Medical Tourism: Barriers in Financial Management and Coordination for International Patients and the Development of Sustainable Financial Models – A Comparative Analysis of Turkey, India, and Thailand

Öz

Background: Medical tourism growth raises financial-management and coordination challenges that may undermine sustainability and equity. Objective: To identify financial and coordination barriers faced by international patients and to propose a hybrid sustainable financial model through a comparative secondary-data analysis of Turkey, India, and Thailand (2018–2025). Methods: We conducted a systematic search of academic databases and official reports (PubMed, Scopus, WHO, national statistics, and industry reports) using predefined keywords (see Supplementary File A). Sources were thematically coded; country-specific indicators (revenue, patient volumes, regulatory features) were extracted into comparative matrices. Limitations of secondary data are discussed. Results: Key cross-cutting barriers include insurance portability gaps, pricing opacity, currency risk, and fragmented coordination among providers, insurers, and tourism intermediaries. Country findings: Turkey strong infrastructure but regulatory fragmentation; India cost advantage with quality heterogeneity; Thailand integrated wellness offerings with increased post— pandemic operational costs. Drawing on comparative strengths, we propose a hybrid model combining blockchain-enabled price transparency, public–private partnership (PPP)-based portable insurance, and capitation elements to stabilize financing and reduce inequities. Conclusions: The hybrid model that integrates blockchain-based price transparency, PPP insurance mechanisms, and capitation components emerges as a feasible and promising approach in light of the available secondary data. However, the model’s long-term impacts and quantitative gains can only be conclusively determined through field pilots and primary data collection.

Anahtar Kelimeler

• Medical tourism
• financial management barriers
• international patient coordination
• comparative analysis

Sağlık Turizm: Uluslararası Hastalar İçin Finansal Yönetim ve Koordinasyondaki Engeller ve Sürdürülebilir Finansal Modellerin Geliştirilmesi – Türkiye, Hindistan ve Tayland'ın Karşılaştırmalı Analizi

Öz

Amaç: Bu çalışmanın amacı, tıbbi turizmde uluslararası hastaların karşılaştığı finansal yönetim ve koordinasyon engellerini belirlemek ve Türkiye, Hindistan ile Tayland örneklerinde sürdürülebilir bir finansal model önermektir. Yöntem: 2018–2025 dönemi için PubMed, Scopus, WHO ve ulusal istatistikler dahil olmak üzere ikincil kaynaklar sistematik olarak tarandı; tematik kodlama ve karşılaştırmalı matrislerle ülke göstergeleri çıkarıldı. Bulgular: Sigorta taşınabilirliği eksikliği, fiyatlamada şeffaflık yokluğu, döviz riski ve sağlayıcı-sigortacı-turizm aracılarının parçalı koordinasyonu ortak sorunlar olarak tespit edildi. Ülke bazında; Türkiye altyapı güçlü fakat düzenleyici uyum sorunları, Hindistan maliyet avantajı fakat kalite farklılığı, Tayland bütünleşik hizmet ve artan operasyonel maliyetlerle öne çıktı. Sonuç: Blokzincir tabanlı fiyat şeffaflığı, kamu-özel ortaklığı (PPP) sigorta modelleri ve kapitation unsurlarını birleştiren hibrit model, mevcut ikincil veriler ışığında uygulanabilir ve umut vadeden bir yaklaşım olarak öne çıkmaktadır. Modelin uzun vadeli etkileri ve sayısal kazanımları ancak saha pilotları ve birincil veri toplama ile kesinleştirilebilecektir.

Anahtar Kelimeler

• finansal yönetim engelleri
• uluslararası hasta koordinasyonu
• karşılaştırmalı analiz
• Sağlık Turizm

Kaynakça

1. Alasiri, A. A. (2025). Predictors of healthcare providers' readiness for health system transformation in Saudi Arabia (Doctoral dissertation, Old Dominion University).
2. Chen, Y.-Y., & Flood, C. M. (2013). Medical tourism's impact on health care equity and access in low-and-middle-income countries: Making the case for regulation. J. Law Med. Ethics, 41(1). https://ssrn.com/abstract=2286259
3. COMCEC. (2021). Medical tourism in OIC member countries: Opportunities and challenges. Standing Committee for Economic and Commercial Cooperation of the Organization of Islamic Cooperation. https://www.comcec.org
4. Cynthia, A. N. (2025). Ethical dilemmas in international medical health tourism: A critical commentary. SSM Health Syst, 100, Article 100111. https://doi.org/10.1016/j.ssmhs.2025.100111
5. FineUp Clinic. (2024). Turkey medical tourism market analysis 2024. https://fineupclinic.com
6. Grand View Research. (2024). Thailand medical tourism market size, industry report 2024–2030: Size, share & trends analysis report by treatment type (neurosurgery and spine surgery, ENT surgery, dentistry, oncology). https://www.grandviewresearch.com/industry-analysis/thailand-medical-tourism-market-report
7. Hafizan, A. H., Mardiana, O., Syafiq, S. S., Jacinta, M. R., Sahar, B., & Rosliza, A. M. (2018). Analysis of medical tourism policy: A case study of Thailand, Turkey and India. Int. J. Public Health Clin. Sci., 5(3), 17–31.
8. India Brand Equity Foundation. (2024). India medical tourism market overview 2024. https://www.ibef.org

9. Jalali, M., Haghgoshayie, E., Janati, A., Yoshari, P., & Khodayari-Zarnaq, R. (2025). Health tourism: A global perspective on the barriers and facilitators. Discov. Public Health, 22(1), Article 157. https://doi.org/10.1186/s12982-025-00545-2
10. Market.us. (2025). Global medical tourism market trends and forecasts. https://market.us
11. Mayakul, T., Kiattisin, S., & Prasad, R. (2018). A sustainable medical tourism framework based on the enterprise architecture design: The case in Thailand. J. Green Eng., 8(3), 359–388. https://doi.org/10.13052/jge1904-4720.838
12. Mordor Intelligence. (2024). Medical tourism market: Growth, trends, and forecasts (2025–2030). https://www.mordorintelligence.com
13. Rokni, L., Turgay, A., & Park, S. H. (2017). Barriers of developing medical tourism in a destination: A case of South Korea. Iran. J. Public Health, 46(7), 930–938.
14. Snyder, J., Crooks, V. A., Johnston, R., Adams, K., & Whitmore, R. (2015). Medical tourism's impacts on health worker migration in the Caribbean: Five examples and their implications for global justice. Glob. Health Action, 8(1), Article 27348.
15. Tsekouropoulos, G., Vasileiou, A., Hoxha, G., Dimitriadis, A., & Zervas, I. (2024). Sustainable approaches to medical tourism: Strategies for Central Macedonia, Greece. Sustainability, 16(1), Article 121.
16. USHAŞ. (2025, July 4). 2024 annual report. https://www.ushas.gov.tr/en/2024-annual-report/
17. Zada, M., Erkol Bayram, G., Contreras-Barraza, N., Kaptangil, K., & Aylan, S. (2025). Integrating social media-driven service innovation and sustainable leadership: Advancing sustainable practices in tourism and hospitality. Sustainability, 17(2), Article 399. https://doi.org/10.3390/su17020399