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Medical Tourism - Destination - Turkey

General Informations

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Turkey attracts 165,000 medical tourists a year, mostly from Europe and Asia, who are attracted by the natural thermal baths and spas as well as the 35 JCI accredited medical facilities that Turkey has to offer. Cost savings of 58% and 40% when compared to the US and the UK respectively also help. Specialisations in Turkey cover the fields of cardiology, orthopaedics, assisted reproduction, cosmetic and plastic surgery and oncology. Through thorough promotion of Turkey as a medical tourism destination, it is hoped that 36% of its total tourism revenue will be from medical tourism by the end of 2010 despite the fact that the private health sector is relatively small and the public sector is weak.

Turkey
Localisation South-eastern Europe (3%) and South-western Asia (97%), bordering Bulgaria, Greece, Georgia, Armenia, Azerbaijan, Cyprus, Iran, Iraq and Syria
Capital Ankara
Biggest cities (population) Istanbul (9,216,400), Ankara (3,329,400), Izmir (2,322,500)
Inhabitants 74,816,000
Politics parliamentary republic
Religion Islam (99%), Christianity and Judaism (1%)
Currency Turkish Lira (TRY) = € 0.446230
GDP € 325,740 million, 1.20% of world’s GDP
Official language(s) Turkish
Climate Mediterranean and continental, average summer temperature is 30°C while it is around 0°C in winter
Time zone GMT +2
Happy Planet Index (HPI) 83

Cultural Aspects

General Culture

Turkey’s culture has derived from the varying influences of the Ottoman and Byzantine Empire, the Anatolian region and Western Europe. These impacts have resulted in a country that is essentially ‘modern’ and Western but with a high regard for religious traditions and values. This can be seen in the music of Turkey, which is a blend of Turkish, Arabic and European styles. It is these styles that can be identified in the cuisine of Turkey too. Most Turkish dishes consist of meat in some form, often kebabs. A traditional side dish is fruit, although it is often cooked with the meat. Eggplant holds a special place in Turkish cuisine with dishes such as moussaka revolving around this vegetable.

Safety

Turkey is number 121 on the GPI making it one of the more dangerous areas in its region so tourists must be aware of pickpockets and riots.

Tourists Attractions and Sights

  • Haghia Sophia Museum: a converted church that is a masterpiece depiction of Byzantine art in Istanbul
  • The Blue Mosque: located in Istanbul and so called because of the tiles that decorate the insides of the mosque. In the summer evenings, light and sound shows are played
  • Pamukkale: a geographical formation in Denizli from over 14,000 years ago that is said to produce water with healing qualities
  • Temple of Artemis: one of the Seven Wonders of the World, where St Paul lived and preached. It is located in Ephesus
  • Mount Nemrut: an extension of the hill range in Southeast Turkey, but also the home of the God Antiochos’ sanctuary with statues of Zeus, Apollo and himself

Visa Requirements

With regard to visas, any foreign national must possess a visa, which can be purchased on arrival and a passport valid for six months. Nationals of France, Germany, Greece, Italy, Luxembourg, Malta, the Netherlands and Spain may enter with a national ID card, which must have a validity of one year.

Infrastructure

Transportation

Not only does Turkey have satisfactory road conditions, the country also boasts rail connections with all surrounding countries, a metro system in Ankara, trams in Istanbul and the ‘Ankaray’ which is a mixture of the two latter transport options. In addition, alongside the bus services provided, there are ‘dolmuses’ which are small vans that carry 20 passengers at a time, and are a bus option specific for travelling to the countryside. Taxis are also available and are not particularly expensive although they do use liquefied natural gases, which require a tank in the boot so space may be limited for luggage.

For inbound tourists, Turkey boasts 117 airports (including military airports), with the seven international ones being located in the major tourist cities such as Ankara and Istanbul.

Accommodation

With cities such as Istanbul and Ankara being highly sought after destinations, accommodation possibilities cater to a large range of clients from backpackers to the luxury market, as well as offering many resorts. Tourists should be aware that a five star hotel may be a regional five star hotel, and resemble international three star quality. Hilton Worldwide has plans to triple their market share in Turkey through building more hotels, and Accor Hotels are building 38 new hotels by 2015.

Hospitals do not work together with hotels so often, but they do make reservations for patients’ families if requested. Hospitals sometimes have a small guesthouse on the premises for the accompanying people.

