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However order 60caps serpina with amex, it is usually not valid to use this metric to compare costs of different drugs or drug groups purchase serpina 60 caps amex. It will usually be the manufacturer who has best access to the information required for an application buy serpina 60caps low cost. Other users of the system are therefore encouraged to work through the manufacturer in submitting applications effective 60 caps serpina. In some cases, it may be necessary to await a classification until the new medicinal product has been approved in at least one country (especially for chemical entities where it is considered difficult to establish a new 5th level). The Centre also provides regular training courses to assist those working on the system at a national level. The applicant receives this information within 6-8 weeks after receipt of the request. A deadline will then be allowed for interested parties to comment or object to the decisions. A deadline is then allowed for any interested part to comment or object to the decision. Summaries of submissions to, or evaluations from, major regulatory agencies relating to the above are useful, as well as market research data showing the percentage use for the main indications. Independent of whether it has been decided to change or not to change, a deadline will be allowed for the applicant to comment or object to this decision. A deadline is then allowed for any interested part to comment or object to the change. If a change in the main therapeutic use is the reason for the proposed change, the data submitted should clearly indicate this change (e. If new knowledge of pharmacology or mechanism of action is the reason for the proposed change, relevant evidence should be submitted. Justifications based on reimbursement, pricing or marketing reasons will not be considered. If the decision is kept, then the decision is considered final after this meeting. Conclusive arguments might be: 44 - a change in the main indication so that the average dose used has been altered. This would need to be supported by detailed market research data in a range of countries including developing countries. However, for the three year revision a smaller change can be accepted (see page 29). If no special problems or issues arose during that process, no comments are given. A survey of each main group is given in the beginning of each of the following chapters. A Alimentary tract and metabolism B Blood and blood forming organs C Cardiovascular system D Dermatologicals G Genito urinary system and sex hormones H Systemic hormonal preparations, excl. It is difficult to differentiate between preparations for use in the mouth and preparations for use in the throat. Preparations for the treatment of throat infections, (lozenges for common cold conditions) are classified in R02 - Throat preparations. Products used in common minor infections of mouth and throat are classified in R02, e. Becaplermin in a kit for implantation indicated to treat periodontally related defects is classified here. Antacids in combination with liquorice root or linseed are classified in this group. All oral formulations containing sodium bicarbonate including products indicated for metabolic acidosis are classified in this group. Antacids in combination with liquorice root or linseed are classified in A02A - Antacids. Combinations of psycholeptics and antispasmodics could be classified in A03 or in N05 - Psycholeptics etc. The main indication for the use of the 55 combination will, together with the relative effect of the active components, decide the classification. In the treatment of pain caused by spasms, the spasmolytic component must be judged as more important than the analgesic component. Accordingly, analgesic/antispasmodic combinations should be classified in A03 if the main effect of the preparation is the antispasmodic action. Semisynthetic derivatives such as butylscopolamine, are classified in A03B - Belladonna and derivatives, plain. Systemic combinations containing papaverine are classified at the plain level for papaverine. When classifying such combined products, it is necessary to look at the main indication and the composition, to see if the preparation should be classified in A03 or in N05 - Psycholeptics (see comments under A03). When classifying these combination products, it is necessary to look at the indications and the composition to see if the preparation should be classified in A03 or in N02 - Analgesics. Combinations containing codeine are classified here, provided the codeine content is less than 20 mg. This group comprises all combined preparations with antispasmodics and anticholinergics, which are not covered by A03C or A03D. Otherwise combination products are classified at separate 5th levels using the corresponding 50-series. Laxatives in combination with centrally acting antiobesity agents are classified in A08A - Antiobesity preparations, excl. A major part of the products classified in this group are various combinations of two or more contact laxatives. Most of the combined products containing more than one antibiotic, contain neomycin. Insulin preparations are classified at 4 different 4th levels, according to onset and duration of action. Before classifying any product it is important to be familiar with the main subdivision of the group. It may be necessary to consider whether a product is a vitamin preparation with iron or an iron preparation with vitamins, a mineral preparation with vitamins or a vitamin preparation with minerals, or if the product should be regarded as a tonic etc. Some definitions: Multivitamins: Products containing minimum vitamins A, B, C and D. B-complex: Products containing minimum thiamine, riboflavine, pyridoxine, nicotinamide. Preparations containing more 2+ 3+ than 30 mg Fe (or corresponding doses of Fe ) are classified as iron preparations (B03A) regardless of therapeutic use. Vitamin B-complex in combination with other vitamins than vitamin C, see A11J - Other vitamin products, combinations. This group comprises also all combined potassium preparations used in the treatment of potassium deficiency conditions.

