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E saogalemu le turisi faʻafomaʻi?

Restricting Growth:

Lengthy partial reimbursements by payers and difficulties associated with travel, language barriers, availability of documentation and VISA approval issues impede the growth of medical tourism.

The Covid 19 pandemic and its impact on the global economy has disrupted the industry creating uncertainty in demand for specific products and limited availability of medical and industrial applications.

The countries severely impacted by Covid 19 include India, and China. In addition, travel restrictions and suspension of cross-border transportation has brought international travel to a halt, adversely impacting on the growth of medical tourism.

Iloa Ae E te leʻi alu:

Patients can save from 30-80 percent of the total treatment costs by leaving the USA. Low costs and easy availability of labor is a primary incentive for the increased interest in medical tourism destinations.

Malaga ma se mafuaʻaga: Fafo turisi

For travelers interested in pursuing medical tourism, a full and complete research effort should include the accreditation and/or certified skill level of the provider and the facilities. Two organizations (on an international level) offering insight into the educational, skill, knowledge and background of facilities and practitioners include the Joint Commission International (considered the gold standard for international credentialing). Their seal is considered to be internationally a sign that a hospital operates with the highest standards. The International Organization for Standardization (ISO) includes approximately 100 countries and ISO90000.2001 is designed as a management tool to achieve control and consistency in all aspects of business, from technical to administrative.

Faʻagasolo ma le faʻaeteete:

For people contemplating medical tourism healthcare professionals recommend a visit to a US travel medicine specialist at least one month before departure to ensure that their medical conditions are well controlled, have adequate medication and receive appropriate vaccinations. Medical tourists are also advised to verify the qualifications of the individuals providing their care and the credentials of the facility where they will be treated. It is critical to be aware of the fact that foreign standards for healthcare providers and facilities may be different from those of the United States, and all procedures carry risks.

Host countries frequently have no or lax enforcement of malpractice laws, posing additional risk. Little or no malpractice insurance costs allow developing country practitioners and facilities to maintain low prices but leave medical tourists with few options if malpractice is suspected. In Singapore and Malaysia, courts overseeing malpractices suits defer to the opinions of attending physicians, essentially requiring a doctor to “confess” to malpractice in order for any compensatory damages to be awarded.

It may not matter to many medical tourists; however, the concentration of host countries on foreign medical travelers is, in fact, denying benefits to the poorer citizens in these developing countries and the use of medical services is considered a generic equity issue.

Malaga ma se mafuaʻaga: Fafo turisi

The medical tourist should also be concerned with the reality that government and basic medical insurance may not cover international medical procedures requiring patients to pay in cash. In addition, there may be little postoperative care for potential negative side effects as recovery needs vary on the basis of the nature of the procedure. Some markets offer recovery retreats with a 24-hour trained nursing staff, while others offer recovery time at hotels or lodges several miles away from the physician and patient after surgery, greatly increasing the response time could create post-operative complications.

Before Committing:

Malaga ma se mafuaʻaga: Fafo turisi

When all the features, advantages and benefits have been analyzed along with risks, potential medical tourists should look closely at their current health insurance policies and plans. Most travelers heading to Thailand, Singapore, Malaysia and India have pre-paid for their medical treatment; however, if they experience medical complications or have to cancel the trip, without additional insurance, they may be unable to recover their costs and experience higher than anticipated medical expenses.

For travelers who have pre-paid their medical treatment and want protection against the high costs associated with medical complications additional insurance may be a viable option if there is an interest in protection of the financial investment in case the trip is cancelled. There may also be an advantage to acquiring evacuation coverage in case the patient has to be moved to another medical facility. It may also be useful to acquire insurance for incidents unrelated to medical treatment.

Malaga ma se mafuaʻaga: Fafo turisi

Risk Review

1.            Infections: One of the biggest risks is infections. Other countries have different standards of sanitation and medical facilities may present a challenge. Infections can occur anywhere for a wide variety of reasons, including unsanitary practices and facilities and/or the equipment used during surgery may not be sterile. Bacterial and viral infections are a major health risk. HIV and hepatitis from dirty needles and surgical equipment could present a problem. Check out all facilities (domestic and foreign) before they are necessary.

2.            Medication dangers. Counterfeit medications are not confined to one country; however, the quality may differ from one hospital to another and from one country to another. Research the doctor and the pharmacy before venturing abroad.

3.            Communication barriers can put a glitch in medical treatments. If you do not speak the language of the host country your ability to share your issues with your medical team may send the professionals in the wrong direction, even when an interpreter is available.

4.            Blood transfusions may be required during or after treatment so it is imperative that the foreign medical facility has high screening standards for blood donations. The standards vary and medical tourists may be at risk for hepatitis or HIV.

5.            Travel may create hiccups in medical plans. Air travel may increase the risk of blood clots. In addition, the combination of surgery and stress or fatigue following long multi-time zones flights can make the risk higher.

6.            Post-operative care protocols differ among hospitals and locales and the appropriate follow-up can often be crucial to the success of the procedure. Patients who travel abroad for medical treatment risk returning with complications or infections that require costly treatment. Check and document follow-up procedures (and associated costs) at the host country medical facility.

7.            Laws and lawyers. If there are issues with the surgery or treatment what are the legal remedies available? It may be difficult to pursue a legal remedy for your case as you may have no legal rights and unable to receive compensation for a mishandled surgery.

8.            Credentialled standards differ widely from hospital to hospital and from locale to locale. Will the professional selected be licensed and what are the specifics? Check the credentials of everyone and everyplace.

9.            There may be hidden costs. Medical tourism may appear to be a less expensive alternative – but are you sure? Require a written agreement with the health care facility or the group arranging the trip, defining treatment, supplies, medications, and care… covered (and not covered) by the costs associated with the trip. If additional hospital days are required and / or extra medical care is necessary, what are the costs associated with these situations?

Transplant tourism is part of medical tourism with a focus entirely on transplantation surgery. With a critical shortage of available organs in the US, transplant tourism has become popular. Currently the United Network of Organ Sharing (UNOS) reports there are more than 105,000 American on the transplant candidate waiting list with more than 15,000 patients awaiting a liver transplant. UNOS data shows a decline in donorship with living donor numbers decreasing by 1.7 percent and deceased donors down by 1.2 percent in 2008.

The AASLD and International Liver Transplant Society (ILTS) have positions against the exploitation of donors, the recovery of organs from executed prisoners and condemned the use of paid living donors. Can you verify that the organ you receive has been obtained in an ethical manner? You could potentially be contributing to the exploitation of lower income populations, teenagers, children or prisoners.

Malaga ma se mafuaʻaga: Fafo turisi

Contacts and Records

Before leaving your home for a medical procedure, make contact with your local doctor so he/she knows where you are going and what you are doing – just in case you need follow-up assistance when you return.

Have copies of your medical records that includes the lab and other studies done related to your condition for which you are getting the care and a list of allergies you have. Prepare copies of all prescriptions and a list of all the medicines taken, including the brand names, generic names, manufacturers and dosage. Get copies of all medical procedures and meds administered for your treatment so you can share them with your home-based medical team.

Medical tourism can be dangerous, so it is critical to understand the risks prior to departure.

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Dr. Elinor Garely - faʻapitoa i le eTN ma le faatonu sili, uaina