Medical Tourism

Institutional Affiliation

Student Name

Course

Date

Medical Tourism

What are the ethical issues and challenges facing medical tourism implementation and how can
it be improved.

Aims:

To identify challenges in the implementation of medical tourism.

Analyses and synthesize relevant research and use the information to develop an action plan to
facilitate the implementation of Medical tourism.

Objectives:

To identify problems that hinder the implementation of Medical tourism.

To consider ethical issues relevant to medical tourism in this setting.

To establish is medical tourism is being implemented the right way.

To look at ways to improve medical tourism for effective treatment.

Framework for proposal

The framework proposed by Punch (2016) will be used to clarify and justify the approach,
method and design suggested in this proposal.

Background

Medical tourism is a growing industry in the world today. It comprises of situations where
patients move from their home country to go and look for treatment abroad. The number of
patients looking for various treatment abroad increases each day. Especially those suffering
from chronic, dental, and cosmetic treatment. The most affected area in the south-east of Asia.
Different issues come up during the medical tour and these issues raise other medial legal
factors and concerns that affect the patient. This includes patient follow-up and patient
handling of the foreign country. There should specialists who are experts in offering advice to
patients concerning their travel, treatment strategies and also provide advice relating to the
health of the patient looking for treatment in a foreign country (Heung, 2016).

Different countries apply different criteria while handling patients. Over time, it has been noted
that there is unreliability in the assessment procedures for health care quality and this differs
from one country to the other. Another challenge is the insufficient information provided to
patients regarding the risk and complication involved in medical tourism. On the health ethical
issues, there have been inadequate policies to govern all ethical issues. Handling of
international patients needs legal policies which clearly states who patients from other
countries are handled (Heung, 2016).

Most of the time patient s are not aware of the conditions and requirements for their
treatment. The information given is inadequate affecting their planning and the overall
treatment process. Due to the nature of these diseases, patients have very slight control in the
decision-making process where they can give suggestions of where they would prefer to go and
how the treatment process should be handled. Research has shown that people in
underdeveloped countries are the most affected and they tend to look for help to the
developed country. This is because of the cost implication attached to the facilities and
equipment needed for the specific treatment.
This literature review will help in providing information necessary to streamline the medical
tourism process right form the patient, doctor, and the engaged countries. The review will also
help in deepening the understanding of factors affecting medical tourism, the challenges people
face in this setting, and how they can be mitigated to improve this mode of treatment. In
general, medical tourism is of great importance for it helps patients recover from diseases that
would otherwise take them to grave if treatment is not sorted from the right specialists who
have the required knowledge and the necessary equipment for the specific kind of treatment.

Preliminary literature review

The publication of Medical tourist issues has not been that aggressive and less information is
available to people who could require it in one way or the other. This preliminary review will
give in detail what is already known concerning medical tourists and by use of synthesis and
analysis of findings, give the response regarding the research question being asked. The medical
tourist aspect should be a platform to give new hope to millions of people who might be
suffering in their countries without help. So, strengthening this sector will not only give a new
look to the health sector worldwide but also give health institutions in underdeveloped
countries a new look (Hanefeld et al, 2015).

The demand for good health services has been a worldwide phenomenon connected to the
social-economic development of people. The increase in the population of the aged,
environmental changes, the high cost of treatment in our home country, low standards of
living, and desire for improved health services have been some of the factors contributing to
the rising of the number of people suffering from chronic deceases. Sometimes people move in
search of affordable services and services which are not available at their homes. The globe has
been inter-linked especially in the health sector starting from manufacturing, supply, and trade
of medical equipment between countries. Research done by Dr. Hongs (2014) revealed that
there is an exponential growth in the number of Chinese people looking for treatment in the
U.S where the growth was estimated to have grown with up to 400 percent. The Chinese come
to the U.S mostly for oncological needs. A group of researchers in Texas at A&M Center
suggested that there will be an increase of medical tourists in the US due to the increased
wealth for the wealthy social class and because of development brought about by the internet.
Dr. Hong also pointed on the information provided to the international patients saying that
there is a need to have strategies laid that shall ensure international patients are provided with
key information and policies which shall enable them to make informed decisions regarding
their health.

The global community should come up with ways to streamline medical tours by understanding
the barriers that affect effective medical tourists. Also, getting insights on how these barriers
can be overcome. This review mainly analyzes these aspects to make the medical tour better
and beneficial to all people. Every person has the right to access information especially when it
comes to one's health. But it has been noted that there has not been a clear communication
channel between the health care centers and the patients. This makes it hard for patients to
make decisions since their decisions will lack fundamental facts as far as medical tours are
concerned (Fetscherin, 2016).