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Publication 502 (2017) Page 7 Eye Surgery Home Improvements You can include in medical expenses the amount you pay See Capital Expenses purchase 60 caps serpina mastercard, earlier order 60 caps serpina otc. Hospital Services Fertility Enhancement You can include in medical expenses amounts you pay for the cost of inpatient care at a hospital or similar institution if a principal reason for being there is to receive medical You can include in medical expenses the cost of the fol- lowing procedures to overcome an inability to have chil- care generic serpina 60 caps without prescription. Procedures such as in vitro fertilization (including tem- Insurance Premiums porary storage of eggs or sperm) serpina 60 caps free shipping. Surgery, including an operation to reverse prior sur- You can include in medical expenses insurance premiums gery that prevented the person operated on from hav- you pay for policies that cover medical care. Hospitalization, surgical services, X-rays, Prescription drugs and insulin, Guide Dog or Other Service Animal Dental care, You can include in medical expenses the costs of buying, Replacement of lost or damaged contact lenses, and training, and maintaining a guide dog or other service ani- Long-term care (subject to additional limitations). See mal to assist a visually impaired or hearing disabled per- Qualified Long-Term Care Insurance Contracts under son, or a person with other physical disabilities. The cost of the medical part must Health Institute be separately stated in the insurance contract or given to you in a separate statement. These amounts are treated as Reimbursement Request Form, to receive a reim- medical insurance premiums. Home Care If advance payments of the premium tax credit were See Nursing Services, later. Medicare D is a voluntary prescription drug insurance pro- Employer-Sponsored Health Insurance Plan gram for persons with Medicare A or B. Because you are an employee whose insurance pre- 65 (but not for less than 5 years). You employer to provide coverage for qualified long-term care also must include in gross income the value of unused services under a flexible spending or similar arrangement sick leave that, at your option, your employer applies to must be included in your income. You can include this cost of continuing participation in the health plan as a medical ex- Retired public safety officers. This applies only to distributions that would cost of your continuing participation in the health plan otherwise be included in income. In this situation you can The part of your car insurance that provides medical include the premiums you paid for Medicare A as a medi- insurance coverage for all persons injured in or by cal expense. Premi- Health or long-term care insurance if you elected to ums you pay for Medicare B are a medical expense. You can include in medi- Disabled, Special Home for cal expenses advance payments to a private institution for lifetime care, treatment, and training of your physically or You can include in medical expenses the cost of keeping mentally impaired child upon your death or when you be- a person who is intellectually and developmentally disa- come unable to provide care. Lodging Lead-Based Paint Removal You can include in medical expenses the cost of meals and lodging at a hospital or similar institution if a principal You can include in medical expenses the cost of removing reason for being there is to receive medical care. See lead-based paints from surfaces in your home to prevent a Nursing Home, later. You can include the cost of such lodging while away from home if all of the following requirements are met. If, instead of removing the paint, you cover the area with wallboard or paneling, treat these items as capital ex- 1. The medical care is provided by a doctor in a licensed hospital or in a medical care facility related to, or the Learning Disability equivalent of, a licensed hospital. There is no significant element of personal pleasure, recreation, or vacation in the travel away from home. Page 10 Publication 502 (2017) The amount you include in medical expenses for lodg- 2. Provide that refunds, other than refunds on the death person receiving the medical care. For example, if a pa- of the insured or complete surrender or cancellation rent is traveling with a sick child, up to $100 per night can of the contract, and dividends under the contract must be included as a medical expense for lodging. The amount of qualified long-term care premiums you Long-Term Care can include is limited. Qualified long-term care premiums up to the following qualified long-term care services and premiums paid for amounts. Provided pursuant to a plan of care prescribed by a li- censed health care practitioner. He or she is unable to perform at least two activities of wise have been included in your income. Activities of daily living are eating, toileting, transferring, bathing, dressing, and conti- You can include in medical expenses the cost of meals at nence. He or she requires substantial supervision to be pro- ing there is to get medical care. Mainte- nance or personal care services is care which has as its primary purpose the providing of a chronically ill individual Medical Conferences with needed assistance with his or her disabilities (includ- ing protection from threats to health and