Hashmi Saman K, Klein Sierra, Acharya Rushil, Mothi Suraj Sarvode, Boggs Jacklyn, Dodd Tracy, Johnson Liza-Marie
Department of Oncology and Hospitalist Medicine Program, St Jude Children's Research Hospital, Memphis, TN.
Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN.
JCO Glob Oncol. 2025 Apr;11:e2400454. doi: 10.1200/GO-24-00454. Epub 2025 Apr 16.
Medical tourism is defined as travel outside one's home country to seek medical care. International travel for medical care can have financial, logistical, and ethical implications for patients, families, and accepting institutions. Data on medical tourism in pediatrics are sparse, especially for care of rare or life-threatening diseases such as cancer. To our knowledge, this study provides the first description of international patients seeking medical care in the United States for oncologic and hematologic diseases.
We performed a retrospective review of international patients seen at St Jude Children's Research Hospital from August 2, 2009, through June 30, 2019. These included patients with acceptance obtained through the referral process and those who arrived without approval (walk-in patients). Demographic and clinical data were collected and analyzed using descriptive statistics.
Of the 372 international patients seen, most identified as White (n = 258; 69.4%) and not Hispanic (n = 232; 62.4%). A minority (n = 23; 6.2%) arrived as walk-in patients. The highest number of patients was from the Latin America and Caribbean region (n = 181; 48.7%) and from upper-middle-income countries (UMICs) (n = 182; 48.9%). Six patients (1.6%) were from low-income countries (LICs). Oncologic diagnoses were the most common reason for referral, with a similar distribution of accepted patients across hematologic, CNS, and non-CNS solid tumors although hematologic malignancies predominated among walk-in patients (n = 17; 81%).
International patients came to the United States from across the world, mostly through formal acceptance. However, there were more patients from UMICs at our institution than from low- and middle-income countries and LICs. Additional studies are needed to investigate this observation which supports the continuous need for global capacity-building collaborations in pediatric oncology.
医疗旅游被定义为在本国境外寻求医疗服务。出国就医会给患者、家庭及接收机构带来经济、后勤和伦理方面的影响。儿科医疗旅游的数据稀少，尤其是针对癌症等罕见或危及生命疾病的治疗。据我们所知，本研究首次描述了在美国寻求肿瘤和血液疾病治疗的国际患者情况。
我们对2009年8月2日至2019年6月30日在圣裘德儿童研究医院就诊的国际患者进行了回顾性研究。这些患者包括通过转诊程序获得接纳的患者以及未经批准前来就诊的患者（即自行前来的患者）。收集人口统计学和临床数据，并使用描述性统计方法进行分析。
在372名就诊的国际患者中，大多数为白人（n = 258；69.4%）且非西班牙裔（n = 232；62.4%）。少数患者（n = 23；6.2%）为自行前来就诊。患者数量最多的来自拉丁美洲和加勒比地区（n = 181；48.7%）以及中高收入国家（UMICs）（n = 182；48.9%）。6名患者（1.6%）来自低收入国家（LICs）。肿瘤诊断是转诊的最常见原因，尽管血液系统恶性肿瘤在自行前来就诊的患者中占主导（n = 17；81%），但接受治疗的患者在血液、中枢神经系统和非中枢神经系统实体瘤中的分布相似。
国际患者从世界各地来到美国，大多是通过正式接纳。然而，我们机构中来自中高收入国家的患者多于低收入和中等收入国家以及低收入国家。需要进一步研究来调查这一观察结果，这支持了儿科肿瘤学持续开展全球能力建设合作的必要性。
