Caracterización del turismo médico transfronterizo en Ciudad Juárez motivado por la crisis derivada del COVID-19

María Teresa Martínez Almanza; Santos Morales; Jorge Antonio Breceda Pérez

doi:10.21670/ref.2206090

Autores/as

María Teresa Martínez Almanza Universidad Autónoma de Ciudad Juárez https://orcid.org/0000-0002-1056-9204
Santos Morales Universidad Autónoma de Ciudad Juárez https://orcid.org/0000-0001-5330-9974
Jorge Antonio Breceda Pérez Universidad Autónoma de Ciudad Juárez https://orcid.org/0000-0001-5280-6936

Palabras clave:

turismo médico, pandemia, salud transfronteriza, estado de bienestar

Resumen

El trabajo vincula la movilidad transfronteriza y el turismo médico durante la pandemia de COVID-19. El objetivo fue analizar el comportamiento del turismo médico en Ciudad Juárez durante octubre de 2020 a julio de 2021 de esta pandemia. La variable contextual es la movilidad regular frente a la actividad del comercio de servicios de salud de las ciudades fronterizas. Es un estudio cualitativo y exploratorio de 34 entrevistas semiestructuradas de casos reales. Se encontraron pacientes transfronterizos que acuden a Ciudad Juárez en busca de atención sanitaria para la enfermedad de COVID-19 en hospitales públicos y privados y para la atención y seguimiento de las secuelas relativas. En las conclusiones se expone la vulnerabilidad de las personas que realizan turismo médico y las deficiencias institucionales que abonan a los desafíos del estado de bienestar durante la pandemia de COVID-19. Se identifica la noción de la funcionalidad de las fronteras.

Abstract

The work links cross-border mobility and medical tourism during the COVID-19 pandemic. The objective was to analyze the behavior of medical tourism in Ciudad Juárez during October 2020 to July 2021 of this pandemic. The contextual variable is regular mobility compared to the activity of the trade in health services in border cities. It is a qualitative and exploratory study of 34 semi-structured interviews of real cases. Cross-border patients who come to Ciudad Juárez in search of health care for COVID-19 disease in public and private hospitals and for the care and follow-up of the related sequelae were found. The conclusions expose the vulnerability of people who carry out medical tourism and the institutional deficiencies that contribute to the challenges of the welfare state during the COVID-19 pandemic. The notion of the functionality of borders is identified.

Citas

Bassett, M. T., Chen, J. T. & Krieger, N. (2021). Variation in racial/ethnic disparities in COVID-19 mortality by age in the United States: a cross-sectional study. PLOS Medicine, 18(2). https://doi.org/10.1371/journal.pmed.1003541 DOI: https://doi.org/10.1371/journal.pmed.1003541

Beckfield, J. & Bambra, C. (2016). Shorter lives in stingier states: social policy shortcomings help explain the US mortality disadvantage. Social Science & Medicine, 171, 30-38. https://doi.org/10.1016/j.socscimed.2016.10.017 DOI: https://doi.org/10.1016/j.socscimed.2016.10.017

Bollyky, T. J. & Nuzzo J. (2020, 1 de octubre). Trump’s ‘early’ travel ‘bans’ weren’t early, weren’t bans and didn’t work. Washington Post. https://www.washingtonpost.com/outlook/2020/10/01/debate-early-travel-bans-china/

Bollyky, T. J. & Patrick, S. M. (2020). Improving pandemic preparedness: lessons from COVID-19. Council on Foreign Relations. https://www.cfr.org/report/pandemic-preparedness-lessons-COVID-19

Bommes, M. & Geddes, A. (2001). Immigration and welfare: Challenging the borders of the welfare state. Routledge. DOI: https://doi.org/10.4324/9780203464526

Butler, J. (2010). Marcos de guerra: las vidas lloradas. Paidós.

