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Dimensions and Drivers of Medical Tourism Industry: A Systematic Review of Qualitative Evidence
Abstract
The 21st century has seen an upsurge in the demand for global healthcare services. And one such niche sector of this rapidly growing market is medical tourism. The rising disparity in healthcare costs is fulling the growth of medical tourists to emerging markets, especially those with advance healthcare facilities and a proximity to developed countries. The interesting pace of this industry has received a growing curiosity from both researchers and practitioners. But most extant research still ignores the factors of competitiveness of a medical tourism destination. Against this backdrop, the present study seeks to identify and analyze the dimensions and drivers of the medical tourism industry. It does so by systematically synthesizing qualitative studies that elicit views of various stakeholders practitioners, management, government, industry associations, facilitators and the academia.
... These were conducted face to face, were audio recorded, after checking with the participants, and later transcribed verbatim. Vital areas of concern were recognised after a thorough literature review on medical tourism and an appraisal of the dimensions of competitiveness of a medical tourism destination, identified by (Malhotra & Dave, 2022). These served as the guide for conducting interviews. ...
... The theoretical background referred to in this paper is a study, by the same authors, on the dimensions and drivers of medical tourism industry. (Malhotra & Dave, 2022) previously developed this paper based on a systematic review of empirical studies on the medical tourism industry globally. ...
... This study uses the extant structure to systemize its findings from research work in Delhi NCR that pursues an understanding on how the value proposition of medical tourism industry can be redefined here. This helps us explore the wider relevance of the proposed dimensions in the study by (Malhotra & Dave, 2022) and its implications in a specific context. By analysing the experiences of the practitioners from Delhi NCR, the study has able been able to identify an additional dimension that impact a medical tourism destinations' competitiveness. ...
India has emerged as a prominent medical tourism hub, yet the dynamic forces in the regional and global landscape are creating a complex balance of opportunities and risks for the Indian stakeholders. The outbreak of Corona virus pandemic in 2019 has further complicated the market dynamics for the medical tourism industry. This study aims to analyze the key driving factors for the medical tourism industry in India and the issues that Indian stakeholders should address in crafting a winning strategy. A qualitative research design was adopted, and data were collected through semi structured in-depth interviews with practitioners and senior representatives of the hospital management. The study adopted abduction logic and analyzed data by means of constant comparison method. The study presents the assessment of the medical tourism industry in India and the scope of opportunity for Indian players.
Full version of the paper is available at the following link - https://rdcu.be/cSQy8
... These were conducted face to face, were audio recorded, after checking with the participants, and later transcribed verbatim. Vital areas of concern were recognised after a thorough literature review on medical tourism and an appraisal of the dimensions of competitiveness of a medical tourism destination, identified by (Malhotra & Dave, 2022). These served as the guide for conducting interviews. ...
... The theoretical background referred to in this paper is a study, by the same authors, on the dimensions and drivers of medical tourism industry. (Malhotra & Dave, 2022) previously developed this paper based on a systematic review of empirical studies on the medical tourism industry globally. ...
... This study uses the extant structure to systemize its findings from research work in Delhi NCR that pursues an understanding on how the value proposition of medical tourism industry can be redefined here. This helps us explore the wider relevance of the proposed dimensions in the study by (Malhotra & Dave, 2022) and its implications in a specific context. By analysing the experiences of the practitioners from Delhi NCR, the study has able been able to identify an additional dimension that impact a medical tourism destinations' competitiveness. ...
India has emerged as a prominent medical tourism hub, yet the dynamics in the regional and global landscape are creating a complex balance of opportunities and risks for the Indian stakeholders. Taking Delhi NCR as the case, this study aims to analyze the key driving factors for the Indian medical tourism industry and the issues that Indian stakeholders should address in crafting a winning strategy. A qualitative research design was adopted, and data was collected from practitioners and senior representatives of the hospital management. The study presents the assessment of the Indian medical tourism industry and the scope of opportunity for Indian players.
... Outside of Taiwan, previous studies on IMS have mostly focused on questionnaire development and testing [19][20][21][22], factors that affect IMS development [23][24][25][26][27], international patients' selections of destinations [28][29][30], customer loyalty [31][32][33][34], revisiting intentions [35][36][37], and competitiveness of IMS [4,38]. Most of the studies were quantitative studies and focused on patients with nonurgent diseases (e.g., dental care or general surgery) seeking short-term treatments (< 4 days) [39,40]. ...
Background
With the globalization of medical services on the rise, Asia has ascended to a destination of choice for its high-quality medical services at very reasonable rates. Monitoring the quality of the international medical industry is vital to maintain service demand. The experiences of healthcare personnel (HCP) involved in international medical services (IMS) regarding the provision of services to international cancer patients have not yet been discussed. This study aimed to explore oncology HCP experiences of IMS quality in caring for international cancer patients in Taiwan.
