Revista de Comunicación y Salud, 2025, No. 15, 1-19.
Editado por Cátedra de Comunicación y Salud
ISSN: 2173-1675
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Received 31/01/2025
Accepted 17/04/2025
Published 29/05/2025
DEVELOPMENT OF MEDICAL TOURISM IN MEXICO'S NORTHERN BORDER AND COMMUNICATION STRATEGIES
Flor Micaela Ramírez Leyva[1]: University of Guadalajara. Mexico.
micaela.ramirez@academicos.udg.mx
Janet García González: Autonomous University of Nuevo León. Mexico.
Mayda González Espinoza: Autonomous University of Baja California. Mexico.
How to cite this article
Ramírez-Leyva, Flor Micaela; García-González, Janet & González-Espinoza, Mayda (2025). Development of medical tourism in Mexico's northern border and communication strategies. Revista de Comunicación y Salud, 15, 1-19. https://doi.org/10.35669/rcys.2025.15.e368
Abstract
Introduction: The development of a medical tourism destination is linked to complex processes and the involvement of various actors, giving institutional communication a crucial role. This study addresses the socioeconomic dynamics of the health services market with international mobility in Baja California, Mexico, aiming to highlight communication strategies. Methodology: The study was conducted using an ethnographic approach in the Mexicali Medical District, interviews with 188 tourist patients and documentary analysis of research, specialized and general media, and reports from government and official agencies. Results: There are 55 to 70% cost savings in 8 of 16 medical procedures used by tourists, even lower prices on medicines in Mexico compared to the United States; an intense marketing effort in medical tourism and the implementation of public policies with high investments have transformed the city of Mexicali and the northern border, highlighting the Mexicali Health Care medical cluster. Conclusions: Although institutional communication strategies have yielded good results, there is a need to address social issues such as public safety, understand the evaluation of public programs and policies, and follow up on them. Additionally, there is a need to expand the reach to European and South American markets. Communication is crucial in the health sector, especially in medical tourism, where cultural adaptation and relational dynamics play an important role.
Keywords:
Medical tourism, health, communication, development, economic impact.
1. INTRODUCTION
Tourism as an industry has been one of the most dynamic and representative sectors for the economic development of any country. At the global level, tourism constitutes one of the principal activities, generating 9% of gross domestic product (GDP) worldwide, and in Mexico it is one of the pillars of national capital; according to data from the Instituto Nacional de Estadística y Geografía (INEGI)[2], in 2021 it contributed 7.5% of GDP (INEGI, 2022).
In recent years, Mexico has become a tourism powerhouse, and the number of foreign visitors to the country has increased considerably each year. In 2022, the World Tourism Organization (UNWTO) ranked Mexico sixth in international tourist arrivals, with more than 38.3 million visitors, making it the Latin American country with the highest number of visitors in this category (Secretaría de Turismo, 2022). The development of medical tourism is closely linked to effective communication strategies, which play a fundamental role in attracting and retaining international patients.
1.1. The relevance of communication strategies in health tourism
Institutional communication strategies are fundamental to the competent interaction of organizations with their stakeholders, the management of their brand identity, and the achievement of their strategic objectives. This type of communication is complemented by a performative mode, emphasizing action-oriented messaging capable of enacting change and influencing community behavior, which is of central importance in the field of medical tourism. These strategies have undergone considerable transformation with the emergence of new media and the increasing complexity of organizational environments. Institutional theory provides a conceptual framework for understanding strategic communication. The phenomenological approach is particularly noteworthy, as it emphasizes communication processes together with their cultural and social contexts (Sandhu, 2022). In order to engage effectively with their audiences, new media require institutions to adapt their communication models (Nicolae et al., 2023).
Communication strategies in health tourism are crucial for effectively attracting and retaining international patients by addressing their health and tourism needs. The integration of digital communication tools, such as social media, virtual reality, and augmented reality, has become essential for promoting health tourism destinations and services, as these tools enhance both reach and engagement with potential tourists (Sunaryo et al., 2023; Lacárcel & Huete, 2023).
Social media platforms facilitate the dissemination of information, influence the decisions of potential tourists, and enhance the visibility of medical tourism destinations. The effective use of social media platforms can significantly increase the number of international tourists by providing targeted and engaging content. Social media are an integral part of the marketing strategies of medical tourism providers. They enable the integration of online and offline marketing tools, thereby improving the reach and effectiveness of promotional campaigns (Kop, 2024). Branding is another critical aspect, as countries need to establish a competitive identity in order to stand out in the global market (Yildirim, 2020).
