THE PRINCIPLES OF MEDICAL TOURISM INDUSTRY –

OUTBOUND – INBOUND- INTRABOUND / USA

DR.AYŞE TURANMD, MA

FROM SPAS TO COGNITIVE COMPUTINGSUMERIAN POOLSST.MORITZ DRINKING SPRINGSASCLEPIUMAYURVEDAROMAN BATHSJAPANESE SPASMANSURI HOSPITALVILLE D’EAUX********************** INDUSTRIALIZATION1720 BATH ENGLANDTBC1900-1997 ENGLAND-USA1933 ABMS-The American Board of Medical Specialists-standards1958 UEMS1960 YOGA1980-1990-dental/eye/cosmetic/heart

1997-2020 GLOBAL MEDICAL TOURISM ERA

• 1997 JCA-I –SE ASIA & LATIN AMERICA• DENTISTRY AND COSMETIC SURGERY• PARTNERSHIPS WITH THE US BASED HEALTH

PROVIDERS• BABY BOOMERS- OUTSOURCING-

NONEMERGENY PROCEDURES

TRANSATLANTIC STORY OF AN ARTIFICIAL HIP

• 112,317 dollar / 13,660 dollar• Intermediaries• St.Rembert’s Belgium• 1000 USA orthopedists-200 million dollars-

2007 311 million settlement• 2020-2030 ---144 billion dollars joint

replacement --- USA 1/6 military budget

USA MEDICAL TOURISM GUIDELINESAMA- OUTBOUND

• Voluntary• Diagnostic and therapeutic alternatives • Recognized İnternational Accrediting• Follow –up care• Travel costs included• Patients rights and legal recourse• Doctors licensing and outcomes data• Facility accreditation and outcomes data• HIPAA Guidelines for patient data transfer• Surgical procedures / travel/ vacation risks

INTRABOUND & INBOUND MEDICAL TOURISM STANDARDS / USA - 1

• Doctors recommendation• ----------------------------------- • AHA American Hospital Association• Annual Survey- reputational survey of

physicians• IHQ Index of Hospital Quality-hard data• Structure X Process X Outcomes

STRUCTURE

• Resources for patient care: • nurse/bed• Technology• Patient services• Recognized designation : Nurse Magnet

/National Institute/Center of Excellence /Reference Center

• Discharge number – inpatient data

PROCESS

• Delivery of Care• ----------------------------------------- • Patient safety quality indicators• Reputation survey• Diagnosis-treatment-prevention-patient

education

OUTCOMES

• STRUCTURE-PROCESS:OUTCOMES• --------------------------------------------- • Mortality rate• Risk adjustment• Complexity of cases-severity of illness• Readmissions• Patient safety• Infection rates

INDEX OF HOSPITAL QUALITY

• ELIGIBILITY• 1- Teaching Hospital-OR-Medical School

Affiliation –OR-200 beds set up and staffed-OR at least 100 beds and 4/8 key technologies

• 2-Minimum severity of illness complex care experience treating discharge volume

EXAMPLE TECHNOLOGIES• -Ablation of Barret’s esophagus• -Cardiac intensive care unit• -Computer assisted orthopedic surgery• -Diagnostic Radioisotope services• -ERCP• -Endoscopic Ultrasound• -Full Field Digital Mammography• -Imageguided radiation therapy• -CT• -PET/CT• -Robotic surgery• -Shaped beam Radiation• -Single Photon emission CT• -Stereotactic radiosurgery• -Transplant services

PATIENT SERVICES• Alzheimer’s center• Arthritis treatment center• Cardiac rehabilitation• Fertility clinic• Genetic testing /counseling• Hospice• Infection isolation room• Pain management program• Palliative care• Patient controlled analgesia• Psychiatric geriatric service• Translators• Wound Management services

METHODOLOGY

• MULTIDISCIPLINARY

• INTERDISCIPLINARY

• TRANS DICIPLINARY

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