Healthcare in the USA and Abroad: Patients’ Comparative Experiences Worldwide
Focused review of patient-experience studies, expanded to Asia, Europe, Turkey, and other destinations. Research involving U.S. patients is distinguished from international evidence that does not directly compare care with the USA. Publication dates are retained because several particularly relevant studies are older.
1. Summary
Expanding beyond the Western Hemisphere reveals a similar pattern: selected patients describe care abroad as more affordable, more accessible, and sometimes more personally attentive than care in the United States. Research involving U.S. residents includes treatment in Thailand, India, Eastern Europe, South Korea, and Turkey—not only Mexico and Panama. However, the evidence supports comparisons of patient experience more strongly than comparisons of clinical safety or treatment effectiveness. The essential distinction is experience versus independently measured clinical quality. See the Alaska patient-interview study, the Korean immigrant study, and the Turkey narrative study.
[1][2][3]This is a geographically expanded review, not a representative worldwide survey. The available studies do not establish a global percentage of patients who prefer foreign care, and many do not verify that every participant received comparable treatment in both countries. The report therefore distinguishes direct comparative accounts, U.S.-patient studies of care abroad, and broader international context.
2. Studies Involving U.S. Patients Outside the Western Hemisphere
A. Thailand, India, and Eastern Europe: Interviews With Alaska Residents
Eissler and Casken, “Seeking Health Care Through International Medical Tourism”, published in 2013, interviewed 15 Alaska residents who had traveled for medical or dental treatment. A subsequent integrative review’s study table reports that seven participants received care in Thailand, three in Eastern Europe, and one in India; destinations also included Mexico and Costa Rica. These destination counts overlap and should not be added to infer separate, nonoverlapping groups.
[1][4]- Standard of care: Patients described positive experiences with staffing, feelings of security, and having their healthcare needs met. The review quotes one participant saying, “I was amazed by the level of staffing.” These findings concern perceived care and service, not independently audited technical outcomes.
- Availability: Unmet healthcare needs and perceived failures in their local healthcare system helped motivate travel. Participants described finding treatment abroad that they believed they could not satisfactorily obtain at home.
- Cost: High domestic costs were an important reason for seeking alternatives. The accessible evidence does not provide a standardized, all-inclusive savings estimate.
This is particularly relevant evidence because it records U.S. residents’ own accounts across several world regions. Its limitations are the small, self-selected sample and the distinctive circumstances of Alaska; it cannot establish separate national ratings for Thailand, India, or individual Eastern European countries. Source for the detailed findings and limitations.
[4]B. South Korea: U.S. Immigrants Comparing Healthcare Options
Sou Hyun Jang’s 2017 doctoral dissertation, “Medical Transnationalism: Korean Immigrants’ Medical Tourism to the Home Country,” analyzed surveys of 507 Korean immigrants and interviews with 120 Korean immigrants in New York and New Jersey. These are overall study samples, not counts of people who all traveled for care. The study examined barriers to U.S. healthcare, domestic alternatives, and experiences of medical travel to South Korea.
[2]- Standard of care: The dissertation reports that the vast majority of immigrant medical tourists were satisfied with their experiences. Its accessible abstract does not supply an exact satisfaction percentage or establish equivalent clinical outcomes.
- Availability: More than half of the overall sample faced U.S. healthcare barriers; language and lack of insurance were the two largest. Care in South Korea offered an alternative within a familiar language and social environment.
- Cost: Insurance status and cross-border social ties strongly influenced the decision to travel. This makes the comparison partly one of access and coverage—not simply the price of an identical service.
This is substantial U.S.-based qualitative and survey evidence, but it concerns one immigrant community and is a doctoral dissertation rather than a nationally representative, peer-reviewed comparative survey. Study abstract and publication details.
[2]C. South Korea: Preventive Care and Screening Access
Ko and colleagues’ 2016 community-based study surveyed 193 Korean Americans aged 50–75 in metropolitan Seattle using data collected in 2013. Approximately one-third reported traveling abroad for healthcare within the previous five years; South Korea accounted for 95% of reported destinations. This study measures healthcare use and screening, rather than asking every participant to rate both systems.