Due to lack of sufficient information, patients under the medical tour program sometimes akes
uninformed decisions out of desperation. This is because it's the responsibility of that country
to have polices on ready which are used to guide the conduct of medical tours. The government
should also come in to regulate the pricing systems to ensure all health care services are
affordable to all people regardless of your financial status.

There should be a formulated council set apart in every country whose work is entire to offer
guidance to international patients and provide all necessary support including information and
advice. The state of mind of the medical tourist is never stable during this time and often they
tend to make irrational decisions that may affect them later out of desperation. Patients tend to
behave differently and this makes them make different choices concerning their health state, so
what should be provided is just guidance on how they should conduct themselves in the new
country but not to be given directives on how and what do conduct themselves. The same
applies to decisions regarding the treatment procedures, there should be a room where the
patient in entirely involved in any procedure taken during the treatment phase (Lunt et al,
2013).

Methodology.

The goal of this research is to do a literature review to realize the better quality and relevant
findings that shall be synthesized, appraised, and then analyzed to get more understanding on
how Medical Tourists should be implemented. An introductory engagement has been done in
the ` preliminary of this review and it has been noted that some good steps and development
have been done especially in south-east Asia and the US where they deal with specific diseases
and they can give informed treatment. However, the implementation process in these two
countries has been faced by certain identified problems which help in forming the basis of this
research question (Nicola & Kai, 2015).

Countries such as India also helps in providing research finding on the issue. This helps to
increase the size of the knowledge base where insights for our research question will be found.
Different countries have different settings that make our research diverse and unbiased. By this,
the researcher will be able to apply knowledge from different backgrounds to come up with a
concrete answer to the research question. To get quality and the best review, there is a need to
use a systematic approach without being subjective (Caballero-Danell & Mugomba, 2017).

To have a well-developed, applicable, and reduced biasness, pre-defined research terms,

inclusion method, and approach exclusion criteria shall be exercised to note significant studies.
It has been projected that a range of distinct findings approaches shall be identified and this will
enable the application of a descriptive approach rather than the application of meta-analysis.
The meta-analysis approach is applicable when the research is interested in determining the
size and effects of size and result by synthesizing the analysis on statistics of stated similar
findings like trials done randomly (Aveyard, 2017).
Due to the nature of this research question, the primary data collection method could be used
where the research would engage in interviews with groups of professionals like doctors,
patients, and government agencies to respond to questions that made give answers to the
research question. Primary methods such as observation could also be applied where the
researcher will schedule some time to observe the behavior of medical tourists and out of their
conduct derive answers for the research question. However, the primary method for data
collection is expensive and time-consuming, and relying only on this method might provide data
that is not complete. This call for embracing other methods which in turn are integrated to
provide findings that are complete and systematic. Another aspect is the ethical part for the
Medical tourists. The data collection method must provide answers to all sides of the research
questions, and following only the primary data collection method the aspect of ethics might be
missed (Tidwell, 2013).

Sample/ Methods of data collection

Through the systematic method, the literature shall be noted using important keywords from
databases such as PsycInfo, PubMed, Emerald, and MEDLINE. Also, the use of journals, peer
published and reviewed studies will help to eliminate biasness in the research findings.
Unpublished work sometimes can also be used since it may provide more insight into the
research. The use of different databases during a search is important since this will give a
diverse and distributed view which brought together forms a strong reviewed finding (Gill,
2018). Biasness is often encountered when researchers rely on one search form or database
and this may take away the feeling and touch of data accuracy. Search repetition in the given
databases also helps in retrieving all necessary information that may be of help answering the
research question.

Inclusion criteria

Exclusion criteria

Primary peer-reviewed Study

Studies were done in other languages rather than English

Unpublished Work

Untrusted Data

Government policies

Children work

Work from 1990 to date

Work from mentally challenged people

Specialist opinion

Reasons for inclusion approach and exclusion method or criteria:

The unique significance of applying the inclusion method is to ensure data collected is within
the required range. For example, the range of years used is to ensure, the research only works
with data from the time Medical tours began today. This will give a historical and systematic
report on how medical tour began and the challenges that have been implemented over the
years and mostly where the issues stand currently. Primary data for research is the best in
proving timely and relevant information giving on-site evidence that can be used to draw
important conclusions during the research (Patino, 2018). The use of experts involved in
medical tours is of great importance, this is because they provide hand on information that is
most relevant to the topic of study. Experts on this matter are specialists whose domain of work
is dealing with medical tourists. They understand problems the medical tourists face and they
well understand the required recommendations to improve this health sector. Experts carry the
practical part of it and any information shared with us backed up by real experiences though
the procedure must be carefully done (Kazemi, 2018).

