Complications and costs to the UK National Health Service due to outward medical tourism for elective surgery: a rapid review (BMJ, 13 January 2025)

Summary

Outward medical tourism is when people seek medical treatment in a different country to the one they live in. Outward medical tourism potentially creates a problem for health services in the home country, because patients may need post-surgery follow-up at home, and because of the risk of post-surgical complications. Treatment of complications due to outward medical tourism can be costly and made more complicated because full information about the initial surgery may be unavailable.

The authors of this research aimed to identify all studies that describe the impact on the UK NHS of patients who require treatment due to outward medical tourism for elective surgery and report on complications, costs and benefits.

Content

Evidence from case series, case reports and surveys shows that outward medical tourism for metabolic/bariatric surgery, cosmetic surgery and ophthalmic surgery can result in serious complications that are treated at NHS specialist units in the UK. The studies identified in this review suggest women may be more likely to seek elective surgery abroad, especially cosmetic surgery. Costs to the NHS ranged from £1058 to £19 549 per patient in 2024 prices, but the certainty of evidence for costs was very low. The highest costs were due to long stays in hospital and to surgical treatment, but it was unclear if all the relevant costs were identified in the majority of studies.

Cost and resource use associated with outward medical tourism for elective surgery to GPs and other primary care services were not reported. We still do not know how many people resident in the UK go abroad for elective surgery or how many people subsequently experience complications. Without these data, we cannot fully understand the levels of risk that people seeking surgery abroad are taking.

Awareness-raising campaigns and interventions are warranted to inform members of the public in the UK considering going abroad for surgery about the potential for complications. Those seeking medical treatment abroad should be made aware of which complications the NHS is responsible for treating, and costs for which the patient may be potentially personally liable, including non-emergency treatment.