The magic of medical tourism numbers

Ian Youngman, healthcare industry specialist and author of the IMTJ Medical Tourism Facts and Figures 2018, shows how hard it is to get real numbers for the global medical tourism industry.

There are no accurate official or unofficial medical tourism statistics

It is almost impossible to put a figure on the size of the medical tourism market. By adding together the known and unknown, and excluding domestic medical tourism, health and wellness and spas, the inbound country figures give a clue. This would give us a global medical tourism figure of seven million medical tourists, a figure mostly unchanged for six years.

I’ve been collecting, analysing and publishing facts and figures on medical tourism for 12 years, and I’m getting increasingly frustrated with the continual use of figures that have often already been discredited.

Unfortunately, it suits politicians, conference organisers and some consultants to continually circulate these figures, as it either exaggerates the importance of some countries or overstates their potential. It also has the reverse effect of damaging realistic figures and estimates from other countries, and downplays real achievements.

Boosting the numbers

An international medical tourist is one who goes from where they live to another country, primarily for healthcare or health treatment. Many people make the mistake of equating “international patients” with “medical tourists”.

Ways of boosting numbers artificially:

  • Counting the number of visits to hospital, not patients.
  • Including people buying legal drugs from pharmacies at hospitals and clinics, who have never been an inpatient or outpatient.
  • Counting citizens who are not in a health scheme as international patients.
  • Counting international patients (residents who hold foreign passports) instead of medical tourists.
  • Including health and wellness tourists.
  • Including any foreign passport holder who visits a spa, or even a ski resort with a spa.
  • Including any foreign passport holder who visits a hotel with a spa.
  • Including resident expatriates.
  • Including expatriates who live abroad who still have a local home and return home for treatment.
  • Including new immigrants, being treated as non-residents.
  • Counting refugees as international patients.
  • Counting war injured patients as medical tourists.
  • Including international students.
  • Including diplomats of foreign countries.
  • Including the military and their families at bases in the destination country.
  • Counting all nationals with dual nationality as foreigners.
  • Including tourists who fall ill or have an accident.
  • Including business travellers who get ill or have an accident.
  • Including temporary workers from overseas.
  • Including groups who decide not to become citizens.

Definition: Medical tourism or health tourism?

Many countries and organisations regularly use the terms health tourism and medical tourism as interchangeable. So, when a figure is stated for medical tourism, it may or may not include health tourism and/or spa tourism. And health tourism may or may not include medical tourism and/or spa tourism. Many figures originate in a native language so it can even depend how the original version is translated!

Beware round numbers

Over the years I have learnt to distrust national figures that are conveniently rounded up such as 25,000 or 250,000 or a million.

These often mean that they are a best guess, a wild guess or just political hope or hype.

Disappearing figures

When a country is doing well, it is keen to shout about their growing numbers. But if numbers fall, then the new numbers never seem to appear, or they get hidden or are even written out of history.

Be cautious about the source

You may be a medical tourism expert, but many journalists or PR types who write stories about the market may have very little information. So, they can change health to medical tourism or change international patients to medical tourists either because they fail to grasp the difference, or it suits their story or client better.

Actual figure or future target?

I recently read a feature that seemed to suggest that a new study had health tourism figures for Mexico for 2016 and 2017. It even gave the source and a link. When I followed up the link, I found that the figures were from a 2015 study that used a range of sources dating back to the 1980s.The only way a 2015 study could produce 2016 and 2017 figures is to convert future estimates into past reality. Organisations and politicians are sometimes tempted to confuse future targets with actual figures.

“My figures are better than your figures”

Some countries have two, three or even four organisations involved in medical and health tourism and they all produce figures. Sadly, they very rarely agree with each other. Amusingly, in some cases organisations fail to remember what the last figure they gave out was, so you can get the same organisation offering a range of figures for the same time period; this is often a clue that the statistic was the equivalent of sticking a finger in the air and guessing.

Be sceptical of big increases

Anyone new to medical tourism has a problem in sorting out good from questionable figures, as they have nothing to compare with the ‘official’ figures. Having done this for 12 years, I have developed a feel for whether the figure is true or is made up. If a country has five years of similar or slowly increasing figures, that suggests a pattern. If they suddenly then announce a figure twice that of the previous year, then it’s suspicious.

Linking to general tourism figures

There is no direct link between tourism and medical tourism numbers, but medical tourists often tend to be from countries that are big tourism providers to that country. So if political problems, currency changes, war or other factors drastically reduce tourism numbers from country A to country B, but the official figures claim that medical tourism figures from country A to country B are still increasing, it suggests a serious element of misdirection or even lies.

Should domestic medical tourism be added?

If I travel a few miles from one country to another for treatment, then I am a medical tourist. If I travel 1,000 miles across states in the USA (or likewise within China or Russia) for the same treatment, then I am a domestic medical tourist. Figures between European states relate to medical tourism, but between US states relate to domestic medical tourists. So there is an argument that to get a true picture of global medical tourism, domestic medical tourism must be added to the total. But where do you stop? Across the state, overnight stays or 20 miles from home? The variables are endless.

Measuring market potential is impossible

If you asked people: Would you like a return space trip to the moon? You might get 90% saying YES.

If you then asked: Would you take that one hour $1 million trip if you had to sell your house, car, pension, savings and business? Then the numbers saying YES would probably drop to 0.000000009%.

Just like this example, trying to assess global medical tourism potential is impossible due to the sheer number of variables in the decision making process for each individual medical tourist.

Catching fog

Collecting and analysing medical tourism figures can therefore be like trying to bottle fog. You think you have it, but when you look at it again it has transformed into air or water or nothing.

No medical tourism figures can ever be perfect, but I do the best I can based on using thousands of sources over more than a decade, trusting nobody and having a feel for what is true and what is fiction.

Buy the IMTJ Medical Tourism Facts and Figures 2018 Report

Written by Ian Youngman, our latest report provides information on inbound and outbound medical tourism for 165 countries.

Unlike other reports, it does not take claims of volume and value of medical tourism as fact; it questions the data, analyses its credibility and provides an independent assessment of its validity.

The IMTJ Medical Tourism Facts and Figures 2018 Report is the most comprehensive report available on global medical tourism and is compiled by an author who has been researching and writing about medical tourism for the last twelve years.