Spectrum of neurosurgical complications following medical tourism: challenges of patients without borders

Abstract

Background and objectives: The cost of medical care and availability of resources (human and facilities) which differs from nation to nation are amongst others, factors driving medical tourism (MT) despite its potential drawbacks. The aim of the study was to analyse all patients that presented with neurosurgical complications following MT. Methods: A single institution prospective study was carried out. Data which included patients' demographics, diagnosis, Glasgow coma scale score at admission, type of complication, and outcome were collected over a 3 year period and analysed. Results: A total of 23 neurosurgical cases were seen during the study period with a median age of 42 years (17-70 years). India is the most common country visited by Nigerian patients. Nine patients died from various complications on arrival in Nigeria. There was no significant statistical difference between the outcome and patients clinical status prior to travel (p=0.107), country where the surgery was done (p=0.776), admission GCS in Nigeria (p=0.169), and redo surgery in Nigeria (0.181). Conclusion: Government in different nations should have legislations to ensure that medical tourists' receive appropriate care abroad, proper follow-up care upon their return, and also promulgate laws to regulate quasi and organised MT agencies that are operating in a regulatory vacuum.

Physicians as medical tourism facilitators in Nigeria: ethical issues of the practice

“…Likewise, few studies that have been published on the topic in developing countries also antagonize the trend of medical tourism because of negative effects occasionally observed in the patients and the overall effect on the health system (3,13). However, physicians acting as MTFs can be a strategy to get their individual buy-in and thereby alleviate their antagonism through direct engagement and financial inducements.…”

“…Many Nigerians travel to countries such as India and the UK for various treatments including cardiac surgeries, neurosurgeries, cosmetic surgeries, orthopedic surgeries, and renal transplant surgeries (13,14). In 2005, the wife of a serving Nigerian president died after undergoing cosmetic surgery in Spain (15).…”

“…While medical tourism could provide access to health care services that are not available in departure countries, several issues such as cost of service, follow-up after surgery, quality of care, and adverse outcomes are challenges that have plagued the industry (2,13). Not all services provided to medical tourists are of the quality advertised.…”

“…A study recently reported that nine (39%) of 23 patients who presented at a health facility in Nigeria after receiving neurosurgical care outside the country died from complications of the procedures they had undergone. Upon return to the country, over a quarter of these patients presented with infections necessitating follow-up care that was not initially planned (13) and that incurred unplanned expenses, which pushed the cost of care to astronomical levels. Medical tourists, in their bid to seek care, are exposed to infectious microbes that are uncommon in their native environments, thereby facilitating the transfer of these infectious agents across geographic boundaries (17).…”

Global Access to Health Care and Well-Being: A Place for Policy and Science

“…Medical staff ( 34 – 36 ), facilities ( 36 ), support services ( 34 , 35 ), and continuity of care ( 37 ) have been identified as some of the main determinants of patient satisfaction. Although limited in scope and design, evidence from clinical outcome studies suggests that medical tourists may be at increased risk for infection and microbial resistance ( 38 – 42 ), complications ( 43 , 44 ), and mortality ( 45 ) compared with those who receive treatment locally. However, the available research on clinical outcomes lacks the systematic, randomized design that characterizes standard outcome studies and fails to provide follow-up data on patients after they return to their home countries ( 7 ).…”