$ M$!&,& $ 2www.sin'aporemedicine.com3, a 'overnmentBindustry partnership to develop (in'apore as an international medical hub, not only for medical travellers but also research, conventions and education. .hile most international patients are either /ndonesians or e)patriates based in /ndonesia, a Ksi'nificant numberL also come from Malaysia, Myanmar, Pa&istan and Ban'ladesh, etc. !http"##$$$%smarttravelasia%com#*edical'ourism%htm& Cost" +ritics say costs are 4? to 6? percent hi'her than those in Thailand, but even so they remain appreciably lower than in the ( and the G *ain fields of treatment" Due to scarce medical resources in nei'hborin' countries, (in'apore became the upper class-s desi'nation for health chec&ups. /ts lowBcost health chec&ups and antiBa'in' beauty therapies have attracted a lar'e number of tourists from the nei'hborin' countries. Dr Pap says people visit (in'apore for healthcare for many &inds of medical treatment, from KtouristyL addBons to leisure or business trips 2for e)ample, health screenin' or medical spas3, to specific procedures 2such as &nee or hip replacement or cancer treatment3, to emer'ency evacuations after natural or manBmade disasters. The fields most popular with the 'roup-s international patients are cardiolo'y, urolo'y, 'astroenterolo'y, dermatolo'y, orthopaedic sur'ery and neurosur'ery. Many patients also come to see& second opinions on treatments or on dia'noses made by their doctors bac& home. 2http"##$$$%medicalsingapore%com#singaporetravel%html& Auality" Accordin' to (in'apore Medicine director Dr Fason Pap, (in'apore received 485,??? healthcare visitors in ;??6 and healthcare services ran'ed from the very hi'hBtech 2li&e transplants3 to the standard 2hip replacements3 to the Kmedical frin'eL 2includin' medical spas3. (in'apore has a
32
0uarter of all F+/Baccredited facilities in Asia. (in'apore ran&ed #o. : in Asia 2#o. 7 in the world3 for its comprehensive health care services, accordin' to the >irst *lobal $ealth +are (ervice Assessment conducted by the .$E in ;??; which surpassed the ran&in' of Fapan 2#o. :? in the world3 and the .(.A. 2#o. 48 in the world3. Accordin' to a survey by The Political !conomic %is& +onsultancy in ;??4, the medical Q health system of (in'apore ran&ed #o. 4 in the world only after the .(.A. and Australia. Thus, (in'apore has hi'h 0uality infrastructure= international medical hub for medical travelers, research, convention and education, ran& top :6 medical care servicin' industries in Asia 2includin' Australia3 than&s to= sophisticated facilities and advanced technolo'y upper class-s desi'nation for health chec&ups a 0uarter of all F+/Baccredited facilities in Asia, with ::F+/ accreditations B'ourismC" The (in'apore Tourism Board helps healthcare providers and travel a'ents provide comprehensive and economical medical pac&a'es for forei'n patients. Besides pic&Bup facilities from the airport, appointments with the concerned doctors, hospital stays, these medical pac&a'es include recuperative facilities at a holiday resort, with si'htseein' and shoppin' arran'ements later. Arab (treet or Gampon' *lam area is a very interestin' area of (in'apore. /t is also named as the Muslim center of (in'apore. This area has beautiful old shop houses that line the streets. The hi'hli'ht of the area is the 'rand (ultan Mos0ue, a fantastic buildin' with its impressive 'old dome and hu'e prayer hall. Arab (treet itself is a riot of colorful te)tiles from all over Asia at very low prices. (ome of the most visible items for sale are the bas&ets and other cane, straw, rattan and pandan leaf 'oods spillin' out onto the pavements B from baby cradles to floor mats, han'in' chairs to servin' trays. These shops also stoc& interestin' camel s&in ba's, cloisonnTUV bo)es, sewin' &its, and fishin' tac&le items for both the amateur and the professional an'ler. This is one of the motivations of health travellers alon' with world class medical infrastrcuture. A few days can be used in si'ht seein' by the medical tourist. (in'apore see&s to be the business hub of (outheast Asia and has an e)pansive shoppin' precinct located in the Erchard %oad district. Many multistorey shoppin' centres are located at Erchard %oad, the area also has many hotels, and itCs the main tourism centre of (in'apore, other than the Downtown +ore. The local populace also uses Erchard %oad for shoppin' e)tensively. Current status of *' promotion and trend" (in'apore en'a'ed in J(in'apore Medicine- promotions in ;??4 in order to reach the 'oal of becomin' the medical center in Asia. The Americas +onference on /nformation (ystems 2AM+/(3 promoted JMedi(tay- in ;??5. +urrently, :: hospitals have received F+/ certifications. /n order to
