International Accreditation Standards and the Benefits to Hospitals Attracting Medical Tourists: An Exploratory Study

Background

International accreditation for medical tourism facilities in several countries has grown rapidly for many years, in fact it was reported that it has been growing by about 20% a year [as of late 2017] (“Medical Wellness and Tourism”, 2017). It is often considered important for healthcare institutions that are attempting to attract international patients because it establishes a level of confidence, offers assurance of a specific baseline of quality, and create links with insurance companies ((“Medical Wellness and Tourism”, 2017). There are several international accreditation bodies that a hospital can choose from including country-based organizations like: 1) Joint Commission International (also called JCI; part of the Joint Commission which is the accreditation body for the USA health system); 2) Accreditation Canada; 3) Australian Council on Healthcare Standards International; 4) QHA Trent Accreditation (the UK accreditation body); and private organizations like 5) Global Healthcare Accreditation; and 6) TEMOS. In addition, there are ‘non-accreditation’ alternatives like the International Standards Organization (ISO) and Planetree certificates that hospitals can pursue as well. All of these organizations are seeking to enhance the medical tourism market and are responding to the growing hunger for recognition among the many competing countries and facilities (in what has been a lucrative market until the pandemic). The increasing number of alternatives has made the development of the international accreditation business very dynamic. More details about the various accreditation schemes can be found in the Appendix at the end of this paper.

International accreditation is a big investment and the total time for implementation can take from 18 months to two (2) years (Yan, 2015). In addition, the total cost of ownership for this effort is expensive and can cost around USD $108,000 (Salzman, 2017). The question then is, why do these hospitals spend hundreds of thousands of dollars and almost two years for this status? Salzman (2017), in a non-peer reviewed article, suggests that there are benefits for pursuing this route including a hospital experiencing a 14.3% compound annual growth rate (CAGR) revenue increase in 12 years after receiving accreditation and also an example of a facility saving more than USD $12 million over four years due to process improvements. These self-report numbers are impressive but the data in the literature paints a mixed picture. It appears to be clear that the preparation a hospital engages in for an accreditation audit does have a positive impact. Devkaran and O'Farrell (2014) found that “the results demonstrate that, although performance falls after the accreditation survey, the tangible impact of accreditation should be appreciated for its capacity to sustain improvements over the accreditation cycle” (p. 8). But is there a long-lasting and impactful change to the facility, particularly in its abilities to attract more international patients?