Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients

Abstract

BackgroundMedical tourism is the term that describes patients’ international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients’ decision-making in and experiences of these same procedures in their home countries.MethodsFourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery.ResultsThree distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1) comfortable health-related decision-makers; (2) unwavering in their views about procedure necessity and urgency; and (3) firm in their desires to maintain active lives.ConclusionsCompared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients’ pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on surgical outcomes. Arthritis care providers can use the attitudinal characteristics identified here to better advise osteoarthritis patients who are considering seeking care abroad.

Patients’ perceptions of physical activity before and after joint replacement: a systematic review with meta-ethnographic analysis

“…This consisted of 144 people following TKA, and 134 following THA; four participants had other lower limb arthroplasty procedures. The cohort consisted of 104 men and 178 women with a mean age ranging from 59 years12 to 76 years 13. No studies reported the mean duration of pain symptoms and only Harding et al 14 reported the mean number of comorbidities in their cohort (2.8).…”

“…No studies reported the mean duration of pain symptoms and only Harding et al 14 reported the mean number of comorbidities in their cohort (2.8). Three studies included patients who had previously undergone lower limb arthroplasty 12 15 16…”

“…One study was undertaken in the USA,17 fours studies from Canada, 12 18–20 two studies from the UK16 21 and one study each performed in New Zealand,13 Turkey,15 Australia,14 Sweden,22 Japan23 and the Dominican Republic 24…”

“…The longest duration post-arthroplasty where participants were interviewed was to 8 years,12 with the majority gaining the attitudes of people up to 6 months post-arthroplasty 14 16 18 20…”

International patients on operation vacation: medical refuge and health system crisis Comment on "International patients on operation vacation – perspectives of patients travelling to Hungary for orthopaedic treatments"

“…A crucial task is explaining these flows and the push or pull factors underlying them. There is growing empirical evidence in the wider literature about differing motivations (1,(12)(13)(14)(15), and how wordof-mouth information and clinical networks shape travel patterns. Considering the sample, why are patients predominantly Romanian?…”