| Verified against primary record | |
| Tourism classification | Health and medical care is one of eight purpose categories, with no sub-structure[1] |
|---|---|
| EU cross-border activity | Prior authorisation requests received: 7,279 in 2018, 6,935 in 2019, 5,409 in 2020[2] |
| A measured prevalence | 1.32 per cent of respondents in eleven United States states and territories, 2016[3] |
| Records read | A tourism standard, an official data collection and four studies, 2 October 2026 |
| Independently reported | |
| State of the evidence | No authoritative data on the number and flow of medical tourists between nations[4] |
| Bands apply only to the rows beneath them. Every figure here carries its year and its source. No global patient count or market value appears, for the reasons set out below. | |
Medical tourism statistics are the attempts to count medical travel: how many people travel, where from and to, for what, and at what cost. This entry is about what the available statistics actually measure, how far they can be compared, and why the figures most widely circulated in this field cannot be traced to a measurement. It reproduces specific values only where they come from a dated and attributable dataset.
The definitional problem comes first
Before anything can be counted it has to be defined, and here the definition drives the answer more than the world does. A review commissioned by an international economic organisation found that published counts of medical tourists worldwide differed by orders of magnitude, and attributed the spread directly to method: in large part, it states, this disparity may be due to different definitions of medical tourism. It records that one firm’s markedly lower estimates arose from deliberately excluding dental patients and expatriates.[4] Two analysts can produce figures a hundredfold apart without either of them making an arithmetic error.
A peer-reviewed scoping review published in 2010 reached the same conclusion, stating that estimates of patient and currency inflows and their potential for growth are wildly varied, as definitional issues confound the already difficult attempt to determine the scale of the industry, and that there is no reliable hard data on patient numbers, flows, treatment types and success rates.[5]
The international statistical standard for tourism does not help as much as might be hoped. It classifies trips by main purpose, defined as the purpose in the absence of which the trip would not have taken place, and health and medical care is one of eight categories. That category has no sub-structure.[1] A cardiac bypass, a dental check-up and a spa visit all land in the same box, and the standard does not use the term medical tourism at all.
The three kinds of source
Almost every figure in this field comes from one of three places, and each has a characteristic limitation.
Administrative data is generated as a by-product of running a system. The European Commission’s collection under the cross-border healthcare directive is the clearest example, recording prior authorisation requests received as 7,279 in 2018, 6,935 in 2019 and 5,409 in 2020, with 5,220, 4,718 and 3,667 respectively authorised. Its own stated limitations are extensive: several countries could not answer parts of the questionnaire, which may lead to an underestimation; France could not separate requests made under the directive from those made under the social security coordination rules; eight countries operated no prior authorisation system at all; and 2020 was severely affected by the pandemic.[2] The collection has no field for the reason for travel and no breakdown by disease.
Surveys ask people directly. A population-based 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.[3] That is a genuine measurement with a denominator, a year and a confidence interval, and it is also the exception rather than the rule.
Balance of payments statistics measure money rather than people, under a definition set by an international manual. That route is covered in its own entry; the point to carry here is that a national revenue figure and a national patient count answer different questions and are produced by different machinery.
Comparability between countries
Even where countries collect the same nominal indicator, the results are not necessarily comparable. The European statistical office, which collects hospital activity data jointly with two other international bodies, states plainly that the comparability of data across member states is limited by the fact that national data is subject to the way in which information is available, and that some countries cannot cover all providers, with private hospitals noted as particularly difficult.[6] A figure that looks like a cross-country comparison may be a comparison of national recording practices.
How unsourced figures acquire authority
The 2010 scoping review describes the mechanism in one sentence that deserves quoting: initial estimates and ideas about medical tourism were heavily cited and recycled until they became treated as facts. Of the 203 sources it reviewed, only 6 were empirical studies reporting primary data, while 107 came from popular media, and almost all were speculative in nature.[5]
A 2014 commissioned review of the same literature found that reliable calculations of the actual volume of patient flow remain rare, and that most papers cited similar figures for patient flow but often sources were not accessible or figures were based on media reports or on other academic papers, which in turn quoted inaccessible sources. Only eight papers in that review had generated or collected their own data on patient flows.[7]
Those three reviews span 2010, 2011 and 2014. Their findings concern the structure of the evidence base rather than any particular number, which is why they remain useful, but they are dated and this entry does not assert that the position is unchanged today. What it does assert is that any figure offered for global medical travel volume or value should be traceable to a dated dataset with a stated method, and that the reviews found such traceability to be the exception.
See also
- Medical tourism market size, the figure most often quoted and least often traceable
- Administrative data in medical tourism research, the first of the three source types
- Medical tourism surveys, the second
- Medical tourism and balance of payments statistics, the third
References
- United Nations Statistics Division and World Tourism Organization. International Recommendations for Tourism Statistics 2008. Series M No. 83, Rev.1, New York, 2010. Verified against primary record: international statistical standard opened and read. Retrieved 2 October 2026.
- 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.
- Lunt N, Smith R, Exworthy M, Green ST, Horsfall D, Mannion R. Medical Tourism: Treatments, Markets and Health System Implications: A scoping review. 2011, commissioned by the OECD Directorate for Employment, Labour and Social Affairs. Verified against primary record: officially commissioned review 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.
- Eurostat. Health care activities: reference metadata. Verified against primary record: statistical metadata opened and read. Retrieved 2 October 2026.
- King H, in Lunt N, Smith RD, Mannion R, et al. Systematic review: what do we know about medical tourism? In Implications for the NHS of inward and outward medical tourism, NIHR Journals Library, January 2014. Independently reported: publicly commissioned peer-reviewed research. Retrieved 2 October 2026.
Sourcing note: the tourism standard, the Commission data collection, the statistical metadata and the four studies were opened and read on 2 October 2026. Every figure reproduced here carries its reference year and its source, and the Commission figures are given together with the limitations the Commission itself states. No global patient count or market value appears anywhere in this entry. The orders-of-magnitude spread between published counts is described rather than printed, because printing the competing figures would reproduce the claims this entry exists to question. The three literature reviews date from 2010, 2011 and 2014; their findings about the structure of the evidence base are reported with those dates attached and are not asserted as the current position.