evaluation report on medical tourism in turkey 2012
Transcription
evaluation report on medical tourism in turkey 2012
EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 REPUBLIC OF TURKEY MINISTRY OF HEALTH DIRECTORATE GENERAL OF HEALTH SERVICES DEPARTMENT OF HEALTH TOURISM 1 PREPARED BY Prof. Dr. Mehmet BARCA Asst. Assoc. Dr. Erdal AKDEVE Research Asst. 7Ŭlŝm GED7K BALAY WITH THE CONTRIBUTION OF Prof. Dr. 7rfaŶ bENCAN Dr. DƵrsƵŶ AYDIN PREPARED WITH THE COOPERATION OF Designed and Printed by: Opus Printing LLC ISBN: 978-975-590-440-5 All rights are vested in the Republic of Turkey, Ministry of Health, Directorate of Health Services. No citations shall be allowed without the source of reference. In case of citing, the source of reference shall be indicated as: “editor/author names, Directorate of Health Services, Ministry of Health of Turkey, publishing place, publishing date”. Neither full nor partial reproduction shall be allowed without the written permission of the Directorate of Health Services as ordered by the Law Numbered 5846. Note: The Information included in this book is a survey report and does not reflect the official opinions of the T.R. Ministry of Health. You may reach this book In electronic environment through www.saglik.gov.tr/saglikturizmi address and www.saglikturizmi.gov.tr address. CONTENTS PRESENTATION 5 PREFACE 6 EXECUTIVE SUMMARY 7 PREFACE OF THE RESEARCH GROUP 9 A) REGARDING THE RESEARCH 11 B) AN OVERVIEW ON THE HEALTH TOURISM 13 TOURISM THROUGHOUT THE WORLD AND IN TURKEY 14 HISTORICAL EVALUATION OF HEALTH TOURISM 19 HEALTH TOURISM THROUGHOUT THE WORLD 21 C) HEALTH TOURISM IN TURKEY AND REGULATIONS 27 D) REGULATIONS REGARDING HEALTH SECTOR 29 E) FIGURES REGARDING THE MEDICAL ToƵrŝsm IN TURKEY Ͳ 2Ϭ12 33 1Ͳ OVERALL ASSESSMENT 33 2ͲHEALTH TOURISM IN TURKEY BY HOSPITAL 36 3ͲHOSPITALS WITH HIGHEST ADMISSION FIGURES 3ϴ 4Ͳ HEALTH TOURISM BY PROVINCE 43 5Ͳ HEALTH TOURISM BY BRANCH 47 6Ͳ HEALTH TOURISM BY COUNTRY 53 F) SWOT ANALYSIS OF HEALTH TOURISM IN TURKEY 61 G) CONCLUSION AND RECOMMENDATIONS 65 H) SOURCES 6ϴ HEALTH TOURISM ANNUAL REPORT 2Ϭ12 69 3 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 PRESENTATION TƵrŬeLJ͕ ǁŝth ŝts Health TraŶsformaƟoŶ ProŐram ŝŶ the Įeld of health care ŝŶ the last 1Ϭ LJears has shoǁŶ aŶ ƵŶƉrecedeŶted chaŶŐe aŶd deǀeloƉmeŶt ǁorldǁŝde. IŶ terms of access to health care aŶd the ƉroǀŝsŝoŶ of hŝŐh ƋƵalŝtLJ health care to all ŝts cŝƟnjeŶs TƵrŬeLJ ďeŐaŶ to oīer aŶ eƋƵal aŶd ďeƩer serǀŝce ǁheŶ comƉared to maŶLJ ǁesterŶ coƵŶtrŝes. TƵrŬeLJ oīers the hŝŐhest ƋƵalŝtLJ health care ǁŝth the most adǀaŶced techŶoloŐLJ͕ ŝŶ the Ɖrŝǀate hosƉŝtals͕ ƉƵďlŝc health ŝŶsƟtƵƟoŶs͕ aŶd the UŶŝǀersŝtLJ hosƉŝtals. FormerlLJ seŶdŝŶŐ aďroad thoƵsaŶds of ƉaƟeŶts for treatmeŶt oƵr coƵŶtrLJ ŝs Ŷoǁ treaƟŶŐ hƵŶdreds of thoƵsaŶds from maŶLJ coƵŶtrŝes͕ ƉrŝmarŝlLJ from ŶeŝŐhďorŝŶŐ coƵŶtrŝes. AŶatolŝa reŐŝoŶ͕ as has ďeeŶ ŝŶ the Ɖast͕ ŝs Ŷoǁ a ǁorldǁŝde soƵrce of healŝŶŐ aŐaŝŶ. TƵrŬeLJ has ďecome a ceŶter of aƩracƟoŶ ŝŶ the Įeld of health. Wŝth ŝts cŝtLJ hosƉŝtals͕ the coŶstrƵcƟoŶ of ǁhŝch haǀe alreadLJ ďeŐaŶ͕ aŶd the ƉlaŶŶed Health Free oŶes ŝŶ cŝtLJ hosƉŝtals aŶd the ƉlaŶŶed oŶ the l d coŶstrƵcƟoŶ Ɵ ďeŐaŶ ď h health h lh of oƵr coƵŶtrLJ ǁŝll ďecome a leadŝŶŐ coƵŶtrLJ ŝŶ Health ToƵrŝsm. IŶ addŝƟoŶ͕ the ecoŶomŝes of the coƵŶtrŝes haǀe started to hold aŶ ŝmƉortaŶt Ɖlace ŝŶ the serǀŝce sector aŶd the edžƉort of serǀŝces. Health ToƵrŝsm ŝŶ TƵrŬeLJ has started to ďecome a maũor edžƉort ŝtem for foreŝŐŶ cƵrreŶcLJ earŶŝŶŐs. Medŝcal ToƵrŝsm͕ ǁhŝch coǀers the treatmeŶt of foreŝŐŶ ƉaƟeŶts aŶd ǁhŝch coŶsƟtƵtes the ďŝŐŐest Ɖart of the Health ToƵrŝsm͕ ǁŝll sooŶ ďecome a raƉŝdlLJ deǀeloƉŝŶŐ sector ďoth ŝŶ oƵr coƵŶtrLJ aŶd ǁorldǁŝde. Medŝcal ToƵrŝsm ŝs a Ŷeǁ coŶceƉt aŶd Įeld all oǀer the ǁorld aŶd ŝŶ TƵrŬeLJ as ǁell. DesƉŝte ŝts short hŝstorLJ͕ medŝcal ToƵrŝsm aƩracƟŶŐ the aƩeŶƟoŶ of all the staŬeholders ŝŶ the sector͕ oīers Ŷeǁ oƉƉortƵŶŝƟes to TƵrŬeLJ. To seŝnje sƵch aŶ oƉƉortƵŶŝtLJ aŶd to ŬeeƉ alŝǀe the ŝŶterests of academŝc͕ ƉƵďlŝc aŶd Ɖrŝǀate sectors͕ ŐŝǀeŶ the ecoŶomŝc ďeŶeĮts ŝt ǁoƵld Ɖroǀŝde shoƵld ďe deemed a sŝŐŶŝĮcaŶt steƉ. IŶ thŝs seŶse͕ thŝs stƵdLJ͕ ďased oŶ the data oďtaŝŶed from the releǀaŶt deƉartmeŶts of the MŝŶŝstrLJ of Health͕ Ɖroǀŝdes ŝmƉortaŶt ŝŶformaƟoŶ that ǁoƵld ŝllƵmŝŶate aŶd orŝeŶtate the fƵtƵre of medŝcal ToƵrŝsm ŝŶ TƵrŬeLJ. It mƵst ďe oŶe of oƵr most sŝŐŶŝĮcaŶt tarŐets to carrLJ oƵt a ũoŝŶt ǁorŬ ǁŝth the ŐoǀerŶmeŶt aŐeŶcŝes͕ ŶoŶͲŐoǀerŶmeŶtal orŐaŶŝnjaƟoŶs͕ ŝŶtermedŝarLJ orŐaŶŝnjaƟoŶs͕ aŶd ǁŝth all other ŝŶsƟtƵƟoŶs ǁhŝch ǁoƵld haǀe a role ŝŶ the deǀeloƉmeŶt of medŝcal ToƵrŝsm͕ aŶd to estaďlŝsh aŶd edžƉaŶd coordŝŶaƟoŶ amoŶŐ them ǁŝth the aŝm of ŝŶcreasŝŶŐ aŶd deǀeloƉŝŶŐ the share of actƵal health care Ɖroǀŝded ďLJ the TƵrŬŝsh health ŝŶsƟtƵƟoŶs ŝŶ the ǁorld medŝcal ToƵrŝsm moǀemeŶt. I ǁoƵld lŝŬe to thaŶŬ all oƵr assocŝates ǁho coŶtrŝďƵted to thŝs stƵdLJ ǁhŝch emďodŝes a ŶƵmerŝcal ŐeŶeral sƵmmarLJ aŶd aŶalLJsŝs of medŝcal ToƵrŝsm ŝŶ TƵrŬeLJ. Prof. Dr. ReceƉ AKDA) MŝŶŝster of Health 5 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 PREFACE IŶ oƵr coƵŶtrLJ͕ ŝŶ lŝŶe ǁŝth the Health TraŶsformaƟoŶ ProŐram͕ Health ToƵrŝsm ďeŐaŶ to deǀeloƉ raƉŝdlLJ. TodaLJ͕ hŝŐhͲƋƵalŝtLJ health care Ɖroǀŝded ŝŶ oƵr ƉƵďlŝc aŶd Ɖrŝǀate hosƉŝtals ŝs aďle to comƉete ǁŝth the West. MaŶLJ of oƵr hosƉŝtals serǀe ǁŝth hŝŐh techŶoloŐLJ aŶd ƋƵalŝĮed hƵmaŶ Ɖoǁer. IŶ TƵrŬeLJ͕ esƉecŝallLJ ŝŶ AŶŬara͕ IstaŶďƵl͕ Injmŝr͕ MƵŐla͕ AŶtalLJa͕ Kocaelŝ aŶd AdaŶa͕ the health ŝŶsƟtƵƟoŶs admŝt aŶd treat a larŐe ŶƵmďer of foreŝŐŶ ƉaƟeŶts. The health sector adǀaŶced raƉŝdlLJ ŝŶ receŶt LJears aŶd edžcelleŶt facŝlŝƟes haǀe ďeeŶ estaďlŝshed. TodaLJ͕ oƵr almost 5Ϭ health orŐaŶŝnjaƟoŶs haǀe ŝŶterŶaƟoŶal accredŝtaƟoŶ. IŶ oƵr coƵŶtrLJ͕ eǀerLJ LJear͕ more thaŶ 15Ϭ͕ϬϬϬ foreŝŐŶ ƉaƟeŶts are treated ŝŶ oƵr ƉƵďlŝc hosƉŝtals. The hŝŐhͲƋƵalŝtLJ͕ sƉecŝalŝnjed͕ fast͕ aŶd aīordaďle health care serǀŝces͕ ŝŶ Ɖarallel to the ͞Health TraŶsformaƟoŶ ProŐram͟ laƵŶched ďLJ the MŝŶŝstrLJ of Health͕ haǀe ŐoŶe ďeLJoŶd oƵr ďorders͕ aŶd draǁŶ the aƩeŶƟoŶ of doctors aŶd ƉaƟeŶts ŝŶ dŝīereŶt coƵŶtrŝes. Medŝcal ToƵrŝsm has a ŬeLJ role leadŝŶŐ Ɖrŝǀate healthcare sector. The Ɖrŝǀate health sector oīers й 91 of the Medŝcal ToƵrŝsm serǀŝces aŶd ƉƵďlŝc hosƉŝtals oīer 9й. EsƉecŝallLJ ƵŶder the scoƉe of emerŐeŶcLJ medŝcal serǀŝces delŝǀerLJ aŶd ͞Health of the ToƵrŝsts͟ coŶceƉt͕ ŝŶ the reŐŝoŶs ǁhere the Ɖrŝǀate health sector does Ŷot edžŝst͕ ƉƵďlŝc hosƉŝtals haǀe ƉaramoƵŶt ŝmƉortaŶce. IŶ addŝƟoŶ͕ ǁŝth the ŝŶaƵŐƵraƟoŶ of Health CamƉƵses͕ the aƉƉlŝcaƟoŶ of maŶLJ foreŝŐŶ ƉaƟeŶts ǁŝll ďe ŝŶeǀŝtaďle͕ ƉarƟcƵlarlLJ ŝŶ AŶŬara aŶd IstaŶďƵl. WheŶ ǁe edžamŝŶe the resƵlts of thŝs stƵdLJ aŶd the Ɖrocesses͕ ǁe ƵŶderstaŶd that ŝŶ oƵr coƵŶtrLJ the medŝcal ToƵrŝsm deǀeloƉs raƉŝdlLJ. As the MŝŶŝstrLJ of Health͕ ǁe coŶƟŶƵe oƵr eīorts to alŝŐŶ all the ŝŶfrastrƵctƵre aŶd leŐŝslaƟoŶs ǁŝth the ƉroŐressŝŶŐ strƵctƵre. DeƉartmeŶt of Health ToƵrŝsm ǁas estaďlŝshed for thŝs ƉƵrƉose. ThaŶŬs to the ͞Health TraŶsformaƟoŶ ProŐram͟ ǁe ǁŝll carrLJ TƵrŬeLJ to the forefroŶt ŝŶ medŝcal ToƵrŝsm sector ďLJ oīerŝŶŐ oƵr oǁŶ cŝƟnjeŶs aŶd other ƉaƟeŶts throƵŐhoƵt the ǁorld the most edžcelleŶt aŶd aīordaďle health care serǀŝces. We maLJ Ŷote also that͕ ŝŶ the Įeld of Health ToƵrŝsm ŝŶ TƵrŬeLJ to date ƉrofessŝoŶal records of the health toƵrŝst coƵld Ŷot ďe ŬeƉt. MŝŶŝstrLJ of Health ďeŐaŶ to ŬeeƉ the records of the serǀŝces oīered to foreŝŐŶ ƉaƟeŶts aŶ orderlLJ maŶŶer. IŶ addŝƟoŶ͕ ĮŶaŶcŝal sƵƉƉort for the ƉromoƟoŶ of Health ToƵrŝsm aďroad has started aŶd 5Ϭй ŝŶcome tadž relŝef ŝŶ the health serǀŝces oīered to foreŝŐŶ ƉaƟeŶts came ŝŶto force. For theŝr eīorts ŝŶ thŝs stƵdLJ͕ I ǁoƵld lŝŬe to thaŶŬ all the assocŝates aŶd the YŦldŦrŦm BeLJanjŦt UŶŝǀersŝtLJ. Prof. Dr. Nŝhat TOSUN UŶdersecretarLJ 6 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 EXECUTIVE SUMMARY We ďelŝeǀe that thŝs stƵdLJ ǁhŝch reǀeals the deǀeloƉmeŶt ŝŶ the medŝcal ToƵrŝsm sector͕ deemed to haǀe a Őreat ƉoteŶƟal all oǀer the ǁorld͕ ǁŝll ďe ǀerLJ ƵsefƵl for Ƶs ŝŶ creaƟŶŐ the strateŐŝc Ɖolŝcŝes of the Health ToƵrŝsm. WheŶ ǁe taŬe ŝŶto coŶsŝderaƟoŶ the ǁorldǁŝde ƉoteŶƟal aŶd the deǀeloƉmeŶt Ɖrocess of the ͞Medŝcal ToƵrŝsm͕͟ coŶsŝdered as a sƵďͲďraŶch of the Health ToƵrŝsm͕ ǁe ďelŝeǀe that there ǁŝll ďe a sŝŐŶŝĮcaŶt Őloďal comƉeƟƟoŶ ŝŶ the comŝŶŐ LJears. AccordŝŶŐlLJ͕ thŝs stƵdLJ focƵsed oŶ the ŝssƵes sƵch as the ďraŶches the health toƵrŝsts are comŝŶŐ to TƵrŬeLJ for treatmeŶt͕ the ƉroƉorƟoŶs of those ďraŶches ŝŶ the total͕ aŶd the coƵŶtrŝes that Ɖrefer TƵrŬeLJ most. IŶ addŝƟoŶ͕ the shares of the ƉƵďlŝc sector aŶd the Ɖrŝǀate sector ŝŶ the medŝcal ToƵrŝsm sector haǀe ďeeŶ aŶalLJnjed. aŶalLJnjed EsƉecŝallLJ ƵŶder the scoƉe of ͞Health of the ToƵrŝsts͟ coŶceƉt͕ ŝŶ the reŐŝoŶs ǁhere the Ɖrŝǀate health sector does Ŷot edžŝst͕ ƉƵďlŝc hosƉŝtals haǀe ƉaramoƵŶt ŝmƉortaŶce ŝŶ ƉroǀŝdŝŶŐ emerŐeŶcLJ medŝcal serǀŝces. BasŝŶŐ oŶ the data ǁe haǀe oďtaŝŶed as a resƵlt of thŝs stƵdLJ͕ ǁe ǁŝll ďe dŝsƉlaLJŝŶŐ the ƉŝctƵre of TƵrŬeLJ reŐardŝŶŐ the Health ToƵrŝsm aŶd the health serǀŝces oīered to the foreŝŐŶ ƉaƟeŶts͕ as ǁell as the Ŷeed of the ƉƵďlŝc health sector to maŬe Ŷeǁ ŝŶŝƟaƟǀes ŝŶ the Įeld of Health ToƵrŝsm. WheŶ the ŐŝaŶt healthcare camƉƵses start to Ɖroǀŝde serǀŝces ǁŝthŝŶ the frameǁorŬ of the CŝtLJ HosƉŝtals Proũect that ǁŝll ďe ŝŶaƵŐƵrated ŝŶ some ƉroǀŝŶces ďLJ the MŝŶŝstrLJ of Health͕ the ƉƵďlŝc health sector ǁŝll haǀe Őreater mŝssŝoŶ ŝŶ ƉroǀŝdŝŶŐ health serǀŝces ŝŶ the scoƉe of Health ToƵrŝsm. The health serǀŝce that ǁoƵld ďe Ɖroǀŝded ďLJ the ƉƵďlŝc hosƉŝtals to the foreŝŐŶ ƉaƟeŶts ǁoƵld ŝŶ the loŶŐ term coŶtrŝďƵte the Ɖrŝǀate hosƉŝtals esƉecŝallLJ ŝŶ terms of ƉromoƟoŶ of Health ToƵrŝsm. IŶ thŝs stƵdLJ͕ ǁe haǀe haŶdled the foreŝŐŶ ƉaƟeŶts ƵŶder tǁo seƉarate cateŐorŝes. We coŶsŝdered the ƉaƟeŶts ǁho come to oƵr coƵŶtrLJ for treatmeŶt as health toƵrŝsts aŶd the toƵrŝsts ǁho come to oƵr coƵŶtrLJ for ToƵrŝsm ƉƵrƉoses aŶd haǀe to Őet health care as the health of the toƵrŝsts. ThƵs͕ the aŶalLJsŝs of health serǀŝce oīered to foreŝŐŶers coƵld ďe made more eīecƟǀelLJ. Detaŝled aŶalLJnjes ǁere carrŝed oƵt ďLJ ƉroǀŝŶces͕ coƵŶtrŝes͕ ďraŶches aŶd health care orŐaŶŝnjaƟoŶs. PaƟeŶt records are made oŶ the ďasŝs of the ŶeǁlLJ created record sLJstem. Hoǁeǀer͕ ŝt ŝs ǁorth ŶoƟŶŐ that͕ esƉecŝallLJ deŶtal͕ cosmeƟc aŶd haŝr traŶsƉlaŶt ƉaƟeŶts as ǁell as oƵtƉaƟeŶts at hotels ŝŶ toƵrŝsƟc areas are Ŷot reŐŝstered ŝŶ the sLJstem͕ aŶd theŝr ŶƵmďer ŝs esƟmated to ďe aroƵŶd a hƵŶdred 7 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 thoƵsaŶd. We hoƉe to reach more relŝaďle data ŝŶ the comŝŶŐ LJears ďLJ deǀeloƉŝŶŐ the reŐŝstraƟoŶ sLJstem for foreŝŐŶ ƉaƟeŶts. Hoǁeǀer͕ ŝŶ most Ɖarts of the ǁorld ǁŝthŝŶ the scoƉe of Health ToƵrŝsm͕ foreŝŐŶ ƉaƟeŶts caŶŶot ďe folloǁed ƵƉ sLJstemaƟcallLJ as theLJ caŶ ďe ŝŶ oƵr coƵŶtrLJ. As a resƵlt͕ Health ToƵrŝsm staƟsƟcs throƵŐhoƵt the ǁorld are Ŷot healthLJ ďƵt Őŝǀe oŶlLJ a roƵŐh ŝdea. IŶ oƵr coƵŶtrLJ͕ eǀerLJ LJear͕ more thaŶ 15Ϭ͕ϬϬϬ foreŝŐŶ ƉaƟeŶts are treated ŝŶ ƉƵďlŝc hosƉŝtals. The foreŝŐŶ ƉaƟeŶts comŝŶŐ to TƵrŬeLJ mostlLJ Ɖrefer CardŝoǀascƵlar SƵrŐerLJ͕ OŶcoloŐLJ͕ NeƵrosƵrŐerLJ͕ OrthoƉedŝcs͕ PlasƟc aŶd AestheƟc SƵrŐerLJ͕ ELJe aŶd DeŶtal TreatmeŶts ďraŶches. The facts that the WesterŶ coƵŶtrŝes haǀe ǀerLJ loŶŐ ǁaŝƟŶŐ Ɵme for ƉaƟeŶts͕ health serǀŝces are edžƉeŶsŝǀe aŶd ŝŶsƵraŶce coǀeraŐe ŝs ŶarroǁŝŶŐ doǁŶ͕ eŶaďled TƵrŬeLJ to haǀe aŶ aƩracƟǀe aŶd adǀaŶtaŐeoƵs ƉosŝƟoŶ ŝŶ thŝs Įeld. MaŶLJ of the ŶeŝŐhďorŝŶŐ easterŶ coƵŶtrŝes aŶd ŝŶ Afrŝca͕ hŝŐhͲƋƵalŝtLJ health care͕ sŬŝlled hƵmaŶ resoƵrces aŶd hŝŐh techŶoloŐLJ are ǀerLJ Ɖoor. For these reasoŶs͕ maŶLJ ƉaƟeŶts from the aďoǀemeŶƟoŶed coƵŶtrŝes come to TƵrŬeLJ for treatmeŶt reasoŶs. IŶ the Įeld of Health ToƵrŝsm͕ ŝŶ TƵrŬeLJ to date ƉrofessŝoŶal records of the health toƵrŝst coƵld Ŷot ďe ŬeƉt eīecƟǀe eŶoƵŐh to folloǁ ƵƉ the ƉaƟeŶt. As of 2Ϭ12͕ the DeƉartmeŶt of Health ToƵrŝsm of oƵr Dŝrectorate GeŶeral ǁŝll ďe carefƵllLJ ŬeeƉŝŶŐ records aŶd staƟsƟcal stƵdŝes͕ aŶd ǁŝth the helƉ of the data oďtaŝŶed͕ the health serǀŝce ƋƵalŝtLJ staŶdards ǁŝll ŝŶcrease daLJ ďLJ daLJ. IŶ thŝs stƵdLJ oŶlLJ medŝcal ToƵrŝsm has ďeeŶ eǀalƵated. StaƟsƟcs reŐardŝŶŐ the thermal ToƵrŝsm aŶd elderlLJ ToƵrŝsm haǀe Ŷot ďeeŶ Ɖroǀŝded. Thŝs stƵdLJ ǁŝll ďe ƵƉdated each LJear aŶd ǁŝll ďe ƉƵďlŝshed as aŶ aŶŶƵal reƉort of medŝcal ToƵrŝsm. Thŝs stƵdLJ ŝs made oŶ the ďasŝs of foreŝŐŶ ƉaƟeŶts ǁho receŝǀed health care ŝŶ oƵr coƵŶtrLJ ŝŶ 2Ϭ11. I ǁoƵld lŝŬe to thaŶŬ Dr. DƵrsƵŶ ALJdŦŶ aŶd hŝs Team from DeƉartmeŶt of Health ToƵrŝsm of oƵr Dŝrectorate GeŶeral͕ ǁho haǀe sƵƉƉorted the collecƟoŶ of data͕ aŶd the Scholars of Yŝldŝrŝm BeLJanjŝt UŶŝǀersŝtLJ ǁho aŶalLJnjed the data. Prof. Dr. 7rfaŶ bENCAN Dŝrector GeŶeral 8 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 PREFACE OF THE RESEARCH GROUP Health ToƵrŝsm ŝs oŶe of the sectors ǁhŝch haǀe a sƉecŝal aŶd ƉrŝǀŝleŐed Ɖlace amoŶŐ TƵrŬeLJ͛s edžƉort ŝtems. DƵe to the sŝŐŶŝĮcaŶt coŶtrŝďƵƟoŶ to the ecoŶomLJ of the coƵŶtrLJ aŶd ŝts ƉoteŶƟal of sƵstaŝŶaďŝlŝtLJ ŝŶ the loŶŐ term͕ Health ToƵrŝsm ŝs a sector of strateŐŝc ŝmƉortaŶce. AccordŝŶŐ to a stƵdLJ coŶdƵcted ďLJ the LoŶdoŶ School of EcoŶomŝcs aŶd PolŝƟcs͕ ŝŶ the Ŷedžt decade ŝŶ deǀeloƉed coƵŶtrŝes the share of health care ŝŶ total Őross domesƟc ƉrodƵct ŝs esƟmated to chaŶŐe ďLJ aďoƵt 7Ͳ1Ϭй. Thŝs meaŶs that oŶe of eǀerLJ teŶ edžƉeŶdŝtƵre or oŶeͲ teŶth of the ŝŶcomes ǁŝll ďe oŶ health. IŶ other ǁords͕ ŝŶ the fƵtƵre health serǀŝces ǁŝll ďe at the toƉ of the most reƋƵested serǀŝce or coŶsƵmƉƟoŶ ŝtems. No doƵďt͕ aŶ ŝmƉortaŶt Ɖart of thŝs serǀŝce ǁŝll ďe Ɖroǀŝded oƵtsŝde the ŶaƟoŶal ďorders as Health ToƵrŝsm. TƵrŬeLJ Ŷeeds a Ŷeǁ ǀŝsŝoŶ aŶd aƉƉroaches to taŬe a larŐe share of the ŝŶcreasŝŶŐlLJ ŐroǁŝŶŐ Ɖŝe. Health ToƵrŝsm ŝs oŶe of the tLJƉŝcal sectors of ŬŶoǁledŐe ecoŶomLJ. BecaƵse͕ the healthcare has a ŬŶoǁledŐeͲŝŶteŶsŝǀe featƵre. Neǁ aƉƉroaches aŶd serǀŝce dŝǀersŝĮcaƟoŶ oďserǀed eǀerLJ daLJ ŝŶ the Įeld of health oŶ oŶe haŶd͕ the hŝŐhͲtechŶoloŐLJ ŝŶdƵstrLJ ŝt has deǀeloƉed aŶd ƵƟlŝnjed oŶ the other͕ maŬe the health sector ďecome more ŬŶoǁledŐeͲŝŶteŶsŝǀe. BecaƵse of thŝs featƵre͕ as ŝŶ the other ŝŶformaƟoŶͲŝŶteŶsŝǀe sectors͕ the added ǀalƵe of thŝs sector ŝs ƋƵŝte hŝŐh. Health ToƵrŝsm coƵld serǀe as a catalLJst ŝŶ TƵrŬeLJ͛s traŶsformaƟoŶ from loǁ ǀalƵeͲadded ecoŶomŝc model to hŝŐh ǀalƵeͲadded ŬŶoǁledŐe ecoŶomLJ. As a coƵŶtrLJ that coƵld Ŷot LJet maŬe sŝŐŶŝĮcaŶt ƉroŐress ŝŶ the ŬŶoǁledŐe ecoŶomLJ͕ TƵrŬeLJ caŶ ďe oŶe of the leadŝŶŐ coƵŶtrŝes ŝŶ Health ToƵrŝsm ďLJ declarŝŶŐ Health ToƵrŝsm as a strateŐŝc sector aŶd ďLJ ŝŶcreasŝŶŐ ŝts eīorts ŝŶ thŝs dŝrecƟoŶ. SŝŶce͕ ďoth ŝŶ the Įelds of health aŶd ToƵrŝsm͕ TƵrŬeLJ ŝs amoŶŐ the ƉromŝŶeŶt coƵŶtrŝes of the ǁorld aŶd has the comƉeteŶce͖ oƵr coƵŶtrLJ seems to haǀe the ƉoteŶƟal to ďecome a leader ŝŶ Health ToƵrŝsm͕ aŶ ŝŶteŐraƟoŶ of these tǁo sectors. Health ToƵrŝsm mŝŐht haǀe a leadŝŶŐ sector role ďLJ trŝŐŐerŝŶŐ the traŶsformaƟoŶ to ŬŶoǁledŐe ecoŶomLJ of other sectors ;ŝŶsƵraŶce͕ marŬeƟŶŐ͕ traŶsƉortaƟoŶ͕ edƵcaƟoŶ͕ coƵŶselŝŶŐ͕ medŝcal͕ etc.). IŶ short͕ ŝŶ leaƉŝŶŐ ŝŶto ŬŶoǁledŐe ecoŶomLJ ǁŝthoƵt edžƉerŝeŶcŝŶŐ a matƵre ŝŶdƵstrŝal ecoŶomLJ͕ Health ToƵrŝsm ŝs oŶe of the sectors oīerŝŶŐ sŝŐŶŝĮcaŶt oƉƉortƵŶŝƟes for TƵrŬeLJ. Its realŝnjaƟoŶ ǁoƵld͕ to a larŐe edžteŶd͕ ďe a maƩer of ͞ǀŝsŝoŶ aŶd leadershŝƉ͟. There ŝs alreadLJ a comƉeƟƟoŶ ŝŶ ƉroǀŝdŝŶŐ serǀŝce of the Health ToƵrŝsm ǁhŝch has a ŬŶoǁledŐeͲŝŶteŶsŝǀe featƵre aŶd hŝŐhͲŝŶcome ƉoteŶƟal aŶd there ŝs Ŷo doƵďt that the comƉeƟƟoŶ ǁŝll ŝŶcrease ŝŶ the comŝŶŐ LJears. GŝǀeŶ thŝs dŝrecƟoŶ͕ to achŝeǀe aŶd sƵstaŝŶ comƉeƟƟǀe adǀaŶtaŐe ŝŶ thŝs Įeld amoŶŐ the ǁorld coƵŶtrŝes͕ rather thaŶ cLJclŝcal solƵƟoŶs͕ coŶscŝoƵs aŶd ƉlaŶŶed aƉƉroaches ǁŝthŝŶ the frameǁorŬ of loŶŐͲterm ͞ǀŝsŝoŶarLJ comƉeƟƟǀe strateŐŝes͟ are Ŷeeded. TaŬŝŶŐ ŝŶto coŶsŝderaƟoŶ the comƉeƟtors ŝŶ thŝs Įeld ;deǀeloƉed coƵŶtrŝes)͖ thŝs ŝs ŝŶeǀŝtaďle ŝŶ order to ďe ahead of the comƉeƟƟoŶ. 