Medical tourism

MEDICAL TOURISM INDIA – ITS STATUS & PROSPECTS

BY

A research project submitted in partial fulfillment of the requirement for the

Degree of Bachelor in Hotel & Tourism Management Studies Program in The

University of Mumbai. Year March 2009

TABLE OF CONTENTS

Pg.No.

ACKNOWLEDGEMENT (i)

LIST OF TABLES (ii)

CHAPTERS

I.INTRODUCTION/ PURPOSE OF STUDY 1

II. REVIEW OF LITERATURE 5

III. RESEARCH METHODOLOGY 26

IV. RESULT DISCUSSIONS 32

V. SUMMERY OF FINDINGS 51

VI. CONCLUSIONS & RECOMMENDATIONS 54

BIBLIOGRAPHY 59

APPENDICES 61

A. SAMPLE QUESTIONNAIRE FOR MANAGER

B. SAMPLE QUESTIONNAIRE FOR CUSTOMER

LIST OF TABLES

FROM TRAVELERS POINT OF VIEW

TABLE NO.

TABLE NAME PAGE NUMBER

1. Individuals visiting India for the first time

33

2. Purpose of Travelling 35

3. Income group of the patients

36

4. India was chosen fro health treatment because

38

5. Health treatment in India are less expensive

40

6. Awareness about Medical Tourism

41

7. Recommended changes to improve health care

facilities

42

8. Is India worth next visit 44

FROM DOCTOR’S POINT OF VIEW

TABLE NO. TABLE NAME PAGE NUMBER

9 Doctors that are aware of medical tourism

45

10 Hospitals getting patients from abroad

46

11 Reason as to India is chosen for health treatment

47

12 Ratings given to medical facilities in India

48

13 Steps to improve medical facilities in India

49

CHAPTER I

INTRODUCTION

Tourism in India has always been promising, and it is as aid to the Indian

economy. India is the land to travel to, a sanctuary of tourism escapade, and

a civilization to tour through. Various regions in India have attracted tourism

from almost all over the world and the flow of tourists has been always

incessant. Tourists come to India for its affluence of sights, culture

excitement, and diversity of landscape and in search of that extraordinary

something, an extra punch that only India promises and delivers. From the

murky mangroves of the Sunder bans to the scorching Thar Desert, blistering

cities like Mumbai and Delhi to the scintillating villages of Khajuraho and

Hampi, from the heights of the Himalayas to the deep blue waters around the

Andamans are the attraction of Tourism India. It is a tourism package that

frustrates and delights, as demanding as it is pleasing.

India has ample manpower, skilled people in the medical fraternity and best

medical facilities at very low costs. Yet Medical Tourism in India is not really

very well acquainted concepts abut hold great prospects in the near future.

However, strategic framework needs to be put in place in order to tap foreign

tourist and to exploit the prospects to the fullest. Medical Tourism (a.k.a.

Health Tourism) is a developing concept whereby people from world over visit

India for their medical and relaxation needs. Most common treatment are

Heart surgery, knee transplant, cosmetic surgery and dental care. The reason

India is a favorable destination is because of its infrastructure in which it is

in par with those in USA, UK and Europe. India has some of the best

Hospitals and treatment centers in the world with the best facilities. Since it

is also one of the most favorable tourist destination in the world, Medication

Combined with the concept of Medical Tourism is derived.

This report firstly explores the place of India in the world tourism market

and identifies different types of tourism. Next, Medical Tourism is defied and

different countries that promote medical tourism and identified. The medical

tourism market in India has been pegged to grow to around Rs. 11,000 CR1

by the next couple of year’s approx till 2012-13. Hence it is also analyzed as to

why India is preferred over other countries for medical treatment and to

know thereby, the relative cost different for various such treatments.

To make this study more detailed, it is also necessary to do the market

segmentation of the tourist that opt for India: with respect to countries, age

group, type of treatment etc. There is one more aspect to this term that India

is also famous for rejuvenation and many states have been getting tourists

that come here only for rejuvenation and peace of mind. This report the

states the key challenges faced by the Indian tourism scenario as a whole,

and the medical tourism as a part. Next, measures taken up to overcome

these barriers by other countries are analyzed in order to draw valuable

lessons for India.

Finally, a strategic framework is provided that leverages India’s existing

advantages and unique proposition in order to built an affective medical

tourist image worldwide, There is a whole set of activities that have to be put

in place for the attracting more tourists in India. Emphasis should be placed

on improving to do the right job, up to date machinery and excellent facilities.

Communication stressing on equity of medical care, waiting time reduction,

cost savings and a unique tourist getaway should be the order of the day.

CHAPTER II

REVIEW OF LITERATURE

Travel allows us to see the world as it, not as it is on TV, or in books. The

present condition of travelling is a poor one indeed; travel has devolved into

mere tourism, and our options for travel seem predetermined to turn us all

into tourists, whom Larry Krotz describes as “a caricature somewhere

between a naive and an ignorant buffoon; as unserious passer – through.” Yet

there are some distinct tourists who make it a point to travel to different

places; whatever the reasons might be. The different kinds of tourisms are

distinguished by the kind of tourists and the very purpose of touring.

There are many types of tourism, viz. Adventure Tourism, Eco Tourism,

Nature Tourism, Culture Tourism, Sports Tourism, and of course Medical

Tourism a.k.a. Health Tourism.