Communication strategies must also take into account cultural appropriateness and health literacy in order to meet the diverse expectations and preferences of medical tourists (Kaur et al., 2020). These strategies require attention to cultural, educational, and socioeconomic factors to ensure that information is not only disseminated, but also understood and applied (Suaste Pazmiño et al., 2023). In addition, health communication literacy plays an important role in public health empowerment, especially in tourist areas, by influencing attitudes and behaviors related to health maintenance (Putri et al., 2023).
Health communication literacy is a critical component in promoting effective health outcomes by enabling individuals to access, understand, and apply health information. It encompasses various dimensions, including digital literacy, nutritional literacy, and the use of innovative communication tools.
Overall, a comprehensive communication strategy that leverages digital tools, strategic management, and cultural sensitivity is essential for the success and growth of health tourism.
1.2. Relationship between the development of medical tourism in the border region and communication
In Baja California, a state located on the northwestern border of Mexico, the medical tourism sector is one of the state’s main vocations and, therefore, one of the pillars of the state’s development and growth. It represents a growing niche of opportunity, since everyday hundreds of American and Canadian patients cross the border to consult health specialists, acquire medicines, and undergo tests and analyses in laboratories. There are various causes that explain the increase in medical tourism of Americans to Baja California, among them: Mexico’s relatively lower prices in terms of medical fees, hospital care, and medicines; the lack of medical insurance coverage for a significant part of the population of those North American countries, especially the Latino minority in need of lower-cost medical services (Comité de Turismo y Convenciones [COTUCO][3], 2019). In recent years, the number of patients traveling internationally for healthcare services has increased significantly, increasing their level of demand regarding the care and provision of these services, requiring a certain degree of reliability in the services of hospitals and clinics and in the carrying out of treatments.
The relationship between the development of medical tourism and communication as a process and strategic instrument is a topic of great relevance in the academic and professional spheres. The reasons for the importance of contributing to the analysis of this relationship between medical tourism and communication arise from the strategic and communicational implications, basically in 3 aspects. First, considering marketing and promotion, that is, strategic communication is essential to attract medical tourists. This includes the promotion of medical destinations through marketing campaigns, international health fairs, and collaboration with tourism agencies. Secondly, considering patient information and education: medical tourists need access to clear and precise information about procedures, costs, the credentials of health professionals, and medical facilities. Third: attending to reputation management: the reputation of medical tourism destinations depends to a great extent on the experiences and testimonies of patients. Communication strategies must focus on managing and improving reputation through patient satisfaction and service quality.
Medical tourism involves patients who travel across borders to receive medical care, driven by factors such as cost, quality of care, and the availability of advanced medical technologies. This link is observed, first, in that medical tourism implies interaction among medical service providers, patients, and interested actors such as travel agencies specialized in medical tourism, insurers, health authorities, and regulatory bodies. Secondly, the axis of communication rests on the fact that effective collaboration is required among all these actors in order to guarantee the quality and safety of the medical care provided to patients. The quality of communication with the patient significantly impacts perceptions of the quality of the health service, requiring the training of medical personnel to improve their communication skills and cultural competence (Crooks, 2022). For the reasons indicated, communication plays a crucial role in this process, since it facilitates the transmission of information about the available medical services, procedures, costs, and other aspects relevant to patients.
2. OBJECTIVES
This study aims to identify the context, key developments, achievements, and evolution of medical tourism in the northwestern border region of Mexico during the last 10 years, especially in the city of Mexicali, considering the social incidence and communication strategies, understood as actions and initiatives of the socio-political actors involved. The interaction between public health systems and medical tourism also highlights the need for solid communication to address the deficiencies of national health systems and attract inbound medical tourists. The questions that guided the research are what the characterization of medical tourism in this Mexican border area is and what function communication activities fulfill in the various processes for the development of this type of tourism.
3. METHODOLOGY
The results of the study presented here form part of a broader investigation on the Measurement of the perceived quality of health services in medical tourism: Application in the medical district of Mexicali, Baja California. For the present text, the method used consisted of a combination of place ethnography (Mexicali and surrounding localities in Baja California, Mexico), the conducting of interviews, and qualitative documentary analysis.