9 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 The Health ToƵrŝsm͕ dƵe to the hŝŐh addedͲǀalƵe ŝt created͕ ŝs ďecomŝŶŐ a sector ŝŶ ǁhŝch the deǀeloƉed coƵŶtrŝes maŬe maũor ŝŶǀestmeŶts aŶd thƵs the comƉeƟƟoŶ ŝŶ the sector ŝs ŝŶcreasŝŶŐ eǀerLJ daLJ. To oďtaŝŶ a comƉeƟƟǀe adǀaŶtaŐe ŝŶ sƵch a hŝŐhlLJ comƉeƟƟǀe ŝŶdƵstrLJ ŝt ŝs a mƵst ;ŝ) to haǀe the Įrst moǀer adǀaŶtaŐe͕ ;ŝŝ) to ďƵŝld comƉeteŶcŝes that are Ŷot easLJ to ŝmŝtate͕ aŶd ;ŝŝŝ) to maŬe coŶƟŶƵoƵs ŝŶǀestmeŶts to deǀeloƉ these comƉeteŶcŝes. The MŝŶŝstrLJ of Health͕ Dŝrectorate GeŶeral of Health Serǀŝces͕ DeƉartmeŶt of Health ToƵrŝsm ŝŶ collaďoraƟoŶ ǁŝth ComƉeƟƟǀeŶess Research CeŶter of the Yŝldŝrŝm BeLJanjŝt UŶŝǀersŝtLJ͕ ďased oŶ these oďserǀaƟoŶs aŶd thoƵŐhts͕ carrŝed oƵt thŝs research reǀealŝŶŐ ͞the cƵrreŶt state of Health ToƵrŝsm ŝŶ TƵrŬeLJ͟. IŶ thŝs stƵdLJ͕ the data oďtaŝŶed ŝŶ 2Ϭ11 ďLJ the MŝŶŝstrLJ of Health from ƉƵďlŝc͕ Ɖrŝǀate aŶd ƵŶŝǀersŝtLJ hosƉŝtals ŝŶ ϴ1 cŝƟes ǁas Ƶsed hoǁeǀer͖ the data of all foreŝŐŶ ƉaƟeŶts coƵld Ŷot ďe edžactlLJ reŇected. We ƉreseŶt thŝs stƵdLJ ǁŝshŝŶŐ that ŝt ǁoƵld ďe a refereŶce for fƵrther researches͕ aŶd strateŐŝc ƉƵrsƵŝts. The Research GroƵƉ 10 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 A ) REGARDING THE RESEARCH The Health ToƵrŝsm͕ ǁhŝch creates the hŝŐhest addedͲǀalƵe ŝŶ the ToƵrŝsm ŝŶdƵstrLJ͕ does Ŷot Ɖroǀŝde oŶlLJ ToƵrŝsm ŝŶcome ďƵt also sŝŐŶŝĮcaŶtlLJ coŶtrŝďƵtes to the staŶdard rŝse aŶd ŝŶterŶaƟoŶal acceƉtaŶce of the health care orŐaŶŝnjaƟoŶs aŶd medŝcal schools ƉroǀŝdŝŶŐ health edƵcaƟoŶ. IŶ ŐeŶeral͕ Health ToƵrŝsm ŝs͕ to collaďorate ǁŝth the ToƵrŝsm ŝŶdƵstrLJ ŝŶ order to oīer ͚cost eīecƟǀe͛ medŝcal care to the ƉaƟeŶts ǁho are ŝŶ Ŷeed of sƉecŝal medŝcal care sƵch as sƵrŐerLJ aŶd other medŝcal ŝŶterǀeŶƟoŶs reƋƵŝrŝŶŐ sƉecŝal edžƉerƟse. The maŝŶ ŝdea of the Health ToƵrŝsm ŝs to Őet aǁaLJ from LJoƵr daŝlLJ roƵƟŶe͕ receŝǀe treatmeŶt or health sƵƉƉorƟŶŐ serǀŝces ŝŶ a comfortaďle aŶd dŝīereŶt eŶǀŝroŶmeŶt. The ƉaƟeŶt receŝǀes health serǀŝces͕ ǁhŝle eŶũoLJŝŶŐ the ƉleasƵre of ŝŶteŐraƟŶŐ ǁŝth the ŶatƵre. It ŝs Ɖossŝďle to coŶsŝder thŝs as a sƉŝrŝtƵal͕ emoƟoŶal aŶd ƉhLJsŝcal reŶoǀaƟoŶ. The ŝŶterŶaƟoŶal traǀels realŝnjed ǁŝth the aŝm of receŝǀŝŶŐ treatmeŶts ǁhŝch are ǁŝthŝŶ the scoƉe of medŝcŝŶe ŝŶ ŐeŶeral aŶd are Ɖroǀŝded ďLJ the doctors at the hosƉŝtals͕ caŶ ďe called ͞Health ToƵrŝsm͟. AmoŶŐ those health serǀŝces͕ ǁe caŶ Ŷame the ƉlasƟcͲaestheƟc sƵrŐerLJ oƉeraƟoŶs͕ aŶ ŝŶcreasŝŶŐlLJ ŐroǁŝŶŐ ŝŶ ƉoƉƵlarŝtLJ͕ eLJe defect correcƟǀe sƵrŐerLJ͕ oƉeŶ heart sƵrŐerLJ͕ aŶd deŶtal or caŶcer treatmeŶt͕ aŶd eǀeŶ orŐaŶ traŶsƉlaŶt sƵrŐerŝes. The ƉroŐress ŝŶ the Health ToƵrŝsm emerŐed ŝŶ coŶŶecƟoŶ ǁŝth the deǀeloƉmeŶts ŝŶ medŝcŝŶe ;CoŶŶell͕ 2ϬϬ6). IŶ thŝs resƉect͕ ŝt ŝs sector ŝŶ ǁhŝch medŝcŝŶe aŶd ToƵrŝsm come toŐether aŶd ŝŶteŐrated. DƵrŝŶŐ the Ɖerŝod ǁheŶ medŝcŝŶe aŶd techŶoloŐLJ ǁere Ŷot adeƋƵatelLJ adǀaŶced ŝŶ the deǀeloƉŝŶŐ aŶd ƵŶderdeǀeloƉed coƵŶtrŝes͕ the ƉaƟeŶts͕ ǁho caŶ aīord͕ from those coƵŶtrŝes Ƶsed to Őo to the deǀeloƉed coƵŶtrŝes for medŝcal treatmeŶt. Hoǁeǀer͕ sŝŶce ŝŶ receŶt LJears the deǀeloƉŝŶŐ aŶd ƵŶderdeǀeloƉed coƵŶtrŝes͕ ƉarƟcƵlarlLJ TƵrŬeLJ͕ ŝmƉroǀed themselǀes ŝŶ medŝcal sector so Ŷoǁ theLJ caŶ comƉete aŐaŝŶst the deǀeloƉed coƵŶtrŝes͕ aŶd sŝŶce the medŝcal treatmeŶt edžƉeŶses are cheaƉer thaŶ theLJ are ŝŶ the deǀeloƉed coƵŶtrŝes͕ the roƵte of the Health ToƵrŝsm has comƉletelLJ chaŶŐed. Aim of the study: The aŝm of the stƵdLJ ŝs to ŝdeŶƟfLJ the cƵrreŶt statƵs of TƵrŬeLJ͛s Health ToƵrŝsm ŝŶ the lŝŐht of the data oďtaŝŶed from the MŝŶŝstrLJ of Health͕ to eǀalƵate the deǀeloƉmeŶts aŶd to maŬe recommeŶdaƟoŶ reŐardŝŶŐ ǁhat shoƵld ďe doŶe ŝŶ the fƵtƵre. IŶ thŝs coŶtedžt the folloǁŝŶŐ ǁŝll ďe ƵŶdertaŬeŶ͗ ͻ To determŝŶe the dŝstrŝďƵƟoŶ of the medŝcal ToƵrŝsm ƉaƟeŶts ǁho come to TƵrŬeLJ ŝŶ ƉƵďlŝc aŶd Ɖrŝǀate hosƉŝtals͕ ͻ To determŝŶe ŝŶ ǁhŝch hosƉŝtals ǁhŝch ďraŶches do the medŝcal ToƵrŝsm ƉaƟeŶts ǁho come to TƵrŬeLJ Ɖrefer͕ ͻ To determŝŶe ǁhŝch cŝƟes aŶd ǁhat ŬŝŶd of hosƉŝtals haǀe ƉrŝorŝtLJ ŝŶ TƵrŬeLJ ǁŝthŝŶ the scoƉe of Health ToƵrŝsm͕ ͻ To aŶalLJnje the Health ToƵrŝsm accordŝŶŐ to data oďtaŝŶed͕ ͻ To maŬe eǀalƵaƟoŶs for creaƟŶŐ marŬet ďLJ ŝdeŶƟfLJŝŶŐ ǁhŝch coƵŶtrŝes ǁoƵld Ɖrefer TƵrŬeLJ ŝŶ the Įeld of medŝcal ToƵrŝsm͕ ͻ To dŝscƵss ǁhat caŶ ďe doŶe ǁŝth a strateŐŝc ƉoŝŶt of ǀŝeǁ ŝŶ Health ToƵrŝsm sector. Thŝs stƵdLJ shoƵld ďe coŶsŝdered a starƟŶŐ ƉoŝŶt. Here͕ ŝŶ the lŝŐht of the ĮŶdŝŶŐs͕ ďLJ seƫŶŐ ƵƉ TƵrŬeLJ͛s Health ToƵrŝsm Ɖolŝcŝes͕ ǁe shoƵld ŝdeŶƟfLJ the 2Ϭ12Ͳ2Ϭ23 strateŐŝc oďũecƟǀes aŶd ďƵŝld aŶd deǀeloƉ Ɖroũects to maŬe TƵrŬeLJ ďecome aŶ aƩracƟǀe Health ToƵrŝsm ceŶter. 11 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 Method of the study: The maŝŶ coŶtrŝďƵƟoŶ of thŝs stƵdLJ ŝs maŬŝŶŐ the aŶalLJsŝs aŶd assessmeŶt of data Ɖroǀŝded ďLJ the DeƉartmeŶt of Health ToƵrŝsm. The ŝŶformaƟoŶ͕ ƋƵalŝĮed as ƉrŝmarLJ data͕ ǁas Őathered ďLJ the folloǁŝŶŐ tǁo ǁaLJs͗ ͻ AŶ oĸcŝal leƩer No. 2Ϭϴ2 dated :aŶƵarLJ 16͕ 2Ϭ12 has ďeeŶ seŶt to ϴ1 ƉroǀŝŶcŝal health dŝrectorates ǁhŝch reƋƵested all ƉƵďlŝc aŶd Ɖrŝǀate hosƉŝtals ŝŶ the ƉroǀŝŶces to Ɖroǀŝde data ƵŶder tǁo cateŐorŝes͕ ͞Health ToƵrŝsm͟ aŶd ͞health toƵrŝsts͖͟ ͻ DeƉartmeŶt of Health ToƵrŝsm has a ǁeďsŝte ;ǁeďͲďased reŐŝstraƟoŶ sLJstem) called ͞ForeŝŐŶ ŶaƟoŶals PaƟeŶt TracŬŝŶŐ SLJstem͟. Thŝs ǁeď reŐŝstraƟoŶ sLJstem reŐŝsters the data related to the foreŝŐŶ ƉaƟeŶts ŝŶ all hosƉŝtals ŝŶ ϴ1 ƉroǀŝŶces. The data stored ŝŶ the sLJstem ŝs oďtaŝŶed as moŶthlLJ reƉorts. AŌer data collecƟoŶ͕ the data ǁere aŶalLJnjed for the ƉƵrƉoses of the stƵdLJ. Edžcel aŶd SPSS ƉroŐrams ǁere Ƶsed. ResƵlts are ŝŶterƉreted. IŶ addŝƟoŶ͕ ŝŶ thŝs stƵdLJ the cƵrreŶt state of TƵrŬeLJ has ďeeŶ eǀalƵated ǁŝthŝŶ the frameǁorŬ of SWOT ;streŶŐths͕ ǁeaŬŶesses͕ oƉƉortƵŶŝƟes͕ threats) aŶalLJsŝs. SWOT aŶalLJsŝs has Ɖroǀŝded a ďalaŶced assessmeŶt oŶ the state of Health ToƵrŝsm ŝŶ TƵrŬeLJ͕ formŝŶŐ the ďasŝs of the ƉolŝcLJ docƵmeŶts ;ďoth stroŶŐ aŶd ǁeaŬ͕ ďoth ŝŶ terms of oƉƉortƵŶŝƟes aŶd threats) that ǁoƵld ďe deǀeloƉed ŝŶ the fƵtƵre. Both ƉrŝmarLJ data oŶ the Health ToƵrŝsm moďŝlŝtLJ aŶd the assessmeŶts oŶ the deǀeloƉmeŶts ŝŶ the ǁorld aŶd oŶ the SWOT aŶalLJsŝs ǁere ŝŶterƉreted ŝŶ the lŝŐht of the ŝŶformaƟoŶ oďtaŝŶed from a ǀarŝetLJ of soƵrces sƵch as the ŝŶterŶet͕ lŝďrarLJ͕ oŶlŝŶe search eŶŐŝŶes͕ HEC DocƵmeŶtaƟoŶ CeŶtre͕ the World Health OrŐaŶŝnjaƟoŶ. LŝmŝtaƟoŶs of the stƵdLJ͗ Thŝs stƵdLJ ǁas ďased oŶ data Ɖroǀŝded ďLJ the MŝŶŝstrLJ of Health. Hoǁeǀer͕ the MŝŶŝstrLJ of Health coƵld Ŷot Ɖroǀŝde all the data related to the moďŝlŝtLJ of Health ToƵrŝsm. Therefore͕ dƵe to the deĮcŝeŶcŝes ŝŶ the dataďase of the MŝŶŝstrLJ͖ ŝ. IŶformaƟoŶ reŐardŝŶŐ the smallͲscale health care ŝŶsƟtƵƟoŶs aŶd ŝŝ. Data related to medŝcal toƵrŝsts ǁho haǀe Ŷot ďeeŶ recorded ŝŶ the coƵŶtrLJ ǁere edžclƵded from eǀalƵaƟoŶ. ŝŝŝ. Haŝr traŶsƉlaŶtaƟoŶ͕ aestheƟc sƵrŐerLJ͕ the serǀŝces Ɖroǀŝded ŝŶ the deŶtal clŝŶŝcs aŶd doctors͛ oĸces ǁere Ŷot reŇected ŝŶ the staƟsƟcs. It ŝs esƟmated that aďoƵt 1ϬϬ thoƵsaŶd ƉeoƉle from thŝs ŐroƵƉ also receŝǀed health care ŝŶ oƵr coƵŶtrLJ. SecƟoŶs aŶd coŶteŶt of the stƵdLJ͗ ͻ Health ToƵrŝsm ͻ ToƵrŝsm throƵŐhoƵt the World aŶd ŝŶ TƵrŬeLJ ͻ Hŝstorŝcal DeǀeloƉmeŶt of Health ToƵrŝsm ͻ Health ToƵrŝsm throƵŐhoƵt the World ͻ Health ToƵrŝsm ŝŶ TƵrŬeLJ ͻ ReŐƵlaƟoŶs for Health ToƵrŝsm ͻ Facts aŶd FŝŐƵres reŐardŝŶŐ the Health ToƵrŝsm ŝŶ TƵrŬeLJ ͻ DŝstrŝďƵƟoŶ Health ToƵrŝsm ŝŶ TƵrŬeLJ ďLJ hosƉŝtals ͻ Health ToƵrŝsm ͻ Hŝstorŝcal DeǀeloƉmeŶt of Health ToƵrŝsm ͻ Health ToƵrŝsm throƵŐhoƵt the World ͻ Health ToƵrŝsm ŝŶ TƵrŬeLJ ͻ ReŐƵlaƟoŶs for Health ToƵrŝsm ͻ Facts aŶd FŝŐƵres reŐardŝŶŐ the Health ToƵrŝsm ŝŶ TƵrŬeLJ ͻ DŝstrŝďƵƟoŶ Health ToƵrŝsm ŝŶ TƵrŬeLJ ďLJ hosƉŝtals ͻ The hosƉŝtals ǁŝth hŝŐhest admŝssŝoŶ ĮŐƵres ͻ Health ToƵrŝsm ďLJ the ProǀŝŶce ͻ Health ToƵrŝsm ďLJ the BraŶch ͻ Health ToƵrŝsm ďLJ CoƵŶtrLJ ͻ AssessmeŶt of CƵrreŶt SŝtƵaƟoŶ of Health ToƵrŝsm ŝŶ TƵrŬeLJ oŶ the ďasŝs of SWOT AŶalLJsŝs ͻ CoŶclƵsŝoŶs aŶd RecommeŶdaƟoŶs 12 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 B ) AN OVERVIEW ON THE HEALTH TOURISM It ŝs also Ɖossŝďle to deĮŶe Health ToƵrŝsm as͕ ƉaƟeŶts͛ receŝǀŝŶŐ emerŐeŶcLJ medŝcal serǀŝce͕ or a Ɖreferred health care serǀŝce from dŝīereŶt coƵŶtrŝes. AccordŝŶŐ to MaŐaďlŝh ;2ϬϬ1) ǁho ďroƵŐht a dŝīereŶt ƉersƉecƟǀe to the ŝŶŝƟaƟǀes to deĮŶe Health ToƵrŝsm͕ the ũoƵrŶeLJs for Health ToƵrŝsm haǀe dƵraƟoŶ. PaƟeŶts͛ staLJŝŶŐ Ŷo less thaŶ oŶe daLJ aŶd Ŷot more thaŶ oŶe LJear ŝŶ aŶother coƵŶtrLJ for the ƉƵrƉose of receŝǀŝŶŐ health treatmeŶt or of ƉrotecƟŶŐ theŝr health ŝs deĮŶed as Health ToƵrŝsm. Health ToƵrŝsm sector ŝs ŐroǁŝŶŐ ǁŝth eǀerLJdaLJ. There are dŝīereŶt reasoŶs for the ƉaƟeŶts to traǀel for treatmeŶt ƉƵrƉoses ;DŝŶcer͕ 2Ϭ1Ϭ)͗ ͻ The desŝre to ďe treated ŝŶ coƵŶtrŝes ǁhŝch haǀe adǀaŶced eƋƵŝƉmeŶt aŶd techŶoloŐLJ͕ ǁorldǁŝde eīecƟǀeŶess ŝŶ scŝeŶƟĮc seŶse͕ ͻ Medŝcal serǀŝces͛ ďeŝŶŐ edžƉeŶsŝǀe aŶd to ďe aďle to receŝǀe the same serǀŝce cheaƉer ŝŶ other coƵŶtrŝes͕ ͻ The ƉaƟeŶts͛ ďeŝŶŐ aďle to receŝǀe a ďeƩer ƋƵalŝtLJ health serǀŝce ŝŶ aŶother coƵŶtrLJ thaŶ ŝŶ theŝr oǁŶ coƵŶtrLJ͕ ͻ The Ɖroďlems theLJ haǀe ǁŝth health ŝŶsƵraŶce͕ ͻ The desŝre to shorteŶ the loŶŐ ǁaŝƟŶŐ Ɖerŝod to ďe aďle to receŝǀe medŝcal traŝŶŝŶŐ. The coŶceƉt of ǁellŶess came to the h fore f as Ŷeǀer ďefore. ď f Rather h thaŶ h eŶtertaŝŶmeŶt͕ Health ToƵrŝsm ŝs mostlLJ focƵsed mostlLJ oŶ ŐeƫŶŐ aǁaLJ from ďƵsŝŶess eŶǀŝroŶmeŶts aŶd ďecomŝŶŐ healthLJ aŐaŝŶ at Ɖlaces ǁŝth ǁarm clŝmates aŶd ǁaters. The coŶceƉt of Health ToƵrŝsm ŝŶ ŐeŶeral coǀers all the coŶceƉts related to staLJŝŶŐ healthLJ aŶd Įt͕ ǁhŝle the coŶceƉt of medŝcal ToƵrŝsm coǀers medŝcal ŝŶterǀeŶƟoŶs aŶd treatmeŶt. Medŝcal ToƵrŝsm͕ ǁŝth ŝts sŝmƉlest deĮŶŝƟoŶ͕ ŝs a term Ƶsed to descrŝďe ũoƵrŶeLJs made ŝŶ order to Őet medŝcal treatmeŶt. Health ToƵrŝsm͕ a sƵďͲsector of the ToƵrŝsm sector͕ ǁhŝch has the hŝŐhest added ǀalƵe͕ coŶtrŝďƵtes sŝŐŶŝĮcaŶtlLJ to the ecoŶomŝes of the coƵŶtrŝes. Thŝs coŶtrŝďƵƟoŶ ŝs at hŝŐh rate aŶd also has a larŐe eīect ǁhŝch caŶ Ɖroǀŝde ŝŶƉƵt ǀarŝoƵs sectors. Health ToƵrŝsm ŝŶdƵstrLJ͕ Ɖroǀŝdes ŝŶƉƵt for dŝīereŶt sectors as ďeloǁ͗ 13 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 (Figure 4): Input for Health Tourism (Gonzales, Brenzel, Sancho, 2001) Health Tourism Tourism Industry Quality of the Health Services Health Service Providers Marketing Hotel Services Management Transportation Communication Systems Systems Infrastructure Training Health ToƵrŝsm caŶ ďe eǀalƵated ƵŶder three maŝŶ Ɵtles͗ 1. Medŝcal ToƵrŝsm͗ coǀers the foreŝŐŶers ǁho receŝǀe health care ŝŶ health care facŝlŝƟes. 2. Thermal ToƵrŝsm 3. AdǀaŶced AŐe aŶd DŝsaďŝlŝtLJ ToƵrŝsm IŶ all these three Įelds oƵr coƵŶtrLJ has the hŝŐhest ƉoteŶƟal aŶd͕ ŝŶteŐraƟoŶ ŝs Ŷeeded for deǀeloƉmeŶt aŶd sƵstaŝŶaďŝlŝtLJ of Health ToƵrŝsm. Thŝs reƉort ŝs comƉletelLJ ďased oŶ medŝcal ToƵrŝsm staƟsƟcs 1 ) Tourism THROUGHOUT THE WORLD AND IN TURKEY Health ToƵrŝsm caŶ ďe coŶsŝdered as a sƵďͲsector that ŝs maŝŶlLJ comƉosed of the ŝŶteŐraƟoŶ of health aŶd ToƵrŝsm areas. Health ToƵrŝsm ǁŝll to a larŐe edžteŶt deƉeŶd oŶ deǀeloƉmeŶts ŝŶ the Įeld of health aŶd ToƵrŝsm. IŶ thŝs coŶtedžt͕ the ToƵrŝsm sector Ŷeeds to ďe edžamŝŶed ŝŶ the coŶtedžt of Health ToƵrŝsm. IŶ addŝƟoŶ͕ the ToƵrŝsm sector ŝs the ǁorld͛s fastest deǀeloƉŝŶŐ aŶd ŐroǁŝŶŐ ŝŶdƵstrLJ. Thŝs sector ǁhŝch has a ƉosŝƟǀe aŶd ŝmƉortaŶt coŶtrŝďƵƟoŶ ŝŶ ecoŶomŝc͕ socŝal͕ ƉolŝƟcal aŶd cƵltƵral asƉects has ďecome aŶ ŝŶdƵstrLJ ďLJ ŝtself ŝŶ the ǁorld ecoŶomLJ. The ŶƵmďer of ƉeoƉle ƉarƟcŝƉaƟŶŐ ŝŶ the moǀemeŶt of ŝŶterŶaƟoŶal ToƵrŝsm ŝŶ the ǁorld ŝŶ 195Ϭ ǁas 25.2 mŝllŝoŶ ƉeoƉle aŶd ŝŶ 1995 ŝt ǁas 52ϴ mŝllŝoŶ ƉeoƉle. AccordŝŶŐ to the records of the World ToƵrŝsm OrŐaŶŝnjaƟoŶ ;UNWTO) ŝŶ 2Ϭ11͕ 9ϴϬ mŝllŝoŶ ƉeoƉle ƉarƟcŝƉated ŝŶ the moǀemeŶt of ToƵrŝsm. Thŝs ŶƵmďer ŝs edžƉected to reach oŶe ďŝllŝoŶ ŝŶ 2Ϭ12. 14 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &ŝŐƵƌĞϭ͗/ŶƚĞƌŶĂƟŽŶĂůdŽƵƌŝƐŵDŽǀĞŵĞŶƚƐ;hEtdK͕ϮϬϭϭͿ MŝllŝoŶ IŶterŶĂƟoŶĂů Tourism MoǀemeŶts͕ 1ϵϵϱͲ2011 NƵmďer of ToƵrŝst ͻ IŶ 2Ϭ1Ϭ 935 mŝllŝoŶ ƉeoƉle ƉarƟcŝƉated ŝŶ the moǀemeŶt of ŝŶterŶaƟoŶal ToƵrŝsm ǁŝth aŶ ŝŶcrease ďLJ 6.7й to the ƉreǀŝoƵs LJear. ͻ IŶ 2Ϭ1Ϭ ŝŶterŶaƟoŶal ToƵrŝsm moǀemeŶt Őot ŝŶto a recoǀerLJ Ɖrocess aŶd retƵrŶed to ƉreͲcrŝsŝs leǀel. ͻ IŶ 2Ϭ11͕ the ŝŶcrease ŝŶ the ŶƵmďer of ŝŶterŶaƟoŶal toƵrŝst moǀemeŶt coŶƟŶƵed aŶd reached 9ϴϬ mŝllŝoŶ ƉeoƉle. TodaLJ͕ ŝŶ a raƉŝdlLJ eǀolǀŝŶŐ era of commƵŶŝcaƟoŶ aŶd techŶoloŐLJ͕ coƵŶtrŝes are ŐeƫŶŐ closer to each other at ƵŶŝǀersal dŝmeŶsŝoŶ͕ aŶd thƵs the ǁorld ŝs ŐeƫŶŐ smaller. IŶ other ǁords͕ the ǁorld ǁŝtŶesses a raƉŝd ŐloďalŝnjaƟoŶ. As a resƵlt͕ ƉeoƉle teŶd to traǀel loŶŐer dŝstaŶces. There are maŶLJ factors that aīect thŝs treŶd. The deǀeloƉmeŶt aŶd chaŶŐes ŝŶ the ecoŶomŝc͕ socŝoͲdemoŐraƉhŝc͕ ƉolŝƟcal aŶd leŐal factors as ǁell as the ƉsLJcholoŐŝcal factors ǁhŝch are Ŷot dŝrectlLJ related to ToƵrŝsm͕ ďƵt aīect the ǀolƵme aŶd strƵctƵre of the ToƵrŝsm demaŶd͕ aīect the demaŶd for ŝŶterŶaƟoŶal ToƵrŝsm. 