By Tsogtbaatar Byambaa
Medical tourism (MT) entails the intentional pursuit of medical care beyond the borders of a patient’s home country, privately arranged for and usually paid for out of pocket. These patients are motivated by high costs of care in their home countries, higher quality or faster care abroad, and/or the inability to access care in their home countries. Research on the potential health equity impacts of MT has generally focused on patients traveling from the Global North, thus ignoring the large numbers of patients from the Global South traveling across lower and middle income countries to access medical care. These patients represent different challenges to their home health systems that require independent investigation.
Mongolia is increasingly a source of medical tourists for nearby countries promoting medical care to foreign patients. Between 13-22 April 2012, SFU team that works on Medical tourism traveled to Mongolia to explore the impact on local health services when affluent Mongolian citizens travel abroad for health care. The aim of SFU researchers’ trip was also to develop collaborative research networks in Mongolia, which will ground future comparative research examining the impacts of MT on a diverse array of health systems. Canadians represent the second largest group of international investors in Mongolia and will benefit from a better understanding of the forces shaping the health system of the country and, by extension, the health of Mongolia’s citizens. Further to this, we may glean insights into how Mongolian officials and health care providers are coping with the continuing outflow of patients while struggling to establish and maintain an equitable health care system. These insights can serve as potential areas of innovation to be applied here in Canada, which is another known source country for medical tourists.
Patients from more economically developed countries are flocking to developing countries to receive treatment for everything from elective cosmetic procedures to complex surgeries such as organ transplants and reproductive treatments, controversial stem-cell procedures and multiple sclerosis liberation therapy.
The medical tourism industry is booming in Mongolia. But there is a surprising lack of academic research into the industry’s size, the ethics and risks of medical tourism, and the effects it can have on developing countries’ local health services.
SFU health geographer Valorie Crooks established the SFU Medical Tourism Research Group (MTRG). In 2008, she was the first Canadian researcher to receive a Canadian Institutes of Health Research (CIHR) grant to study the subject. “We found that many Canadians are relying on informal testimonies and anecdotal information from the Internet to make important decisions for surgical care,” says Crooks. “People believe Canadians are going abroad because of waiting lists and Americans are going because it’s cheaper, but our research shows that it’s more complex than that,” says Crooks.
What’s happening to local health-care services in developing countries that cater to medical tourists?
“There’s a lot of speculation that medical tourism is great for the locals because it brings in money and jobs,” says Crooks. “But on the other hand it shifts the focus to high-end surgeries and facilities for treating international patients. “There’s very little evidence one way or the other to prove these two theories.”
Between 13-22 April 2012, Medical tourism team traveled to Mongolia to explore the impact on local health services when affluent Mongolian citizens travel abroad for health care.
“We looked at the health-system challenges this poses for Mongolia to see if there were any lessons we can learn about how a lower-resource environment then deals with its patients,” explains Crooks.
They met with academics and interview facilitators who are sending Mongolians abroad for health services as well as local health officials.
Mongolian health sciences grad student Tsogtbaatar Byambaa, who inspired the research, is concerned about the growing numbers of Mongolians travelling outside of the country to receive medical care. He wants to know more about their outcomes and the long-term impact on the country’s health system. The study went successfully and results are expected to be revealed within next few months.
About Tsogtbaatar Byambaa
Dr. Tsogtbaatar Byambaa is the Project Coordinator for the CIHR funded Equity-Focused Health Impact Assessment Tools and Methodologies in Mongolia: Supporting and Scaling-Up Local Experiences project. He is a PhD candidate in the Faculty of Health Sciences at Simon Fraser University, Burnaby, BC. He received his MSc in Health Administration and International Health Policy from University of Colorado. He is a family physician by background who has worked on several public health projects in Mongolia, including serving as a coordinator for the Global Fund supported HIV/AIDS project of Ministry of Health in Mongolia. His research interest focuses on managing the potentially adverse public health consequences of development sector in developing settings. Tsogtbaatar Byambaa is currently engaged in research projects on health impact assessment policy development, medical tourism and air pollution.