3.1. Ethnography
This approach allowed for a deep and contextual understanding of medical tourism in Mexicali and surrounding localities in Baja California, Mexico. The study was carried out over a period of one year. The ethnography of the place involved direct observation and participation in the study environment, including the downtown area of the city of Mexicali, where the Mexicali Medical District is located. Convenience sampling was used, selecting two hospitals recognized for their prestige and high volume of care for visitors. The sample corresponded to a total of 188 tourist patients, 95 men and 94 women; to locate them, the “snowball sampling technique” was employed, requesting that the informants recommend other actors with experience and knowledge on the subject. Additionally, interviews were conducted with hospital directors. Visits were made to clinics, hospitals, and medical care centers specialized in receiving medical tourists. The categories of analysis included the transit of people and automobiles, urban zones or peripheral areas, neighborhoods, real estate developments, roadways, various plots of land, urban infrastructure including public lighting installations, road and informational signage, among others.
3.2. Interviews
In the case of the tourists who came for medical services, out of the total of 188, the age structure of the population was formed mostly by people under 55 years of age (73.3%) and, to a lesser extent, by people aged 55 or over, mainly from Arizona and California, as represented in Figures 1 and 2. The principal occupations and sources of income are working for a company, being retired, being government employees, or being self-employed, with 44.8%, 17.5%, 13.9%, and 13.4%, respectively.
Figure 1. Composition of the sample by age groups.
Source: Own elaboration.
Figure 2. Composition of the sample by city of origin (percentages).
Source: Own elaboration.
During the fieldwork visits, interviews and informal conversations were carried out with various actors involved in medical tourism. In the case of patients, their experiences and perceptions regarding the services received, the reasons for choosing Mexicali as a medical destination (Figure 3), as well as their expectations and levels of satisfaction, were collected. As for health professionals, including physicians, nurses, and administrative staff, their perspectives on the influx of foreign patients, as well as the challenges and benefits associated with medical tourism, were explored.
Figure 3. Map of the Mexicali Medical District area.
Source: INEGI's National Statistical Directory of Economic Units, 2023
3.3. Documentary analysis
The qualitative documentary analysis prioritized the selection of texts related to health and wellness tourism at the border; a search was carried out on networks using keywords such as Mexicali, Baja California, health services, tourists, and clinics. Likewise, local and regional newspapers were reviewed, particularly those from the last 5 years. Another selection criterion was that they should include diverse voices and official, recognized, or strategic sources in the fields of research, communication, and dissemination. The qualitative documentary analysis complemented the ethnographic record by providing a broader context and a rich database for the study. It included the review of various sources of information, such as academic articles, medical journals, reports in regional newspapers, and reports from official agencies such as the tourism observatory and the State Ministry of Tourism. With these materials, the content was organized considering key aspects in the evolution and promotion of medical tourism in Baja California: economic resources, public policies, perception of the quality of service provision, procedures, limitations, mobility, changes in urban areas, and in the medical cluster of the Mexicali Valley.
4. DEVELOPMENT OF THE RESEARCH
4.1. Context and importance of medical tourism in Mexico
Medical tourism refers to the international flows of travelers who travel in order to receive medical services. This involves one or several processes ranging from consultations, intervention, hospitalization (or clinical care) to the provision of medicines. This sector of tourism has shown significant and sustained growth in recent years worldwide, and it is expected to continue improving its share in the coming years. Medical tourism in Mexico has become an important industry due to various factors, among them the economic asymmetries between the global North and South, and the flexible regulatory environment that allows affordable and high-quality care (Arrioja-Castrejón & López-Fernández, 2021).
In 2019, Deloitte made known the opportunities and perspectives of health tourism in Mexico. This report highlights that the growth of health tourism is 12.8% annually and that its contribution to the tourism sector is 10.7%. This organization also stated that the accelerated growth of the industry is due to the expenses associated with the reason for travel, also known as complementary services.
The proximity to the United States and the service dynamics between both countries make Mexico the second most popular destination for medical tourism worldwide (Dávila-Aragón & Arrioja-Castrejón, 2021). According to Patients Beyond Borders (n.d.), Mexico is the second medical tourism destination in the world, attracting more than one million foreign patients per year, many of whom are of Hispanic origin, mainly from the states of California, Arizona, and Texas. The northern border is a preferred point for medical tourists, due to its proximity, quality of services, low prices, and the warmth of its population.
With respect to Gross Domestic Product, Mexico ranks 12th, surpassing countries such as the United States, Canada, and Germany, due to the low cost of services and the high quality of the services. In this way, any foreigner interested in treating some condition in Mexico will save a considerable amount of money and will have the same quality of service, or even superior, than the medical services in their respective countries.