Chattu, V. K., Adisesh, A. & Yaya, S. (2020). Canada’s role in strengthening global health security during the COVID-19 pandemic. Global Health Research and Policy, 5(16), 1-3. https://doi.org/10.1186/s41256-020-00146-3 DOI: https://doi.org/10.1186/s41256-020-00146-3

Congressional Budget Office. (2012, julio). Estimates for the insurance coverage provisions of the affordable care act updated for the recent supreme court decision. https://www.cbo.gov/publication/43472

Connell, J. (2013, febrero). Contemporary medical tourism: conceptualisation, culture, and commodification. Tourism Management, 34, 1-13. https://doi.org/10.1016/j.tourman.2012.05.009 DOI: https://doi.org/10.1016/j.tourman.2012.05.009

Connell, J. (2015). Medical tourism-concepts and definitions. En N. Lunt, D. Horsfall & J. Hanefeld (Eds.), Handbook on medical tourism and patient mobility (pp. 16-24). Edward Elgar Publishing. DOI: https://doi.org/10.4337/9781783471195.00010

Cormany, D., & Baloglu, S. (2011, agosto). Medical travel facilitator websites: an exploratory study of web page contents and services offered to the prospective medical tourist. Tourism Management, 32(4), 709-716. https://doi.org/10.1016/j.tourman.2010.02.008 DOI: https://doi.org/10.1016/j.tourman.2010.02.008

Dauvergne, C. (2008). Making people illegal: what globalization means for migration and law. Cambridge University Press. DOI: https://doi.org/10.1017/CBO9780511810473

Deloitte. (2019). Oportunidades de mercado y perspectivas del turismo de salud en México. https://www2.deloitte.com/content/dam/Deloitte/mx/Documents/bienes-raices/2019/Turismo-de-Salud-en-Mexico.pdf

Denzin, N. K., & Lincoln, Y. S. (2012). El campo de la investigación cualitativa (Manual de investigación cualitativa, v. 1). Editorial Gedisa.

Devi, S. (2020, mayo). Travel restrictions hampering COVID-19 response. The Lancet, 395(10233), 1331-1332. https://doi.org/10.1016/S0140-6736(20)30967-3 DOI: https://doi.org/10.1016/S0140-6736(20)30967-3

Habibi, R., Burci, G. L., De Campos, T. C., Chirwa, D., Cinà, M., Dagron, S., Eccleston-Turner, M., Forman, L., Gostin, L. O., Mason Meier, B., Negri, S., Ooms, G., Sekalala, S., Taylor, A., Yamin, A. E. & Hoffman, S. J. (2020). Do not violate the international health regulations during the COVID-19 outbreak. The Lancet, 395(10225), 664-666. https://doi.org/10.1016/S0140-6736(20)30373-1 DOI: https://doi.org/10.1016/S0140-6736(20)30373-1

Hall, C. M. (2013). Medical tourism: the ethics, regulation, and marketing of health mobility. Routledge.

Hernández-Sampieri, R. & Mendoza Torres, C. P. (2018). Metodología de la investigación: las rutas cuantitativa, cualitativa y mixta. McGraw Hill México.

Hohman, M. (2020, 22 de septiembre). Why is health care so expensive in the United States? Today. today.com/tmrw/why-healthcare-so-expensive-united-states-t192119

Hurrelmann, A., Leibfried, S., Martens, K. & Mayer, P. (Eds.). (2007). Transforming the golden-age nation state. Springer. DOI: https://doi.org/10.1057/9780230590861

King, G., Keohare, R. O. & Verba, S. (1994). El diseño de la investigación social. Alianza Editorial.

Kupferschmidt, K. (2020, 14 de abril). Ending coronavirus lockdowns will be a dangerous process of trial and error. Science. https://www.science.org/content/article/ending-coronavirus-lockdowns-will-be-dangerous-process-trial-and-error DOI: https://doi.org/10.1126/science.abc2507

Ledsom, A. (2021, 14 de febrero). ‘Shot trips’ to Dubai, Florida, Tel Aviv, Havana: COVID-19 vaccine tourism takes off. Forbes. https://www.forbes.com/sites/alexledsom/2021/02/14/shot-trips-to-dubai-florida-tel-aviv-havana-covid-19-vaccine-tourism-takes-off/?sh=377c6bee199c

