HCAD 660 UMUC Impact of Medical Tourism on Host Countries Healthcare Systems Research

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HCAD 660 Assignment 2: Research Paper Guidelines

Instructions:

You have been hired as the vice president for operations for Intravalley Health. One of your first tasks is to educate the board of directors concerning the evolving nature of healthcare and how it impacts the health system.

Identify a professional or scholarly journal article that addresses a topic within one of these four broad areas:

1. Change management, conflict resolution, strategic communication, preparedness, or crisis management in healthcare.

2. Human resources specific to healthcare:physician relations, staff recruitment and retention, in-service training, policy-making and enforcement, counseling and professional development, credentialing, or unionization of professional staff.

3. The patient experience and satisfaction surveys.

4. Medical Tourism.

Access, review, and integrate the findings of the journal article into a 10-12 page analysis of your topic. Your exploration should include the background of the issue, relevant laws and regulations, and strategic and operational impacts on health services organizations.

The board of directors consists of preeminent social scientists; therefore, your report should be delivered in APA 7th format, including an abstract and references. The page count pertains to the body of the paper only.


***Sources such as Time, Forbes, the Washington Post, and other newspapers, while often useful information resources, would NOT be appropriate for this paper. As a general guideline, if you can find the resource at a magazine stand, it probably is not a professional journal. The articles you choose should be recent (last 5 years) and should be primary rather than secondary. (Please see the APA manual if you do not recall the difference.)

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HCAD 660 Assignment 2: Research Paper

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HCAD 660 Assignment 2: Research Paper
Introduction
Global medical tourism has been on the rise because of various factors, including
economic problems and healthcare system failures in the home countries. Developing countries
have adopted medical tourism as a means to improve their economic productivity, with
significant success. On the other hand, medical tourism could be having a detrimental impact on
the healthcare systems of developing countries involved in the trade. For example, the
redirection of funds towards medical tourism could be depriving the local public health system of
essential resources needed to support healthcare provision. Also, government expenditure on
medical tourism could be an economic burden on the local population. The current analysis
reviews and assesses a primary article on medical tourism's economic benefits to host countries.
It integrates the findings with other research published on the subject to gain insights on the
impact of medical tourism. It argues that the interaction between trade and health and a weak
international regulatory and institutional framework ensures that medical tourism has a net
negative impact on host countries' health systems despite the economic benefits.
Review and Assessment of Professional/Scholarly Journal Article
Beladi, Chao, Ee, and Hollas (2019) study a cross-country analysis of medical tourism's
economic impact. Medical tourism is increasingly becoming popular as more people seek
cheaper access to medical services in other countries. Other reasons include traveling to access
better healthcare systems. The study contends that countries have experienced a reduction in
healthcare service delivery quality because of increased medical tourism. The commercialization
of the healthcare system has led to a decrease in healthcare workers' productivity in the host

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countries. The expansion of the medical tourism sector has created a vacuum in the traditional
healthcare system.
On the other hand, medical tourism's effect on the traditional healthcare system has not
occurred uniformly. Consequently, Beladi, Chao, Ee, and Hollas (2019) sought to determine the
crowding-out impact on labor productivity in the host countries using a cross-country
comparison approach. The background research in the article suggested that many countries
consider medical tourism to boost their economies.
The major stimulating element for the growing interest in medical tourism in the global
healthcare environment was the economic crisis of 2008, which plunged most countries into
economic chaos. On the other hand, the study reports that the phenomenon had earlier origins in
Asia during the 1997 Asian financial crisis. Countries such as Thailand and Malaysia have
institute programs and policies to promote medical tourism. By investing in first-class medical
facilities, the countries mentioned above attract foreign patients, thereby bringing in foreign
exchange currency that boosts the economy. However, medical tourism could be sidelining the
local healthcare environment despite the economic benefits to the host countries. Beladi, Chao,
Ee, and Hollas (2019) provide Malaysia and Thailand's example as successes in using medical
tourism to boost their national economies. Figure 1 shows a significant increase in medical
tourism revenues between 2007 and 2013.
On the other hand, Figure 2 shows that as a percentage of the National Gross Domestic
Product (GDP), medical tourism revenues have not led to a steep increase in GDP. For regions
such as the Middle East and Africa, medical tourism improvements as a percentage of the GDP
have been relatively dismal (Beladi, Chao, Ee & Hollas, 2019). The figure shows a steep