Table 1 shows the comparison of prices in Mexican pesos and the percentage of savings for tourists, in force in 2021. These figures reveal the evident advantage for patients of traveling to Mexico in order to undergo any of the medical procedures presented, even if other costs such as airfare, accommodation, and other travel expenses are added to these amounts, it remains a very attractive alternative for them, depending on their needs or purchasing power.
Table 1. Price comparison for 2021, in Mexican pesos and percentage of savings.
|
MEDICAL PROCEDURE |
USA |
Mexico |
Savings |
|
Heart valve replacement |
170,000 |
10,000- 35,000 |
92% |
|
Spine surgery |
110,000 |
16,000 |
86% |
|
Heart bypass |
123,000 |
15,000- 35,000 |
78% |
|
Hysterectomy |
15,400 |
6,500 |
71% |
|
Hip replacement |
40,364 |
13,500 |
67% |
|
Dental implant |
1,500 |
975 |
64% |
|
Angioplasty |
28,200 |
5,500- 6,200 |
63% |
|
Knee replacement |
35,000 |
12,500 |
63% |
|
Hip resurfacing |
28,000 |
12,000 |
55% |
|
Facelift |
11,000 |
6,200 |
55% |
|
Gastric band |
14,000 |
5,000 |
54% |
|
Sleeve gastrectomy |
16,500 |
6,500 |
46% |
|
Liposuction |
5,500 |
2,500 |
45% |
|
Abdominoplasty |
8,000 |
4,500 |
44% |
|
Rhinoplasty |
6,500 |
3,600 |
42% |
|
Breast implant |
6,400 |
4,200 |
41% |
Source: Authors’ own elaboration based on the Medical Tourism Association,
Medical Tourism (2021).
4.2. Medical tourism in Baja California
Baja California annually receives 15.8 million international visitors, whose main reasons are gastronomy, shopping, health, entertainment, business activities, and sun and beach tourism. Health and wellness tourism ranks third in importance, with 2.8 million patients and an economic spillover of 700 million dollars (Plan Estatal de Desarrollo de Baja California[4] 2022–2027, 2022a). This trend began to intensify from the 1980s onward, when the region’s medical and tourism infrastructure began to develop more significantly.
The state has long experience in the care of foreign patients, which gives it a great advantage over other destinations in the country. This benefit is due to its privileged geographical location, tourism infrastructure and equipment, and the existence of hospital centers and clinics of recognized prestige, which make Baja California a leading state in medical tourism. The Plan Estatal de Desarrollo de Baja California 2022–2027 establishes action for medical tourism, specifically the competitive offer of health and wellness services, whose objective is to achieve recognition both for the degree of specialization in medical procedures, the quality, technology, and innovation of medical services, and the economic advantages of receiving care in our state, as well as for postoperative care and the complementary service offer of the entire value chain of the tourism sector (Plan Estatal de Desarrollo de Baja California 2022–2027, 2022a).
Tijuana and Mexicali are two border cities that offer health services in Baja California, Mexico, and are leading destinations in medical tourism, especially with regard to specialized surgeries, dental and aesthetic treatments, among other options. Mexicali, the state capital, receives at least 32% of the health tourists who arrive in Baja California. In the center of this city there is a medical district located just a few meters from the border line, with more than 70% of the medical and health service options. This area has the necessary infrastructure, such as adapted sidewalks with access for people in wheelchairs, roadways equipped for the transit of visually impaired persons, as well as tourist police located at strategic points (Plan Estatal de Desarrollo de Baja California 2022–2027, 2022b).
In Mexicali, both its advanced medical infrastructure and its proximity to the border with the state of California in the United States have attracted international patients interested in high-quality medical treatments. Mexicali has gained recognition in areas such as bariatric surgery, dentistry, and aesthetic treatments; this has generated an economic impact in the region, stimulating hotel occupancy and consumption in related services, placing it in third place in economic impact within the state.
Another important place for medical tourism is the town of Los Algodones, located 73 kilometers northeast of the city of Mexicali. This site has stood out for having a vast supply of health services, with 350 consulting rooms and specialties ranging from dentistry to plastic surgery. The locality receives from 3,000 to 4,000 patients daily during the high season, most of whom are of American and Canadian origin. Los Algodones holds 3rd place in the state in economic economic impact from medical tourism (COTUCO, 2019).