15 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 TaŬŝŶŐ ŝŶto coŶsŝderaƟoŶ the Ɖlace of the ToƵrŝsm sector ŝŶ the ǁorld trade marŬet aŶd the caƉacŝtLJ ŝt ǁoƵld reach at ŝŶ the fƵtƵre͕ ŝt ŝs ŝmƉossŝďle to thŝŶŬ of aŶLJ coƵŶtrLJ that ǁoƵld remaŝŶ ŝŶdŝīereŶt to thŝs sector. EsƉecŝallLJ for deǀeloƉŝŶŐ coƵŶtrŝes ǁŝth hŝŐh ToƵrŝsm ƉoteŶƟal͕ ŝŶclƵdŝŶŐ TƵrŬeLJ͕ the ToƵrŝsm sector ŝs of Őreat ŝmƉortaŶce. ToƵrŝsm ŝs a sector that ǁoƵld maŬe ecoŶomŝc coŶtrŝďƵƟoŶs to the coƵŶtrŝes͕ as ǁell as creaƟŶŐ Ŷeǁ areas for ũoďs. For thŝs reasoŶ͕ ũƵst lŝŬe the other sectors do͕ ToƵrŝsm also creates a comƉeƟƟǀe eŶǀŝroŶmeŶt ďetǁeeŶ coƵŶtrŝes. The ƉrŝmarLJ oďũecƟǀe of the coƵŶtrŝes ŝŶ thŝs comƉeƟƟǀe eŶǀŝroŶmeŶt ŝs to ŝŶcrease marŬet share ŝŶ the Őloďal ToƵrŝsm marŬet͕ ;AŬat͕ 2ϬϬϬ). Figure 2: The countries that come to the foreground in Health Tourism TƵrŬeLJ ďecame aŶ ŝmƉortaŶt aŶd ƉoǁerfƵl actor ŝŶ ToƵrŝsm sector thaŶŬs to the ToƵrŝsm deǀeloƉmeŶt ŝŶŝƟaƟǀes she started ŝŶ the 19ϴϬs. TƵrŬeLJ ďecame oŶe of the Įrst seǀeŶ coƵŶtrŝes esƉecŝallLJ dƵe to ŝts ďreaŬthroƵŐh ŝŶ the ToƵrŝsm sector oǀer the last decade. IŶ terms of the ŶƵmďer of toƵrŝsts ǀŝsŝƟŶŐ͕ TƵrŬeLJ ǁas ŶƵmďer 17 ŝŶ 2ϬϬ2 aŶd clŝmďed ƵƉ to ŶƵmďer 7 ŝŶ 2ϬϬ9. Whŝle ŝŶ 2ϬϬϴ the ŶƵmďer of toƵrŝsts comŝŶŐ from all oǀer the ǁorld to TƵrŬeLJ ǁas 26.3 mŝllŝoŶ͕ ŝt ǁas almost 31.4 mŝllŝoŶ ŝŶ 2Ϭ11. ToƵrŝsm reǀeŶƵe decreased ďLJ 9.7й comƉared to the same Ɖerŝod last LJear. IŶ the 1st Ɖerŝod ǁhŝch coǀers :aŶƵarLJ͕ FeďrƵarLJ aŶd March͕ ToƵrŝsm reǀeŶƵe͕ ǁŝth a decrease ďLJ 9.7й comƉared to the same Ɖerŝod last LJear͕ ǁas 2͕799͕744͕25Ϭ Ψ. Whŝle 72й of ToƵrŝsm reǀeŶƵes ǁere oďtaŝŶed from foreŝŐŶ ǀŝsŝtors͕ 2ϴй ǁere oďtaŝŶed from the TƵrŬŝsh cŝƟnjeŶs resŝdŝŶŐ aďroad. Vŝsŝtors traǀel eŝther ƉersoŶallLJ or ďLJ toƵr ƉacŬaŐes. IŶ thŝs Ɖerŝod͕ 2͕497͕453͕236 Ψ ǁas sƉeŶt for ƉersoŶal toƵrs͕ ǁhŝle 3Ϭ2͕291͕Ϭ14 Ψ ǁas sƉeŶt for toƵr ƉacŬaŐes. IŶ the 1st Perŝod of 2Ϭ12͕ the aǀeraŐe edžƉeŶdŝtƵre ǁas 664 Ψ. IŶ the same Ɖerŝod͕ aǀeraŐe sƉeŶdŝŶŐ ďLJ foreŝŐŶers ǁas 594 Ψ Ɖer ƉersoŶ aŶd the aǀeraŐe sƉeŶdŝŶŐ Ɖer ƉersoŶ ďLJ cŝƟnjeŶs resŝdŝŶŐ aďroad ǁas 943 Ψ͕ resƉecƟǀelLJ. Numďer of ǀisits deĐreĂsed ďy ϰ͘1й ĐomƉĂred to the sĂme Ɖeriod ůĂst yeĂr IŶ the 1st Perŝod of 2Ϭ12͕ the ŶƵmďer of ǀŝsŝtors deƉarƟŶŐ from TƵrŬeLJ ǁas 4͕219͕161 ƉeoƉle. Of thŝs ŶƵmďer͕ 3͕374͕732 ǁere foreŝŐŶers ǁhŝle͕ ϴ44͕429 ǁere TƵrŬŝsh cŝƟnjeŶs lŝǀŝŶŐ aďroad. 16 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 Tourism edžƉeŶditures deĐreĂsed ďy ϯϲ͘ϲй ĐomƉĂred to the sĂme Ɖeriod of ůĂst yeĂr The ToƵrŝsm edžƉeŶdŝtƵres coŶsŝsƟŶŐ of the edžƉeŶdŝtƵres of the TƵrŬŝsh cŝƟnjeŶs resŝdŝŶŐ ŝŶ TƵrŬeLJ aŶd ǀŝsŝƟŶŐ other coƵŶtrŝes ǁas 759͕Ϭ92͕463 Ψ ǁŝth a decrease ďLJ 36.6й comƉared to the same Ɖerŝod of last LJear. Of thŝs edžƉeŶdŝtƵres͕ 739͕715͕476 Ψ ǁas sƉeŶt for ƉersoŶal toƵrs͕ ǁhŝle 19͕376͕9ϴ7 Ψ ǁas sƉeŶt for toƵr ƉacŬaŐes. The aǀeraŐe edžƉeŶdŝtƵre Ɖer ƉersoŶ of 1͕263͕166 TƵrŬŝsh cŝƟnjeŶs ǁas 6Ϭ1 Ψ. &ŝŐƵƌĞ͗ϮϬϭϭͲϮϬϭϮWĞƌŝŽĚŝĐdŽƵƌŝƐŵ/ŶĐŽŵĞĂŶĚdžƉĞŶƐĞ͕ AǀeraŐe Number of EdžƉenditure Tourism deƉarƟŶŐ ǀisitors Ɖer Ɖerson IŶĐome ($) ($) Year / Term Tourism IŶĐome ($) Number AǀeraŐe of ĐiƟnjeŶs EdžƉenditure residiŶŐ Ɖer Ɖerson in Turkey ($) 2011 I͘Term II. Term III. Term IV. Term AŶŶuĂů ϯ 100 2ϳ0 1ϳ0 5 372 1ϴ9 266 9 339 Ϭ2ϴ 541 5 2Ϭϴ 9Ϭ4 274 2ϯ 020 ϯϵ2 2ϱ0 ϰ ϯϵϴ 2ϯϱ 9 33ϴ Ϭ76 14 991 27Ϭ 7 423 747 ϯϲ 1ϱ1 ϯ2ϴ ϳ0ϱ 575 623 637 ϲϯϳ 1 1ϵϲ ϳϵϳ ϰϳϯ 1 325 6ϴϴ 593 1 Ϭ44 ϴϴ7 999 1 4Ϭϴ ϴϬ2 539 ϰ ϵϳϲ 1ϳϲ ϲ0ϰ 1 ϲϰϲ ϱϳϳ 1 ϴϴ5 979 1 465 6Ϭ1 1 2ϴ3 ϴ15 ϲ 2ϴ1 ϵϳ2 ϳ2ϳ 7Ϭ3 713 1 Ϭ97 ϳϵ2 2012 I͘ Term :aŶƵarLJ FeďrƵarLJ March 2 ϳϵϵ ϳϰϰ 2ϱ0 ϴ99 552 7Ϭ5 ϴ23 626 15ϴ 1 Ϭ76 565 3ϴ7 ϰ 21ϵ 1ϲ1 1 374 4Ϭ1 1 2Ϭ9 Ϭ64 1 635 696 ϲϲϰ 655 6ϴ1 65ϴ ϳϱϵ 0ϵ2 ϰϲϯ 237 946 ϴ2Ϭ 226 Ϭ42 161 295 1Ϭ3 4ϴ2 1 2ϲϯ 1ϲϲ 415 ϴ16 3ϴ1 114 466 236 ϲ01 572 593 633 dĂďůĞϭ͗EƵŵďĞƌŽĨdŽƵƌŝƐƚƌƌŝǀĂůƐŝŶdƵƌŬĞLJ͕ϮϬϬϰͲϮϬϭϭ;DŝŶŝƐƚƌLJŽĨƵůƚƵƌĞĂŶĚdŽƵƌŝƐŵ͕ 'ĞŶĞƌĂůŝƌĞĐƚŽƌĂƚĞŽĨWƌŽŵŽƟŽŶͿ͘ Year 2ϬϬ4 2ϬϬ5 2ϬϬ6 2ϬϬ7 2ϬϬϴ 2ϬϬ9 2Ϭ1Ϭ 2Ϭ11 NƵmďer of Vŝsŝtors 17.516.9Ϭϴ 21.124.ϴϴ6 19.ϴ19.ϴ33 23.34Ϭ.911 26.336.677 27.Ϭ77.114 2ϴ.632.2Ϭ4 31.456.Ϭ76 Rate of ChaŶŐe 24.ϴ6 2Ϭ.6Ϭ Ͳ 6.1ϴ 17.77 12.ϴ3 2.ϴ1 5.74 9.ϴ6 IŶ the lŝst of coƵŶtrŝes seŶdŝŶŐ toƵrŝsts to TƵrŬeLJ ŝŶ 2Ϭ11͕ ǁŝth the rate of 15.34 й aŶd 4͕ϴ26͕315 ƉeoƉle GermaŶLJ ǁas at the Įrst roǁ͕ ǁŝth the rate of 11.Ϭ3 й aŶd 3͕46ϴ͕214 ƉeoƉle the RƵssŝaŶ FederaƟoŶ ǁas at the secoŶd roǁ͕ aŶd ǁŝth the rate of ϴ.21 й aŶd 2͕5ϴ2͕Ϭ54 ƉeoƉle the UŶŝted KŝŶŐdom ǁas at the thŝrd roǁ. IŶ the meŶƟoŶed lŝst IraŶ͕ BƵlŐarŝa͕ the NetherlaŶds͕ GeorŐŝa͕ FraŶce͕ SLJrŝa aŶd the USA folloǁed the UK resƉecƟǀelLJ ;hƩƉ͗ͬͬǁǁǁ. taŶŝtma.Őoǀ.tr). IŶ thŝs ŝŶteŶse comƉeƟƟoŶ ŝŶ the ToƵrŝsm sector TƵrŬeLJ has maŶaŐed to taŬe the Įrst Ɖlace amoŶŐ teŶ coƵŶtrŝes͕ ǁhŝch receŝǀe the most toƵrŝsts. As of 2Ϭ11͕ TƵrŬeLJ raŶŬs seǀeŶth ŝŶ the ToƵrŝsm sector ǁŝth a marŬet share of 2.99й. FraŶce͕ at the Įrst roǁ͕ ŝs folloǁed ďLJ the UŶŝted States. 17 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 Taďle 2͗ CoƵŶtrŝes aŶd MarŬet Shares ;UNWTO͕ 2Ϭ11). Countries and Market Shares (й) CoƵŶtrŝes MarŬet Shares FraŶce ϴ͕Ϭ1 USA 6͕4 PRC 5͕ϴ7 SƉaŝŶ 5͕7ϴ ItalLJ 4͕73 UK 3͕12 TƵrŬeLJ 2͕99 GermaŶLJ 2͕ϴ9 MalaLJsŝa 2͕64 AƵstralŝa 2͕36 Medžŝco 2͕33 Whŝle the ToƵrŝsm ŝŶdƵstrLJ ŝs raƉŝdlLJ deǀeloƉŝŶŐ aŶd ŝŶcreasŝŶŐ ŝŶ dŝǀersŝtLJ ŝŶ the ǁorld͕ the comƉeƟƟoŶ ďetǁeeŶ coƵŶtrŝes also ŝŶcreases ;BaŬŦrcŦ͕ 2ϬϬ2). WŝthŝŶ the frameǁorŬ of ŐloďalŝnjaƟoŶ͕ as ŝŶ all other sectors͕ also ŝŶ the ToƵrŝsm sector Ŷeǁ ŝdeas are ďeŝŶŐ ƉrodƵced aŶd Ŷeǁ ǁaLJs are ďeŝŶŐ soƵŐht for the deǀeloƉmeŶt. ThƵs͕ althoƵŐh ŝŶ ƉreǀŝoƵs LJears͕ the deĮŶŝƟoŶ of ToƵrŝsm ǁas restrŝcted ǁŝth traǀels for holŝdaLJ aŶd leŝsƵre͕ todaLJ ͞ToƵrŝsm͟ coŶceƉt has Ŷeǁ meaŶŝŶŐs aŶd alterŶaƟǀe forms of ToƵrŝsm haǀe emerŐed. Health ToƵrŝsm͕ cƵltƵral ToƵrŝsm͕ relŝŐŝoƵs ToƵrŝsm͕ moƵŶtaŝŶeerŝŶŐ ToƵrŝsm͕ dŝǀŝŶŐ ToƵrŝsm͕ raŌŝŶŐ ToƵrŝsm are oŶlLJ a feǁ of the ToƵrŝsm tLJƉes ǁhŝch caŶ ďe coŶsŝdered as alterŶaƟǀe ToƵrŝsm ;AYMANKUY͕ 2ϬϬ3͖ ErdoŐaŶ͕ 1995͖ KƵmar͕ 1996͖ Onjdemŝr͕ 199ϴ). AccordŝŶŐ to research ďLJ the World ToƵrŝsm OrŐaŶŝnjaƟoŶ͕ of ToƵrŝsm moǀemeŶt͖ 51й ŝs cƵltƵre͕ eŶtertaŝŶmeŶt aŶd leŝsƵre ToƵrŝsm͕ 15й ŝs ǀŝsŝt ToƵrŝsm for ďƵsŝŶess aŶd ƉrofessŝoŶal ƉƵrƉoses͕ aŶd 27й ŝs the frŝeŶds͕ relaƟǀes ǀŝsŝt ToƵrŝsm͕ Health ToƵrŝsm͕ relŝŐŝoƵs aŶd ƉŝlŐrŝmaŐe ToƵrŝsm forms. SeǀeŶ ƉerceŶt of the resƉoŶdeŶts dŝd Ŷot edžƉress aŶ oƉŝŶŝoŶ. IŶ thŝs coŶtedžt͕ Health ToƵrŝsm reƉreseŶts oŶe of the ǀarŝeƟes of alterŶaƟǀe ToƵrŝsm. As for the coŶceƉt of Health ToƵrŝsm͕ there ŝs sƟll Ŷo fƵllLJ aŐreed sŝŶŐle meaŶŝŶŐ. For edžamƉle͕ ǁheŶ toƵrŝsts͕ ǁho ǀŝsŝt for sŝŐhtseeŝŶŐ͕ eŶtertaŝŶmeŶt or for aŶLJ other reasoŶ other thaŶ receŝǀŝŶŐ health serǀŝce͕ Őet sŝcŬ ŝŶ the coƵŶtrLJ theLJ ǀŝsŝt aŶd receŝǀe medŝcal treatmeŶt͕ thŝs sŝtƵaƟoŶ ŝs Ŷot coŶsŝdered ǁŝthŝŶ the scoƉe of Health ToƵrŝsm. Thŝs sŝtƵaƟoŶ ŝs coŶsŝdered as ͞health of the toƵrŝst͟. GoŶnjales͕ BreŶnjel aŶd SaŶcho ;2ϬϬ1) edžamŝŶe serǀŝces oīered ŝŶ Health ToƵrŝsm ǁŝthŝŶ three maŝŶ cateŐorŝes͗ ͻ Serǀŝces to ImƉroǀe Health ;sƉa͕ herďal theraƉLJ͕ massaŐe͕ etc.). ͻ Serǀŝces for treatmeŶt Ͳ Medŝcal ToƵrŝsm ;cosmeƟc sƵrŐerLJ͕ heart sƵrŐerLJ͕ eLJe sƵrŐerLJ͕ caŶcer theraƉLJ͕ etc.). ͻ RehaďŝlŝtaƟoŶ Serǀŝces ;dŝalLJsŝs͕ addŝcƟoŶ ƉroŐrams͕ elder care ƉroŐram) MŝŶŝstrLJ of Health coŶsŝders Health ToƵrŝsm ƵŶder three maŝŶ Ɵtles͖ 1. Medŝcal ;MedŝcŝŶe) ToƵrŝsm 2. Thermal ToƵrŝsm 3. ElderlLJ aŶd Dŝsaďled ToƵrŝsm. 18 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 2) HISTORICAL EVALUATION O& Heaůth Tourism The scŝeŶƟĮc stƵdŝes that ďacŬ thoƵsaŶds of LJears reǀeal that sŝŶce the Įrst ceŶtƵrŝes͕ stƵdŝes haǀe ďeeŶ coŶdƵcted ŝŶ the Įeld of health. IŶ the aŶcŝeŶt Ɵmes͕ the healŝŶŐ eīect of thermal ǁaters has ďeeŶ realŝnjed aŶd eǀeŶ these ǁaters ǁere someƟmes called ͞holLJ ǁater͟. Some edžamƉles͕ oďtaŝŶed as a resƵlt of scŝeŶƟĮc stƵdŝes carrŝed oƵt ŝŶ the aŶcŝeŶt aŐes are lŝsted as folloǁs͕ ;hƩƉ͗ͬͬǁǁǁ.healŝsm.comͬmedŝcalͺ ToƵrŝsm ͬ hŝstorLJ ͬ medŝcalͺToƵrŝsmͺhŝstorLJ ͬ)͗ ͻ The Įrst ŬŶoǁŶ medŝcal comƉledž ǁas ďƵŝlt oŶ a hŝŐh hŝll aroƵŶd the hot ǁater sƵƉƉlLJ ďLJ the SƵmerŝaŶs ;4ϬϬϬ BC). ͻ DƵrŝŶŐ the BroŶnje AŐe ;BC 2ϬϬϬ) at the hŝŐh moƵŶtaŝŶs aroƵŶd the Ɖlace ǁhŝch ŝs Ŷoǁ ŬŶoǁŶ as St. Morŝtnj͕ ŝroŶͲrŝch thermal ǁaters ǁere foƵŶd aŶd the trŝďes ďeŶeĮted from these ǁaters for the treatmeŶt ƉƵrƉoses. ͻ For the Įrst Ɵme͕ the aŶcŝeŶt GreeŬs formed a ŶetǁorŬ of crossͲďorder Health ToƵrŝsm. TheLJ set ƵƉ a larŐe medŝcal ceŶter at the AscleƉŝa Hŝll oŶ ďehalf of ͞AscleƉŝƵs͟ ǁho accordŝŶŐ to theŝr ďelŝef ŝs ͞the God of Health͟. PeoƉle traǀeled from all oǀer the ǁorld ƵƉ to the hŝll to haǀe theŝr dŝseases treated. AƉƉrodžŝmatelLJ ƵŶƟl BC 3ϬϬ͕ domŝŶaŶce of the aŶcŝeŶt GreeŬs oŶ Health ToƵrŝsm coŶƟŶƵed. ͻ AƉƉrodžŝmatelLJ 5͕ϬϬϬ LJears aŐo͕ IŶdŝa started to come to the fore ŝŶ the Health ToƵrŝsm sector͕ ǁheŶ LJoŐa aŶd ALJƵrǀerdŝŬ ďeŐaŶ to sƉread ŐradƵallLJ. StƵdeŶts from ǀarŝoƵs coƵŶtrŝes ďeŐaŶ to come to IŶdŝa to learŶ the emerŐŝŶŐ alterŶaƟǀe health care methods. Hoǁeǀer͕ as the ŶƵmďer of stƵdeŶts aŶd teachers ŝŶcreased͕ Ŷeǁ ceŶters ǁere oƉeŶed ŝŶ IŶdŝa. PaƟeŶts from all oǀer the ǁorld haǀe traǀeled to IŶdŝa to ďe treated ďLJ sƉŝrŝtƵal eŶlŝŐhteŶmeŶt. ͻ IŶ the Ɖerŝod ǁheŶ Rome started to ďecome a maũor force ŝŶ the ǁorld͕ the thermal ǁaters of thŝs reŐŝoŶ ǁere Ƶsed ďLJ the ƉeoƉle for theraƉeƵƟc ƉƵrƉoses aŶd also the strƵctƵres foƵŶded aroƵŶd the thermal ǁaters͕ haǀe ďecome the ceŶter for recreaƟoŶ aŶd leŝsƵre for rŝch aŶd elŝte toƵrŝsts. ͻ IŶ the Mŝddle AŐes͖ ŝŶ :aƉaŶ thermal ǁaters called ͞OŶseŶ͟ haǀe ďecome ƉoƉƵlar ďecaƵse of ŝts healŝŶŐ featƵre. Warrŝor trŝďes haǀe ďeŶeĮted from these ǁaters to heal theŝr ǁoƵŶds͕ to recoǀer the Ɖoǁer theLJ haǀe lost aŶd to relŝeǀe the ƉaŝŶ. ͻ IŶ the ǀerLJ old Islamŝc cƵltƵres͕ a sLJstem for treaƟŶŐ domesƟc aŶd foreŝŐŶ ƉaƟeŶts ǁas estaďlŝshed. The MaŶsoƵrŝ HosƉŝtal estaďlŝshed ŝŶ 124ϴ ŝŶ Caŝro͕ ǁas the theŶ most adǀaŶced aŶd larŐest hosƉŝtal ŝŶ the ǁorld. Wŝth a caƉacŝtLJ of ϴϬϬϬ ƉaƟeŶts the hosƉŝtal ǁas admŝƫŶŐ ƉaƟeŶts all oǀer the ǁorld. ͻ IŶ the 1ϴth CeŶtƵrLJ sƉa treatmeŶt ďeŐaŶ to ďe ƉoƉƵlar. Rŝch toƵrŝsts ǁere ŐoŝŶŐ to the Rŝǀer Nŝle for treatmeŶt ƉƵrƉoses. 19 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 ͻ AccordŝŶŐ to the research ďLJ SmLJth ;2ϬϬ5)͕ ŝŶ the 19th CeŶtƵrLJ͕ aŶother alterŶaƟǀe method of treatmeŶt has emerŐed. The healŝŶŐ eīect of the troƉŝcal clŝmate ǁas ďroƵŐht to the fore aŶd ƉeoƉle started to traǀel to the reŐŝoŶs ǁŝth troƉŝcal clŝmate for treatmeŶt ƉƵrƉoses. Later oŶ ToƵrŝsm tƵrŶed ŝŶto ďeach ToƵrŝsm͕ aŶd ŝt ďecame aŶ acƟǀŝtLJ Ŷot oŶlLJ the rŝch͕ ďƵt also the mŝddle class ƉeoƉle coƵld ďeŶeĮt from. ;Gŝlďert 1954) IŶ the Health ToƵrŝsm sector the most Ɖreferred coƵŶtrŝes are IŶdŝa͕ CƵďa͕ Costa Rŝca͕ ThaŝlaŶd͕ SŝŶŐaƉore͕ Colomďŝa͕ MalaLJsŝa͕ GermaŶLJ aŶd SoƵth Korea. The maŝŶ area of Health ToƵrŝsm ŝs Asŝa. ThaŝlaŶd has made a Ŷame for ŝtself ŝŶ the 197Ϭs ǁŝth sedž reassŝŐŶmeŶt sƵrŐerŝes aŶd later oŶ ŝt started to Őet edžƉerƟse oŶ aestheƟc sƵrŐerLJ. WheŶ the ŶaƟǀe ƉaƟeŶts ŝŶ ThaŝlaŶd ďecame ƵŶaďle to aīord the rŝsŝŶŐ Ɖrŝces aŌer the ecoŶomŝc crŝsŝs͕ ŝŶ 199ϴ͕ MalaLJsŝa ƉarƟcŝƉated ŝŶ thŝs ŐroƵƉ. SŝŶŐaƉore that eŶtered thŝs marŬet later͕ forced the Ɖrŝces doǁŶ to comƉete ǁŝth ThaŝlaŶd aŶd MalaLJsŝa͕ aŶd at the aŝrƉorts Ɖlaced ŝŶformaƟoŶ staŶds oŶ medŝcal ToƵrŝsm alterŶaƟǀes. ;CoŶŶell͕ 2ϬϬ6). TodaLJ͕ IŶdŝa ŝs seeŶ as a ƉŝoŶeer coƵŶtrLJ ŝŶ the Įeld of medŝcal ToƵrŝsm. Whŝle IŶdŝa aŝms at treaƟŶŐ ƉaƟeŶts from EƵroƉe͕ the Mŝddle East aŶd CaŶada͕ SŝŶŐaƉore aŝms at treaƟŶŐ ƉaƟeŶts from the UŶŝted States. ;CBC Neǁs͕ 2ϬϬ7) As of mŝdͲ199Ϭs͕ Health ToƵrŝsm͕ ǁŝth the ŝŶŇƵeŶce of the serŝoƵs comƉeƟƟoŶ ďetǁeeŶ the coƵŶtrŝes aŶd of the ŐloďalŝnjaƟoŶ͕ emerŐed as oŶe of the most soƵŐhtͲaŌer ǀarŝeƟes of alterŶaƟǀe ToƵrŝsm ƵŶder the Ɵtle of Health ToƵrŝsm. WŝthŝŶ the Health ToƵrŝsm ǁhŝch coŶsƟtƵtes aŶ ŝmƉortaŶt area of ToƵrŝsm ŝŶdƵstrLJ͕ tradŝƟoŶal medŝcŝŶe areas ;deŶtal͕ eLJe͕ aestheƟcs͕ cardŝoǀascƵlar aŶd ũoŝŶt Ɖrostheses͕ ŝŶferƟlŝtLJ treatmeŶt͕ sƵrŐŝcal ƉrocedƵres sƵch as ŝŶ ǀŝtro ferƟlŝnjaƟoŶ͕ etc.) comes ƵƉ. PeoƉle͕ ǁho Ŷeed health care serǀŝces͕ teŶd toǁards the coƵŶtrŝes haǀŝŶŐ ƋƵalŝĮed health care orŐaŶŝnjaƟoŶs͕ traŝŶed hƵmaŶ resoƵrces aŶd Ɖrŝce adǀaŶtaŐes. TheraƉLJ aŶd sƵrŐŝcal ŝŶterǀeŶƟoŶ rates ŝŶ SoƵth Asŝa aŶd SoƵth Amerŝca are more adǀaŶtaŐeoƵs thaŶ ŝŶ ŶortherŶ coƵŶtrŝes. Therefore͕ ŝŶ terms of Health ToƵrŝsm the aďoǀemeŶƟoŶed coƵŶtrŝes come to the foreŐroƵŶd. OŶ the other haŶd͕ aŶ ŝmƉortaŶt Ɖarameter ŝŶ Health ToƵrŝsm ŝs the easLJ accessŝďŝlŝtLJ. LooŬŝŶŐ at the hŝstorŝcal deǀeloƉmeŶt of Health ToƵrŝsm͕ ŝŶ earlLJ 19ϬϬs͕ EƵroƉe aŶd Amerŝca͕ as ŝŶ maŶLJ other areas͕ ďeŐaŶ to ďecome real ceŶters ŝŶ health sector. Hoǁeǀer͕ dƵe to the ǀerLJ hŝŐh Ɖrŝces for health care serǀŝces that theLJ oīer͕ oŶlLJ ƉaƟeŶts from hŝŐhͲŝŶcome ŐroƵƉ ǁere aďle to ǀŝsŝt those coƵŶtrŝes for treatmeŶt reasoŶs. U.S. ƉlaŶŶed to maŬe more ƉroŐress 20 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 ŝŶ medŝcŝŶe aŶd to ƵŶŝte medŝcal ƉrofessŝoŶals͛ deleŐaƟoŶs ƵŶder a sŝŶŐle roof͕ aŶd ŝŶ 1933͕ foƵŶded the AmerŝcaŶ Board of Medŝcal SƉecŝalƟes ;ABMS). Thŝs Ɖolŝcŝes aŶd reforms ŝŶ the Įeld of medŝcal edƵcaƟoŶ created ďLJ thŝs commŝƩee formed the ďasŝs of ǁorld staŶdards. IŶ EƵroƉe͕ ŝŶ 195ϴ͕ the EƵroƉeaŶ UŶŝoŶ of Medŝcal SƉecŝalŝsts ;UEMS) ǁas estaďlŝshed to collect the ǁhole medŝcal deƉartmeŶts ŝŶ EƵroƉe ƵŶder oŶe Ƶmďrella aŶd to Ɖroǀŝde a commoŶ ƉoŝŶt of ǀŝeǁ. IŶ the 196Ϭs the ŝŶterest ŝŶ LJoŐa aŶd ALJƵrǀeda treatmeŶts Ƶsed ŝŶ aŶcŝeŶt Ɵmes ŝŶcreased aŐaŝŶ. AlterŶaƟǀe medŝcal treatmeŶts focƵsŝŶŐ oŶ the treatmeŶt of soƵl͕ as ǁell as tradŝƟoŶal treatmeŶts͕ haǀe ďecome aƩracƟǀe ǁorldǁŝde. ThƵs͕ IŶdŝa͕ ǁhere YoŐa ǁas dŝscoǀered ŝŶ the Įrst aŐes͕ ďecame aŶ ŝmƉortaŶt ceŶter for the health toƵrŝsts. IŶ 19ϴϬs aŶd 199Ϭs dƵe to the raƉŝd ŝŶcrease ŝŶ the costs of treatmeŶts͕ ƉaƟeŶts started to receŝǀe treatmeŶt at the oǀerseas. IŶ that Ɖerŝod coŶsŝderaďle amoƵŶt of health toƵrŝsts traǀeled to CeŶtral Amerŝca aŶd CƵďa. The coƵŶtrŝes ǁho ǁaŶt to Őet theŝr share from the Health ToƵrŝsm ďeŐaŶ to oƉeŶ a larŐe ŶƵmďer of hosƉŝtals. Hoǁeǀer͕ the relŝaďŝlŝtLJ aŶd staŶdards comƉlŝaŶce of these hosƉŝtals ǁere oƉeŶ to ƋƵesƟoŶ. For thŝs reasoŶ͕ ŝŶ 1994͕ the :CI accredŝtaƟoŶ ďodLJ has ďeeŶ foƵŶded at the ŝŶterŶaƟoŶal areŶa. Thŝs orŐaŶŝnjaƟoŶ ďeŐaŶ to coŶtrol the staŶdards of hosƉŝtals. The ƉaƟeŶts from all oǀer the ǁorld ďeŐaŶ to ŇocŬ to the accredŝted hosƉŝtals to receŝǀe a more relŝaďle serǀŝce. AsŝaŶ coƵŶtrŝes͕ dƵe to the ecoŶomŝc crŝsŝs ŝŶ 1997 haǀe lost theŝr comƉeƟƟǀe Ɖoǁer. These coƵŶtrŝes͕ ŝŶ order to ŝŶcrease theŝr ecoŶomŝc ƉerformaŶce͕ alterŶaƟǀelLJ tƵrŶed to Health ToƵrŝsm ǁhŝch ǁoƵld oďǀŝoƵslLJ ďrŝŶŐ a larŐe amoƵŶt of ŝŶcome. ThaŝlaŶd ǁŝth ŝts loǁ Ɖrŝces for ƋƵalŝĮed serǀŝces has ďecome a ceŶter esƉecŝallLJ ŝŶ the ƉlasƟc sƵrŐerLJ Įeld. ThaŝlaŶd͕ SŝŶŐaƉore͕ aŶd IŶdŝa came to a ǀerLJ ŝmƉortaŶt ƉoŝŶt ŝŶ Health ToƵrŝsm amoŶŐ the accredŝted ceŶters. These coƵŶtrŝes made ǁorldͲǁŝde fame for accredŝted hosƉŝtals aŶd ceŶters. IŶ 2ϬϬ7͕ the ŶƵmďer of AmerŝcaŶ health toƵrŝsts made ƉeaŬ aŶd reached 3ϬϬ͕ϬϬϬ͕ the eǀer sŝŶce hŝŐhest ŶƵmďer ŝŶ Health ToƵrŝsm. IŶ 2ϬϬϴ͕ a ŶƵmďer of USͲďased health care aŶd health ŝŶsƵraŶce comƉaŶŝes ďeŐaŶ to coŶsŝder oƵtsoƵrcŝŶŐ. TheLJ are oīered theŝr memďers the oƉƉortƵŶŝtLJ of receŝǀŝŶŐ ŶoŶͲƵrŐeŶt treatmeŶts aŶd oƉeraƟoŶs ŝŶ other coƵŶtrŝes. ;Wǁǁ. healthͲToƵrŝsm.comͬmedŝcalͲToƵrŝsmͬhŝstorLJ ͬ). AccordŝŶŐ to research ďLJ the World ToƵrŝsm OrŐaŶŝnjaƟoŶ͕ ŝŶ 2Ϭ12͕ the ǁorld Health ToƵrŝsm ŝs edžƉected to reach a sŝnje of 1ϬϬ ďŝllŝoŶ Ψ. AŶother esƟmaƟoŶ of the World ToƵrŝsm OrŐaŶŝnjaƟoŶ ǁas that ͞ŝŶ 2Ϭ17͕ oŶlLJ from the USA͕ 23 mŝllŝoŶ ƉoteŶƟal ƉaƟeŶts ǁŝll Őo oǀerseas ďLJ sƉeŶdŝŶŐ 79.5 BŝllŝoŶ Ψ͟. ϯ ) Heaůth Tourism THROUGHOUT THE WORLD As a resƵlt of the dLJŶamŝcs the Ɖrocess of ŐloďalŝnjaƟoŶ ŝŶ the ǁorld͕ the Ɖroďlems ŝŶ health care sLJstems of the coƵŶtrŝes ;for edžamƉle͕ loŶŐ ǁaŝƟŶŐ lŝsts aŶd rŝsŝŶŐ costs͕ serǀŝce ƋƵalŝtLJ Ɖroďlems)͕ coŶsƵmer aǁareŶess aŶd the EƵroƉeaŶ UŶŝoŶ ;EU) Health ToƵrŝsm as a raƉŝdlLJ ŐroǁŝŶŐ sector ŝŶ a ǀerLJ ŐeŶeral seŶse coŶsŝsts of leŝsƵre aŶd treatmeŶt. TodaLJ͕ IŶdŝa ŝs amoŶŐ the coƵŶtrŝes ǁŝth the larŐest share of the ǁorld Health ToƵrŝsm. EǀerLJ LJear͕ aƉƉrodžŝmatelLJ 15ϬϬϬϬ health toƵrŝsts Őo to IŶdŝa. The IŶdŝaŶ health sector ŝs recorded a Őroǁth of 3Ϭй Ɖer LJear͕ aŶd aŶŶƵal Health ToƵrŝsm reǀeŶƵe ŝŶ 2Ϭ12 ŝs edžƉected to ďe 1.2 ďŝllŝoŶ ƉoƵŶds. The maŝŶ reasoŶ for thŝs ƉoƉƵlarŝtLJ ŝs that theLJ foresaǁ the Health ToƵrŝsm ƉoteŶƟal earlŝer͕ theLJ ǁorŬ ǁŝth loǁͲcost͕ aŶd Őood ƉromoƟoŶ. IŶdŝa ŝs a former BrŝƟsh coloŶLJ aŶd thŝs Ɖroǀŝdes a more ƉosŝƟǀe recoŐŶŝƟoŶ ŝŶ the UK. The sŝŐŶŝĮcaŶt ŝmƉroǀemeŶt ŝŶ oǀerall ecoŶomŝc terms Ɖerformed ŝŶ receŶt LJears ďLJ IŶdŝa shoƵld Ŷot ďe ŝŐŶored ;Yŝldŝrŝm͕ 2ϬϬ6). 