Medical tourism is the practice of a patient “outsourcing” healthcare services

to an area outside of his/her home country. Medical travel is becoming more

popular, as more people realize its benefits, patients going to a different

country for either urgent or elective medical procedures is fast becoming a

worldwide, multibillion-doller industry.

The reasons patients travel for treatment vary. Many tourists from the

United States are seeking treatment at a quarter or sometimes even a 10th of

The cost at home. From Canada, it is often people who are frustrated by long

waiting times. From Great Britain, the patient can’t wait for treatment by

the National Health Service but also can’t afford to see a physician in private

practice. For others, becoming a medical tourist is a chance to combine a

tropical vacation with elective or plastic surgery.

And more patients are coming from poorer countries such as Bangladesh

where treatment may not be available.

Medical tourism is actually thousands of years old. In ancient Greece,

pilgrims and patients came from all over the Mediterranean to the sanctuary

of the healing god, Asklepios, at Epidaurus. In Roman Britain, patients took

the waters at a shrine at bath, a practice that continued for 2000 years. From

the 18th century wealthy Europeans traveled to spas from Germany to the

Nile. In the 21st century, relatively low-cost jet travel has taken the industry

beyond the wealthy and desperate.

Countries that actively promote medical tourism include Cuba, Costa Rica,

Hungary, India, Israel, Jordan, Lithuania, Malaysia, and Thailand. Belgium,

Poland and Singapore are now entering the field. South Africa specializes in

Medical safaris visit the country for safari, with a stopover for plastic

surgery, a nose job and a chance to see lions an elephants.

The main benefits of health tourism include getting the opportunity to travel

to an exotic destination and reaping potentially big monetary savings. Many

Common operations overseas cost a fraction of what they might cost in the

United States. For instance, the average cost of rhinoplasty (or nose job) in

the U.S. is $6,000 1; the same procedure in Costa Rica costs only $ 1,500. The

savings of $4,500 is more than enough to cover your travel expenses, and

you’ll get to travel destination.

While travel isn’t the first things that comes to mind when contemplating

going under the knife, going abroad for many medical treatments cam

actually be an incredibly beneficial experience. The term commonly applied

to this kind of travel is medical tourism and as costs for even simple

procedures rise, it’s becoming an increasingly popular choice for people all

over the world.

Costs for dental work, cosmetic surgery, and a variety of other medical

treatment abroad can be as little as a tenth of the cost of the same treatment

at home. Many countries actively promote medical tourism and offer

incredibly competitive rates along with other benefits. There are also

numerous companies that specialize in arranging medical tourism packages

for you, which combine surgery with a restful vacation, all for less than you

would spend if you opted to have the procedures done at home. Its little

wonder why this practice is becoming so popular.

Medical tourism can also be a boon for those who can’t get the treatment they

need in a timely manner. In some instances, the wait for a major surgery can

be as long as year which isn’t exactly a recipe for happy or healthy patients

these long waits are often a deciding factor for those who choose to seek

treatment elsewhere, as in most countries where medical tourism thrives

wait times are short or nonexistent. This allows patients to get the care they

need sooner and at a time when it is convenient for them.

Many people are reluctant to travel for surgery because they are concerned

about the quality of care they will receive away from home, but in reality a

majority of these fears are unfounded. While there will always be facilities

that are decidedly below par, a majority are top notch and in cases might be

better than those at home. Many doctors that participate in medical tourism

have been trained in the United States and Europe and many are certified

with highly prestigious medical associations. Hospital are often corporately

owned , and as such are very competitive and will often exceed expectations

of care and comfort.

Medical tourism also affords the chance to get in a little sightseeing before or

after your treatment. You can spend your recovery relaxing under an

umbrella on a scenic beach or a mountain resort or even just enjoying the

benefits of a high class hotel’s room service. In some places, medical tourism

packages may be all inclusive, providing you with medical staff on call at

your lodgings.

All these benefits don’t come risk-free, however, but a majority of the risk

associates with medical tourism can be managed with careful planning and

research. There are a number of options available to those seeking treatment

outside their home country and this website as well as others can be a great

resource to figuring out which destination is best for you. Popular

destinations include brazil, Costa Rica, India, Malaysia, south Africa and

turkey just to name a few.

Countries promoting medical tourism

With state of the art medical facilities so close to home why travel thousands

of miles to get treatment somewhere else? There are number of reasons why

traveling for medical reasons can actually be better for your health (and your

wallet) than staying at home. In fact, it’s becoming a more than worth your

time to figure out if medical tourism could benefit you as well.

One of the primary benefits of medical tourism is the huge potential for

savings. Even when the cost of the plane ticket and lodging for the weeks

that you are there are added in, treatment in a foreign country can still be

significantly cheaper than back home. In some places, the cost can be as little

as a tenth of what it would cost to have the same treatment in your home

country. Dental work provides the greatest overall savings, but other

cosmetic and major surgeries can be had at a significant discount as well.

Often, unlike hospitals in the U.S., hospitals abroad are willing to give you as

estimate of the cost up front, as they know no matter what they charge it’s

still going to be cheaper than you would pay in your home country. This can

help you to avoid many of the hidden costs that can be associated with

surgery. It should also be noted that some insurers will cover overseas

surgeries. Checks with your insurance provider to see of you are eligible to

have these costs covered so you won’t be paying it all out of pocket.

