title: The cost of bariatric medical tourism on the Canadian healthcare system.
abstract: BACKGROUND
  Medical tourists are defined as individuals who intentionally travel from their home province/country to receive medical care. Minimal literature exists on the cost of postoperative care and complications for medical tourists. The costs associated with these patients were reviewed.
  
  
  METHODS
  Between February 2009 and June 2013, 62 patients were determined to be medical tourists. Patients were included if their initial surgery was performed between January 2003 and June 2013. A chart review was performed to identify intervention costs sustained upon their return.
  
  
  RESULTS
  Conservatively, the costs of length of stay (n = 657, $1,433,673.00), operative procedures (n = 110, $148,924.30), investigations (n = 700, $214,499.06), blood work (n = 357, $19,656.90), and health professionals' time (n = 76, $17,414.87) were summated to the total cost of $1.8 million CAD.
  
  
  CONCLUSIONS
  The absolute denominator of patients who go abroad for bariatric surgery is unknown. Despite this, a substantial cost is incurred because of medical tourism. Future investigations will analyze the cost effectiveness of bariatric surgery conducted abroad compared with local treatment.
authors.affiliation: Centre for the Advancement of Minimally Invasive Surgery, Room No. 502 CSC, 10240 Kingsway Avenue, Royal Alexandra Hospital, Edmonton, Alberta T5H 3V9, Canada; University of Alberta, 2-590 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta T6G 1C9, Canada.
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Sheppard
authors.affiliation: University of Alberta, 2-590 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta T6G 1C9, Canada.
authors.forename: Erica L W
authors.initials: EL
authors.lastname: Lester
authors.affiliation: Centre for the Advancement of Minimally Invasive Surgery, Room No. 502 CSC, 10240 Kingsway Avenue, Royal Alexandra Hospital, Edmonton, Alberta T5H 3V9, Canada; University of Alberta, 2-590 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta T6G 1C9, Canada.
authors.forename: Shahzeer
authors.initials: S
authors.lastname: Karmali
authors.affiliation: University of Alberta, 2-590 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta T6G 1C9, Canada. Electronic address: cdegara@ualberta.ca.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: de Gara
authors.affiliation: Centre for the Advancement of Minimally Invasive Surgery, Room No. 502 CSC, 10240 Kingsway Avenue, Royal Alexandra Hospital, Edmonton, Alberta T5H 3V9, Canada; University of Alberta, 2-590 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta T6G 1C9, Canada.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Birch
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000191:economics*; D002170:Canada; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D057193:Medical Tourism / Q000191:economics*; D008875:Middle Aged; D011182:Postoperative Care / Q000191:economics*; D011183:Postoperative Complications / Q000191:economics* / Q000628:therapy
keywords: Complications; Cost; Interventions; Medical tourism; Morbid obesity