An evidence-based policy for improving choice in global health access through medical travel

Global medical travel has had an increasing trend without a comprehensive, evidence-driven policy to ensure safe and effective practice. To identify key factors that influence medical travel, we conducted a series of studies culminating with a preference and decision-making component of over 500 prospective medical travelers from a number of countries. Results indicated that quality of care was the most critical factor in the decision, followed by lower costs of procedure and shorter waiting times. Lower costs were less of a factor if the procedure was more invasive, which also increased the importance of waiting time in the decision. The most desired destinations for care were in Europe (United Kingdom, Germany) and North America (United States). Building on these insights and previous literature, we present a model that implements applications from these factors and additional insights generated across the series of studies toward an effective policy framework.     

The economic impact of H1N1 on Mexico's tourist and pork sectors

By examining tourist arrivals and pork output and trade statistics, this analysis estimates the economic impact to the Mexican tourism and pork sectors because of the H1N1 influenza pandemic. It also assesses the role of the international response in the context of this economic impact. For tourism, losing almost a million overseas visitors translated into losses of around $US2.8bn, which extended over a five‐month period, mostly because of the slow return of European travellers. For the pork industry, temporal decreases in output were observed in most of the country and related to H1N1 incidence (p = 0.048, r = 0.37). By the end of 2009, Mexico had a pork trade deficit of $US27m. The losses derived from this pandemic were clearly influenced by the risk perception created in tourist‐supplying and pork trade partners. Results suggest that the wider economic implications of health‐related emergencies can be significant and need to be considered in preparedness planning. For instance, more effective surveillance and data gathering would enable policy to target emergency funding to the sectors and regions hardest hit. These results also stress the importance of being familiar with trade networks so as to be able to anticipate the international response and respond accordingly. Copyright © 2012 John Wiley & Sons, Ltd.     

AIDS orphan tourism: A threat to young children in residential care

The dominant global perception that sub-Saharan Africa is experiencing an “AIDS orphan crisis”, coupled with growing trends in international voluntourism, has fostered a potentially high-risk situation for already vulnerable young children in the region. This article reviews the current discourse on what is being called a crisis of care for children, as well as literature on out-of-home/family care and its adverse impacts on child development. We also describe an emerging “AIDS orphan tourism”, and show how short-term attachments formed between children in group residential care and volunteers may worsen known impacts of institutional care. This article advocates against the exploitation of especially vulnerable young children in sub-Saharan Africa for commercial gain by tour operators in the current growth of “AIDS orphan tourism”. We instead propose that young people who wish to volunteer their time and talents to assist children less fortunate than themselves be properly informed about children's development and attachments to others, as well of the vulnerabilities and rights of young children, especially those outside of family care.     

旅游医疗发展与实施策略

目的：本文主要探讨通过某医院的旅游医疗战略,将某医院的医疗优势资源与三亚市的旅游优势资源相结合。方法本文首先分析旅游医疗相关概念及近年来国内外旅游医疗发展现状与问题,并结合某医院的实际分析医院开展旅游医疗工作的优劣势,同时综述医院战略及战略分析方法,并分析某医院的外部宏观环境和自身既定的内在条件。然后,依据上述分析,制订某医院开展旅游医疗的战略目标,确定旅游医疗的实施策略。结果某医院在内在条件及核心竞争力等方面的基础条件比较优越,应依靠内部的优势,不断捕捉外部机会,增强竞争实力,将旅游医疗培育成海南岛旅游的新兴支柱项目。某医院旅游医疗的发展战略应当包括：提高医疗水平、人力资源的合理配置、医疗资源的优化配置、持续开发市场、降低医疗成本,为患者提供高质量服务等。结论旅游医疗具有自身的独特性,某医院具有开展旅游医疗的优势,通过实施合理的策略,旅游医疗一定会蓬勃开展。     

The Determinants of Medical Tourism Intentions: Applying the Theory of Planned Behavior

This study introduces the theory of planned behavior to health care marketers by extending and replicating a prior study that predicted student's intention to engage in medical tourism. Based on a sample of 164 usable survey responses, our findings suggested that the MEDTOUR scale (developed and introduced a prior study) is robust and works reasonably well with a national sample. Based on these findings, MEDTOUR appears to be worthy of further consideration by health marketing scholars.     