Availability and lack of a wait is also a major benefit of taking your

treatment abroad. Wait times for surgery can be months or up to a year in

some cases and those needing treatment more quickly might actually be

better served by seeking treatment elsewhere. Most surgeries whether major

or cosmetic can be schedules within a few days or weeks if done in a less

overburdened foreign hospital. Whether you have a pressing need due to

personal comfort and quality of life, or if you simply want to get it taken care

of more quickly, medical tourism can be a great way to more easily and

quickly get the attention you need.

Though it might come as a surprise to some, one benefit to travelling for

medical reasons is that you may actually be able to get better and more

personal care at a foreign hospital than you can get at home. Many hospitals

specialize in medical tourism, an in order to draw in customers they provide

exceptional quality and service. Depending on your destination you have the

opportunity to get treatment from some of the best doctors in their field,

many of which will have been trained at prestigious institutions abroad.

Equipment and facilities are actually very comparable to those in the U.S.

and patients will often find that they can afford a more luxurious hospital

stay abroad than they could at home.

Medical tourism isn’t just about getting more reasonably priced medical care;

it’s also a great way to spend your recovery in a relaxing and beautiful

environment, free from the ringing phone and responsibilities that could

plaque your recovery at home. You will have the opportunity to spend your

recuperation time under an umbrella on the beach or shopping in luxury

boutiques. The savings on the surgery can also allow you to bring along

friends or family members and still pay less than you would have at home.

Bringing along familiar faces can also help make getting treatment in a

foreign country less intimidating. Many packages deals are also available

which can help you easily bundle your treatment in with sightseeing,

massages, and spa treatments.

Medical tourism isn’t a perfect solution to combating rising medical costs but

for many it can be a much more rewarding experience than dealing with

medical facilities at home. Not to mention it has the added benefits of a

vacation afterwards.

Depending upon your situation the benefits of seeking treatment away from

your home country can actually outweigh the risks, and medical tourism can

be an incredibly rewarding way to get your medical care.

While travelling to get medical treatment in nothing new, medical tourism

has been an explosion in popularity over the past few years. Why are so many

people travelling miles from home to get medical treatment? There are many

reasons. But the simple answer is that it’s actually a better deal for many

people. If planned carefully, medical tourism has many benefits to patients

and because of that more and more people are willing to travel abroad to get

treatment they could get at home.

Perhaps one of the greatest factors in the popularity of medical tourism is

cost. Treatment in many countries has reached outrageous levels due to

bureaucracy and the cost of medical malpractice insurance amidst a sue-

happy population. Even those with medical insurance can find themselves

shouldering a hefty burden for medical costs that aren’t covered by their plan.

Medical tourism offers a solution for many, since costs of treatment in many

of other countries are as little as a tenth to a quarter of what they are in the

United States. In some cases, even when insurance does cover treatment,

travelling abroad to get it is encouraged, especially for plans through

employers who stand to benefits from the cheap treatment as well.

Medical tourism has also seen a boom in popularity due to longer and longer

waits for treatments because of overburdened health systems. Many patients

simply cannot wait months to get the operations they need. Leaving the

country allows them to fit in the treatment more quickly or more

conveniently into their schedule and despite the risks of travel can actually

be better for their health.

Patients coming from smaller countries or those with rare or specific medical

conditions may be forced to travel because the kind of care and specialty they

need simply isn’t available back home. For these cases, quick turnaround and

cost savings are simply the icing on the cake.

Sometimes it isn’t that the kind of care a patient needs isn’t availability in

their home country, but that they can simply afford better care somewhere

else where costs are less, In many countries where medical tourism is big

industry the government has poured money into the medical facilities

available and also to making sure that doctors and nurses are highly trained.

This investment can amount to a higher quality of care for patients and state

of the art facilities and research centers for doctors.

Medical tourism is also popular simply for the tourism aspects. Getting away

from the stresses of home and work can be a much better and more relaxing

way to recover from an operation. Many people find it more convenient to

combine these two, and companies specializing in medical tourism packages

have made it easier than ever to do so.

For many, Medical tourism is simply a better option than staying in their

home country to get treatment. Lower costs, quicker treatment, and the

possibility of recovering on a beach have helped to make medical tourism a

growing international phenomenon.

ROLE OF INDIA

India is considered the leading country promoting medical tourism – and it is

moving into a new area of “medical outsourcing,” where subcontractors

provide services to the overburdened medical care system in western

countries.

India’s National Health Policy declares that treatment of foreign patients is

legally an “export “and deemed “eligible for all fiscal incentives extended to

export earning.” Government and private sector studies in India estimate

that medical tourism could bring between $1 billion US into the country by

2012. The reports estimate that medical tourism to India is growing by 30

per cent a year.

India’s top-rated education system is not only churning out computer

programmers and engineers, but an estimated 20,000 to 30,000 doctors and

nurses each year.

The largest of the estimated half-dozen medical corporation in India serving

medical tourists is Apollo Hospital Enterprises, which treated an estimated

60,000 patients between 2001 and spring 2004. It is Apollo that is

aggressively moving into medical outsourcing. Apollo already provides

overnight computer services for U.S. insurance companies and hospitals as

well working with big pharmaceutical corporations with drug trials. Dr.

