Department of Global Health and Development, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
Health Policy. 2011 Dec;103(2-3):276-82. doi: 10.1016/j.healthpol.2011.06.009. Epub 2011 Jul 20.
With increasing globalization, many countries are considering opening their health systems to greater cross-border movement of patients. This is usually done from the viewpoint of a multi-lateral trade relationship. This paper considers the issues that arise from this debate from a bi-lateral perspective.
A systematic literature review was carried out on 'Medical Tourism' from the perspective of a bi-lateral trade relationship, using the UK and India as a case study.
There is a dearth of data and discussion on such bi-lateral trade. This limited evidence offers some suggestions. Exporting countries may benefit from medical tourism by generating foreign exchange and reversing the brain drain, but run the risk of creating a dual system, where the local population is crowded out. Importing countries can benefit from alleviating waiting lists and lowering healthcare costs, but may risk quality of care and legal liability. However, evidence from a bi-lateral perspective suggests that the positive aspects can be capitalised, and the negative ones reduced.
The key recommendations from this paper are for more evidence to be collected at the country and international level, and for countries to consider trade in health services from a bi-lateral rather than multi-lateral perspective.
随着全球化的不断推进，许多国家都在考虑向更大范围的跨境就医开放其医疗体系。这通常是从多边贸易关系的角度来考虑的。本文从双边关系的角度来探讨这一争论所引发的问题。
本研究采用英国和印度作为案例研究，从双边贸易关系的角度对“医疗旅游”进行了系统的文献回顾。
在这种双边贸易中，数据和讨论都很匮乏。这有限的证据提供了一些建议。出口国可以通过创造外汇和扭转人才外流来从医疗旅游中受益，但也存在创建双重体系的风险，使当地人口被排挤在外。进口国可以通过缓解等候名单和降低医疗保健成本从中受益，但可能面临医疗质量和法律责任的风险。然而，从双边角度来看，有证据表明可以利用积极的方面，并减少消极的方面。
本文的主要建议是在国家和国际层面收集更多的证据，并使各国从双边而不是多边的角度来考虑医疗服务贸易。