33
promote wellness services, (in'apore-s 'overnment websites are lin&ed to international medical related service sites 2Descriptions of visa issuance and accommodation3. !http"##$$$%tier%org%t$#eng533.#eng/analysis#9=533D31%asp& Contribution to the economy" /n ;??5, 4;?,??? patients visited (in'apore. Based on J(in'apore Medicine- underta&en by (in'apore !conomic Development Board, (in'apore Tourism Board, and /! (in'apore, : million patients of forei'n nationals are e)pected to see& medical attention in (in'apore annually with a production value of (H4 billion by ;?:;, ta&in' up to :D of the *DP, comparin' with (H :.6 billionM 5?? people in ;??6. 4. Ca%$ %0(!5 4: M$!&,a# 0.()&%1 & V&$0 a1 ;& !&//$)$ 0 3&$6 !($ 0. 0+$ & /a 0 = "$& ' %0a0$ & M$!&,a# 0.()&%1 /&$#! ./ VN< Evershadowed until now by the medical tourism industries in other nearby Asian countries li&e (in'apore and Thailand, "ietnam is slowly emer'in' as a potential challen'er for touristB friendly Thailand. /n addition to offerin' sur'eries of all &inds includin' cosmetic and dental procedures, "ietnam is a leader in traditional +hinese medicine. Acupuncture is widely practiced as a curative measure for many types of illness. A!3a 0a'$%: )$#a0&3$ .3&,$ "(0 "$& ' 'a& & ' )$*(0a0&. : Althou'h "ietnam is a relative novice on the medical tourism scene, it is 'radually 'ainin' a reputation for itself as a destination capable of offerin' a broad selection of sur'ical procedures with a hi'h standard of e)pertise and preB and postBoperative care. The country also offers alternative medical treatments such as acupuncture, which is attractin' increasin' numbers of patients with conditions for which .estern medicine has proven unsuccessful in treatin'. Low +ost= The sur'ical procedures available in "ietnam are as wide and varied, as in its competitor-s clinics, and the service, 0uality and prices are similar, with most sur'eries costin' appro)imately 6? percent of what they would in a developed western country. .ith prices that are up to 8? percent cheaper than in the west Efferin' broad selection of sur'ical procedures with alternative medical treatments= acupuncture, etc. 2e). +osmetic sur'ery-s selection of procedures= clinics offerin' the usual selection of procedures, includin' rhinoplasty, blepharoplasty, abdominoplasty, liposuction and breast
34
au'mentation. A small number of establishments also offer orthopedic and obstetric treatment. Dental sur'ery is a bur'eonin' field as well, with both essential and cosmetic procedures on offer.3 $i'h standard of e)pertise and preB and postBoperative care= $anoi and $o +hi Minh +ity have several 'ood eye specialists where eye e)ams are as common as laser sur'ery. "ietnam doesnCt yet have the reputation for more serious procedures such as heart sur'eries or hip replacements, but such operations e)ist and are performed with e)pert s&ill. 2Discussed more in detail in cosmetic sur'ery in KMain fieldsL part3. A leader in +hina medicine the leadin' Eriental medicine= +hinese traditional medicine is widely practiced in "ietnam, and there are countless practitioners that prescribe herbs and other natural medicines for various ailments. >or more serious pain, most +hinese doctors are trained in acupunctureOa techni0ue popular in the westOto relive specific types of pain. A wealth of attractions across the len'th of the country durin' convalescence= Pretty beach resorts are on hand for those who need to rest after sur'ery. "ietnam has plenty to offer medical tourists beyond treatment, and visitors can ta&e advanta'e of a wealth of attractions across the len'th of the country durin' convalescence. Pretty beach resorts are on hand for those who need to rest after sur'ery. L&1&0a0&. %: Despite developments in recent years, "ietnam has not yet fully reali@ed its potential as a medical tourist hub and isn-t comparable with nei'hborin' Thailand in terms of its medical infrastructure. Limitations in mar&etin' strate'ies and in the number of !n'lishBspea&in' doctors available have so far prevented the country in competin' with other Asian medical tourism destinations. Lan'ua'e "ietnamese can be the reason ma&in' the conversation difficult. $owever, as these issues improve, "ietnam is seein' a si'nificant rise in medical tourist fi'ures. Ma& /&$#!%: ,.%1$0&, %()'$)5, !$ 0a# %()'$)5. +osmetic sur'ery is the main field concentrated on by "ietnam-s medical tourism industry with clinics offerin' the usual selection of procedures, includin' rhinoplasty, blepharoplasty, abdominoplasty, and liposuction and breast au'mentation. A small number of establishments also offer orthopedic and obstetric treatment. Dental sur'ery is a bur'eonin' field as well, with both essential and cosmetic procedures on offer. The "ietnamese cosmetic sur'ery industry is based predominantly in $o +hi Minh +ity in the country-s south. Doctors are hi'hly educated and clinics offer a hi'h level of service, 0uality and cleanliness. All the usual procedures li&e breast au'mentation, tummy tuc&s, face lifts, rhinoplasty