21 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 East EƵroƉeaŶ coƵŶtrŝes͕ esƉecŝallLJ ďLJ taŬŝŶŐ adǀaŶtaŐe of loǁ laďor costs aŶd EU memďershŝƉ͕ started to taŬe a sŝŐŶŝĮcaŶt share of Health ToƵrŝsm Ɖŝe. EsƉecŝallLJ HƵŶŐarLJ͕ a Ɖreferred coƵŶtrLJ ŝŶ EƵroƉe͕ eǀeŶ ďLJ the TƵrŬŝsh resŝdeŶts͕ ǁŝth 2 mŝllŝoŶ Ψ ŝt receŝǀed aŶŶƵallLJ oŶlLJ from the deŶtal treatmeŶts ŝs amoŶŐ the coƵŶtrŝes ǁhŝch are ŝŶ the asceŶdaŶcLJ. As a ǁest EƵroƉeaŶ coƵŶtrLJ͕ BelŐŝƵm͕ esƉecŝallLJ oŶ aestheƟc sƵrŐerLJ aŶd treatmeŶt of oďesŝtLJ͕ ŐaŝŶed a ǀerLJ serŝoƵs marŬet share ;YŦldŦrŦm͕ 2ϬϬ4). AccordŝŶŐ to a stƵdLJ coŶdƵcted ďLJ the FreŶch Le FŝŐaro ŶeǁsƉaƉer͕ CeŶtral EƵroƉeaŶ͕ AsŝaŶ aŶd North AfrŝcaŶ toƵrŝsƟc coƵŶtrŝes haǀe ďeŐƵŶ to create Ŷeǁ toƵrŝst reserǀe ŝŶ health serǀŝces sƵch as heart sƵrŐerLJ͕ ŬŝdŶeLJ traŶsƉlaŶts͕ deŶtal aŶd eLJe care. AccordŝŶŐ to the same sƵrǀeLJ͕ IŶdŝa comes to the foreŐroƵŶd ŝŶ heart sƵrŐerLJ͕ ThaŝlaŶd ŝŶ ŬŝdŶeLJ traŶsƉlaŶtaƟoŶ͕ HƵŶŐarLJ aŶd PolaŶd ŝŶ deŶtal care͕ TƵŶŝsŝa aŶd Morocco ŝŶ eLJe health. Researches ŝŶdŝcate that comƉared to WesterŶ EƵroƉe health serǀŝces ŝŶ these coƵŶtrŝes are cheaƉer ďLJ aƉƉrodžŝmatelLJ 4Ϭй to 7Ϭй ;Le FŝŐaro͕ 2ϬϬ6). The Brŝts aŐree to receŝǀe medŝcal treatmeŶt thoƵsaŶds mŝles aǁaLJ sŝŶce theLJ haǀe to ǁaŝt for a loŶŐ Ɵme to ďeŶeĮt from theŝr ŶaƟoŶal ƉƵďlŝc health serǀŝces aŶd sŝŶce the Ɖrŝǀate health serǀŝces are ǀerLJ edžƉeŶsŝǀe. The FreŶch͕ hoǁeǀer͕ haǀe adoƉted thŝs tLJƉe of ToƵrŝsm for health serǀŝces sƵch as deŶtƵres or deŶtal ǀeŶeer ǁhŝch theŝr oǁŶ ŝŶsƵraŶce ŝŶsƟtƵƟoŶs do Ŷot ƉaLJ for ;Le FŝŐaro͕ 2ϬϬ6). EsƉecŝallLJ ŝŶ PolaŶd aŶd HƵŶŐarLJ͕ the coƵŶtrŝes ǁhŝch came to the fore ďLJ deŶtal care͕ the ŶƵmďer of Ɖrŝǀate clŝŶŝcs serǀŝŶŐ ŝŶ EŶŐlŝsh͕ FreŶch aŶd GermaŶ are ŝŶcreasŝŶŐ eǀerLJ daLJ. The ŝŶterŶaƟoŶal health care Ɖroǀŝders ŝŶ East Asŝa aŶd CeŶtral EƵroƉeaŶ coƵŶtrŝes coŶsŝder Health ToƵrŝsm as a rŝsŝŶŐ star. IŶdŝa ŝs a ǀerLJ Őood edžamƉle ŝŶ thŝs reŐard. IŶdŝa ŝs ƋƵŝte adǀaŶced ŝŶ terms of oƉeŶ heart sƵrŐerLJ͕ cosmeƟc sƵrŐerLJ͕ ũoŝŶt reƉlacemeŶt sƵrŐerLJ aŶd deŶtal treatmeŶts. IŶ ƉarƟcƵlar͕ from the UŶŝted States eǀerLJ LJear͕ a larŐe ŶƵmďer of ƉaƟeŶts haǀe ďeeŶ traǀelŝŶŐ to those ceŶters ŝŶ IŶdŝa for the ƉƵrƉose of treatmeŶt. CƵraƟǀe health serǀŝces ŝŶ the UŶŝted States are ǁell ŬŶoǁŶ that theLJ are the most edžƉeŶsŝǀe ŝŶ the ǁorld. UŶŝt costs of maŶLJ sƵrŐerŝes ŝŶ IŶdŝa are 4Ͳ5 Ɵmes cheaƉer thaŶ that of the USA aŶd eǀeŶ some treatmeŶts sƵch as͕ ďoŶe marroǁ traŶsƉlaŶtaƟoŶ are 7Ͳϴ Ɵmes cheaƉer. Thŝs maŬes IŶdŝa ǀerLJ aƩracƟǀe for the U.S. cŝƟnjeŶs ǁho caŶŶot aīord to receŝǀe treatmeŶt ŝŶ theŝr oǁŶ coƵŶtrŝes or ǁhose medŝcal edžƉeŶses are Ŷot coǀered ďLJ health ŝŶsƵraŶce͕ ;CBC Neǁs͕ 2ϬϬ7). The researches oŶ Health ToƵrŝsm ŝŶdŝcate that sŝŶce 2ϬϬϬ Health ToƵrŝsm marŬet ŝŶ the ǁorld has ďeeŶ ŐroǁŝŶŐ raƉŝdlLJ aŶd has ďecome a ǀerLJ ŝmƉortaŶt marŬet. IŶ 2ϬϬ5 19 mŝllŝoŶ ƉeoƉle traǀeled for medŝcal treatmeŶt ǁŝth a ǀolƵme of 2Ϭ ďŝllŝoŶ U.S. Dollars. These trŝƉs are esƟmated to doƵďle aŶd reach at 4Ϭ ďŝllŝoŶ Dollars Ɖer LJear ďLJ 2Ϭ12. Thŝs ĮŐƵre coŶsƟtƵtes 22 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 4й of the Őloďal traǀel marŬet aŶd shoǁs a sŝŐŶŝĮcaŶt ŝŶcrease eǀerLJ daLJ. SŝmŝlarlLJ͕ ŝŶ some coƵŶtrŝes͕ esƉecŝallLJ ŝŶ Asŝa ĮŐƵres are ŝmƉressŝǀe. AccordŝŶŐ to the World ToƵrŝsm OrŐaŶŝnjaƟoŶ͕ from the WesterŶ coƵŶtrŝes aŶŶƵallLJ oǀer 15Ϭ͕ϬϬϬ ƉeoƉle are alreadLJ receŝǀŝŶŐ medŝcal treatmeŶt ŝŶ IŶdŝa. AccordŝŶŐ to McKŝŶseLJ͕ ŝŶ thŝs sector IŶdŝa ŝŶ 2ϬϬ3͕ ŐaŝŶed 333 mŝllŝoŶ EƵros of ŝŶcome aŶd thŝs ŝŶcome ŝs edžƉected to ďe 3 ďŝllŝoŶ EƵros ŝŶ 2Ϭ12 ;Odžford AŶalLJƟca͕ 2ϬϬ6). PATIENT TRA&&IC O& Heaůth Tourism THROUGHOUT THE WORLD As caŶ ďe seeŶ ŝŶ FŝŐƵre 4͕ the ƉaƟeŶt traĸc throƵŐhoƵt the World ŝs shoǁŶ oŶ the coŶƟŶeŶts of Amerŝca͕ EƵroƉe͕ Afrŝca͕ aŶd Asŝa. FŝŐƵre 5͗ CoƵŶtrŝes oīerŝŶŐ Health ToƵrŝsm ;Health Traǀel TechŶoloŐŝes͕ healthtraǀeltechŶoloŐŝes.com) AccordŝŶŐ to data from the World Health OrŐaŶŝnjaƟoŶ͕ folloǁŝŶŐ are the 5 coƵŶtrŝes ŝŶ the ǁorld ǁŝth hŝŐhest admŝssŝoŶ ĮŐƵres͖ 1. PaŶama 2. Branjŝl 3. MalaLJsŝa 4. Costa Rŝca 5. IŶdŝa. 23 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 The coƵŶtrŝes seŶdŝŶŐ toƵrŝsts most theŝr reasoŶs for seŶdŝŶŐ toƵrŝsts are as folloǁs͗ ͻ UŶderdeǀeloƉed coƵŶtrŝes ;SƵdaŶ͕ Somalŝa͕ AfŐhaŶŝstaŶ͕ LŝďLJa͕ etc.) Basŝc reasoŶ͗ ŝŶadeƋƵacLJ of health serǀŝces aŶd lacŬ of ƉersoŶŶel͕ ͻ The AsŝaŶ coƵŶtrŝes ;PaŬŝstaŶ͕ IraƋ͕ SLJrŝa etc.) Basŝc reasoŶ͗ ŝŶadeƋƵacLJ of health serǀŝces aŶd lacŬ of ƉersoŶŶel͕ ͻ The USA͕ EƵroƉe͕ The ďasŝc reasoŶ ŝs͗ Health care ŝs edžƉeŶsŝǀe aŶd loŶŐ ǁaŝƟŶŐ lŝsts for ƉaƟeŶts͕ ͻ CoƵŶtrŝes ǁŝth mƵch elderlLJ ƉoƉƵlaƟoŶ The ďasŝc reasoŶ ŝs͗ hŝŐh elderlLJ ƉoƉƵlaƟoŶ͕ lacŬ of ƉersoŶŶel aŶd hŝŐh maŝŶteŶaŶce costs. 24 HEALTH TOURISM IN TURKEY AND REGULATIONS EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 C) HEALTH TOURISM IN TURKEY AND REGULATIONS Health ToƵrŝsm͕ aŝms at ƉroǀŝdŝŶŐ medŝcal oƉƟoŶs to eŶsƵre the comfort of ƉaƟeŶts aŶd theŝr famŝlŝes. IŶ Ɖarallel ǁŝth the hŝŐh leǀel of edƵcaƟoŶ aŶd ǁealth ŝŶ deǀeloƉed coƵŶtrŝes͕ the cost of health care delŝǀerLJ ŝs also hŝŐh. The share of health Ŷeeds aŶd health care costs of aŶ aŐŝŶŐ ƉoƉƵlaƟoŶ ŝŶ deǀeloƉed coƵŶtrŝes ŝs ŝŶcreasŝŶŐ eǀerLJ daLJ. The ŝŶcreasŝŶŐ costs of socŝal secƵrŝtLJ costs are caƵsŝŶŐ ĮŶaŶcŝal dŝĸcƵlƟes for socŝal secƵrŝtLJ ŝŶsƟtƵƟoŶs. To oǀercome these Ɖroďlems the socŝal secƵrŝtLJ ŝŶsƟtƵƟoŶs aŶd Ɖrŝǀate ŝŶsƵraŶce ŝŶsƟtƵƟoŶs ŝŶ deǀeloƉed coƵŶtrŝes are ƉaLJŝŶŐ eīorts to maŬe ƉacŬaŐe aŐreemeŶts to Őet loǁͲcost health care serǀŝces ŝŶ the coƵŶtrŝes ǁhŝch oīer hŝŐhͲ ƋƵalŝtLJ medŝcal serǀŝces aŶd ǁhŝch are at theŝr ǀŝcŝŶŝtLJ ;YalcŝŶ͕ 2ϬϬ6͖ AŬsƵ͕ 2ϬϬ1). As meŶƟoŶed aďoǀe͕ aroƵŶd the ǁorld there ŝs a raƉŝd ƉroŐress ŝŶ the Įeld of Health ToƵrŝsm. Thŝs ƉroŐress created a hƵŐe marŬet͕ aŶd all coƵŶtrŝes are eŶŐaŐed ŝŶ a race for marŬet share. Seǀeral factors staŶd oƵt to Őet the larŐest share of Health ToƵrŝsm. WheŶ the ƉoteŶƟal medŝcal toƵrŝsts maŬe a research for treatmeŶt͕ the aŶsǁer to the ƋƵesƟoŶ ͞WhLJ TƵrŬeLJ͟ ŝs ǀerLJ ŝmƉortaŶt ;FŝŐƵre 6). CheaƉ Serǀŝce World StaŶdard YƵalŝtLJ WhLJ TurŬeLJ Short WaŝƟŶŐ Tŝme Rŝch Cultural HerŝtaŐe PersoŶal Serǀŝce &ŝŐƵƌĞϲ͗dƵƌŬĞLJ͛Ɛ^ĐŚĞŵĞŽĨŽŵƉĞƟƟǀĞŶĞƐƐůĞŵĞŶƚƐŝŶ,ĞĂůƚŚdŽƵƌŝƐŵ 27 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 SŝŶce the 2ϬϬϬs͕ the Ɖrŝǀate sector ŝŶǀestmeŶt has ŝŶcreased also ŝŶ health sector as dŝd ŝŶ all areas. Both for meeƟŶŐ the chaŶŐŝŶŐ domesƟc Ŷeeds as ǁell as taŬŝŶŐ the adǀaŶtaŐe of Health Tourŝsm͕ Ɖrŝǀate hosƉŝtals aŶd health ceŶters haǀe ďeeŶ estaďlŝshed all oǀer the couŶtrLJ. As ǁell as the Ɖrŝǀate hosƉŝtals͕ stateͲsƉoŶsored ŝŶǀestmeŶts ǁhŝch could comƉete ǁŝth EuroƉeaŶ staŶdards are ŝŶcreasŝŶŐ daLJ ďLJ daLJ. The cost of these ŝŶǀestmeŶts ŝs ǀerLJ hŝŐh. Thus͕ TurŬeLJ Ŷeeds to head to the foreŝŐŶ marŬet͕ aŶd must haǀe more ƉromoƟoŶ. Our couŶtrLJ has Őreat adǀaŶtaŐes ŝŶ terms of Health Tourŝsm. Our couŶtrLJ ŝs ǀerLJ coŶǀeŶŝeŶt ŝŶ terms of ŐeoŐraƉhŝcal locaƟoŶ. The Ŷumďer of FaculƟes of MedŝcŝŶe has ŝŶcreased aŶd sŝŐŶŝĮcaŶt ƉroŐress ŝs made ŝŶ terms of ƋualŝĮed humaŶ resources ŝŶ Health sector͕ ǁhŝch ǁas aŶ ŝmƉortaŶt shortaŐe. BLJ the reŐulaƟoŶs ŝssued ŝŶ Noǀemďer 2Ϭ11͕ the MŝŶŝstrLJ of Health has ďecome resƉoŶsŝďle also from the Health Tourŝsm ǁorŬs aŶd oƉeraƟoŶs aŶd eŶsurŝŶŐ ŝŶterͲaŐeŶcLJ coordŝŶaƟoŶ. UŶder the MŝŶŝstrLJ of Health a ceŶtral uŶŝt͕ ͞DeƉartmeŶt of Health Tourŝsm͟ ǁas estaďlŝshed to ƉlaŶ͕ moŶŝtor aŶd staŶdardŝnje the deǀeloƉmeŶt of Health Tourŝsm ŝŶŝƟaƟǀe at the ŶaƟoŶal leǀel. SŝmŝlarlLJ͕ Health Tourŝsm ǁas oŶe of the ƉrŝorŝtLJ areas ŝdeŶƟĮed ŝŶ the 2Ϭ23 DraŌ ReƉort of Tourŝsm StrateŐLJ of TurŬeLJ ƉreƉared ďLJ the MŝŶŝstrLJ of Culture aŶd Tourŝsm. TurŬeLJ ŝŶ Health Tourŝsm͕ esƉecŝallLJ ŝŶ the last 1Ϭ LJears has made sŝŐŶŝĮcaŶt ŝmƉroǀemeŶts aŶd ďeŐaŶ to comƉete ǁŝth couŶtrŝes such as IŶdŝa͕ MalaLJsŝa͕ ThaŝlaŶd͕ aŶd HuŶŐarLJ ǁhŝch are stroŶŐ ŝŶ the sector. IŶ receŶt LJears͕ the deǀeloƉmeŶt of curreŶt techŶoloŐŝes thaŶŬs to the stateͲsƉoŶsored Ŷeǁ ŝŶǀestmeŶts ŝŶcreased the ƋualŝtLJ of the ŶaƟoŶal health serǀŝces ŝŶ IstaŶďul͕ AŶŬara aŶd Injmŝr ƉroǀŝŶces. The share of ŝŶǀestmeŶts ŝŶ hosƉŝtals aŶd health care ƉersoŶŶel ŝs sŝŐŶŝĮcaŶt ŝŶ the deǀeloƉmeŶts ŝŶ the Įeld of Health Tourŝsm. IŶ addŝƟoŶ͕ the Ŷumďer of medŝcal schools ƉroǀŝdŝŶŐ educaƟoŶ ŝŶ EŶŐlŝsh ŝŶcreased͕ aŶd ƉhLJsŝcŝaŶs haǀe scholarshŝƉ oƉƉortuŶŝƟes to folloǁ closelLJ the deǀeloƉmeŶts ŝŶ other couŶtrŝes aŶd to coŶduct research ŝŶ deǀeloƉed couŶtrŝes. 28 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 D) REGULATIONS REGARDING HEALTH SECTOR Health Tourŝsm UŶŝt has ďeeŶ estaďlŝshed to coŶtrol the Tourŝsm health serǀŝces from a sŝŶŐle source ǁŝth the aƉƉroǀal Ŷo. 1ϴ529͕ dated March 31͕ 2Ϭ1Ϭ͕ of TurŬeLJ GeŶeral Dŝrectorate of PrŝmarLJ Health Care. IŶ order to carrLJ out acƟǀŝƟes related to Health Tourŝsm͖ S S S S IŶterŶaƟoŶal CoordŝŶaƟoŶ Health Tourŝsm͕ Thermal Tourŝsm SƉaͲWellŶess AdǀaŶced AŐe aŶd DŝsaďŝlŝtLJ Tourŝsm secƟoŶs haǀe ďeeŶ estaďlŝshed uŶder Health Tourŝsm UŶŝt ǁŝthŝŶ the GeŶeral Dŝrectorate of PrŝmarLJ Health. Thŝs uŶŝt ǁas traŶsferred to the GeŶeral Dŝrectorate of CuraƟǀe Serǀŝces ŝŶ MaLJ of 2Ϭ11 as the Health Tourŝsm CoordŝŶator͕ aŶd coŶƟŶues to serǀe as the DeƉartmeŶt of Health Tourŝsm uŶder the GeŶeral Dŝrectorate of Health Serǀŝces ďLJ the Decree Laǁ No. 663͕ dated 2Ϭ12. DeƉartmeŶt of Health Tourŝsm͕ esƉecŝallLJ ŝŶ seǀeŶ maũor cŝƟes orŐaŶŝnjed ǁŝthŝŶ the ProǀŝŶcŝal Health Dŝrectorate. IŶfrastructure ǁorŬs for leŐŝslaƟoŶ ƋuŝcŬlLJ started. BLJ Decree No. 663 EmƉloLJmeŶt of foreŝŐŶ doctors aŶd Ŷurses has ďeeŶ eŶaďled. 444 47 2ϴ lŝŶe ;IŶterŶaƟoŶal PaƟeŶt SuƉƉort UŶŝt) Őŝǀes ŝŶterƉretaƟoŶ serǀŝces for Health Tourŝsm ƉaƟeŶts ŝŶ GermaŶ͕ EŶŐlŝsh͕ Araďŝc aŶd RussŝaŶ laŶŐuaŐe for 7ͬ24. LeŐŝslaƟoŶ ǁorŬs reŐardŝŶŐ Health Free oŶes ŝs uŶderǁaLJ IŶ addŝƟoŶ͕ ďLJ the leŐal reŐulaƟoŶs ŝŶ 2Ϭ12 a 5Ϭй ŝŶcome tadž relŝef for Health Tourŝsm has ďeeŶ oďtaŝŶed. FŝŶaŶcŝal suƉƉort uƉ to Ψ 3ϬϬ ϬϬϬ Ɖer LJear for oǀerseas ƉromoƟoŶ of health ŝŶsƟtuƟoŶs has ďeeŶ ŐŝǀeŶ. IŶ addŝƟoŶ͕ ĮŶaŶcŝal suƉƉort ŝs ŐŝǀeŶ to research ŝŶ the Įeld of Health Tourŝsm͕ reƉorƟŶŐ͕ oŶlŝŶe adǀerƟsŝŶŐ aŶd ƉlaŶe ƟcŬets of the medŝcal tourŝsts comŝŶŐ to TurŬeLJ for treatmeŶt. The Laǁ ;Laǁ No. 6322͕ dated Ϭ5.31.2Ϭ12)͕ orŐaŶŝnjed ďLJ the MŝŶŝstrLJ of FŝŶaŶce͕ a 5Ϭй ŝŶcome tadž relŝef͕ sƉecŝal to the Ɖrŝǀate health ŝŶsƟtuƟoŶs lŝceŶsed ďLJ the MŝŶŝstrLJ of Health͕ for ƉroǀŝsŝoŶ of health serǀŝces ŝŶ TurŬeLJ to the ƉeoƉle ǁho are resŝdŝŶŐ aďroad came ŝŶto eīect. TodaLJ ŝŶ TurŬeLJ͕ 47 health care ŝŶsƟtuƟoŶs haǀŝŶŐ :oŝŶt CommŝssŝoŶ IŶterŶaƟoŶal ;:CI) accredŝtaƟoŶ ǁhŝch ŝs seeŶ as the most ŝmƉortaŶt oŶe amoŶŐ the 5 ŝŶterŶaƟoŶal hosƉŝtal accredŝtaƟoŶ sLJstem throuŐhout the ǁorld. Thŝs ĮŐure ŝs the hŝŐhest ĮŐure ǁorldǁŝde aŶd corresƉoŶds to aƉƉrodžŝmatelLJ 1Ϭй of the accredŝted hosƉŝtals all oǀer the ǁorld. ComƉared ǁŝth TurŬeLJ͕ ŝŶ IŶdŝa 16͕ ŝŶ ThaŝlaŶd 11͕ ŝŶ SŝŶŐaƉore 16͕ ŝŶ Branjŝl 23͕ aŶd ŝŶ Saudŝ Araďŝa 33 :CI accredŝted hosƉŝtal are ŬŶoǁŶ to edžŝst. 29 FIGURES REGARDING THE MEDICAL TOURISM IN TURKEY 2012 TmRK7YE MED7KAL TUR7M7 DE)ERLEND7RME RAPORU 2012 E) &IGURES REGARDING THE MEDICAL TOURISM IN TURKEY Ͳ 2012 1 Ͳ OVERALL ASSESSMENT The ŝŶcrease ŝŶ the Ŷumďer of Ɖrŝǀate hosƉŝtals ǁŝth a hŝŐh ƋualŝtLJ of serǀŝce aŶd staŶdards ƉlaLJ aŶ ŝmƉortaŶt role ŝŶ the ŝŶcrease of moďŝlŝtLJ of Health Tourŝsm. The maŝŶ coŶtrŝďuƟoŶ of thŝs studLJ ŝs the aŶalLJsŝs aŶd assessmeŶt of data Ɖroǀŝded ďLJ the DeƉartmeŶt of Health Tourŝsm. There are tǁo ǁaLJs thŝs ŝŶformaƟoŶ reŐarded as ƉrŝmarLJ data are collected͗ ͻ AŶ oĸcŝal leƩer No. 2Ϭϴ2 dated :aŶuarLJ 16͕ 2Ϭ12 has ďeeŶ seŶt to ϴ1 ƉroǀŝŶcŝal health dŝrectorates ǁhŝch reƋuested all Ɖuďlŝc aŶd Ɖrŝǀate hosƉŝtals ŝŶ the ƉroǀŝŶces to Ɖroǀŝde data uŶder tǁo cateŐorŝes͕ ͞Health Tourŝsm͟ aŶd ͞health tourŝsts͖͟ ͻ DeƉartmeŶt of Health Tourŝsm has a ǁeďsŝte ;ǁeďͲďased reŐŝstraƟoŶ sLJstem) called ͞ForeŝŐŶ NaƟoŶals PaƟeŶt TracŬŝŶŐ SLJstem͟. Thŝs ǁeď reŐŝstraƟoŶ sLJstem reŐŝsters the data related to the foreŝŐŶ ƉaƟeŶts ŝŶ all hosƉŝtals ŝŶ ϴ1 ƉroǀŝŶces. The data stored ŝŶ the sLJstem ŝs oďtaŝŶed as moŶthlLJ reƉorts. dĂďůĞϯ͗ŝƐƚƌŝďƵƟŽŶŽĨ&ŽƌĞŝŐŶĞƌƐZĞĐĞŝǀŝŶŐ,ĞĂůƚŚ^ĞƌǀŝĐĞŝŶdƵƌŬĞLJďLJzĞĂƌ Public Health Establishment Private Health Establishment Total IŶ 2ϬϬϴ͕ 24й of foreŝŐŶ ŶaƟoŶals receŝǀŝŶŐ health care ŝŶ TurŬeLJ Ɖreferred Ɖuďlŝc hosƉŝtals ǁhŝle 76й Ɖreferred Ɖrŝǀate hosƉŝtals. IŶ 2ϬϬ9͕ 77й of the foreŝŐŶ ƉaƟeŶts ǁere treated ŝŶ Ɖrŝǀate hosƉŝtals ǁhŝle 23й ŝŶ Ɖuďlŝc hosƉŝtals. IŶ 2Ϭ1Ϭ͕ the ƉroƉorƟoŶ of foreŝŐŶ ƉaƟeŶts ǁho ǁere treated ŝŶ Ɖuďlŝc hosƉŝtals ŝŶcreased to 3Ϭй͕ due to the ŝŶcrease ŝŶ the ƋualŝtLJ of serǀŝce aŶd staī at the Ɖuďlŝc hosƉŝtals. IŶ 2Ϭ11͕ ŝt ǁas oďserǀed that 73й of the ƉaƟeŶts ǁere treated at Ɖrŝǀate hosƉŝtals͕ ǁhŝle 27й ǁere at Ɖuďlŝc hosƉŝtals͕ ;FŝŐure 7). 