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Abstract Background Travelling seeking healthcare is becoming common phenomenon. There is limited research to understand factors associated with destinations of choice. Each year the Dubai Health Authority (DHA) spends millions of dollars to cover Emiratis seeking healthcare overseas. The objective of this study is to examine the association of treatment destinations, patients’ characteristics and motivation factors among the patients treated overseas from the UAE during 2009–2012. Method The data from the Knowledge, Attitudes and Perceptions Survey 2012 in Dubai on medical travel. Examining destinations by patients’ characteristics and motivational factors under push and pull factor framework. Modified Poisson regression model was used to identify factors associated with treatment destinations. Results Three hundred thirty-six UAE national families with a member who sought overseas treatment during 2009–2012 were analyzed for this study regarding their most recent trip. The aim of the survey is to explore their knowledge, attitudes and perceptions. The majority of respondents were family members not the patients who had experienced the medical treatment overseas (63%). Germany was the top treatment destination (45%). The top 3 medical conditions for which people traveled overseas were cancer (17%), bone and joint diseases (16%), and heart diseases (15%). However, patients diagnosed with stroke (brain hemorrhage or clot) are more likely to travel to Germany for medical treatment while patients diagnosed with eye diseases are more likely to seek medical treatment at other destinations. Cost was a primary motivational factor for choosing a treatment destination. Conclusion This study addressed knowledge gap related medical travel in the UAE. The results provided evidence about perceptions when choosing treatment destinations. Medical condition and financial factors were main predictors for choosing treatment destination. The result will influence policies related financial coverage by the government. The results suggest understanding patients’ perceptions in-depth related their medical conditions and financial factors for better regulation of overseas treatment strategy in the UAE.

Abstract Background Each year, the Dubai Health Authority (DHA) spends millions of dollars to cover the costs of United Arab Emirates (UAE) nationals seeking healthcare overseas. Patients may travel overseas to seek an array of treatments. It is important to analyze the number of trips and treatment destinations for patients travelling overseas to provide baseline information for the DHA to improve polices and strategies related to overseas treatment for UAE nationals. Methods Administrative data were obtained from the DHA for UAE nationals who sought medical treatment overseas during 2009–2016. We examined the number of trips and treatment destinations by medical specialty, age, gender, years of travel and travel seasons. Multinomial logistic and negative binomial regression models were used to assess the relationships of the treatment destinations and number of trips, respectively, with the key variables of interest. Results The study included data from 6557 UAE nationals. The top three treatment destinations were Germany (46%), the UK (19%) and Thailand (14%). The most common medical specialties were orthopedic surgery (13%), oncology (13%) and neurosurgery (10%). Oncology had the highest expected number of trips adjusted for a number of covariates (IRR 1.34, 95% CI: 1.24–1.44). Regarding destination variation, patients had a lower relative risk ratio of seeking healthcare in Germany in the winter (RRR 0.68, 95% CI: 0.57–0.80). Endocrinology was the most common medical specialty sought in the UK (RRR 3.36, 95% CI: 2.01–5.60). Conclusions This is the first study to systematically examine the current practice of medical treatment overseas among UAE nationals. The results demonstrate that treatment destinations, medical specialties for which treatment was sought, age, gender and travel season are significant factors in understanding overseas travel for medical care. The study can guide the DHA in collecting more data for further research that may lead to policy-relevant information about sending patients to the best-quality treatment choices at an optimal cost.

Background: The study examined the implications of inward and outward flows of private patients for the NHS across a range of specialties and services. Objectives: To generate a comprehensive documentary review; to better understand information, marketing and advertising practices; examine the magnitude and economic and health-related consequences of travel; understand decision-making frames and assessments of risk; understand treatment experience; elicit the perspectives of key stakeholder groups; and map out medical tourism development within the UK. Design and participants: The study integrated policy analysis, desk-based work, economic analysis to estimate preliminary costs, savings and NHS revenue, and treatment case studies. The case studies involved synthesising data sources around bariatric, fertility, cosmetic, dental and diaspora examples. Overall, we drew on a mixed-methods approach of qualitative and quantitative data collection. The study was underpinned by a systematic overview and a legal and policy review. In-depth interviews were carried out with those representing professional associations, those with clinical interests and representative bodies (n = 16); businesses and employees within medical tourism (n = 18); NHS managers (n = 23); and overseas providers. We spoke to outward medical travellers (46 people across four treatment case studies: bariatric, fertility, dental and cosmetic) and also 31 individuals from UK-resident Somali and Gujarati populations. Results: The study found that the past decade has seen an increase in both inward and outward medical travel. Europe is both a key source of travellers to the UK and a destination for UK residents who travel for medical treatment. Inward travel often involves either expatriates or people from nations with historic ties to the UK. The economic implications of medical tourism for the NHS are not uniform. The medical tourism industry is almost entirely unregulated and this has potential risks for those travelling out of the UK. Existing information regarding medical tourism is variable and there is no authoritative and trustworthy single source of information. Those who travel for treatment are a heterogeneous group, with people of all ages spread across a range of sociodemographic groups. Medical tourists do not appear to inform their decision-making with hard information and consequently often do not consider all risks. They make use of extensive informal networks such as treatment-based or cultural groups. Motivations to travel are in line with the findings of other studies. Notably, cost is never a sole motivator and often not the primary motivation for seeking treatment abroad. Limitations: One major limitation of the study was the abandonment of a survey of medical tourists. We sought to avoid an extremely small survey, which offers no real insight. Instead we redirected our resources to a deeper analysis of qualitative interviews, which proved remarkably fruitful. In a similar vein, the economic analysis proved more difficult and time consuming than anticipated. Data were incomplete and this inhibited the modelling of some important elements. Conclusions: In 2010 at least 63,000 residents of the UK travelled abroad for medical treatment and at least 52,000 residents of foreign countries travelled to the UK for treatment. Inward referral and flows of international patients are shaped by clinical networks and longstanding relationships that are fostered between clinicians within sender countries and their NHS counterparts. Our research demonstrated a range of different models that providers market and by which patients travel to receive treatment. There are clearly legal uncertainties at the interface of these and clinical provision. Patients are now travelling to further or ‘new’ markets in medical tourism. Future research should: seek to better understand the medium- and long-term health and social outcomes of treatment for those who travel from the UK for medical treatment; generate more robust data that better capture the size and flows of medical travel; seek to better understand inward flows of medical travellers; gather a greater level of information on patients, including their origins, procedures and outcomes, to allow for the development of better economic costing; explore further the issues of clinical relationships and networks; and consider the importance of the NHS brand. Funding: The National Institute for Health Research Health Services and Delivery Research programme.