35
and liposuction are available. $air transplants are becomin' more popular in "ietnam, with the (H:,6?? procedure costin' a mere (H6?? in "ietnam compared to in the west. "isitors to "ietnam-s cities will notice the si'ns for dentists showin' a hu'e mouthful of strai'ht, pearly white teeth. These local dentists can handle any re'ular dental wor&, but for more complicated sur'ery it-s best to loo& to the private sector. Dental clinics can perform root canals and caps and most offer cosmetic procedures li&e whitenin' and strai'htenin'. !http"##$$$%discovermedicaltourism%com#vietnam#medical tourism#&
36
CHAPTER 4: CONCLUSION
I. Ma2.) /& !& '% Medical tourism is li&ely to increase over the ne)t decade as more patients are able to access the /nternet and ac0uire information relevant to care offered overseas at an affordable price. /t brin's its customers a number of benefits. To be'in with, medical tourism is considered to brin' the patients lower medical fees, sometimes less than three times as the amount they have to pay in their home countries for the same medical service. Moreover, the patients who receive medical tourism service can save more time since medical tourism offer a shorter waitin' time in order to attract the customers from other forei'n countries. /t also raises the livin' standard by providin' its customers more options for their medical services. Last but not least, the patients of this &ind of service can combine their treatment with entertainment and tourism. They may feel more rela)ed and comfortable when en1oyin' medical tourism services. .hile some patients will benefit immensely from treatment as a medical tourist, many le'al and ethical issues will also arise. The patients who participate in medical tourism may not be 'uaranteed for the medical services. The malpractice may occur, however, it seems to be more difficult for these patients to 'ain the support of the country where they have had operation than in their home countries. /n order to fit the new re0uirement of the 1ob, nurses themselves have to traditional tas&s, nurses are e)pected to broaden their mind in business and mana'ement field. Potential medical tourists will benefit from the services of a &nowled'eable health professional in their home country who can discuss the many issues that relate to this medical tourism. /t is e)pected that medical tourism will provide a new role for nurses as this healthcare trend e)pands around the world. /n specific countries in the studied cases, each country has there own attractive features that can attract forei'n patients from all over the world. They are cost effective, hi'h 0ualified with advanced medical technolo'y, different types of speciali@ed treatments, uni0ue and rich wealth of attraction and especially, as conse0uences of those, the hu'e contribution to the economy. "ietnam has been 1ust 1oinin' in the Medical tourism mar&et in recent years and 'ained some certain achievements li&e in Dental treatment, +osmetic sur'ery with a rich and spectacular attractions. II. L&1&0a0&. % Despite the 'reat effort of the researchers, there still e)ist some restrictions in the research paper as follows= /nitially, it was the limited source of data that prevented the authors from e)tendin' the scope of the study. The paper only offered the information of the development of medical tourism in few countries such as Thailand, /ndia, (in'apore and "ietnam. Althou'h there is a variety of material on the internet, it was difficult for people to control its reliability as well as validity. As a
37
