Samsudin Mohd Fauzy, Lim Yin Cheng, Rochmah Thinni Nurul, Dahlui Maznah
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, MYS.
Department of Health Administration and Policy, University of Airlangga, Surabaya, IDN.
Cureus. 2024 Jul 11;16(7):e64308. doi: 10.7759/cureus.64308. eCollection 2024 Jul.
Background Malaysia has been one of the most prominent destination countries for medical tourism. The industry received significant government support to create a conducive environment for its growth, such as the provision of an investment tax allowance for the facilities participating in medical tourism and the establishment of the Malaysia Healthcare Travel Council (MHTC) to coordinate collaboration between various industry stakeholders to promote medical tourism activities at the international level and facilitate inbound medical tourists. The establishment of the MHTC facilitates collaboration between various industry stakeholders. In addition to facilitating medical tourism activities, MHTC is also involved in analysing relevant data, including but not limited to the socio-demography of medical tourists, the trend of their healthcare service utilisation, revenue generated, and market intelligence to promote the industry's growth. The council serves as a medium to facilitate the collaboration of stakeholders such as the hospitals participating in medical tourism, the Association of Private Hospitals Malaysia, the Malaysian Society for Quality in Health, and various government agencies, including the Ministry of Health and the Department of Immigration, Malaysia. We explore the policy-related implications of medical tourism and its relationship with the Malaysian national healthcare system. Methodology We revisited Pocock and Phua's conceptual framework of policy implications for medical tourism to explore its relevance after more than a decade of intensive government support and the aftermath of the COVID-19 pandemic. We employed a qualitative case study design using semi-structured, in-depth interviews with stakeholders from the Ministry of Health Malaysia, the private health sector, professional bodies, academics, and health-related civil society organisations. Results Our study found that many issues identified in the original framework remain relevant after over a decade. However, we also identified additional implications, such as the role of insurance portability in encouraging the growth of international hospital accreditation and the issue of equitable access to healthcare within the context of the current Malaysian healthcare system in the aftermath of COVID-19. Conclusion Due to its vulnerability, there is a need to develop a strategic collaboration that includes incorporating medical tourism activities into a broader framework, such as promoting aged care within the retirement destinations package for expatriates, which could ensure its sustainability instead of relying solely on medical tourism activities. In the meantime, policy implications arising from the industry remain relevant and should be addressed through a comprehensive structural reform of the national healthcare system involving stakeholders from the public and private health sectors.
背景
马来西亚一直是医疗旅游最著名的目的地国家之一。该行业得到了政府的大力支持，以营造有利于其发展的环境，例如为参与医疗旅游的设施提供投资税收减免，以及成立马来西亚医疗旅游理事会（MHTC），以协调各行业利益相关者之间的合作，在国际层面推广医疗旅游活动，并为入境医疗游客提供便利。MHTC的成立促进了各行业利益相关者之间的合作。除了推动医疗旅游活动外，MHTC还参与分析相关数据，包括但不限于医疗游客的社会人口统计学、他们的医疗服务利用趋势、产生的收入以及市场情报，以促进该行业的发展。该理事会作为一个媒介，促进了参与医疗旅游的医院、马来西亚私立医院协会、马来西亚健康质量协会以及包括马来西亚卫生部和移民局在内的各政府机构等利益相关者之间的合作。我们探讨了医疗旅游的政策相关影响及其与马来西亚国家医疗系统的关系。
方法
我们重新审视了波科克和傅华关于医疗旅游政策影响的概念框架，以探讨在政府十多年的大力支持以及新冠疫情之后其相关性。我们采用了定性案例研究设计，对马来西亚卫生部、私立医疗部门、专业团体、学者以及与健康相关的民间社会组织的利益相关者进行了半结构化的深入访谈。
结果
我们的研究发现，在十多年后，原始框架中确定的许多问题仍然相关。然而，我们也发现了其他影响，例如保险可携带性在鼓励国际医院认证增长方面的作用，以及在新冠疫情后马来西亚当前医疗系统背景下医疗保健公平获取的问题。
结论
由于其脆弱性，有必要开展战略合作，包括将医疗旅游活动纳入更广泛的框架，例如在为外籍人士提供的退休目的地套餐中推广老年护理，这可以确保其可持续性，而不是仅仅依赖医疗旅游活动。与此同时，该行业产生的政策影响仍然相关，应通过涉及公共和私立医疗部门利益相关者的国家医疗系统全面结构改革来解决。
