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Regulating medical tourism: evidence from the Spanish case

Public economics

Senior Researcher : Judit Vall Castelló

Research Centre or Institution : Universitat de Barcelona. Fundació Institut d'Economia

Abstract

Medical tourism, defined as those individuals who travel to another country to receive medical treatment or surgery, is increasing in several parts of the world. This was also the case in Spain. In 2009, the Spanish government spent 441 million euros in medical assistance to non-residents. In response, in 2012, the Spanish government restricted free access to the public health system for those who do not legally reside in the country. In this project, we propose to analyze the effectiveness of the restriction in the deterrence and reduction of medical tourism  using  a  complete  administrative  data  set  of  all  medical procedures performed in Spain between 2008 and 2015. Methodologically, we will rely on a quasi­ experimental approach that exploits the geographical and temporal variation in access to public health care by non-residents. Specifically, we take advantage of the fact that the reform was implemented differently in all regions (hereinafter: autonomous communities) since sorne of them approved altemative measures to guarantee the continuous access of non-residents to the  public system, while others did  not. In assessing  its  impact, we distinguish between several types of medical interventions. In addition, we pay attention to the impact of the 2012 restrictions on the duration of treatments and hospital stays, the number of interventions, readmissions, financing used and the expenses incurred in medical care. We conclude with an approximate calculation of the savings obtained with the reform. We believe that the findings will be relevant for Spain, as we will evaluate the effectiveness of the policy in reducing medical intervention spending and in ensuring the sustainability of the public health system. However, the results of our project will also be important for other countries with similar experiences in the incidence of medical tourism.

 

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