result, the information 'iven in the paper must be restricted in order to ma&e sure that it would reflect the 'rowth and the trends of medical tourism e)actly. (econdly, the ma1or findin' does not cover all the parts that the research 0uestions concerned in the introduction part. The roles of nurses could not be discussed in each case study due to the lac& of material as well as the 'enerali@ation of roles of nurses all over the world. +onse0uently, it is impossible for the researchers to specify roles of nurses in each country. /n addition, despite the availability of data related to the topic, there was little material that mentions to the roles of nurses. As a result, the researchers only referred to the 'eneral roles of nurses such as care'ivers, advisors and so on. Moreover, since "ietnam has been a novice person in Medical tourism, it was difficult to e)plore materials that suit the cate'ories of benefits, disadvanta'es, role2s3 of nurses and its contributions to the world economy. To some e)tent, only some main points were discussed in details and some how those should have provided audience some &ey information about "ietnam Medical tourism. Because of time and financial limitations, this study cannot be completed as researcherse)pectation. /t must be more reliable and vivid if the researchers could as& for consultation from e)perts in this field or 'o abroad for thorou'h study. Most the information was obtained throu'h readin' the materials on websites 2the reliable ones3 and discussin'. III. C. 0)&"(0&. ./ 0+$ %0(!5 Despite the limitation mentioned above, to some e)tent, this paper can ma&e some certain contribution. Ence finished this paper mi'ht be considered one of the materials for other further academic studies. /n addition, this mi'ht be used as a useful medical handboo& of overall information for those who want to e)perience medical tourism. IV. S(''$%0&. % /.) /()0+$) %0(!5 Due to some limitations mentioned above, any further study can ta&e advanta'e to develop to ma&e improvement in terms of chan'es in role2s3 of nurses in each country as well as further deep study on Medical tourism in "ietnam a novice country in the Medical tourism mar&et.
38
APPENDICES
>CI, K$ $0+ Ma5%, a00a,+1$ 0 ./ ,())$ 0 S0a0(% ./ MT %$,0.) D$3$#.*1$ 0 & Ma2.) Na0&. % a).( ! 0+$ 6.)#!
1. T+$ >CI:
Due to increasin' demands for improved 0uality and safety internationally, the Foint +ommission /nternational 2F+/3 in :<<< implemented an accreditation pro'ram to create international standards for safe practices. .hile accreditation can improve healthcare within various countries, it has had the side effect of benefittin' medical travelers who see& out care within those countries, accordin' to David Faimovich, MD, chief medical officer for F+/ and Foint +ommission %esources. There are many reasons a facility would pay the avera'e H5:,??? for F+/ accreditation, aside from a desire to improve 0uality and safety, Faimovich said. Accreditation can also reduce ris&s by standardi@in' patient care processes, achieve better outcomes throu'h measurable 0uality indicators, decrease costs by diminishin' waste, and potentially increase medical travelBa si'nificant financial incentive, he added. AAccreditation is now bein' loo&ed upon by insurers, 'overnment and non'overnment a'encies, and 'lobal employers as a way to 'au'e whether a healthcare or'ani@ation is a safe one for their constituents,A Faimovich said. As of May ;9, F+/ had accredited :89 or'ani@ations in 4; countries, with :45 havin' applied to 'o throu'h the process in ;??9 The accreditation pro'ram re0uires a facility to demonstrate acceptable compliance with specific standards 2e.'., ambulatory care, care continuum, clinical laboratory, diseaseB or conditionBspecific care certification, medical transport3, which were updated as of ;??9, as well as an overall compliance with /nternational Patient (afety *oal re0uirements. There are 'race periods for facilities to correct compliance with any standards that are not up to par with F+/ re0uirements, and accreditation must be renewed every three years. Despite the accreditation process, American patients travelin' abroad would be wise to do their own research before si'nin' up for sur'ery overseas to reduce overall ris&s. AThere will be some ris&s
39
with respect to patient safety due to poor communication,A Poon said. (he added that cultural differences mi'ht also affect 0ualitative patient care. AThere is always some ris& involved, even here in the nited (tates,A said +ynthia (pry, %#, MA,
M(#, +#E%, an infection control consultant who wor&s internationally. ABut you can increase the odds of 'ettin' 0uality care by reviewin' the sur'eonCs resume and tal&in' with someone who has had sur'ery under this sur'eon.A AE%#Cs national E% +ommittee on Perioperative Practice is also addressin' how sur'ical pro'rams abroad may impact sur'ical volumes in the (.
2. K$
$0+ Ma5%
Bumrun'rad-s mar&etin' director.
3. A00a,+1$ 0 C())$ 0 S0a0(% ./ M$!&,a# T.()&%1 S$,0.) D$3$#.*1$ 0 &

