Doctoral Dissertation Research: Factors Driving Changes within Global Healthcare Markets

医疗旅行——在国外寻求医疗服务——虽然不是一个新现象，但随着个人寻求全球市场来满足他们的医疗需求，医疗旅行继续快速增长。虽然人类学家已经指出了医疗旅行经历的巨大多样性，但对于推动医疗旅行的不同类型的医疗保健问题，以及个人和家庭如何在财务、官僚和其他系统中获得国外医疗服务，仍有许多需要了解的地方。该项目旨在以经验为基础的科学研究方法培养研究生，旨在了解个人和家庭对特定医疗保健治疗（例如癌症筛查和治疗）的愿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关注如何证明有关疾病，健康和医疗保健系统期望的不断变化的想法。了解这些因素对于为响应当代全球医疗保健寻求的变化性质的计划和政策提供信息是必要的，特别是因为它影响到美国和其他地方的医疗保健服务的迁移和使用。在夏威夷大学马诺阿分校Jan Brunson博士的指导下，Zakea Boeger将研究影响旅行服务医疗需求的因素。这个为期一年的研究项目将在汤加王国的Nuku'alofa进行，研究人员在那里进行了以前的工作。由于汤加政府支持公共资助的医疗保健系统，Nuku'alofa是一个合适的网站，可以确定促使个人寻求国外医疗保健的关键医疗问题，并利用通常有限的资源来做到这一点。医疗旅行的科学研究往往集中在拥有更广泛的资源来资助医疗旅行的人群上，因此本网站提供了一个机会来测试一些关于医疗旅行驱动因素的普遍假设。研究人员将与从事和/或计划从事医疗旅行的个人和家庭进行广泛的访谈，以便了解个人能够在国外获得医疗保健的动机和手段。访谈将提供深入了解汤加人的主要医疗旅游目的地（如美国）与当代，正在进行的汤加和太平洋移民到美国和其他地方之间可能的关系。访谈还将考虑医疗旅行经历如何与不断变化的社会文化健康观念、适当的卫生保健以及汤加和国外对卫生保健系统的期望交织在一起。项目研究结果将有助于阐明推动全球医疗旅行的更广泛的健康问题，以及这种旅行如何影响美国和国外的医疗保健系统。

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.