| Verified against primary record | |
| Leading EU origins, 2020 | France 1,646, Ireland 924 and Luxembourg 597 prior authorisation requests[1] |
|---|---|
| A measured prevalence | 1.32 per cent of respondents in eleven United States states and territories, 2016[2] |
| How the United States estimates spending | From a survey of international air travellers[3] |
| Records read | A Commission collection, a survey study and a statistical agency publication, 2 October 2026 |
| Independently reported | |
| Global ranking of origins | No measured basis located for any ranking of source countries |
| Bands apply only to the rows beneath them. The three collections measure authorisation requests, survey-reported travel and survey-reported spending respectively, and are not comparable. | |
Source markets in medical tourism are the countries patients travel from. The term comes from tourism marketing, where it describes a population to be sold to, and it carries that purpose with it: lists of the largest source markets are typically produced to guide promotion rather than to describe measured movement. This entry sets out what the origin side of a flow is actually measured by.
Three collections, three different quantities
Origin-side data exists in three forms, and the distinction between them matters more than the figures.
The first is administrative, recording applications made to a public payer. The European Commission’s collection under the cross-border healthcare directive reports countries of affiliation, and for 2020 the leading ones were France with 1,646 prior authorisation requests, Ireland with 924 and Luxembourg with 597.[1] That counts requests to a state, not patients and not journeys, and it covers only publicly funded care sought under one instrument. France could not separate requests made under the directive from those made under the social security coordination rules, and 2020 was pandemic-affected.[1]
The second is a population survey, asking residents whether they travelled. A study using a United States behavioural survey for calendar year 2016 found an overall medical tourism prevalence of 1.32 per cent, with a 95 per cent confidence interval of 1.00 to 1.64, among 93,492 respondents across eleven states and territories, of whom 517 were identified as medical tourists.[2] This is the only population-based measurement of outbound medical travel located for this site. It covers eleven states rather than a nation, and one year.
The third is a passenger survey used to estimate spending rather than numbers. The United States estimates health-related travel from the Survey of International Air Travelers, using data on the incidence and expenditures of travellers travelling for health purposes.[3] That produces a money figure for the origin economy as an import of services, not a patient count.
No two of those three can be combined. One counts applications, one counts survey respondents who say they travelled, and one estimates money from self-reported spending.
Why origin data is harder than destination data
A destination hospital sees every foreign patient it treats, even if it records them badly. An origin country sees almost nothing. A resident who flies abroad, pays privately for treatment and returns leaves no trace in any domestic health record, generates no claim against any payer, and appears in national statistics only if a survey happens to ask them.
That asymmetry explains why the only origin-side counts that exist are either administrative records of a payer relationship, which capture publicly funded care alone, or sample surveys, which capture a small number of respondents and carry sampling error. It also explains why complications returning home are so poorly documented across this site’s other entries: the home system first learns of the treatment when something goes wrong.
On rankings of source markets
Lists ranking the largest source markets circulate widely. No measured basis for any such ranking was located. A ranking would require a comparable count for each country, and the three collections described above exist for two countries, measure different things, and cover only part of each. A 2010 peer-reviewed review states that there is no reliable hard data on patient numbers, flows, treatment types and success rates.[4]
Where a ranking is offered, the four questions to ask of it are what is being counted, for which year, by whom, and whether the same thing was counted the same way in every country on the list.
See also
- Destination markets in medical tourism, the receiving side
- Medical tourism patient flows, the measured movement between the two
- Outbound medical tourism, the same phenomenon seen from the origin
- Medical tourism surveys, the instrument most origin data depends on
References
- Olsson J, De Smedt L, De Wispelaere F. Data on patient mobility under Directive 2011/24/EU: Trend report, reference years 2018 to 2020. European Commission, December 2021. Verified against primary record: official data collection opened and read. Retrieved 2 October 2026.
- Stoney RJ, Kozarsky P, Walker AT, Gaines J. Population-based surveillance of medical tourism among U.S. residents from 11 states and territories. Infection Control and Hospital Epidemiology, vol. 43, no. 7, July 2022; survey reference year 2016. Independently reported: peer-reviewed analysis of an official survey instrument. 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.
- Johnston R, Crooks VA, Snyder J, Kingsbury P. What is known about the effects of medical tourism in destination and departure countries? A scoping review. International Journal for Equity in Health, 9:24, 2010. Independently reported: peer-reviewed scoping review. Retrieved 2 October 2026.
Sourcing note: the Commission collection, the survey study and the statistical agency publication were opened and read on 2 October 2026. The three figures are kept separate because they measure authorisation requests, survey-reported travel and survey-reported spending respectively and cannot be combined. The Commission figures carry the limitations the Commission states. No ranking of source markets is given, and no global origin figures appear, because no measured basis for either was located.