33 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &ŝŐƵƌĞϳ͗ZĂƚĞƐŽĨ&ŽƌĞŝŐŶWĂƟĞŶƚƐ͛ZĞĐĞŝǀŝŶŐ,ĞĂůƚŚ^ĞƌǀŝĐĞŝŶdƵƌŬĞLJĂƚWƵďůŝĐͲWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐĂƐŽĨ 2011 PUPLIC PRIVATE IŶ ŐeŶeral͕ a sŝŐŶŝĮcaŶt ŝŶcrease ďLJ aƉƉrodžŝmatelLJ 52й ŝs oďserǀed ŝŶ the Ŷumďer of health tourŝsts ǁho ǁere treated ŝŶ Ɖuďlŝc aŶd Ɖrŝǀate hosƉŝtals ďetǁeeŶ the LJears 2ϬϬϴͲ2Ϭ11 due to the ŝŶcrease ŝŶ the Ŷumďer of Ɖrŝǀate hosƉŝtals aŶd the ŝŶcrease ŝŶ serǀŝce ƋualŝtLJ of the Ɖuďlŝc hosƉŝtals aŶd theŝr staī thaŶŬs to the leŐal reŐulaƟoŶs ŝŶ the Įeld of medŝcal tourŝsm. Number of Patients &ŝŐƵƌĞϴ͗ŝƐƚƌŝďƵƟŽŶŽĨdŽƵƌŝƐƚƐZĞĐĞŝǀŝŶŐ^ĞƌǀŝĐĞĂƚWƵďůŝĐĂŶĚWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐŝŶdƵƌŬĞLJďLJzĞĂƌ Private Public It ŝs oďserǀed that Health Tourŝsm has dŝīereŶt coŶceƉtual deĮŶŝƟoŶs ďoth ŝŶ ƉracƟce aŶd lŝterature. Tourŝsts ǁho do Ŷot come to our couŶtrLJ for treatmeŶt reasoŶs ;ďut traǀelŝŶŐ for sŝŐhtseeŝŶŐ͕ eŶtertaŝŶmeŶt͕ ďusŝŶess͕ aŶd etc. ƉurƉoses)͕ are treated ŝŶ Ɖrŝǀate or Ɖuďlŝc health care facŝlŝƟes ŝŶ case of ŝllŶesses or accŝdeŶts. For more relŝaďle results͕ ŝt ǁould ďe ďeƩer to edžamŝŶe the tourŝsts ŝŶ thŝs coŶtedžt ŝŶ a seƉarate cateŐorLJ. IŶ thŝs studLJ͕ ǁe haǀe edžamŝŶed the tourŝsts ǁho came to our couŶtrLJ oŶlLJ for medŝcal treatmeŶt uŶder ͞Health Tourŝsm͟ aŶd the tourŝsts ǁho traǀel to our couŶtrLJ for other ƉurƉoses aŶd receŝǀe medŝcal treatmeŶt ŝŶ case of ŝllŶess the ͞health of the tourŝst͟. As of 2Ϭ11 a total of 156176 foreŝŐŶ ƉaƟeŶts receŝǀŝŶŐ treatmeŶt ŝŶ our couŶtrLJ are shoǁŶ ŝŶ Taďle 1. SŝdžtLJ tǁo ƉerceŶt of those tourŝsts receŝǀed medŝcal treatmeŶt sŝŶce theLJ Őot ŝll durŝŶŐ theŝr traǀel to TurŬeLJ for ƉurƉoses other thaŶ treatmeŶt ;durŝŶŐ ǀacaƟoŶ). The ƉerceŶtaŐe of the tourŝsts ǁho traǀeled to TurŬeLJ for treatmeŶt reasoŶs ǁas 3ϴ. 34 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 As LJou caŶ see ǁhŝle oŶlLJ 9й of 59473 health tourŝsts Ɖrefer Ɖuďlŝc hosƉŝtals͕ 91й of health tourŝsts͕ ǁhŝch ŝs a sŝŐŶŝĮcaŶt Ŷumďer͕ choose Ɖrŝǀate hosƉŝtals ;FŝŐure ϴ). WheŶ ǁe looŬ at the Ŷumďer of tourŝsts ǁho are coŶsŝdered ǁŝthŝŶ the health of the tourŝst cateŐorLJ͕ the sŝtuaƟoŶ ŝs slŝŐhtlLJ dŝīereŶt. Of the tourŝsts ǁho come to our couŶtrLJ for reasoŶs other thaŶ medŝcal treatmeŶt͕ aŶd Őet sŝcŬ durŝŶŐ theŝr ǀacaƟoŶ͕ 3ϴй Ɖrefer Ɖuďlŝc hosƉŝtals͕ ǁhŝle 62й Ɖrefer to ďe treated ŝŶ Ɖrŝǀate hosƉŝtals ;FŝŐure 9͕ FŝŐure 1Ϭ aŶd FŝŐure 11). NOTE͗ It ŝs esƟmated that arouŶd 1ϬϬ thousaŶd ƉeoƉle receŝǀed health care ŝŶ our couŶtrLJ at haŝr traŶsƉlaŶtaƟoŶ͕ aestheƟc surŐerLJ͕ deŶtal clŝŶŝcs ďut ǁhose records ǁere Ŷot ŬeƉt. Hoǁeǀer͕ sŝŶce there are Ŷo records͕ theLJ ǁere Ŷot ŝŶcluded ŝŶ thŝs studLJ. &ŝŐƵƌĞϵ͗EƵŵďĞƌŽĨWĂƟĞŶƚƐŝŶ,ĞĂůƚŚdŽƵƌŝƐŵͲ,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚ,ĞĂůƚŚEƵŵďĞƌŽĨWĂƟĞŶƚƐ ZĞĐĞŝǀŝŶŐdƌĞĂƚŵĞŶƚĂƚWƵďůŝĐͲWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐ PUBLIC PRIVATE TOTAL Health of the Tourist Health Tourism TOTAL &ŝŐƵƌĞϭϬ͗dŚĞZĂƚĞŽĨ,ĞĂůƚŚdŽƵƌŝƐƚƐZĞĐĞŝǀŝŶŐdƌĞĂƚŵĞŶƚĂƚWƵďůŝĐĂŶĚWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐ PUBLIC PRIVATE TOTAL &ŝŐƵƌĞϭϭ͗dŚĞZĂƚĞŽĨdŽƵƌŝƐƚƐƵŶĚĞƌƚŚĞĂƚĞŐŽƌLJŽĨ͚,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚ͛ZĞĐĞŝǀŝŶŐdƌĞĂƚŵĞŶƚĂƚ WƵďůŝĐĂŶĚWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐ PUBLIC PRIVATE TOTAL 35 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 2 Ͳ HEALTH TOURISM IN TURKEY BY HOSPITAL As a result of the Ŷeǁ leŐŝslaƟoŶ͕ the ƋuaŶƟtLJ aŶd ƋualŝtLJ of hosƉŝtals ŝŶ our couŶtrLJ ŝs raƉŝdlLJ ŝŶcreasŝŶŐ. IŶ addŝƟoŶ͕ techŶŝcal eƋuŝƉmeŶt of the medŝcal schools ǁhŝch traŝŶ ƉhLJsŝcŝaŶs ǁho͕ uŶdertaŬŝŶŐ the ǁorld͛s most ŝmƉortaŶt tasŬ ǁŝll taŬe care of humaŶ health aŶd the Ŷumďer of edžƉerts ŝŶ the Įeld of academŝcs are ŝŶcreasŝŶŐ eǀerLJ daLJ. For thŝs reasoŶ͕ TurŬeLJ made sŝŐŶŝĮcaŶt ƉroŐress ŝŶ medŝcŝŶe ďoth ŝŶ the couŶtrLJ aŶd aďroad͕ aŶd thŝs Ɖrocess ŝs to sustaŝŶ. HosƉŝtals ŝŶ TurŬeLJ are dŝǀŝded ŝŶto dŝīereŶt cateŐorŝes accordŝŶŐ to the ŝŶsƟtuƟoŶ or orŐaŶŝnjaƟoŶ theLJ are suďordŝŶate to aŶd to the ƉurƉose of theŝr estaďlŝshmeŶt ;FŝŐure 12). &ŝŐƵƌĞϭϮ͗dLJƉĞƐŽĨ,ŽƐƉŝƚĂůƐŝŶdƵƌŬĞLJ TYPES OF THE HOSPITALS PUBLIC HOSPITALS STATE HOSPITALS EDUCATION AND RESEARCH HOSPITALS PRIVATE HOSPITALS UNIVERSITY HOSPITALS AccordŝŶŐ to data of 2Ϭ11͕ medŝcal tourŝsts͕ ǁho Ɖreferred to receŝǀe medŝcal treatmeŶt ŝŶ TurŬeLJ͕ Ɖreferred 165 hosƉŝtals ŝŶ the ǀarŝous ƉroǀŝŶces of the couŶtrLJ. Of those hosƉŝtals͕ 72 are state hosƉŝtals͕ 14 are teachŝŶŐ aŶd research hosƉŝtals͕ 1Ϭ are uŶŝǀersŝtLJ hosƉŝtals͕ aŶd 69 are Ɖrŝǀate hosƉŝtals ;FŝŐure 13͕ Taďle 4). &ŝŐƵƌĞϭϯ͗ŝƐƚƌŝďƵƟŽŶŽĨƚŚĞƚLJƉĞƐŽĨŚŽƐƉŝƚĂůƐƉƌĞĨĞƌƌĞĚďLJƚŚĞ,ĞĂůƚŚdŽƵƌŝƐƚƐ S.H. E.R.H. U.H. P.H. 36 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 The ƉroƉorƟoŶ of the Ŷumďers of the health tourŝsts aŶd the Ŷumďer of the hosƉŝtals theLJ Ɖrefer ŝŶdŝcates that the Ɖrŝǀate hosƉŝtals are the most Ɖreferred oŶes ǁŝth 754 ƉaƟeŶts Ɖer hosƉŝtal. Hoǁeǀer͕ ǁŝth 61 ƉaƟeŶts Ɖer hosƉŝtal Ɖuďlŝc hosƉŝtals are Ŷumďer tǁo͕ ǁŝth 6Ϭ ƉaƟeŶts Ɖer hosƉŝtal the educaƟoŶ aŶd research hosƉŝtals ǁere Ŷumďer three. IŶ addŝƟoŶ͕ ŝt has ďeeŶ reǀealed that 19 ƉaƟeŶts Ɖer hosƉŝtal Ɖreferred the uŶŝǀersŝtLJ hosƉŝtals. dĂďůĞϰ͗EƵŵďĞƌŽĨƚŚĞ,ĞĂůƚŚƚŽƵƌŝƐƚƐĂŶĚdLJƉĞƐŽĨƚŚĞ,ŽƐƉŝƚĂůƐdŚĞLJWƌĞĨĞƌƌĞĚ PUBLIC HOSPITALS Number of HosƉitaůs 72 Number of PaƟent 1172 EDUCATION AND RESEARCH HOSPITALS Number of HosƉitaůs 14 Number of PaƟent ϴ41 UNIVERSITY HOSPITALS Number of HosƉitaůs 1Ϭ PRIVATE HOSPITALS Number of HosƉitaůs 69 Number of PaƟent 196 Number of PaƟent 52Ϭ43 The hosƉŝtal ƉrefereŶces of the tourŝsts edžamŝŶed uŶder the cateŐorLJ of ͚health of the tourŝst͛ are slŝŐhtlLJ dŝīereŶt. AccordŝŶŐ to data ŝŶ 2Ϭ11 tourŝsts ŝŶ our couŶtrLJ͕ ŝŶ cases ǁheŶ theLJ suddeŶlLJ Őet sŝcŬ ŝŶ our couŶtrLJ͕ 2ϴ6 of them Ɖreferred state hosƉŝtals͕ 2ϴ Ɖreferred educaƟoŶ aŶd research hosƉŝtals͕ 2ϴ Ɖreferred uŶŝǀersŝtLJ hosƉŝtals͕ aŶd 2Ϭ5 Ɖreferred Ɖrŝǀate hosƉŝtals ;FŝŐure 14͕ Taďle 5). &ŝŐƵƌĞϭϰ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚͲŝƐƚƌŝďƵƟŽŶdLJƉĞƐŽĨ,ŽƐƉŝƚĂůƐWƌĞĨĞƌƌĞĚ S.H. E.R.H. U.H. P.H. The ƉroƉorƟoŶ of the Ŷumďer of ƉaƟeŶts aŶd Ŷumďer aŶd tLJƉes of hosƉŝtals͕ Ŷumďer of ƉaƟeŶts Ɖer Ɖuďlŝc hosƉŝtal ŝs 75͕ of 2ϴ educaƟoŶ aŶd research hosƉŝtal the Ŷumďer of ƉaƟeŶts Ɖer hosƉŝtal ŝs 112͕ aŶd Ɖrŝǀate hosƉŝtals͕ ǁhŝch raŶŬ Įrst ǁŝthŝŶ Health Tourŝsm͕ has the thŝrd Ɖlace ǁŝth 294 ǁŝth ƉaƟeŶts. UŶder the cateŐorLJ of health of the tourŝst͕ the uŶŝǀersŝtLJ hosƉŝtals admŝt 294 ƉaƟeŶts Ɖer hosƉŝtal. dĂďůĞϱ͗EƵŵďĞƌŽĨWĂƟĞŶƚƐǁŝƚŚŝŶƚŚĞĐĂƚĞŐŽƌLJŽĨƚŚĞŚĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚĂŶĚƚŚĞƚLJƉĞŽĨƚŚĞ ŚŽƐƉŝƚĂůƐƚŚĞLJƉƌĞĨĞƌƌĞĚ PUBLIC HOSPITALS Number of HosƉitaůs 2ϴ6 Number of PaƟent 2153Ϭ EDUCATION AND RESEARCH HOSPITALS Number of HosƉitaůs 2ϴ Number of PaƟent 3159 UNIVERSITY HOSPITALS Number of HosƉitaůs 2ϴ 37 Number of PaƟent 9595 PRIVATE HOSPITALS Number of HosƉitaůs 2Ϭ5 Number of PaƟent 6Ϭ333 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 ϯ ʹ HOSPITALS WITH HIGHEST ADMISSION &IGURES FolloǁŝŶŐ ŝs the ŐraƉhŝc of the Įrst 1Ϭ Ɖuďlŝc hosƉŝtals Ɖreferred ďLJ the ƉaƟeŶts of Health Tourŝsm. Bƺ Ŭ ER LJƺ H Ŭĕ eŬ m ec e bŝ SH Ɣlŝ Eƞ al Ho sƉ Ul ŝta uc l aŶ la rE Ka LJe rt al ER Lƺ H ƞŝ KŦ Ye rd dŝ ar Ŭu le ER Ch H es tD Ka ŝse ra as de es Ŷŝ njT ec hŶ ŝc al H. 7st aŶ ďu lE RH H At at ƺr ER se Ŭŝ Ha Ta T ŬsaŬ sŝm ŝm EER RHH &ŝŐƵƌĞϭϱ͗ŝƐƚƌŝďƵƟŽŶŽĨƚŚĞĮƌƐƚϭϬWƵďůŝĐ,ŽƐƉŝƚĂůƐĂĚŵŝƫŶŐĨŽƌĞŝŐŶƉĂƟĞŶƚƐŝŶ,ĞĂůƚŚdŽƵƌŝƐŵ As ŝŶdŝcated ŝŶ the chart͕ the Įrst three Ɖuďlŝc hosƉŝtals Ɖreferred ďLJ the health tourŝsts are the educaƟoŶ aŶd research hosƉŝtals ŝŶ IstaŶďul aŶd AŶŬara. GeŶerallLJ sƉeaŬŝŶŐ͕ ŝŶ terms of the hosƉŝtals ŝŶ ǁhŝch the health tourŝsts receŝǀe treatmeŶt͕ the chart ŝŶdŝcates that the Ɖuďlŝc hosƉŝtals ŝŶ our tǁo metroƉolŝtaŶ cŝƟes of AŶŬara aŶd IstaŶďul come to the foreŐrouŶd comƉared to the hosƉŝtals ŝŶ other cŝƟes. dĂďůĞϲ͗dŚĞĮƌƐƚϭϬWƵďůŝĐ,ŽƐƉŝƚĂůƐĂĚŵŝƫŶŐĨŽƌĞŝŐŶƉĂƟĞŶƚƐŝŶ,ĞĂůƚŚdŽƵƌŝƐŵĂŶĚƚŚĞEƵŵďĞƌŽĨ WĂƟĞŶƚƐ THE HOSPITAL NUMBER OF PATIENTS TAKS7M EDUCATION AND RESEARCH HOSPITAL ;ERH) 3ϴ3 HASEK7 ERH 321 ANKARA ATATmRK ERH 26Ϭ BmYmKEKMECE PUBLIC HOSPITAL ;PH) 212 b7bL7 ETFAL HOSPITAL 2ϬϬ ULUCANLAR EYE ERH 151 KARTAL LmTF7 KIRDAR ERH 114 YED7KULE PULMANORY DISEASES ERH 122 KARADEN7 TEKN7K mN7VERS7TES7 FARAB7 HOSPITAL 75 7STANBUL ERH 6ϴ 38 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 FolloǁŝŶŐ ŝs the ŐraƉhŝc of the Įrst 1Ϭ Ɖrŝǀate hosƉŝtals Ɖreferred ďLJ the ƉaƟeŶts of Health Tourŝsm NY A Dm PR IV AT E TA L PI HO S SU N SA M LP AR K M HO ED SP IC ITA AL PA L RK ͲF AT 7H HO SP PR ITA IV AT PR L E IV BA AT E Y IN M DI ED R IC HO AL SP PA ITA RK GP L PR T EP IV AT E HO E AC SP IB ITA AD PR L IV EM AT E FU M ED LY A IC AL HO PA SP RK ITA BA 7ST L HÇ AN EL BU 7E VL LI ER NT HO ER SP NA ITA TI L ON PR A L IV HO AT E SP M ED ITA IC L A HO LIC M ÇA M LIU ITA SP HO GP A TA KP Y A HO ER NT CE AL IC ED M PR IV AT E LU DO NA P. A PR IV AT E SP I SP I TA L TA L &ŝŐƵƌĞϭϲ͗ŝƐƚƌŝďƵƟŽŶŽĨƚŚĞĮƌƐƚϭϬWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐĂĚŵŝƫŶŐĨŽƌĞŝŐŶƉĂƟĞŶƚƐŝŶ,ĞĂůƚŚdŽƵƌŝƐŵ It ŝs oďserǀed that ŝŶ the ŝŶ the cateŐorLJ of Ɖrŝǀate hosƉŝtals Ɖreferred ďLJ the Health Tourŝsts͕ sŝmŝlar to the dŝstrŝďuƟoŶ of Ɖuďlŝc hosƉŝtals͕ the Ɖrŝǀate hosƉŝtals ŝŶ IstaŶďul͕ AŶŬara aŶd AŶtalLJa͕ come to the fore ;FŝŐure 16͕ Taďle 7). dĂďůĞϳ͗dŚĞĮƌƐƚϭϬWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐĂĚŵŝƫŶŐĨŽƌĞŝŐŶƉĂƟĞŶƚƐŝŶ,ĞĂůƚŚdŽƵƌŝƐŵ THE HOSPITAL P. ANADOLU MEDICAL CENTER HOSPITAL PRIVATE HOSPITALIUM ÇAMLICA HOSPITAL PRIVATE DmNYA GP ATAKPY HOSPITAL PRIVATE MEDICALPARKͲFAT7H HOSPITAL PRIVATE BAYINDIR HOSPITAL PRIVATE MEDICAL PARK GPTEPE HOSPITAL PRIVATE ACIBADEM FULYA HOSPITAL PRIVATE MEDICAL PARK BAHÇEL7EVLER HOSPITAL 7STANBUL INTERNATIONAL HOSPITAL PRIVATE MEDICAL PARK SAMSUN HOSPITAL As caŶ ď ďe seeŶ ŝŝŶ TTaďle 7͕ Kocaelŝ Prŝǀate AŶadolu CeŶter HosƉŝtal ďLJ th the A ďl 7 K lŝ P ŝ t A d l Medŝcal M dŝ l C t H ŝt l ǁhŝch hŝ h ŝs ŝ folloǁed f ll dď Prŝǀate HosƉŝtalŝum Camlŝca admŝƩed almost tǁŝce as much medŝcal Tourŝsm ƉaƟeŶts. DƺŶLJa GƂnj HosƉŝtal ǁhŝch has a ǁorldǁŝde recoŐŶŝƟoŶ ŝŶ the eLJe dŝsorders ŝs the thŝrd ŝŶ the ǁorld. NOTE͗ Each hosƉŝtal has ďeeŶ assessed ŝŶdeƉeŶdeŶtlLJ͕ aŶd the ŐrouƉ hosƉŝtals͕ sŝŶce theLJ haǀe a sƉecŝal sŝŐŶŝĮcaŶce ŝŶ terms of ďraŶdŝŶŐ͕ are eǀaluated also ǁŝthŝŶ themselǀes. 39 40 KAb STATE HOSPITAL EM7RDA) STATE HOSPITAL MARMAR7S STATE HOSPITAL AKDEN7 UNIVERSITY HOSPITAL KUbADASI STATE HOSPITAL MANAVGAT STATE HOSPITAL FETHIYE STATE HOSPITAL KEMER STATE HOSPITAL T.E.V. SULTANBEYL7 STATE HOSPITAL ANTALYA ERH EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &ŝŐƵƌĞϭϳ͗ŝƐƚƌŝďƵƟŽŶŽĨƚŚĞĮƌƐƚϭϬWƵďůŝĐ,ŽƐƉŝƚĂůƐĂĚŵŝƫŶŐĨŽƌĞŝŐŶƉĂƟĞŶƚƐŝŶƚŚĞ,ĞĂůƚŚŽĨƚŚĞ ƚŽƵƌŝƐƚĂƚĞŐŽƌLJ TOTAL NUMBER OF PATIENTS EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 WheŶ ǁe edžamŝŶe the dŝstrŝďuƟoŶ of the Įrst 1Ϭ Ɖuďlŝc hosƉŝtals ǁŝthŝŶ the cateŐorLJ of health of the tourŝsts͕ ǁe see that the hosƉŝtals at the ƉroǀŝŶces ǁhŝch aƩract the most tourŝsts come to the foreŐrouŶd ;FŝŐure 17͕ Taďle ϴ). IŶ addŝƟoŶ͕ for the treatmeŶt of TurŬŝsh cŝƟnjeŶs ǁho lŝǀe aďroad aŶd come to TurŬeLJ for medŝcal treatmeŶt Ɖrefer EmŝrdaŐ State HosƉŝtal ǁŝthŝŶ the scoƉe of ďŝlateral aŐreemeŶts. For thŝs reasoŶ͕ EmŝrdaŐ State HosƉŝtal ŝs ŝŶ the toƉ 1Ϭ lŝst of the most Ɖreferred hosƉŝtals ǁŝthŝŶ the cateŐorLJ of health of the tourŝst. dĂďůĞϴ͗dŚĞĮƌƐƚϭϬWƵďůŝĐ,ŽƐƉŝƚĂůƐĂĚŵŝƫŶŐĨŽƌĞŝŐŶƉĂƟĞŶƚƐŝŶƚŚĞĐĂƚĞŐŽƌLJŽĨƚŚĞ,ĞĂůƚŚŽĨƚŚĞ ƚŽƵƌŝƐƚĂŶĚƚŚĞEƵŵďĞƌŽĨWĂƟĞŶƚƐ THE HOSPITAL NUMBER OF PATIENTS ANTALYA EDUCATION AND RESEARCH HOSPITAL ;ERH) 22ϴ7 T.E.V. SULTANBEYL7 PUBLIC HOSPITAL 227ϴ KEMER PUBLIC HOSPITAL 173ϴ FETH7YE PUBLIC HOSPITAL 1Ϭ66 MANAVGAT PUBLIC HOSPITAL ϴ6ϴ KUbADASI PUBLIC HOSPITAL 7Ϭ9 AKDEN7 UNIVERSITY HOSPITAL 691 MARMAR7S PUBLIC HOSPITAL 67ϴ EM7RDA) PUBLIC HOSPITAL 522 KAb PUBLIC HOSPITAL TOTAL NUMBER OF PATIENTS 41 PRIVATE BODRUM HOSPITAL PRIVATE KUSADASI HOSPITAL PRIVATE AKDENI HOSPITAL PRIVATE HAYAT HOSPITAL PRIVATE MANAVGAT SEVGI HOSPITAL PRIVATE MARMARIS AHU HETMAN HOSPITAL PRIVATE ALMAN HOSPITAL PRIVATE KEMER YASAM HOSPITAL PRIVATE BILGI HOSPITAL PRIVATE ASPENDOS HOSPITAL FŝŐure ;1ϴ) aŶd Taďle ;9)͕ shoǁ the dŝstrŝďuƟoŶ of Ɖrŝǀate hosƉŝtals Ɖreferred ďLJ the tourŝsts͕ ǁho come to TurŬeLJ for reasoŶs other thaŶ medŝcal treatmeŶt aŶd Őet sŝcŬ durŝŶŐ theŝr ǀacaƟoŶ͕ aŶd the Ŷumďer of ƉaƟeŶts EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 As ƉreǀŝouslLJ meŶƟoŶed͕ the outstaŶdŝŶŐ ďoth Ɖuďlŝc aŶd Ɖrŝǀate hosƉŝtals ǁŝthŝŶ the cateŐorLJ of the health of the tourŝsts are usuallLJ at the reŐŝoŶs that aƩract most tourŝsts. dĂďůĞϵ͗dŚĞĮƌƐƚϭϬWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐĂĚŵŝƫŶŐĨŽƌĞŝŐŶƉĂƟĞŶƚƐŝŶƚŚĞĐĂƚĞŐŽƌLJŽĨƚŚĞ,ĞĂůƚŚŽĨƚŚĞ ƚŽƵƌŝƐƚĂŶĚƚŚĞEƵŵďĞƌŽĨWĂƟĞŶƚƐ HOSPITAL PRIVATE ASPENDOS HOSPITAL PRIVATE B7LG7 HOSPITAL PRIVATE KEMER YAbAM HOSPITAL PRIVATE ALMAN HOSPITAL UHG Ͳ TAKS7M PRIVATE MARMAR7S AHU HETMAN HOSPITAL PRIVATE MANAVGAT SEVG7 HOSPITAL PRIVATE HAYAT HOSPITAL PRIVATE AKDEN7 HOSPITAL PRIVATE KUbADASI HOSPITAL PRIVATE BODRUM HOSPITAL As edžƉected͕ Prŝǀate AsƉeŶdos HosƉŝtal taŬes the Įrst Ɖlace͕ located ŝŶ the Tourŝsm Ɖaradŝse AŶtalLJa. Prŝǀate hosƉŝtals ŝŶ IstaŶďul͕ hosƟŶŐ maŶLJ tourŝsts for ďusŝŶess or ǀacaƟoŶ ƉurƉoses also taŬe theŝr Ɖlace amoŶŐ the Įrst teŶ hosƉŝtals. The hosƉŝtals located ŝŶ Kusadasŝ aŶd Bodrum͕ the cŝƟes ǁhŝch the tourŝsts traǀelŝŶŐ to TurŬeLJ for holŝdaLJ esƉecŝallLJ durŝŶŐ the summer moŶths mostlLJ ǀŝsŝt͕ are also amoŶŐ the toƉ teŶ hosƉŝtals. It must ďe ŬeƉt ŝŶ coŶsŝderaƟoŶ that the health tourŝsts Ɖrefer the hosƉŝtals accordŝŶŐ to the ďraŶch theLJ ǁould receŝǀe health treatmeŶt. ProďaďlLJ͕ ďefore the treatmeŶt Ɖerŝod͕ theLJ studLJ ǁhŝch hosƉŝtal Őoes out there oŶ that ďraŶch aŶd choose the hosƉŝtal ŝŶ accordaŶce. IŶ addŝƟoŶ͕ the cŝƟes as ǁell as hosƉŝtals Ɖreferred ǁŝthŝŶ the cateŐorŝes of Health Tourŝsm aŶd health of the tourŝst are of Őreat ŝmƉortaŶce. IŶ the folloǁŝŶŐ Ɖarts of the studLJ͕ cateŐorŝes of Health Tourŝsm aŶd health of the tourŝst ǁŝll ďe haŶdled ďLJ ďraŶch͕ ƉroǀŝŶce aŶd couŶtrLJ. 42 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 ϰ Ͳ HEALTH TOURISM BY PROVINCE ThaŶŬs to stateͲsƉoŶsored aŶd Ɖrŝǀate sector ŝŶǀestmeŶts͕ Ŷumďer of hosƉŝtals aŶd ƋualŝĮed serǀŝce uŶderstaŶdŝŶŐ ŝs oŶ rŝse ŝŶ our couŶtrLJ ǁhere Health Tourŝsm ŝs raƉŝdlLJ deǀeloƉŝŶŐ. Some of the ƉroǀŝŶces receŝǀed a larŐer share from thŝs ŝŶcrease ďoth due to theŝr ƉosŝƟoŶs aŶd theŝr socŝoͲ ƉolŝƟcal sŝŐŶŝĮcaŶce. CoŶsŝderŝŶŐ the total Ŷumďer of ƉaƟeŶts ŝŶ Health Tourŝsm aŶd health of the tourŝst cateŐorŝes͕ the data of 2Ϭ11 ŝŶdŝcate that folloǁŝŶŐ are the Įrst teŶ ƉroǀŝŶces͗ ͻ AŶtalLJa ͻ 7staŶďul ͻ Kocaelŝ ͻ AŶŬara ͻ MuŒla ͻ 7njmŝr ͻ AdaŶa ͻ ALJdŦŶ ͻ SamsuŶ ͻ TraďnjoŶ ;FŝŐ. 19͕ 2Ϭ). &ŝŐƵƌĞϭϵ͗ŝƐƚƌŝďƵƟŽŶŽĨƚŚĞĮƌƐƚϭϬWƌŽǀŝŶĐĞƐŽƵƚƐƚĂŶĚŝŶŐŝŶƚŚĞĚĂƚĂŽĨϮϬϭϭ,ĞĂůƚŚdŽƵƌŝƐŵ HEALTH TOURISM 43 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &ŝŐƵƌĞϮϬ͗ŝƐƚƌŝďƵƟŽŶŽĨƚŚĞŶƵŵďĞƌŽĨƉĂƟĞŶƚƐŝŶĐĂƚĞŐŽƌŝĞƐŽĨ,ĞĂůƚŚdŽƵƌŝƐŵĂŶĚ,ĞĂůƚŚŽĨƚŚĞ ƚŽƵƌŝƐƚďLJƚŚĞĮƌƐƚϭϬWƌŽǀŝŶĐĞƐ Health of the tourŝst Health tourŝsm It ŝs Ŷot surƉrŝsŝŶŐ to see AŶtalLJa͕ the ƉroǀŝŶce ǁhŝch has a hŝŐher tourŝst ƉoteŶƟal comƉared to other ƉroǀŝŶces esƉecŝallLJ durŝŶŐ summer͕ outstaŶdŝŶŐ ŝŶ terms of health of the tourŝst. Thŝs result caŶ ďe ŝŶterƉreted as the tourŝsts͛ comŝŶŐ to AŶtalLJa for traǀel aŶd eŶtertaŝŶmeŶt reasoŶs aŶd ŐeƫŶŐ sŝcŬ uŶedžƉectedlLJ aŶd receŝǀŝŶŐ treatmeŶt ŝŶ hosƉŝtals. It ŝs also Ŷatural for the couŶtrLJ͛s larŐest metroƉolŝtaŶ cŝtLJ of IstaŶďul to ďe at the forefroŶt of Health Tourŝsm. IstaŶďul ŝs a cŝtLJ ǁhŝch caŶ ďe Ɖreferred ďLJ the tourŝst for ďusŝŶess͕ eŶtertaŝŶmeŶt aŶd treatmeŶt reasoŶs. IŶ Kocaelŝ͕ sƉecŝal aŶd ŶoŶstaŶdard Health Tourŝsm eīorts of the Prŝǀate AŶadolu HosƉŝtal are ǀerLJ ŝmƉortaŶt here. The eīorts of Prŝǀate AŶadolu HosƉŝtal carrŝed Kocaelŝ to thŝrd Ɖlace. Due to ŝts ƉrodžŝmŝtLJ to IstaŶďul͕ strateŐŝc locaƟoŶ͕ ŝts stroŶŐ ecoŶomLJ for ďeŝŶŐ aŶ ŝŶdustrLJ reŐŝoŶ͕ aŶd the suƉƉort ŐŝǀeŶ ŝŶ receŶt LJears ďLJ the MuŶŝcŝƉalŝtLJ of Kocaelŝ aŶd the GoǀerŶor͛s Oĸce to the Health Tourŝsm͕ ŝt ŝs a Ŷatural result for Kocaelŝ to share ǁŝth ϴ й the thŝrd Ɖlace ǁŝth AŶŬara͕ the caƉŝtal cŝtLJ ǁhŝch has maŶLJ medŝcal schools aŶd hosƉŝtals ǁŝth ƋualŝĮed serǀŝce uŶderstaŶdŝŶŐ aŶd ǁhŝch ŝs aŶ outstaŶdŝŶŐ ƉroǀŝŶce ŝŶ ďusŝŶess Tourŝsm. As for the other ƉroǀŝŶces͕ Injmŝr͕ MuŐla͕ ALJdŝŶ aŶd TraďnjoŶ are the oŶes ǁhŝch haǀe Őreat tourŝst ƉoteŶƟal. The ƉroǀŝŶces of AdaŶa aŶd SamsuŶ are ŝmƉortaŶt ŝŶ terms of Tourŝsm aŶd caŶ aƉƉeal the health tourŝsts aŶd ƉaƟeŶts ŝŶ the health of the tourŝst cateŐorLJ due to theŝr locaƟoŶs. Numďer of foreŝŐŶ ŶaƟoŶals ǁho traǀel for ďusŝŶess ƉurƉoses to AdaŶa caŶŶot ďe ŝŐŶored. AdaŶa ŝs the ŐateǁaLJ to the Mŝddle East aŶd the receŶt ŝŶcrease ŝŶ Ɖrŝǀate health orŐaŶŝnjaƟoŶs ƉlaLJed aŶ ŝmƉortaŶt role here. For thŝs reasoŶ͕ ŝt ǁas aŶ edžƉected result for those ƉroǀŝŶces to ďe amoŶŐ the Įrst teŶ. AccordŝŶŐ to the data of 2Ϭ11͕ the Įrst teŶ ƉroǀŝŶces Ɖreferred ďLJ the health tourŝsts to receŝǀe treatmeŶt ͻ 7staŶďul ͻ Kocaelŝ ͻ AŶŬara ͻ AŶtalLJa ͻ MuŒla ͻ SamsuŶ ͻ AdaŶa ͻ AŬsaraLJ ͻ 7njmŝr ͻ NeǀƔehŝr ;FŝŐure 21). 