A GROUP PROJECT REPORT

ON

‘ A QUALITATIVE STUDY OF INTERNATIONAL MEDICAL TOURISTS FROM HOSPITALS IN

AHMEDABAD CITY’

SUBMITTED TO

DR. DEEPAL JOSHI

SOMLALIT INSTITUTE OF BUSINESS ADMINISTRATION
GUJARAT UNIVERSITY
AHMEDABAD CITY
GUJARAT STATE
INDIA

TOWARDS PARTIAL FULFILMENT OF SEMESTER 6 REQUIREMENTS FOR

BACHELOR OF BUSINESS ADMINISTRATION DEGREE

SUBMITTED BY
GROUP NUMBER 4

SR. NO. ROLL NO. NAME OF THE STUDENT

1 29 NIKHIL RAMESHBHAI GANGAJALIYA

2 36 NIVEDAN MADHUSUDAN GOSWAMI

3 39 HITEN GIRISHBHAI HINGOL

4 47 HRISHIKESH RATILAL JAISWAL

5 57 MAHIMA UDAYBHAI KHATOLIYA

6 63 NISHA PRAMOD MAHTO

7 192 VERONICA MANDUA BEATRIZ

8 193 DIANE SEBA ESRAEL

9 194 EBRIMA MODOU JALLOW

10 196 GONÇALVES RAIMUNDO DE LIMA

SUBMITTED ON

27 FEBRUARY, 2024
 CERTIFICATE

This is to certify that this project report entitled ‘A QUALITATIVE STUDY OF INTERNATIONAL
MEDICAL TOURISTS FROM HOSPITALS IN AHMEDABAD CITY’ is a bonafide work of the undersigned
group of students, from Somlalit Institute of Business Administration, affiliated to the Gujarat University,
Ahmedabad, Gujarat state, India. This work is submitted as a semester 6 requirement for partial fulfilment of
Bachelor of Business Administration (B.B.A.) degree from the Gujarat University.

SR. NO. ROLL NO. NAME OF THE STUDENT SIGNATURE

1 29 NIKHIL RAMESHBHAI
GANGAJALIYA

2 36 NIVEDAN MADHUSUDAN GOSWAMI

3 39 HITEN GIRISHBHAI HINGOL

4 47 HRISHIKESH RATILAL JAISWAL

5 57 MAHIMA UDAYBHAI KHATOLIYA

6 63 NISHA PRAMOD MAHTO

7 192 VERONICA MANDUA BEATRIZ

8 193 DIANE SEBA ESRAEL

9 194 EBRIMA MODOU JALLOW

10 196 GONÇALVES RAIMUNDO DE LIMA

_________________________ _________________________
DR. DEEPAL JOSHI EXTERNAL EVALUATOR
(PROJECT GUIDE & INSTITUTE DIRECTOR)

27 FEBRUARY, 2024

DATE OF SUBMISSION
 ACKNOWLEDGEMENT

“Research is seeing what everybody else has seen and thinking what nobody else has thought.” – Albert Szent
Gyoryi

Research is deep-diving into the unknown and trying to seek answers. This project report is a culmination of the
research idea of our group. The successful completion of this project report would not have been possible
without the sincere efforts and genuine support of many.

We take this opportunity to express our deepest gratitude towards Gujarat University for incorporating a
practical studies subject in our curriculum of semester 6 BBA course. We are deeply thankful to our institute –
Somlalit Institute of Business Administration (SLIBA) for giving us an opportunity to undertake this work.

We feel a deep sense of obligation towards our project guide and institute director – Dr. Deepal Joshi, for
inculcating a sense of discipline and hard work among us. She guided us through the various steps of this
research right from problem definition, designing research, collecting secondary and primary data to analysis of
the data and deriving conclusions from our work.

We are highly thankful to the various organisations (you can name a few in particular) whose information we
have used as secondary data. We are extremely grateful to our respondents who spared their time and energy to
provide us with invaluable primary data for our research. Technology is a huge enabler and facilitator for
research. We give immense credit to technology for its guidance and assistance in our research. We are also
thankful to our group members and all our friends who directly or indirectly helped us with this mammoth
work.

MEMBERS OF GROUP NUMBER 4

SLIBA SEMESTER 6
DATE OF SUBMISSION:
27 FEBRUARY, 2024
 PREFACE

The business world is changing fast and evolving rapidly. The business environment is characterised as
‘VUCA’ – Volatile, Uncertain, Complex and Ambiguous. Change will be the only constant in this new business
environment. As students of business management, we all will need to learn and adapt to these changes for
sustainability and growth in future. To meet such upcoming challenges, the Gujarat University Bachelor in
Business Administration course has introduced practical studies and research as a part of semester 6 curriculum.
In accordance with that requirement, we have prepared and submitted this report.

Research on medical tourism in India has been done by us. We chose this subject because it is a developing
industry that has the potential to significantly impact our Forex and help India project its soft power abroad.
Qualitative research has facilitated our interactions with a wide range of individuals from around the
[Link] evaluation of a variety of viewpoints and facts has been necessary in order to analyse the
advantages and disadvantages of medical [Link] analysing numerous arguments, we have reached a
conclusion. Exposure to global perspectives and healthcare systems has been facilitated by this [Link]
have made an effort to make recommendations to different medical healthcare stakeholders.

During the first and the second year, we learnt the practical business aspects through industrial visits,
preparation of project reports and viva-voce. That exercise was solo for each student. However, in the third
year, we take up research projects as a group of 10 students each. Therefore, this project is a learning on team
work, communication, positive and negative group dynamics, as well.

‘The only source of knowledge is experience’, says Albert Einstein. Research is never the end of work, it is just
the beginning. We are sure this first research experience will help us undertake many more research projects in
future – to contribute and add value to the body of existing knowledge and systems. We hope and pray to enrich
our lives and lives of everyone around us – our family, friends, society, country and the world at large, with our
ongoing research inclinations.
 TABLE OF CONTENT

Chapter Chapter Title Page

Number Number

Introduction

1.1 Indian Healthcare System In Brief

1.2 Medical Tourism In India

1 1-43
1.3 Data On Medical Tourism In India

1.4 India As A Medical Tourism Centre - Pros And Cons

1.5 Comparison Of Indian Medical Tourism With Select Countries Of The World

1.6 Summary Of 5 Research Papers On Medical Tourism

Research Methodology

2.1 Objectives of the study

2.1.1 Primary Objectives

2.1.2 Secondary Objectives

2.2 Source of Data

2 44-47
2.2.1 Secondary Data

2.2.2 Primary Data

2.3 Sampling method

2.4 Sample Size

2.5 Limitation of study

Findings and Analysis

3 3.1 Findings 48-53

3.2 Analysis

Recommendations and Conclusion

4.1 Recommendations

4.1.1 Recommendations for Hospitals and doctors 54-58

4
4.1.2 Recommendations for Government

4.1.3 Recommendations for Patients

4.1.4 Other Recommendations

 4.2 Conclusions

5 Bibliography and References 59-64

Annexures

6 6.1 Emerging Themes From The Interview Transcripts 65-71

6.2 Schedule of Interviews
 CHAPTER- 1

INTRODUCTION

1
 1.1 - Indian Health Care System In Brief

1.1.1 Introduction

The Healthcare industry in India is the fastest growing industry. A nation with a huge number of people needs a
good and healthy environment. The healthcare industry is not only providing service to the people of the nation
but also to foreigners. The diseases and remedies are similar. New and developed diseases are discovered and
new research and development in the field of healthcare are also introduced from time to time. Many people are
playing a vital role in the healthcare industry i.e., hospitals, doctors, supportive services like blood banks,
scanning centres, government, scientists, pharmaceutical companies, retail medical shops and all the human
beings who need medical treatment.
India has a multi-payer universal health care model that is paid for by a combination of public and private
health insurance funds along with the element of almost entirely tax-funded public hospitals. The public
hospital system is essentially free for all Indian residents except for small, often symbolic co-payments in some
services. Ever since the nation gained its sovereignty, the public healthcare infrastructure has been wholly
sustained via comprehensive taxation.

1.1.2 History

Medical treatment facilities available in India have been well-known to the world since ancient times. Ayurveda
is the process of natural healing and naturopathy has been the trademark of Indian Medical tours. Travellers
from different parts of the world have visited Kerala to attain the unique Ayurveda treatments that are only
available in Kerala.
During the 17th and 18th centuries, there was a slow and steady growth of the modern system of medicine in
India, starting with the arrival of European Christian missionaries in South India in the 17th century. In 1664 at
Chennai, the British opened the first modern hospital for soldiers and, in 1688, another for the civilian
population. Organised medical training began with the opening of the first medical college in Calcutta in 1835,
followed by a school in Mumbai in 1845 and one in Chennai in 1850.
Since independence, considerable progress has been achieved in the promotion of health in India. Though the
public sector is not expanding its healthcare services, private, co-operative and other non-profit organisations
have started hospitals and are providing medical services to the public. Moreover, the Government of India is
taking other steps to improve healthcare. For example, the Government has, from time to time, appointed
various committees to address the pervasive problems in the healthcare sector. In addition, it has demonstrated a
strong commitment to population control, including the implementation of family planning programs geared
towards controlling the population.
In the year 2006, the quality council of India, through the National Accreditation Board for Hospitals (NABH)
has come out with hospital standards that apply to Indian hospitals. The likelihood of an insurance boom in the

2
healthcare sector and the potential for health tourism are important reasons for accrediting hospitals. Therefore,
accreditation and quality health service will be the main agenda of hospitals in the years to come.
Over the last few decades India, especially Kerala had made tremendous achievements in the Medical industry.
We are now in a position to cure and to provide any such advanced surgical and health care treatments
cost-effectively. Today thousands of foreigners from the USA, Europe, the Middle East, and other countries
travel to India in search of these unique Ayurveda treatments and high-end medical facilities to get relief from
their illnesses. Medical tourism is a growing sector in India. In mid–2020, India's medical tourism sector was
estimated to be worth US$ 5–6 billion. In 2017, 495,056 patients visited India to seek medical care. As per the
reports, most of the medical tourist arrivals in India were from Southeast Asia, Middle le East, Africa, the and
SAARC region. India also receives a significant number of medical tourists from Australia, Canada, China,
Russia, the United Kingdom, and the United States.

1.1.3 National Health Policy

The National Health Policy was endorsed by the Parliament of India in 1983 and was updated in 2002, and then
again updated in 2017. The four main updates in 2017 highlight the necessity of addressing the escalating
burden of non-communicable diseases, the emergence of a robust healthcare industry, the increasing instances
of unsustainable expenditure due to healthcare costs, and the rising economic growth that enables an enhanced
fiscal capacity. Furthermore, in the long term, the policy aims to set up India's goal to reform its current system
to achieve universal health care.
In practice however, the private healthcare sector is responsible for the majority of healthcare in India, and a lot
of healthcare expenses are paid directly out of pocket by patients and their families, rather than through health
insurance due to incomplete coverage.
Government health policy has thus far largely encouraged private-sector expansion in conjunction with
well-designed but limited public health programmes.

1.1.4 The Indian Health Care System Is Mainly Divided Into 2 Parts:

1. Public Health Care

Public healthcare is free for every Indian resident. The Indian public health sector encompasses 18% of
total outpatient care and 44% of total inpatient care. Middle and upper-class individuals living in India
tend to use public healthcare less than those with a lower standard of living. Additionally, women and
the elderly are more likely to use public services. The public healthcare system was originally developed
to provide a means of healthcare access regardless of socioeconomic status or caste. However, reliance
on public and private healthcare sectors varies significantly between states. Several reasons are cited for
relying on the private rather than the public sector; the main reason at the national level is the poor
quality of care in the public sector, with more than 57% of households pointing to this as the reason for
a preference for private health care. Much of the public healthcare sector caters to rural areas, and the

3
 poor quality arises from the reluctance of experienced healthcare providers to visit rural areas.
Consequently, the majority of the public healthcare system catering to the rural and remote areas relies
on inexperienced and unmotivated interns who are mandated to spend time in public healthcare clinics
as part of their curricular requirements. Other major reasons are long distances between public hospitals
and residential areas, long wait times, and inconvenient hours of operation.
Different factors related to public healthcare are divided between the state and national government
systems in terms of making decisions, as the national government addresses broadly applicable
healthcare issues such as overall family welfare and prevention of major diseases, while the state
governments handle aspects such as local hospitals, public health, promotion and sanitation, which
differ from state to state based on the particular communities involved. Interaction between the state and
national governments does occur for healthcare issues that require larger-scale resources or present a
concern to the country as a whole.
Considering the goal of obtaining universal health care as part of Sustainable Development Goals,
scholars request policymakers to acknowledge the form of healthcare that many are using. Scholars state
that the government has a responsibility to provide health services that are affordable, adequate, new
and acceptable for its citizens. Public healthcare is very necessary, especially when considering the costs
incurred with private services. Many citizens rely on subsidised healthcare. The national budget,
scholars argue, must allocate money to the public healthcare system to ensure the poor are not left with
the stress of meeting private sector payments.
Following the 2014 election which brought Prime Minister Narendra Modi to office, the government
unveiled plans for a nationwide universal health care system known as the National Health Assurance
Mission, which would provide all citizens with free drugs, diagnostic treatments, and insurance for
serious ailments. In 2015, implementation of a universal health care system was delayed due to
budgetary concerns. In April 2018 the government announced the Ayushman Bharat scheme that aims to
cover up to Rs. 5 lakh to 100,000,000 vulnerable families (approximately 500,000,000 persons – 40% of
the country's population). This will cost around $1.7 billion each year. Provision would be partly
through private providers.

