Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-28T21:22:12.915Z Has data issue: false hasContentIssue false
  • English
  • Français

Population-based surveillance of medical tourism among US residents from 11 states and territories: Findings from the Behavioral Risk Factor Surveillance System

Published online by Cambridge University Press:  15 July 2021

Rhett J. Stoney Open the ORCID record for Rhett J. Stoney [Opens in a new window] ,
Phyllis E. Kozarsky Open the ORCID record for Phyllis E. Kozarsky [Opens in a new window] ,
Allison T. Walker  and
Joanna L. Gaines
Rhett J. Stoney*
Affiliation:
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia
Phyllis E. Kozarsky
Affiliation:
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia
Allison T. Walker
Affiliation:
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia
Joanna L. Gaines
Affiliation:
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Author for correspondence: Rhett J. Stoney, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To describe medical tourism among a subset of US residents; identify possible indicators for medical tourism.

Methods:

The US Centers for Disease Control and Prevention collaborated with 11 states and territories to ask 6 questions about medical tourism, using the Behavioral Risk Factor Surveillance System. Data collected from January 1, 2016, through December 31, 2016, included whether respondents traveled internationally for preplanned care, travel reasons and destinations, procedures received, and occurrence and treatment of complications. A descriptive analysis of demographics, socioeconomic status and health access variables was performed, and a regression model with a log-link function and Poisson distribution was used to estimate prevalence ratios (PR) for medical tourism.

Results:

Of 93,492 respondents, 517 (0.55%) traveled internationally during the previous year for care. Mexico was the most common destination (41% of trips). Dentistry accounted for 55% of treatments. Complications from care received abroad were reported by 5% of medical tourists; 67% sought care upon returning to the United States. The prevalence of medical tourism was 1.32% (95% CI, 1.00–1.64). The prevalence of medical tourism was higher in Hispanics and non-whites (PR, 3.97; 95% CI, 2.48–6.32) and higher among those without current health insurance (PR, 2.70; 95% CI, 1.69–4.34).

Conclusions:

