Healthcare Beyond Borders: Patterns and Drivers of Cross-Border Patient Mobility from Sudurpaschhim, Nepal to India

Abstract

Cross-border healthcare is a common practice in Nepal-India border area. It is normal for people from the Sudurpaschhim Province to seek diagnostic services, specialist advice, surgical procedures, emergency care, medication, and post-treatment therapy in India. The current study explores patients' characteristics, diagnoses, preferred places of treatment, social networks, frequency and mode of travel, and barriers to continuity of care in this group. This study was conducted using exploratory sequential mixed-method design that is qualitative dominant. This study employed in-depth individual interviews of patients, caregivers, key informants (healthcare providers, pharmacists, ambulance drivers) as well as field observations and structured descriptive reports. The qualitative data were analysed thematically and descriptive statistics were generated to summarise the characteristics of patients, diagnosis, treatment facilities, routes and frequency of travels.

The discovery shows that for many border trippers it is a regular and accepted practice to access healthcare services in India. Most of them go to Indian hospitals for scheduled treatment and ask for immediate treatment in emergencies. The most frequent diagnoses are cancer, kidney disease, heart disease, neurological disorders, orthopedic disorders, complications during pregnancy and childhood, chronic disease, unresolved, and alternative opinion. The most common transit points for Kailali and Kanchanpur people are Gaurifanta and Gaddachowki respectively. The decision on which hospital to use depends on services available, infrastructure for transportation, costs, social networks and trust. The specialist accreditation system, the capacity for diagnostics, referrals, insurance claims, counselling, and cross-border coordination can be improved to decrease the informal migration for health care