Attracting a geographically diverse patient base: who is willing to travel for hospital care?

Medical tourism, characterized by patients leaving their home community to seek health-care services elsewhere, is on the rise globally. In New York state, approximately 5% of the 35,661,559 hospital visits in 2018 were non-residents. Although some are visiting New York for other reasons, and unintentionally wind up hospitalized – a percentage of this population come to New York intentionally to seek care. Understanding the make-up, needs and patterns of this population allows hospitals to tailor investments in marketing, technological resources and culturally responsive initiatives to prepare for broadening their patient population and remain competitive globally.

Using a rich all-hospital discharge data set, the authors identify patterns in diagnoses, treatment and hospital choice of patients who intentionally travel across borders for health care. The authors model the characteristics associated with “elective” admit patients with a multivariate logistic regression approach.

The authors find that among non-resident patients in New York, domestic travelers, those using insurance plans for payment and women are positively associated with seeking elective inpatient care across border. There are clear patterns of type of treatment that is more likely to be sought, with care for musculoskeletal concerns accounting for more than one-third of all non-resident elective admissions. Proximity also matters, both in terms of patients being more likely to live in a travel zone adjacent to the state, as well as being more likely to seek care from hospitals in counties closest to the borders.

To the best of the authors’ knowledge, this is the first study, using a large set of claims data, that is able to empirically differentiate between patients who travel to NY for the primary purpose of obtaining health care versus those who emergently must access care while traveling for other reasons. This approach can inform future studies seeking to better understand patient migration patterns and strategic educational and marketing initiatives to motivate consumers to cross borders to seek care.