Unpublished work will also be used to ensure every information relevant to the research is
found and recorded. Experiences of people who have undergone the process are of great
significance though they might not be published. Countries, where medical tours have been
implemented, provide a good example where hospitals involved can give information on how
they have been operating and also give examples of challenges they have been experiencing
since they began (Aust Fam Physician, 2015).

Involving the governments for different states help in identifying different policies set and
implemented by different countries. Since the research id did and documented in English, the
resources used shall be in the English language to avoid omission of important details that
might be left behind during translation. The people involved during data collection must be of
sound mind. This is to ensure data collected is correct and reliable. Children shall not be used in
data collection since they may lack the necessary knowledge to answer as far as the research
question is concerned.

Methods/Access

The following table shows the terms used during the search together with synonyms. Some of
these names shall be used interchangeably and frequently used throughout the research
(Meline, 2016).

Search term:

Medical Tourist

Patients

Experts
Hospital staff

Ethics

Synonyms

Medical Tours

Hospitalized

Hospital

Secondary care

Specialists

Nursing staff

Hospital staff

Multi-disciplinary team

Doctors

Medics

Mental Capacity

Wildcards and truncation

Medical Tour Plan

Hospitalized

Diseases

Ethic*

Wildcards and truncation

Data collection: Appraisal, Synthesis, and Analysis

For a literature review to be complete there must be three steps that should guide the process.
This process involves assembling and data gathering, synthesizing, and analyzing. During the
initials steps of data collection and assembling, data is thoroughly to validate the correctness of
the work presented and check its relevancy. Then selected works are then critically validated to
identify their limitations, strengthens, their relevance as far as the research question is
considered. Advanced tools used for data critique shall be employed to give guidance to the
data verification process. For this research, a Critical review form for quantitative work shall be
employed. This tool presents evidence-based guidance on how the questions have been
created and provides a guideline to the users especially for the work that needs to be
appraised. The appraisal process is significant since it provides information on whether data
collected can provide sufficient and convincing evidence that can be used to conclude the
research. The findings shall later be recorded correctly and verified to ensure only relevant data
is recorded (Okoli & Schabram, 2015).

After the proper recording of all verified studies, they are further grouped into a tally matrix
where arguments on each study are checked to ensure whether the data is relevant or it's still
questionable. This analysis is to ensure the research findings provided the relevant answers to
the research question. The step by step analysis ensures that the research reaches a justified
conclusion that shows that the findings have been critically reviewed, corrected, and critiqued
using the best methods (Snyder, 2015).

Ethical Issues

Ethical issues are things that people and organizations have to make decisions between given
alternatives which need to be evaluated to be right (ethical) or wrong.everything that is done
should be ethically right and accepted deep down the hearts of people. The study done should
be ethically right in its implementation and any other process attached to it. The study ensures
all ethical codes and values are adhered to by providing original records that have not been
plagiarized. In the case of using someone else's information, it shall be referenced appropriately
(Beecher, 2015). As far as there are laws that govern any particular state, lawyers always put
aside what is written as asked themselves where the lawing to be made it ethically right or
wrong. Any development or improvement especially in the health sector should ensure the
values of people in that particular country are not violated. When a subject is ethically correct,
people tend to embrace it so fast unlike when it comes to the implementation of a project that
goes against the values and believes of the people.

Rigor

Rigor represents the accuracy of the data collected and used for research purposes. To ensure
accuracy, care must be taken during the data collection process, analysis phase, and recording
to ensure the information recorded is of the best quality and is beneficial to the research done.

Accuracy of the study shall be achieved by ensuring that the research has been done following
an arranged and systematic way. Search terms should be provided in the method and rationale
on why to use the selected method given. Use of the right tools for critique and appraisal
throughout the study. In conclusion, it shall be carefully done to ensure that conclusion given
has been generalized (Bettany, 2012). The most critical part of this particular research is in the
method of data collection used, how the data was analyzed, and how was the findings
recorded. If all steps are done as expected, it would be a clear indication that the data provided
is authentic and can be trusted.

