| Verified against primary record | |
| What is counted | Medical and dental services, other health care, food, accommodation and local transport[1] |
|---|---|
| Its status | A supplementary item under the standard item personal travel, not part of required reporting[1] |
| How the United States estimates it | From a survey of international air travellers about incidence and expenditure[2] |
| Records read | A balance of payments guidance note, two national statistical sources and a state series, 2 October 2026 |
| Independently reported | |
| Averaging does not work | Applying an average medical expense to a patient count would not yield reasonably good estimates[1] |
| Bands apply only to the rows beneath them. Figures are given with their year and compiler. No global revenue figure appears. | |
Medical tourism revenue figures mostly come from one place: the travel account of a country’s balance of payments. Knowing that is enough to understand both what the figures include and why they are weaker than they look.
The definition, and what it covers
Under the international balance of payments framework, travel credits cover goods and services acquired from an economy by non-residents during visits to that economy. Health-related travel is a supplementary item under the standard item personal travel, and covers medical and dental services, other health care, food, accommodation and local transport acquired by persons travelling abroad for medical reasons.[1]
Two things in that follow immediately. The figure is not a measure of what hospitals earn: it includes hotels, meals and taxis. And a supplementary item is not part of the required standard reporting set, which is one reason coverage varies so much between countries.
The compilers’ own account of the problems
What makes this topic unusually well documented is that the task team revising the framework set out the defects in its own words. It records that different interpretations of what can and cannot be considered medical reasons, and who can and cannot be considered health travellers, could lead to differences in the coverage; that confusion may arise because health expenditure by those not travelling for a health purpose, for example people receiving health services during a holiday trip, is included under all other personal travel; and that national compilers have asked for these points to be explicitly clarified.[1]
Its annex on measurement difficulties is more striking still. Immigration offices cannot reliably separate patients from their companions where both travel on ordinary tourist visas. Hospitals and clinics lack information on companions staying outside the facility. Tourism surveys struggle because medical expenses vary tremendously across diseases and treatment techniques, which prevents compilers from forming clusters. And the note states directly that unlike the case of estimating expenses of normal tourists, applying an arithmetic or geometric average of medical expenses to the number of patients would not yield reasonably good estimates of health-related expenses.[1]
That last sentence matters because multiplying an average spend by a patient count is exactly how most quoted revenue figures are constructed.
Companions are outside the figure
The framework treats the accompanying person in a way that cuts against industry arithmetic. The residence of accompanying dependents of patients is determined in the same manner as the persons they accompany, but the task team recommended, for the next edition of the manual, categorising patients’ companions as normal travellers and recording all their expenses under other personal travel.[1] On that treatment the headline health-related travel figure deliberately excludes companion spending, which promotional estimates of a medical traveller’s economic value routinely include.
A seventh edition of the manual was released on 20 March 2025 under the title Integrated Balance of Payments and International Investment Position Manual.[3] Its own travel text was not read for this entry, so the treatment above is described as recommended and approved for inclusion rather than as what the new manual states.
What a national figure actually rests on
The United States publishes health-related travel separately within personal travel, alongside education-related travel and other personal travel. The method is stated plainly: for statistics on health-related travel, estimates use data from the Survey of International Air Travelers about the incidence and expenditures of travelers traveling for health purposes.[2]
So a national medical travel revenue figure of the kind quoted as industry evidence originates in a sample survey of air passengers, reporting their own purpose of travel and their own spending. It is a reasonable way to estimate the quantity. It is not a count of patients or of medical transactions, and it carries the sampling and self-report error of any passenger survey.
There is also a break in the series. Health-related travel was previously included in a category called other personal services, and moved into travel services with the monthly trade report of 4 June 2014, a change made to bring the accounts into closer harmony with trading partners and following a recommendation of the international manual.[4] Any time series spanning 2014 reflects that reclassification as well as any change in activity.
A worked example, and an incompatible pair
Turkey publishes a health tourism series sourced to its national statistical institute, recording revenue of about 1.46 billion United States dollars in 2019, 2.21 billion in 2022, 3.01 billion in 2023, 3.02 billion in 2024 and 3.02 billion in 2025, alongside aggregate patient counts.[5] That is a dated, attributable national series, and it carries no breakdown by procedure.
Against it sits a figure of 4.5 billion dollars for 2015, attributed in a professional society’s statement to a travel agency association. That is roughly three times the statistical institute’s own figure for 2019, a later year with a larger patient count. The two cannot both be describing the same quantity, and a trade association is not a statistical authority. They should never appear in the same series.
See also
- Medical tourism and balance of payments statistics, the framework in detail
- Medical tourism market size, the global figure and why it is not traceable
- Companions in medical travel, whose spending sits outside the figure
- Destination markets in medical tourism, where national series are published
References
- International Monetary Fund, Committee on Balance of Payments Statistics, Current Account Task Team. Guidance Note C.7: Treatment of Travel Packages, Health-Related Travel, and Taxes and Fees on Passengers’ Tickets. Approved March 2022. Verified against primary record: guidance note opened and read; the manual itself could not be opened and its definitions are quoted as this note reproduces them. Retrieved 2 October 2026.
- United States Bureau of Economic Analysis. U.S. International Services. Survey of Current Business, October 2020. Verified against primary record: statistical agency publication opened and read. Retrieved 2 October 2026.
- International Monetary Fund. IMF and Statistical Community Release New Global Standards for Macroeconomic Statistics. Press release PR25/072, 20 March 2025. Verified against primary record: press release opened and read. Retrieved 2 October 2026.
- United States Bureau of Economic Analysis. International Statistical Update: Health- and Education-Related Travel Now Part of Travel Services. 16 June 2014. Verified against primary record: statistical agency publication opened and read; it is a blog post and is cited as explanatory rather than as a methodology standard. Retrieved 2 October 2026.
- USHAS, Turkish state international health services company. Health Tourism Data. Page states the source as the Turkish Statistical Institute. Verified against primary record: official body republishing official statistics, opened and read. Retrieved 30 September 2026.
Sourcing note: the guidance note, the two statistical agency publications and the press release were opened and read on 2 October 2026; the Turkish series was opened for earlier work on this site and is dated accordingly. The manual the guidance note quotes could not be opened directly, so its definitions are attributed as the note reproduces them, and the seventh edition’s own travel text was not read. The treatment of companions is described as recommended and approved for inclusion rather than as what the new manual states. No global revenue figure appears, and the conflicting Turkish figures are set against each other rather than reconciled, because they come from bodies of different kinds.