title: Cross-border movement of older patients: a descriptive study on health service use of Japanese retirees in Thailand.
abstract: Thailand's policy to promote long-stay tourism encourages Japanese retirees to relocate to Thailand. One concern of such an influx is the impact of these elderly foreign residents on the Thai health system. This study aims to reveal the current use of and needs for health services amongst Japanese retirees residing in various locations in Thailand.
  
  
  
  In collaboration with nine Japanese self-help clubs in Bangkok, Chiang Mai, Chiang Rai, and Phuket, questionnaire surveys of Japanese long-stay retirees were conducted from January to March 2015. The inclusion criteria were being ≥ 50 years of age and staying in Thailand for ≥30 days in the previous 12 months while the main exclusion criteria included relocation by company, relocation due to marriage, or working migrants.
  
  
  
  The mean age of the 237 eligible participants was 68.8, with 79.3% of them being male, 57.8% having stayed in Thailand for ≥5 years, 63.3% having stayed in Thailand for ≥300 days in the previous 12 months and 33% suffering from chronic diseases or sequelae. Of the 143 who had health check-ups in the previous 12 months, 48.3% did so in Thailand. The top 3 diseases treated either in Thailand or Japan in the previous 12 months were dental diseases (50 patients), hypertension (44 patients), and musculoskeletal disorders (41 patients), with the rate of treatment in Thailand standing at 46.0, 47.7, and 65.9%, respectively. Of the 106 who saw a doctor in Thailand in the same period, 70.8% did so less than once a month. Only 23.2% of the participants preferred to receive medical treatment for serious conditions in Thailand. However, this number rose to 32.9% for long-term care (LTC) use.
  
  
  
  The usage of Thai health services amongst Japanese long-stay retirees is currently limited as they prefer going back to Japan for health screenings and treatment of chronic or serious diseases. However, the number of Japanese residents requiring health services including LTC and end-of-life care is expected to increase. The potential impact of promoting long-stay tourism on the Thai public health should be acknowledged and investigated by the Thai government, including the tourism authority.
authors.affiliation: International Health Policy Program, Thailand, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand. yumiko@ihpp.thaigov.net.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Miyashita
authors.affiliation: International Health Policy Program, Thailand, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand.
authors.forename: Chutima
authors.initials: C
authors.lastname: Akaleephan
authors.affiliation: World Health Organization, Regional Office for South East Asia, World Health House, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi, 110002, India.
authors.forename: Nima
authors.initials: N
authors.lastname: Asgari-Jirhandeh
authors.affiliation: Previously with International Health Policy Program, Thailand, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand.
authors.forename: Channarong
authors.initials: C
authors.lastname: Sungyuth
mesh_terms: D000368:Aged; D003695:Delivery of Health Care; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D011159:Population Surveillance; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology; D014171:Transients and Migrants / Q000706:statistics & numerical data
keywords: Health service use; Japanese; Long-stay tourism; Retirees; Thailand; Trade in health services