44 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &ŝŐƵƌĞϮϭ͗EƵŵďĞƌŽĨ,ĞĂůƚŚdŽƵƌŝƐŵWĂƟĞŶƚƐďLJWƌŽǀŝŶĐĞƐ AccordŝŶŐ to the data of 2Ϭ11͕ 25Ϭ73 foreŝŐŶ ƉaƟeŶts a LJear are come to IstaŶďul for treatmeŶt. IŶ IstaŶďul͕ ǁhŝch ŝs a cŝtLJ deǀeloƉŝŶŐ coŶƟŶuouslLJ aŶd leadŝŶŐ maŶLJ ŝŶŶoǀaƟoŶs also ŝŶ the health sector as ǁell as ŝŶ maŶLJ other sectors͕ ŝŶ 2Ϭ1ϬͲ2Ϭ11 a total of 266 mŝllŝoŶ TL has ďeeŶ ŝŶǀested ŝŶ health care ;FŝŐure 22). It ŝs ŬŶoǁŶ that health ŝŶǀestmeŶts ŝŶ IstaŶďul accelerated. Health care facŝlŝƟes ŝŶ IstaŶďul͕ serǀŝŶŐ ŝŶ ǁorld staŶdards͕ leadŝŶŐ role ŝŶ ŝs the ƉrotecƟoŶ aŶd ŝmƉroǀemeŶt of ŝŶdŝǀŝdual aŶd Ɖuďlŝc health. IŶ IstaŶďul͕ ŝŶ Ɖarallel ǁŝth the ŝŶcreasŝŶŐ ƉoƉulaƟoŶ aŶd deǀeloƉŝŶŐ techŶoloŐLJ͕ health care has ďeeŶ ŐroǁŝŶŐ at the same rate. The most ŝmƉortaŶt ŝŶ IstaŶďul͛s turŶŝŶŐ ŝŶto aŶ aƩracƟǀe ceŶter of health factor ŝs the ŝŶcrease ŝŶ caƉacŝtLJ aŶd ƋualŝtLJ achŝeǀed ŝŶ hosƉŝtals aŶd the serǀŝce Ɖroǀŝded ďLJ the hosƉŝtals. 45 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &ŝŐƵƌĞϮϮ͗ŝƐƚƌŝďƵƟŽŶŽĨWƵďůŝĐͲWƌŝǀĂƚĞŝŶ,ĞĂůƚŚdŽƵƌŝƐŵďLJWƌŽǀŝŶĐĞ Puďlŝc Prŝǀate OŶ the other haŶd͕ as meŶƟoŶed earlŝer͕ ŝŶ 2Ϭ11 1Ϭ947 ƉeoƉle haǀe Ɖreferred to receŝǀe treatmeŶt ŝŶ Kocaelŝ͕ the ƉroǀŝŶce that made sŝŐŶŝĮcaŶt ďreaŬthrouŐh aŶd that has a coŶǀeŶŝeŶt locaƟoŶ. The ǀast maũorŝtLJ of thŝs Ŷumďer as oďserǀed ŝŶ other ƉroǀŝŶces Ɖreferred Ɖrŝǀate hosƉŝtals. &ŝŐƵƌĞϮϯ͗EƵŵďĞƌŽĨƉĂƟĞŶƚƐŝŶƚŚĞŚĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚĐĂƚĞŐŽƌLJďLJƉƌŽǀŝŶĐĞ WheŶ ǁe looŬ at the raŶŬŝŶŐ of ƉroǀŝŶces the ƉaƟeŶts Ɖreferred to receŝǀe treatmeŶt ŝŶ the cateŐorLJ of health of the tourŝst͕ TurŬeLJ͛s most ƉoƉular tourŝsƟc ƉroǀŝŶce of AŶtalLJa ŝs ŝŶ the Įrst Ɖlace ;FŝŐure 23). IŶ the health of the tourŝst cateŐorLJ͕ as ŝŶ the Health Tourŝsm͕ IstaŶďul ŝs amoŶŐ the Ɖreferred 1Ϭ ƉroǀŝŶces rŝch ŝŶ hŝstorŝcal͕ tourŝsƟc aŶd cultural dŝǀersŝtLJ. EǀerLJ LJear͕ MuŐla͕ Injmŝr aŶd ALJdŝŶ receŝǀe larŐe Ŷumďer of tourŝsts traǀelŝŶŐ for recreaƟoŶ aŶd eŶtertaŝŶmeŶt. Therefore͕ ŝt ǁas aŶ edžƉected result to see these ƉroǀŝŶces outstaŶdŝŶŐ ŝŶ the cateŐorLJ of health of the tourŝst. AŶŬara͕ due to ŝts ďeŝŶŐ the caƉŝtal cŝtLJ aŶd strateŐŝc locaƟoŶ͕ ŝs mostlLJ ǀŝsŝted for ďusŝŶess͕ coŶŐresses aŶd scŝeŶƟĮc acƟǀŝƟes͕ ďut also has a hŝŐh tourŝst ƉoteŶƟal. For thŝs reasoŶ͕ accordŝŶŐ to the data of 2Ϭ11͕ ǁŝth 32Ϭ7 ƉaƟeŶts ŝt has the ĮŌh Ɖlace ŝŶ the cateŐorLJ of health of the tourŝst. TraďnjoŶ͕ ǁŝth ŝts Ŷatural aŶd cultural rŝchŶess͕ ŝs oŶe of the ǁorldͲreŶoǁŶed ƉroǀŝŶces. Hoǁeǀer͕ Bursa͕ ǁŝth ŝts rŝchŶess of hŝstorŝcal Tourŝsm aƩracƟoŶs as ǁell as the sŬŝ Tourŝsm͕ has aŶ uŶdŝsƉuted Ɖlace ŝŶ summer aŶd ǁŝŶter Tourŝsm. Neǀsehŝr͕ due to the Ŷatural ǁealth aŶd Ɖeculŝar cultural structure͕ eǀerLJ LJear aƩracts 46 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 maŶLJ foreŝŐŶ ǀŝsŝtors. KoŶLJa͕ ǁhŝch has a Ɖlace amoŶŐ the 1Ϭ ƉroǀŝŶces ŝŶ terms of Health Tourŝsm aŶd health of the tourŝst͕ ŝs oŶe of TurŬeLJ͛s maũor cŝƟes. KoŶLJa͕ due to ŝts sŝŐŶŝĮcaŶt tourŝsƟc features aŶd locaƟoŶ͕ ŝs oŶe our outstaŶdŝŶŐ ƉroǀŝŶces ŝŶ terms of Health Tourŝsm. &ŝŐƵƌĞϮϰ͗ŝƐƚƌŝďƵƟŽŶŽĨWƵďůŝĐͲWƌŝǀĂƚĞŝŶ,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚĂƚĞŐŽƌLJďLJWƌŽǀŝŶĐĞ Puďlŝc Prŝǀate As ǁe haǀe seeŶ ŝŶ AŶtalLJa͕ IstaŶďul͕ MuŐla ƉroǀŝŶces ŝŶ terms of emerŐeŶcLJ medŝcal serǀŝces tourŝsts Ɖreferred to ďe treated ŝŶ Ɖrŝǀate hosƉŝtals ;FŝŐure 2Ϭ). Whŝle ŝŶ AŶŬara͕ Injmŝr aŶd TraďnjoŶ Ɖuďlŝc hosƉŝtals ǁere Ɖreferred͕ ŝŶ ALJdŝŶ Bursa͕ KoŶLJa aŶd Neǀsehŝr͕ the rate of ƉreferrŝŶŐ Ɖrŝǀate or Ɖuďlŝc hosƉŝtals ŝs almost the same. ϱ Ͳ HEALTH TOURISM BY BRANCH TurŬeLJ has reached a ǀerLJ ŝmƉortaŶt ƉoŝŶt reŐardŝŶŐ the ƋualŝtLJ of health care serǀŝces. IŶ some of the medŝcŝŶe ďraŶches͕ turŬeLJ reached the coŶtemƉorarLJ leǀel of techŶoloŐLJ aŶd caƉacŝtLJ. TurŬeLJ closelLJ folloǁs aŶd ƋuŝcŬlLJ adaƉts the fastͲŐroǁŝŶŐ techŶoloŐLJ ŝŶ the ǁorld. IŶ medŝcal educaƟoŶ͕ ƋualŝtLJ ŝŶ medŝcal schools has ŝŶcreased aŶd more ŝmƉortaŶce to foreŝŐŶ laŶŐuaŐe educaƟoŶ ŝs ŐŝǀeŶ. IŶ our couŶtrLJ͕ the Ŷumďer of medŝcal schools tauŐht ŝŶ EŶŐlŝsh ŝŶcreases raƉŝdlLJ͕ thus deǀeloƉmeŶts ŝŶ the Įeld of medŝcŝŶe caŶ ďe more closelLJ moŶŝtored. At the same Ɵme͕ aŶ ŝŶcreasŝŶŐ Ŷumďer of Ɖroũects ŝŶ the Įeld of health are ƉroƉosed. The MŝŶŝstrLJ of Health͕ tarŐeƟŶŐ aŶ eĸcŝeŶt͕ hŝŐhͲƋualŝtLJ aŶd sustaŝŶaďle health care serǀŝces͕ for thŝs ƉurƉose aƉƉlŝes ͞Health TraŶsformaƟoŶ ProŐram͟ the ŝŶŇueŶce of ǁhŝch ǁas felt at the ŶaƟoŶal leǀel ;hƩƉ͗ͬͬǁǁǁ.medŝcalͲtrŝďuŶe.com.tr). IŶ ǀarŝous Ɖarts of the couŶtrLJ oƉerate maŶLJ Ɖrŝǀate aŶd Ɖuďlŝc hosƉŝtals ǁhŝch haǀe ǁorldǁŝde staŶdards ǁŝth theŝr hŝŐhͲƋualŝĮed ƉhLJsŝcŝaŶs aŶd other health care ƉersoŶŶel aŶd ǁŝth theŝr techŶoloŐŝcal eƋuŝƉmeŶt. FolloǁŝŶŐ are the ďraŶches the foreŝŐŶ ƉaƟeŶts receŝǀŝŶŐ treatmeŶt ŝŶ TurŬeLJ Ɖreferred ƉrŝmarŝlLJ͖ S CardŝoloŐLJͲCardŝoǀascular SurŐerLJ ;CVS) S ELJe S DeŶtal S OrthoƉedŝcs S PlasƟc SurŐerLJ S OŶcoloŐLJ S BraŝŶ SurŐerLJ IŶ TurŬeLJ͕ 11й of the foreŝŐŶ ƉaƟeŶts receŝǀe treatmeŶt for eLJe dŝsorders ;FŝŐure 25). It ŝs folloǁed ďLJ OrthoƉedŝcs ǁŝth a raƟo of ϴй aŶd ďLJ CardŝoloŐLJ͕ a ďraŶch that ŝs raƉŝdlLJ ŝmƉroǀŝŶŐ aŶd that has ǁorldͲreŶoǁŶed ƉhLJsŝcŝaŶs͕ ǁŝth 5й. BraŶches of orthoƉedŝcs͕ ƉlasƟc surŐerLJ aŶd oŶcoloŐLJ are the oŶes the health tourŝsts comŝŶŐ to TurŬeLJ for treatmeŶt Ɖrefer. 47 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 OTHER OrthoƉedŝcs DeŶtal PlasƟc SurŐerLJ ELJe BraŝŶ SurŐerLJ OŶcoloŐLJ CardŝoloŐLJͲ Cardŝoǀascular SurŐerLJ ;CVS) &ŝŐƵƌĞϮϱ͗,ĞĂůƚŚdŽƵƌŝƐŵʹŝƐƚƌŝďƵƟŽŶďLJďƌĂŶĐŚƚŚƌŽƵŐŚŽƵƚdƵƌŬĞLJ It ŝs seeŶ that the maũorŝtLJ of foreŝŐŶers Ɖreferred. Prŝǀate hosƉŝtals ŝŶ medŝcal ďraŶches meŶƟoŶed aďoǀe͕ ;FŝŐure 26). &ŝŐƵƌĞϮϲ͗,ĞĂůƚŚdŽƵƌŝƐŵʹŝƐƚƌŝďƵƟŽŶŽĨWƵďůŝĐͲWƌŝǀĂƚĞďLJďƌĂŶĐŚƚŚƌŽƵŐŚŽƵƚdƵƌŬĞLJ Other ELJe OŶcoloŐLJ OrthoƉedŝcs CardŝoloŐLJ ;CVS) BraŝŶ SurŐerLJ PlasƟc SurŐerLJ DeŶtal Prŝǀate Puďlŝc WheŶ ǁe edžamŝŶe the dŝstrŝďuƟoŶ ďLJ ďraŶch of ƉaƟeŶts ǁho receŝǀe medŝcal treatmeŶt at Ɖuďlŝc hosƉŝtals ŝŶ the Įrst 1Ϭ outstaŶdŝŶŐ ƉroǀŝŶces͕ ŝt ŝs uŶderstood that CardŝoloŐLJ has the hŝŐhest ĮŐures ;FŝŐure 23͕ Taďle 1Ϭ). &ŝŐƵƌĞϮϳ͗,ĞĂůƚŚdŽƵƌŝƐŵͲŝƐƚƌŝďƵƟŽŶďLJďƌĂŶĐŚŝŶWƵďůŝĐ,ŽƐƉŝƚĂůƐŝŶϭϬWƌŽǀŝŶĐĞƐ CardŝoloŐLJ ;CVS) OŶcoloŐLJ BraŝŶ SurŐerLJ ELJe PlasƟc SurŐerLJ DeŶtal OrthoƉedŝcs Other 48 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 dĂďůĞϭϬ͗,ĞĂůƚŚdŽƵƌŝƐŵʹEƵŵďĞƌŽĨWĂƟĞŶƚƐdƌĞĂƚĞĚŝŶƚŚĞWƵďůŝĐ,ŽƐƉŝƚĂůƐďLJƌĂŶĐŚ PROVINCE L KARDYOLOJ CardŝoloŐLJ KVC;CVS) OŶcoloŐLJ ONKOLOJ BraŝŶ BEYN CERRAH SurŐerLJ GÖZELJe PlasƟc PLASTK CERRAH SurŐerLJ DeŶtal D ORTOPED OrthoƉedŝcs Other DER TOTAL TOPLAM STANBUL KOCAEL ANKARA ANTALYA MULA SAMSUN ADANA AKSARAY ZMR NEVEHR GENEL GRAND TOPLAM TOTAL WheŶ ǁe edžamŝŶe the aforemeŶƟoŶed outstaŶdŝŶŐ 1Ϭ ƉroǀŝŶces ŝŶ Health Tourŝsm͕ ǁe see that͕ as ǁell as other ďraŶches ŝŶ IstaŶďul͕ the orthoƉedŝc ďraŶch comes to the fore ŝŶ 2Ϭ11 ;FŝŐure 2ϴ͕ Taďle 11). Whŝle 127 ƉaƟeŶts Ɖrefer Ɖuďlŝc hosƉŝtals͕ 317ϴ ƉaƟeŶts Ɖreferred Ɖrŝǀate hosƉŝtals. At the oŶcoloŐLJ uŶŝt ŝŶ Kocaelŝ͕ oŶlLJ 2 ƉaƟeŶts ǁere treated ŝŶ Ɖuďlŝc hosƉŝtals. Hoǁeǀer͕ ŝŶ Ɖrŝǀate hosƉŝtals͕ 797Ϭ ƉaƟeŶts haǀe ďeeŶ treated. IŶ thŝs case͕ ŝt seems͕ a larŐe Ɖart of the ƉaƟeŶts comŝŶŐ to TurŬeLJ to ďe treated ŝŶ the Įeld of oŶcoloŐLJ Ɖrefer Ɖrŝǀate hosƉŝtals ŝŶ Kocaelŝ. As for AŶŬara͕ a mass ŝs oďserǀed at the other ďraŶches. There ŝs Ŷo ďŝŐ dŝīereŶce ďetǁeeŶ the Ŷumďer aŶd rate of ƉaƟeŶts ǁho came to AŶŬara reŐardŝŶŐ the ďraŶches ǁe haǀe haŶdled. SŝŶce the DƺŶLJa GƂnj AŶtalLJa HosƉŝtal ŝs located ŝŶ AŶtalLJa͕ comƉared to other ďraŶches more foreŝŐŶ ƉaƟeŶts ǁere treated for eLJe dŝsorders ŝŶ AŶtalLJa. &ŝŐƵƌĞϮϴ͗,ĞĂůƚŚdŽƵƌŝƐŵͲŝƐƚƌŝďƵƟŽŶďLJďƌĂŶĐŚŝŶWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐŝŶϭϬWƌŽǀŝŶĐĞƐ CardŝoloŐLJ ;CVS) OŶcoloŐLJ ELJe BraŝŶ SurŐerLJ 49 PlasƟc SurŐerLJ DeŶtal OrthoƉedŝcs Other EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 dĂďůĞϭϭ͗,ĞĂůƚŚdŽƵƌŝƐŵʹEƵŵďĞƌŽĨWĂƟĞŶƚƐdƌĞĂƚĞĚŝŶƚŚĞWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐďLJƌĂŶĐŚ PROVINCE L KARDYOLOJ CardŝoloŐLJ KVC ;CVS) STANBUL BEYN BraŝŶ CERRAH SurŐerLJ ELJe GÖZ PlasƟc PLASTK CERRAH SurŐerLJ DeŶtal Other OrthoƉedŝcs D ORTOPED DER 1 KOCAEL 1 ANKARA 1 ANTALYA 1 1 11 1 1 11 1 1 1 1 1 1 1 1 1 ADANA TOTAL TOPLAM 1 1 1 MULA SAMSUN OŶcoloŐLJ ONKOLOJ 1 1 1 1 1 1 1 1 1 AKSARAY ZMR NEVEHR GENEL GRAND TOPLAM TOTAL 1 1 1 1 1 1 1 1 1 1 1 1 FolloǁŝŶŐ are the ďraŶches admŝƫŶŐ tourŝsts͕ ǁho ǀŝsŝt TurŬeLJ for sŝŐhtseeŝŶŐ͕ eŶtertaŝŶmeŶt͕ aŶd etc.͕ receŝǀe medŝcal treatmeŶt ǁheŶ theLJ Őet sŝcŬ ŝŶ durŝŶŐ theŝr ǀacaƟoŶ͗ S EmerŐeŶcLJ ClŝŶŝc S IŶterŶal MedŝcŝŶe S Pedŝatrŝc S SurŐerLJ SecƟoŶs S AmďulaŶce ;FŝŐure 29). 50 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 Numďer of PaƟeŶt &ŝŐƵƌĞϮϵ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚʹŝƐƚƌŝďƵƟŽŶŽĨEƵŵďĞƌƐŽĨWĂƟĞŶƚƐŝŶWƵďůŝĐͲWƌŝǀĂƚĞďLJďƌĂŶĐŚ ƚŚƌŽƵŐŚŽƵƚdƵƌŬĞLJ OTHER PATIENT ADMITTED TO EMERGENCY INTERNAL DISEASES PEDIATRIC HEALTH AND DISEASES SURGERY UNITS ;POLYCLINIC TRANSFER BY TO BE MENTIONED) AMBULANCE ;LANDͬAIR) Prŝǀate Puďlŝc As caŶ ďe seeŶ ;FŝŐure 29) ŝŶ case of emerŐeŶcLJ tourŝsts oŌeŶ Ɖrefer treatmeŶt ŝŶ Ɖuďlŝc hosƉŝtals. At other secƟoŶs͕ the Ɖrŝǀate hosƉŝtals are ŝŶ the foreŐrouŶd. IŶ thŝs case͕ ŝt ŝs Ɖossŝďle saLJ that edžceƉt for aŶ emerŐeŶcLJ treatmeŶt͕ that ŝs to saLJ for ƉlaŶŶed treatmeŶts͕ foreŝŐŶ ƉaƟeŶts Ɖrefer Ɖrŝǀate hosƉŝtals. Moreoǀer͕ the data of 2Ϭ11 ŝŶdŝcate that oŶlLJ 69 stateͲoǁŶed amďulaŶces ǁere Ɖreferred͕ ǁhereas 225ϴ Ɖrŝǀate amďulaŶces ǁere Ɖreferred. &ŝŐƵƌĞϯϬ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚʹŝƐƚƌŝďƵƟŽŶďLJďƌĂŶĐŚŝŶWƵďůŝĐ,ŽƐƉŝƚĂůƐŝŶϭϬWƌŽǀŝŶĐĞƐ PATIENT ADMITTED TO EMERGENCY INTERNAL DISEASES PEDIATRIC HEALTH AND DISEASES SURGERY UNITS OTHER TRANSFER BY AMBULANCE ;LANDͬAIR) The Tourŝsm Ɖaradŝse AŶtalLJa ŝs oŶe of the most ƉoƉular cŝƟes ŝŶ terms of the Ŷumďer of ƉaƟeŶts coǀered ďLJ health of the tourŝst as ǁas meŶƟoŶed ŝŶ the Ɖreǀŝous chaƉters. IŶ thŝs case͕ oŶ the ďasŝs of the Ɖuďlŝc hosƉŝtals ŝŶ AŶtalLJa͕ the Ŷumďer of tourŝsts admŝƩed to emerŐeŶcLJ ƉolLJclŝŶŝcs ŝs hŝŐher thaŶ that of other ďraŶches ;FŝŐure 3Ϭ͕ Taďle 12). IŶ IstaŶďul aŶd AŶŬara͕ as ŝŶ the other ƉroǀŝŶces͕ althouŐh the ǀast maũorŝtLJ of the ƉaƟeŶts Ɖrefer emerŐeŶcLJ ƉolLJclŝŶŝcs of Ɖuďlŝc hosƉŝtals͕ some tourŝsts aƉƉear to receŝǀe treatmeŶt at the ŝŶterŶal medŝcŝŶe aŶd surŐerLJ deƉartmeŶts of the Ɖuďlŝc hosƉŝtals. 51 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 dĂďůĞϭϮ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚʹEƵŵďĞƌŽĨWĂƟĞŶƚƐdƌĞĂƚĞĚŝŶƚŚĞWƵďůŝĐ,ŽƐƉŝƚĂůƐďLJƌĂŶĐŚ PROVINCE L ACL POLKLNE PATIENT ADMITTED BAVURAN TO EMERGENCY HASTA INTERNAL DISEASES DAHLYE PEDIATRIC ÇOCUK HEALTH AND BÖLÜMÜ DISEASES CERRAH SURGERY UNITS BÖLÜMLER OTHER DER ;POLYCLINIC TO BE (POLKLNK MENTIONED) BELRTLECEK) TRANSFER BY AMBULANS AMBULANCE NAKL ;LANDͬAIR) (KARA / HAVA) ANTALYA 6363 288 500 1695 5230 1000 STANBUL 866 1127 118 539 276 3 MULA 1258 81 21 239 252 13 ZMR 1573 104 117 654 293 0 ANKARA 2288 388 29 264 163 0 AYDIN 645 81 70 160 343 4 TRABZON 597 27 77 57 305 0 BURSA 322 15 24 29 178 0 NEVEHR 41 0 0 0 75 0 KONYA 212 87 92 72 304 4 The 2Ϭ11 data oŶ the ďasŝs of Ɖuďlŝc hosƉŝtals ŝŶ the Įeld of health of the tourŝst͕ ǁŝth 6363 ƉaƟeŶts AŶtalLJa ŝs the ƉroǀŝŶce ǁŝth the hŝŐhest admŝssŝoŶ to the emerŐeŶcLJ ƉolLJclŝŶŝcs ;Taďle 12). IŶ IstaŶďul ǁŝth 1127 ƉaƟeŶts͕ IŶterŶal MedŝcŝŶe ďraŶches ŝŶ Ɖuďlŝc hosƉŝtals are Ɖreferred more thaŶ the Ɖuďlŝc hosƉŝtals ŝŶ other ƉroǀŝŶces. Whŝle AŶtalLJa ŝs aŐaŝŶ ŝŶ the Įrst Ɖlace ǁŝth 5ϬϬ ƉaƟeŶts admŝƩed to the Pedŝatrŝc Health ďraŶches͕ she ŝs leadŝŶŐ aŐaŝŶ ŝŶ the surŐŝcal deƉartmeŶts ǁŝth 1695 ƉaƟeŶts. As for the amďulaŶce serǀŝces͕ 13 stateͲoǁŶed amďulaŶces ǁere called ďLJ foreŝŐŶ tourŝsts ŝŶ the ƉroǀŝŶce of MuŐla. IŶ AŶtalLJa aŶd IstaŶďul 3 aŶd ŝŶ ALJdŝŶ 4 stateͲoǁŶed amďulaŶces ǁere Ɖreferred. &ŝŐƵƌĞϯϭ͗,ĞĂůƚŚŽĨƚŽƵƌŝƐƚƐŝŶƚĞŶĚŝīĞƌĞŶƚƉƌŽǀŝŶĐĞƐ͕ŝƐƚƌŝďƵƟŽŶ/ŶƚĞƌŵƐŽĨĞƉĂƌƚŵĞŶƚƐŽĨ WƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐ PATIENT ADMITTED TO EMERGENCY INTERNAL DISEASES PEDIATRIC HEALTH AND DISEASES SURGERY UNITS OTHER TRANSFER BY AMBULANCE ;LANDͬAIR) From a cateŐorLJ teŐorLJ of health of the tourŝst ŝŶ Ɖrŝǀate hosƉŝtals ŝŶ the ƉroǀŝŶce of AŶtalLJa ǁhŝle 2ϴй 2 of the tourŝsts receŝǀed treatmeŶt ŝŶ surŐerLJ deƉartmeŶts͕ aƉƉrodžŝmatelLJ 22й admŝƩed to the emerŐeŶcLJ ƉolLJclŝŶŝcs ;FŝŐure 31). AƉƉrodžŝmatelLJ 15й Ͳ 16й of the tourŝsts are treated ŝŶ ŝŶterŶal͕ Ɖedŝatrŝc͕ aŶd other ďraŶches. IŶ IstaŶďul͕ tourŝsts͕ ǁho came to IstaŶďul for ƉurƉoses other thaŶ treatmeŶt͕ mostlLJ admŝƩed to emerŐeŶcLJ ƉolLJclŝŶŝcs of Ɖrŝǀate hosƉŝtals. IŶ Injmŝr aŶd MuŐla͕ other tourŝsƟc cŝƟes ŝŶ our couŶtrLJ͕ tourŝsts receŝǀed treatmeŶt maŝŶlLJ ŝŶ surŐerLJ ďraŶches͕ aŶd ŝŶ emerŐeŶcLJ ƉolLJclŝŶŝcs aŶd ŝŶterŶal medŝcŝŶe ďraŶches. The Ŷumďer of tourŝsts ŝŶ thŝs cateŐorLJ ǁho admŝƩed to Ɖrŝǀate hosƉŝtals ŝŶ AŶŬara seems to ďe less thaŶ ŝt ŝs ŝŶ other ƉroǀŝŶces. IŶ thŝs case͕ ǁheŶ ǁe haŶdle AŶŬara ŝŶdeƉeŶdeŶtlLJ͕ ŝt ŝs Ɖossŝďle to saLJ that ŝŶ AŶŬara the Ŷumďer of ƉaƟeŶts admŝƩed to the emerŐeŶcLJ ƉolLJclŝŶŝcs ŝs slŝŐhtlLJ more that the oŶes ǁho admŝƩed to other ďraŶches. IŶ ALJdŝŶ more tourŝsts admŝt to ŝŶterŶal medŝcŝŶe deƉartmeŶts ŝŶ Ɖrŝǀate hosƉŝtals͕ ǁhereas ŝŶ Neǀsehŝr͕ Bursa aŶd TraďnjoŶ͕ the Ŷumďer of ƉaƟeŶts treated ŝŶ the emerŐeŶcLJ ƉolLJclŝŶŝc aŶd other ƉolLJclŝŶŝcs ŝs hŝŐher thaŶ ŝt ŝs ŝŶ the other deƉartmeŶts. 