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”

Document Type : Commentary


Department of Social Policy and Social Work, University of York, Heslington, York, UK


An understanding of patient mobility, international patients and medical tourism includes supply and demand side considerations. As well as micro-level reports of motivation and satisfaction we must acknowledge broader system-level dynamics. Exploring these may unearth more complex geographies of patient travel.


Main Subjects

  1. Lunt N, Smith RD, Mannion R, Green ST, Exworthy M, Hanefeld J, et al. ‘Implications for the NHS of inward and outward medical tourism: a policy and economic analysis using literature review and mixed-methods approaches. Health Services and Delivery Research 2014; 2(2). doi: 10.3310/hsdr02020
  2. Ministry for National Economy Hungary (MNEH). New Széchenyi Plan. Budapest: MNEH; 2010.
  3. Kiss K. Analysis of Demand for Wellness and Medical Tourism in Hungary. Applied Studies in Agribusiness and Commerce. APSTRACT: Applied Studies in Agribusiness and Commerce 2012; 6(5). Available from:
  4. Rosenmöller M, McKee M, Baeten R. Patient mobility in the European Union: learning from experience. Copenhagen; World Health Organisation: 2006.
  5. Lowson K, West P, Chaplin S, O’Reilly J. Evaluation of Patients Travelling Overseas: Final Report. York: York Health Economics Consortium; 2002.
  6. Glinos IA, Baeten R, Boffin N. Cross-border contracted care in Belgian hospitals. In: Rosenmöller M, Baeten R, McKee M, editors.) Patient mobility in the European Union: learning from experience. Denmark: European Observatory on Health Systems and Policies; 2006.
  7. Jones CA, Keith LG. Medical tourism and reproductive outsourcing: The dawning of a new paradigm for healthcare. Int J Fertil Womens Med 2006; 51: 251-5.
  8. Milstein A, Smith M. America\'s New Refugees — Seeking Affordable Surgery Offshore. N Engl J Med 2006; 355: 1637-40. doi: 10.1056/nejmp068190
  9. Ormond ME. Medical tourism, medical exile: responding to the cross-border pursuit of healthcare in Malaysia. In: Minca C, Oakes T, editors. Real Tourism; Practice, care, and politics in contemporary travel culture. Oxford:  Routledge; 2011.
  10. Organisation for Economic Co-operation and Development (OECD). Health Accounts Experts, Progress Report. Trade in Health Care Goods and Services Under the System of Health Accounts. Paris: OECD; 2010.
  11. Kovacs E, Szocska G, Knai C. International patients on operation vacation - perspectives of patients travelling to Hungary for orthopaedic treatments. Int J Health Policy Manag 2014; 3: 333-40. doi: 10.15171/ijhpm.2014.113
  12. Glinos IA, Baeten R, Helble M, Maarse H. A typology of cross-border patient mobility. Health Place 2010; 16: 1145-55. doi: 10.1016/j.healthplace.2010.08.001
  13. Culley L, Hudson N, Rapport F, Blyth E, Norton W, Pacey AA. Crossing borders for fertility treatment: motivations, destinations and outcomes of UK fertility travellers. Hum Reprod 2011; 26: 2373-81. doi: 10.1093/humrep/der191
  14. Crooks VA, Cameron K, Chouinard V, Johnston R, Snyder J, Casey V. Use of medical tourism for hip and knee surgery in osteoarthritis: A qualitative examination of distinctive attitudinal characteristics among Canadian patients. BMC Health Serv Res 2012; 12:417. doi: 10.1186/1472-6963-12-417
  15. Holliday R, Hardy K, Bell D, Jones M, Probyn E, Sanchez Taylor J. Sun, Sea, Sand and Silicone: Mapping Cosmetic Surgery Tourism, ESRC Study. Leeds: Economic and Social Research Council (Grant Reference RES-062-23-2796), University of Leeds; 2014.
  16. Lunt N, Horsfall D, Hanefeld J. Elgar Handbook of Medical Tourism and Patient Mobility. Cheltenham: Edward Elgar Publishing; 2015 (in press).
  17. Gillet K, Taylor M. Romanian health service in crisis as doctors leave for UK and other states. The Guardian. 7 February 2014. Available from:       romanian-health-service-crisis-doctors-uk
  18. Feraru PD. Romania and the crisis in the health system: migration of doctors. Global Journal of Medical Research Interdisciplinary 2013; 13: 5.
  19. Holt E. ‘Romania’s health system lurches into new crisis. Lancet 2010; 376: 1211-2. doi: 10.1016/s0140-6736(10)61864-8
  20. Stancu E. Mass exodus: Why corruption in Romania\'s healthcare system is forcing its doctors to work abroad. The Independent. 2 January 2014. Available from:        mass-exodus-why-corruption-in-romanias-healthcare-system-is-forcing-its-doctors-to-work-abroad-9035108.html