Survival analysis of medical tourism facilitators

Over the last decade or so, many U.S. patients with inadequate health insurance have been attracted to countries such as Thailand, Singapore, and Costa Rica by health care prices that are often one quarter of U.S. prices or less.  Some Canadians and Europeans have also sought treatment abroad in order to receive more timely treatment.  An industry of medical tourism facilitators, or MTFs, has arisen to help patients in one country find and receive treatment in a foreign country.  The MTF industry has the characteristics of monopolistic competition, including easy entry and high turnover rates.  Arribas and Vila (2007) and Dencker, et al., (2009) suggest that human capital has an impact on firm survival.  Cormany and Baloglu (2011) and Frederick and Gan (2014) have found that MTFs in the destination countries and MTFs in the travelers’ home countries have different strengths, which suggests that firms based in affluent Western countries should have different survival rates than non-Western firms would have.  The objective of this study is to test whether the longevity of these firms can be predicted by the skills and knowledge brought to the firms by their owners or by the different advantages of being based in a destination country or in a traveler’s home country.   This study uses information culled from the Web sites of nearly 200 firms in the MTF industry.  Determination of the dates of creation was made by research on the firms’ founders and by the history of the firms’ domain names.  Pan’s (2000) method of performing Cox proportional-hazards regressions on interval-censored data is used.  Preliminary results find no evidence that having a medical degree, having experience as a travel agent, or having experience in health administration or insurance has an effect on a firm’s survival.  However, there is evidence that, unexpectedly, non-Western MTFs have better survival than Western firms.