2. Private Health Care

Since 2005, most of the healthcare capacity added has been in the private sector, or in partnership with
the private sector. The private sector consists of 58% of the hospitals in the country, 29% of beds in
hospitals, and 81% of doctors.
According to the National Family Health Survey-3, the private medical sector remains the primary source
of health care for 70% of households in urban areas and 63% of households in rural areas. The study
conducted by IMS Institute for Healthcare Informatics in 2013, across 12 states in over 14,000
households indicated a steady increase in the usage of private healthcare facilities over the last 25 years
for both Out-Patient and In-Patient services, across rural and urban areas. In terms of healthcare quality in

4
 the private sector, a 2012 study by Sanjay Basu et al., published in PLOS Medicine, indicated that
healthcare providers in the private sector were more likely to spend a longer duration with their patients
and conduct physical exams as a part of the visit compared to those working in public healthcare.
However, the high out-of-pocket cost from the private healthcare sector has led many households to incur
Catastrophic Health Expenditure, which can be defined as health expenditure that threatens a household's
capacity to maintain a basic standard of living. Costs of the private sector are only increasing. One study
found that over 35% of poor Indian households incur such expenditure and this reflects the detrimental
state in which the Indian health care system is at the moment. With government expenditure on health as
a percentage of GDP falling over the years and the rise of the private healthcare sector, the poor are left
with fewer options than before to access healthcare services. Private insurance is available in India, as are
various government-sponsored health insurance schemes. According to the World Bank, about 25% of
India's population had some form of health insurance in 2010. A 2014 Indian government study found
this to be an overestimate and claimed that only about 17% of India's population was insured. Private
healthcare providers in India typically offer high-quality treatment at unreasonable costs as there is no
regulatory authority or statutory neutral body to check for medical malpractices. In Rajasthan, 40% of
practitioners did not have a medical degree and 20% have not completed a secondary education. On 27
May 2012, the popular show Satyamev Jayate did an episode on "Does Healthcare Need Healing?" which
highlighted the high costs and other malpractices adopted by private clinics and hospitals.

1.1.5 Top 5 Reasons Why India Is Lacking Access To Quality Health Care:

1. Lack Of Infrastructure
The epidemic showed that the Indian healthcare system is not ready for any catastrophic events similar
to COVID. The government’s spending on healthcare, the gap in demand and supply, and chronic
shortages are some of the concerns that need urgent attention. Data suggests that India has 1.4 beds per
1,000 people, 1 doctor per 1,445 people, and 1.7 nurses per 1,000 people.
2. The Disparity In The Rural-Urban Healthcare System
Over 75% of the healthcare infrastructure is concentrated in metro cities, where only 27% of the total
population resides—the rest 73% of the Indian population lack even basic medical facilities. The
primary medical centres are lacking over 3,000 doctors and in the last decade, the shortage has increased
by ~200%. Quality healthcare treatment can be found in the urban areas but often the person from a
rural part of the country cannot afford to come to the metro cities for the treatment.
3. Lack Of Trained And Skilled Resources
One of the most critical concerns is the gap in the doctor-patient ratio. According to the Indian Journal
of Public Health India needs 2070000 doctors by 2030. However, a doctor in the government hospital
attends to ~11000 patients, which is more than the WHO recommendation of 1:1000.
4. Expensive Healthcare Treatment

5
 Medical procedures similar to cancer treatment, transplants, and critical ails bear immediate attention.
Overburdened government hospitals often delay in offering timely treatment which diverts individuals
to seek medical care in the costlier private hospitals. The Insurance Regulatory and Development
Authority (IRDAI) directed all health insurance companies to offer obligatory Aarogya Sanjeevani
policies in April 2020. The policy will provide coverage up to Rs 5 lakh – 10 lakhs for essential
healthcare treatment, but the policy is not sufficient to cover advanced treatments, transplants, and
critical surgeries.
5. High Out-Of-Pocket Expenses
Indians pay ~63% of their medical expenses out-of-pocket, which is considered to be the highest in the
world. A report from Brookings India based on NSSO surveys claims that ~7% of India’s population is
pushed into poverty every year due to healthcare expenses.

Today, medical crowdfunding has emerged as an alternative financing option for India’s missing middle. In
India, it is common for people to be drained of all life savings while trying to meet medical emergencies. often,
even without the promise of recovery, leaving caretakers grasping at straws to stay afloat. Medical
crowdfunding is an avenue for individuals to reach out to people and seek financial support. The crowdfunding
platforms use state-of-the-art technology to enable a seamless fundraising process. With the advent of
technology, the process of donation has become easy and transparent. However, the Indian crowdfunding
industry has just scratched the surface and experts see sizable potential in tier 2 and tier 3 cities. With the right
awareness campaigns, collaborations, and education drives, we believe we can bring significant change in
people’s lives in the rural part of the country too.

6
 1.2 – Medical Tourism Introduction
“Travel for health, return with happiness”

1.2.1 What Is Tourism?

The word Tourism is derived from the word tour, which comes from Old English turian, from Old French
torner, from Latin tornare - "to turn on a lathe", which is itself from Ancient Greek tornos (τόρνος) - "lathe".
Tourism is one of the most important and fastest-growing industries that generate employment, exports and
wealth worldwide. Tourism means people travelling for fun and it includes activities like camping and
sightseeing. India is one of the most popular tourist destinations in Asia. Tourists are drawn to India because of
its welcoming customs, diverse way of life, cultural legacy, and vibrant fairs and festivals. According to the
World Travel and Tourism Council Report, the contribution of the travel and tourism sector to India's economy
by 2023 will be Rs.16.5 trillion is estimated. The tourism sector includes cultural tourism, medical tourism,
sports tourism, dark tourism etc.

1.2.2 What Is Medical Tourism?

The term “Medical Tourism” means to travel to another country to receive medical care. In the last few years,
this refers to those people from underdeveloped countries that travelled to countries with major medical
facilities for treatments that are not available in their country. A major part of the global medical care system is
based on a well-structured medical tourism environment. Medical tourism has become an area of interest and
profit due to the increasing growth of the economy, research and development, advanced technology and also
global relations.
Looking at the history of medical tourism, spa towns and sanitaria were early forms of medical tourism. In
18th-century Europe, patients visited spas because they supposedly contained healing mineral waters, which
treated diseases ranging from rheumatism to liver disorders and bronchitis. We can experience both qualitative
and quantitative changes in patient mobility, as people travel from rich to less developed countries to seek
health services. Such changes are largely driven by the relatively low cost of treatment in less developed
countries, the availability of cheap flights, and increased marketing and online consumer information about the
availability of medical services.
JCI (Joint Commission International) has accredited more than 123 medical facilities and institutions across
Asia, Europe, the Middle East, the Caribbean and South America. Healthcare systems can vary greatly from
one country to another or from one region to another within the same country. Accordingly, what citizens can
find when they seek medical treatment abroad is likely to fluctuate depending on the nature of health care
coverage, financing, and domestic regulation. Medical tourists travel to all four corners of the world for
executive health assessment, ophthalmology care, cosmetic dentistry and surgery, bariatric procedures, joint
resurfacing or replacement, cardiac surgery, organ and stem cell transplantation, gender reassignment surgery
and in-vitro fertilisation etc.
7
Many Central and South American countries have developed a strong reputation for cosmetic and plastic
surgery, bariatric procedures, and dental care. Governments and private-sector actors, particularly in Asia,
Europe and Latin America, have begun to actively promote their countries, cities and medical facilities as
medical tourism destinations to promote and diversify their tourism and healthcare (Wong and Musa, 2012).

1.2.3 Importance:

According to UNWTO (World Tourism Organisation) Secretary-General Zurab Pololikashvili, "Health tourism
helps to diversify destinations, create jobs, support businesses and pass these benefits on to rural communities."

[Link] Other Benefits Are Given Below:

1. In some countries, some medical treatment is very expensive, but due to medical tourism, they get the
same treatment at a relatively low cost. So they get the benefit of low cost.
2. Due to the search for good and high-quality medical treatment, some foreign patients leave their
countries and go to other countries for medical treatment.
3. Patients can receive a wide range of treatments depending on their needs. Whether surgery, dental care,
or fertility treatment, they can likely find a destination that offers standardised medical services with
top-class doctors.
4. According to OECD (Organisation for Economic Cooperation & Development) Report, Freedom in the
movement of goods and services between nations has boosted the international mobility of medical
equipment, medical professionals, and travellers seeking medical services. Medical tourism has emerged
as a significant economic industry due to the ease of visa services.
5. Medical tourism is as much about tourism as it is about medical treatment. Those patients undergoing
major surgery can recover faster with a better climate. Medical tourists also take their treatment abroad
to enjoy vacations along with treatment.

1.2.4 Disadvantages Of Medical Tourism:

Some of the disadvantages of medical tourism are as follows:

1. Due to cultural and language barriers, sometimes people choosing medical travel do not like the fact that
they cannot interact personally with foreign healthcare professionals or staff during their visit.
2. People avoid going for medical treatment in foreign countries due to additional expenses like flight,
hotel, transportation, food, travel etc.
3. The quality of food and water consumed in foreign hospitals may vary which may upset a person with a
sensitive stomach. If you have diarrhoea, vomiting, or nausea before or after surgery, this can be a very
unpleasant experience. Therefore, sometimes people receive treatment in their own country.

8
1.2.5 Growth Of Medical Tourism Around The World:

The number of individuals that travel to another country to receive treatment has reached billions and continues
to increase each year. With the fast and sudden growth of medical tourism and its benefits, it also provides
several employment opportunities and healthcare development. The rapid development of various new
technologies and increasing investments in research activities for improved and effective drugs and medical
devices are expected to present a significant growth opportunity for the market players in the near future. For
instance, the development of targeted therapies, gene-targeted therapies, laser treatments and various other
advanced treatments are the major growth drivers of the global medical treatment market.
The global medical tourism market is projected to grow from $13.98 billion in 2021 to $53.51 million in 2028
at a CAGR (COMPOUND ANNUAL GROWTH RATE) of 21.1% in the forecast period, 2021-2028. In Asia,
India, Thailand and Singapore are the three countries that receive maximum medical tourists due to the low cost
of treatment, quality healthcare infrastructure and availability of highly-skilled doctors.
The Covid-19 crisis has severely affected the tourism industry through a combination of business and health
regulations. However, The medical tourism market has experienced a significant rebound over the past couple
of years due to ease in travel restrictions post-COVID-19 pandemic. To remain competitive, medical tourism
companies must offer advanced and latest technologies for treatments along with competitive pricing.
The top ten medical tourism destinations are Japan, Korea, the US, Taiwan, Germany, Singapore, Malaysia,
Sweden, Thailand, and India by 2020. According to the Medical Tourism Index-2020 report, the first five
positions among the top 25 countries in the medical tourism business are France, Spain, the United States,
Turkey and Italy. Several Asian countries with incredibly well-developed healthcare infrastructures have
emerged as key players in the market, according to a report produced by FICCI (Federation of Indian Chambers
of Commerce & Industry), Singapore, Malaysia and India accounted for 60% of the total revenue generated by
the Asian medical tourism industry in 2012. The leading companies that specialise in medical tourism are the
Mayo Clinic, The Cleveland Clinic Foundation, Singapore General Hospital, Raffles Medical Hospital, Charite
University Hospital of Berlin, Bumrungrad Hospital Public Company Ltd, Seoul National University
Hospital, Asklepios Kliniken GmbH & Co. KGaA, Apollo Hospitals Enterprise Ltd, and Bangkok Chain
Hospital Public Co Ltd.

9
 1.3 - Data On Medical Tourism In India
The medical tourism industry in India is growing rapidly and is expected to continue to do so in the coming
years.
According to the Ministry of Tourism, India has emerged as a popular destination for medical tourism. In 2019,
India saw a total of 595,000 medical tourists which was a 22.3 percent increase vis-a-vis 2018.
Another report by the Federation of Indian Chambers of Commerce & Industry (FICCI) said that India received
around 650,000 medical tourists in 2022, despite the challenges posed by the pandemic. This represents a
significant increase compared to the previous year's figures resulting in the practice of medical tourism,
according to the information, people come from various corners of the world looking to take care of their
health, India, among the developing countries, is a popular medical tourism destination for inter- national
medical patients looking for low-cost yet quality.

1.3.1 Countries Popular For Medical Tourism:

Countries JCI accredited Hospital Savings w.r.t

USA

Brazil 62 20-30%

Costa Rica 2 45-65%

India 38 65-90%

Israel 29 -

Malaysia 13 65-80%

Mexico 8 40-65%

Singapore 24 25-40%

South Korea 24 30-45%

Taiwan 13 40-55%

Thailand 67 50-75%

Turkey 43 50-65%

Source: FICCI-EY,2019 Report (Link)

10
1.3.2 Type Of Treatment:

● Bone Marrow ● Knee

● Transplant ● Liver Tratament
● Brain ● Neo Transplant
● Cancer ● Spine Surgery
● Gynaecological ● surgery, tumour operation and others.
● Heart Disease ● Replacement Surgery
● Hip ● Kidney Transplant
● Tumour,

1.3.3 Tourist Vs Medical Tourist Visits

As per the answer given in Rajya Sabha by the Minister of Tourism to the question asked by Dr. Anil
Sukhdeora. FTAs is Foreign Tourist Arrivals.

Source: MINISTRY OF TOURISM, GOVERNMENT OF INDIA.

11
Another report by the Federation of Indian Chambers of Commerce & Industry (FICCI) said that India received
around 650,000 medical tourists in 2022, despite the challenges posed by the pandemic. This represents a
significant increase compared to the previous year’s figures.

