Medical Tourism Patient Mortality

Medical tourism is a process in which a consumer travels from one's place of residence and receives medical treatment, thus becoming a patient. Patients Beyond Borders (PBB) forecasts some 1.9 million Americans will travel outside the United States for medical care in 2019. This chapter explores media representations of patient mortality associated with medical tourism within the global news media occurring between 2009-2019. A qualitative content analysis of 50 patient mortality cases found that (1) a majority of media representations of medical tourism patient death are of middle-class, minority females between 25-55 years of age who seek cosmetic surgery internationally; (2) sudden death, grief, and bereavement counseling is noticeably absent from medical tourism providers (MTPs); and (3) risk information from authority figures within the media reports is often vague and abstract. A detailed list of health communication recommendations and considerations for future medical tourists and their social support systems are provided.

Resurrecting the Hospital Autopsy: Impact of an Office of Decedent Affairs on Consent Rates, Providers, and Next-of-Kin

Context.— Autopsy rates have decreased dramatically despite providing important clinical information to medical practices and social benefits to decedents' families. Objective.— To assess the impact of an institutional Office of Decedent Affairs (ODA), a direct communication link between pathology and decedents' families, on hospital autopsy consent rates, autopsy-related communication, practitioner views, and next-of-kin experiences. Design.— A before and after study involving all hospital decedents whose deaths did not fall within the jurisdiction of the medical examiner's office from 2013 to 2018. A pathology-run ODA launched in May 2016 to guide next-of-kin through the hospital death process (including autopsy-related decisions) and serve as the next-of-kin's contact for any subsequent autopsy-related communication. Critical care and hematology/oncology practitioners were assessed for their autopsy-related views and decedents' next-of-kin were assessed for their autopsy-related experiences. Autopsy consent rates for non–medical examiner hospital deaths, autopsy-related communication rates, practitioner views on the role and value of autopsy, and next-of-kin autopsy experiences and decisions factors were compared prior to and after ODA launch. Results.— Autopsy consent rates significantly increased from 13.2% to 17.3% (480 of 3647 deaths versus 544 of 3148 deaths; P < .001). There were significant increases in the rate of autopsy-related discussions and bereavement counseling provided to decedents' families. Practitioner views on the positive role of autopsy for any hospital death and those with advanced stage cancer also significantly increased. Next-of-kin indicated more consistent autopsy-related discussions with the potential benefits of autopsy discussed becoming key decision factors. Conclusions.— An ODA improves hospital autopsy consent rates, autopsy-related communication, providers' autopsy-related views, and next-of-kins autopsy experiences.

Medical Tourism Patient Mortality

Medical tourism is a process in which a consumer travels from one's place of residence and receives medical treatment, thus becoming a patient. Patients Beyond Borders (PBB) forecasts some 1.9 million Americans will travel outside the United States for medical care in 2019. This chapter explores media representations of patient mortality associated with medical tourism within the global news media occurring between 2009-2019. A qualitative content analysis of 50 patient mortality cases found that (1) a majority of media representations of medical tourism patient death are of middle-class, minority females between 25-55 years of age who seek cosmetic surgery internationally; (2) sudden death, grief, and bereavement counseling is noticeably absent from medical tourism providers (MTPs); and (3) risk information from authority figures within the media reports is often vague and abstract. A detailed list of health communication recommendations and considerations for future medical tourists and their social support systems are provided.