Prathap C. Reddy, the chairman of the company, began negotiations in the

spring of 2004 with Britain’s tests for patients at a fraction of the cost in

Britain for either government or private care.

Apollo’s business began to grow in the 1990s, with the deregulation of the

Indian economy, which drastically cut the bureaucratic barriers to expansion

and made it easier to import the most modern medical equipment. The first

patients were Indian expatriates who returned home fro treatment; major

investment houses followed with money and then patients from Europe, the

Middle East and Canada began to arrive. Apollo now has 37 hospitals, with

about 7,000 beds. The company is in partnership in hospitals in Kuwait, Sri

Lanka and Nigeria.

Western patients usually get a packages deal that includes flights, transfers,

hotels, treatment and often a post-operative vacation.

Apollo has also reacted to criticism by Indian politicians by expanding its

services to India’s millions of poor. It has set aside free beds for those who

can’t afford care, has set up a tryst fund and is pioneering remote, satellite-

linked telemedicine across India.

Medical tourism services – a term used to define used the influx of foreign

patients for health and medical care packaged with tourism; are gaining

momentum across countries such as Australia, Switzerland, Germany,

Canada, Cuba, Argentina, Malaysia, Singapore, Thailand and Indonesia.

A combination of three key factors – quality, availability and costs, has been

key in fuelling the phenomenal growth witnessed in the Indian medical

industry. 60% of doctors in India’s leading Indian hospitals have

international qualifications, thus increasing the acceptance and comfort

levels among international patients. An English speaking populace, exotic

tourist locations and alternative medicinal cures are some factors that add to

the advantage India holds over neighboring countries. On the demand side,

prohibitive medical costs and lengthy waiting time are the prime drivers in

people seeking treatment beyond the home country. Private hospitals and

enterprises have driven the spurt in medical tourism.

Some of the key initiative that have been undertaken by the private players

include:

US insurer Blue Cross Blue Shield Association’s clients are covered in Wockhardt’s hospitals in India. Wockhardt,along with Apollo, was also part of the CII led healthcare mission to Britain.

Apollo group regularly sends representative to international symposiums to showcase it’s high success rates (98.5% in heart operations’, 87% in bone marrow and 95% in kidney transplants).

The group has also allied with the Tamil Nadu Tourism Development Corporation

for discounted packages.

Of late, the government too, has increased its commitment towards the healthcare

sector for foreign tourists.

Following the “Policy framework for reforms in Healthcare”, drafted by the Prime Minister’s Advisory Council on trade and Industry, the National Health Policy 2002 actively promoted health tourism.

Import duties on medical equipment have been slashed in order to reduce infrastructure costs, thus enable hospitals to offer world class facilities affordable costs.

The state government are also jumping into the fray in order to gain a larger share of

the health tourism pie. The government of Maharashtra collaborated with FICCI to

form a council to boost tourism – the Medical Tourism Council of Maharashtra,

(MTCM).

POTENTIAL FOR THE INDUSTRY

MEDICAL TREATMENT & COST DIFFERENCE

Important cost difference subsists between U.K. and India when it comes to medical

treatment tourism packages. Every year innumerable number of alien visitors form

different parts of the world visits India for its historical escaped. Moreover, many a time

some of them fall ill as illness knows no place. India is not only cheaper in respect of

medical treatment packages but the waiting time is almost zero. This is due to the

explosion of the private sector, which comprises of hospitals and clinics with the up –

to-the-minute technology and best practitioners.

India offers world-class healthcare that costs substantially less than those in developed

countries, using the same technology delivered by competent specialists attaining

similar success rates.

If a liver transplant costs in the range of 137,867 USD – 160,845 USD in Europe and

double that in the US, a few Indian hospitals have the wherewithal to do it in around

34,466 USD – 45,955 USD. Similarly, if a heart surgery in the US costs about Rs. 45,955

USD , a leading Indian hospitals will do it in roughly 4,595 US$

Procedure Charges in India & US (US$):

Procedure costs (US $)

United States

India

Bone Marrow Transplant 2,50,000 69,000

Liver Transplant 3,00,000 69,000

Heart Surgery 30,000 8,000

Orthopedic Surgery 20,000 6,000

Cataract Surgery 2,000 1,250

These costs are a standard and might not have been the real cost to be incurred. Robert

Walter Beeney was not competent to walk due to a stiff hip when he landed in India

January 24. Twenty days, afterwards, he not only improved after a typical hip

substitution surgery at Apollo Hospital here but also visited the famous Tag Mahan in

Agra after that. So India is now becoming well known for its medical tourism.

All these despite that India is now emerging as a medical treatment hub also. India with

its blend of low cost quality medical services and exotic tourist locations is touted as the

next central location for medical tourists worldwide. According to the CII – McKinsey

Report4 on healthcare in India revenues from foreign patients seeking medical

treatment in India are expected to reach $2 billion by 2012, thereby accounting for 3 to

5 per cent of the total healthcare delivery market. Around 150,000 foreign patients

visited India in 2002, contributing about Rs. 1200 crore to Rs. 1500 crore in revenues.

While this figure, compared to neighboring medical tourism sector is expected to grow

at a rate of 30% over the next few years (well above other countries).

The reputation earned by the Indian medical professionals all over the world. A number

of prominent hospitals throughout US, UK and Canada comprise of Indian nurses,

doctors & paramedics, who are the backbone of the overall healthcare systems of these

countries.