1.3.4 Country-Wise Foreign Tourist Arrivals In India For Medical Purpose, Top 10 Only

Source: MINISTRY OF TOURISM

Nations 2018 2019 2020 2021
1 BANGLADESH 322567 401228 99155 186633
2 IRAQ 59258 56310 16647 15357
3 MALDIVES 13595 50978 11055 22798
4 AFGHANISTAN 46811 33004 16185 19556
5 OMAN 27528 22393 4328 7610
6 YEMEN 11859 16671 4111 4612
7 SUDAN 8673 8908 2763 3908
8 KENYA 8037 7841 2041 3423
9 NIGERIA 5660 6999 2028 2914
10 Tanzania 5236 5192 1637 2194

Figure: Top 5 Countries Foreign Tourist Arrivals (FTA) for Medical Treatment and Wellness.

12
India is quickly becoming the top spot for medical tourism just because of 11 10th cost with the developed
countries. Chennai, Kolkata, Mumbai, Vellore, Coimbatore, Bangalore, Hyderabad, Hyderabad, Goa and Delhi
are the among popular medical tourism spots in India. Below is the top medical tourism destination in India:
1 Chennai
One of the most popular destinations for medical treatment in India. 40% of people chose to get treated in
Chennai for its high quality. Chennai, also known as the health capital of India, has nearly 200 international
patients for bone marrow transplants, cardiac bypass, Eye surgery, hip replacement and alternative medicine
treatment.
2 Mumbai
Mumbai is The fastest-growing medical tourism destination in India. Mumbai is famous for its cosmetics and
Ayurveda treatments. 27% of foreigners visit here for medical help.
3 Goa
Goa's natural environment, its popularity among visitors and Government support to promote health and
wellness have helped medical tourism to become a medical.
4 New Delhi
National Capital is home to several fantastic private hospitals. Patience for general surgery, eye surgery, heart
care and neurosurgery visits in Delhi.
5 Ahmedabad
Hospitals with world-class amenities, a lot of non-residents before getting treatment in Ahmedabad. It is home
to a civil hospital, one of the largest in Asia, SAL hospital and others.

1.3.5 List Of Popular Hospital Chains Among Medical Tourists

As per Mediflam private limited 2021, below are the popular hospitals chains among Medical Tourists:
1. Apollo Group Of Hospitals
Apollo Hospital was started by Dr Prathap C. Reddy in 1983 in Chennai, Tamil Nadu is the first corporate
healthcare provider in India. Over time, it started its operations in more than 25 states of India. Apollo has
created a niche for itself and is one of the first Indian hospitals to get the JCI certification. Thus, it is no surprise
that its name is quoted by many international patients, rightly earning it the distinction of medical tourism
hospital in India. Apollo has also opened up a lot of centres in other countries from where they provide
consultation services and help the patient to get the right treatment by bringing them to India. It offers almost
all kinds of treatments and the costs are comparable to its peers. (Mediflam, 2021)

2. Fortis Group Of Hospitals

They have 4 JCI-accredited hospitals and 18 NABH-accredited hospitals. They have treated more than 200000
patients from 175 countries and have a dedicated team that caters to international patients. They have hospitals
in all parts of India and have a team of well-qualified and experienced doctors. All these have helped Fortis
13
group of hospitals to earn a respected name as a medical tourism hospital in India with affordable costs and in
proportion to the treatments offered. Modern technology and vast experience make this hospital one of the main
attractions for international patients. (Mediflam, 2021)

3. Aster Hospital
Aster group of hospitals is a well-recognized name in the healthcare industry and recently was awarded The
Economic Times Best Healthcare Brand 2021. It has got 14 hospitals spread across states that include Kerala,
Karnataka, Telangana, Andhra Pradesh, and Maharashtra. The one in the state of Kerala is the most famous and
is more commonly known as Aster MIMS Kottakkal Hospital. It is a JCI-accredited hospital and offers a
multitude of treatments in 40+ specialities. They have more than 1600 doctors having vast experience and treat
3 lakhs plus patients every year. These achievements are testimony to the fact that it is considered one of the
best medical tourism hospitals in India. (Mediflam, 2021)

4. Lilavati Hospital
Lilavati Hospital is one of the most trusted names when it comes to the private health sector in India. Located in
Mumbai India, this is the hospital of choice of many Bollywood celebrities. It started in 1997 as a 10 bedded
facility with a team of 22 doctors. Today it has grown to a facility having 323 beds, more than 300 clinical
consultants, and around 1800 employees. They serve around 300 inpatients and 1500 outpatients daily. It is also
very close to Mumbai international airport thus making it a favourable choice for international tourists. With the
above advantages, it has rightly earned its name as one of the best medical tourism hospitals in India.
(Mediflam, 2021)

5. Miot Hospital
Established in the year 1999, MIOT Hospital, located in Chennai is one of the names that are famous amongst
international patients. It is a 1000 bedded facility and serves people from more than 130 countries. Considered
one of the best medical tourism hospitals in India, this hospital has top-notch medical facilities in diagnostic as
well as surgical divisions. It has almost all medical specialities and hence can serve most of the patients from
various countries. The costs of MIOT hospital are much more affordable and hence a lot of international
patients seek treatment in this hospital. (Mediflam, 2021)

14
 1.4 - India As A Medical Tourism Center - Pros And Cons

1.4.1 Pros

The tourism sector is always a sector of vital importance to a country as it contributes economically as well as
socially. Economically it generates mass employment and contributes significantly to GDP. Socially the sector
offers massive opportunities for interaction within and with the outside world. Health tourism or medical
tourism is a recent development in this sector and is showing good potential. Patients from developed countries
are increasingly visiting India to avail medical treatments of various kinds and they mostly end up their visit
seeing the tourist attractions of the place. Though the primary objective of the tour remains achieving better
health, recreation is also sought. India is developing as one of the most promising markets for medical tourism.
Following are some of the pros of India as a destination for medical tourists:

1. Blend Of Medical And Leisure Tourism

India serves both the purposes of medical tourism and leisure tourism. The country offers a wide range of
sightseeing destinations, historical monuments and pilgrim centres along with exquisite handicrafts and
exclusive fairs and exhibitions around different parts of the country. Therefore, when somebody comes to India
for health revitalization, there are always options to spend leisure time with the family who accompanies the
patient.

2. World Class Medical Services

India is considered as the hub of highly educated specialised doctors and the treatment facilities are at par with
the world’s standard medical services. Indian nurses and para-medical staff are among the best in the world.

3. Alternative Medicine Systems

India enjoys a niche when it comes to alternative systems of medicine like Ayurveda, yoga, naturopathy and
Unani. These medicine systems prove very effective in various ailments and people across the globe are
increasingly recognizing this fact. In future, the demand for these treatments is expected to rise as people are
more inclined to herbal treatment nowadays.

4. Advancement In It
India is also among the world’s fastest-growing Information Technology (IT) hubs. The advancement and
sophistication in the field of IT has facilitated the healthcare sector. There is an increasing use of computers and
the Internet in medical tourism adding to the demand and convenience in this sector.

5. Infertility Treatments

15
India also has an edge in the field of infertility treatments and is considered one of the best and most
economical places for various modern reproductive techniques including test-tube babies and surrogacy
services.

6. Easy Access
The initiatives taken by both the Government and private sector provide a host of facilities like easier access to
medical visas, several flights and domestic transportation systems to travel to and within the country,
economical tour packages customised to travellers’ needs, easier access to the internet and other
communication facilities, availability of certified drugs and medicines within easy reach adding to the Indian
advantage in medical tourism.

7. Cost Savings
One of the biggest draws of medical tourism in India is the significantly lower cost of medical procedures
compared to developed countries. Patients can save anywhere from 30% to 80% on medical expenses, making
it an attractive option for those seeking high-quality treatment at affordable prices.

8. Quality Healthcare
India is home to many internationally accredited hospitals and medical facilities. Many doctors in India have
received their education and training from top institutions abroad, ensuring that patients receive quality medical
care. Some hospitals even specialise in specific medical fields, offering expertise in complex treatments. For
instance Mediflam in 2021 listed some hospitals which are popular among tourists. They are:
1. Apollo Group of Hospitals
2. Fortis Group of Hospitals
3. MIOT Hospital
4. Aster Hospital
5. Lilavati Hospital

9. Skilled Medical Professionals

India has a large pool of skilled and experienced doctors, surgeons, and medical staff who often have
international training and certifications. This expertise, combined with advanced medical technology, ensures
that patients receive world-class medical treatment.

10. State-Of-The-Art Facilities

Many hospitals and medical centres in India are equipped with the latest medical technologies and equipment.
This enables them to offer advanced treatments and procedures, including organ transplants, heart surgeries,
cosmetic surgeries, and more.

16
 11. Minimal Waiting Times
In contrast to some countries with long waiting lists for certain medical procedures, medical tourists in India
often experience shorter waiting times. This is particularly beneficial for patients who require urgent treatments
or surgeries.

12. Personalised Care

Indian hospitals often provide a high level of personalised care to medical tourists. Many facilities have
dedicated international patient services that assist with travel arrangements, accommodation, and treatment
coordination.

13. Wide Range Of Treatments

India offers a wide range of medical treatments, from routine surgeries to specialised procedures. Patients can
find medical expertise in various fields, including cardiology, orthopaedics, neurology, fertility treatments, and
more.

14. Cultural Experience:

Medical tourists have the opportunity to combine their treatment with a unique cultural experience. They can
explore India's rich history, diverse cuisine, and vibrant traditions during their recovery period.

15. Language And Communication

Many doctors and medical staff in India are proficient in English, making communication easier for
international patients. Additionally, some hospitals offer interpreter services to ensure clear understanding.

16. Follow-Up Care And Rehabilitation

After the medical procedure, patients can choose to stay in India for follow-up care and rehabilitation,
benefiting from ongoing medical support and guidance. Support from the
Doctor to monitor the improvement of the patient .

It's important to note that while there are numerous advantages to medical tourism in India, potential travellers
should thoroughly research and plan their trip, including choosing reputable hospitals, understanding the legal
and regulatory aspects, and considering any potential risks associated with travelling for medical purposes.

1.4.2 Cons

Medical tourism specifically is not a new phenomenon, what is new is the trend of practising medical tourism.
Medical tourism is a rapidly evolving trend driven by marketplace forces. Articles and guidebooks are
increasingly published in the print and electronic media and only Google Internet has more than eight million
such sites. Health and medical tourism are regarded as one of the fastest-expanding areas in Destination India
17
marketing. Hence, individual professionals and medical organisations need to understand the factors and forces
shaping India as a medical tourism destination phenomenon. It can be a source of revenue generation in
developing countries like India whereas developed countries consider medical tourism a dent to their economy.
But there are some important issues and concerns related to medical tourism in which some potential
disadvantages due to medical tourism centres in India are as follows:

1. Greater Inequity In The Health System

The private healthcare sector in India has responded to the demand for medical tourism by establishing
super-speciality centres and joint ventures. This has led to the development of speciality corporate hospitals,
which are being built in collaboration with Indian and foreign companies. However, the potential revenue from
medical tourism could lead private hospitals to demand greater subsidies from the government, potentially
diverting resources from the public health system. This could exacerbate disparities in the two-tiered healthcare
system, with the corporate segment focusing on high-level technology and services, while the public sector
struggles to meet the needs of the local population. Additionally, medical tourism has led to greater inequity in
the health system, as private healthcare providers cater to medical tourists who can afford their services, while
the public healthcare system struggles to meet the needs of the local population. Furthermore, medical tourism
has led to an increase in healthcare costs, as private healthcare providers charge higher fees to medical tourists
than to local patients. This system has created a system where those who need less but can pay more are served
at the expense of the poor and more deserving.
2. Mediator Issue
The role of medical facilitators was not highlighted in the original framework. The Delhi-NCR region,
however, raised several critical systems impacts and policy implications regarding the role of medical
facilitators or middlemen in the Indian medical tourism market. Participants demonstrated a consistent view
regarding the prominent role of the facilitators in the medical value chain, in channelizing international patients
towards a particular country and subsequently a healthcare service provider. There is a prevalent concern
regarding the lack of transparency and regulation in the way these middlemen operate, quality of service
delivered, corruption or any unethical practices, and most of all a lack of credibility. Participants expressed
apprehension about the way these facilitators impact the quality-of-care delivery or the overall experience of
overseas patients. The issue of safety and quality is a primary concern for medical tourists.
3. Cost-Related Issue
India's low-cost medical procedures offer a competitive advantage for its targeted segments, as inbound tourists
have a reference price for the procedure. However, other costs like lodging and boarding are perceived as
prohibitive. Hospitals argue that the actual price charged is higher than what was quoted, and some hospitals
use differential pricing for post-care support. This has led to non-resident Indians and persons of Indian origin
(PIO) travelling as domestic patients. To better target price-conscious customers, hospitals should reconsider
their pricing strategies. Post-care costs are particularly hurting, as patients often need routine health checks with
the same hospital after the procedure. When recovery time is longer, medical tourists may need to arrange stays

