Costa Rica medical tourism numbers under question

 

2011 figures from International Promotion for Costa Rican Medicine (Promed) suggest that the number of medical tourists to Costa Rica was 48,000, compared to 36,000 in 2010.

Seven out of 10 private clinics in San Jose provide services to medical tourists, and in Guanacaste, 4 out of 10 clinics do, says Promed.

San Jose has registered 1,223 businesses connected with the medical tourism industry, with an average of 38 procedures annually per centre. In Guanacaste, the total amount of clinics providing services to medical tourists was registered at 109, each attending to an average of 16.3 medical tourists annually.

Promed says that Costa Rica received 48,253 medical tourists in 2011 and that the average amount spent per medical tourist was $7,000; this suggests a revenue value of $338 million. Yet in other recent press interviews Promed claims for 2011 are $196 million on health, with patients spending an additional $84 million in hotels, meals, travel and shopping, and numbers of 40,000.

That San Jose has 1,223 businesses involved in medical tourism may seem hard to believe. But these are not just hospitals and clinics; they include hotels and restaurants. So if a medical tourist uses a medical travel agent, stays at a hotel, eats in a restaurant and goes to a clinic for cosmetic surgery, then each of those four will count the same person.

Timothy Morales of Costa Rican Medical Care comments, “Our business is growing every year, but these numbers are way out of line. This says that 132 arrive every day for treatment. Of course no one works on weekends so that number is 185 people based on a 5-day week. That is 78 new dental patients a day? Each dental patient needs at least one to two hours with 3 to 5 days, so where is the time for all the new people. There is too much over counting. The hotel, the clinic, the agency and the restaurants each count the same patient, which is very misleading.”

Promed defends the methodology of multiple types of businesses counting the same patient, “It is necessary in order to tabulate the total revenue generated by the industry. The dentist and the hotel must both be counted. If the average revenue per medical tourist is $7,000, obviously the same patient is being counted by multiple businesses as that figure is more than the medical cost; but the point of the figures is more to see what the economic impact of medical tourism is as a whole; which that methodology accomplishes, though it could appear misleading.”

This multiple counting system has been used for several years, and finally offers a reason why claimed figures and actual patient volume have been so far apart.  

Massimo Manzi of Promed says that 42% of the procedures are related to dental work, whereas 22% are surgery-related (orthopedics, general surgery and gynecology), 16% is preventive medicine, 10% cosmetic surgery and the remaining 10% is other specialities.

Through various interviews carried out with medical tourists who received care at Clinica Biblica, Colina Dental Clinic and Las Cumbres Inn Recovery Center, Promed says that the majority of medical tourists came to Costa Rica as a result of information found on the Internet.

In 2010, Promed reported 36,000 medical tourists, (a 20% increase over 2009), which generated approximately $252 million dollars. But those figures also multiple counted each medical tourist. Promed needs to revise figures to actual numbers of medical figures, with no double counting; which could cut the 2011 figure down to around 20,000. Despite reservations on the confusing figures, it is clear that Costa Rica is becoming more popular as a destination, and nearly all medical tourists come from the USA, with a few from Canada.

The country will have to take more care in maintaining the quality of hospitals and clinics. It only had 3 hospitals, all in San Jose, with JCI status and now it is down to 2. One of Costa Rica’s private hospitals is no longer considered a hospital that is up to the international standards required for international accreditation. La Católica lost international accreditation granted by the Joint Commission International, after it failed an inspection in October.

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