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increase in economic productivity for both countries because of medical tourism, demonstrating
how lucrative the trade has become for these and other countries.
On the other hand, it shows the potentially severe adverse consequences medical tourism could
have on the local population. The medical tourism phenomenon has not been confined to Asian
countries alone. Still, it has extended to Latin America and the Middle East, demonstrating the
phenomenon's popularity in dealing with economic issues or promoting economic growth.
Despite the positive economic outcomes for the multiple countries reviewed in the study, the
host country's public health system could be facing serious challenges. The researchers
conducted an extensive review of the literature on the potential negative outcomes of medical
tourism on the host countries.
Figure 1: Medical Tourism Revenue Generated between 2007 and 2013

(Source: Beladi, Chao, Ee & Hollas, 2019)
Figure 2: Medical Tourism's Contribution to GDP (2007-2013)

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(Source: Beladi, Chao, Ee & Hollas, 2019)
The study reports that the most studied negative impact of medical tourism is its impact
on the host country's public health system because of the diversion of public health resources to
medical tourism and the attendant brain drain to serve the foreign tourists. Other negative effects
reported in the article include an increased tax burden on the local population. Based on the
preliminary introduction and background analysis, Beladi, Chao, Ee, and Hollas (2019) state,
their study's major contribution to the effects of medical tourism is on the economic costs. They
point out the gap in research on the economic costs, which researchers have neglected owing to
the widely reported positive economic outcomes.

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The study uses a literature review methodology to hypothesize medical tourism's
economic impact on host countries. The literature review is extensive and detailed. Also, Beladi,
Chao, Ee, and Hollas (2019) divided the literature review themes into appropriate sections,
including the impact of medical tourism on the host and sending countries. The subsections
include positive and negative effects, which form the basis for developing the hypothesis tested.
Another major strength of the article is using an extensive cross-country database on medical
tourism from 2007 to 2013 acquired from the Euromonitor International health and wellness
tourism reports. Euromonitor is a reputable database website with reliable statistical and other
information, which gives the analysis in Beladi, Chao, Ee, and Hollas' (2019) article a high
validity and reliability level. Other elements that make the article that make it particularly
reliable include statistical methods in data analysis, including regression analysis and equations
the researchers developed to calculate relationships between GDP and other variables required to
deal with medical tourism's economic impact. Furthermore, the researchers present their findings
in tables for easy visualization. Finally, Beladi, Chao, Ee, and Hollas (2019) use sensitivity
analysis to check the data's reliability.
Based on the data analysis, the researchers conclude that there is insufficient robust data
to measure medical tourism's economic effects on the host country, including the potential
exacerbation of existing healthcare access inequalities in developing countries. The study's major
findings include the conclusion that medical tourism increases countries' economic growth rate
and has a detrimental effect on worker productivity because of inadequate public health access.
Finally, the researchers found a high overestimation of the positive effect of medical tourism on
host countries, which they estimated to be about 26.8 percent higher than was the case (Beladi,
Chao, Ee & Hollas, 2019). Beladi, Chao, Ee, and Hollas (2019) attribute the overestimation to

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previous studies' failure to account for the reduction in worker productivity caused by reduced
access to public health. Overall, the methodology adopted and the data used in the analysis
makes the study highly empirically valid. The next section integrates the findings with other
studies conducted on the issue.
Integration of Findings with other Research
Background of the Issue
Medical tourism is not a novel phenomenon, but globalization and the increasing
complexity of the political, economic, social, and ethical issues have excited studies on its
impact on exporting and importing healthcare systems. Previous research conducted on the
medical tourism phenomenon has reiterated many of the issues identified in the Beladi, Chao,
Ee, and Hollas (2019) article. For example, Béland and Zarzeczny (2018) note that some of the
major concerns reported in the research include brain drain of healthcare professionals from host
countries by for-profit organizations offering non-resident care, increasing inequalities in
healthcare access because of medical tourism. Béland and Zarzeczny (2018) reiterate Beladi,
Chao, Ee, and Hollas' (2019) contention that there is a lack of robust data on the medical tourism
industry and its effects, making studies on the subject difficult.
Another element that features prominently in the research is medical tourism's popularity
in developing and emerging economies in Asia, some of the most popular medical tourism
destinations. Pocock and Phua (2011) focus on Malaysia, Singapore, and Thailand in their
research. Like Beladi, Chao, Ee, and Hollas' (2019) study, the three Asian countries' focus
demonstrates that they are the foremost destination for medical tourism. According to Pocock
and Phua (2011), the promotion of medical tourism by private and government actors could
potentially impact the local population. The focus of the article is the potential interaction