18
outside the hospital. Service providers should network to bundle procedure and post-procedure costs, making
them more attractive.
4. Hurdle Of Indian Medical Visa
India is a global hub for medical tourism, attracting over 1.4 million medical tourists annually. In 2022, the
country issued over 650,000 medical visas to international patients. However, obtaining medical visas for
international patients remains a significant hurdle. The Indian Ministry of Tourism has introduced the 'M'
category of visas for medical tourists, aiming to improve airport infrastructure and streamline complex visa
procedures. The medical visa scheme is not successful due to its higher cost, ease of obtaining, and limited
availability in some countries, particularly African ones. Additionally, there is reported abuse of medical visas,
which can be time-consuming and cumbersome for patients and their families, leading to delays and potential
cancellations. The enhanced visa application process could open doors for more experiences for citizens of
Poland, Russia, Indonesia, Finland, and Iceland in India. However, certain countries like Iran, Kazakhstan,
Kyrgyzstan, Qatar, and Uzbekistan are still not eligible for an e-medical visa to India. Simplifying
documentation requirements without compromising verification processes would enhance the visa experience.
Streamlining visa procedures, implementing user-friendly online application systems, simplifying
documentation requirements, accessibility to visa application centres, and minimising processing delays are
essential steps to enhance the experience for international patients.
5. Service Concerns
Medical tourists in the Delhi National Capital Region (NCR) have expressed concerns about streamlined and
standardised care delivery in various aspects of healthcare, travel, tourism, airport, and hospitality. The
interface between patients and hospitals in India is not as smooth as it should be, and there is a lack of trust in
the healthcare system. The perception of India as a country and the safety of travel are also a concern.
Hospital-accrediting organisations and processes in India need to be more prominent and widely advertised.
The ecosystem to attract international patients is lacking, with patients spending 80-85% of their time in
guesthouses around hospitals. Standardisation of guesthouses and hospitality players should be introduced to
improve patient-specific hotels near hospitals. Organisations like Healthgrades and RateMDs could expand to
emphasise provider reviews specifically tailored for medical tourists.
6. Language-Related Problems For Non-English Speaking Patient
Language barriers in healthcare delivery negatively impact patient safety, satisfaction, and the quality of care.
Interpreter services can help address these issues, but they can also increase costs and treatment durations.
Patients who do not speak local languages or English may face communication difficulties with healthcare
professionals. The Indian government should promote medical tourism to Afro-nations, considering India's
friendly image and long-standing relations with Afro-nations. Hospitals need to train linguists and interpreters
for languages like Arabic, Russian, and French. Online translation tools like Google Translate and MediBabble
can help overcome these challenges. Combining interpreter services and online translation tools can enhance
healthcare delivery and patient safety.
7. Competition

19
Medical tourists come from industrialised countries like the UK, USA, Japan, and Canada, where medical costs
are high and treatment wait times are long. They travel to countries like Thailand, Singapore, India, Malaysia,
South Korea, Brazil, Belgium, Hungary, and Jordan. India faces stiff competition in the medical tourism
industry, but it counters this with alternative therapies like yoga, meditation, and Ayurveda. India needs to
improve immigration efficiency, infrastructure, affordable hotels, and language interpreters to increase medical
tourism. Legal issues, such as differences in legal systems and jurisdictional issues, can make it difficult for
patients to pursue legal action. Patients should research hospitals and medical facilities in India to ensure safe
and effective care. The healthcare system in India needs to take a giant leap towards leveraging unconventional
operating models and technological revolutions, building an ecosystem that encourages innovation. This will
help India solidify its position as a leading destination for medical value travel and attract more patients from
around the world.
8. Other Problems
The medical tourism industry currently facing are the aftereffects of not enough focus by the Government of
India in the past, comprehensive effort at marketing the industry, no accreditation for hospitals defining the
capability of servicing international patients, and a lack of standardisation of pricing policies.
The surge in air pollution in north India has proved to be a major roadblock in growth. Experts warn that
prolonged exposure to this toxic air could lead to multiple serious problems. Some macroeconomic focusable
environmental factors like safety, pollution, drinking water quality, other environmental quality, sanitation, and
corruption lead to becoming important points for Indian medical tourism towards medical tourism.
There some necessary steps must be taken by the Indian government to stop or reduce the brain drain process of
doctors. The allure of higher salaries, better working conditions, and career advancement in other countries can
lead to a loss of skilled professionals from the Indian healthcare system.
To make the journey of foreign nationals to India must be hassle-free and fast. Build better infrastructure
facilities in the country like more super-speciality hospitals, better rail-road network within the country and air
transport within and outside the country. Also includes aiding from the start of the journey till they leave the
country. Visa-on-arrival can be provided to medical tourists. The Indian embassy in foreign countries can
coordinate with the hospitals and officials in the country.
There were some mixed opinions among many medical tourists regarding the role of the government as a
facilitator. Most of the medical tourists felt that the government should stay out of the medical tourism sector
and the system. Medical tourists strongly felt that any kind of intervention or regulation by the government
would hamper the growth of this industry in India. The other opinion recognises the government’s efforts in a
positive state. They feel the government has stepped in whenever it needs to, for visa facilitation, rationalisation
of visa costs and the like. Initiatives from government and regulatory bodies are required to make the system
cleaner and more transparent like other competitor countries.
Patients considering medical tourism in India should thoroughly research the facility and medical professionals
they plan to work with to ensure that they are receiving safe and effective care. Though hospitals are clinically
competent, a lack of skill at the paramedic level was felt by several medical tourists. Most of them reflected the

20
need for superior training programmes for paramedics, not just in specialities but also in the general category
and front staff. Only then will service quality standards be met. Others expressed the problem of the lack of
retention of trained paramedics and the healthcare workforce.
However, there are also several potential drawbacks, such as language barriers, quality control issues, cultural
differences, and travel risks, that should be carefully considered before making any decisions.

1.5 - Comparison Of Indian Medical Tourism With Select Countries Of The

World

1.5.1 United States Of America

U.S.A, the world's largest economy in terms of gross domestic product and also the most technologically
powerful. But when it comes to medical tourism, why do people not prefer to visit the USA and try to visit
some other country? This point will be discussed here.
One of the major reasons is the cost of the medical.
The waiting period is also another reason why people do not prefer the USA and prefer some other nation.
Unfortunately, data on medical tourist flows are poor therefore one has to rely on service to estimate the flows
as well as the economic might of the medical tourism industry. In 2006 worldwide business and medical
tourism caused about 60 billion dollars which reached 100 billion dollars in 2012.
The World health organisation on the occasion of its 75th anniversary says that the world has been put to the
toughest possible test during the Covid-19 pandemic. Who have shown some shortcomings of medical tourism
are the shortage of healthcare professionals, the cost of treatment and the waiting list time. The World Health
Organization has treated the US as the most expensive healthcare system and in the absence of universal health
insurance many Americans struggle to pay their medical bills. Dressing the challenges listed in the charts
require a combination of increased investment in the health and starting and the infrastructure as well as aspects
to improve the efficiency and accessibility of the health care delivery. (Richter 2023)

21
Unit cost for different types of medical procedure (in USD)

Types of procedure USA hospital Indian hospital

hip replacement 50000 7500-9000

Knee replacement 45000 6000-8000

PTCA (angioplasty) 70000 4000-7500

Spinal fusion 75000 5000-8000

Breast augmentation 9000 3500-5000

Face and neck lift 11500 2500-4000

Heart bypass 100000 6000-9000

Healthcare index is an estimation that evaluates the overall quality of the health care system, including factors
such as health care professionals, equipment, staff, doctor and cost. It provides an assessment of the healthcare
infrastructure, services and resources available in a specific location. (“Health Care Comparison Between India
And United States”, n.d.)

22
As per the Hindu Business on June 15, 2023, India earned $7.4 billion (“India earned $7.4 billion through
medical tourism in last decade: Officials” 2023) through medical tourism
Whereas the USA earned $5 billion. Annually 40000 patients visit the USA for medical purposes whereas in
India approximately 2 million patients visit India each year from 78 countries for medical, wellness and IVF
treatments.

23
[Link] Swot Analysis In Brief:

1.5.2 Singapore

[Link] Medical Tourism In India:

Medical Tourism in India, in mid-2020, was estimated to be worth around USD 9 billion which makes India
stand at Number 10 in Global Medical Tourism Index. Approximately 2 million patients visit India each year
from 78 countries for medical, wellness and IVF treatments, generating $6 billion for the industry which is
expected to reach $13 billion by 2026 backed by the government’s Heal in India initiative. This not only
generates jobs, profits and forex for hospitals but also creates very valuable soft power for India, positioning it

24
as the Healing Center of the world. It also creates demand for high-end equipment, which results in continuous
upgradation of Indian healthcare, resulting in a spiral of demand generating quality, generating more demand.

[Link] Medical Tourism In Singapore

1. Singapore is one of the world’s top medical tourism destinations. According to the Medical Tourism
Association, Singapore ranks second after Canada in the Medical Tourism Index.
2. The city-state receives approximately 500,000 medical tourists each year. As many as 250,000 medical
tourists come from Indonesia alone!
3. Singapore's private hospitals offer exceptional healthcare services with state-of-the-art facilities and
well-trained medical specialists.
4. International medical tourists visit Singapore each year for a whole range of medical care and treatments
from health screenings to surgery.
5. Medical tourists can cover healthcare costs by obtaining an international health insurance plan.

Just like many of its neighbours, Singapore has thrived over the years as a destination for medical tourists to
seek medical treatment that would otherwise be unavailable or very expensive back at [Link] country’s
medical tourism sector is built on high-quality services and the involvement of up to 21 accredited hospitals
that are Joint Commission International (JCL) accredited. Medical tourists travel to Singapore for its excellent
healthcare system and structure, with the knowledge that medical professionals here use some of the most
advanced, high-end diagnostic equipment.

Even though the costs of seeking treatment can be higher than its neighbours (which is why securing
international health insurance coverage is recommended), medical tourists view Singapore as a safe country to
visit with clean and safe neighbourhoods and a stable political [Link] tourists travel to Singapore for
a wide array of services and operations, which include but are not limited to the following:

● Orthopaedic surgery (e.g. hip and knee replacements, spinal fusion, hip resurfacing: SGD $12,000 -
16,000)
● Cardiac surgeries (e.g. heart bypass, valve replacements: SGD $5,500 - $130,000)
● Cancer treatments (e.g. chemotherapy/radiology/immunotherapy: SGD $1,500 - $234,000)

[Link] Comparison Of Indian Medical Tourism With Singapore

Prominent strategies in the medical tourism industry the two countries have adopted a combination of different
strategies to gain competitive advantage and promote MT growth. These strategies are overviewed in Table 1
and compared against each other in this section

MT(Medical Tourism) strategies pursued by India and Singapore

25
 INDIA SINGAPORE
Cost leadership strategy Differentiation strategy (high-end complex
quality & superior technology)
Diversification strategy (from alternative Branding strategy (as a regional hub of
Ayurvedic therapy to a variety of medical medical excellence")
interventions)

Comparative cost percentages between India and Singapore

Particulares India Singapore

Heart-valve 9000 12500
replacement
Angioplasty 11000 13000
Hip 9000 12000
replacement
Hysterectomy 3000 6000
Knee 8500 13000
replacement
Spinal Fusion 5500 9000

Medical specialities are diverse and might be delivered with different levels of clinical practice proficiency. It is
important here to note that the excellence of one destination over another in a speciality extends beyond the
resource-based approach such as relying on human resources (like experienced and highly qualified practising
professionals) or physical resources (like cutting-edge technology). Considerably, such excellence is also a
matter of clinical excellence (Kapur, 2008), which can leverage disparately on wide-ranging competencies
including but not limited to medical education and training, patient care management, deployment of systems
for evidence-based practice, policy and succession planning, income-resource generation, etc.

Therefore, a crucial portion of success in establishing a MT market with a competitive edge can be viewed as a
process of strategic alignment between resources pertaining to medical speciality and core competencies of
clinical excellence.

[Link] Strategic Resources Of Mt Destinations: India And Singapore

INDIA SINGAPORE
Recognized medical • Cardiac surgery • Sophisticated diagnostic and surgical
specialities • Cranio- facial surgery procedures related to cardiology, neurology,
• Neuro-surgery oncology, ophthalmology, organ

26
 • Orthopaedic surgery transplants, orthopaedics, and paediatrics
No. JCI accredited 38 23(25)
organisations
(programs)
MT sector A private-dependent sector (10) A public-private dependent sector
infrastructure • A large number of multi-speciality • Two leading integrated healthcare private
corporate hospitals like Apollo, medical groups known as, Parkway
Fortis, Wockhardt, Max Healthcare & Medical Group and Raffl es Medical Group
Manipal. by which several of well-known hospitals
• Private medical chains have are run in the country besides a strong
international presence & tie-ups with overseas presence through joint venturing
many countries in Africa, the Middle and global strategic alliances with countries
East, and Europe & America, to refer such as China, India, and United Arab
patients to India Emirates. (9,12,13)
• A robust integrated medical informatics
infrastructure 22(14)
• Singapore Tourism Board (STB) which
operates many regional offices performs
several activities mutually with private
medical groups to support and broaden
their reach and referral networks in key
target international markets.15
Reputation • An attractively low cost-effective • A modern centre of clinical excellence,
medical care destination biomedicine & biotechnology
• A global spot of herbal medicine
(Known as the botanical garden of the
world)

[Link] Swot Analysis Of India And Singapore

India Singapore

Strengths
Strengths
1. Leading tourist destinations in Asia
1. High-Quality Service at an economic cost.
2. Popular for business travelling
2. A large pool of qualified doctors.

27
 3. Patients across the globe in more than 55 3. Rich in economy
countries are treated in India. 4. Safe
4. Strong presence in advanced healthcare e.g.
Opportunities
cardiovascular, organ transplants – high
success rate in surgery.
1. Strategic location
Opportunities
2. Tourists arrivals
1. Increased demand for healthcare services 3. Tourism receipts
from countries like the US, and UK with 4. Outbound tourism
ageing populations. 5. Outbound tourism expenditure
2. Fast-paced & stressful lifestyle increases 6. Medical tourism industry
demand for wellness tourism and alternative 7. MICE industry
cures.
Weaknesses
3. Deficiency of supply in National Health
Systems in countries like the U.K. and
1. Small country
Canada.
2. Limitations on amount of visitors
4. Demand from countries with
3. Limited resources
underdeveloped healthcare facilities.
4. Man Made attractions
5. Demand for retirement homes for elderly
Threats
people especially Japanese.
Weakness 1. Countries mimic.
2. Expensive to Live.
1. No strong government support/initiative to
promote medical tourism.
2. Low Coordination among the various
service providers in the industry– airlines,
hotels, travel agents and hospitals.
3. An unhygienic country as per the Perception
of the Customer.
4. No mandatory accreditation and regulation
system for hospitals.
Threats

1. Strong and tuff competition from Thailand,

and Singapore.
2. Lack of international accreditation for
overseas medical care not covered by
insurance providers.