Medical procedures in India cost just a quarter as compared to the West and also quality

are as goes as that international standards. As per a recent market research report

named, “Indian Tourism Outlook (2006)”, published by RNCOS, “The medical system in

India has the potential to lure more than one million medical tourists every year”.

As per experts at RNCOS, “The number of foreigners visiting India for medical

treatment is growing at a rate of 17% per year”. “The foreign patients are likely to spend

about $2.5 billion on medical treatment in India by the year 2012”, further added

experts.

KEY CHALLEGES

Experts have identified a number of problems with medical tourism

Government and basic medical insurance, and sometimes extended medical insurance,

often does not pay for the medical procedure, meaning the patient has to pay cash.

There are littile follow-up cares. The patient usually is in hospital for only a few days,

and then goes on the vacation portion of trip or returns home. Complications, side-

effect and post – operative care is then the responsibility of the medical care system in

the patients home country.

Most of the countries that offer medical tourism have weak malpractice laws, so the

patients has little recourse to local courts or medical boards if something goes wrong.

There are growing accusations that profitable; private- sector medical tourism is

drawing medical resources and personnel away from the local population, although

some medical organizations that market to outside tourists are taking steps to improve

local service.

As various countries vie for a greater share in the medical tourism industry, India needs

to carve out a distinct niche for itself, by leveraging its existing strengths and thereby

offering a unique value proposition.

Broadly speaking there are three types of Medial tourists:

Foreigners coming especially for treatment Foreigners seeking treatment and leisure Expatriates

The key lies in effectively segmenting various customer groups, and customizing

packages based on the group’s generic needs. Ensuring a high quality image with

world-class standards at low prices necessary to induce foreign patients to visit India. In

addition country specific marketing strategies need to be involved based on current

growth rate of 30% is well above other countries existing needs gaps. Western and

European countries, currently forming a negligible fraction of India’s medical tourists,

could provide a rich source of tourist cum patients. An analysis of strategies being

followed in other countries would provide useful learning in evolving strategies for the

Indian medical tourism industry.

SEGMENTATION OF THE PATIENT POPULATION

Currently, the bulk of the patients come to India from neighboring countries such as

Bangladesh, Pakistan, other Asian and the Middle East. In many cases the driver for

cross border care is a question of quality of care than cost itself. The quality of care that

we provide in India is simply not available in some of the neighboring countries.

The second segment is the segment of patients sponsored by the governments in their

respective countries such as Middle East and Africa. For those governments, India is

relatively a cost-effective option compared to Europe or the US. Private patients (not

sponsored) from these countries look at India as value for money option vis a vis Europe

and US. Moreover, post 9/11 there has been a dramatic drop in patients from Middle

East to the US.

The market segment that the healthcare industry is targeting is the patient population

from Europe and the US. There are several patients of Indian origin residing in UK and

US, who are already using the services of hospitals in India, when they are on vacation

etc. Apart from this we have the widely-publicized cases on patients from the US and

Australia.

True, these countries do have an increasing population and the healthcare systems are

on the verge of collapse. Even though it is economically viable for some of these

governments to officially bless shipping of patients abroad, It is the political viability of

such a decision that may need to be worked on. Would a political party in power in

Europe/US want to face the next election as the pioneer of shipping patients to third

world countries?

We may want to recognize that a strategy which works for attracting patients from

Bangladesh may not be work for patients from Britain, since the expectation & drivers

are different. The industry think tank may want to recognize the diversity in the

medical tourism patient population and devise strategies to tap into each of the

segments.

COMPETITION

What is a reason for an average senior citizen in the US to fly 18-20 hours to get his hip

replaced? Can the even travel either hips in such bad shape? Obviously if he is not

covered by insurance and cannot afford the same in US he has to look at options. What

if this can be done in Mexico or Costa Rica at comparable rate and a shorter flight?

South Africa draws many cosmetic surgery patients, especially from Europe, and many

South African clinics offer packages that includes personal assistants, visits with trained

therapists, trips to top beauty salons, post – operative care in luxury hotels and safaris

or other vacation incentives. Because the South African rand has such a long-standing

low rate on the foreign exchange market, medical tourism packages there are the

premier place to go for sex change surgery, In fact, that is one of the top 10 procedures

for which patients visit Thailand.

Argentina ranks high for plastic surgery, and Hungary draws large numbers of patients

from Western Europe and the US for high – quality cosmetic and dental procedures that

cost half of what they would in Germany and America. Dubai is scheduled to open the

Dubai Healthcare City by 2010. Situated on the Red Sea, this clinic will be the largest

international medical centre between Europe and South East Asia.

The Indian healthcare industry needs to examine the factors that have made these

medical tourism destinations popular.

There are definitely areas for improvement as the Indian healthcare industry starts

marketing services to newer patients segments. A key difference in healthcare services

in India, unlike the IT sector is the critical role the government has to play to utilize

medical tourism opportunity to its best. Some of the areas for improvement, to make

India a global healthcare destination are good image building, improvement in

infrastructure facilities, trained doctors and support staff(viz. nurses, value for money

treatments, shorter waiting time, etc.

