title: Medical tourism services available to residents of the United States.
abstract: BACKGROUND
  There are growing reports of United States (US) residents traveling overseas for medical care, but empirical data about medical tourism are limited.
  
  
  OBJECTIVE
  To characterize the businesses and business practices of entities promoting medical tourism and the types and costs of procedures being offered. DESIGN, PARTICIPANTS, AND OUTCOMES: Between June and August 2008, we conducted a telephone survey of all businesses engaged in facilitating overseas medical travel for US residents. We collected information from each company including: the number of employees; number of patients referred overseas; medical records security processes; destinations to which patients were referred; treatments offered; treatment costs; and whether patient outcomes were collected.
  
  
  RESULTS
  We identified 63 medical tourism companies and 45 completed our survey (71%). Companies had a mean of 9.8 employees and had referred an average of 285 patients overseas (a total of approximately 13,500 patients). 35 (79%) companies reported requiring accreditation of foreign providers, 22 (50%) collected patient outcome data, but only 17 (39%) described formal medical records security policies. The most common destinations were India (23 companies, 55%), Costa Rica (14, 33%), and Thailand (12, 29%). The most common types of care included orthopedics (32 companies, 73%), cardiac care (23, 52%), and cosmetic surgery (29, 66%). 20 companies (44%) offered treatments not approved for use in the US--most commonly stem cell therapy. Average costs for common procedures, CABG ($18,600) and knee arthroplasty ($10,800), were similar to previous reports.
  
  
  CONCLUSIONS
  The number of Americans traveling overseas for medical care with assistance from medical tourism companies is relatively small. Attention to medical records security and patient outcomes is variable and cost-savings are dependent on US prices. That said, overseas medical care can be a reasonable alternative for price sensitive patients in need of relatively common, elective medical procedures.
authors.affiliation: University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA. brandon-alleman@uiowa.edu
authors.forename: Brandon W
authors.initials: BW
authors.lastname: Alleman
authors.forename: Tana
authors.initials: T
authors.lastname: Luger
authors.forename: Heather Schacht
authors.initials: HS
authors.lastname: Reisinger
authors.forename: Rene
authors.initials: R
authors.lastname: Martin
authors.forename: Michael D
authors.initials: MD
authors.lastname: Horowitz
authors.forename: Peter
authors.initials: P
authors.lastname: Cram
mesh_terms: D003625:Data Collection / Q000379:methods; D017558:Elective Surgical Procedures / Q000191:economics / Q000592:standards / Q000639:trends; D006297:Health Services Accessibility / Q000191:economics / Q000639:trends*; D006801:Humans; D040541:Marketing / Q000191:economics / Q000379:methods / Q000639:trends; D008499:Medical Records / Q000191:economics / Q000592:standards; D057193:Medical Tourism / Q000191:economics / Q000639:trends*; D011787:Quality of Health Care / Q000191:economics / Q000592:standards / Q000639:trends; D012111:Residence Characteristics; D014195:Travel / Q000191:economics / Q000639:trends*; D014481:United States