Medical Tourism as booming industry and its scope in India

1. Medical Tourism
Ravi Rohilla
Community Medicine
PGIMS Rohtak

2. CONTENTS
Tourism
Medical Tourism
Scope of Medical
Tourism
Components
Accreditation
Medical Tourism
Provider
Indian Scenario
SWOT analysis
Role of Government
and Private
Innovations

3. Tourism
“Tourism” comprises of the activities of
persons traveling to and staying in place
outside their usual environment for leisure,
business and other purposes.
Tourists are the people who "travel to and
stay in places outside their usual environment
for not more than one consecutive year for
leisure, business and other purposes not
related to the exercise of an activity
remunerated from within the place visited“.
-World Tourism
Organisation

4. Types of Tourism
United Nations classified three forms of
tourism in its Recommendations on Tourism
Statistics (1994).
 Domestic tourism, involving residents of the
given country travelling only within the country.
 Inbound tourism, involving non-residents
travelling in the given country.
 Outbound tourism, involving residents travelling
in another country

5. Medical Tourism
Medical tourism is a term involving people
who travel to a different place to receive
treatment for a disease, ailment, or condition,
and who are seeking lower cost of care,
higher quality of care, better access to care,
or different care than they could receive at
home.
-Global Spa Summit 2011

6. Why Medical Tourism?
Healthcare and Tourism industries are the
fastest growing industries in the world.
Medical Tourism is being promoted as a
Fusion product of these industries.
Various countries like Thailand, Malaysia,
India, etc are promoting Medical Tourism
aggressively.
Medical tourism has tremendously generated
services and revenues across the globe and
numerous possibilities still remain
unexplored.

7. Reasons for Medical
Tourism
 Cost Effectiveness
 Availability of services
 Expertise
 Absence of waiting lists

8. Scope of Medical
Tourism
Healthcare industry
 World's largest industry
 Total revenue of approximately US$2.8 Trillion.
In India
 Healthcare industry has emerged as one of the
largest service sectors
 Estimated revenue of around US$30 billion
constituting 5% of GDP and offering employment
to around 4 million people

9. Scope of Medical Tourism in
India
Medical tourism market is valued to be worth over
$310 million with foreign patients coming by 100,000
every year, and the market is predicted to grow to $2
billion by 2012.
An estimated 180,000 medical tourists were treated
at Indian facilities in 2004 (up from 10,000 in year
2000), and the number has been growing at 25-30%
annually. -
CII-McKinsey report 2008

10. Scope of Medical
Tourism
There are various kinds of services that are
provided under medical tourism
 Service Delivery – Medical services
 Travel Services (Airlines & Hotels)
 Shopping & Entertainment for tourists and their
family members
 Insurance Coverage towards the risks involved
during the treatment
 Websites providing information, booking facilities
and promotions

11. Countries currently offering International
Medical Tourism healthcare services.
Argentina
Australia
Bahrain
Bangladesh
Barbados
Belgium
Brazil
India
Lebanon
Lithuania
Malaysia
Canada
Cayman Islands
Chile
Costa Rica
Cuba
Cyprus
Switzerland
Taiwan
Thailand
Turkey

12. Healthcare
& Medical
Tourism
Components

13. Treatment of Illnesses
 Joint replacements
 Heart surgery
 Cancer treatment,
 Neurosurgery,
 Transplants(Liver and Bone marrow)
 Dental treatment.

14. Enhancement
‘Enhancement’ procedures are carried out
mainly for aesthetic purposes(much of this
work is non-disease related unless
disfigurement is caused by disease). These
are:
 All cosmetic surgeries
 Breast surgeries
 Facelifts,
 liposuction and cosmetic dental work.

15. Wellness(Spa/Alternate
therapies)
The ‘wellness’ segment of medical and
healthcare tourism promotes healthier
lifestyles. These products can include:
 Treatment in spas
 Thermal and water treatment
 Acupuncture and Aromatherapy
 Beauty care, facials, exercise and diet
 Herbal healing, homeopathy, massage
 Yoga and naturopathy.

16. Reproduction(Fertility)
Under this component, there are patients who
seek fertility-related treatments such as in
vitro and in vivo fertilization and other similar
procedures.
At times, potential parents travel for the
purposes of adopting children because the
legislation and supply of babies for adoption
is easier in host countries.