CHAPTER III

RESEARCH METHODOLOGY

There are many ways to get information. The most common research methods are

literature searches, talking with people, focus groups, personal interviews, telephone

survey, mail survey, email survey, internet survey. A research project can adopt the

following method of research collection for the primary data:

1. Literature search : A literature search involves reviewing all readily available materials. These materials can internal company information, relevant trade, publication, newspaper, magazine, annual reports, company literature, on line data basis and may published materials. This refers to secondary data.

2. Questionnaire: Questionnaires a tool to collect primary data. It includes questions of different aspects of the subject of study. It is very wide and direct observation is not possible. This requires respondents to answer one or other category.

3. Schedule: They are type of Questionnaire. The difference between schedule and Questionnaire is that in Questionnaire the respondent replies to the question whereas in a schedule the researcher encodes the reply in proper places specified in the schedule.

4. Interview : Personal interview are way to get in – depth and comprehensive information. They involve one person interviewing another person for detailed information. During the course of discussion information and facts ate gathered and interview includes questions that are predetermined but are not asked in a definite order.

5. Focus group: This is used as a preliminary research technique to explore ideas and attitudes. It often used to test new approaches like product or advertising and discover customer concerns. The disadvantage is that the sample is very small and may not be represented by the population in general.

6. Talking with People: This is a good way to get information during the initial stage of a research project. It can be used to gather information that is not publicly available or that is too new to be found in the literature.Example, Meeting with prospects, customers, suppliers and other types of business conversations at trade shows, seminars and associates meetings. Although often valuable the information has questionable validity because It is highly subjective and might not be representative of the population.

7. Telephone Service: They are the fastest method of gathering information from a relatively large sample that is 100 to 400 respondents. The interviewer follows the prepared script that is essentially same to the questionnaire and the telephone survey allows opportunity for some opinion.

8. Mail Survey: They are cost effective method gathering importance. They are ideal for large sample size when the samples come from wide geographical area but it takes more time to complete as compared to telephone surveyed.

9. Case study/ Observation: This requires Investigation to be physically present at the data collection site and observe the phenomenon under investigation.

10. Experiment: This requires actual experiment to be conducted to obtain accurate data.Example: Making of Cocktail, lab study and analysis based on actual experiments research.

For this research project the methods chosen to collect primary data are :

1. Literature Search2. Questionnaires3. Schedules4. Interviews5. Talking with people

Sampling plan : My unit of sampling plan comprises of :

1.Tourists that come to India for medical treatment 2. Hospitals & Doctors

The sampling size of sample plan was of:

1. 30 tourists2. 10 Hospitals

The sampling procedures adopted was:

1. Tourists: Stratified random Sample, Cluster Sample2. Hospitals : Conversation Sample, Judgment Sample

Statistical analysis of data: Data obtained during the study was analyzed using standard statistical method qualitative tool like need and frequency.

The frequency are converted into percentage and presented in the form of bar, line graph, pie chart, bar graph which also includes table and figure.

CHAPTER IV

RESULT DISCUSSION

FROM TRAVELERS POINT OF VIEW

1.Out of the surveyed individuals, those visiting India for the first were,

TABLE NO. 1

Answers Frequency Percentage

Yes 16 53.33%

No 14 46.67%

This percentage shows that foreign patients come to India on regular basis. There are

first and frequent travelers. It should also noted that medicals tourism in India is not a

well organized sector, hence efforts should be put in to attract tourists. It is also

possible to attract patients to undergo healthcare treatment, thereby promoting India

as a tourism destination as a whole.

2. Those who had visited India before, their purpose of travelling was,

TABLE NO. 2

Purpose Frequently Percentage

Travel & Leisure 7 23.33%

Medical Treatment 7 23.33%

Business 3 10.00%

Other 2 6.67%

3. Patients who chose India for health treatment were mainly consisting from the following income groups,

TABLE NO. 3

INCOME FREQUENCY PERCENTAGE

$1000 Or Below 1 3.33%

$1000 - $ 2000 0 0.00%

$2000 - $ 2000 1 3.33%

$3000 - $ 3000 3 10.00%

$5000 - $ 5000 11 36.67%

$7000 - $ 7000 10 33.33%

$10000 and more 5 16.67%

The Income group mainly consists of affluent individuals. The income group is mainly of

$5000 to $ 10000 and above. This informs us the kind of income group India attracts for

medical treatments. India attracts for medical treatments. India should further

undertake proper marketing about its medical facilities on the global market to attract

tourists. This will attract more tourists and thereby boost India’s tourism currency.

4 India was chosen for health treatment because of the following reasons.

TABLE NO. 4

REASONS FREQUENCY PERCENTAGE

Lesser expenses on treatment

17 56.67%

Quick surgeries and discharge

10 33.33%

Best treatment and follow up

12 40.00%

Better medical facilities

4 13.33%

Any other reasons 2 6.67%

Lesser expenses on treatment, Best treatment and follow up, & quick surgeries and

discharge are the major reasons that substantiate the preference India is given over

other countries; for medical treatments. There is a large group of patients (Viz,57%) to

whom medical expenses in India are way too less. These reasons can be further

Best treatment and follow up 40%

Quick surgeries and discharge 33%

Better medical facilities 13%

Any other reason 7%

developed and nourished to attract a larger segment of patients in India for advanced

medical therapies.

5 According to the survey conducted, health treatments in India are less expensive.

TABLE NO. 5

ANSWER FREQUENCY PERCENTAGE

YES 28 93.33%

NO 2 6.67%

To a large segment of patients, health treatments in India cost lesser than that in their

native countries.