Health Care System

WHO ranking 70
Physicians per 10,000 population 16.0 (2006)
Nurses per 10,000 population 29.0 (2006)
GDP spent on health care 7.2% (2007)
Education period of doctors 6 years
Education period of specialists Additional 2 to 5 years

Health Care Providers

At this point in time, the system of health care delivery in Turkey is reasonably well organised compared to its middle- eastern neighbours, but not as developed as in Europe. Only 4% of the total number of hospital beds are provided by the private sector as the largest provider of health care is the Ministry of Health (MoH). Out of the 1,201 hospitals, 305 are run privately (25.4%), 677 are run by the MoH (56.7%) and Social Security Authority (SSK) run 115 (9.6%).

Insurance

The general rule is that everyone is insured and covered in case of an emergency similar to every other democracy. However, in Turkey, only 67.2% (2003) of Turks were covered. The main group which lacks insurance is the rural, low-income population. Those not insured can still receive ambulatory treatments, but not medication.

In 2001, the Turkish private insurance market was complied of 600,000 people who formed a USD 200 million market (€ 134 million). The Turkish insurance industry is targeting 6-8 million insurance holders before the year 2005. There are about 30 agencies that provide private insurance in Turkey.

Reforms / Policies

In the years since 2003, Turkey has been working on its health care five year plan. This reform was meant to organise health care better, provide more financing to the health care sector and decrease the difference between the standards provided to the privately and publicly insured populations.

Since 2003, the government has also been working on a plan to increase the percentage of the population covered by a valid insurance plan.

Medical Tourism

Being a popular tourist destination, Turkey received around 26 million international visitors in 2008. Out of these, 165,000 were estimated to be medical tourists, a 40% increase from 2007. This resulted in revenue of around USD 360 million (€ 240 million) and is said that 36% of the total tourism revenue by the end of 2010 will be from medical tourism. The majority of the medical tourists come for spas and thermal baths in regions such as Izmir. To promote medical tourism, Turkey annually publishes 5,000 copies of ‘Health Tourism Guidebook’, which is available in different languages and is distributed at conferences and fairs globally.

Flows

In 2007, the largest flow visiting were the British (30%), who rated Turkey as one of the top three medical tourism destinations, alongside Germans and Middle Eastern citizens.

Reasons

  • Proximity: the European location is attractive for Arabs as they consider this to be of superior quality whereas Europeans are attracted by the idea of cost savings.
  • Cost savings: the medical costs include cost savings of 58% and 40% when compared to the US and the UK respectively.

Specialisation

The main areas of medical specialisation in Turkey include:

  • Cardiology (cardiac bypass)
  • Dentistry
  • Orthopaedics (hip replacement)
  • Assisted reproduction
  • Cosmetic and plastic surgery
  • Oncology

Top Facilities

The top facilities have been selected using the following criteria’s, listed in order of importance: JCI Accreditation, ISQua accreditation, international orientation. In general national accreditation systems have not been taken into consideration, due to the fact that there are too many and judging them is out of the scope of this study. Turkey has 35 medical facilities that have been accredited by the JCI. The top five are as follows:

  • Anadolu Medical Centre, Kocaeli
  • Memorial Hospital (MHG) Istanbul, Istanbul
  • Sema Hospital, Istanbul
  • Acibadem International Hospital, Istanbul
  • American Hospital A.S., Istanbul

SWOT

Strengths Weaknesses
  • Increasing accommodation options
  • Natural spas and thermals
  • Established holiday destination
  • Promotion of medical tourism is in place
  • Located at the join of three continents
  • Cost savings of 58% and 40% compared to US and UK respectively
  • 35 JCI accredited medical facilities
  • Safety is an issue as it ranks 121 on the GPI
  • Small private sector in healthcare and low quality in public healthcare
  • Accommodation quality ratings can be misleading

Conclusion

Turkey boasts natural spas and thermal baths and 35 JCI accredited medical facilities that have been an advantage in bringing in the 165,000 medical tourists from Europe and Asia (mainly the UK). Cost savings exist of 58% and 40% when compared to the US and the UK respectively. Medical tourism is also encouraged through thorough promotion. However, the private health sector is relatively small and the public sector is weak. Nevertheless, Turkey is predicting that 36% of its total tourism revenue will be from medical tourism by the end of 2010.