This influx has led to the development of collaboration networks among the stakeholders in health tourism, fostering innovation in products, services, and marketing strategies, improving competitiveness and sustainability (Zermeño-Flores et al., 2019). The problems faced by this sector in the state of Baja California should not be omitted. This difficult condition is due to the scarce synergy among the actors that represent it, the perception of insecurity on the Mexican border on the part of visitors, deficient efforts regarding the promotion of all the services that are offered, lack of procedures for the collection of statistical information for decision-making, and finally the lack of standards of regulation and certification for this sector (Plan Estatal de Desarrollo de Baja California 2022–2027, 2022a). Particularly, with respect to insecurity, derived from an environment undermined by organized crime or by the complex sociocultural situation of that valley, exposed to risks on public roads or in certain urban spaces.
Medical tourism in Baja California faces several communication challenges that impact its effectiveness and growth. One important issue is the insufficient communication regarding the costs and quality of medical services, which hinders the decision-making process for potential medical tourists (Ramírez-Pérez et al., 2021). In addition, the strong dependence on the media to disseminate information lacks the persuasive power necessary to convince people to seek medical care abroad (Zermeño-Flores et al., 2020).
4.3. Profile of medical tourism in Baja California
The tourism industry in Baja California is segmented into 5 axes, focused on: meetings and business, medical and wellness, nature and adventure, nautical and cruises; and finally culinary and wine-related tourism. For the medical and wellness axis, Baja California has generated a proposal of great value in attracting thousands of medical tourists. The factors that benefit the development of health or medical tourism are: experience in the care of foreign patients, the privileged geographical location, the existence of infrastructure, and hospitals and clinics with international accreditations.
According to data from the Secretaría de Turismo del Estado de Baja California[5] (2022), medical and health tourism has experienced notable growth in recent years, attracting approximately 2.8 million visitors annually and generating a significant economic impact. With an average expenditure of 190 dollars per person, this sector represents a key opportunity for economic development and the promotion of the destination. The government of the state of Baja California has proposed as its main public policy actions, including communication strategies, the improvement of the urban image, the strengthening of public security, the reorganization of roads and transport, the enhancement of the tourist vocation of the area, security and improvement of pedestrian walkways, among others (Programa Sectorial de Turismo BC[6] 2022–2027). The duration of stay and total expenditure are variables that show a significant correlation, given that a longer stay will imply greater expenditures on accommodation, food, and services additional to those directly related to health; the average expenditure per visit was slightly more than 300 dollars (3,968 MXN) and the average duration amounted to 1.59 days, see Table 2.
Table 2. Profile of the visitor to Baja California, 2022–2023.
|
Place of origin |
39.6% national |
60.4% foreign |
|
Total expenditure of the visitor |
Total trip per person: $ 8,949 mxn |
|
|
Total per day per person: $ 3,968mxn |
||
|
Percentage by place of origin |
United States 58.7% Mexico 39.6% Others 1.7% |
|
Source: Authors’ own elaboration based on data from the Secretaría de Turismo. (2023).
The medical tourist comes mostly from the United States of America, mainly from the state of California (cities of Escondido, Calexico, Alpine, Heber, La Jolla, Vista, Realto, Poway, Lakeside, La Mesa, Irvine), from the state of Arizona (cities of Yuma, Somerton, and Phoenix) and, at a lower level, from Canada, from the state of Saskatchewan (Reyna county and Regina) and the state of Alberta (counties of Emerton and Ontario). Many are also people over 40 years of age who require specialized medical treatments, such as bariatric surgery, cosmetic dentistry, or facial rejuvenation procedures. Medical tourists travel accompanied by family members or friends who provide emotional and logistical support during their stay in Baja California, which also contributes to companion tourism in the region.
With respect to the profile of the medical tourist who arrives in the city of Mexicali, characterized by being a group of people of foreign nationality or residence with mobility, 95% cross for the purpose of attending a medical visit, while the remaining 5% do so exclusively to acquire medicines. Eighty-seven percent come from the counties of Imperial and Riverside, California. In the case of Imperial County, they come mainly from Calexico, El Centro, and Brawley. As for Riverside, most of the people originate from Indio, Coachella, and Cathedral City. In relation to the medical specialties sought, it was found that the majority go to receive dental or general medicine services, followed by specialties such as surgery, ophthalmology, pediatrics, orthopedics, and plastic surgery. In 45% of the cases, the expenses are covered by an insurance company; 12.9% report that this is a first visit, while 87.1% of them correspond to a subsequent visit, typically the 5th or 6th attendance, which evidences their satisfaction with the services received.
