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Medical tourism to Tijuana fell 20 percent during the first four months of 2014, leading to staff layoffs and price reductions for certain procedures, the Baja California daily newspaper El Mexicano reports.

A 30 percent increase in the cost of supplies, the January 1 hike in the sales tax, and continuing economic woes in California were blamed for the decline by Karim Chalita Rodriguez II, president of the professional association Clúster Médico, in an interview recently published by the newspaper.

As a consequence, some clinics and hospitals have reduced staffing levels, trimming their payrolls by as much as 30 percent, El Mexicano reported.

In other instances, physicians have decided to reduce their fees in an effort to draw patients across the border. For example, bariatric surgery (gastric banding) that once cost $10,000 now costs between $4500 and $6500, the newspaper reported.

According to the Tourism and Conventions Committee of Tijuana, medical tourism attracts 600,000 visitors to Baja California each year, 480,000 of them to Tijuana.

The typical medical tourism patients come to Tijuana for dental care, bariatric surgery, or cosmetic surgery.