title: What do we know about medical tourism? A review of the literature with discussion of its implications for the UK National Health Service as an example of a public health care system.
abstract: BACKGROUND
  Medical tourism is a growing phenomenon. This review of the literature maps current knowledge and discusses findings with reference to the UK National Health Service (NHS).
  
  
  METHODS
  Databases were systematically searched between September 2011 and March 2012 and 100 papers were selected for review.
  
  
  RESULTS
  The literature shows specific types of tourism depending on treatment, eg, dentistry, cosmetic, or fertility. Patient motivation is complex and while further research is needed, factors beyond cost, including availability and distance, are clearly important. The provision of medical tourism varies. Volume of patient travel, economic cost and benefit were established for 13 countries. It highlights contributions not only to recipient countries' economies but also to a possible growth in health systems' inequities. Evidence suggests that UK patients travel abroad to receive treatment, complications arise and are treated by the NHS, indicating costs from medical travel for originating health systems.
  
  
  CONCLUSIONS
  It demonstrates the importance of quality standards and holds lessons as the UK and other EU countries implement the EU Directive on cross-border care. Lifting the private-patient-cap for NHS hospitals increases potential for growth in inbound medical tourism; yet no research exists on this. Research is required on volume, cost, patient motivation, industry, and on long-term health outcomes in medical tourists.
authors.affiliation: Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Johanna
authors.initials: J
authors.lastname: Hanefeld
authors.forename: Richard
authors.initials: R
authors.lastname: Smith
authors.forename: Daniel
authors.initials: D
authors.lastname: Horsfall
authors.forename: Neil
authors.initials: N
authors.lastname: Lunt
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008389:Marketing of Health Services / Q000706:statistics & numerical data; D057193:Medical Tourism / Q000191:economics / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D013222:State Medicine; D006113:United Kingdom