4.4. Social impact and communication strategies on the part of managers or stakeholders
Strategic communication, marketing, presence in digital media, and public relations are used to promote medical destinations, clinics, and specific services at the international level. The rise of social media and digital communication has transformed the way in which patients access information about medical services abroad. Clinics and medical destinations use online platforms to promote themselves and to establish relationships with patients and potential clients. In order to establish relationships with patients and potential clients, another marketing strategy for expanding the reach of both tourism in general and medical tourism is social media. These not only allow clients to approach companies or providers of medical care, but also to share experiences and give recommendations.
Considering that patients come from developed countries and, consequently, have had greater contact with communication technologies, since these form part of their everyday practices, clinics in the health sector should at least have an informative website that allows them to be visible and accessible to patients when choosing their medical services.
Another strand of actions related to strategic communication is integrated into the initiatives of the Secretaría de Turismo del Estado de Baja California[7] (2023), as part of the action plan for medical and health tourism in Baja California, among whose objectives the following stand out: to increase the number of medical and health tourists through promotion on digital platforms, at international fairs, and through collaborations with specialized tourism agencies. The second objective is to improve the quality of services, ensuring high standards of quality and safety. Diversifying the offer is the third, by expanding the range of medical and health services available to satisfy the needs and preferences of diverse market segments. The fourth objective focuses on promoting sustainability: fostering sustainable practices in the medical and health tourism industry in order to preserve the natural and cultural environment. Finally, the aim is to strengthen public-private collaboration: to establish strategic alliances among the government, the private sector, and non-profit organizations in order to promote the development and promotion of this industry.
4.5. Communication strategies and actions
In the area of public-private collaboration, the following strategies are carried out. First, the creation and promotion of the health tourism cluster, called Mexicali Health Care, which is made up of various hospital tourism companies and civil associations; its substantial function is to incorporate more medical units in the city in order to train them and update their facilities in such a way that they offer health services with high quality standards. This cluster is supported by the government of the state of Baja California, the city council of Mexicali, the Ministry of Tourism, the Tourism and Conventions Committee, the Tourism Promotion Trust, the Ministry of Economic Development, the Hotel and Motel Association, the National Chamber of Restaurants, and the National Chamber of Commerce (Mexicali Health Care, 2017).
Among some of the actions carried out by this civil association, the following stand out. On the one hand, the creation of the Medical Lane or medical pass line. Enabled in May 2012 at the initiative of COTUCO, as part of a strategic plan to promote medical tourism in Mexicali, it is an access lane at the international border crossing exclusively for foreign users of health services, such as hospitals, clinics, doctors, pharmacies, or laboratories affiliated with the medical lane. Patients receive a pass to return to the United States by that route, reducing the waiting time to cross the border. To use the lane, users must have foreign license plates, show proof of residence in another country, a receipt, prescription, or appointment card that supports the patient’s treatment; or a receipt for the purchase of medicines up to 400 pesos. The implementation of public policy to modernize the urban development of Mexicali through the improvement of the urban image of the city’s medical district is another of the priority actions, as is the adaptation of sidewalks, preparations for underground wiring, gardening, road stamping allusive to the district, and lighting.
In the second category, the area of marketing and promotion, Mexicali Health Care carries out marketing campaigns directed specifically at the medical and health tourism segment in key markets, highlighting the quality of the services and the accessibility of the prices. Likewise, this cluster participates in international medical tourism fairs and events.
As a third set of strategies, regarding the area of quality and safety, the implementation of certification and accreditation programs for providers of medical and health services is developed, ensuring compliance with international standards. In addition, feedback and follow-up mechanisms have been established to evaluate patient satisfaction and continuously improve the quality of services. To monitor relevant indicators, generating information aimed at covering clients’ needs and enhancing the offer of this economic sector.
5. DISCUSSION
The impact and communication strategies of health tourism are multifaceted, involving various public actors (state and municipal government) and private actors (businesspeople, developers, investors), as well as economic, political, cultural, and social factors in Mexicali. Health tourism, which includes medical and wellness services, has experienced significant growth due to competitive prices and ease of access in Baja California. Bilingualism plays a crucial role in improving the experience of medical tourists by facilitating effective communication between patients and healthcare providers. Offering multilingual support, including translators and interpreters, ensures that patients fully understand their medical options, which is vital for informed decision-making in a foreign healthcare system.
Language barriers, although they are a minor problem for bilingual patients, can still pose challenges in complex medical situations. Additionally, the quality of care and post-treatment follow-up may vary significantly between countries, which requires careful research and planning on the part of patients (Kundury et al., 2024) (Bhadiyadra et al., 2024). Bilingual health providers can communicate directly with patients in their native language, which significantly improves understanding and reduces the risk of miscommunication. The presence of bilingual health professionals and culturally sensitive environments in medical tourism destinations further enhances patient satisfaction. This cultural congruence is crucial for the patient’s healing and well-being, as it fosters a sense of comfort and trust between patients and providers (Ghaderi et al., 2024). However, challenges such as low bilingualism among healthcare providers and poor communication between international patients and local physicians create barriers (Carrión-Ramírez et al., 2022).
