One in five expats, equivalent to around 38 million people around the globe, would prefer to be treated outside their country of residence if they fell seriously ill, a survey has revealed.

And almost half, some 44% of expats are not happy with the health care available in the country where they live, the study by Bupa International shows.

Despite their lack of faith in their new homes’ health care standards, over half, 50.5%, of expats surveyed said that they feel happiest in their current country of residence. Although one in five believes that their health has deteriorated since moving abroad.

The top places where people surveyed said they would like to be treated were Singapore at 23%, the US at 15%, and South Africa and the UK both on 10%.

Dr. Sneh Khemka, medical director for Bupa International said that wherever in the world you live it is important to have access to expert medical advice to be sure that you are going to be directed to the most appropriate facilities.

‘While Singapore is seen to have the best healthcare by nearly a quarter of expats, the truth is that while there are many excellent hospitals in Singapore the quality of healthcare available there varies, like it does in every country around the world,’ he explained.

Lee Gerry, underwriting manager for insurance company Expatriate Healthcare, said that there are a number of factors that can lead to dissatisfaction with the level of care available in a new country. ‘Language is a particular barrier, as it is important that the customer feels that they are being listened to,’ he said.

‘Also, services that people take for granted may simply not be common practice in a new country. For example, in Spain it is usual for some nursing care to be provided by family members. Expats usually only have one generation of family living with them, so that is rarely an option, especially if their partner works,’ he explained.

Recently the NatWest International Personal Banking Quality of Life report found almost three quarters, 71%, of expat health insurance policyholders are happy with their retired lifestyle and believe they have made the right decision to relocate abroad.

Those who benefit the most from the lifestyle expats are those that keep active and have a good social life, especially if they are older, according to Caroline Moye, head of communications for age charity Independent Age.

She said it is important to engage in social activities and meet up with like minded people and that vital for older people, particularly if they live alone. Physical activity is also beneficial to health for expats of any age, as keeping fit helps to reduce the likelihood of having to make an overseas medical insurance claim.