6 Individuals who were aware about the concept of tourism were.

TABLE NO. 6


YES 17 56.67%

NO 13 43.33%

A little more than half of the individuals knew about the concept of medical tourism.

7 The recommended changes to improve healthcare facilities in India are,

TABLE NO. 7

CHANGES FREQUENCY PERCENTAGE

Infrastructure / Telecommunication

12 40.00%

Improved Hotels 6 20.00%

Trained Doctors / Staff 11 36.67%

Travel Agencies 2 6.67%

No changes required 6 20.00%

Any Other 4 13.33%

Although the medical facilities in India are very cheap, there are some charges that are

necessary so as to pull in more tourists from across the world. Better Infrastructures

and Telecommunication and knowledgeable and efficient doctors and other staff are

the critical factors to retain and attract more tourist traffic.

8 The following are the people who find India worth next visit for health treatment.

TABLE NO. 8


YES 27 90.00%

NO 3 10.00%

90% of the surveyed people find India worth next visit.

FROM DOCTORS POINT OF VIEW

1. The following percentage of doctors were aware of the concept of Medical Tourism.

TABLE NO. 9


YES 6 60.00%

NO 4 40.00%

This shows that many doctors are aware of Medical Tourism, yet there is still scope for

improvement to spread awareness.

2. Hospitals in India bet many patients from abroad who come for various health treatments.

TABLE NO. 10

RESPONSES FREQUENCY PERCENTAGE

Yes, Many 5 50.00%

Yes, but not in significant number

3 30.00%

No, Very negligible 2 20.00%

No, none at all 0 0%

This shows many hospitals in India DO get patients from abroad to seek medical help.

3. India is chosen for medical treatments because of the following reasons

TABLE NO. 11


Leaser expenses on treatment

17 56.67%

Quick suregeries and discharge

10 33.33%

Best treatment and follow up

12 40.00%

Better medical facilities 4 13.33%

Any other reasons 2 6.67%

According to the doctors, cheap treatments and very good trail of follow up are the

main reasons in the boom in medical tourism in India.

4. According to many doctors, healthcare facilities in India are,

TABLE NO. 12


Excellent 4 40.00%

Very Good 6 60.00%

Good 0 0.00%

Fair 0 0.00%

Average 0 0.00%

Poor 0 0.00%

Doctors find the medical facilities and services in India are VERY GOOD.

5. According to many doctors, following can be done to harness and grow medical facilities in India,

TABLE NO. 13


Infrastructure / Telecommunication

7 70.00%

Improved Hotels 0 0.00%

Trained Doctors / Staff 3 30.00%

Travel Agencies 1 10.00%

No Changes required 0.00%

Any other 0 0.00%

In addition to these questions, some open ended questions were asked in the survey.

According to the results, India is getting many tourists seeking medical help from other

countries. There are a number of places that are very famous for giving treatments, In

Mumbai, Delhi, and Bangalore to name a few.

Various treatments that are most done on foreign patients are heart surgeries.

Kidney transplant, skin therapies, dental treatments and cosmetic surgeries. These cost

a fortune abroad, but in India they can be done with very less expenses, and with the

same results.

Places in Mumbai such as Hiranandani Hpspital, Lilavati Hospital, Wockhatdt Hospital

attract many such tourists.

CHAPTER V

SUMMERY OF FINDINGS

FINDINGS OUT OF THE SURVEY DONE ON TRAVELERS

Patients coming to India for medical treatment are mostly from higher income groups.

The most preferred / famous health treatments are various dental treatments (viz. root canal, smile designing et. Al.), various heart – related surgeries and other treatments which involve high costs in India or otherwise.

The total costs of such treatments in India is very less as compared to the same treatments in other countries, this is, perhaps, the main reason India ia on the rise for Medical Tourism.

However, there is little, or almost negligible amount of knowledge and awareness about the concept of Medical Tourism with the people.

According to most patients, the medical treatments that they got in India are good, but there is still room for improvement in certain areas, such as follow up.

FINDINGS OUT OF THE SURVEY DONE ON DOCTORS

According to many doctors, planned and constant marketing of India as a Medical Tourism Destination should be put in place.

Doctors think India should be publicized globally and in the right manner to promote her as a medical tourism destination.

Doctors think there are some areas of improvement to the medical facilities in India.

CHAPTER VI

CONCLUSIONS & RECOMMENDATION

CONCLUSIONS

India’s relatively developing medical tourism has been anointed by healthcare and tourism industry pundits as the next “Best” thing for the country.

According to a McKinsey report, India is poised to generate business worth USD 2.2 billion by 2012, however there are plenty of challenges’ that need to be addressed for India to become the world’s preferred healthcare destination.

Prominent among them being the need for proper accreditation and requisite standardization systems in place, a tripartite synergy between hospitals, tour operators and respective state governments.

Extremely cheap medical cost and good treatment is the major driving factors these factors that dictate selection of India for medical tourism by various tourists. Hence these factors should be identified and further harnessed in order attract even more tourists.

There are various challenges impending the growth of the medical tourism industry and emphasized the need for a synergy between hospitals, state and government and international tour operators.

The doctors and other staff need to be more professional and careful while treating foreign patients as it will boost India’s image in the world market.

India will have to project itself as being a holistic medical destination to get an edge over other countries.