Ma2.) Na0&. % a).( ! 0+$ W.)#!
+ountry Developm ent >ocus Production "alueM#o. of People M 2Medical Tourism 3 +urrent (tatus s of Promotion W Medical center development features and continual %QD of ener'y medicine W *overnment W Provision of stateBofB theBart ma1or provision care recoveryMrehabilitation illnesses of medical and for technolo'y, treatment of lon'Bterm W !stablishment and of JGorea tourism JGorea .(.A. Medical Q health W #o official data available +uba Medical Q health W (H5? million in ;??; W ;?D annual 'rowth from ;??4 (wit@erland Medical W #o official data (outh Gorea Medical W #o official data available
available
dominance in hospital, spa, clinic investments
$ospitality in $ealthcare- in ;??8 W medical of mar&et development. !stablishment (ector $ealthcare Promotion
A'ency- to promote medical travel. Appointment of hospitals as tourism institutions that provide services. W +onstruction of medical oneBstation medical
40
resorts by Ber1aya +orp. in Fe1u and Malaysia e)pected to be >eatures W Treatment of W Adoption of the lowB cost strate'y to attract tourists W Provision of online completed in ;?::. W Plastic sur'ery tourism W Gorean medical tourism 2dermatolo'y, beauty seminar, hair stylin'3 W Treatment Q recovery within W #o official data W(wiss Leadin' $ospital the duration of travel. W JFasen' $ospital of Eriental Medicine- tar'ets natural Gorean therapies for spinalM1oint pains, dietin'. Provision of tailorBmade (elfB!)perience +ourse (ervices Por&B
ma1or
illnesses
medical services W Provision of 0uality lon'Bterm careMrecovery
and provision of lon'Bterm care for recoveryMrehabilita +ases tion W Mayo clinic in Minnesota is the lar'est the world. W #ew Presbyterian $ospitalM+olombia niversity Medical +enter3 W +leveland +linic private medical system in
available
Development >ocus Production "alueM#o. of People M 2Medical Tourism 3 +urrent (tatus of Promotions
Thailand Medical Q health ;??7 (H74? millionM:.5 million people W ;??8 (H 85? millionM:.65 million people W 6BPear #ational Development Plan Promotion in ;??5. /nte'ration of tourism stren'th and promotion of medical service sector internationali@ation. Thailand is e)pected to become the J$ealth Tourism $ub of Asia-, .ellness +apital of Asia, and Thai $erbs for $ealthW 6 hospitals received F+/ Accreditation in 6 hospitals.
Malaysia Medical W ;??6 :??,??? people W (H 7? million by ;?:?
(in'apore Medical ;??6 (H :.6 billionM5??,??? people W (H 4 billionM: million people by ;?:; WAdvisories by $ealth (ervices .or&in' *roup2$(.*3 in ;??; W Promotion of Medical +are Pro'ram 2(in'apore Medicine3 in ;??4 tar'etin' (in'apore-s becomin' a medical care center in Asia. W Promotion of JMedi(tay- by Americas J+onference on /nformation (ystemsC 2AM+/(3 in
Philippines Medical Q health W (H 6? millionM8??,??? people
W 9th Malaysia Plan, ;??:B;??6 in :<<9 incorporated J*lobali@ationB$ealth tourism as one of the si) a'endas. W +oBor'ani@ed by private hospitals, hotels, and travel a'encies. W >ast passes for patients and immediate relatives.
WMedical tourism sector incorporated under incentive cate'ory of investment priorities, which entitled investors to income ta) e)emptionsMreductions for 5X9 years. W EneBstep passes provisioned in JThe Philippine Medical Tourism Pro'ram, PMTP-, certifyin' institution personnel trainin', etc., that tar'et becomin' the medical Q health core in Asian re'ions.
41
>eatures
+ases
W Provision of specific medical acts, professional medical care. W Provision of lowBcost professional medical care. W /nstant services W Lar'est 'ender reassi'nment sur'ery mar&et in the world W Suality tourism resources W +onstruction of travel medical centers in Ban'&o&, Phu&et /sland, and +hian' Mai, promotion of Medical "/P +ard for lifeBtime services W Ban'&o& $ospital with translators for ;< lan'ua'es W Bimurun'ard $ospital became the first F+/ certified hospital in Asia in ;??;, listed as top :? worldBclass tourist spot in #ewswee&