52 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 dĂďůĞϭϯ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚͲEƵŵďĞƌŽĨdŽƵƌŝƐƚƐZĞĐĞŝǀŝŶŐDĞĚŝĐĂůdƌĞĂƚŵĞŶƚŝŶWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐďLJ Branch ACL POLKLNE ADMITTED TO PROVINCE PATIENT L BAVURAN EMERGENCY HASTA PEDIATRIC ÇOCUK INTERNAL DÂHLYE HEALTH AND BÖLÜMÜ DISEASES DISEASES OTHER DER CERRAH SURGERY ;POLYCLINIC TO BE (POLKLNK BÖLÜMLER UNITS MENTIONED) BELRTLECEK) TRANSFER BY AMBULANS AMBULANCE NAKL ;LANDͬAIR) ( KARA / HAVA) ANTALYA 7287 5177 5677 9001 5361 1089 STANBUL 3116 1253 554 1916 4619 350 MULA 1842 1696 559 2343 128 593 ZMR 243 121 149 827 398 0 ANKARA 44 10 0 9 11 0 AYDIN 103 491 277 319 315 16 TRABZON 28 7 6 44 102 0 BURSA 82 43 30 16 348 0 NEVEHR 537 35 7 6 0 213 KONYA 29 17 6 24 16 0 IŶ the cateŐorLJ of health of the tourŝst͖ ŝŶ reŐards to the Ŷumďer of ƉaƟeŶts ŝŶ Ɖrŝǀate hosƉŝtals AŶtalLJa aƉƉears to ďe ǁell ahead of other ƉroǀŝŶces ŝŶ all ďraŶches ;Taďle 13). IŶ the cateŐorLJ of Health of the tourŝsts͕ ŝt ǁas aŶ edžƉected result that ŝŶ most of the ƉroǀŝŶces the Ŷumďer of ƉaƟeŶts admŝƫŶŐ to the emerŐeŶcLJ ƉolLJclŝŶŝcs of the Ɖuďlŝc hosƉŝtals ŝs more thaŶ the Ŷumďer of admŝssŝoŶ to other deƉartmeŶts. Because ŝŶ such cases the tourŝsts eŝther Őet suddeŶlLJ sŝcŬ or haǀe aŶ accŝdeŶt. GŝǀeŶ the fact that the tourŝsts ǁho admŝt to other ďraŶches do Ŷot haǀe aŶ emerŐeŶcLJ sŝtuaƟoŶ aŶd ŐeŶerallLJ admŝt to a hosƉŝtal ŝŶ a ƉlaŶŶed ǁaLJ͕ ŝt ŝs Ŷot surƉrŝsŝŶŐ to see the tourŝsts ƉreferrŝŶŐ Ɖrŝǀate hosƉŝtals. ϲ Ͳ Heaůth Tourism By Country IŶ thŝs Ɖart of our studLJ͕ ǁe ǁŝll scruƟŶŝnje ŝŶ the cateŐorLJ of the health tourŝst the dŝstrŝďuƟoŶ of health tourŝsts ǁho traǀeled to TurŬeLJ ďLJ theŝr couŶtrLJ of orŝŐŝŶ͖ the Ŷumďer of health tourŝsts ďLJ theŝr ƉrefereŶce of Ɖuďlŝc or Ɖrŝǀate hosƉŝtals͖ ŝŶ the cateŐorLJ of health of the tourŝst͕ the dŝstrŝďuƟoŶ of the tourŝsts ďLJ theŝr ƉrefereŶce of Ɖuďlŝc or Ɖrŝǀate hosƉŝtals͖ the ďraŶches ŝŶ ǁhŝch the health tourŝsts receŝǀe treatmeŶt ŝŶ the Ɖuďlŝc aŶd Ɖrŝǀate hosƉŝtals seƉaratelLJ͕ aŶd the dŝstrŝďuƟoŶ of the secƟoŶsͲ ďraŶches͕ ŝŶ ǁhŝch the tourŝsts comŝŶŐ to TurŬeLJ for reasoŶs other thaŶ receŝǀŝŶŐ treatmeŶt haǀe to admŝt to ŝŶ our couŶtrLJ͕ are ŐoŝŶŐ to ďe scruƟŶŝnjed ďoth ŝŶ terms of Ɖuďlŝc aŶd Ɖrŝǀate hosƉŝtals. As of 2Ϭ11͕ 449 ƉaƟeŶts ǁho came from AnjerďaŝũaŶ to TurŬeLJ ǁere treated ŝŶ Ɖuďlŝc hosƉŝtals. Thŝs Ŷumďer reƉreseŶts 22й of health tourŝsts are treated ŝŶ Ɖuďlŝc hosƉŝtals ŝŶ our couŶtrLJ. Thŝs ŝs folloǁed ďLJ health tourŝsts from GermaŶLJ ǁŝth 22й. The role of the TurŬŝsh cŝƟnjeŶs lŝǀŝŶŐ ŝŶ GermaŶLJ edžƉatrŝates ŝs coŶsŝdered to ďe sŝŐŶŝĮcaŶt ŝŶ GermaŶLJ͛s haǀŝŶŐ the secoŶd Ɖlace ;FŝŐure 32͕ 33). Numďer of PaƟeŶt &ŝŐƵƌĞϯϮ͗,ĞĂůƚŚdŽƵƌŝƐŵʹŝƐƚƌŝďƵƟŽŶŽĨEƵŵďĞƌŽĨWĂƟĞŶƚƐďLJŽƵŶƚƌLJʹWƵďůŝĐ,ŽƐƉŝƚĂůƐ;ĮƌƐƚϭϬ countries) ŝũaŶ rďa Anje Numďer of PaƟeŶt aŶLJ rm Ge AnjerďaŝũaŶ GermaŶLJ a rŝ lŐa Bu BulŐarŝa ŝa orŐ Ge GeorŐŝa Ƌ Ira IraƋ 53 a ssŝ Ru Russŝa Ŭm Tur Ŷ ŝsta eŶ TurŬmeŶŝstaŶ ce Ŷ Fra FraŶce a Ŷ ŝ SLJr SLJrŝa Ira IraŶ EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &ŝŐƵƌĞϯϯ͗,ĞĂůƚŚdŽƵƌŝƐŵʹŝƐƚƌŝďƵƟŽŶŽĨWĂƟĞŶƚƐďLJŽƵŶƚƌLJʹWƵďůŝĐ,ŽƐƉŝƚĂůƐ;ĮƌƐƚϭϬĐŽƵŶƚƌŝĞƐͿ eŶ ŝst aŶ SLJ rŝa Tu rŬ m Ru ss ŝa Ira Ŷ Ira Ƌ Ge or Őŝa Fr aŶ ce rŝa Bu lŐa Ge r Anj er ďa m ŝũa Ŷ aŶ LJ Numďer of PaƟeŶts It has ďeeŶ ŝdeŶƟĮed that ǀast maũorŝtLJ of health tourŝsts ǁho Ɖrefer Ɖrŝǀate hosƉŝtals for treatmeŶt ŝŶ our couŶtrLJ͕ come from GermaŶLJ aŶd BulŐarŝa͕ resƉecƟǀelLJ. At the same Ɵme͕ from deǀeloƉed couŶtrŝes such as the UŶŝted KŝŶŐdom aŶd UŶŝted States serŝous Ŷumďer of health tourŝsts came to our couŶtrLJ ;FŝŐure 34͕ 35). Numďer of PaƟeŶts &ŝŐƵƌĞϯϰ͗,ĞĂůƚŚdŽƵƌŝƐŵͲŝƐƚƌŝďƵƟŽŶŽĨWĂƟĞŶƚƐďLJŽƵŶƚƌLJͲWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐ;ĮƌƐƚϭϬĐŽƵŶƚƌŝĞƐͿ aŶLJ rm Ge Numďer of PaƟeŶt rŝa lŐa Bu GermaŶLJ Ƌ Ira BulŐarŝa Ŷŝa LJa Lŝď ma Ru IraƋ RumaŶŝa ŝũaŶ Őla EŶ rďa Anje AnjerďaŝũaŶ LŝďLJa Ŷd d llaŶ Ho EŶŐlaŶd HollaŶd A US USA a ssŝ Ru Russŝa &ŝŐƵƌĞϯϱ͗,ĞĂůƚŚdŽƵƌŝƐŵʹŝƐƚƌŝďƵƟŽŶŽĨWĂƟĞŶƚƐďLJŽƵŶƚƌLJʹWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐ;ĮƌƐƚϭϬĐŽƵŶƚƌŝĞƐͿ 54 Ru ss ŝa US A d Ho lla Ŷ Ŷd EŶ Őla Ŷ ŝũa Anj er ďa Lŝď LJa aŶ ŝa m Ru Ƌ Ira rŝa Bu lŐa Ge rm aŶ LJ Numďer of PaƟeŶts EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 It ŝs ŬŶoǁŶ to eǀerLJďodLJ that esƉecŝallLJ durŝŶŐ the summer seasoŶ͕ our couŶtrLJ hosts tourŝsts from all oǀer the ǁorld couŶtrŝes as a haǀeŶ for ǀacaƟoŶ. ForeŝŐŶ tourŝsts freƋueŶtlLJ ǀŝsŝt our couŶtrLJ sŝŶce theLJ ǁaŶt to sƉeŶd theŝr holŝdaLJs receŝǀŝŶŐ cheaƉ ďut hŝŐhͲƋualŝtLJ serǀŝce. IŶ ƉarƟcular͕ from edžƉeŶsŝǀe aŶd cold couŶtrŝes such as GermaŶLJ͕ Russŝa͕ the NetherlaŶds aŶd FraŶce͕ maŶLJ tourŝsts ŇocŬ to TurŬeLJ ŝŶ the summer. It has ďeeŶ fouŶd out that ǁheŶ the tourŝsts ǁho come to TurŬeLJ for holŝdaLJ Őet sŝcŬ or haǀe aŶLJ accŝdeŶt͕ 3ϴй of them Ɖrefer Ɖuďlŝc hosƉŝtals. The ǀast maũorŝtLJ of thŝs rate coŶsŝsts of tourŝsts from GermaŶLJ͕ AnjerďaŝũaŶ͕ GeorŐŝa͕ Russŝa ;FŝŐ. 36͕ 37). SŝŶce AnjerďaŝũaŶ ŝs a couŶtrLJ that has ďusŝŶess coŶŶecƟoŶs ǁŝth TurŬeLJ for maŶLJ LJears͕ maŶLJ AnjerďaŝũaŶŝ cŝƟnjeŶs come to our couŶtrLJ for ǀacaƟoŶ aŶd leŝsure͕ as ǁell as for ďusŝŶess ƉurƉoses. Therefore͕ ŝŶ the cateŐorLJ of the health of the tourŝst͕ ŝt ŝs Ŷo surƉrŝse that AnjerďaŝũaŶ ŝs amoŶŐ the Įrst 1Ϭ couŶtrŝes. SŝmŝlarlLJ͕ 2153 ƉaƟeŶts receŝǀŝŶŐ medŝcal treatmeŶt ǁŝthŝŶ the cateŐorLJ of health of the tourŝst ŝŶ Ɖuďlŝc hosƉŝtals are from GeorŐŝa aŶd the rate ŝs 11й. IŶ receŶt LJears͕ the ƉeoƉle of GeorŐŝa͕ ǁho haǀe dŝĸcultLJ ŝŶ aīordŝŶŐ theŝr lŝǀes ďecause of the ecoŶomŝc crŝsŝs ŝŶ GeorŐŝa͕ are taŬŝŶŐ care of ƉaƟeŶts͕ the elderlLJ or ďaďŝes ŝŶ our couŶtrLJ ŝŶ order to maŬe moŶeLJ. IŶ thŝs case͕ ǁheŶ those GeorŐŝaŶ ƉeoƉle ǁŝth Ŷo socŝal securŝtLJ ŝŶ TurŬeLJ͕ Őet sŝcŬ ŝt ŝs ŝŶeǀŝtaďle for them to Ɖrefer Ɖuďlŝc hosƉŝtals. Therefore͕ ǁe caŶ saLJ that the Ŷumďer of GeorŐŝaŶ tourŝsts ǁho come to our couŶtrLJ for ďusŝŶess reasoŶs mŝŐht ďe aďout 2153. IŶ addŝƟoŶ͕ the ǀŝsaͲfree traŶsŝƟoŶ from GeorŐŝa also helƉed the ŝŶcrease ŝŶ the Ŷumďer of ƉaƟeŶts comŝŶŐ for treatmeŶt. Numďer of PaƟeŶts &ŝŐƵƌĞϯϲ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚʹŝƐƚƌŝďƵƟŽŶŽĨEƵŵďĞƌŽĨWĂƟĞŶƚƐďLJŽƵŶƚƌLJʹWƵďůŝĐ,ŽƐƉŝƚĂůƐ;ĮƌƐƚ 10 countries) aŶLJ rm Ge ŝũaŶ rďa Anje GermaŶLJ Numďer of PaƟeŶt ŝa orŐ Ge a ssŝ Ru AnjerďaŝũaŶ Russŝa d llaŶ Ho HollaŶd GeorŐŝa a Ira Ŷ ŝ SLJr IraŶ SLJrŝa Ŷm De arŬ DeŶmarŬ ce Ŷ Fra FraŶce Őla EŶ Ŷd EŶŐlaŶd &ŝŐƵƌĞϯϳ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚʹŝƐƚƌŝďƵƟŽŶŽĨWĂƟĞŶƚƐďLJŽƵŶƚƌLJʹWƵďůŝĐ,ŽƐƉŝƚĂůƐ;ĮƌƐƚϭϬ countries 55 Ŷd EŶ Őla ce Fr aŶ Ŭ ŝa ar De Ŷm SLJ r Ŷ Ira d Ho lla Ŷ Ge or Őŝa Ru ss ŝa Ŷ ŝũa Anj er ďa Ge rm aŶ LJ Numďer of PaƟeŶts EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 OŶ the other haŶd͕ ŝŶ the health of the tourŝst cateŐorLJ ǁŝth reŐard to the Ŷumďer of the tourŝsts ƉreferrŝŶŐ Ɖrŝǀate hosƉŝtals GermaŶLJ͕ ǁŝth a stroŶŐ ecoŶomLJ͕ ŝs ǁell ahead of other couŶtrŝes. GermaŶLJ ŝs folloǁed ďLJ the RussŝaŶ FederaƟoŶ ǁŝth 29й rate aŶd 1133ϴ ƉaƟeŶts ;FŝŐ. 3ϴ͕ 39). There are ƉeoƉle comŝŶŐ to TurŬeLJ from AfŐhaŶŝstaŶ͕ oŶe of the Ɖoorest couŶtrŝes ŝŶ the ǁorld͕ aŶd receŶtlLJ from SLJrŝa͕ ǁhŝch has receŶtlLJ eŶtered ŝŶto a serŝous ecoŶomŝc ďoƩleŶecŬ͕ most of ǁhom are ďelŝeǀed to haǀe come to ǁorŬ ŝŶ TurŬeLJ. Therefore͕ ŝt ŝs Ŷo surƉrŝse that those ƉeoƉle are ŝŶ the ͞Įrst 1Ϭ͟ lŝst of Ŷot the Ɖrŝǀate hosƉŝtals ďut the Ɖuďlŝc hosƉŝtals. Numďer of PaƟeŶts &ŝŐƵƌĞϯϴ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚʹŝƐƚƌŝďƵƟŽŶŽĨEƵŵďĞƌŽĨWĂƟĞŶƚƐďLJŽƵŶƚƌLJʹWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐ ;ĮƌƐƚϭϬĐŽƵŶƚƌŝĞƐͿ LJ aŶ rm Ge Numďer of PaƟeŶt a ssŝ Ru GermaŶLJ d Ŷ lla Ho Russŝa HollaŶd ce Ŷ Fra FraŶce Ƌ Ira Ŷ ŝũa a erď Anj IraƋ AnjerďaŝũaŶ Ŷe raŝ UŬ UŬraŝŶe um lŐŝ taŶ hs Ŭ a nj Ka BelŐŝum KanjaŬhstaŶ Be LJa Lŝď LŝďLJa &ŝŐƵƌĞϯϵ͗,ĞĂůƚŚŽĨƚŚĞƚŽƵƌŝƐƚʹŝƐƚƌŝďƵƟŽŶŽĨWĂƟĞŶƚƐďLJŽƵŶƚƌLJʹWƌŝǀĂƚĞ,ŽƐƉŝƚĂůƐ;ĮƌƐƚϭϬ countries) Our couŶtrLJ has recorded a marŬed ŝmƉroǀemeŶt ŝŶ maŶLJ areas of medŝcŝŶe aŶd traŝŶs ǁorldͲ reŶoǁŶed ƉhLJsŝcŝaŶs aŶd scŝeŶƟsts. Both ǁŝth ƋualŝtLJ of her ƉhLJsŝcŝaŶs aŶd staī as ǁell as her fullͲ ŇedŐed hosƉŝtals ǁŝth ǁorldͲclass ƋualŝtLJ of serǀŝce coŶceƉt͕ TurŬeLJ turŶed ŝŶto a couŶtrLJ that ŝs ŝŶsƉŝred ďLJ most of the couŶtrŝes aŶd that caŶ comƉete ǁŝth the leader couŶtrŝes. As for the medŝcal ďraŶches Ɖreferred ďLJ the health tourŝsts ŝŶ our couŶtrLJ͕ Ŷumďer of the tourŝsts from ŶeŝŐhďorŝŶŐ couŶtrŝes of IraŶ aŶd AnjerďaŝũaŶ treated ŝŶ cardŝoloŐLJ deƉartmeŶt are more thaŶ the Ŷumďer of tourŝsts from other couŶtrŝes. For cardŝoloŐLJ ďraŶch͕ the IraŶŝaŶ aŶd the AnjerďaŝũaŶŝ health tourŝsts Ɖrefer Ɖrŝǀate hosƉŝtals rather thaŶ Ɖuďlŝc hosƉŝtals. The Ŷumďer of ƉaƟeŶts ŝŶ the OŶcoloŐLJ secƟoŶ from BulŐarŝa ŝs far ahead of the Ŷumďer of tourŝsts from other couŶtrŝes. For treatmeŶt͕ the BulŐarŝaŶ tourŝsts Ɖrefer Ɖrŝǀate hosƉŝtals to Ɖuďlŝc hosƉŝtals. We caŶ saLJ that ŝŶ receŶt LJears TurŬeLJ made a sŝŐŶŝĮcaŶt ŝmƉroǀemeŶt ŝŶ eLJe dŝsorders aŶd outƉacŝŶŐ maŶLJ couŶtrŝes ŝŶ thŝs reŐard Ŷoǁ turŶed ŝŶto a rŝǀal for deǀeloƉed couŶtrŝes. Most of the ƉaƟeŶts comŝŶŐ to TurŬeLJ from GermaŶLJ͕ AnjerďaŝũaŶ aŶd IraƋ͕ resƉecƟǀelLJ͕ for eLJe dŝsorder treatmeŶt Ɖrefer Ɖrŝǀate hosƉŝtals. The maũorŝtLJ of health tourŝsts comŝŶŐ for orthoƉedŝc treatmeŶt are from GermaŶLJ theLJ are treated ŝŶ Ɖrŝǀate hosƉŝtals ;FŝŐure 4Ϭ͕ Taďle 14). 56 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &ŝŐƵƌĞϰϬ͗ƌĂŶĐŚĞƐƚŚĞ,ĞĂůƚŚdŽƵƌŝƐƚƐƌĞĐĞŝǀĞƚƌĞĂƚŵĞŶƚ;ĮƌƐƚĮǀĞĐŽƵŶƚƌŝĞƐͿ GermaŶLJ ELJe OrthoƉedŝcs Prŝǀate Puďlŝc Puďlŝc Prŝǀate Puďlŝc Puďlŝc PlasƟc SurŐerLJ Russŝa Prŝǀate ELJe AnjerďaŝũaŶ Prŝǀate OŶcoloŐLJ BraŝŶ SurŐerLJ Prŝǀate Puďlŝc Puďlŝc Prŝǀate Puďlŝc CardŝoloŐLJ Prŝǀate IraƋ Prŝǀate Puďlŝc BulŐarŝa Other GermaŶLJ ŝs ŝŶ Įrst Ɖlace amoŶŐ the couŶtrŝes͕ ǁhere maŶLJ TurŬŝsh cŝƟnjeŶs resŝde. It ŝs Ŷo ŝŶdŝsƉutaďle that thŝs sŝtuaƟoŶ aīects the Ŷumďer of health tourŝst comŝŶŐ to our couŶtrLJ from GermaŶLJ. The Ŷumďer of health tourŝsts͕ ǁho come from GermaŶLJ for treatmeŶt of eLJe dŝseases͕ ŝs hŝŐher thaŶ the other ďraŶches. Moreoǀer͕ the Ŷumďer of ƉaƟeŶts ǁho Ɖrefer Ɖrŝǀate hosƉŝtals to receŝǀe treatmeŶt for eLJe dŝseases ŝs almost 42 Ɵmes hŝŐher thaŶ the Ŷumďer of tourŝsts ǁho Ɖrefer Ɖuďlŝc hosƉŝtals. The sŝtuaƟoŶ ŝs Ŷo dŝīereŶt ŝŶ other secƟoŶs. Whŝle the Ŷumďer of the tourŝsts ǁho Ɖreferred Ɖrŝǀate hosƉŝtals ŝŶ cardŝoloŐLJ ŝs aƉƉrodžŝmatelLJ 1ϴ Ɵmes aŶd ŝŶ orthoƉedŝcs 22 Ɵmes of the health tourŝsts ǁho Ɖreferred Ɖuďlŝc hosƉŝtals͕ data of 2Ϭ11 ŝŶdŝcate that from GermaŶLJ Ŷo health tourŝst admŝƩed to Ɖuďlŝc hosƉŝtals for oŶcoloŐLJ ďraŶch. The same sŝtuaƟoŶ also aƉƉlŝes to ƉlasƟc surŐerLJ aŶd ŶeurosurŐerLJ ďraŶches. IŶ DeŶtal dŝseases͕ there ŝs Ŷo ŐaƉ as larŐe as ŝŶ the other secƟoŶs. The health tourŝsts comŝŶŐ from GermaŶLJ for deŶtal treatmeŶt Ɖrefer Ɖrŝǀate hosƉŝtals to Ɖuďlŝc hosƉŝtals aŶd ŝts rate ŝs 5.6. dĂďůĞϭϰ͗ŝƐƚƌŝďƵƟŽŶŽĨWƵďůŝĐͲWƌŝǀĂƚĞ^ĞĐƚŽƌĂĐĐŽƌĚŝŶŐƚŽEƵŵďĞƌŽĨ,ĞĂůƚŚdŽƵƌŝƐƚƐďLJƌĂŶĐŚĞƐ CardŝoloŐLJ Kardiyoloji Puďlŝc Kamu 11 Öze l Puďlŝc Kamu 207 Prŝǀate BraŝŶ Beyin SurŐerLJ Cerrahisi OŶcoloŐLJ Onkoloji ELJe Göz PlasƟc Plastik SurŐerLJ Cerrahi DeŶtal Di OrthoƉedŝcs Ortopedi Öze l Puďlŝc Kamu Özel Prŝǀate Öze Puďlŝc Kamu Prŝǀate l Öze Puďlŝc Kamu Prŝǀate l Puďlŝc Kamu Öze l Puďlŝc Kamu 0 33 0 282 37 1558 0 131 12 68 4 257 75 132 1 48 6 Prŝǀate Prŝǀate Other Dier Öze l Puďlŝc Kamu Özel Prŝǀate 22 514 329 2580 7 70 53 32 64 Prŝǀate 13 301 2 416 9 37 594 10 359 14 225 29 515 2 60 1 51 25 385 66 1668 62 335 10 312 18 83 100 550 0 92 14 29 34 119 211 1132 8 50 5 162 3 32 17 200 2 14 7 42 35 103 76 545 Wŝth reŐard to BulŐarŝa͕ ǁŝth 4169 ƉaƟeŶts͕ oŶcoloŐLJ deƉartmeŶts of Ɖrŝǀate hosƉŝtals admŝt most of the health tourŝsts from BulŐarŝa. Health tourŝsts from IraƋ͕ AnjerďaŝũaŶ aŶd Russŝa also Ɖrefer Ɖrŝǀate hosƉŝtals. The Ŷumďer of ƉaƟeŶts admŝƫŶŐ to the ďraŶches of Ɖrŝǀate hosƉŝtals ŝs madžŝmum 6ϬϬ͕ aŶd oŶlLJ 29 ƉaƟeŶts from AnjerďaŝũaŶ admŝƩed to the Ɖrŝǀate hosƉŝtals ŝŶ TurŬeLJ for the treatmeŶt of deŶtal dŝseases. Hoǁeǀer͕ 25ϴϬ ƉaƟeŶts from GermaŶLJ͕ 166ϴ ƉaƟeŶts from IraƋ͕ 1132 ƉaƟeŶts from AnjerďaŝũaŶ ǁere treated ŝŶ other secƟoŶs of Ɖrŝǀate hosƉŝtals ŝŶ TurŬeLJ. 57 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 IŶ Ɖuďlŝc hosƉŝtals͕ the Ŷumďer of health tourŝsts ŝŶ the raŶŐe of 1Ͳ1ϬϬ. The Ŷumďer of health tourŝsts comŝŶŐ oŶlLJ from GermaŶLJ to the other ďraŶches of Ɖuďlŝc hosƉŝtals ŝs 329 dĂďůĞϭϱ͗ŝƐƚƌŝďƵƟŽŶŽĨWƵďůŝĐͲWƌŝǀĂƚĞ^ĞĐƚŽƌĂĐĐŽƌĚŝŶŐƚŽEƵŵďĞƌŽĨWĂƟĞŶƚƐŝŶƚŚĞ,ĞĂůƚŚŽĨƚŚĞ ƚŽƵƌŝƐƚƐďLJƌĂŶĐŚĞƐ EmerŐaŶcLJ Acil IŶterŶal Dahiliye ChŝldreŶ Çocuk Puďlŝc Kamu Prŝǀate Özel Puďlŝc Kamu Prŝǀate Özel Puďlŝc Kamu Prŝǀate Özel Puďlŝc Kamu Prŝǀate Özel Puďlŝc Kamu Prŝǀate Özel Puďlŝc Kamu Prŝǀate Özel GermaŶLJ Almanya 2451 1819 213 2494 246 1625 831 4419 1278 2358 2 130 Russŝa Rusya 1454 4018 78 943 64 2827 244 2074 562 1474 0 18 HollaŶd Hollanda 548 699 89 945 44 386 322 1067 482 861 2 1201 AnjerďaŝũaŶ Azerbaycan 1122 204 998 224 61 86 477 379 535 741 8 110 FraŶce Fransa 500 493 22 294 72 197 47 367 77 454 718 142 Dŝseases SurŐerLJ Cerrahi Other Dier AmďulaŶce Ambulans IŶ the health of the tourŝst cateŐorLJ͕ tǁo thŝrd of the tourŝsts from GermaŶLJ admŝƩed to emerŐeŶcLJ ƉolLJclŝŶŝcs of Ɖuďlŝc hosƉŝtals as a result of theŝr uŶedžƉected sŝcŬŶess. As for the tourŝsts from FraŶce͕ the Ŷumďer of tourŝsts ǁho Ɖrefer the emerŐeŶcLJ ƉolLJclŝŶŝcs of Ɖrŝǀate hosƉŝtals aŶd Ɖuďlŝc hosƉŝtals ŝs almost eƋual. As meŶƟoŶed earlŝer͕ ŝf ǁe are to maŬe our esƟmaƟoŶs ďasŝŶŐ oŶ the assumƉƟoŶ that other thaŶ the suddeŶ sŝcŬŶess cases͕ the admŝssŝoŶs are ƉlaŶŶed ŝŶ adǀaŶce͕ ǁe caŶ saLJ that the tourŝsts from GermaŶLJ aŶd FraŶce oŌeŶ Ɖrefer Ɖrŝǀate hosƉŝtals ŝŶ ŝŶterŶal͕ Ɖedŝatrŝc͕ surŐerLJ aŶd other secƟoŶs. At the same Ɵme͕ ǁhŝle 13Ϭ ƉaƟeŶts Ɖrefer Ɖrŝǀate amďulaŶce͕ oŶlLJ 2 ƉaƟeŶts called a stateͲoǁŶed amďulaŶce ;Taďle 15). Tourŝsts from Russŝa aŶd the NetherlaŶds ŝŶ case of emerŐeŶcLJ or other outƉaƟeŶt treatmeŶt haǀe mostlLJ Ɖreferred Ɖrŝǀate hosƉŝtals to Ɖuďlŝc hosƉŝtals. AƉƉrodžŝmatelLJ ϴ5й of tourŝsts comŝŶŐ from AnjerďaŝũaŶ aŶd admŝƫŶŐ to emerŐeŶcLJ clŝŶŝcs Ɖreferred Ɖuďlŝc hosƉŝtals Ɖrefer aŶd ǀast maũorŝtLJ of the ƉaƟeŶts haǀŝŶŐ treatmeŶt ŝŶ ŝŶterŶal medŝcŝŶe secƟoŶ Ɖreferred Ɖuďlŝc hosƉŝtals. IŶ surŐerLJ ďraŶches͕ the rate of ƉreferrŝŶŐ Ɖuďlŝc hosƉŝtals ŝs also hŝŐher. IŶ Ɖedŝatrŝc ďraŶches͕ other ďraŶches aŶd amďulaŶce serǀŝces͕ tourŝsts comŝŶŐ from AnjerďaŝũaŶ haǀe choseŶ Ɖrŝǀate hosƉŝtals. 58 SWOT ANALYSIS OF HEALTH TOURISM IN TURKEY EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 &) SWOT ANALYSIS O& Heaůth Tourism IN TURKEY AŶother ǁaLJ to eǀaluate the curreŶt state of Health Tourŝsm ŝŶ TurŬeLJ ŝs the SWOT aŶalLJsŝs. ThrouŐh the folloǁŝŶŐ eǀaluaƟoŶ of Health Tourŝsm sector as a ǁhole ǁe ǁŝll trLJ to Őŝǀe a ŐeŶeral ŝdea of the curreŶt sŝtuaƟoŶ ŝŶ TurŬeLJ. Oǀerall eǀaluaƟoŶ ǁŝll ďe ďLJ taŬŝŶŐ ŝŶto coŶsŝderaƟoŶ the streŶŐths aŶd ǁeaŬŶesses of the sector͕ as ǁell as the oƉƉortuŶŝƟes aŶd threats ŝt faces. STRENGTHS 1. IŶ the health sector͕ TurŬeLJ ŝs coŶsŝdered amoŶŐ the leadŝŶŐ couŶtrŝes ŝŶ the ǁorld ;ŝŶ health sector͕ TurŬeLJ ďoth has ƋualŝĮed humaŶ resources aŶd health ŝŶfrastructure aŶd techŶoloŐLJ) 2. IŶ TurŬeLJ there ŝs a ǁŝde raŶŐe of Tourŝsm oƉƉortuŶŝƟes that could haǀe ƉosŝƟǀe ŝŶŇueŶce oŶ the demaŶd for health serǀŝces͕ ;cultural Tourŝsm͕ relŝŐŝous Tourŝsm͕ marŝŶe Tourŝsm͕ Ŷature Tourŝsm͕ health aŶd sƉa Tourŝsm͕ etc.) 3. IŶ the serǀŝce sector TurŬeLJ ŝs ŝŶ a Őood sŝtuaƟoŶ aŶd the serǀŝce sector has a hŝŐh ƉosŝƟǀe ŝmƉact of Health Tourŝsm 4. TurŬeLJ ŝs amoŶŐ the Įrst couŶtrŝes ǁhŝch oīer Health Tourŝsm serǀŝces aŶd haǀe ŐaŝŶed edžƉerŝeŶce ŝŶ thŝs reŐard 5. Health care ŝs a relaƟǀelLJ ŝŶedžƉeŶsŝǀe comƉared to the adǀaŶced couŶtrŝes sellŝŶŐ health serǀŝces 6. There are ǀarŝous leŐal reŐulaƟoŶs aŶd state suƉƉort for Health Tourŝsm WEAKNESSES 1. As ŝŶ ŝŶdustrLJ͕ also ŝŶ health serǀŝces͕ ŝŶ ŐeŶeral͕ TurŬeLJ ŝs focused oŶ ƉroducƟoŶ aŶd relaƟǀelLJ ŶeŐlects marŬeƟŶŐ 2. VerLJ feǁ orŐaŶŝnjaƟoŶs ŝŶ ďoth Ɖuďlŝc aŶd Ɖrŝǀate sectors are ŝŶ aŶ acƟǀe eīort reŐardŝŶŐ Health Tourŝsm 3. WeaŬ ͞cooƉeraƟoŶͲcorƉoraƟoŶ culture͟ ǁhŝch ǁould helƉ the realŝnjaƟoŶ of the ŝŶteŐrated aƉƉroach ;health aŐeŶcŝes͕ Tourŝsm aŐeŶcŝes͕ marŬeƟŶŐ aŐeŶcŝes͕ loŐŝsƟcs aŶd traŶsƉort orŐaŶŝnjaƟoŶs͕ etc.) Health Tourŝsm reƋuŝre 4. LacŬ of clear ŶaƟoŶal strateŐLJ for the maŶaŐemeŶt of Health Tourŝsm 5. SŝŐŶŝĮcaŶt Ɖart of the hosƉŝtals͕ esƉecŝallLJ Ɖuďlŝc hosƉŝtals are Ŷot readLJ to Ɖroǀŝde Health Tourŝsm serǀŝce 6. At ƉreseŶt͕ ͞health of the tourŝst͟ serǀŝce ;the health serǀŝce receŝǀed for emerŐeŶcLJ sŝtuaƟoŶs ďLJ the tourŝsts ǁho come to our couŶtrLJ ǁŝth tourŝsƟc ƉurƉoses) ǁŝth a loǁ addedͲǀalue ŝs ƉreƉoŶderaŶt aŐaŝŶst ͞Health Tourŝsm͟ serǀŝce ;the health serǀŝce receŝǀed ďLJ the tourŝsts ǁho come to our couŶtrLJ ǁŝthŝŶ a ƉlaŶ to Őet health serǀŝce) ǁŝth a hŝŐh addedͲǀalue 7. LacŬ of deǀeloƉed aŶd fuŶcƟoŶŝŶŐ comƉreheŶsŝǀe sLJstems aŶd Ɖrocesses to record aŶd suƉerǀŝse the moďŝlŝtLJ ŝŶ terms of Health Tourŝsm at ŶaƟoŶal leǀel ϴ. The fact that the health care orŐaŶŝnjaƟoŶs lacŬ aƩeŶƟoŶ͕ sƉeed aŶd cooƉeraƟoŶ reƋuŝred to share data aŶd ŝŶformaƟoŶ ǁŝth the MŝŶŝstrLJ of Health. OPPORTUNITIES 1. TreŶd ŝŶ the ǁorld ŝŶ carrLJŝŶŐ the health serǀŝce ďeLJoŶd the ŶaƟoŶal ďorders ŝs ŝŶcreasŝŶŐ ;the ŝmƉact of ŐloďalŝnjaƟoŶ). 