28
 3. Low investment in health infrastructure.
4. General infrastructure is not impressive.

1.5.3 South Africa

Medical tourism is a well-established sector in developing countries and attracts a significant number of tourists
from developed countries. Medical tourism is a strong driver of economic growth, but some argue that this kind
of tourism promotes inequality in terms of access to healthcare facilities in both developing and developed
countries.
Medical tourism traditionally involves patients from less developed countries travelling to more developed and
medically advanced centres for treatment they cannot receive in their home countries (Connell, 2013).
However, an increasing number of patients from more developed countries now seek medical services in less
developed countries, such as South Africa, India and Thailand. Asia currently boasts the top three major global
medical tourism destinations, namely, India, Singapore and Thailand (Crush, 2012). More specifically, the
development of medical tourism as an economic development strategy in India is argued to have resulted from
the liberalisation of the economy and related efforts to reduce public expenditure and open the Indian economy
to foreign investment.
South Africa’s healthcare sector is influenced by remnants of apartheid inequalities which left the present
government with enormous challenges to provide comprehensive, quality, and affordable healthcare for South
African citizens.

[Link] Medical Tourism In South Africa

According to the 2020 Global Healthcare Index, South Africa is one of the most popular destinations for
medical tourism, with a global ranking of 22nd out of 47 destinations in the world medical tourism index. Every
year, medical tourists from all over Africa, Europe, the U.S. and other parts of the world visit South Africa
because they are attracted by the country's high-quality care with attractive destinations and activities. Cape
Town is the leading medical destination for travellers on the African continent.
Legendary surgeon Christiaan Barnard performed the world's first heart transplant in Cape Town.

[Link].1 Common Treatments In South Africa

South Africa is popular for affordable cosmetic surgeries such as breast augmentation, liposuction, nose
remodelling, facelift, tummy tuck, etc.
Other common treatments in the South African area:
1. Heart surgery
2. Orthopaedic surgery
3. Dentistry
4. Organ transplantation, etc.
29
[Link] Medical Tourism In India
India is an important role player, and after Thailand, the leader in the field of medical tourism. It is amongst a
group of nations, mainly developing, that offers relatively inexpensive treatment for foreigners. This is
notwithstanding its reputation as an impoverished country that is very often unable to maintain even the most
basic hygiene for its own population of 1 billion people. Despite this. India is a very good option for medical
tourism as it offers cheap top quality treatment in state-of-the-art private hospitals.

[Link].1 Common Treatments In India

The most popular treatments sought in India by medical tourists are
1. Alternative medicine
2. Bone-marrow transplant
3. Cardiac bypass
4. Eye surgery
5. Hip replacement.

[Link] Medical Treatment Costs In India And South Africa

(Approximate figures in US Dollars)

Procedure INDIA (USD) SOUTH AFRICA(USD)

CORONARY ARTERY - 50,000
ANGIOPLASTY 11,000 14,200
HIP REPLACEMENT 9,000 20,000
SPINAL FUSION 5,500 8,000
DENTAL IMPLANT 1,100 850

[Link] Swot Analysis Of India And South Africa

India South Africa

Strength Strength

1. Affordable healthcare cost. 1. Price advantages.

2. Short waiting time. 2. Credibility and professionalism of
3. Low pharmaceutical cost. healthcare providers.
4. Low-cost accommodation. 3. Good English proficiency in tourist
5. A large pool of quality doctors. destinations.
6. Patients across the clove in more than 55 4. Unlike many other African countries, urban
countries are treated in India. South Africa and especially Cape Town

30
 7. Strong presence in advanced healthcare e.g. offers a modern, cosmopolitan experience
cardiovascular organ transplants - high for medical travellers.
success rate in surgery International 5. English is widely spoken in most of the
recognition and reputation of hospitals and country, especially in major cities like Cape
Doctors. Town, simplifying communication.
8. Skilled, well-behaved, professional nursing
Weakness
staff.
9. World-class medical technology, equipment 1. Widening disparities due to unequal

and facilities. distribution of health care.

10. Diversity of tourism destinations. 2. Internal brain drain, disadvantaged

struggling rural public health systems.
Weakness
3. Inadequate legal framework for medical
1. Lack of transparency in government malpractices.
procedures. 4. Non-congruent treatment continuity and
2. No strong government support/initiative to patient follow-ups.
promote medical tourism. 5. Illicit medical practices like illegal organ
3. Low Coordination among the various trade.
service providers in the industry- airlines, 6. Inadequate skilled and well-trained public
hotels, travel agents and hospitals healthcare.
Unhygienic country as per Perception of the
Opportunities
Customer No mandatory accreditation and
regulation system. Thanks to the weakness of the brand, hundreds of

4. Only 17 JCI accredited and 198 NABH medical procedures are available at a comparatively
accredited hospitals in India. low cost, with most surgeries coming in at roughly a

5. Lack of uniform pricing policies. third of the price for an equivalent procedure in the

6. Weak infrastructure. UK.

7. Internal level doctor. Threats

8. Unhygienic hospital.
1. Increasing competition from other medical
Opportunities tourism in Africa

1. The higher growth potential of the medical 2. High cost to travel to South Africa.

tourist industry. 3. Lack of appreciation of medical tourism’s

2. The spread of regional markets. importance by the world government and

3. Shortage of supply in the National health society alike.

system of developed countries (e.g. UK,

Canada).

31
 Threats

1. The constraint of internal resources.

2. Overseas medical care is not covered by the
health insurance provider.
3. Low investment and subsidies for the
hospital.

1.5.2 Global Comparison

Let's have a glance at Doctor per patient ratio in various countries:

(Fleck 2023)

32
The top 20 nations in terms of medical tourism are

Figure: Top 20 countries as per Medical Tourism Index,2020-21

Brain-Drain of the Doctor from various countries (Buchholz 2023):

33
1.6 - Summary Of 5 Research Papers On Medical Tourism

1.6.1 Title: Medical Tourism: Treatment, Therapy & Tourism (Bagga Et Al., 2020)

[Link] Introduction
This research paper introduces the concept of medical tourism, which involves travelling to other countries for
healthcare treatment. India is highlighted as a rapidly growing destination for medical tourism due to its rich
medical history and modern medical facilities. The paper mentions the increasing number of visitors to India
for medical treatment, particularly from Bangladesh. The motivations and satisfaction of medical tourists are
discussed, as well as the competition among medical institutions to attract these tourists. Overall, India is
developing into a leading destination for medical tourism.

[Link] Literature Review

The paper explores the interrelationships between different forms of medical tourism and highlights the
importance of reliable information and the role of medical tourism facilitators in helping patients select the
most appropriate medical hub. The review also emphasises the importance of considering the emotional,
financial, and political aspects of medical tourism, as well as factors such as accreditation standards and quality
of care. Barriers to medical tourism are also identified, such as costs, government reforms, and infrastructure.

[Link] Research Methodology

The research methodology used to collect data was a combination of primary and secondary research. Primary
data was collected from 200 medical tourists using a self-administered questionnaire in offline mode.
Convenience sampling was used to collect data from medical visitors at Focus Imaging & Research Centre,
Hauz Khas (Delhi). The collected data was then analysed using Excel and SPSS tools. Secondary research was
also utilised for aggregating information on the study by reviewing associated literature to ease the buildup of
the fundamental structure of the research study. Exploratory & descriptive research was used to explore and
describe the factors considered by the tourists to choose their preferred medical tourism destination.

[Link] Findings:
The study found that the majority of medical tourists visiting India for treatment and tourism are between 19-30
years old and are primarily from Bangladesh. Approximately 30% of these tourists are seeking cosmetic and
plastic surgery. The main sources of information for these travellers are intermediary websites (45%), followed
by blogs (14%) and social media (12%). A significant number of visitors (45%) stay for a short period of 15-30
days, combining post-treatment recovery with vacation activities. Thailand is the preferred alternative
destination for medical tourism due to its numerous rejuvenation centres and vacation spots. The reputation of
the medical facility and the availability of state-of-the-art equipment and facilities are key factors influencing

34
destination choices. Additionally, many medical tourists consider the opportunity to combine medical services
with a vacation as an important factor in their decision-making process.

[Link] Conclusions:
The process of medical tourism involves researching and finding the best deals for state-of-the-art treatments in
foreign countries. The revenue generated by medical tourists is being recognized by governments and policies
are being implemented to encourage medical tourism. The competition among low-cost, high-quality medical
destinations has led to the development of websites, clinical packages tailored to specific medical conditions,
and personalised web pages. This is aimed at staying ahead in the competitive market of medical tourism.

[Link] Limitations
The study's limitations include a small survey sample of 200 responses, which is insufficient for accurately
predicting the medical tourism scenario in any country. The reasons for India's emergence as a medical tourism
destination cannot be generalised. The survey was conducted only at Focus Imaging & Research Centre in
Delhi, providing limited insight for developing an action plan for India's medical tourism landscape.
Additionally, language barriers with foreign patients made data collection challenging and time-consuming.

1.6.2 Title: A Study On The Challenges And Outlooks Of Medical Tourism In India With
Reference To The Chennai Region (Sasirekha & Sanskar, 2022, )

[Link] Introduction
It was in 1764; Sir Edward Winter began the first hospital in India at Fort St. Medical departments were
established during 1785 at Bengal, Madras, and Bombay presidencies with specialised surgeons and Indians
were given access to these facilities during the year 1842.
The Portuguese introduced the Western system of medicine to India and the entire base for the systematised
network of government-run hospitals started from the main hospital in Madras (Chennai city is the name we
know).
Madras Medical College was formed during the year 1835 which made it one of the oldest colleges of European
medicine in Asia which is still in existence. CMC (Christian Medical College) at Vellore was established in
1900 attracting many of the best talents from the United States. Joining supportive hands for all these
initiatives, The Madras Public Health Act was passed in 1939 which was the first of its kind in India

[Link] Objectives
The objective of this study is to determine the Challenges and Outlooks of medical tourism in Chennai city and
evaluate the actual potential foreign patients represented by Facilities, Cost, waiting period and feel-good-factor
in recognizing the role of government and relevant departments in this medical tourism industry. The purpose

35
of this study is to determine the impact of challenges and outlooks that lead international medical tourists to
select hospitals in Chennai as their medical tourism destination.
The purpose of this research was to investigate the challenges and outlooks of medical tourism affecting the
tourist’s preference in selecting hospitals in Chennai, Tamil Nadu for medical treatment.
Based on the above references, this study aims to determine whether “Facilities” or “Cost” is the necessary
variable that leads global tourists for medical assistance to select Chennai hospitals for health treatments.

[Link] Research Methodology

Both Primary and Secondary data were collected for the study. Primary data was collected through a structured
questionnaire taken from 200 foreign patients who were admitted at Apollo - Multi Specialty Hospital, Rela-
Multi Specialty Hospital, Gleneagles - Multi Specialty Hospital and SIMS - Multi Specialty Hospital.

[Link] Results
A descriptive analysis will comprise dimensions of dispersion (Gesler, W., 2007) diagrams, frequency tables,
and dimensions of central tendency.
To evaluate the developed hypotheses in the current study, multiple regression analyses were performed. To
examine which factors have the most impact on the Challenges and Outlooks of Medical Tourism, the beta
values were used.
The five significant factors, based on the beta values of the predictor factors, that will exercise the most
powerful impacts on the Challenges and Outlooks of Medical Tourism, which is: Facilities (β = .359), followed
Cost (β = .278), Waiting Time (β = .219), and FeelGood-Factor, (β = .210).
Independent Variables Facilities Cost Waiting Time Feel-Good-Factor R.

[Link] Discussion
The purpose of this research was to investigate the challenges and outlooks of medical tourism affecting the
tourist’s preference in selecting hospitals in Chennai, Tamil Nadu for medical treatment.
Control principles are the reflection of an individual’s personal view of travelling abroad for health care.
These three antecedents predict a patient’s intention to be involved in medical tourism in the near future.
K's (2008) study proved that the “Facilities” provided by the country and the hospitals the patients choose is the
solitary factor that attracts medical travellers to seek medical treatment abroad.
Based on the above references, this study aims to determine whether “Facilities” or “Cost” is the necessary
variable that leads global tourists for medical assistance to select Chennai hospitals for health treatments

[Link] Conclusion
The results confirm that the Ministry of Tourism, Tamil Nadu inputs rigorous efforts in promoting Chennai as
their destination image is reasonably effective, possibilities always exist to improvise the current situation if we
want to compete with other major tourism destinations within the country.
36
The result is in line with that of the facts demonstrated by previous studies In terms of service and quality of the
treatment and latest technologies installed in the hospitals, most of the patients are satisfied with the current
circumstances existing in the Chennai hospitals
The result is reliable with that demonstrated by previous studies The research contributes to the theoretical
improvement by applying the results as an example for understanding on how a Facilities, Cost,
patient-waiting-period and feel-good-factor has strong impacts on the aspects of challenges and outlooks in
medical tourism prevailing in the high-tech hospitals of Chennai city.