W Low costs W +ustomer 'roup tar'et= the upper class in /ndonesia W Suality tourism resources
W Pantai $ospital 2Gura Lumpur3 W Mah&ota Medical +enter 2Malacca3 W Loh Puan Lye (pecialists +enter 2Penan'3
;??5. W:: hospitals received F+/ accreditations. W Disclosure of medical fees, 'overnment website lin&s, etc. 2descriptions of "isa, accommodation3 W Tar'etin' patientsprivacy, simple, fast, and convenient access. W AntiBa'in' beauty therapies and lowBcost health chec&ups W $i'hB0uality tourism resources. W Par&way *roup $ealthcare Medical %eferral +enter W %affles /nternational Patients +enter W These two proprietors ran& top :6 medical care servicin' industries in Asia 2includin' Australia3.
W #onBmainstream therapies W Traditional massa'eB$ilot
W Sue@on +ityB$ealth and .ellness +enter W %etirement villa'e plannin' underta&en by Department of $ealth, %epublic of The Philippines
42
+ountry Development >ocus Production "alueM#o. of People M 2Medical Tourism 3 +urrent (tatus of Promotions
/ndia Medical Q health W ;??7 (H 4:? millionM: million people W (H ; billion by ;?:; W Promotin' private enterprise involvement in the sector since :<<: W The 'overnment-s setup of Ban'alore $ealth +ity and establishment of Medical Tourism Department with collaborated efforts of >ederation of /ndian +hambers of +ommerce and (ector. W Active development in the south re'ardin' health promotion throu'h herbal medicine in traditional medicine in /ndia W Suality tourism resources W Apollo $ospitals *roup is the lar'est medical 'roup in Asia with 46 branches. W Ban'alore $ealth +ity
Dubai Medical W #o official data available
>eatures
W Dubai Medical +enter is one of the latest town buildin' pro'rams. .ith assistance of $arvard Medical (chool, it shall become a comprehensive medical institution and research unit by ;?:? that meets customers- demand for oneBstop shoppin'services. W Dubai permits independent hospital fundin'. >orei'n investors are entitled to ta) e)emptions. W Suality medical techni0ues and tourism resources
+ases
W Dubai $ealth +ity plannin' covers academic medical centers such as $arvard Medical (chool Dubai +enter, medical services 2Mayo +linic branches3, medical centers in different countries, lon'Bterm care, pharmaceutical companies, "illa +linic, etc.
43
REFERENCES
:. 2. 4. 4. 6. 6. http=MMwww.imoa&.comM www.cbc.caMnewsMbac&'roundMhealthtourism.html http=MMwww.travelandleisure.comMarticlesMworstBmedicalBtourismBdisastersM: http=MMwww.indiahealthvisit.comMhealthBtourismBindia.htm http=MMtrendsupdates.comMtheBhealthcareBtravellerM http=MMwww.hotelmar&etin'.comMinde).phpMcontentMarticleM?7?5:?YmedicalYtourismYasiasY'r owthYindustryM 7. http=MMwww.medscape.comMviewarticleM8?9?84Y4 8. http=MMwww.asianewsnet.netMnews.phpNsecZ;QidZ;;6: 9. http=MMwww.tier.or'.twMen';??9Men'YanalysisM>(;??<?5.asp 10. http=MMwww.smarttravelasia.comMMedicalTourism.htm 11. http=MMblo's.reuters.comMfromBreuterscomM;??<M:?M;9M'raphicBmedicalBtourismBbyBcountryM 12. http=MMwww.aorn.or'M#ewsMFuly;??9#ewsMMedicalTourismM 13. http=MMwww.medicaltourismco.comMthailandBhospitalsMmedicalBtourismBThailand.php 14. http=MMwww.ncpa.or'MpubMst4?5 15. http=MMwww.financiale)press.comMprinterMnewsM5?7;9?M 16. http=MMwww.discovermedicaltourism.comMvietnamMmedicalBtourismM 17. http=MMwww.healism.comMblo'sMtheYstanleyYrubentiYmedicalYtourismYblo'MwhoYratesYmedic alYtourismYinYsin'aporeM 18. http=MMwww.medicalsin'apore.comMsin'aporetravel.html
44