Lee, K., Grépin, K. A., Worsnop, C., Marion, S., Piper, J. & Song, M. (2021). Managing borders during public health emergencies of international concern: a proposed typology of cross-border health measures. Globalization and Health, 17, Artículo 62, 1-19. https://doi.org/10.1186/s12992-021-00709-0 DOI: https://doi.org/10.1186/s12992-021-00709-0

Leibfried, S. & Zürn, M. (Eds.). (2005). Transformations of the State? Cambridge University Press. DOI: https://doi.org/10.1017/CBO9780511752193

López, L., Hart, L. H. & Katz, M. H. (2021). Racial and ethnic health disparities related to COVID-19. JAMA, 325(8), 719-720. https://doi.org/10.1001/ jama.2020.26443 DOI: https://doi.org/10.1001/jama.2020.26443

Martínez-Almanza, M. T., Morales-Muñoz, S. A., & González-Macías, C. J. (2019). Gobernanza y gestión del turismo médico en la región fronteriza de Ciudad Juárez-El Paso. Dimensiones turísticas, 3(4), 87-109. https://doi.org/10.47557/SNLE6377 DOI: https://doi.org/10.47557/SNLE6377

Mason Meier, B., Habibi, R. & Yang, T. (2020). Travel restrictions violate international law. Science, 367(6485), 1436. https://doi.org/10.1126/science.abb6950 DOI: https://doi.org/10.1126/science.abb6950

Mathijsen, A. (2019). Home, sweet home? Understanding diasporic medical tourism behaviour. Exploratory research of Polish immigrants in Belgium. Tourism Management, 72, 373-385. https://doi.org/10.1016/j.tourman.2018.12.009 DOI: https://doi.org/10.1016/j.tourman.2018.12.009

Merrell, R. C., Boucher, D., Carabello, L., Herrick, D. M., Lazzaro, V., Ludwick, L., Toral, R., Woodman, J. & Doarn, C. R. (2008). Medical tourism. Telemedicine and e-Health, 14(1), 14-20. https://doi.org/10.1089/tmj.2008.9995 DOI: https://doi.org/10.1089/tmj.2008.9995

Moré, Í. (2011). The borders of inequality: where wealth and poverty collide. University of Arizona Press.

National Research Council. (2011). Explaining divergent levels of longevity in high-income countries. The National Academies Press. https://doi.org/10.17226/13089 DOI: https://doi.org/10.17226/13089

Organisation for Economic Co-operation and Development (OECD). (2020). Tourism policy responses to the coronavirus (COVID-19). https://www.oecd.org/coronavirus/policy-responses/tourism-policy-responses-to-the-coronavirus-covid-19-6466aa20/

Organización Mundial de la Salud. (2022). Cobertura universal de salud. https://www.who.int/es/health-topics/universal-health-coverage#tab=tab_1

Ortega, A. N., Fang, H., Perez, V. H., Rizzo, J. A., Carter-Pokras, O., Wallace, S. P. & Gelberg, L. (2007). Health care access, use of services, and experiences among undocumented Mexicans and other Latinos. Archives of Internal Medicine, 167(21), 2354-2360. https://doi.org/10.1001/archinte.167.21.2354 DOI: https://doi.org/10.1001/archinte.167.21.2354

Parker, R. W. (2021). Why America’s response to the COVID-19 pandemic failed: lessons from New Zealand’s success. Faculty Articles and Papers, (528). https://opencommons.uconn.edu/law_papers/528

Pew Hispanic Center. (2013, 29 de enero). A nation of immigrants: a portrait of the 40 million, including 11 million unauthorized. https://www.pewresearch.org/hispanic/2013/01/29/a-nation-of-immigrants/

Pierson, P. (2001). The new politics of the welfare state. Oxford Scholarship. DOI: https://doi.org/10.1093/0198297564.001.0001

Preston, S. H. & Vierboom, Y.C. (2021). Excess mortality in the United States in the 21st century. Proceedings of the National Academy of Sciences of the United States of America, 118(16). https://doi.org/10.1073/pnas.2024850118 DOI: https://doi.org/10.1073/pnas.2024850118