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between trade and health because of medical tourism. Therefore, they recognize an economic
dimension to medical tourism's problem that should focus on studies on the impacts of the
practice, especially in the destination countries (Pocock & Phua, 2011). Beladi, Chao, Ee, and
Hollas (2019) filled an important gap in the academic literature because they considered the
negative economic impact rather than solely on positive outcomes. The overtly positive focus on
medical tourism's positive outcomes could result from the interaction between private and
government interests. In other words, it could be resultant from the interaction of trade and
health policy. From the business literature, it is apparent that the profit motive often leads to
negative outcomes for other stakeholders such as communities. Beladi, Chao, Ee, and Hollas
(2019) diverged from previous research by highlighting the potential negative outcomes of
allowing medical tourism. An analysis of the legal and regulatory environment demonstrates
insufficient institutional frameworks to address the background research's negative outcomes.
Laws and Regulations
The US healthcare system provides an example in which healthcare regulations and laws
have contributed to medical tourism. The country has a 9 percent uninsured population despite
legislation such as the Affordable Care Act (ACA) instituted in 2010 (Béland & Zarzeczny,
2018). Within the Canadian healthcare system, the healthcare regulatory environment mandates
that all citizens receive medical care, which has been in force since the 1970s. Under the Canada
Health Act (CHA), people are entitled to healthcare services access limiting the necessity to seek
treatment in other countries through medical tourism. On the other hand, multiple services do not
fall within the umbrella of the CHA regulation, which means there is some potential that patients
might seek treatment in other countries for some conditions (Béland & Zarzeczny, 2018). In the
US, the ACA has contributed to high healthcare costs, leading the US population to seek cheaper

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healthcare systems, most in developing countries (Béland & Zarzeczny, 2018). The trend is
particularly worrying considering that Beladi, Chao, Ee, and Hollas (2019) found that developing
countries experience negative outcomes in their healthcare systems because of brain drain and
the associated loss of qualified healthcare personnel. Therefore, in developed countries,
institutional healthcare issues could necessitate developing countries to engage in domestic
tourism to attract health tourists from countries such as the US. Béland and Zarzeczny (2018)
point out that research has found a high influx of American patient tourists to Mexico through
the Los Algodones border to seek pharmacy, optometrist, and dentistry services. The researchers
point out that Canada does not exhibit similar trends because of universal healthcare coverage
availability.
On the other hand, Canadian patients are more likely to engage in medical tourism
because of long waiting times compared to those in the US because the latter country does not
have significant issues with waiting lists (Béland & Zarzeczny, 2018). Regardless of medical
tourism in both countries, the major underlying element is the institutional factor driving medical
tourism in developed countries. In terms of healthcare regulation and policy, institutional failures
in the developed world could tempt developing and emerging economies to consider it a viable
option for economic growth and development. At the international level, actors in medical
tourism have instituted regulations and laws to manage tourism.
The Joint Commission International (JCI) is one regulatory body responsible for
managing medical tourism. It is responsible for accrediting medical tourism to ensure that it
operates within the appropriate legal and regulatory framework. Pocock and Phua (2011) state
that of the three Asian countries included in their research Singapore had 18 accredited medical
tourism providers while Malaysia and Thailand each had 7 and 13 providers. JCI accreditation

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might be an excellent way to ensure quality management in medical tourism, but countries
subscribe to the institution voluntarily. In Malaysia, the Malaysia Society for Quality in Health
(MSQH) regulates the medical tourism industry in conjunction with the Malaysian Medical
Association, Association of Private Hospitals of Malaysia, and the Ministry of Health. Other
policy options ensure that there are common medical tourism standards for the private and public
sectors to ensure quality (Pocock & Phua, 2011). Despite attempts to regulate the medical
tourism industry, accreditation's voluntary nature means th...


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