What is Known about the Effects of Medical Tourism in Destination and Departure Countries? A Scoping Review.

Background: Medical tourism involves patients intentionally leaving their home country to access non-emergencyhealth care services abroad. Growth in the popularity of this practice has resulted in a significant amount ofattention being given to it from researchers, policy-makers, and the media. Yet, there has been little effort tosystematically synthesize what is known about the effects of this phenomenon. This article presents the findings ofa scoping review examining what is known about the effects of medical tourism in destination and departurecountries. Methods: Drawing on academic articles, grey literature, and media sources extracted from18 databases, we followa widely used scoping review protocol to synthesize what is known about the effects of medical tourism indestination and departure countries. The review design has three main stages: (1) identifying the question andrelevant literature; (2) selecting the literature; and (3) charting, collating, and summarizing the data. Results: The large majority of the 203 sources accepted into the review offer a perspective of medical tourismfrom the Global North, focusing on the flow of patients from high income nations to lower and middle incomecountries. This greatly shapes any discussion of the effects of medical tourism on destination and departurecountries. Five interrelated themes that characterize existing discussion of the effects of this practice were extractedfrom the reviewed sources. These themes frame medical tourism as a: (1) user of public resources; (2) solution tohealth system problems; (3) revenue generating industry; (4) standard of care; and (5) source of inequity. It isobserved that what is currently known about the effects of medical tourism is minimal, unreliable, geographicallyrestricted and mostly based on speculation. Conclusions: Given its positive and negative effects on the health care systems of departure and destinationcountries, medical tourism is a highly significant and contested phenomenon. This is especially true given itspotential to serve as a powerful force for the inequitable delivery of health care services globally. It isrecommended that empirical evidence and other data associated with medical tourism be subjected to clear andcoherent definitions, including reports focused on the flows of medical tourists and surgery success rates.Additional primary research on the effects of medical tourism is needed if the industry is to develop in a mannerthat is beneficial to citizens of both departure and destination countries