This is the largest collection of population-based surveillance data describing medical tourism among US residents from multiple states and territories. Understanding the demographic and socioeconomic factors associated with medical tourism can inform evidence-based recommendations for travelers and clinicians who may advise or care for these individuals before, during, or after travel.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 7 , July 2022 , pp. 870 - 875
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Benowitz, I, Gaines, J, 2019. Medical tourism. Brunette, GW, editor. CDC Yellow Book 2020: Health Information for International Travel. New York: Oxford University Press; 2019.Google Scholar
Chen, LH, Wilson, ME. The globalization of healthcare: implications of medical tourism for the infectious disease clinician. Clin Infect Dis 2013;57:1752–1759.CrossRefGoogle ScholarPubMed
Foley, BM, Haglin, JM, Tanzer, JR, Eltorai, AEM. Patient care without borders: a systematic review of medical and surgical tourism. J Travel Med 2019. doi: 10.1093/jtm/taz049.CrossRefGoogle Scholar
Österle, A, Johnson, T, Delgado, J. A unifying framework of the demand for transnational medical travel. Int J Health Serv 2013 43:415–436.CrossRefGoogle ScholarPubMed
Lunt, N, Carrera, P. Medical tourism: assessing the evidence on treatment abroad. Maturitas 2010;66:27–32.CrossRefGoogle ScholarPubMed
Medical tourism market—growth, trends, and forecast, 2019–2024. Mordor Intelligence website. https://www.mordorintelligence.com/industry-reports/medical-tourism-market Accessed August 16, 2019.Google Scholar
Medical tourism market size, share, industry trend report, 2019–2026. Grand View Research website. https://www.grandviewresearch.com/industry-analysis/medical-tourism-market. Accessed August 16, 2019.Google Scholar
Traveler’s guide to safe dental care. Organization for Safety Asepsis and Prevention website. https://www.osap.org/page/travelersguide. Accessed May 28, 2019.Google Scholar
Ehrbeck, T, Guevara, C, Mango, PD. Mapping the market for medical tourism. McKinsey Qtrly 2008;May:1–11.Google Scholar
Schnabel, D, Esposito, DH, Gaines, J, et al. Multistate US outbreak of rapidly growing mycobacterial infections associated with medical tourism to the Dominican Republic, 2013–2014. Emerg Infect Dis 2016;22:1340–1347.CrossRefGoogle Scholar
Gaines, J, Poy, J, Musser, KA, et al. Notes from the field: nontuberculous mycobacteria infections in US medical tourists associated with plastic surgery—Dominican Republic, 2017. Morb Mortal Wkly Rep 2018;67:369–370.CrossRefGoogle Scholar
Kracalik, I, Ham, C, Smith, AR, et al. Notes from the field: verona integron-encoded metallo-beta-lactamase-producing carbapenem-resistant Pseudomonas aeruginosa infections in US residents associated with invasive medical procedures in Mexico, 2015–2018. Morb Mortal Wkly Rep 2019;68:463–464.CrossRefGoogle Scholar
Centers for Disease Control and Prevention. Detection of Enterobacteriaceae isolates carrying metallo-beta-lactamase—United States, 2010. Morb Mortal Wkly Rep 2010;59:750.Google Scholar
Ruggeri, K, Záliš, L, Meurice, CR, et al. Evidence on global medical travel. Bull World Health Organ 2015;93:785–789.CrossRefGoogle ScholarPubMed
About the Behavioral Risk Factor Surveillance System (BRFSS). Centers for Disease Control and Prevention website. https://www.cdc.gov/brfss/about/index.htm. Published 2019. Accessed August 20, 2019.Google Scholar
Overview: BRFSS 2016. Centers for Disease Control and Prevention website. https://www.cdc.gov/brfss/annual_data/2016/pdf/overview_2016.pdf. Published 2017. Accessed August 20, 2019.Google Scholar
Chambers, A. Trends in US health travel services trade. US International Travel Commission website. https://www.usitc.gov/publications/332/executive_briefings/chambers_health-related_travel_final.pdf. Published 2015. Accessed August 22, 2019.Google Scholar
Keckley, PH, Underwood, HR. Medical tourism: update and implications. Report no: 9112. Deloitte Center for Health Solutions website. http://deloitte.com/assets/DcomUnitedStates/Local%20assets/documents/us_chs_medicaltourism_111209_web.pdf. Published 2009. Accessed August 18, 2019.Google Scholar
Lozano, K, Ogbu, UC, Amin, A, Chakravarthy, B, Anderson, CL, Lotfipour, S. Patient motivators for emergency department utilization: a pilot cross-sectional survey of uninsured admitted patients at a university teaching hospital. J Emerg Med 2015;49:203–210.CrossRefGoogle Scholar
Bies, W, Zacharia, L. Medical tourism: outsourcing surgery. Math Comput Model 2007;46:1144–1159.CrossRefGoogle Scholar
Helble, M. The movement of patients across borders: challenges and opportunities for public health. Bull World Health Organ 2011;89:68–72.CrossRefGoogle ScholarPubMed
Reed, CM. Medical tourism. Med Clin North Am 2008;92:1433–1446.CrossRefGoogle ScholarPubMed
Keystone, JS. Visiting friends & relatives: VFR travel. Brunette, GW, editor. CDC Yellow Book 2020: Health Information for International Travel. New York: Oxford University Press; 2019.Google Scholar
Akoh, JA. Key issues in transplant tourism. World J Transplant 2012;2:9–18.CrossRefGoogle ScholarPubMed
Canales, MT, Kasiske, BL, Rosenberg, ME. Transplant tourism: outcomes of United States residents who undergo kidney transplantation overseas. Transplantation 2006;82:1658–1661.CrossRefGoogle ScholarPubMed
Murthy, VH. Oral health in America, 2000 to present: progress made, but challenges remain. Public Health Rep 2016;131:224–225.CrossRefGoogle ScholarPubMed
Mertz, EA. The dental-medical divide. Health Affairs 2016;35:2168–2175.CrossRefGoogle ScholarPubMed
Ramírez de Arellano, AB. Patients without borders: the emergence of medical tourism. Int J Health Serv 2007;37:193–198.CrossRefGoogle ScholarPubMed
Jang, SH. Here or there: recent US immigrants medical and dental tourism and associated factors. Int J Health Serv 2017;48:148–165.CrossRefGoogle Scholar
Supplementary material: File

Stoney et al. supplementary material

Appendix 1

Download Stoney et al. supplementary material(File)
File 19.8 KB
Supplementary material: File

Stoney et al. supplementary material

Appendix 2

Download Stoney et al. supplementary material(File)
File 16 KB