safety due to se- You can include in medical expenses amounts paid for vere cognitive impairment). The costs of Qualified Long-Term Care Insurance the medical conference must be primarily for and neces- Contracts sary to the medical care of you, your spouse, or your de- A qualified long-term care insurance contract is an insur- pendent. The majority of the time spent at the conference ance contract that provides only coverage of qualified must be spent attending sessions on medical information. Be guaranteed renewable, Publication 502 (2017) Page 11 The cost of meals and lodging while attending the long-term care can be included in medical expenses. Additionally, certain expenses for household services or for the care of a qualifying indi- Medical Information Plan vidual incurred to allow you to work may qualify for the child and dependent care credit. Divide the food bank and retrieves and furnishes the information upon re- expense among the household members to find the cost quest to an attending physician. If you had to pay Medicines additional amounts for household upkeep because of the attendant, you can include the extra amounts with your You can include in medical expenses amounts you pay for medical expenses. A prescribed drug is one pay because you moved to a larger apartment to provide that requires a prescription by a doctor for its use by an in- space for the attendant. For information on em- ployment tax responsibilities of household employers, see Nursing Home Pub. You can include in medical expenses the cost of medical Operations care in a nursing home, home for the aged, or similar insti- tution, for yourself, your spouse, or your dependents. You can, however, include in medical expenses the part of the cost that is for Optometrist medical or nursing care. Nursing Services Organ Donors You can include in medical expenses wages and other amounts you pay for nursing services. These services can You can include in medical expenses amounts you pay to be provided in your home or another care facility. Generally, only the amount spent for nursing services is Oxygen a medical expense. If the attendant also provides per- sonal and household services, amounts paid to the at- tendant must be divided between the time spent perform- You can include in medical expenses amounts you pay for ing household and personal services and the time spent oxygen and oxygen equipment to relieve breathing prob- for nursing services. She spends 10% of her Physical Examination time doing household services such as washing dishes and laundry. You can include only $270 per week as med- You can include in medical expenses the amount you pay ical expenses. Page 12 Publication 502 (2017) Pregnancy Test Kit Psychologist You can include in medical expenses the amount you pay You can include in medical expenses amounts you pay to to purchase a pregnancy test kit to determine if you are a psychologist for medical care.

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The only characteristic that is not found in hard d) presence of mixed chancre chancre is: a) clear basis 9 generic 60caps serpina. Which secondary syphilis lesions are important in d) absence of inoculation chancre terms of contagion? Tertiary syphilis lesions may appear after a long c) greater number of cases of resistant T order serpina 60 caps online. The dark field microscopy is a laboratory tool that d) more localized lesions should be used: a) if there are no fluorescent microscopes available 5 60caps serpina fast delivery. The false-negative results in non-treponemic tests serpina 60caps overnight delivery, the so-called prozone effect, are due to: 6. The earliest neurological involvement of syphilis a) small number of treponemas in this stage is: b) low specificity of cardiolipin a) tabes dorsalis c) an excess of antibodies b) gommatous neurosyphilis d) very concentrated serum c) progressive general paralysis d) meningeal alterations 13. Today the treponemic tests are used primarily: a) to confirm the cases of syphilis 7. In which stage of pregnancy the embryo becomes b) in diagnosis of neurosyphilis infected? A pregnant woman was treated with erythromycin d) benzathine penicillin, two weekly doses of 2g/day for 15 days. Benzathine penicillin is the first line drug to treat should be treated for 30 days syphilis because of: b) penicillin is the only drug considered effective a) its low cost in pregnant women b) low incidence of side effects c) correct treatment, provided it is a case of c) its ability to cross the blood brain barrier primary syphilis d) it maintains therapeutic levels for longer periods d) it should not have been used for causing many side effects 20. The Jarish-Herxheimer reaction was described in other diseases caused by spirochetes, such as lep- 16. They are the unsung heroes of intracameral antibiotic prophylaxis of endophthalmitis following cataract surgery. Published by the European Society of Cataract and Refractive Surgeons, Temple House, Temple Road, Blackrock, Co Dublin, Ireland www. The visual loss and debilitation that occur unequivocally demonstrated a clinical beneft, with a in a large proportion of postoperative endophthalmitis fve-fold reduction in postoperative endophthalmitis rates cases can be severe and irreversible. Those most in need in patients who received a 1mg intracameral injection of of the operation are often