In the medical tourism–mass media binomial, tensions among stakeholders exert an influence, that is, physicians, agencies and advertisers, medical travel agencies, commission agents or facilitators, representatives of some state and federal government offices, due to incongruences between non-medical industries that do not conform to the medical ethics of the receiving country.
Added to this are technologies in the media sphere, such as social media, which likewise influence the channels and practices of tourism (in a less controlled manner, without collaboration with the key actors of the tourism system). This public interest (especially among non-specialists) is due to the socio-political phenomenological fact of tourism, which attributes functions of public communication to it. Under this typology of communication lies the importance of managing strategic communication within an appropriate thematic agenda for the destination country, addressing the realities and risks of medical travel. The media and the effective use of health marketing have the power to promote tourist destinations, objectively through promotion and information; however, at the beginning of 2019, with the impact of the Covid-19 pandemic, an increase in digital innovations was recorded in the sphere of medical tourism, and with the use of specialized websites, the term electronic medical tourism was reinforced.
6. CONCLUSIONS
In general, addressing these communication aspects is essential for the successful functioning and growth of medical tourism. Communication is crucial in the healthcare field, especially in medical tourism, where cultural adequacy and relational dynamics play an important role. Perceptions regarding patient communication and service quality are also influenced by the experience and language skills of medical personnel, which indicates the need for better training and allocation of resources to improve these aspects. In addition, the continuous exchange of information among patients, medical professionals, and other service personnel is often interrupted by internal conflicts, stress, and external environmental factors, which leads to communication crises within medical institutions.
Given the potential of medical and health tourism in Baja California to contribute to economic growth and regional well-being, it is crucial to continue strengthening the comprehensive strategy supported by communication as a process that combines destination promotion, improvement of service quality, and the fostering of sustainability. The results highlight that Mexicali has important advantages, in addition to its privileged location on the border with the United States, being a pioneer and remaining at the forefront in technology and health services. The changes and achievements have been generated through actions of intersectoral management and the implementation of communication mechanisms, such as the operation of the medical lane or ‘medical pass’ line at the international border crossing, the remodeling of the urban image, the modernization of roadways, public services, infrastructure in the medical district, and research and evaluation initiatives of instruments to measure the perception of service quality among tourist users of the medical district, within the facilities of hospitals and specialized medical centers themselves.
7. RECOMMENDATIONS
Considering what has been presented in this work, it would be useful to strengthen some dimensions of the research, especially by studying in greater depth the following aspects that would allow a more complete assessment. Below, it is suggested that three issues be taken into account.
The first is to use information and strategic communication to carry out a diagnosis of the concrete effects of insecurity (and the perception of insecurity) on medical tourism and on the economic spillover, as well as to reverse this scenario. A campaign could be used to improve particularly the problem of public security, focusing on how public security policy has favored medical tourism and social dynamics, or by disseminating the benefits of or adjustments to the Program “Reinforcement of security, citizen and tourist assistance” for the Historic District Office. In this case, in addition to the improvement of pedestrian walkways, consideration should also be given to the repair and reinforcement of public lighting, the strengthening of surveillance networks, and the culture of service and tourism vocation. The issue of security in Mexico is one of the main pending matters, particularly in the border area, and represents one of the greatest challenges for any government or administration. Strengthening security for inhabitants can bring benefits in different aspects, which, in turn, contribute to improving health and medical tourism indicators.
As a second aspect, in the field of digital marketing campaigns, the services of consultants in Mexico and internationally could be employed, whose services suggest using, in accordance with medical specialties, commercial objectives, and the concrete demands of medical tourists (national and foreign), resources such as Google Ads campaigns for stakeholders, positioning through a website, presence on Google My Business and Google Maps, registration in digital medical directories, creation of educational content for patients, reviews on the experience and the perception of service quality regarding the diversification of the offer and the expansion of the range of medical and health services.