1.6.3 Title: An Assessment Of Competitiveness Of Medical Tourism Industry In India: A Case

Of Delhi NCR (Malhotra & Dave, 2022)

India has emerged as a prominent medical tourism hub, yet the dynamic forces in the regional and global
landscape are creating a complex balance of opportunities and risks for the Indian stakeholders. The outbreak of
the Coronavirus pandemic in 2019 has further complicated the market dynamics for the medical tourism
industry. This study aims to analyse the key driving factors for the medical tourism industry in India and the
issues that Indian stakeholders should address in crafting a winning strategy. A qualitative research design was
adopted, and data were collected through semi-structured in-depth interviews with practitioners and senior
representatives of the hospital management. The study adopted abduction logic and analysed data using a
constant comparison method. The study presents the assessment of the medical tourism industry in India and
the scope of opportunity for Indian players.

[Link] Introduction
Catalysed by emerging technologies, varying economic and demographic trends and a new age of healthcare
consumerism; the worldwide scenario of healthcare is rapidly evolving.
A growing ageing population and a swelling burden of diseases are rising the demand and cost of medical
services. This evolution in healthcare is driving cross-country and cross-industry convergence (Deloitte Global,
2021), resulting in an upsurge in the worldwide medical tourism market.
As this trend towards healthcare is enduring around the world, more and more countries are extending their
health systems to access care, not just for their natives and gaining strength as leading service providers for
international patients. Governments of these developing countries are working towards prioritising their health
systems; enhancing productivity, boosting avenues for innovation and entrepreneurship, generating employment
opportunities, increasing foreign exchange earnings, and driving GDP growth (Rahman, 2019)

[Link] Objectives
This study aims to analyse the key driving factors for the medical tourism industry in India and the issues that
Indian stakeholders should address in crafting a winning strategy. The purpose of the study was to identify and

37
analyse the factors and dimensions that influence the competitiveness of a country as a medical tourism
destination. The purpose of this research is to analyse the factors that are crucial for India to identify, create and
deliver a distinctive value proposition as medical tourism destination

[Link] Methods
Considering the emerging nature of this industry, a qualitative approach was exercised to truly analyse the value
proposition of India as a medical tourism destination. The case study method was adopted to classify and
analyse the dimensions that can position India as a prominent healthcare service provider for overseas
[Link] case being studied becomes the boundary of the research, and by focussing on a single context this
approach seeks to offer an extensive enquiry and meaning of the phenomenon under study (Creswell, 2007;
Miles & Huberman, 1994; Yin, 2011). The context was bounded geographically and the problem at hand was
thoroughly explored in the Delhi-NCR region. As suggested by Stake (1995), a holistic analysis of the medical
tourism industry in Delhi NCR allowed for an instrumental way to investigate the phenomenon at a broader
level in India.

[Link] Results
This section organises the fieldwork findings around the dimensions outlined in the (Malhotra & Dave, 2022)
study to identify any contrast and facilitate discussion on Delhi-NCR’s proposition as a medical tourism
destination. These dimensions are: assessing a country’s competence as a medical tourism destination,
successful positioning and government as a facilitator. While each of these dimensions has been considered
independently, for analytical purposes, the apparent correlation between these three domains should be
acknowledged. The major reasons reported for India’s exponential growth in this segment are its clinical
expertise, major cost competitiveness over other countries, and conducive and friendly environment

[Link] Discussion
Research aimed at exploring the sources of competitiveness, in a particular industry, for firms competing in
international or regional markets ([Link], 2019; Moon et al, 2015; Thompson et al, 2013) have
emphasised the role of abilities, proprietary knowledge, innovation capability, sustainable business and
economic model, technological innovation, pace of internationalisation, quality, business excellence and human
resources. Based on their research and taking the above-mentioned factors into consideration, India’s capability
as a medical tourism destination is assessed below and gap areas are identified.

38
 Dimension Key growth drivers Opportunity scope for Indian
stakeholders

Healthcare Growth of a robust private sector with Remedial investment in healthcare

infrastructure and clinical and technical expertise and infrastructure, human capital
human resource international standards development, digital and technological
innovations and advancements

Tourism and India scores high on parameters like Increase focus on logistics and
hospitality cultural adaptability, soft skills and hospitality infrastructure, services and
budget friendly hotels and travel quality standards
destinations

Refined delivery Emergence of newer unconventional Proactively address streamlining,

operating models and technological standardisation and transparency of
revolutions service—healthcare, travel, tourism and
hospitality

Government initiatives Few government initiatives to Procedural shifts, streamlined policies

and regulatory augment the medical tourism market along with regulatory interventions to
framework facilitate business and fuel growth

Collaboration and Initial level of representation with Collaborative efforts and public private
coordination forums like FICCI and CII partnerships extend potentials to
enhance expertise, efficiency and
investment

Successful positioning India’s value proposition with the Brand building initiatives, focus on key
right combination of cost and quality target groups, user/region/country
efficiency specific marketing strategy

[Link] Conclusion
India’s evolution, as amongst the world’s most preferred medical tourist destinations, is expected to sustain a
steady growth. This growth is driven by five major factors: cost competitiveness, medical expertise, quality of
healthcare services, robust private sector and cultural adaptability.
Even as these factors propel India forward, there are some major gaps to bridge. Pandemic and uncertainty
around it have further intensified the need for the industry players to direct their focus on realignment and
revaluation of their business models and work towards enhancing resilience and agility

39
1.6.4 Title: A Comparative Analysis Of Medical Tourism Competitiveness Of India, Thailand
And Singapore (Ahmed & Ganguli, 2019)

[Link] Introduction
Medical tourism (MT), as an international market, has been witnessing robust growth over the past decade. Past
research has not considered the competitiveness of these destinations from a strategic and comparative point of
view which can reinforce tourism planners in countries with newly emerging MT trends to base their decisions
on. Carrera and Bridges (2006) who sought to standardize the definitions of 'medical tourism' and 'health
tourism' found a conceptual ambiguity regarding these in the existing literature. They recognized 'health
tourism' as an umbrella concept defined as "the organized travel outside one's local environment for the
maintenance, enhancement or restoration of an individual's wellbeing in mind and body" (p. 447), while a
subset of this tourism segment consists of 'medical tourism' defined as "the organised travel outside one's
natural healthcare jurisdiction for the enhancement or restoration of the individual's health through medical
intervention" (p. 447).
This paper, through its external strategic overview, can support previous research investigating internal strategic
factors responsible for developing a potential for investment in MT (Ebrahim & Ganguli, 2017)

[Link] Findings
Thailand, Singapore and India are being recognized as the three coveted destinations of MT and are projected to
control more than 80 per cent of the Asian market in the future (Rose Mary, 2014).
In India and Thailand, these programs during 2016-mid 2018 alone have raised amounts which are 30% more
than the entire number of accredited programs before this period

[Link] Conclusion
How have India, Thailand, and Singapore achieved a competitive edge in the global MT market?
Based on the examination of relevant literature and cross-country benchmarking analysis, there is no short
answer to this question. Thailand's product bundling strategy has been aligned with what is known as the
best-cost provider strategy; this approach has played a catalyst role in its overall tourism and hospitality sector
attractiveness and subsequently, boosted its performance. The identified resources like the qualities of medical
specialities, obtained international accreditations, Medical Tourism sector infrastructure, and established
reputation are found distinctively central to each of these destinations' strategic approach and significant for
creating true value for medical tourists and key players in each sector. Resources are managed in a dynamic and
a complex process in which each destination has exhibited different niches, and subsequently this justifies the
different cost structures and value propositions created.

40
1.6.5 Title: Medical Tourism In India: Possibilities And Problems Of Alternative Medical
Treatment (Prakash & Kummar, 2020,)

Medical Tourism In India: Possibilities And Problems Of Alternative Medical Treatment is a research paper by
Prakash Gautam of Soka University, Japan and Kumar Bhatta of Chiba University, Japan published in
Internatıonal Journal Of Health Management And Tourism in the year 2020. This study aims to explore the
problems and potential of medical tourism in India. India has become one of the destination countries for
medical tourists from around the world. However, due to issues at both the policy and operational levels, India,
like many other such countries, faces several problems in the development of its medical tourism industry.
Indian medical tourism can be divided into four categories: surgical treatment, cosmetic surgery, alternative
medical treatment, and wellness treatment. In this study, the authors focus on alternative medical treatment and
wellness tourism and explore the possibilities and problems.

[Link] Introduction
Medical tourism has become popular in countries such as Singapore, Indonesia, Malaysia, the Philippines,
Thailand, the UK, the USA, Japan, Korea, and India. High medical treatment costs in the home country,
dissatisfaction with long waiting times, a low-cost carrier, development of almost all medical technologies and
improvements in services are considered to be among the factors explaining this growth.

[Link] Literature Review

Medical tourism consists of tourism for surgical treatment, cosmetic surgery, complementary alternative
medicine (CAM), and wellness treatment. The Indian healthcare system is well-known for providing quality
medical services at an affordable cost. India has the potential to be one of the primary health tourism
destinations not only for Asian visitors but for tourists from elsewhere in the world.

[Link] Alternative Medical Treatment And Medical Tourism In India

Ayurveda, Unani, Yoga, Naturopathic, Siddha, and Homeopathy are rapidly gaining popularity in India. The
Indian government created the Ministry of AYUSH in 2014, in part to promote medical tourism in the country.
Despite advances, however, Indian alternative treatment and wellness tourism is not free from challenges.

[Link] Types Of Medical Tourism In India

Medical tourism can be broadly divided into health tourism and wellness tourism. We further divide these two
broad categories into four subcategories: surgical treatment tourism, cosmetic surgery tourism, alternative
medical tourism, and wellness treatment tourism.

41
[Link] Introduction Of Alternative Medical Treatments Of Ayush
AYUSH is the acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy. All of these
alternative medical treatment systems attract international patients and generate medical tourism. In recent
years, many people have sought a healthier lifestyle and vacation patterns in India.

[Link] Wellness Tourism

The annual Indian wellness industry growth rate is 18.6 %, while the global wellness industry is expanding at a
rate of 15%. Around the world, China, Brazil, the United States, India, and Indonesia represent the largest
growth markets (Manideep [Link]., 2018)

[Link] Possibilities of Alternative Medical Treatment

Alternative medicine is becoming a medical trend worldwide. There are multiple explanations for the growing
popularity of alternative medical treatment. Ayurveda, the most popular alternative system practised by Indians,
is currently the most commonly used treatment method for elderly patients. The revival of traditional and
alternative medicine such as AYUSH has helped to boost India's medical tourism market.

[Link] Problems Of Alternative Medical Treatment

The Indian herbal drug and medicine industry needs to ensure the procurement of standardised, authentic raw
materials free from toxic contaminants. Improved processing technologies and conducting all operations under
the government of India is also needed. Indian doctors and the clinical infrastructure in India are considered
excellent. However, the general infrastructure does not necessarily meet the needs of medical tourists.

[Link] Findings
The government has continued to increase the budget of the AYUSH ministry every year; in 2018 the total
budget increased by more than 13% as compared to the previous year [Press Trust of India-PTI, 2018].
Between 2013 and 2015, the number of wellness tourism trips to India increased by 18% (Global Wellness
Institute, 2016), and the revenue from wellness tourism has grown by 7.8% over the past five years (Global
Wellness Institute, 2018). According to a 2013 European Environment Agency report, the world's elderly (60
years and older) population has increased to approximately 841 million, comprising more than 60% of the total
population (European Environment Agency, 2013). The 2012 NHIS reports that the use of Yoga and yoga
therapy in children had increased from 2.5% to 3.2% since 2007

[Link] Conclusion
This study examines Indian medical tourism in general, with an emphasis on wellness travel and alternative
medical care. The use of standardised, authentic raw materials must be ensured by the herbal drug and medicine
industry. Processing technologies must also be improved. Infrastructure must also be upgraded. Non-medical

42
staff must receive more training in cross-cultural sensitivity and language skills, and the issue of exorbitant
lodging and boarding must be addressed. These issues must be thoroughly examined and fixed as they may
seriously limit the development of India's medical tourism sector. Future studies should examine the challenges
facing alternative medicine and wellness tourism in India using primary data from the supply and demand sides.
It is necessary to perform logistics research.

43
 CHAPTER- 2

RESEARCH
METHODOLOGY

44
 2.1 - Objective Of The Study

There are various primary as well as secondary objectives of this research.

2.1.1 Primary Objectives

Various Primary objectives of our research are mentioned below:

● To know which factors influence the patients to choose India for Medical Treatment.
● What are the challenges and opportunities that medical tourists face?
● How the Indian Government and Healthcare industry can improve the medical tourism experience.

2.1.2 Secondary Objectives:

Various secondary objectives of the research:

Disease related:

● What is the name of the disease that the patient is suffering from?
● Is it life-threatening?
● Whether the treatment is available, If yes then what’s the name? If NO, is the treatment likely to be
available in near future?
● Is there a history of the same disease in the patient’s family?
● When did the patient first realise that something was wrong with the patient’s body?

Decision regarding Foreign Treatment:

● Why did the patient decide that they wanted to get the treatment from a foreign country, not from their
home country?
● Which countries were there for consideration for medical tourism?
● From where did the patient find India?
● What factors influence a patient's decision to choose India for medical treatment?
● How often did the patient receive conflicting information from different medical care professionals for
Indian Hospitals?
● What were the Patient’s expectations for their medical tourism experience?

Agent/consultant Information:

● Does the patient hire any agent?

● Is the patient medical travel facilitator well-acquainted with the referral hospital?
● What is the name of the Agent and how did the patient find out about the agent?
● What was the service provided by the Agent?
● Rate the patient for his/her service
● Do the patients think that they could have managed without an agent?
● Will they recommend others to hire an agent or to do it by themselves?

India and Hospital:

● What were the top 3 cities in India in consideration for treatment?

● Why that city?

45
 ● What were the biggest challenges patients faced as a medical tourist in India?
● In which hospital is the treatment going on?
● How comfortable is the patient with the procedure and the treatment received so far?
● What did the treatment cost?
● Is the treatment covered under insurance?
● How much is the cost difference between the treatment in the patient's country and India?
● Why specifically that hospital?
● Were the patients satisfied with the quality of the facilities and equipment at the hospital?
● Difference between the treatment of healthcare providers in a patient's country and India?
● Overall experience of the patient?
● Do the patient have any concerns or complaints about the hospital?

