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“Best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in Barbados

INTRODUCTION: Many countries have demonstrated interest in expanding their medical tourism sectors because of its potential economic and health system benefits. However, medical tourism poses challenges to the equitable distribution of health resources between international and local patients and pr...

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Autores principales: Johnston, Rory, Adams, Krystyna, Bishop, Lisa, Crooks, Valorie A, Snyder, Jeremy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320816/
https://www.ncbi.nlm.nih.gov/pubmed/25643761
http://dx.doi.org/10.1186/s12939-015-0147-1
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author Johnston, Rory
Adams, Krystyna
Bishop, Lisa
Crooks, Valorie A
Snyder, Jeremy
author_facet Johnston, Rory
Adams, Krystyna
Bishop, Lisa
Crooks, Valorie A
Snyder, Jeremy
author_sort Johnston, Rory
collection PubMed
description INTRODUCTION: Many countries have demonstrated interest in expanding their medical tourism sectors because of its potential economic and health system benefits. However, medical tourism poses challenges to the equitable distribution of health resources between international and local patients and private and public medical facilities. Currently, very little is known about how medical tourism is perceived among front line workers and users of health systems in medical tourism ‘destinations’. Barbados is one such country currently seeking to expand its medical tourism sector. Barbadian nurses and health care users were consulted about the challenges and benefits posed by ongoing medical tourism development there. METHODS: Focus groups were held with two stakeholder groups in May, 2013. Nine (n = 9) citizens who use the public health system participated in the first focus group and seven (n = 7) nurses participated in the second. Each focus group ran for 1.5 hours and was digitally recorded. Following transcription, thematic analysis of the digitally coded focus group data was conducted to identify cross-cutting themes and issues. RESULTS: Three core concerns regarding medical tourism’s health equity impacts were raised; its potential to 1) incentivize migration of health workers from public to private facilities, 2) burden Barbados’ lone tertiary health care centre, and 3) produce different tiers of quality of care within the same health system. These concerns were informed and tempered by the existing a) health system structure that incorporates both universal public healthcare and a significant private medical sector, b) international mobility among patients and health workers, and c) Barbados’ large recreational tourism sector, which served as the main reference in discussions about medical tourism’s impacts. Incorporating these concerns and contextual influences, participants’ shared their expectations of how medical tourism should locally develop and operate. CONCLUSIONS: By engaging with local health workers and users, we begin to unpack how potential health equity impacts of medical tourism in an emerging destination are understood by local stakeholders who are not directing sector development. This further outlines how these groups employ knowledge from their home context to ground and reconcile their hopes and concerns for the impacts posed by medical tourism.
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spelling pubmed-43208162015-02-09 “Best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in Barbados Johnston, Rory Adams, Krystyna Bishop, Lisa Crooks, Valorie A Snyder, Jeremy Int J Equity Health Research INTRODUCTION: Many countries have demonstrated interest in expanding their medical tourism sectors because of its potential economic and health system benefits. However, medical tourism poses challenges to the equitable distribution of health resources between international and local patients and private and public medical facilities. Currently, very little is known about how medical tourism is perceived among front line workers and users of health systems in medical tourism ‘destinations’. Barbados is one such country currently seeking to expand its medical tourism sector. Barbadian nurses and health care users were consulted about the challenges and benefits posed by ongoing medical tourism development there. METHODS: Focus groups were held with two stakeholder groups in May, 2013. Nine (n = 9) citizens who use the public health system participated in the first focus group and seven (n = 7) nurses participated in the second. Each focus group ran for 1.5 hours and was digitally recorded. Following transcription, thematic analysis of the digitally coded focus group data was conducted to identify cross-cutting themes and issues. RESULTS: Three core concerns regarding medical tourism’s health equity impacts were raised; its potential to 1) incentivize migration of health workers from public to private facilities, 2) burden Barbados’ lone tertiary health care centre, and 3) produce different tiers of quality of care within the same health system. These concerns were informed and tempered by the existing a) health system structure that incorporates both universal public healthcare and a significant private medical sector, b) international mobility among patients and health workers, and c) Barbados’ large recreational tourism sector, which served as the main reference in discussions about medical tourism’s impacts. Incorporating these concerns and contextual influences, participants’ shared their expectations of how medical tourism should locally develop and operate. CONCLUSIONS: By engaging with local health workers and users, we begin to unpack how potential health equity impacts of medical tourism in an emerging destination are understood by local stakeholders who are not directing sector development. This further outlines how these groups employ knowledge from their home context to ground and reconcile their hopes and concerns for the impacts posed by medical tourism. BioMed Central 2015-02-03 /pmc/articles/PMC4320816/ /pubmed/25643761 http://dx.doi.org/10.1186/s12939-015-0147-1 Text en © Johnston et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Johnston, Rory
Adams, Krystyna
Bishop, Lisa
Crooks, Valorie A
Snyder, Jeremy
“Best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in Barbados
title “Best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in Barbados
title_full “Best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in Barbados
title_fullStr “Best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in Barbados
title_full_unstemmed “Best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in Barbados
title_short “Best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in Barbados
title_sort “best care on home ground” versus “elitist healthcare”: concerns and competing expectations for medical tourism development in barbados
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320816/
https://www.ncbi.nlm.nih.gov/pubmed/25643761
http://dx.doi.org/10.1186/s12939-015-0147-1
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