# Investigating Tourists’ Emergency Healthcare Access Barriers: A Systematic Literature Review

## TL;DR

This review identifies barriers tourists face when accessing emergency healthcare abroad, such as language issues and insurance problems.

## Contribution

The study systematically reviews literature to highlight unaddressed challenges in emergency healthcare access for international tourists.

## Key findings

- Language and cultural barriers were the most common challenges reported by tourists.
- Financial and insurance coverage issues significantly hindered access to timely emergency care.
- Most studies were conducted in Asian countries, highlighting regional variations in healthcare access for tourists.

## Abstract

Background: Tourists often travel within their own country or abroad for business, leisure or to receive planned healthcare. However, they are often not prepared for unexpected medical emergencies that occur far from home. Seeking emergency healthcare during travel may pose various barriers and challenges to tourists. Aims: This systematic review aimed to identify the challenges and barriers tourists face while seeking emergency healthcare during travel. Methods: A comprehensive search was performed in PubMed, Scopus, Web of Science and ScienceDirect from 1st January 1995 to 31 October 2025. The review included studies focusing on tourists who sought emergency healthcare abroad. Due to the methodological heterogeneity of the studies making meta-analysis impossible, a narrative synthesis of the results was conducted. The review protocol was registered with PROSPERO (ID CRD420251156975). Results: From 608 initial titles (603 from database searches and 5 additional from similar articles), 10 studies were selected—5 cross-sectional and 5 retrospective. Most (7/10) were conducted in Asian countries, while others were conducted in Europe (1), the U.S.A. (1) and multiple countries (1). The participant number ranged from 37 to 2333. All studies included both genders, apart from one that focused exclusively on pregnant women. The most common challenges identified were language and cultural barriers, limited access to healthcare services in terms of appropriateness and timeliness of care and financial and insurance coverage issues. Conclusions: The findings underscore that tourists face multiple barriers when seeking emergency healthcare abroad, resulting in negative tourist travel experiences. Once identified, specific strategies should be adopted to improve accessibility and the overall quality of care for tourists.