Finally, it would be ideal to enrich the contribution in the field of communication strategies with a broader perspective. This would imply comparing studies on the perception of the quality of services in medical tourism in Mexico; learning about the follow-up and evaluation of the actions of the various programs such as tourism awareness, customer care, and visitor service. Another set of studies may be oriented toward the optimization of tourism based on other strategies: first, the use of other international social networks and portals, in addition to the websites of the hospitals and clinics themselves dedicated to medical tourism in Baja California; second, the dissemination of the services of Mexicali Health Care at events and forums in other countries in Europe and the Middle East. It would also be important to inquire into how work is being carried out with the rest of the key agents of Mexico’s medical tourism clusters, in order to enhance the advantages of the synergy of contacts and alternative methods for the growth of this socioeconomic and health-related sector.
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AUTHOR CONTRIBUTIONS, FUNDING, AND ACKNOWLEDGEMENTS
Conceptualization: Ramírez-Leyva, Flor Micaela; García González, Janet; & González Espinoza, Mayda. Methodology: Ramírez-Leyva, Flor Micaela; & González Espinoza, Mayda. Validation: García González, Janet; & González Espinoza, Mayda. Formal analysis: Ramírez-Leyva, Flor Micaela, García González, Janet; & González Espinoza, Mayda. Data curation: García González, Janet. Writing – original draft preparation: Ramírez-Leyva, Flor Micaela. Writing – review and editing: Ramírez-Leyva, Flor Micaela; García González, Janet, and González Espinoza, Mayda. All authors have read and accepted the published version of the manuscript: Ramírez-Leyva, Flor Micaela; García González, Janet; & González Espinoza, Mayda.
Funding: This research received no external funding.
Conflict of interest: None.
AUTHORS
Flor Micaela Ramírez-Leyva
University of Guadalajara
Holder of a PhD in New Journalistic Models from the Miguel Hernández University of Elche, Alicante. National Researcher (Level 1) and Evaluator for SECIHTI. Member of the Mexican and Latin American Associations of Communication Researchers, in the Communication and Health (CyS) Research Group; and in InCom-UAB. Member of the Sociocultural Anthropology and Communication Academic Body UDG-CA-1013. Research lines: Communication and health, public health; journalism, gender, exclusion, violence, and power; birth rate in childhood and adolescence; internal communication and medical training in public institutions. Reviewer of articles in academic journals in Brazil, Chile, Spain, and Mexico.
micaela.ramirez@academicos.udg.mx
Índice H: 3
Orcid ID: https://orcid.org/0000-0001-8269-2570
Google Scholar: https://scholar.google.es/citations?hl=es&user=ft1HxO0AAAAJ
ResearchGate: https://www.researchgate.net/profile/Flor-Ramirez-Leyva
Academia.edu: https://independent.academia.edu/FRAMIREZLEYVA
Janet García González
Autonomous University of Nuevo León
Holder of a PhD in Communication, Coordinator of the Master’s Program at the Faculty of Communication Sciences of the UANL, National Researcher Level 1 SECIHTI. Leader in Mexico of the Ibero-American Network of Marketing in Health (RIMS); National Coordinator of the Communication and Health research group of the Mexican Association of Communication Researchers (AMIC); and Vice-Coordinator of the Communication and Health research group of the Latin American Association of Communication Researchers (ALAIC).
Índice H: 11
Orcid ID: https://orcid.org/0000-0002-7188-5331
Google Scholar: https://scholar.google.com.mx/citations?user=Qq4KRQ4AAAAJ&hl=es
ResearchGate: https://www.researchgate.net/profile/Janet_Garcia_Gonzalez
Academia.edu: https://uanl.academia.edu/JGarc%C3%ADa
Mayda González Espinoza
Autonomous University of Baja California
Holder of a PhD in Administrative Sciences from the Institute of University Studies, and a Master’s degree in Administration from the Faculty of Social and Administrative Sciences of the U.A.B.C., Ensenada Campus, Baja California. She is a candidate for the National System of Researchers (SNI) through SECIHTI and a member of the academic body in consolidation: “Adoption of ICTs, Administrative Management and Marketing for the Competitiveness of Organizations,” with code UABC-CA-239. She is a professor-researcher at the Autonomous University of Baja California. She holds the accreditation of Full-Time Professor with Desirable Profile from PRODEP. She is accredited before the National Association of Faculties and Schools of Accounting and Administration (ANFECA). She teaches in the Bachelor’s degree programs in Marketing and Tourism Management. She is currently Coordinator of the Tourism Management Educational Program at the Faculty of Administrative Sciences, Mexicali campus.
Índice H: 4
Orcid ID: https://orcid.org/0000-0001-9867-4756
Google Scholar: https://scholar.google.es/citations?user=8pHzvEkAAAAJ&hl=es&oi=ao
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