Background: International travelers pursue medical care abroad for many reasons and have varied treatment outcomes.
Objective: Describe the nature of health care sought, treatments received, outcomes, reasons for planning medical care abroad, and outcomes for travelers who received planned healthcare outside of their country of residence.
Methods: GeoSentinel is a global data collection network of travel and tropical medicine providers that monitors travel-related morbidity. Records from the GeoSentinel database for travelers from May 2, 2017–March 24, 2020 were extracted for demographic, clinical, and travel information.
Results: Forty patients reported planned healthcare abroad. Median age was 40 years (range: 22-81); 25 (63%) were female. Only 4 (10%) reported pretravel encounters. Destination countries most frequently reported were the United States (n=6, 15%) , France (n=5, 12.5%), Dominican Republic (n=4, 10%), Belgium (n=3, 7.5%), and Thailand (n=3, 7.5%). The most frequent healthcare settings were hospitals (n=25, 62.5%), outpatient clinics (n= 7, 17.5%), and free-standing surgical facilities (n=3, 7.5%). The most frequent types of planned healthcare were medical (n=18, 45%), cosmetic procedures (n=9, 22.5%), surgical (n=5, 12.5%) and check up or consultation (n=3, 7.5%). Procedures included surgeries (cosmetic, cardiac, cholecystectomy, herniorrhaphy, ophthalmologic, orthopedic and laryngomalacia surgery), obstetrical care, and dental care. Twenty-three (57%) patients reported uneventful courses, 13 (32.5%) experienced early complications (infection, pain, re-surgery), and 4 (10%) reported late complications (infection, fistula). One-third of patients were hospitalized on return from travel. Reasons for planned healthcare abroad were unavailability of procedure at home (n=9, 18.8%), expertise abroad (n=9, 18.8%), less costly (n=8, 16.7%), more convenient (n=7, 14.6%), second opinion (n=4, 8.3%), trusted known doctor (n=3, 6%), and anonymity (n=1, 2%). The diagnoses for which travelers were seen at GeoSentinel sites after their planned healthcare abroad included: atypical mycobacterial skin lesion, skin and soft tissue infection, bacteremia, leishmania, schistosomiasis, and dog bite. Approximately 15 (37%) diagnoses were related to medical care abroad.
Conclusions: These data describe the spectrum of conditions and potential complications of travelers seen at GeoSentinel sites following planned healthcare abroad. Travelers with planned healthcare abroad often had conditions for which pre-travel consultations could provide advice and prevent complications.
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Abstract
Background: International travelers pursue medical care abroad for many reasons and have varied treatment outcomes.
Objective: Describe the nature of health care sought, treatments received, outcomes, reasons for planning medical care abroad, and outcomes for travelers who received planned healthcare outside of their country of residence.
Methods: GeoSentinel is a global data collection network of travel and tropical medicine providers that monitors travel-related morbidity. Records from the GeoSentinel database for travelers from May 2, 2017–March 24, 2020 were extracted for demographic, clinical, and travel information.
Results: Forty patients reported planned healthcare abroad. Median age was 40 years (range: 22-81); 25 (63%) were female. Only 4 (10%) reported pretravel encounters. Destination countries most frequently reported were the United States (n=6, 15%) , France (n=5, 12.5%), Dominican Republic (n=4, 10%), Belgium (n=3, 7.5%), and Thailand (n=3, 7.5%). The most frequent healthcare settings were hospitals (n=25, 62.5%), outpatient clinics (n= 7, 17.5%), and free-standing surgical facilities (n=3, 7.5%). The most frequent types of planned healthcare were medical (n=18, 45%), cosmetic procedures (n=9, 22.5%), surgical (n=5, 12.5%) and check up or consultation (n=3, 7.5%). Procedures included surgeries (cosmetic, cardiac, cholecystectomy, herniorrhaphy, ophthalmologic, orthopedic and laryngomalacia surgery), obstetrical care, and dental care. Twenty-three (57%) patients reported uneventful courses, 13 (32.5%) experienced early complications (infection, pain, re-surgery), and 4 (10%) reported late complications (infection, fistula). One-third of patients were hospitalized on return from travel. Reasons for planned healthcare abroad were unavailability of procedure at home (n=9, 18.8%), expertise abroad (n=9, 18.8%), less costly (n=8, 16.7%), more convenient (n=7, 14.6%), second opinion (n=4, 8.3%), trusted known doctor (n=3, 6%), and anonymity (n=1, 2%). The diagnoses for which travelers were seen at GeoSentinel sites after their planned healthcare abroad included: atypical mycobacterial skin lesion, skin and soft tissue infection, bacteremia, leishmania, schistosomiasis, and dog bite. Approximately 15 (37%) diagnoses were related to medical care abroad.
Conclusions: These data describe the spectrum of conditions and potential complications of travelers seen at GeoSentinel sites following planned healthcare abroad. Travelers with planned healthcare abroad often had conditions for which pre-travel consultations could provide advice and prevent complications.