Factors Influencing Decision Making of Afghan Patients to Seek Medical Treatment in Pakistan: A Cross-Sectional Study

Abdul Ghafar Sherzad,1,2,* Imran Zafarzai,3 Mohammad Sediqe Zahirzai,4 Abdul Nasir Jabarkhil,2 Mohammad Azim Azimee,1 Ali Jan Adil,5 Habibullah Mulavizada,2 Muhibullah Shinwari,6 Kamran Zafarzai,2 Qingchun Zeng7,* 1Department of Biochemistry, Faculty of Medicine, Nangarhar University, Jalalabad, Nangarhar, Afghanistan; 2Department of Respiratory and Rheumatic Heart Diseases, Faculty of Medicine, Nangarhar University, Jalalabad, Nangarhar, Afghanistan; 3Department of Forensic Medicine, Faculty of Medicine, Nangarhar University, Jalalabad, Nangarhar, Afghanistan; 4Department of Pediatrics, Faculty of Medicine, Nangarhar University, Jalalabad, Nangarhar, Afghanistan; 5Department of Basic Sciences, Faculty of Medicine, Nangarhar University, Jalalabad, Nangarhar, Afghanistan; 6Department of Physiology, Faculty of Medicine, Nangarhar University, Jalalabad, Nangarhar, Afghanistan; 7Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Abdul Ghafar Sherzad, Department of Biochemistry, Faculty of Medicine, Nangarhar University, Jalalabad, Nangarhar, Afghanistan, Email [email protected] Qingchun Zeng, Department of Cardiology, Nanfang Hospital, Southern Medical University, 1838, Northern, Guangzhou Ave, Guangzhou, 510515, People’s Republic of China, Email [email protected]: Due to inadequate healthcare facilities and certain technologies in Afghanistan, many Afghan patients seek medical treatment abroad. Thus, this study aimed to determine the factors that influence Afghan patients’ decision to seek medical treatment abroad.Methods: A cross-sectional study was conducted on 384 respondents in the center of the Special Commission, dispatching the patients to Torkham from June to September 2024 in Jalalabad City, Afghanistan. A non-probability convenience sampling method was used to select study participants. Data were collected using a pretested structured questionnaire. A hierarchical regression analysis was conducted to determine the factors influencing their satisfaction level toward medical treatment in Pakistan.Results: A total of 384 respondents were enrolled, including 64.9% male and 35.1% female. 88.10% of participants were satisfied with medical treatment in Pakistan. 49.5% of respondents obtained information about medical tourism primarily from relatives. Among them, 24.2% were cancer patients, 16% were cardiology patients, 10.1% were surgical patients, and 8.8% were kidney patients. Medicines used in Afghanistan are of low quality; Pakistan’s availability of internationally accredited hospitals, cultural/religious similarity, well-experienced and reputable doctors, similar language, and high-quality medical facilities with internationally certified physicians and staff were top-ranked items. According to regression analysis, the facility and services factor was the strongest factor (β = 0.386, t = 8.508, p = 0.001), followed by the country environment (β = 0.213, t = 4.697, p = 0.001) and medical tourism cost factor (β = 0.142, t = 3.198, p = 0.001).Conclusion: The study concluded that facility and service factors were the strongest predictors of medical tourism, followed by the country’s environment and medical tourism cost. Therefore, healthcare providers and policymakers need to consider the diverse preferences of Afghan patients and provide accurate, accessible healthcare services and advanced professional training of the healthcare providers, including attitude towards services.Keywords: predictors, medical treatment, medical tourism, treatment destination, medical tourism costs