NHS Faces £20k Per Patient Due to Medical Tourism Issues: A Comprehensive Review
A recent study published in BMJ Open reveals that postoperative complications from medical tourism could be costing the NHS up to £20,000 per patient. However, the researchers caution that data on the use, frequency, and consequences for the NHS are incomplete and haphazard, making it impossible to fully understand the risks of opting for surgery overseas.
The number of medical tourists has risen steadily over the past several decades, and treatment of any postoperative complications usually falls to the home country's health service. The researchers highlight the absence of systematically collected data, making it challenging to gauge the costs and savings to the NHS of medical tourism, as well as the type, frequency, and complications involved.
To address this gap, the researchers conducted a comprehensive review of research databases and 'grey literature' published between 2012 and December 2024. They excluded studies that described cases of emergency and urgent surgery abroad, treatment for cancer, infertility, and dentistry, and transplant surgery.
The review included 90 full-text articles, with 38 reports describing 37 studies. These studies focused on complications arising from metabolic/bariatric surgery (19), cosmetic surgery (17), and eye surgery (1). The case series and case reports involved 655 patients treated by the NHS between 2011 and 2024 for complications from these surgeries.
The most commonly reported procedures were sleeve gastrectomy, breast surgery enlargement, and abdominoplasty. The studies reported on the destination country, with Turkey being the most common (61%). Most patients were women (90%), with an average age of 38, ranging from 14 to 69.
Twenty-two studies reported complications, with no deaths reported. However, at least 196 patients (53%) experienced moderate to severe complications. Treatment details were not clearly reported, and only 14 studies provided associated costs, ranging from £1058 to £19,549 per patient in 2024 prices.
The review also examined hospital stay lengths for treating complications from metabolic/bariatric surgery tourism, cosmetic surgery complications, and eye surgery tourism. The combined average lengths of stay were 17 days, 6 days, and over 50 outpatient appointments and 4 surgical procedures, respectively.
The researchers emphasize the low certainty of the evidence due to the retrospective nature of most studies, incomplete data, and missing demographic details. They suggest that both the complications and associated costs are likely underestimated.
The study highlights the lack of representation in published evidence from certain areas of the UK, such as Wales and the South West of England. The researchers call for a systematic approach to collecting information on the number of people traveling abroad for elective surgery and the impact on the UK NHS.
They also emphasize the need for awareness-raising campaigns and interventions to inform the public about potential complications and the costs they may face. The researchers recommend that those seeking medical treatment abroad should be aware of the NHS's responsibilities and potential personal liabilities for non-emergency treatment.