those at greatest risk, such as cefuroxime at the close of cataract surgery1. In parallel, scientifc principles that underlie Although cataract surgery ranks among the most frequently microbial eradication in the atypical spaces of the eye have performed surgical procedures worldwide, data to defne been explored. The clinical beneft of scientifc principles that help us understand how bacteria this intervention seemed apparent. Other forms Exogenous endophthalmitis may present in an acute, of endophthalmitis may arise from endogenous sources virulent form, or a more chronic, late endophthalmitis. An endophthalmitis is related to the virulence and inoculum acceleration phase and, fnally, a destructive phase of the of infecting bacteria, as well as time to diagnosis and the infection develops. The acceleration phase follows primary infection of the The infectious process undergoes an initial incubation posterior segment and leads to infammation of the anterior phase which may be clinically unapparent, lasting at chamber and an immune response with macrophages and least 16-18 hours, during which a critical load of bacteria lymphocytes infltrating into the vitreous cavity within about proliferate and break down the aqueous barrier; this is 7 days. By 3 days after intraocular infection, pathogen- followed by fbrin exudation and cellular infltration by specifc antibodies can be detected; these help to eliminate neutrophilic granulocytes. The incubation phase varies microbes through opsonisation and phagocytosis within with the generation time of the infecting microbe, (eg: up about 10 days. Infammatory mediators, especially cytokines, further such as production of bacterial toxins. With common recruit leucocytes, which may add to destructive effects, microorganisms such as S. Surgical complications are endophthalmitis originate from environmental, a known risk factor for endophthalmitis, with higher climatic, surgical, and patient-specifc factors, among endophthalmitis rates cited where complications occur. In these Guidelines, we focus on prophylaxis Although the internal eye is protected to some degree of endophthalmitis after cataract surgery, and the by ocular barriers that confer an “immune privilege,” if microorganisms most commonly implicated in these compromised (e. The etiology of microorganisms infecting the eye during cataract surgery include the following: • patients presenting preoperatively with blepharitis and infammation or infection of the eyelids. It is • the patient’s own ocular surface fora [Speaker 1991, worthwhile mentioning that atopic patients and those Bannerman 1997]. A majority of contaminants during, with rosacea have altered conjunctival and lid bacterial and even after, surgery can be traced to the patient’s fora, with a higher preponderance of Staphylococcus own ocular surface fora. Patients with rosacea also exhibit an enhanced topical antibiotic drops in the early postoperative period systemic cell-mediated immunity to S. These patients • infection stemming from contaminated surgical should undergo treatment for their blepharitis prior to instruments, tubing or the surgical environment, cataract surgery with appropriate antibiotic therapy. Measures needed to assure the sterility of the surgical suite, airfow and instruments are briefy outlined here, but are too broad for comprehensive review, and the reader is referred to appropriate guidelines and practice standards. Because none of these factors endophthalmitis may vary with regions of the world, as can be precisely quantifed or identifed prior to cataract depicted in Table 6. Common microorganisms in postoperative endophthalmitis * Commonly cited prevalence may vary with geographic regions Table 2. In keeping with most reports, an important group of pathogens to be considered when Gram-positive microbes predominated, including species selecting a prophylactic antibiotic regimen. All groups received povidone-iodine 5% (Betadine) before surgery and were presented levofoxacin 0. Microorganisms identifed in In Sweden, where intracameral cefuroxime has been used endophthalmitis isolates, Swedish National Study extensively, the Swedish Cataract Register routinely tracks the spectrum of microorganisms isolated in cases of postoperative endophthalmitis. The recent report by Friling Species (n) (%) and associates3 presents six-year results, shown in Table 5. A shift in preponderance may alter clinical Pseudomonas species 10 7% presentation and require adjustments in management. It is to the fourth generation fuoroquinolones moxifoxacin worthwhile noting that all isolates of streptococci were and gatifoxacin [per Fig. Countries included Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey, United Kingdom. From January 2003-December 2009, patients received intracameral cefazolin 1mg cefazolin at the end of surgery. These two studies are also consistent with the Swedish report5, Early in the 20th century, the incidence of endophthalmitis where background rates of postoperative endophthalmitis after cataract surgery was fairly high - approximately 10%. Tables 7 and 8 display the higher background hygiene, reduced this infection rate (c. Furthermore, each surgeon faces the possibility that specifc risk factors may impact any one A degree of controversy has arisen in recent years over patient and increase the risk of infection. Tables 7 and 8 display