Outbound medical tourism from Mongolia: a qualitative examination of proposed domestic health system and policy responses to this trend.
BACKGROUND
Medical tourism is the practice of traveling across international boundaries in order to access medical care. Residents of low-to-middle income countries with strained or inadequate health systems have long traveled to other countries in order to access procedures not available in their home countries and to take advantage of higher quality care elsewhere. In Mongolia, for example, residents are traveling to China, Japan, Thailand, South Korea, and other countries for care. As a result of this practice, there are concerns that travel abroad from Mongolia and other countries risks impoverishing patients and their families.


METHODS
In this paper, we present findings from 15 interviews with Mongolian medical tourism stakeholders about the impacts of, causes of, and responses to outbound medical tourism. These findings were developed using a case study methodology that also relied on tours of health care facilities and informal discussions with citizens and other stakeholders during April, 2012.


RESULTS
Based on these findings, health policy changes are needed to address the outflow of Mongolian medical tourists. Key areas for reform include increasing funding for the Mongolian health system and enhancing the efficient use of these funds, improving training opportunities and incentives for health workers, altering the local culture of care to be more supportive of patients, and addressing concerns of corruption and favouritism in the health system.


CONCLUSIONS
While these findings are specific to the Mongolian health system, other low-to-middle income countries experiencing outbound medical tourism will benefit from consideration of how these findings apply to their own contexts. As medical tourism is increasing in visibility globally, continued research on its impacts and context-specific policy responses are needed.
Simon Fraser University, Blusson Hall 10516, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. Jcs12@sfu.ca.
Jeremy
J
Snyder
Simon Fraser University, Blusson Hall 10516, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. tsogtbaatar_byambaa@sfu.ca.
Tsogtbaatar
T
Byambaa
Simon Fraser University, Blusson Hall 10516, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. rrj1@sfu.ca.
Rory
R
Johnston
Simon Fraser University, Blusson Hall 10516, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. crooks@sfu.ca.
Valorie A
VA
Crooks
Simon Fraser University, Blusson Hall 10516, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. craig_janes@sfu.ca.
Craig
C
Janes
Simon Fraser University, Blusson Hall 10516, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. mce3@sfu.ca.
Melanie
M
Ewan
D003695:Delivery of Health Care; D005260:Female; D006078:Government Programs; D006282:Health Personnel; D006285:Health Planning; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D008483:Medical Assistance; D057193:Medical Tourism; D008986:Mongolia; D036301:Qualitative Research