Language:

● How will the patient rate their as well as staff English speaking and comprehension skills?

Others:

● Did anyone travel/stay with patients when coming to India for treatment?
● Any cultural challenges faced by patients during medical tourism?
● How would patients rate the quality of medical treatment in India?
● What advice would he/she give to other patients considering medical tourism in India?
● Has the patient noticed any changes in the dietary habits?
● What factors do the patient believe have contributed to the rise in medical tourism in India?

2.2- Sources of Data

2.2.1 secondary Data

Secondary Data is collected from the internet, books, magazines etc. A detailed list of sources of secondary
data is mentioned in Chapter 5, Page number 58.

2.2.2 Primary Data

Research instrument – Interview Schedule (A copy of questionnaire is attached in Chapter 6, Annexure 2,

Page number 68).

Population – Ahmedabad city in November – December 2023

Sampling Element – An individual foreign who has come to India for medical purposes and is ready to give an
interview about his/her experience and findings.

2.3- Sampling Method

In our qualitative research we have used the judgement sampling method.

46
Judgement sample is a type of non-random sample and we have selected based on the opinion of our project
guide. As we are doing research on foreign visitors for medical treatment/tourism we wanted to examine them
only that’s why we have selected the Judgement sampling method.

2.4- Sample size

12, as instructed by the project guide.

2.5 -Limitations of the study

● Lack of reliable data:

The human equation may distort the returns. If an interviewer has a certain bias, he may unconsciously
devise questions so as to secure confirmation of his [Link] are conducting interviews with foreigners
and majority Our presence (interviewers) on the spot may over stimulate the respondent, sometimes
even to the extent that he may give imaginary information just to make it interesting. He may tell things
about which he may not himself be very [Link] is also possible that the interviewer’s presence may
inhibit free responses because there is no anonymity. It is based on the patient’s opinion and experience.
Individual bias can be there.

● Time constraints:

Another key limitation was time constraints. The window of opportunity to collect the data was very
limited. It would have been more beneficial to take more time to collect surveys. And it was not easy to
find the patient as they are not Indian and some of them are not even resident in India.

● Cause and relationship:

As we have done qualitative research, we are having an individual's response not any number by the
respondents. Therefore we cannot do analysis of the data we collected and can’t show fact based things.

● Problem in questionnaire

The choice and wording of the questions on a questionnaire may influence the descriptive findings.

● Ahmedabad based study

This research is limited to the value proposition of the medical tourism industry in Ahmedabad city
only. However to get an overall perspective of India as a medical tourism destination it is required to
study conditions in other major cities also.

47
 CHAPTER- 3

FINDINGS AND
ANALYSIS

48
 3.1 - Findings
This section organises the findings of the fieldwork done by conducting interviews of medical tourists to assess
the competitiveness of Ahmedabad as a destination for medical tourism in India as well as India’s global
positioning in the Medical Tourism market. Based on the interviewee’s responses, below are the findings of the
research

3.1.1 India’s Competence as a Medical Tourism Destination

India shines as a medical tourism hub, offering cutting-edge treatments at a fraction of the cost in developed
nations, thanks to its highly skilled professionals and world-class hospitals.

Healthcare Infrastructure
Over the past few decades Indian hospitals have invested a lot of money and resources in modernising their
equipment and tools used for minimally invasive surgeries. Most of the respondents agreed that India has very
good medical infrastructure compared to their countries and it was one of the if not primary reasons behind
choosing India as a destination for medical treatment.

“What factors, according to you, have contributed to the very large number of patients coming to India
for treatment?
Efficiency, availability of good medical equipment, doctors.” - Patient no. 9, Mr. Charles.

Hospital Staff and Doctors

According to most of the respondents the hospital staff was very cooperative and the patients who were able to
speak English had very little difficulty in communicating with the Hospital admin staff and doctors. Their only
problem according to them in terms of communication with the hospital was with the nurses and ward boys.
They felt that improvement could be made if Nurses and Ward boys could speak in English.

High-quality care
India boasts a large pool of highly qualified and experienced medical professionals, many of whom have
trained or worked in the US, UK, or other developed countries. Hospitals are also increasingly adopting
cutting-edge technology and adhering to international standards of care.

Wide range of treatments:

Indian hospitals offer a wide range of medical treatments, including cardiac surgery, joint replacement,
oncology, organ transplants, and Ayurveda. This makes India a one-stop shop for patients seeking specialised
care.
Cost-effectiveness:
The other reason is treatment available at a cheaper rate as compared to other nations.
“Can you give me an estimate? That's the difference between Rajabhoj and Gangu-Teli, that much.
Okay, sir. Right? Yes sir. Now I will tell you where Rajabhoj is. Rajabhoj in India, Gangu-Teli in
Australia.” - Patient 9 Vandeben Trivedi

3.1.2 Promoters of Indian Medical Tourism Industry.

People working in Indian high commissions in foreign countries.
In one of the interviews, the respondent revealed that he was close friends with an Indian diplomat who
influenced him to get treatment in India.
49
Doctors who have previously worked in Developed countries
Few of the respondents revealed during the conversation that they used to get the treatment in their country
from the same doctor who operated on them in India. On further investigation, it was revealed that some of the
doctors have made such a good repo with their patients that they are willing to come to India to get treatment
from the same doctor.

Hospitals which Have Subsidiaries in Developing Nations

Two respondents revealed that the hospitals they visited in their country advised them to get their treatment
done in their hospitals in India and when we probed it further we found out that the respondents were advised to
do so because of good infrastructure in their Indian branch hospitals.

3.1.3 Reasons Behind India Getting Medical Tourists From Developed Countries
As we all know developed countries have far superior medical industries when it comes to access to equipment
and drugs and technical advancement but still people are travelling to countries such as India for medical
treatment and it is not just because of cost savings. It is one of the major reasons but not the only reason. Here
are some of the other reasons we found out during our research:

Waiting Period:
According to one of the respondents the waiting period is very long in developed countries and he believes in
India you can get treatment very quickly. He believes that the doctors in India act faster than doctors of
developed countries.

Experienced doctors
Respondents believe that Indian doctors are much more skilled than doctors from any other country and when
asked why so they say it can be attributed to India’s very large population, and low doctor-patient ratio which
give doctors more hands-on experience.

Cost-effectiveness:
The other reason is treatment available at a cheaper rate as compared to other nations.

“It's a huge difference, it's a huge difference. Here you have to pay a lot, a lot. And this like compared to
US, over there is nothing. And other is Yeah, even though if you have insurance, maybe the copay is very
huge over here” - patient 11 Neetal Patel.

3.1.4 Government as a Facilitator

There is a mixed opinion among the respondents about government interventions. Some respondents believed
there should be some government intervention and some believed that the government has no role in it.
Government hospitals like U.N Mehta have built trust among the patients but the majority of the respondents
were from Private hospitals. One of the respondents advised that one should at least visit the government
hospital once before getting any treatment from the private sector.

50
 “But I would prefer everyone to go to the first civil hospital in Ahmedabad than any other hospital.” -
Patiënt 9 Vandeben Trivedi.

3.1.5 Positioning
Most respondents talked about how they found out about India through friends, family and their local hospitals
which helped them get in touch with foreign patient teams of the hospitals.

“I was at the hospital. There is a doctor. The hospital's name is regency. I met Dr. Gupta. Okay, there
was Dr. Gupta in your country who recommended you to go to India. Yes? Yeah, and he told me that you
go over there.” - patient 7, Taslim Abdul Sattar Ayub

According to the respondents they chose Ahmedabad over other major cities because of its lower cost of living.

“Ahmedabad, because you know the treatment is cheaper than Mumbai, you know. We used to go to
Mumbai fast, but we had like Andabad is cheaper than Mumbai so we came there.”- patient 8, Issak
Omar

Benefits of Medical Tourism

Creates a positive image in the mind of the patient and it helps create a positive image of India in the world
which will help India become ‘Vishwa guru’.

3.1.6 Avenues for Future Research

Further research can be done by taking all the major Medical tourism destinations into consideration. Another
research can be done where not just allopathic but ayurvedic and other alternative treatments are also taken as
research.

51
 3.2 Analysis
We analysed the data by converting the audio conversation into a transcript and then we went through the
transcript and tried to come up with various themes and to identify the correlation between various themes and
their interdependencies.

Figure: Interconnection between various themes found during the research

Influences:
In our conversation with the patients we found out that the following are the top 3 biggest influences on the
patient while choosing a particular country and hospital for treatment.
● Friends & Family: It was found that a patient is more likely to come to India if one of his/her friends
and relatives has already gotten treatment from India.
● Local Doctors: The local doctors work with Indian Hospitals, they recommend their patients to go to
India to a particular hospital which can be their own or sometimes other hospitals.
● Agents: The agents are advertising their services on Facebook and local WhatsApp groups to scout
clients for their tie-up hospitals. These agents are especially targeting clients who do not speak English.
Local Doctors as well as the Agents work with Indian private hospitals to refer patients to them on commission.

Hospital Types:
● Government Hospitals: Here it not just includes government hospitals but PPP model hospitals too. It
was found that the foreign patients went there not because of advertisements or agents but because of

52
 word of mouth. It was analysed that the patients had a slit mistrust of private hospitals and trusted
government hospitals more because of government hospitals being cheaper than private hospitals.
● Private Hospitals: They successfully pull patients because of their network of doctors and agents. They
have dedicated teams to handle international patients and give them quality services at competitive
prices.
○ They have monetary incentive schemes for the doctors and agents to recommend their hospitals.

India’s Competencies:
After analysing the responses we found out that the following are the things working in favour of India as the
preferred destination for medical tourism:
● Low Cost: Cost is the biggest factor for patients coming from low-income countries and India has
positioned itself very well in terms of cost.
● English-Speaking Country: Most Indian professionals are fluent in English, which works in favour of
the country because English is the most preferred language for international exchange.
● Skilled Doctors: Indian doctors worldwide are known for their competence and skills.
● Generic Medicines: India is known for being the pharmacy of the world which helps Indian hospitals
reduce their costs for medication.

Problems:
While talking to the respondents we found out that although they had an overall good experience they faced
some problems too which are listed below:
● Warm Weather: For some of the respondents Ahmedabad’s weather was too hot.
● Non-Veg Food: A lot of the respondents felt that they were discriminated against because of their eating
preferences.
● Blood Bank: According to one respondent they had a problem procuring blood from the blood banks
and the hospitals were not helping them in that.

Opportunities:
With problems come opportunities to solve them and also new services for the medical tourist to enhance their
experience.
● Alternative Medical Treatments: The government has started working in this direction by creating The
Ministry of Ayush, a ministry of the Government of India, which is responsible for developing
education, research and propagation of traditional medicine and alternative medicine systems in India.
The private sector just needs to promote it more in foreign countries. It will open up new sources of
patients for the hospitals.
● Blood Banks: We all know that India has a shortage of blood which makes it harder to procure blood
during times of need. It is a fundamental problem which can be solved by optimisation of the supply
chain of blood to reduce wastage and predicting the need for blood before it even arises by using
technology.

53
 CHAPTER-4

RECOMMENDATIONS
AND
CONCLUSIONS

54
 4.1 - Recommendations
Due to constant propagation and popularity among the media, researchers and the policy-makers this particular
term “medical tourism” gained its momentum. The necessity to add the word "tourism" in this medical
treatment concept is far better than its looks but with some suggestions Indian medical tourism may achieve top
level position in the whole medical tourism world market. They are described below.

4.1.1 Recommendations For Hospitals And Doctors

● Medical tourists get attracted to world-class healthcare facilities. Hospitals need to invest wisely in
technology-enabled services and facilities as per global standards. Hospitals need to focus on
Healthcare-IT(Information Technology) collaboration as India's medical tourism market is expected to
grow at a significant rate, so invest in advanced IT infrastructure to enhance patient care and experience.
For that a call for increasing healthcare-IT collaboration should be made.
● Emphasise luxury hospitals as the rise of luxury hospitals in India has contributed to the country's
popularity as a medical tourism destination. Hospitals can continue to invest in state-of-the-art facilities
and high-end services to attract more international patients.
● Focus on digitalization, streamlined visa processes, and international collaborations are essential to
strengthen India's medical tourism standing. Hospitals can prioritise digital healthcare solutions and
establish international partnerships to enhance their global reputation. And also for better accessibility to
services they can create an app for using the services offered by hospitals or clinics.
● Understand the competitive landscape as it is essential for doctors to be aware of the competitive
pricing, highly trained doctors, and the range of treatments available in India to position their services
effectively within the medical tourism industry.
● The main objective of medical tourists is to receive good quality medical treatment, doctors should
focus on providing high-quality care and operational excellence to attract and retain medical tourists.
● The Indian government is investing a significant amount to improve hospitals and support the tourism
sector, aiming to create outstanding medical tourism hubs with the latest technology. Hospitals can
utilise these investments to upgrade their infrastructure and medical facilities. The Government plans to
include subsidies and benefits for medical tourists in India and aims to improve the country's medical
tourism sector. Hospitals and doctors can leverage these subsidies to make medical treatments more
affordable for international patients.
● In many hospitals accreditation and regulation systems was not proper handled. With lack of uniform
pricing policies across hospitals also may be cause to decline in medical tourism in India.
● Interpretation service helps hospitals as they can hire staff for international patients who are fluent in
speaking English. Hospitals need to hire translators for non-English speaking patients also. Leverage the
advantage of English fluency among doctors and nurses in India, making it easier for international
patients to communicate with healthcare providers

55
4.1.2 Recommendations For Government

● Some stakeholders in the medical tourism industry have expressed the need for increased governmental
support to develop medical tourism at a larger scale. Medical tourism is a team effort. Government
needs to invest in collaborating with hospitality partners, representatives of international health officials,
and others. With low coordination between the various players in the industry exp. airline operators,
hotels and hospitals can decrease in Indian medical tourism.
● Highlight the cost advantage of healthcare services in India compared to western countries, as India
offers world-class care and treatment at lower costs, with significant savings that needs to be maintained
in future also.
● Emphasise the quality of healthcare services by encouraging wellness centres to seek accreditation from
recognized organisations like the NABH (National Accreditation Board for Hospitals & Healthcare
Providers) and AYUSH.
● Customer perception as an unhygienic country, poor infrastructure in government aided hospitals and
lack of international accreditation for medical facilities in India should be a downfall for Indian medical
tourism that must be going to change.
● Promotion and Marketing from the government side should continue to promote India as a premier
healthcare destination through campaigns like "Heal in India" and by providing quality publicity
material.
● The government can promote seamless relationships between patients and providers across borders by
providing hassle-free e-visas, medical technology, knowledge exchange, insurance packages
incentivizing medical travel, ease travel for medical tourism purposes by providing special medical
visas for patients and their attendants.