the dramatic Report by Shorstein and Associates (United States) 2013 reduction in infection rates after intracameral antibiotics A recent and interesting report from the United States2 became a standard prophylactic intervention. Decreasing endophthalmitis rates with postoperative endophthalmitis rates prior to, and after, the increasing use of intracameral antibiotics initiation of intracameral cefazolin at the close of surgery. Prophylaxis in prior time periods included subconjunctival Decreased postoperative Endophthalmitis rate after cefazolin, gentamicin, dexamethasone; subconjunctival institution of intracameral antibiotics in a Northern cefazolin was then changed to intracameral cefazolin California Eye Department injection, with other interventions remaining similar. A recent study from Singapore also lends support to the intracameral injection where cefazolin was used, rather than cefuroxime. Its purpose was: to investigate the role of initial pars plana Intravenous antibiotic: There was no statistical difference vitrectomy in the managment of postoperative bacterial in fnal visual acuity or media clarity between patients who endophthalmitis; determine the role of intravenous received systemic antibiotics or not. Of the 855 2) Vitrectomy, no intravenous antibiotics patients presenting with endophthalmitis within 6 weeks, 510 met eligibilitiy criteria and fnally 420 were enrolled.

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In light of this generic serpina 60caps with amex, our broad review outlines key health policy considerations buy serpina 60 caps without prescription, and draws attention to significant gaps in the research evidence order serpina 60 caps online. The central conclusion from this review is that there is a lack of systematic data concerning health services trade discount 60 caps serpina free shipping, both overall and at a disaggregated level in terms of individual modes of delivery, and of specific countries. Mechanisms are needed that help us track the balance of trade around medical tourism on a regular basis. L‘accroissement général de la circulation transfrontières des patients et des professionnels de la santé ainsi que de la technologie médicale et des capitaux, et l‘extension des régimes réglementaires au- delà des frontières nationales, ont donné lieu à de nouveaux modes de consommation et de production des services de santé au cours des dernières décennies. L‘expansion du commerce des soins de santé s‘est en particulier caractérisée par les mouvements transfrontières de patients à la recherche de traitements médicaux et de santé, phénomène que l‘on désigne communément à l‘aide de l‘expression « tourisme médical ». On parle de tourisme médical lorsque des consommateurs choisissent de traverser des frontières internationales dans l‘intention de recevoir un traitement médical sous une forme ou sous une autre, lequel peut relever de toutes les spécialités médicales, mais concerne le plus souvent la dentisterie, la chirurgie esthétique, la chirurgie non vitale et l‘assistance à la procréation. Une évolution s‘est produite en ce sens que ce sont surtout les patients de nations plus riches et plus développées qui se rendent dans des pays moins développés pour bénéficier de services de santé, essentiellement en raison du faible coût des traitements, des possibilités de voyager à bon marché et de la disponibilité d‘informations sur l‘internet. Même si l‘on écrit de plus en plus sur ce thème, les travaux publiés se fondent rarement sur des données probantes. Le tourisme médical présente à la fois des risques et des avantages pour les patients. La présente étude identifie les principaux enjeux liés à l‘expansion du « tourisme médical ». L‘étude fait le point des connaissances actuelles sur la circulation des touristes médicaux entre les pays et examine les interactions de la demande et de l‘offre de services de tourisme médical. Elle présente les divers groupes et organisations impliqués dans cette activité, y compris l‘ensemble des intermédiaires et des services auxiliaires qui sont apparus parallèlement à son développement. L‘accent est mis sur les modalités des traitements (qualité, sécurité et risques) et sur les conséquences systémiques du phénomène pour les pays d‘origine et de destination (questions financières, équité et impact sur les prestataires et les professionnels intervenant dans le tourisme médical). L‘étude envisage les services de tourisme médical sous l‘angle des dommages, des responsabilités et des possibilités de recours en s‘intéressant particulièrement aux aspects juridiques et éthiques ainsi qu‘à la qualité des soins. Cette vaste étude présente donc d‘importantes considérations liées à la politique de la santé et appelle l‘attention sur l‘existence de sérieuses lacunes dans les données disponibles. La principale conclusion sur laquelle elle débouche est le manque de données systématiques, tant globales que désagrégées sur le commerce des services de santé au niveau des différents modes de prestation et des pays, et cela, à la fois sur le plan du commerce proprement dit et sur le plan de ses implications. Il est nécessaire de mettre au point des mécanismes qui nous aident à suivre régulièrement l‘évolution des échanges commerciaux liés au tourisme médical. Les données dont on dispose, qui sont insuffisantes, ne permettent pas de déterminer qui est gagnant