2. It ŝs ďecomŝŶŐ easŝer aŶd free of cost to oďtaŝŶ ŝŶformaƟoŶ oŶ health care facŝlŝƟes aŶd serǀŝces ŝŶ other couŶtrŝes ;throuŐh ǁeď sŝtes͕ eͲmaŝl͕ aŶd so oŶ). 3. TurŬeLJ͛s streŶŐth ŝŶ the ŝŶterŶaƟoŶal areŶa ŝŶcreased aŶd thus the ƉosŝƟǀe ƉerceƉƟoŶ that came out ŝŶ Ɖarallel. 61 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 4. MŝŶŝstrLJ of EcoŶomŝc Aīaŝrs suƉƉort edžƉorts of health serǀŝces ;suƉƉort ŝŶ research͕ oƉeŶŝŶŐ oĸce at the oǀerseas͕ aŶd ƉromoƟoŶ͕ etc.). 5. TurŬeLJ ŝs amoŶŐ the toƉ 1Ϭ ŝŶ the ǁorld ŝŶ Tourŝsm aŶd ŝŶ Ɵme she ǁŝll ďe much more seƩled ŝŶ the froŶt roǁ. 6. CŝƟnjeŶs of maŶLJ couŶtrŝes Ɖrefer to receŝǀe health care serǀŝces ŝŶ TurŬeLJ due to her ŐeoŐraƉhŝcal aŶd socŝoͲƉolŝƟcal ƉosŝƟoŶ. 7. IŶcreasŝŶŐ domesƟc comƉeƟƟoŶ ŝŶ health care Ɖromotes the edžƉort of health serǀŝces aďroad. ϴ. FŝŌLJ ƉerceŶt tadž relŝef of Ɖroceeds ŐaŝŶed from treatmeŶt of foreŝŐŶ ƉaƟeŶts has ďeeŶ eŶacted. 9. The Ŷumďer of the ƉeoƉle ;from LŝďLJa͕ AfŐhaŶŝstaŶ͕ etc.) ďrouŐht ďLJ the TurŬŝsh ŐoǀerŶmeŶt ŝŶto our couŶtrLJ as a maƩer of ŝŶterŶaƟoŶal ƉolŝcLJ aŶd the stateͲsuƉƉorted treatmeŶt of those ƉeoƉle ŝŶcreases. Thŝs causes ƉromoƟoŶ ͬ adǀerƟsemeŶt. 1Ϭ. TurŬeLJ also started to maŬe maŶLJ leŐal reŐulaƟoŶs related to Health Tourŝsm aŶd Health Tourŝsm started to ďe coordŝŶated ďLJ the MŝŶŝstrLJ of Health ŝŶ accordaŶce ǁŝth the Ŷeǁ orŐaŶŝnjaƟoŶ laǁ No. 663 of the MŝŶŝstrLJ of Health. 11. Health Tourŝsm has ďeeŶ coǀered sŝŐŶŝĮcaŶtlLJ ďoth ŝŶ the strateŐŝc acƟoŶ ƉlaŶ of the MŝŶŝstrLJ of Health aŶd ŝŶ the teŶth deǀeloƉmeŶt ƉlaŶ of TurŬeLJ. THREATS 1. The ƉolŝƟcal ŝŶstaďŝlŝtLJ ŝŶ ŶeŝŐhďorŝŶŐ couŶtrŝes aŶd ŝt ŝs Ɖossŝďle reŇecƟoŶ to TurŬeLJ 2. The ŐroǁŝŶŐ demaŶd for doctors ŝŶ WesterŶ couŶtrŝes due to the aŐŝŶŐ ƉoƉulaƟoŶ͕ aŶd the charm created ďLJ thŝs demaŶd to ǁorŬ aďroad ;thus ŝŶcreasŝŶŐ the ƉossŝďŝlŝtLJ of receŝǀŝŶŐ health care serǀŝces ǁhere theLJ are) 3. FreƋueŶt state ŝŶterǀeŶƟoŶ ŝŶ the health sector ŝŶ terms of leŐŝslaƟoŶ͕ the ŝŶsƟtuƟoŶs of the sector ;Ɖuďlŝc aŶd Ɖrŝǀate) haǀe to sƉeŶd Ɵme aŶd resources ŝŶ order to adaƉt the chaŶŐes reƋuŝred ďLJ these ŝŶterǀeŶƟoŶs aŶd͕ due to these reasoŶs lacŬŝŶŐ adeƋuate focus oŶ ŝssues reƋuŝrŝŶŐ loŶŐͲterm strateŐŝc aƉƉroaches such as Health Tourŝsm 4. LacŬŝŶŐ domesƟcallLJ͕ ŝŶsƟtuƟoŶs for accredŝtaƟoŶ oŶ the ďasŝs of ŝŶterŶaƟoŶal staŶdards 5. LacŬŝŶŐ serǀŝce staŶdards ŝŶ Health Tourŝsm͕ ƉossŝďŝlŝtLJ of edžƉerŝeŶcŝŶŐ ďad ŝŶcŝdeŶts aŶd haǀŝŶŐ ŶeŐaƟǀe ŶaƟoŶal ŝmaŐe as a result. WheŶ the ŝŶterŶal streŶŐths aŶd ǁeaŬŶesses aŶd edžterŶal oƉƉortuŶŝƟes aŶd threats are eǀaluated as a ǁhole͕ ŝt ŝs Ɖossŝďle to meŶƟoŶ that ŝŶ terms of Health Tourŝsm TurŬeLJ dŝsƉlaLJs the sƉecŝĮcaƟoŶs of aŶ actor at the ͞ďeŐŝŶŶer͛s leǀel͟. IŶ order to achŝeǀe a larŐe marŬet share ŝŶ the sector aŶd to ďe a leader͕ TurŬeLJ Ŷeeds to deǀeloƉ aŶd aƉƉlLJ ǀŝsŝoŶ͕ aƉƉroaches aŶd Ɖroũects ǁhŝch ǁould deǀeloƉ her streŶŐths aŶd maŬe uƉ her ǁeaŬŶesses oŶ oŶe haŶd aŶd taŬe the adǀaŶtaŐe of the oƉƉortuŶŝƟes aŶd elŝmŝŶate the threats oŶ the other. 62 CONCLUSION and RECOMMENDATIONS EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 G) CONCLUSION AND RECOMMENDATIONS IŶ the lŝŐht of the data collected from health ŝŶsƟtuƟoŶs oŶ the Health Tourŝsm͕ thŝs studLJ maŝŶlLJ aŶalLJnjed the Ŷumďer of the health tourŝsts͕ theŝr couŶtrŝes of orŝŐŝŶ͕ oŶ ǁhŝch ŝssues theLJ receŝǀed serǀŝce͕ aŶd so oŶ. IŶ addŝƟoŶ to these͕ hoǁeǀer͕ studŝes must ďe made oŶ ŝssues that ǁould ƉosŝƟoŶ TurŬeLJ ŝŶ the ǁorld͕ ǁould reǀeal the caƉacŝtLJ of health ŝŶsƟtuƟoŶs aŶd more ŝmƉortaŶtlLJ͕ the couŶtrŝes ǁhŝch comƉose a ƉoteŶƟal marŬet should ďe researched. Thus͕ aŶalLJsŝs of the ƉreseŶt sŝtuaƟoŶ ǁŝll ďe aďle to reach the rŝchŶess aŶd deƉth that ǁould ďe estaďlŝshed ďased oŶ deǀeloƉŝŶŐ strateŐŝes. AŌer aŶalLJsŝs of the curreŶt sŝtuaƟoŶ͕ eīorts oŶ the maŝŶ oďũecƟǀe of strateŐLJ deǀeloƉmeŶt should coŶƟŶue. These studŝes͕ ŐoŝŶŐ ďeLJoŶd a sŝtuaƟoŶ aŶalLJsŝs͕ ǁould shed lŝŐht oŶ the ƉracƟƟoŶers ŝŶ case ŐuŝdŝŶŐ strateŐŝes oŶ ǀarŝous leǀels caŶ ďe deǀeloƉed. For thŝs ƉurƉose͕ ƉarƟcularlLJ the MŝŶŝstrLJ of Health͕ ŝŶcludŝŶŐ other Ɖuďlŝc aŶd Ɖrŝǀate sector orŐaŶŝnjaƟoŶs ŝŶ health sector should focus oŶ deǀeloƉŝŶŐ strateŐŝes. DetermŝŶŝŶŐ strateŐŝes or master strateŐLJ for Health Tourŝsm͕ esƉecŝallLJ assessmeŶts of the folloǁŝŶŐ suďͲstrateŐŝes must ďe doŶe at the ŶaƟoŶal leǀel or oŶ the ďasŝs of ŝŶsƟtuƟoŶ ͬ orŐaŶŝnjaƟoŶ͕ aŶd ǀŝsŝoŶ͕ Őoals aŶd Ɖroũects should ďe created͗ POSITION STRATEGY͗ The ƉosŝƟoŶ strateŐLJ ǁould eŶaďle to ŝdeŶƟfLJ hoǁ to ƉosŝƟoŶ TurŬeLJ or the health care eŶƟƟes aŐaŝŶst the actors ;comƉeƟtors͕ customers͕ Ŷeǁ ŝŶǀestors͕ suƉƉlŝers aŶd suďsƟtuƟŶŐ sectors) of the Health Tourŝsm. GŝǀeŶ the edžŝsƟŶŐ aŶd ƉoteŶƟal comƉeƟtors ŝŶ the ǁorld͕ ǁhat should ďe the ƉosŝƟoŶ of TurŬeLJ or health care eŶƟtLJ ŝŶ Health Tourŝsm͍ Whŝch areas of health sector should ďe focused oŶ or haǀe ƉrŝorŝtLJ͍ Whŝle determŝŶŝŶŐ thŝs ƉosŝƟoŶ͕ ǁhat ŝs the ƉosŝƟoŶ of the ƉrŝmarŝlLJ ŝmƉortaŶt strateŐŝc customers͕ ďarŐaŝŶŝŶŐ Ɖoǁer of suƉƉlŝers of Health Tourŝsm sector ŝŶ the couŶtLJ aŶd aďroad͕ aŶd the status of the suƉƉorƟŶŐ aŶd suďsƟtuƟŶŐ sectors͍ GŝǀeŶ all thŝs͕ ǁhere aŶd hoǁ should TurŬeLJ or health care eŶƟƟes ƉosŝƟoŶ themselǀes ŝŶ the sector͍ To thŝs aŝm͕ ŝŶ the Health Tourŝsm ŝŶdustrLJ͕ ͞ŐeŶerŝc strateŐŝes͟ should ďe deĮŶed͕ aŶd ŝt must ďe determŝŶed͕ ǁhat ŐeŶerŝc strateŐLJ or strateŐŝes the couŶtrLJ or health care eŶƟƟes should Őŝǀe ƉrŝorŝtLJ. Choŝce of ŐeŶerŝc strateŐLJ ǁŝll clarŝfLJ the facts such as ǁhŝch customers should ďe focused oŶ͕ ǁhŝch serǀŝce chaŶŶels to use͕ the staŶdard of serǀŝce͕ ǁhat ŬŝŶd of admŝŶŝstraƟǀe structures are Ŷeeded͕ the ŶecessŝtLJ to haǀe ũoŝŶt marŬeƟŶŐ aŶd ŝŶformaƟoŶͲsharŝŶŐ ŶetǁorŬs. BASIC COMPETENCY STRATEGY͗ Basŝc comƉeteŶcLJ strateŐLJ ŝs Ŷeeded to determŝŶe ǁhat must ďe the resources aŶd caƉaďŝlŝƟes that ǁould eŶaďle TurŬeLJ or the health care eŶƟƟes to ďe dŝsƟŶŐuŝshed from aŶd suƉerŝor to theŝr comƉeƟtors ŝŶ other couŶtrŝes. The Įrst steƉ ŝs to determŝŶe the strateŐŝc ƉosŝƟoŶ͕ ǁhereas the determŝŶŝŶŐ the comƉeteŶcŝes or aďŝlŝƟes that ǁould ďe deǀeloƉed ďasŝŶŐ oŶ the Ɖreferred strateŐŝc ƉosŝƟoŶ ǁŝll ďe the secoŶd steƉ. ComƉeteŶce ďuŝldŝŶŐ ŝs oŶe of the most ŝmƉortaŶt strateŐŝc studŝes͕ ďecause the source of oďtaŝŶŝŶŐ aŶd maŝŶtaŝŶŝŶŐ comƉeƟƟǀe adǀaŶtaŐe ŝs the comƉeteŶcŝes. ComƉeteŶcŝes caŶŶot ďe ďuŝlt ŝŶ short term. ComƉeteŶcŝes reƋuŝre ŝŶǀestmeŶt ŝŶ the loŶŐ term͕ feedŝŶŐ aŶd deǀeloƉmeŶt. IŶ thŝs coŶtedžt͕ the maŝŶ ƋuesƟoŶ to ďe aŶsǁered ŝs ǁhat should ďe the comƉeteŶcŝes that ǁould eŶaďle TurŬeLJ or the health care eŶƟƟes to ďe dŝsƟŶŐuŝshed from theŝr comƉeƟtors ŝŶ other couŶtrŝes͕ to ďe Ɖreferred aŶd Ɖroǀŝde a sustaŝŶaďle comƉeƟƟǀe adǀaŶtaŐe͖ aŶd hoǁ should ŝt ďe ďuŝlt͍ BUSINESS MODEL STRATEGY͗ BusŝŶess model strateŐLJ ǁould helƉ determŝŶŝŶŐ ǁŝth ǁhat ŬŝŶd of uŶderstaŶdŝŶŐ͕ Ɖrocess͕ sLJstem͕ orŐaŶŝnjaƟoŶal stLJle͕ aƉƉroach͕ etc. TurŬeLJ or the health care eŶƟƟes Ɖroǀŝde the health serǀŝce. Also the ďusŝŶess model aŶd serǀŝce ƉreseŶtaƟoŶ format͕ scoƉe aŶd coŶteŶt ǁŝll ďe determŝŶed. IŶ terms of customers͕ ďusŝŶess model ŝs a factor ǁhŝch theLJ ǁould aƉƉrecŝate faster aŶd thus maŬe theŝr ƉrefereŶces ŝŶ accordaŶce. Thŝs ŝs ǁhLJ the ďusŝŶess model strateŐLJ ŝs a 65 EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 crŝƟcal strateŐŝc success factor reŐardŝŶŐ aƉƉlŝcaƟoŶ aŶd ŝs oŶe of the most ŝmƉortaŶt comƉoŶeŶts of the master strateŐLJ. BusŝŶess model also has to ďe dLJŶamŝc. IŶ other ǁords͕ ƉroĮt njoŶes of the medŝcal Tourŝsm ŝŶdustrLJ ǁŝll chaŶŐe ŝŶ Ɵme. IŶ order to ŝdeŶƟfLJ͕ deǀeloƉ aŶd ďeŶeĮt strateŐŝcallLJ from the ƉroĮtaďle of suďͲsector areas͕ ŝt ǁŝll ďe ŝŶeǀŝtaďle to moŶŝtor the chaŶŐes oŶ oŶe haŶd aŶd to desŝŐŶ aŶd ŝmƉlemeŶt Ŷeǁ ďusŝŶess models oŶ the other. IŶ order to ďe amoŶŐ the leadŝŶŐ couŶtrŝes ŝŶ Health Tourŝsm͕ ŝt ŝs to maŬe ƉroŐress aŶd oďtaŝŶ a ƉosŝƟoŶ that caŶ comƉete ǁŝth other couŶtrŝes Ŷot oŶlLJ ŝŶ the Įeld of medŝcŝŶe ďut also ŝŶ maŶLJ other sectors. ParƟcularlLJ ŝŶ terms of hotel serǀŝces͕ aŐeŶcLJ acƟǀŝƟes͕ eŶǀŝroŶmeŶt͕ ŝŶfrastructure͕ archŝtecture͕ traŶsƉortaƟoŶ aŶd so oŶ͕ ŝt ŝs ŝmƉortaŶt to ďe dŝsƟŶŐuŝshed from other couŶtrŝes͕ to Ɖroǀŝde adǀaŶced serǀŝces aŶd ƉossŝďŝlŝƟes. IŶ order to ďe Ɖreferred ďLJ foreŝŐŶ tourŝsts͕ a couŶtrLJ must ďe ǁell ŬŶoǁŶ aŶd Ɖromoted ŝŶ maŶLJ areas other thaŶ ŝts success ŝŶ medŝcŝŶe. It ŝs ŶecessarLJ to haǀe hŝŐh ƋualŝtLJ͕ relŝaďle aŶd ǀŝsuallLJ aƉƉealŝŶŐ tourŝsƟc facŝlŝƟes. The ƉrofessŝoŶal aŐeŶcŝes haǀe sŝŐŶŝĮcaŶt role ŝŶ Health Tourŝsm sŝŶce theLJ caŶ ŝŶ a dŝscŝƉlŝŶed maŶŶer suƉƉlLJ tourŝsƟc facŝlŝƟes to sƉeŶt leŝsure Ɵmes as ǁell as the health facŝlŝƟes ƉroǀŝdŝŶŐ medŝcal treatmeŶt. Hoǁeǀer͕ the eŶǀŝroŶmeŶtal coŶdŝƟoŶs of the couŶtrLJ ǁhere the ƉaƟeŶts are suƉƉosed to receŝǀe treatmeŶt are ǀerLJ eīecƟǀe ŝŶ terms of ƉaƟeŶts͛ morale. Therefore͕ eŶǀŝroŶmeŶtal aŶd archŝtectural arraŶŐemeŶts are of Őreat ŝmƉortaŶce. IŶ order to ďecome a leader ŝŶ Health Tourŝsm͕ ŝŶ lŝŶe ǁŝth the aďoǀeͲmeŶƟoŶed strateŐŝc aƉƉroach͕ TurŬeLJ must taŬe the folloǁŝŶŐ coŶcrete steƉs͗ Focus oŶ MarŬeƟŶŐ͗ Success ŝŶ Health Tourŝsm deƉeŶds to a larŐe edžteŶt oŶ marŬeƟŶŐ. Health Tourŝsm Ŷecessŝtates focusŝŶŐ marŬeƟŶŐ acƟǀŝƟes aďroad͕ as ǁell as ǀersaƟle aŶd ƉrofessŝoŶal marŬeƟŶŐ eīorts. EmƉhasŝs oŶ staŶdardŝnjaƟoŶ aŶd accredŝtaƟoŶ͗ ŝdeŶƟĮcaƟoŶ of serǀŝce staŶdards ǁŝth the ŶaƟoŶal aŶd ŝŶterŶaƟoŶal accredŝtaƟoŶ orŐaŶŝnjaƟoŶs aŶd the ŝmƉlemeŶtaƟoŶ of those staŶdards are of crŝƟcal ŝssues for the success of medŝcal Tourŝsm. SustaŝŶaďŝlŝtLJ aŶd Ɖroǀŝde hŝŐhͲƋualŝtLJ serǀŝce are ǀerLJ ŝmƉortaŶt. To start Ɖlaƞorm oƉeraƟŶŐ sLJstem ŝmmedŝatelLJ ďoth ŝŶ Ɖrŝǀate sector aŶd ŝŶ stateͲsƉoŶsored sector͗ Health Tourŝsm maŶaŐemeŶt ŝs maŝŶlLJ carrŝed out ŝŶ Ɖlaƞorm maŶaŐemeŶt stLJle ǁhŝch ŝs carrŝed out electroŶŝcallLJ aŶd ǁhŝch ŝs ďased oŶ the ŝŶteŐraƟoŶ of maŶLJ ŝŶsƟtuƟoŶs aŶd the suďͲsectors. Plaƞorm oƉeraƟŶŐ sLJstems ŝs ŝŶeǀŝtaďle for Health Tourŝsm ŝŶ order to ďecome a larŐeͲscale sector. EstaďlŝshmeŶt͕ suƉerǀŝsŝoŶ aŶd deǀeloƉmeŶt of State sƉoŶsored ͞trust sLJstem͗͟ ͞trust͟ ŝs the ŐrouŶd oŶ ǁhŝch Health Tourŝsm moďŝlŝtLJ taŬes Ɖlace. It ǁŝll Ŷot ďe Ɖossŝďle to realŝnje or sustaŝŶ Health Tourŝsm ŝŶ a medŝa or coŶtact ŶetǁorŬ ǁhere trust does Ŷot edžŝst. CoŶĮdeŶceͲďuŝldŝŶŐ aŶd deǀeloƉmeŶt ŝs of crŝƟcal ŝmƉortaŶce ŝŶ thŝs resƉect. The estaďlŝshmeŶt of ŝŶteŐrated sLJstems͗ the deǀeloƉmeŶt of the sector to a larŐe edžteŶt ǁŝll deƉeŶd oŶ the estaďlŝshmeŶt of ŝŶteŐrated sLJstems ;leŐal ŝŶfrastructure͕ ŝŶceŶƟǀes͕ etc.) ďetǁeeŶ the maŝŶ ;hosƉŝtals) aŶd the suƉƉorƟŶŐ ŝŶsƟtuƟoŶs aŶd serǀŝces ;accredŝtaƟoŶ aŐeŶcŝes͕ marŬeƟŶŐ comƉaŶŝes͕ traŶsƉortaƟoŶ comƉaŶŝes͕ ŝŶsuraŶce comƉaŶŝes͕ tour oƉerators͕ etc.) PromoƟŶŐ aŶd ƉreƉarŝŶŐ for ŶoŶͲmedŝcal serǀŝces͗ SuƉƉorƟŶŐ comƉaŶŝes ;traŶsƉort comƉaŶŝes͕ Tourŝsm comƉaŶŝes͕ ŝŶsuraŶce comƉaŶŝes͕ etc) should ďe eŶcouraŐed aŶd suƉƉorted to ďecome a ƉlaLJer ŝŶ medŝcal Tourŝsm͕ ǁhŝch reƋuŝres dŝīereŶt stLJle from theŝr tradŝƟoŶal serǀŝces. IŶ terms of suƉƉort serǀŝces ŝŶterƉretaƟoŶ aŶd hotel serǀŝces haǀe ŝmƉortaŶt Ɖlace ŝŶ Health Tourŝsm. The ƉreƉaraƟoŶ of the ŶaƟoŶal Health Tourŝsm master ƉlaŶ͗ Both the deǀeloƉmeŶt a comƉreheŶsŝǀe aŶd loŶŐͲterm ͞ŶaƟoŶal master strateŐLJ͕͟ ǁhŝch ǁould ŝŶclude the suďͲstrateŐŝes such as the aďoǀeͲ meŶƟoŶed ƉosŝƟoŶ͕ comƉeteŶce aŶd ďusŝŶess model͕ aŶd the ŝmƉlemeŶtaƟoŶ of thŝs master strateŐLJ ŝŶ a ƉlaŶŶed maŶŶer ǁŝthŝŶ aŶ ŝdeŶƟĮed frameǁorŬ͕ are of Őreat sŝŐŶŝĮcaŶce to oďtaŝŶ aŶd sustaŝŶ ŶaƟoŶal comƉeƟƟǀe adǀaŶtaŐe. 66 SOURCES EVALUATION REPORT ON MEDICAL TOURISM IN TURKEY 2012 H) SOURCES AKAT͕ P. ;2ϬϬϬ). Panjarlama AŒŦrlŦŬlŦ Turŝnjm 7ƔletmecŝlŝŒŝ. MoƟf Matďaa. Bursa͕ TƺrŬŝLJe. GARCIAͲALTES͕ A. ;2ϬϬ5). The DeǀeloƉmeŶt of Health Tourŝsm Serǀŝces. AŶŶals of Tourŝsm Research. 32͕ 262–266. AKSU͕ A. ;2ϬϬ1). TurŝsƟŶ SaŒlŦŒŦ. YeŶŝ TƺrŬŝLJe DerŐŝsŝ͕ 7͕ 39. AYMAKUY͕ Y. ;2ϬϬ3). KoŶŐre Turŝnjmŝ ǀe Fuar OrŐaŶŝnjasLJoŶlarŦ. DetaLJ YaLJŦŶcŦlŦŬ. AŶŬara͕ TƺrŬŝLJe. BAKIRCI͕ M. ;2ϬϬ2). EŬo Turŝnjm II. Turŝnjm burasŦ Bŝldŝrŝlerŝ͕ Turŝnjm BaŬaŶlŦŒŦ YaLJŦŶlarŦ. COHEUR͕ A. ;2ϬϬ3). ͞HosƉŝtal CooƉeraƟoŶ͗ IŶ Border ReŐŝoŶs ŝŶ EuroƉe PracƟcal EdžƉerŝeŶcesͲ PersƉecƟǀes͕͟ Free MoǀemeŶtaďd CrossͲBorder CooƉeraƟoŶ ŝŶ EuroƉe͗ The role of HosƉŝtalsΘPracƟcal EdžƉerŝeŶces ŝŶ HosƉŝtals. LudžeŶďourŐ͗ EŶteŶtedes HosƉŝtaudž LudžemďourŐeoŝs. CONNELL͕ :. ;2ϬϬ6). Medŝcal Tourŝsm͗ Sea͕ SuŶ͕ SaŶdaŶd SurŐerLJ. Tourŝsm MaŶaŐemeŶt͕ 27͕ 1Ϭ93Ͳ11ϬϬ. D7NÇER͕ S. ;1995). ͞DoŒu KaradeŶŝnj YaLJlalar BƂlŐesŝŶde KƺltƺrelͲFŝnjŝŬŝ Çeǀre EtŬŝleƔŝmŝ ǀe Turŝnjm 7lŝƔŬŝlerŝ mnjerŝŶde Bŝr 7Ŷceleme͕͟ 7staŶďul TeŬŶŝŬ mŶŝǀersŝtesŝ͕ YƺŬseŬ LŝsaŶs Tenjŝ. ERDO)AN͕ H. ;1995). EŬoŶomŝŬ SosLJal Kƺltƺrel Çeǀresel YƂŶlerŝ ŝle UluslararasŦ Turŝnjm͕ UludaŒ mŶŝǀersŝtesŝ YaLJŦŶlarŦ͕ 1ϴ͕ ϬϬ3ͲϬ275. GILBERT͕ E. ;1954). BrŝŐhtoŶ͗ Old oceaŶ͛s ďauďle. LoŶdoŶ͗ MethueŶ GONALES͕ A.͕ BRENEL͕ L.͕ SANCHO͕ :. ;2ϬϬ1). Health Tourŝsm aŶd Related Serǀŝces͕ CarŝďďeaŶ DeǀeloƉmeŶt aŶd IŶterŶaƟoŶal Trade. FŝŶal ReƉort. ;Weď͗ ;hƩƉ͗ͬͬǁǁǁ.crŶm.orŐͬŝŶdedž. ƉhƉ͍oƉƟoŶсcomͺ docmaŶΘItemŝdсϴ5). KAYA͕ H. ;1996). 7ŶaŶĕ Turŝnjmŝ. PnjhaŶ MatďaasŦ͕ Bursa. MAINI͕ AŶŝl K. ;2ϬϬ9). SaŒlŦŬ TurŝnjmŝŶŝŶ GeleceŒŝ. SaŒlŦŬ Turŝnjmŝ BƺlteŶŝ͕ 7͕22. MUGOMBA͕ C. ǀe CABELLEROͲDANELL͕ S. ;2ϬϬ7)͕ ͞Medŝcal Tourŝsm͕ aŶd ŝts EŶtreƉreŶeurŝal OƉƉortuŶŝƟes Ͳ A CoŶceƉtual FrameǁorŬ for EŶtrLJ ŝŶ to the IŶdustrLJ͟ TourŝsmaŶd HosƉŝtalŝtLJ MaŶaŐemeŶt Master Thesŝs School of BusŝŶess͕ EcoŶomŝcsaŶd Laǁ͕ GoteďorŐ UŶŝǀersŝtLJ. ODEM7R. M. ;199ϴ). Turŝnjme FŝsŬe TaƔlarŦ ;19ϴ9Ͳ199ϴ). ReŬmaLJ Ltd. bƟ MatďaasŦ͕ AŶŬara. SMYTH͕ F. ;2ϬϬ5). Medŝcal GeoŐraƉhLJ͗ TheraƉeuƟcƉlaces͕ sƉacesaŶd ŶetǁorŬs. ProŐress ŝŶ HumaŶ GeoŐraƉhLJ͕ 29͕ 4ϴϴͲ495. T.C. SaŒlŦŬ BaŬaŶlŦŒŦ Tedaǀŝ Hŝnjmetlerŝ GeŶel MƺdƺrlƺŒƺ͕ ;2Ϭ11). ͞MedŝŬal Turŝnjm AraƔƨrmasŦ͕ 2Ϭ11͟. YALÇIN͕ P. ;2ϬϬ6). TƺrŬŝLJe͛de SaŒlŦŬ TurŝnjmŝŶde AltLJaƉŦ OluƔturulma GereŒŝ ǀe SaŒlŦŬ KurumlarŦŶa YƂŶelŝŬ Bŝr AraƔƨrma. AŶŬara Ganjŝ mŶŝǀersŝtesŝ SosLJal Bŝlŝmler EŶsƟtƺsƺ͕ 7Ɣletme AŶaďŝlŝm DalŦ͕ HastaŶe 7ƔletmecŝlŝŒŝ Bŝlŝm DalŦ ;YƺŬseŬ LŝsaŶs Tenjŝ 68