Health policies and data

International Trade in Health Services


International trade in health services, including its most prominent component ‘medical tourism’, has attracted a great deal of policy interest and media attention in recent years. The apparent growth in this area has been fuelled by a number of factors. Ease of travel and technological advances in information systems and communication allow patients or third party purchasers of healthcare the possibility to seek out treatment of a similar quality at lower cost and more immediately from abroad. An increase in the portability of health insurance cover, both public and private, is also poised to further increase patient mobility.

Most articles and studies on the subject to date concur that there is a lack of hard data on the extent of the provision of services across borders. However, as agreements on cross-border movement come into force and there is the potential for growing effects on domestic or regional health systems, there is a more immediate need to collect comparative data and monitor trends.

System of Health Accounts (SHA) provides a standard accounting framework for the comparable measurement and reporting of health expenditures by the resident population. In theory, this allows a reporting of those healthcare goods and services acquired from foreign healthcare providers – whether hospitals or dentists abroad, or retail internet pharmacies based in another country. In practice, current reporting has been scarce due to a lack of guidance on the specific concepts, definitions and potential sources of information. The project Improving estimates of exports and imports under the SHA framework seeks to provide the necessary definitions, concepts and guidelines to respond to the growing need for comparable and timely statistics on international trade in health.


Final report available in English and in French:


Despite the high-profile media interest and coverage, there is also a lack of hard research evidence on the role and impact of medical tourism for OECD countries. Medical tourism introduces a range of attendant risks and opportunities for patients.

The review details what is currently known about the flow of medical tourists between countries and discusses the interaction of the demand for, and supply of, medical tourism services. It highlights the different organisations and groups involved in the industry. Treatment processes (including consideration of quality, safety and risk) and system-level implications for countries of origin and destination (financial issues; equity; and the impact on providers and professionals of medical tourism) are highlighted.


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