Limitation

Working under a tight time frame and the research being a post-graduate work requires careful
consideration to ensure getting the best results. Activities outlined in the work frame should be
done and deliverables presented at the required stages. The student should use the skills
learned before to ensure data synthesis and analysis are done systematically. Be careful to note
every step taken to advance skills on the subject matter. The time set is for ensuring no step as
been skipped and that all deliverables are presented at the right time.

Time frame

Time frame is a planned schedule used in project management tas a guide in ensuring project
activities are done on time and deliverables expected received the right time. Every activity
must feature somewhere in the time frame to ensure no step has been skipped. The
completion of a single stage in timeframe leads to another activity within the time frame.
Therefore all activities in this research project are linked together to form one systematic
method for project implementation.

Activity/Month

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep
Oct

Nov

Dec

Scoping Search

Develop Question

Write Background

Prelim Review

Search And Select

Appraise

Synthesis/Analysis

First Written Draft

Edit And Re-Write

Action Plan

Dissemination

The study shall be used to form a prototype of setting up a better Medical Tour where medical
tourists shall enjoy better health services. This work remains privately owned and anyone
desiring to be part of its application or own it should first request permission to the relevant
body.

References

Aust Fam Physician. (2015, January 16). PubMed.

Aveyard H (2017) Doing a literature review in health and social care: a practical guide (2nd
Edition). Maidenhead: McGraw-Hill Open University press

Beecher, H.K., (2016). Ethics and clinical research. In Biomedical ethics and the law (pp. 215-
227). Springer, Boston, MA.
Bettany- Malikov J (2012) How to do a systematic Literature review in Nursing. A step-by-step
guide. Maidenhead: McGraw-Hill Open University press

Brooks, E. M., Magee, M. L., & Ryan, M. (2018). Fostering transformative learning, self-
reflexivity, and medical citizenship through guided tours of disadvantaged neighborhoods.
Medical education online, 23(1), 1537431.

Caballero-Danell, S., and Mugomba, C., (2017). Medical Tourism and its Entrepreneurial
Opportunities-A conceptual framework for entry into the industry. rapport nr.: Master Thesis
2006: 91.

Canonico, M., & De Russis, L. (2018). A comparison and critique of natural language
understanding tools. Cloud Computing, 2018, 120.

Fetscherin, M., & Stephano, R. M. (2016). The medical tourism index: Scale development and
validation. Tourism Management, 52, 539-556.

Flick, U. (2015). Introducing research methodology: A beginner's guide to doing a research

project. Sage.

Gill, P., Stewart, K., Treasure, E., and Chadwick, B., (2018). Methods of data collection in
qualitative research: interviews and focus groups. British dental journal, 204(6), pp.291- 295.

Hart, C. (2018). Doing a literature review: Releasing the research imagination. Sage.

Hanefeld, J., Lunt, N., Smith, R., and Horsfall, D. (2015). Why do medical tourists travel to where
they do? The role of networks in determining medical travel. Social Science & Medicine, 124,
pp.356-363.

Heung, V.C., Kucukusta, D. and Song, H., (2016). Medical tourism development in Hong Kong:
An assessment of the barriers. Tourism Management, 32(5), pp.995-1005.

Kazemi, Z. (2018). Study of the effective factors for attracting medical tourism in Iran.

Mackey, A., & Gass, S. M. (2015). Second language research: Methodology and design.
Routledge.

Meline, T., (2016). Selecting studies for systemic review: inclusion and exclusion criteria.
Contemporary issues in communication science and disorders, 33(Spring), pp.21-27.

Nicola, S. P. & Kai H. P. (2015, May 4). Medical tourism and policy implications for health
systems: A conceptual framework from a comparative study of Thailand, Singapore, and
Malaysia. Globalization and Health.
https://globalizationandhealth.biomedcentral.com/articles/10.1186/1744-8603-7-12
Okoli, C. & Schabram, K., (2015). A guide to conducting a systematic literature review of
information systems research.

Patino, C.M. & Ferreira, J.C., (2018). Inclusion and exclusion criteria in research studies:
definitions and why they matter. Jornal Brasileiro de Pneumologia, 44(2), pp.84-84.

Snyder, J., Crooks, V.A., Adams, K., Kingsbury, P. & Johnston, R., (2015). The 'patient's physician
one-step removed': the evolving roles of medical tourism facilitators. Journal of Medical ethics,
37(9), pp.530-534.