Republished with permission from The Association for Professionals in Infection Control and Epidemiology (APIC)
Medical tourism is a growing practice in the United States. The Centers for Disease Control and Prevention (CDC) estimates that more than 750,000 people travel to other countries each year for surgical or dental procedures. Dental work, cardiac surgery, and bariatric, cosmetic, and orthopedic procedures are the most common procedures.
The most common reason for seeking care outside of the U.S. is cost savings, which can be one third to one half less expensive. For example, the AARP reports that cardiac surgery in Thailand is $23,000 compared to $88,000 in the United States. Immigrants returning to their home country account for a part of this trend, as do travelers who require medical care unexpectedly while abroad.
Undoubtedly, there are risks associated with any surgical procedure regardless of country. There is no reliable data tracking the outcomes of persons who have surgery outside the U.S. However, persons considering surgery abroad should be aware that the quality standards may not be the same in a foreign country.
From an infection prevention perspective, the surgical traveler may be at risk for acquiring:
- Bloodborne organisms such as hepatitis B and HIV because of improper use or reuse of needles and syringes.
- Bloodborne organisms if the safety of the blood supply is compromised. This may occur if the country relies on paid donors or does not follow the strictest screening measures.
- Antibiotic resistant infections that are more prevalent in some parts of the world. (See APIC’s ABC’s of Antibiotics infographicfor more information on antibiotic resistant infections.)
- Bacterial infections related to improper sterilization and disinfection methods of the instruments and medical equipment.
- Infections resulting from poor water quality used in the procedure.
The CDC, the Organization for Safety, Asepsis and Prevention (OSAP), and the International Society of Aesthetic Plastic Surgery (ISAPS) recommend that medical tourists take the following questions into consideration before choosing to have a procedure done outside the United States:
- Is the surgeon board certified? Does the surgeon belong to internationally recognized professional organizations?
- What type of facility will be used? Is it a hospital or ambulatory (outpatient) practice? Seek a facility that has received accreditation from the Joint Commission International. This organization certifies facilities that meet certain safety and quality standards. More than 350 hospitals internationally have this certification.
- Does the facility use the World Health Organization Checklist?
- What is the rate of surgical infections and bloodstream infections?
- What is their practice for using prophylactic (preventative) antibiotics before surgery?
- How do they sterilize the surgical instruments? Do they disinfect other equipment in between each patient?
- When you are at the practice, observe if the staff members clean their hands regularly. Do they change their gloves and wash their hands in between patients?
- Are there any recommended vaccinations I should receive before leaving the U.S.? (Check with your physician.)
With adequate research, thorough preparation, and realistic expectations before you leave home, surgery abroad can be safe and deliver quality outcomes.