4.1.3 Recommendations For Patients

● It is important to note that the quality of medical care can vary widely between different hospitals and
doctors, both in India and in other countries. Patients should conduct thorough research about the
hospital, the specific treatment or procedure, and the healthcare providers. This includes checking the
hospital's accreditations, success rates, and patient reviews.
● It is advisable for patients to have detailed consultations with the healthcare providers in India to
understand the treatment plan, potential risks, and expected outcomes.
● Many times by the cultural difference international patients face problems to deal with. That patient
should build a support system with fellow international students, expatriates, or local individuals can
provide emotional support and a sense of community.
● While engaging in self-care activities such as exercise, meditation, hobbies, and relaxation techniques
can help manage stress and promote emotional well-being. A daily routine can provide structure and
stability, which is beneficial for mental health and emotional stability.

56
4.1.4 Other Recommendations: -

● Promoting alternative healthcare services with doctors can promote alternative healthcare services,
especially through traditional therapies like Ayurveda, Yoga, Sidha, and Naturopathy to position India as
an attractive destination for medical tourism.
● Offering extra services such as quotation assistance, visa assistance, and comfortable travel and stay
arrangements can make the experience more convenient for medical tourists and enhance the
attractiveness.
● Investing in technology can help enhance global collaboration among stakeholders in the medical
industry.
● India has the potential to become a leader in the medical tourism industry by adopting a niche marketing
approach, providing alternative medicine, and offering excellent customer service.
● Financial incentives, streamlined visa processes for medical tourists, and investments in healthcare
infrastructure, promoting alternative healthcare services, addressing mental health, and fostering
public-private partnerships are some of the key expectations for boost to Indian medical tourism.
● The limited resources for mental health care in India, such as a shortage of trained psychiatrists and
mental health beds, can pose challenges for international patients seeking emotional support and mental
health treatment. For that, steps must be taken to solve it.

57
 4.2 Conclusion
Based on our research, India is emerging as the world's most preferred medical tourist destination and is
expected to grow.
Various factors that support the medical tourist are:
● cheaper cost as compared to other developed Nations
● support of government hospitals like U.N. Mehta
● Quality of healthcare services
● modern equipment as well as efficiency of the hospitals
● less waiting period
● robust private sector

As every coin has two sides, medical tourism also has two sides. They experience both good terms as well as
face challenges.
Challenges like:
● problems in conversion of currency
● problems in getting visas in underdeveloped countries or during the festival time
● corruption
● language barrier
● change in environment as well as dietary
● infrastructure
This research mainly focuses on India's specialist Ahmedabad as competence in medical tourism. Our research
shows the key factors that have contributed to medical tourism and various opportunities for various
stakeholders in healthcare.

We have also been allotted such practical tasks in previous years but it was an individual task and this year we
have worked in a group. Presenting yourself in a group has taught us many things like working with patience,
listening to everyone and respecting individuals' suggestions. While taking interviews, knowing people from
different countries and cultures was fabulous and exciting.

Further research on this topic can be done by considering all the major Medical tourism destinations. Another
research can be done where not just allopathic but ayurvedic and other alternative treatments are also taken as
research.

58
 CHAPTER- 5

BIBLIOGRAPHY
AND
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64
 CHAPTER- 6

ANNEXURES

65
6.1 - Emerging Themes From The Interview Transcripts

Patient Hospital & Experience & Money Challeng

Disease Related Influence
Details Doctor Opinion Related es
Staff was nice &
Cycle Cell Anaemia Aashka Hospital Agent cheap language
helpful
Symptoms when 7 Discrimination lack of
Hematologist In India for a year
patient 1 years old because of Non-Veg support
(Silva Would recommend Food
Treatment 30 days Friends
Kazamne) others (Non-Veg)
Competence of Liked Indian
On-going
Doctors treatment
Cheap price
Agrawal Eye
Replacement of Cornea Good Medicine
Hospital
Native Dr. Costed
Patient Symptom: Eye pain Good Experience Language
recommended around 60K
2(Pedro
Under Food(No
Shouk) 5 Hours of Surgery Student here Interaction was good
Insurance Non-Veg)
Purchased in problem
Follow-up every week
India with staff
Modern
Large VSD UN Mehta Satisfied 1.8 lacs Language
Equipments
Dr. Would recommend
3 weeks of stay Satisfied with Both Culture
Recommendation others
Patient 3
(Mark Options: Delhi, Satisfied with UN
Recovery in 9 months
Mumbai & A'bad Mehta
Finley)
Sym[toms after birth Best Treatment
Good doctors
Comfortable
Huge Visa
Tetralogy if Phalloid UN Mehta War in Yemen Smooth Treatment
difference Problem
Options: Delhi, $500 spent
OPen heart surgery Cheap Very Comfortable
Pune Mumbai in Visa

Patient Majority High

about 2 months Yemennie coming No Agent required Exchange
4(Muhhamm
here Rate
ad Ali)
Symptoms when child Language
was of a year Problem
Because of
Festival
Crowd

66
 Congestive Heart Cultural
Epic Hospital Insurance Very Comfortable 20-30K
Failure Challenge
Huge
Ongoing Satisfied Cost Good Experience
Patient Difference
5(Dashrat Colleague worked Would recommend
No surgery
Lal) here others
In US waiting period
Symptoms in 2023
is more
2 days treatment
Heart Problem Sterling Hospital Good Facility satisfied 6 lacs Spicy Food
Availability
Pacemaker installed in of room
Good Staff Efficiency change in diet No insurance
heart with
Patient 6(Mr. kitchen

Charles) Twice in
14 days Satisfied Cheap efficiency
kenya
2 days of Friend no improvement in
recommend others
hospitalisation Recommended kenya
no complaints
Dr.
Thyroid Cancer Sterling Hospital No agent 2 lacs
Recommended
Dr. Somesh Double in
about 3 months Father's bypass Cool HOspital
Chandra Kenya
Surgery Good No insurance
Patient
7(Taslim Symptoms in
used visa
2021(gaining weight Cheap
Abdul) card
breathing prob)
no agent if know
removed thyroid clits
doctor
In 2021 Biopsy was
done
2 times Hot
Prostatic Hyperplasia Sterling Hospital Reputation Nice communication
treatment Weather
Treatment: satisfied with
Options: A'bad, Good Facilities &
Transurethral International 1st - 2 lacs
Mumbai Navsari services
Patient Vasectomy co-ordinator
8(Issac South Africa &
About a month Native Nice Facility 2nd - 65K
Omar) India
Symptoms 2 years ago Cheap in a'bad would advice other
Symptoms: prob in
passing urine,nutrition
lack
Bhavin Bhai is
Good facility in 10-20K per
Rheumatic heart Epic Hospital everything(godfat
emergency Year
patient her)
9(Vandaben Ayushman
2 months Trust on Doctors Confidentiality Cheap
Trivedi) Bharat

67
 HUge
No surgery because of Options: India & Waiting period is
very comfortable Difference
age Singapore less
of cost
In India: A'bad & Hospital there is would recommend
since 2015
Baroda not so good others
worked as
Don't show you are
orthopaedic in ethics
foreigner
A'bad
kind of treatment
criticised Apollo
in emergency
trust
Sanjeevani Super The patient was
The patient had acute Comfortable with
Speciality living and 30K cost
gastroenteritis Treatment .
Hospital studying.
Both Surat and in India which
Satisfied with Double
plus viral fever. Ahmedabad were influenced him
quality of facilities there
Patient 10 in to seek
(stacy) communic
Treatment 2 to 3 his consideration & equipment at the ation
treatment here.
months for treatment. hospital. problem
with
Completed staff
follow up for a year
The biggest
experience was Around 5
Uterus Issue Sushrusha Hospital Family challenge is
smooth Lacs
it was
Option:Delhi,Mu Huge
improvement in blood getting
Completed mbai & difference
banks blood.
Bangalore of cost
Satisfied with the
Treatment 10 days
Procedures
patient
11(Neeta surgery for uterus staff was nice and
removal. stuff, they are
Patel)
Recovery period 15
very cooperative.
to 20 days
Early symptoms it was
like heavy
bleeding and pain
Symptoms appeared
5 years ago
lack of
Don't have any
Completed Convenience Convenience 30000 costed family
complaints
support
Patient
Better logistics and Should higher 50000 in his
12(France Pneumothorax
better services
Demand
consultant country
language
Gonde)
Smoke surgery Cheap better logistics Comfortable Insured food

68
 Ahmedabad People especially
Have to pay
1-2 weeks Mumbai and Surat Gujarati is our close
put of pocket
were the options minded
Recommended his
Follow up after 6
KD hospital Father's treatment father for the
months
treatment
Good infrastructure
Good service

69
6.2 - Schedule Of Interview

OPENING
● Thank you for taking the time to participate in this interview. My name is [name] and We are final year
students of the Som-Lalit Institute of Business Administration. We are conducting research on medical
tourism in India and I am interested in hearing your experiences and perspectives.
● Before we begin, I would like to explain the purpose of this interview. I am interested in learning more
about the factors that influence patients to choose India for medical treatment, the challenges and
opportunities that medical tourists face, and how the Indian government and healthcare industry can
improve the medical tourism experience.
● All of your responses will be confidential and will be used only for research purposes. You are free to
withdraw from the interview at any time.

BODY

Questions About 1. Name of the patient?

the Patient 2. Age and sex of the patient?
3. What is the status of your medical treatment?
A.) Ongoing B.) Not yet start C.) Completed
4. Nationality of the patient?
5. Approximate duration of stay?

Questions 1. What is the name of the disease that the patient is suffering from?
Relating to 2. Is the disease/condition life-threatening?
Disease. 3. Is there a cure/surgery available for it?
a. If Yes:
i. What is the name of the treatment?
ii. What is the approximate time of recovery?
iii. Will you have to come back for a follow-up after the surgery?
b. If No:
i. Is there a treatment likely to be available in the near future?
ii. What are the steps taken to relieve the patient from the
symptoms?
4. Is there a history of the same disease in the patient's family?
5. When was the first time you came to know that there was something wrong
with your/patient's body?

Deciding a 1. Why did you decide that you wanted to get the treatment from a foreign
Country for country and not from your country?
Foreign Treatment 2. Which were the countries that were in consideration for medical treatment?
3. From where did you find out about India?
4. What factors influenced your decision to choose India for medical treatment?
5. How often did you receive conflicting information from different medical
care professionals for Indian hospitals? Can you share some experience?
6. What were your expectations for your medical tourism experience?

Agent/Consultant 1. Did you hire an agent/consultant?

Related Questions 2. Is your medical travel facilitator well-acquainted with the referral hospital?
3. What is the name of the agent and how did you find out about the agent?
4. What were the services provided by the agent?
5. If you had to rate your agent between 1-10 how much would you rate your
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 agent?
10 being excellent 5 being ok and 1 being terrible
6. Do you think you could have managed without an agent? (If the answer to
question 1 is yes)
7. Will you recommend others to hire an agent or do it by themselves?

Coming to India 1. What were the top 3 cities in India in consideration for treatment?
2. Why [City Name]?
3. What were the biggest challenges you faced as a medical tourist in India?

Hospital 1. In Which hospital is the treatment going on?

2. How comfortable are you with the procedures and treatment you have
received so far?
A.) Very comfortable
B.) Moderately Comfortable
C.) Neither Comfortable nor Uncomfortable
D.) Moderately Uncomfortable
E.) Very Uncomfortable
3. And how much did the whole treatment cost?
4. Is your treatment covered under insurance?
5. How much is the cost difference between treatment in your country and
India?
6. Why specifically this hospital?
7. What was the communication like between you and the hospital staff?
8. Were you satisfied with the quality of the facilities and equipment at the
hospital?
9. Difference between the treatment of healthcare providers in your country and
India?
10. How would you rate your overall experience with the hospital?

10 being excellent 5 being ok and 1 being terrible

11. Do you have any concerns or complaints about the hospital?

Language 1. How will you rate your English speaking and comprehension skills?

Miscellaneous 1. Did anyone travel/stay with you when going to India for treatment?
questions 2. Did you experience any cultural challenges during your medical tourism
experience?
3. How would you rate the quality of your medical treatment in India?
4. Will you recommend other patients to come to India for treatment?
5. What advice would you give other patients considering medical tourism in
India?
6. Have you noticed any changes in your dietary habits?
7. What factors do you believe have contributed to the rise in medical tourism in
India?

CONCLUSION
Thank you again for your time and participation. Your insights will be invaluable to our research.

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