et qui est perdant au niveau des systèmes, des programmes, de l‘organisation des soins et des traitements. The free movement of goods and services under the auspices of the World Trade Organization and its General Agreement on Trade in Services (Smith, 2004, Smith et al,. As health care is predominantly a service industry, this has made health services more tradable, global commodities. A significant new element of this trade has involved the movement of patients across borders in the pursuit of medical treatment and health care, a phenomenon commonly termed ‗medical tourism‘. The consumption of health care in a foreign land is not a new phenomenon, and developments must be situated within the historical context. Individuals have travelled abroad for health benefits since th ancient times, and during the 19 Century in Europe for example there was a fashion for the growing middle-classes to travel to spa towns to ‗take the waters‘, which were believed to have health-enhancing th qualities. During the 20 Century, wealthy people from less developed areas of the world travelled to developed nations to access better facilities and highly trained medics. However, the shifts that are currently underway with regard to medical tourism are quantitatively and qualitatively different from earlier forms of health-related travel. The key differences are a reversal of this flow from developed to less developed nations, more regional movements, and the emergence of an ‗international market‘ for patients. Fundamentally, such developments point towards a paradigm shift in the understanding and delivery of health services. The market in medical tourists is set to grow, with potentially far-reaching impacts on publicly-funded health care including the developing notion of patients as ‗consumers‘ of health care rather than ‗citizens‘ with rights to health care services. There will of course also be a range of attendant risks and 6 opportunities for patients. Predictions for this emerging global market are difficult but the direction and speed of its travel is becoming increasing clear. This report identifies the key emerging policy issues relating to the rise of ‗medical tourism‘. In this introductory section we explore competing definitions and concepts relating to medical tourism. For the purposes of this report we define medical tourism as when consumers elect to travel across international borders with the intention of receiving some form of medical treatment. Setting the boundary of what is health and counts as medical tourism for the purposes of trade accounts is not straightforward. Medical tourism is related to the broader notion of health tourism which, in some countries, has longstanding historical antecedents of spa towns and coastal localities, and other therapeutic landscapes. Some commentators have considered health and medical tourism as a combined phenomenon but with different emphases. This definition encompasses medical tourism which is delimited to ―organised travel outside one‘s natural health care jurisdiction for the enhancement or restoration of the individual‘s health through medical intervention‖. As Figure 1 suggests, medical tourism is distinguished from health tourism by virtue of the differences with regard to the types of intervention, setting and inputs. Medical tourism can be understood as a subset of the wider notion of patient mobility which itself may be sub-divided as follows: 13. Temporary visitors abroad: These include those individuals holidaying abroad who use health services as a result of an accident or a sudden illness. These would not be considered as ‗medical tourists‘, more just ‗unfortunate tourists‘! Such residents may receive health services funded variously by the country of residence, the country of origin, private insurance, or through private contributions. Common borders: countries that share common borders may collaborate in providing cross- national public funding for health care services from providers in other countries (Rosenmöller et al. Outsourced patients: are those patients opting to be sent abroad by health agencies using cross- national purchasing agreements. Typically, such agreements are driven by long waiting lists and a lack of available specialists and specialist equipment in the home country. These patients often travel relatively short distances and contracted services (both public and private) are more likely to be subject to robust safety audits and quality assurance (Lowson et al. These individuals could be described as ‗collective‘ medical tourists, albeit they being state or agency-sponsored rather than acting as individual consumers in the traditional sense. Medical tourism more commonly refers to patients who are mobile through their own volition and this type of patient mobility is the focus of this report. Within the European context a medical tourist may be categorised in one of two ways. There is ongoing debate about the most appropriate terminology to describe the movement of individuals overseas for treatment. A range of nomenclature is used in the health services literature, including international medical travel (Huat, 2006a, Fedorov et al. Although for the purposes of this report we adopt the term medical tourism, some commentators object to the use of this term (Whittaker, 2008, Glinos et al.

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