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Global Partnership of Asian Colleges

University of Economics and Business, VNU

VIETNAM MATIONAL UNIVERSITY, HANOI UNIVERSITY OF ECONOMICS AND BUSINESS -------------------------------------------

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

Global Partnership of Asian Colleges

University of Economics and Business, VNU

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

Global Partnership of Asian Colleges

University of Economics and Business, VNU

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

CHAPTER 2: LITERATURE REVIEW

Global Partnership of Asian Colleges

University of Economics and Business, VNU

Global Partnership of Asian Colleges

University of Economics and Business, VNU

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

.(. H4?? to H5?? R..0 ,a a# /ndia H;?? to H5?? .(. H4,6??

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S& 'a*.)$ :9,6?? :;,6?? :4,??? :;,??? 7,??? :4,??? <,???

'able ," 'he international price comparisons

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

B$00$) a ! *)./$%%&. a# %*$,&a#&%0% a !

()%$%= .ith lower labor costs, medical tourism

Global Partnership of Asian Colleges

University of Economics and Business, VNU

!http"##$$$%healism%com#medical/tourism#overvie$#disadvantages/of/medical/tourism#& &&. L$'a# ,. ,$) :

Global Partnership of Asian Colleges

University of Economics and Business, VNU

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

Global Partnership of Asian Colleges

University of Economics and Business, VNU

Global Partnership of Asian Colleges

University of Economics and Business, VNU

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

Global Partnership of Asian Colleges

University of Economics and Business, VNU

-----------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Hng, Tho, Thy, Xoan -leader)

CHAPTER 3: RESULTS AND DISCUSSION: CASE STUDIES

'able ," 6nternational price comparisons

------------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Tho, Thy, Xoan -leader)

The overall comparison can be presented as follow=

------------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Tho, Thy, Xoan -leader)

9igure 5%5" Comparisons in term of costs among countries

------------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Tho, Thy, Xoan -leader)

------------------------------------------------------------------------------------------------------------------------------Medical tourism _ TTXVN (Tho, Thy, Xoan -leader)

B$00$) a ! )./$%%&. a# %$,&a#&%0% a !