18. Hospital Accreditation
Accreditation has been defined as "A self-assessment
and external peer assessment
process used by health care organisations to
accurately assess their level of performance
in relation to established standards and to
implement ways to continuously improve“.
Fundamentally healthcare and hospital
accreditation is about improving how care is
delivered to patients and the quality of the
care they receive.

19. Accreditation Schemes
Trent Accreditation Scheme (based in UK-Europe)
QHA Trent Accreditation, based in the UK
Joint Commission International, or JCI (based
in USA)
Australian Council for Healthcare Standards
International, or ACHSI (based in Australia)

20. Accreditation Canada (formerly the Canadian
Council on Health Services Accreditation or
CCHSA -based in Canada)
Accreditation of France (La Haute Autorité de
Santé) based in Paris, France.
NABH(National Accreditation Board for
Hospitals and Health Centres- based in India)

21. The Ministry of Health and Family Welfare
has set up a National Accreditation Board for
Hospitals(NABH), under the Quality Council
of India for accreditation of hospitals
Established in year 2006.
There are 16 JCI accredited and 63 NABH
accredited healthcare providers in India.

22. Outline of NABH
Standards
Access, Assessment and Continuity of Care
Patient Rights and Education
Care of Patient
Management of Medication
Hospital Infection Control
Continuous Quality Improvement
Responsibility of Management
Facility Management and Safety
Human Resources Management
Information Management System

23. Medical Tourism Provider
A Medical Tourism Provider is an
organisation or a company which seeks to
bring together a prospective patient with a
service provider, usually a hospital or a clinic.
Some such organisations and companies
specialize in certain areas of healthcare, such
as cosmetic surgery, dentistry or transplant
surgery, while others are more generalised in
their approach.

24. Medical tourism provider
Medical quality standards vary around the
world, and international accreditation is
relatively new.
For these reasons, Medical tourists look to
health tourism providers to provide
information about
 Quality,
 Safety and
 Legal issues.

25. Various issues for
Medical Tourists
Medical issues
 Availability of
techniques
 Pre-travel health issues,
such as antimalarial
therapy and relevant
immunisations
 Medico-legal issues
Non Medical issues
 Prices and how to pay
 Hotels(checking in)
 Language issues
 Ethics

26. Various service providers(India)
http://www.medaccessindia.com/
http://www.recoverdiscover.com/
http://www.medicaltourisminindia.net/
http://www.forerunnershealthcare.com/
http://www.medicalresortindia.com/
http://www.medicaltourism-india.in/
http://www.medicaltourismco.com/

28. NEJM echoes
The New England Journal of Medicine
detailed an account of a self-employed
carpenter who had an acute mitral-valve
prolapse that required surgery.
Estimated fees at the nearest hospital
approached $200,000, half of which needed
to be paid in advance.
After some more digging around, this patient
was able to find a hospital in Texas that could
perform the procedure for $40,000.

29. After some more research, the patient
decided to fly to New Delhi, India where he
had the procedure performed for less than
$7,000.
Shortly after returning to North Carolina, the
patient went back to work with a healthy
heart.
To India

30. Why India?
India has several advantages that make it a
natural choice for Medical treatment.
 Cost advantage during treatment as well as
medication
 Large pool of good doctors, nurses and
paramedics
 World-class facilities
 High brand value of leading Indian medical
professionals across the globe
 Good English speaking population
 Vibrant Pharmaceutical industry

31. Healthcare Pricing(Comparision)
Procedure US UK Burmungrad
Bangkok
Raffles
Singapore
Max Healthcare
(India)
Angioplasty 30000 21000-
27000
4000 - 5000 5000 4000 - 5000
Angiography 2500 -
3000
2000 1100 800 400
Hip
replacement
19000 13000-
16000
_ 6600 6000
Knee
replacement
27000-
32000
16000-
18000
_ 6000 6000
CABG 30000 _ 9600 6400
Lasik _ 2250-
2900
750 _ 400

32. Major Players
Following are major players in the
Medical Tourism industry.
 Escorts
 Apollo Hospital
 Max Healthcare
 Indraprastha Apollo Hospital
 Hinduja Hospital
 Jaslok Hospital
 Fortis
 Wockhardt

34. Competition
Thailand, Singapore, Malaysia, India
and Philippines are the major destinations
in the Asian medical tourism market.
Thailand is more popular among Western
European medical tourists for cosmetic
surgery.
Singapore and India specialize in complex
procedures with India having a cost
advantage and Singapore a technology
advantage.