Top Facility Chart

Turkey Anadolu Medical Centre Memorial Hospital (MHG) Istanbul Sema Hospital Acibadem International Hospital American Hospital A.S.
Location and website Kocaeli www.anadolusaglik. org Istanbul www.memorial. com.tr Istanbul www.semahospital. com Istanbul www. internationalhospital. com.tr Istanbul www. americanhospitalistanbul. com
Accreditations or certifications JCI, ISO 9001 - 2000, ISO 14001 JCI, ISO 9001, TS-EN-ISO-9001 JCI, ISO 9001, ISO 14001, OHSAS 18001 JCI, ISO 9001 JCI, ISO 9001, ISO 14001
Capacity of hospital beds 209 beds 213 beds 219 beds 106 beds 300 beds
Possible for accompanying person to stay in room No, but assistance with accommodation No, but assistance with accommodation Yes, in private rooms No, but assistance with accommodation Yes, in private rooms
Medical tourists 3,000, mainly US, UK, Europe, 50% from Romania and Bulgaria 8,500 from EU, US, Balkans, Azerbaijan, Iraq 3,466 of all, 56% Europe, 19% Middle East, 17% Asia Patients from Georgia, Serbia, Canada, Netherlands, UK and US Patients from US, Canada, Australia and New Zeeland
Number of medical staff doctors/nurses 150 physicians and 700 nurses Information N/A 74 physicians, 98 nurses, 50 specialists 1,000 physicians in 6 hospitals, 5 clinics and 1 speciality centre 451 specialists and 1,028 nurses
Type of rooms available (prices) Private single / deluxe rooms and suites (around € 300) Hospital-hotel 10 rooms (€ 80 to € 200) Private single / deluxe / executive rooms and suites Private single rooms Private single / deluxe rooms and suites (€ 200-€ 398)
International patient department Yes, they organise all the arrangements Yes, they organise all the arrangements Yes, they organise all the arrangements Yes, they organise all the arrangements Yes, they organise all the arrangements
Adaptations to cultures and nations Yes, in food, language and religious habits Yes, in food, language and religious habits Yes, in food Yes, in religious habits Yes, in religious habits
Languages spoken by staff Turkish, English, German, French, Spanish, Romanian, Russian, Arabic and Albanian Turkish, English, German, French, Spanish, Russian, Italian, Arabic and Albanian English, German, French, Azeri, Bulgarian, Arabic, Russian and Kurdish Turkish, English, German, French, Arabic, Italian, Spanish, Bulgarian, Russian, Persian and Albanian Turkish, English
Marketing of the facility/USP Johns Hopkins is strategic partner; cooperation with US & UK insurance companies Personalised assistance with all medical and travel arrangements; Participation at conferences and fairs Word of mouth advertising overseas, cooperation with foreign insurance companies and banks International hospital promotes itself using the advertising of Acibadem hospital group through online promotion, partnerships and conferences Publications, international collaboration with facilities in Texas, New York and EU's Institute of Oncology. Offer packages in IVF, Lasik eye surgery and birth
Specialisations Oncology, cardiology, orthopaedics, neurology traumatology, urology, ophthalmology, gastro-entology and paediatrics IVF, cardiology, genetics, orthopaedics and organ transplant Orthopaedics, cardiology, dentistry, plastic surgery, IVF, ophthalmology, neurosurgery Oncology, neurosurgery, cardiology, IVF, neurology, orthopaedics and ophthalmology IVF, ophthalmology, neurology, paediatrics, physiotherapy, rheumatology, urology, psychology

Price Chart (in €uro)

Treatment Average Price Anadolu Medical Centre Memorial Hospital (MHG) Istanbul
Cardiac bypass 12,025 13,250 N/A
Gastric bypass 7,925 N/A 16,587
Knee replacement 5,010 10,500 11,286
Hip replacement 4,676 12,250 14,587
Hip resurfacing 6,480 10,500 N/A
Botox treatment 221 N/A N/A
Breast augmentation 2,338 3,650 3,349
Facelift 2,338 5,500 2,870
Liposuction 1,670 5,000 2,870
Dental implants 802 1,350 1,000
Rhinoplasty 2,338 4,500 2,153
Lasik eye surgery 835 1,250 300

Note: All prices are estimates, and may vary widely from source to source depending on services included in the estimate (i.e. doctor’s fees, hospitalisation, administration costs or the patient’s age and medical history). Due to non-disclosure strategies of the various locations, it was not possible to make a clear separation between those factors. All prices given for the specific facilities have been provided by the hospitals/clinics themselves via email or telephone contact. The prices are given in Euros (€).

N/A means either that treatment are not available in the specific hospital, that a price estimation cannot be found or that the medical facility did not disclose the information. For the average prices, printed literature has been used before researching sources on the internet.