A cross-sectional population-based study on the influence of the COVID-19 pandemic on incomes in Greece

The Coronavirus Disease 2019 (COVID-19) pandemic induced economic shock in Greece, which translated into a decrease in household income. Thus, the objective of this study is to measure social inequality with regard to income loss due to the COVID-19 pandemic in Greece. In addition, we aim to identify the characteristics of those experiencing income loss due to the pandemic. The study uses data from the “Public Opinion in the European Union (EU) in Time of Coronavirus Crisis. Third Round” survey. The sample consists of 1036 individuals aged between 16 and 54 years. To measure inequality, the Erreygers'' Concentration Index (CI) is calculated, using social class as the ranking variable. To identify the characteristics of those experiencing income loss, a logistic regression model is fitted using the region of residence and several demographic and socioeconomic variables as potential predictors. According to the results, social inequality does not exist with regard to income loss due to the COVID-19 pandemic. Thus, our findings indicate the negative influence of the pandemic on the incomes of individuals from all social classes in Greece. According to the results of the logistic regression model, the odds of experiencing income loss are higher for residents of the Aegean Islands and Crete but also for self-employed, part-time employed, and unemployed individuals. These findings indicate the negative influence of the pandemic on Greek tourism and on sectors employing a large proportion of non-standard workers. Although inequality does not exist, a substantial proportion of those losing income due to the pandemic is in line with the global picture.     

环鄱阳湖区旅游系统定位研究

本文首先指出现代市场营销学中所描述的定位是一个多维的过程,包括产品定位、市场定位、形象定位、功能定位等,已经形成了一个有机的整体,应该用全面的、系统的观点来指导定位,并给出了系统定位的概念。然后在对环鄱阳湖旅游营销环境认真分析的基础上,提出了环鄱阳湖区旅游的形象定位、市场定位、产品定位、功能定位。     

Long-term outcomes of kidney allografts obtained by transplant tourism: observations from a single center in Korea

Aim: Organ shortages lead end stage renal disease patients to seek overseas kidney transplantations (OTs), but the long‐term outcomes of OTs have not been evaluated extensively. Methods: Patients who received OT and were followed at Seoul National University Hospital (SNUH) from 2000 to 2009 (n = 87) were compared with patients who received kidneys from local donors (LTs) and were followed at SNUH (n = 577). Furthermore, we matched OT patients and LT patients via a propensity score using operation date, age, renal replacement therapy duration, and donor sources (n = 87 vs 87). Results: The recipient age was older in the OT group (48 vs 41 years), and donor age was younger in the OT group (29 vs 39 years). The estimated glomerular filtration rates (eGFR) of functioning grafts between the groups were not different throughout the follow‐up period. Biopsy‐proven acute rejection, infectious disease, and hospitalization were more frequent in the OT group (27/87 vs 141/577, log‐rank P < 0.001; 39/87 vs 28/577, log‐rank P < 0.001; 66/87 vs 99/577, log‐rank P < 0.001). The graft survival rate was lower in the OT group (82/87 vs 542/577, log‐rank P = 0.003). Patient survival rate, however, was similar between the groups. After propensity score matching, the donor age was still younger in the OT group (29 vs 38 years). The risks of biopsy‐proven acute rejection, infectious disease, and hospitalization were still higher in the OT group (27/87 vs 36/87, log‐rank P = 0.04; 39/87 vs 3/87, log‐rank P < 0.001; 66/87 vs 19/87, log‐rank P < 0.001). Conclusion: Overseas kidney transplantation connotes risk factors that may negatively affect the long‐term graft outcome.     

山岳型风景区旅游垃圾索道运输模式初析

介绍了垃圾索道运输技术的发展以及国外国家公园和我国风景名胜区旅游垃圾的管理概况,并根据山岳型风景区生态环保要求与地理特征提出采用游览索道运输景区垃圾的收运机械化新模式,探析了利用客运索道运输垃圾的可行性和原则要求。     

山西省旅游景点餐饮从业人员食品安全知识调查

目的了解旅游景点餐饮单位从业人员对食品安全知识的知晓情况及其影响因素,以保障游客饮食卫生安全,进一步促进旅游产业的发展。方法随机抽取山西省4A级旅游景点18个,在其周边饭店进行问卷调查。结果餐饮从业人员文化水平以初中和高中居多,分别占37.76%和31.12%;29.61%的人不知道原料采购索票制度;食品原料采购人员和管理人员对原料采购索票制度不知晓的占到25.25%,且不同组别调查的结果差别有统计学意义（X2=18.619 P〈0.05）;31.66%的人不能准确回答对传染病知晓情况;26.28%的人不知道有卫生领导小组和卫生制度;28.35%的人对当前山西省旅游餐饮安全形势的评分在60分以下;45.57%的受调查者认为造成目前餐饮安全问题的主要原因是不法食品生产加工企业和个人利欲熏心。结论山西省旅游景点餐饮从业人员的文化水平以中学为主,食品安全知识均较低。