Doctoral Dissertation Research: Factors Driving Changes within Global Healthcare Markets

尽管医疗旅行绝不是一个新现象，但随着个人寻求全球市场来满足他们的医疗需求，医疗旅行-寻求海外医疗服务-继续快速增长。尽管人类学家指出，医疗旅行经历的性质千差万别，但关于推动医疗旅行的不同类型的医疗保健担忧，以及个人和家庭如何利用财务、官僚和其他系统在国外获得医疗服务，仍有许多需要了解。该项目对研究生进行以经验为基础的科学研究方法的培训，旨在了解个人和家庭对特定医疗治疗(例如癌症筛查和治疗)的渴望如何影响他们临时或长期移民到美国和其他地方，以及他们不断变化的医疗保健担忧如何证明对疾病、健康和对医疗保健系统的期望的观念发生了变化。了解这些因素对于为应对当代全球医疗保健需求性质变化的计划和政策提供信息至关重要，特别是当它影响到美国和其他地方的医疗保健服务的移民和使用时。Zakea Boeger将在夏威夷大学马诺阿分校的Jan Brunson博士的指导下，研究影响旅行以满足医疗保健需求的因素。这一为期一年的研究项目将在汤加王国努库阿洛法进行，研究人员以前曾在那里开展工作。由于汤加政府支持公共资助的医疗体系，努库阿洛法是一个合适的网站，可以找出促使个人到海外寻求医疗保健的关键医疗问题，并利用往往有限的资源来做到这一点。医疗旅行的科学研究倾向于关注拥有更广泛资源的人群，以资助医疗目的的旅行，因此这个网站提供了一个机会，来检验关于医疗旅行驱动因素的一些普遍假设。研究人员将与已经和/或计划从事医疗旅行的个人和家庭进行广泛的访谈，以了解个人能够在国外获得医疗保健的动机和手段。访谈将深入了解汤加人的主要医疗旅行目的地(例如美国)之间的可能关系。当代，正在进行的汤加和太平洋移民到美国和其他地方。访谈还将考虑医疗旅行体验如何与不断变化的社会文化健康观念、适当的医疗保健以及由此产生的对汤加和国外医疗保健系统的期望交织在一起。项目发现将有助于阐明推动全球医疗旅行的更广泛的健康担忧，以及这种旅行可能如何影响美国和国外的医疗体系。

Though by no means a new phenomenon, medical travel - the seeking of healthcare services abroad - continues to grow rapidly as individuals look to the global market to meet their healthcare needs. While anthropologists have pointed to the intensely varied nature of medical travel experiences, there remains much to be understood about the different kinds of healthcare concerns which drive medical travel, as well as how individuals and families navigate financial, bureaucratic, and other systems to obtain care abroad. This project, which trains a graduate student in methods of empirically-grounded, scientific research, seeks to understand how individuals' and families' desires for particular healthcare treatments (e.g. cancer screenings and treatments) may influence their temporary or long-term migrations to the U.S. and elsewhere, as well as how their shifting healthcare concerns may evidence changing ideas regarding illness, health, and expectations of healthcare systems. Understanding these factors is imperative to informing programs and policies that respond to the shifting nature of contemporary, global healthcare seeking, particularly as it impacts migrations to and the use of healthcare services in the U.S. and elsewhere. Zakea Boeger, under the supervision of Dr. Jan Brunson of the University of Hawai'i at Manoa, will examine the factors impacting travel to service healthcare needs. This yearlong research project will be conducted in Nuku'alofa, Kingdom of Tonga, where the researcher has conducted previous work. As the Tongan government supports a publically funded healthcare system, Nuku'alofa is an apt site for identifying key healthcare concerns that drive individuals to seek healthcare abroad, and to draw on often-limited resources to do so. Scientific research of medical travel has tended to focus on populations with more extensive resources to finance travel for medical purposes, so this site offers an opportunity to test a number of prevailing assumptions about the drivers of medical travel. The researcher will engage in extensive interviews with individuals and families who have engaged in and/or plan to engage in medical travel, so as to gain an understanding of the motivations for and means by which individuals are able to access health care abroad. Interviews will provide insight into the possible relationship between Tongans' primary medical travel destinations (e.g. the U.S.) and contemporary, ongoing Tongan and Pacific migration to the U.S. and elsewhere. Interviews will also consider how medical travel experiences may be intertwined with shifting socio-cultural notions of health, appropriate health care, and resultant expectations of healthcare systems in Tonga and abroad. Project findings will help illuminate broader health concerns that drive global, medical travel, as well as how this travel may impact healthcare systems in the U.S. and abroad.