India needs to cub together a couple of “Pathies” because we have a very strong base of alternative healing therapies like yoga, homeopathy, naturopathy, ayurveda, etc.

Creating awareness about India’s facilities is a must establish credibility in foreign markets.

Standardization of a price band for graded hospitals and a quality Assurance model should be taken up immediately to take medical tourismAhead.

Perception of Quality Care by the patients will help a great deal to this industry as a whole.

RECOMMENDATIONS

The Indian healthcare industry needs to examine the factors that have made these medical tourism destinations popular.

There are definitely areas for improvement as the Indian healthcare industry starts marketing services to newer patient segments. A key difference in healthcare services in India , unlike the IT sector is the critical role the government has to play to utilize medical tourism opportunity to its best. Some of the areas for improvement, to make india a global healthcare destination are good image building, improvement in infrastructure facilities, trained doctors and support staff ( viz . nurses), value for money medical treatments, shorter waiting time, etc.

Finally, adopting and adapting of IT systems and standards that are in vogue in the developed world would be required to ease the administrative processes involved in cross- border care and integration with the medical records in the country of origin.

It is high time that the government really looked hard at the demand supply situation of human resources in the healthcare sector and recalibrated the supply of specialist and paramedical in the country. This would mean changes to policies on post-graduate medical education, nursing education etc.

Foreigners coming on ‘M visa’ will be required to get themselves registered mandatory well within the period of 14 days of arrival with the concerned FRROs/FROs.

Attendant/family members of the patient coming to India for medical treatment shall be granted miscellaneous visa co-terminus with the ‘M Visa’ of the patient. Such visa may be granted the spouse/children or those who have blood relations with the patient.

CHAPTER VII

BIBLIOGRAPHY

Health Tourism India .com

www. Cbc.ca

The Financial Times , 2 July 2003

CII – McKinsey & Company (2002) - “Healthcare in India” The road ahead.

“INDUSTRY INSIGHT” - INDIAN HEALTH CARE

Cygnus Economic & Business Research (September 2004)

“INDUSTRY MONITOR – HEALTH CARE”, Vol. 10

INGRES (ICRA information, grading & research Services)

(September 2003) – “industry Comment : Indian Healthcare Sector, Indian Medical Care Industry

CHAPTER VIII

APPENDICES

MEDICAL TOURISM IN INDIA – ITS STATUS & PROSPECTUS

QUEATIONNAIRE

1. Aditya S. Oak, student studying in the third year BHTMS in Rizvi College of Hotel Management & catering Technology, Bandra (W), Mumbai 50, am doing a research on Medical Tourism in India - its status & prospectus. I would be highly grateful if you could spare some of your valuable time in filling this questionnaire to help me be held strictly confidential and be used for research purpose only.

Thanking You.

Name of the Hospital ______________________________________

Name ___________________________________________________

Destignation _______________________________________________

1. Are you aware of concept of medical tourism? Yes No

2. Do you get patients from abroad who come to India, for medical Treatment?

Yes, Many Yes, But not in significant number

No, Very negligible No, none at all

3. If YES, can you state the number such of patients that come to this hospital for medical treatment every year?

4. What kinds of treatments are mostly preferred by such patients?

5. Why, according to you, is India chosen for healthcare treatments by patients abroad?

Lesser expenses on treatment Quick surgeries & discharge Best treatment and follow up Better medical facilities Any other reason (Please Specify)

6. Rate the healthcare facilities in India Excellent Very good Good Fair Average Poor

7. What, do you think, should be improved in order to attract more foreign tourists to India?

Infrastructure / Telecommunication Improved Hotels Trained Doctors / Staff Travel Agencies No changes required Any Other (Please Specify)

Date ------------------

Signature -----------------------

MEDICAL TOURISM IN INDIA – ITS STATUS & PROSPECTUS

QUEATIONNAIRE

1. Aditya S. Oak, student studying in the third year BHTMS in Rizvi College of Hotel Management & catering Technology, Bandra (W), Mumbai 50, am doing a research on Medical Tourism in India - its status & prospectus. I would be highly grateful if you could spare some of your valuable time in filling this questionnaire to help me be held strictly confidential and be used for research purpose only.

Thanking You.

Name __________________________________________

Nationality _________________________________________

Age ___________________ years

1. Is this your first visit to India? Yes No

2. A) If NOT, how many times have you visited India?

AND

B) What was the purpose of your earlier visits?*Travel & Leisure* Rejuvenation / Medical treatment* Business* Other (Please Specfy)

3. What is your approximate monthly income? $1000 or below Between $ 1000 - $2000 Between $ 2000 - $3000 Between $ 4000 - $5000 Between $ 5000 - $7000 Between $ 7000 - $10000 $ 10000 AND MORE

4. What kind of Healthcare treatment are you going to undergo/have undergone in India?__________________________________________________________________

5. Which place in India have you been to/are going to for medical treatment?

6. What, approximately, is the total cost of this treatment?___________________________________________________________________

7. You chose India for health treatment because of, Lesser expenses on treatment Quick surgeries & discharge Best treatment and follow up Better medical facilities Any Other reason (Please Specify)

8. Do health Treatments in India cost you less than that in your native country? Yes No

9. Are you aware of the concept of Medical Tourism? Yes No

10. Are you aware of other countries promoting medical tourism? Yes No