Department of Geography, Simon Fraser University, Burnaby, British Columbia, Canada.
BMJ Open. 2013 Feb 8;3(2). doi: 10.1136/bmjopen-2012-002302. Print 2013.
Medical tourism involves patients' intentional travel to privately obtain medical care in another country. Empirical evidence regarding health and safety risks facing medical tourists is limited. Consideration of this issue is dominated by speculation and lacks meaningful input from people with specific expertise in patient health and safety. We consulted with patient health and safety experts in the Canadian province of British Columbia to explore their views concerning risks that medical tourists may be exposed to. Herein, we report on the findings, linking them to existing ethical and legal issues associated with medical tourism.
We held a focus group in September 2011 in Vancouver, British Columbia with professionals representing different domains of patient health and safety expertise. The focus group was transcribed verbatim and analysed thematically.
Seven professionals representing the domains of tissue banking, blood safety, health records, organ transplantation, dental care, clinical ethics and infection control participated.
Five dominant health and safety risks for outbound medical tourists were identified by participants: (1) complications; (2) specific concerns regarding organ transplantation; (3) transmission of antibiotic-resistant organisms; (4) (dis)continuity of medical documentation and (5) (un)informed decision-making.
Concern was expressed that medical tourism might have unintended and undesired effects upon patients' home healthcare systems. The individual choices of medical tourists could have significant public consequences if healthcare facilities in their home countries must expend resources treating postoperative complications. Participants also expressed concern that medical tourists returning home with infections, particularly antibiotic-resistant infections, could place others at risk of exposure to infections that are refractory to standard treatment regimens and thereby pose significant public health risks.
医疗旅游涉及患者有意前往另一个国家寻求私人医疗服务。关于医疗游客面临的健康和安全风险的经验证据有限。对这个问题的考虑主要是基于猜测，缺乏对患者健康和安全具有特定专业知识的人的有意义的意见。我们咨询了加拿大不列颠哥伦比亚省的患者健康和安全专家，探讨他们对医疗游客可能面临的风险的看法。在此，我们报告调查结果，将其与与医疗旅游相关的现有伦理和法律问题联系起来。
我们于 2011 年 9 月在不列颠哥伦比亚省温哥华举行了一次焦点小组会议，与会者代表了患者健康和安全专业知识的不同领域。焦点小组的讨论内容被逐字转录，并进行了主题分析。
七位代表组织库、血液安全、健康记录、器官移植、牙科护理、临床伦理和感染控制等领域的专业人员参加了会议。
与会者确定了五个 outbound medical tourists 的主要健康和安全风险：（1）并发症；（2）器官移植的具体问题；（3）抗生素耐药菌的传播；（4）医疗记录的（不）连续性；（5）（无）知情决策。
与会者表示，医疗旅游可能对患者的国内医疗保健系统产生意想不到和不理想的影响。如果患者所在国家的医疗保健机构必须花费资源来治疗术后并发症，那么医疗游客的个人选择可能会对其公共健康产生重大影响。与会者还表示关切的是，返回国内的医疗游客如果携带感染，特别是抗生素耐药性感染，可能会使其他人面临感染的风险，这些感染对标准治疗方案有抗药性，从而构成重大的公共卫生风险。
