|Characteristics of Australian newspaper coverage of medical tourism, May 2005 – June 2011 (n = 65)*|
|National focus ( n )||Medical focus ( n )||News actor ( n )||Appeals (%)**||Credibility (%)||Risks (%)|
|Thailand – 27||Cosmetic surgery – 29||Expert – 56 (Au: 45)||Low cost – 53.8||Reference to number of international patients – 35.4||Uncertainty as to what is on offer – 69.2|
|India – 19||Transplant surgery – 22||Patient – 27 (F: 19; Au: 26)||Access to services (except for reasons of cost) – 36.9||Use of personal testimonials – 18.5||Complications – 47.7|
|China – 12||Orthopaedic surgery – 11||Medical tourism facilitator/representative of overseas hospital – 23 (Au: 21)||No waiting time – 33.8||Logo/branding symbol – 15.4||Ethical dilemmas – 36.9|
|Malaysia and The Philippines – 11 each||Dental surgery – 9||Government spokesperson or official – 15 (Au: 6)||Travel opportunity – 32.3||Surgeon/practitioner biography or education – 12.3||Exposure to novel risks – 24.6|
|Other – 8||Cardiac surgery – 7||Family member/carer – 7 (F: 4)||Ability to ‘feel good’ – 29.2||Mention of international accreditation – 4.6||Lack of legal recourse – 21.5|
|Pakistan – 6||Reproductive therapies – 5||Other – 6 (Au: 5)||Greater convenience – 20.0||Ease of contacting practitioner post-procedure – 4.6||Post-operative care – 21.5|
|Iraq – 4||‘Medical tourism’ in general; novel, drug-resistant infection and stem-cell therapy – 3 each||Lawyer – 3||State-of-the-art facilities – 20.0||Procedural risk – 16.9|
|Brazil – 3||Other – 2||Kidney donor – 2 (F: 1; Au: 1)||High-quality services – 15.4||Difficulty in contacting practitioner post-procedure – 6.2|
|Colombia and South Africa – 2 each||Politician – 1 (Au: 1)||Personalised service – 15.4|
|‘Asia’ in general – 1||Surgeon/practitioner expertise – 6.2|
|No country named – 8||Access to ‘medical breakthrough’ – 4.6|
|Access to latest technology – 3.1|
* Counts sum to more than 65, as some items cover more than one medical focus, or include more than one news actor.
** This refers to the percentage of stories to feature mention of the particular appeal, credibility or risk in question.
Au: Australian (where ‘Au’ is not indicated, none of the news actors in that category were Australian).
• Expert: specialists in medical and health-related disciplines, researchers/scientists in fields relevant to the story content, surgeons and representatives of medical-professional bodies.
• ‘Other’: individuals who were difficult to classify or who appeared in very small numbers; includes journalists/editors, social commentators and ethicists.
Coding categories for characteristics of media coverage on medical tourism (after Mason and Wright 2011).
Appeals: features of medical tourism mentioned in an item, either by the journalist or by a news actor, as attractive for a potential or actual patient.
• Ability to ‘feel good’: the opportunity for patients to feel better about their appearance or increase confidence in their looks as a result of the procedure.
• Access to services not available (for whatever reason – except cost) at home.
• Access to latest technology: the fact that a facility has the most modern medical equipment/techniques.
• No waiting time: the fact that patients going overseas for procedures can effectively ‘jump the (real or perceived) queue’.
• Greater convenience: the ability to have a procedure performed at the patient’s convenience rather than when facilities/doctors are available.
• High-quality services: patients leave satisfied with the outcome of their procedure(s).
• Longer hospital stays: the opportunity for greater hospital recuperation time.
• Low cost: the lesser cost of procedures, as compared to Australia/elsewhere.
• Medical breakthrough: the ability to access a very new treatment or procedure.
• Personalised services: how good care is/how well patients are looked after.
• Physician or surgeon expertise: patient confidence in their treating doctor’s experience and level of education.
• State-of-the-art facilities: the quality of accommodation or ‘extras’ offered by hospitals (such as meals and recreation facilities).
• Travel opportunity: the chance to have a holiday as well as surgery.
Credibility: dimensions of the medical tourism experience mentioned in an item, either by the journalist or by a news actor, to give it integrity or authority in the mind of a potential or actual patient.
• Accreditation: that the facility is independently accredited by some body of international standing.
• Ease of contacting practitioners post-procedure: medical practitioners making themselves easily available for follow-up in case of questions or complications.
• Logo-/branding symbol: inclusion of a facility or medical tourism agency’s logo.
• Physician or staff biography and education: mention of where medical practitioners were trained, or where they may previously have worked.
• Reference to number of international patients: mention of how many overseas patients (are believed to) visit a certain country or facility each year.
• Use of testimonies: inclusion of case-studies/profiles of satisfied patients.
Risks: aspects of the medical tourism experience mentioned, either by the journalist or by a news actor, as a source of actual or perceived risk (and perhaps as a reason not to proceed with an overseas medical procedure).
• Complications: the risk (or actuality) of complications as a result of a procedure.
• Ease of contacting practitioners post-procedure: the real or perceived concern that practitioners will not be easily available in case of questions or complications following a procedure.
• Ethical dilemmas: expressed concern that a procedure, or some dimension of it, is morally troubling.
• Exposure to novel risks: the potential for (or reality of) particular medical risks because of the location in which the procedure was performed.
• Legal recourse: the fear (or actuality) that due process may not be available in the case of anything going wrong as a result of an overseas medical procedure.
• Postoperative care: concern with regard to the standard or availability of post-operative care.
• Procedural risk: explicit mention of risk inherent in the procedure itself.
• Uncertainty as to what’s on offer: expressed concern as to quality of care, standards of overseas medical training, treatment or care, sterility in foreign medical facilities or the source of biological material (such as organs, eggs or sperm).
Imison and Schweinsberg
Imison and Schweinsberg BMC Public Health 2013 13:109 doi:10.1186/1471-2458-13-109