Traveling to foreign countries for medical procedures, treatments or surgeries - so-called ‘medical tourism’ - may not be as cost saving or as popular among U.S. residents as previously thought, suggests a new survey of companies promoting the practice.

The international travel of wealthy patients from poor countries to prestigious U.S. medical centers is well known. In recent years, however, another trend has emerged: people living in wealthy countries traveling afar to find lower cost care, or even procedures that may not be available domestically.

Since its rise, debates have flared over the dangers and ethics of medical tourism, from concerns over the use of procedures that have not been rigorously tested to the potential for citizens of poor nations to be neglected in favor of serving the “tourists.”

Yet little hard data regarding the actual medical tourism market has been available.

To fill in that gap, Brandon Alleman of the University of Iowa Carver College of Medicine, in Iowa City, and his colleagues conducted a phone survey of businesses engaged in facilitating overseas medical travel for U.S. residents.

The 45 companies that completed the survey - representing around 70 percent of the market - had referred about 13,500 U.S. patients for care overseas, a number far lower than prior reports of between 500,000 and 2 million.

For Americans who did seek medical attention abroad, the researchers found cost savings to be the primary driving factor.

However, the team also found that the prices of procedures overseas were similar to what Medicare pays for the same procedures in the U.S. A heart bypass surgery costs an average of $18,600 outside the country, for example, and Medicare pays about $21,000 for the procedure.

Costa Rica, India and Thailand were the most frequented destinations for care, and orthopedic, cardiac, infertility and cosmetic procedures the most common forms of care sought, report the researchers in the Journal of General Internal Medicine.

Further, the researchers noted that quality of care appeared to be the main concern of people considering medical tourism, despite also discovering that the majority of companies referring medical tourists required some kind of accreditation and certification of their foreign providers or hospitals.

“As in the U.S., the quality of care likely varies between hospitals,” Alleman told Reuters Health in an e-mail.

The coordination of follow-up care appeared to be an issue too. The researchers found that 93 percent of the companies expected such care to be delivered by U.S. physicians.

“Medical tourism can definitely be a good option for patients,” Alleman said.

He noted that this may be particularly true for people without insurance or who are unable to negotiate an affordable price. Prior studies have noted that some insurance companies are even encouraging patients to seek expensive medical procedures at lower cost overseas.

Alleman said “patients need to be proactive in making sure they are comfortable with the provider they will be visiting, how their medical records are handled and how care is coordinated between different providers.”

SOURCE: Journal of General Internal Medicine, online December 15, 2010.