35. Brand India
Medical Treatment in USA
=
A tour to India + Medical
Treatment + Savings
“First World Services at Third
World Cost”.

36. Medical Tourism : SWOT
approach
Business/service firms undertake SWOT
analysis to understand their external and
internal environments.
Through such an analysis, the Strengths and
Weaknesses existing within the medical
tourism can be matched with the
Opportunities and Threats operating in the
Indian environment so that an effective
strategy can be formulated.

37. Strengths
A strength is an inherent capacity which an
organization can use to gain strategic
advantage.
 Quality and Range of Services
 Affordable costs
 Vast supply of qualified doctors:
 Strong presence in advanced health care
 International Reputation of hospitals and Doctors.
 Diversity of tourism destinations and experiences

38. Weakness
A weakness is an inherent limitation or
constraint which creates strategic
disadvantages.
 No strong government support/initiative to promote
medical tourism.
 Low coordination between the various players in
the industry- airline operators, hotels, and
hospitals.
 Lack of uniform pricing policies across hospitals.
 Customer Perception as an unhygienic country
 Political problems etc

39. Opportunities
An opportunity is a favorable condition in the
service industry which enables it to
consolidate and strengthen its position
 Increased demand for healthcare services from
countries with aging population (US, UK)
 Fast-paced life style increases demand for
wellness tourism and alternative cures.
 Shortage of supply in National Health Systems in
countries like UK, Canada.

40. Opportunities
 Demand from countries with underdeveloped
healthcare facilities.
 Demand for retirement homes for elderly people
especially Japanese.
 Personal touch by the doctors in India.
 Traffic system is well developed and easy to go
from one country to another country.
 Medicines and lab-our cost is low as compared to
developed countries.

41. Threats
A threat is an unfavourable condition in the
industry’s environment which creates a risk
for, or causes damage to, the industry.
 Strong competition from countries like Thailand,
Malaysia and Singapore.
 Lack of international accreditaion – a major
inhibitor.
 Overseas medical care not covered by insurance
providers.
 Under – investment in health infrastructure.

42. Threats
 Exploitation of tourists by illegal money changers.
 Terrorism
 Rise of Resistant strains (NDM-1)

43. Role of Government
The role of Indian Government for success in
medical tourism is two-fold:
 Acting as a Regulator to institute a
uniform grading and accreditation system
for hospitals to build consumers’ trust.
 Acting as a Facilitator for encouraging
private investment in medical infrastructure
and policymaking for improving medical
tourism.

44. Government’s Role
Investment facilitator:
Recognize healthcare as an infrastructure
sector, and extend the benefits under sec 80-IA
of the IT Act.
Should actively promote FDI in healthcare
sector
Providing low interest rate loans, reducing
import/excise duty for medical equipment
Facilitating clearances and certification

45. Government’s Role
Tourism facilitator:
 Reduce hassles in visa process(M-Visa)
 Follow an Open-Sky policy to increase
inflow of flights into India
 Create Medical Attachés to Indian
embassies that promote health services to
prospective Indian visitors

46. Private Sector Role
1. Increased participation in building
infrastructure
2. Integrate Horizontally
3. Joint Ventures / Alliances

47. Innovation Through MEDICITIES
Software industry-Establishment of
Export Oriented Software Technology
Parks
Medical tourism industry-Medicities

48. MEDICITY
MEDICITY-A self-sustained healthcare
hub with
 Super specialty hospitals of international
standards
 Ancillary facilities
 Research institutions
 Health resort
 Rehabilitation centers and residential
apartments.

50. References
World Tourism Organisation, unwto.org/
Ministry of Tourism, India, tourism.gov.in/
Incredible India, www.incredibleindia.org/
NABH, www.nabh.co/
CII-McKinsey Report

51. THANK
S