Rothgang, H., Cacace, M., Frisina, L., Grimmeisen, S., Schmid, A. & Wendt, C. (2010). The state and healthcare: comparing OECD countries. Springer. DOI: https://doi.org/10.1057/9780230292345

Shi, L. (2001). The convergence of vulnerable characteristics and health insurance in the US. Social Science & Medicine, 53(4), 519-529. https://doi.org/10.1016/S0277-9536(00)00357-9 DOI: https://doi.org/10.1016/S0277-9536(00)00357-9

Telemundo 48 El Paso. (2019, 12 deseptiembre). Disminuye turismo médico en Ciudad Juárez. Telemundo 48. https://www.telemundo48elpaso.com/noticias/local/disminuye-turismo-medico-en-ciudad-juarez-el-paso/1837608/

The need for a coordinated international pandemic response. (2020). Bull World Health Organ, 98(6), 378-379. https://www.who.int/bulletin/volumes/98/6/20-020620/en/ DOI: https://doi.org/10.2471/BLT.20.020620

Tolbert, J., Orgera, K., & Damico, A. (2020, 6 de noviembre). Key facts about the uninsured population. Kaiser Family Foundation. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/

Vargas Bustamante, A. (2020). U.S.-Mexico cross-border health visitors: how Mexican border cities in the state of Baja California address unmet healthcare needs from US residents. Journal of Ethnic and Migration Studies, 46(20), 4230-4247. https://doi.org/10.1080/1369183X.2019.1597473 DOI: https://doi.org/10.1080/1369183X.2019.1597473

Vargas Bustamante, A. (2021). Use of health care services by Mexican adults in the U.S. before and after age 65: implications for cross-border health care in Mexico. En Migration and Health: Reflections and Challenges about the Health of Migrants (pp. 27-42). Secretaría de Gobernación/Conapo. https://www.gob.mx/cms/uploads/attachment/file/390663/Migraci_n_y_salud_2017_web_final1.pdf

Von Tigerstrom, B., & Wilson, K. (2020). COVID-19 travel restrictions and the International Health Regulations (2005). BMJ Global Health, 5, Artículo e002629. https://doi.org/10.1136/bmjgh-2020-002629 DOI: https://doi.org/10.1136/bmjgh-2020-002629

Whittaker, A. (2015). The implications of medical travel upon equity in lower-and middle-income countries. En N. Lunt, D. Horsfall & J. Hanefeld (Eds.), Handbook on medical tourism and patient mobility (pp. 112-122). Edward Elgar Publishing. DOI: https://doi.org/10.4337/9781783471195.00020

Wolfsteller, P. (2020, 29 de julio). Uncoordinated government response to coronavirus hinders recovery: experts. Flight Global. https://www.flightglobal.com/safety/uncoordinated-government-response-to-coronavirus-hinders-recovery-experts/139540.article

Wonders, N. A. (2006). Global flows, semi-permeable borders, and new channels of inequality. En S. Pickering & L. Weber (Eds.), Borders, mobility, and technologies of control (pp. 63-86). Springer. https://www.academia.edu/41937823/BORDERS_MOBILITY_AND_TECHNOLOGIES_OF_CONTROL DOI: https://doi.org/10.1007/1-4020-4899-8_4

Woolf, S. H. & Aron, L. (Eds.). (2013). U.S. health in international perspective: shorter lives, poorer health. National Academies Press. https://www.nap.edu/catalog/13497/us-health-in-international-perspective-shorter-lives-poorer-health

Woolf, S. H., Masters, R. K. & Aron, L. Y. (2021). Effect of the COVID-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data. BMJ, 373(1343). http://dx.doi.org/10.1136/bmj.n1343 DOI: https://doi.org/10.1136/bmj.n1343

Woolf, S. H. & Schoomaker, H. (2019). Life expectancy and mortality rates in the United States, 1959-2017. JAMA, 322(20), 1996-2016. https://doi.org/10.1001/jama.2019.16932 DOI: https://doi.org/10.1001/jama.2019.16932

World Health Organization. (2020). Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). https://www.who.int/news/item/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)