[5]- Standard of care: The authors discuss earlier patient interviews describing good-quality care and advanced technology in South Korea. Those perceptions are background evidence, not clinical-quality findings established by this survey.
- Availability: The paper describes integrated preventive-care services that reduce the need for multiple referrals and visits. Participants who traveled for care were more likely to be up to date with colorectal cancer screening: 82%, compared with 45% among nontravelers.
- Cost: The authors identify U.S. out-of-pocket charges and South Korea’s lower procedure prices as reasons patients sought care abroad. Airfare, accommodation, and possible delays until a return trip complicate the affordability comparison.
The screening difference is an association, not proof that travel caused better preventive care. The sample was recruited by convenience, screening was self-reported, and some travelers lacked a usual source of U.S. care; this is supporting access evidence rather than a strict same-patient comparison of equivalent treatment. Results, discussion, and limitations.
[5]D. Turkey: Patient Narratives Including Eight U.S. Travelers
Ozan-Rafferty and colleagues’ 2014 study analyzed public narratives from 36 people who underwent 47 procedures in Turkey during 2007–2012. Eight travelers were from the United States. Procedures ranged from hair transplantation and dentistry to heart surgery, fertility treatment, and other specialist care. Findings were generally reported for the combined international sample, not separately for Americans.
[3]- Standard of care: Twenty-seven of 36 narrative authors, or 75%, explicitly reported satisfaction with treatment outcomes. Patients frequently praised physicians’ expertise and responsiveness. Others described unsatisfactory results, communication difficulties, unexpected provider substitutions, or service gaps. The 75% figure is not a clinical success rate, and the remaining 25% should not automatically be classified as dissatisfied.
- Availability: Three travelers described treatment options unavailable in their home country. Facilitators helped arrange appointments, records, transport, and accommodation. Some U.S. travelers sought treatments they described as experimental in the USA; availability does not establish effectiveness.
- Cost: Twenty-two of 36 cited home-country costs as a reason for leaving; 23 identified destination prices as an attraction. Three U.S. travelers seeking noncosmetic treatment described absent or inadequate insurance coverage. One narrative reported unexpected medication expenses after discharge.
These figures describe selected, publicly posted narratives, not a probability sample. They should not be presented as American-specific satisfaction rates or as a current assessment of Turkish healthcare overall. Full study, including country counts and patient accounts.
[3]E. Multiple Destinations: What U.S. Patients Expected Versus What They Experienced
Guiry and Vequist’s 2011 study used SERVQUAL, a service-quality questionnaire, to assess U.S. medical travelers’ expectations and perceptions of care abroad. Significant differences appeared in four dimensions: reliability, assurance, physical features, and empathy; responsiveness showed no significant gap.
[6]This study is useful because it shows why satisfaction should not be assumed merely because someone chose foreign care. However, it compares experience abroad with expectations—not directly with a matched U.S. treatment episode. Its accessible abstract also does not establish the direction of each gap, so it cannot support a claim that overseas care generally exceeded or fell below expectations. Study abstract and measurement description.
[6]3. Western Hemisphere Findings Retained for Comparison
The 2013 study of 46 U.S. retirees in Mexico and Panama remains directly relevant. Participants commonly praised personal attention, physician access, outpatient care, dentistry, and lower prices. Counterpoints included uneven capabilities, emergency transport, language, records, and financial exposure when insurance did not cover care abroad. Some preferred U.S. hospitalization because of their coverage. These are historical accounts, based on interviews in 2007–2008, rather than current countrywide ratings.
Raudenbush’s 2021 study of Mexican immigrants in San Diego adds an important distinction: patients sometimes used Mexican services to supplement U.S. treatment through second opinions, specialist access, or medications. Their comparison was not necessarily “one system is better,” but “each system provides something the other does not.”
4. Broader Worldwide Evidence: Relevant, but Not Direct USA Comparisons
A 2020 integrative review by Xu, Wang, and Du synthesized 21 studies of medical travelers. It extends the geographic picture, but several constituent studies involve non-U.S. patients. Their findings must not be relabeled as Americans’ comparisons with U.S. care.
[4]| Destination or study | Reported experience | Relevance and limitation |
|---|---|---|
| Malaysia: 173 international patients from 21 countries | Patients rated medical staff most favorably, ahead of supporting and administrative services, and perceived treatment as good value. | Supports a positive patient-experience pattern in Southeast Asia; does not establish a USA comparison. Review’s Manaf study entry. |
| Thailand: 330 international patients at one center, predominantly European | Perceived value and service quality contributed to satisfaction and intentions to return. | Provides destination experience, not a paired comparison with U.S. care. Review’s Prajitmutita study entry. |
| South Korea: 309 international patients, including 10.9% Americans | Perceived clinical and service quality, and trust in staff and clinics, were associated with satisfaction. | Includes Americans, but does not report a separate matched USA-versus-Korea assessment. Review’s Han and Hyun study entry. |
| European fertility destinations, particularly Spain and the Czech Republic | UK patients sought timely donor access, lower costs, and perceived better prospects after unsatisfactory domestic experiences. | Illustrates availability and affordability in Europe, but the home comparator is the UK—not the USA. Review’s Culley study entry. |
| Fertility treatment across 18 countries, including South Africa, Australia, India, and European destinations | The review reports predominantly positive experiences involving access, treatment quality, and greater control, alongside coordination and language difficulties. | Adds African and Oceanian destinations, but pooled findings cannot establish separate country ratings or direct USA comparisons. Review’s Hudson study entry. |
| India and Sri Lanka: travelers from the Maldives | High satisfaction with treatment coexisted with substantial concerns about continuity of care; unavailable domestic services motivated travel. | Shows that availability can outweigh price, but does not compare either destination with the USA. Review’s Suzana study entry. |
For Africa, Oceania, and much of the Middle East, this focused review did not identify sufficiently detailed same-patient USA-versus-destination studies to support regional conclusions. That is an evidence gap—not evidence that care in those regions is inferior or superior.
5. Synthesis Across Standard of Care, Availability, and Cost
Standard of Care
The most consistent favorable reports concern attention, staffing, communication with physicians, responsiveness, and perceived competence. These findings appear across the Alaska travelers, Korean immigrant research, Turkey narratives, and broader international studies. They do not establish lower complication rates or better long-term outcomes than comparable U.S. treatment. Language barriers, uneven service, and fragmented follow-up qualify the favorable accounts. Worldwide patient-experience synthesis; Turkey’s positive and negative narratives.
[3][4]Availability
“Available” has several meanings: a service may be offered locally but unaffordable, difficult to schedule, restricted by referral or insurance rules, or unavailable under local regulations. U.S.-linked research identifies unmet needs and insurance barriers; international research additionally highlights donor availability and domestic treatment restrictions. These should not be collapsed into a universal claim that foreign healthcare has shorter waits. U.S. immigrant access barriers; International motivations and barriers.
[2][4]Cost
Lower prices are a recurring attraction, especially when U.S. insurance excludes a procedure or leaves substantial out-of-pocket charges. But the relevant comparison is the complete episode: treatment, transport, accommodation, time away, follow-up, and any corrective care. The studies do not establish a single worldwide savings percentage, and insured patients’ personal costs need not track providers’ quoted prices. The Turkey narratives illustrate both attractive packages and unexpected medication costs; the Korean American study discusses travel expenses and potential delays.
[3][5]6. Overall Interpretation and Limits
The expanded literature shows that favorable comparative experiences are not confined to the Americas. U.S. residents have described benefits from care in Asia, Eastern Europe, and Turkey, particularly in affordability, access, and interpersonal care. However, the evidence remains concentrated in selected private providers, elective services, immigrant networks, and people motivated to seek alternatives. It does not justify ranking entire national systems or assuming equivalent safety from favorable testimonials. Integrative review and study limitations.
[4]Most importantly, research on planned medical travel is not representative of everyone who receives care while abroad. These studies provide much less information about unplanned emergencies, ordinary care during travel, or the full range of chronic illness management. A rigorous worldwide comparison would require patients with verified experience in both settings, comparable conditions and treatments, complete costs, and standardized follow-up—features the studies summarized here generally do not combine.