Methods
Descriptive phenomenological method and were analyzed through Colaizzi’s seven-step approach. In this study, 19 respondents were collected data by using in-depth semi-structured interviews. An average interview lasted approximately 45 min.
Results
Four major themes were identified from the interviews: patient selection, psycho-oncology care, predicaments, and promoting suggestions. Additionally, thirteen subthemes emerged, including necessary selection of patients, reasons for unwillingness to enroll international patients, helpless patients, emotional distress, care with warmth, insufficient manpower, an unfair reward mechanism, poor hardware equipment, the predicaments of oncology care, various publicity strategies, one-on-one service model, design of a designated area, and reasonable benefit distribution.
Conclusions
This study explored oncology HCP experiences of IMS quality in caring for international cancer patients, with implications for hospitals in developing high-quality IMS. Due to the fact that IMS is a global trend, HCPs, administrators, and policy-makers are advised to improve the quality of IMS in the oncology department, which has been the least studied field in IMS quality.
Medical tourism is quickly growing in developing countries. The healthcare players have recognized it as a potential area for economic diversification. The major factors affecting medical tourism in a country are cost, quality, language, and ease of travel. The healthcare services in India cost significantly lower than in western countries and the middle east. That is one of the reasons behind India attracting customers from these countries. The government promotes India as a premier healthcare destination and has made policies to ease travel for medical tourism purposes. Quality has been one of the important criteria for the selection of healthcare providers even for price-conscious customers. This study uses the case of the eastern part of the state of Uttar Pradesh to investigate the reason behind the low penetration of medical tourism in the region. The study identifies factors affecting medical tourism in post-COVID times and maps them with enablers using a focus group discussion. The study further uses SERVQUAL, a multidimensional research instrument to measure service quality by capturing patient's expectations and perceptions along five dimensions of service quality. The study contributes to the existing literature in two ways. It provides the framework for the promotion of medical tourism in a region. Second, it provides future directions for research in the area of medical tourism in the post-COVID world.
Medical tourism is becoming an increasingly popular option for tourists who seek healthcare services from sources outside the country along with having the opportunity to combine it with visiting the tourist attractions of that country (Connell 2013, Crooks et al.2011). Medical tourism as a progressive economic strategy can make a significant contribution to the medical tourism destinations’ s economy. Therefore, investing in the medical industry is a way to increase the gross domestic product (GDP), upgrade services, generate foreign exchange and create a more favorable balance of trade situation, and boost tourism (Ramirez de Arellano 2007).Although medical tourism is an expanding segment in global tourism, only a few academic studies have focused on the sector. There is a lack of research on medical tourism. Medical tourism destinations are facing complex and numerous challenges in developing, maintaining and sustaining their destinations, specifically in highly competitive environment. Due to the limited literature and empirical evidence on the topic, this study attemptsto better understand not only challenges in medical tourism destination managementfaced by main medical tourism stakeholders but also impacts of medical tourism.Several studies presented the need of destination management in helping tourism destinations to be competitive and sustainable (Crouch and Ritchie 1999, Dwyer and Kim 2003, Presenza, Sheehan and Ritchie2005). Based on the foregoing description, the following research questions will be addressed in this study. Research question 1:What are the challenges of medical tourism destination management faced by main stakeholders?Research question 2: What are the economic, socio-cultural and environmental impacts of medical tourism?
Purpose
The purpose of this paper is to extend understanding of marketing in MENA by investigating how women entrepreneurs use social networking sites (SNS) in marketing their businesses in Lebanon.
Design/methodology/approach
To address contextual issues arising from research in this region, this study consists of a two-phase research design of, first, a panel of specialised business commentators and, second, digital qualitative data collection that enabled access to hard to reach informants.
Findings
The study reveals that the activities of women entrepreneurs are fundamentally enabled by SNS as it allows them to optimise their networks in prospecting, communicating and developing relationships with stakeholders. It also allows them to support the social fabric of the family unit by providing an extra source of income and facilitating connections.
Research limitations/implications
This study draws on a single country within the MENA region; nonetheless, the analysis offers new and nuanced understanding to marketing of small businesses in uncovering how Lebanese women entrepreneurs are able to build and run their businesses using SNS.
Practical implications
This research demonstrates how women entrepreneurs can set up and run businesses using SNS to reach and extend their networks in a culturally diverse and growing economy. SNS provides an inclusive platform through which women build and run a small business.
Social implications
This research responds to a World Development aim of studying the relationships between gender and trade such as women entrepreneurs using social technologies.
Originality/value
This research responds to a World Development aim of studying the relationships between gender and trade, here by investigating how women entrepreneurs set up and run small businesses enabled by SNS.
This empirical study applies complexity theory to understand complex interactions of demographics and medical tourism index (MTI) dimensions in predicting causal models leading to high and low levels of satisfaction and behavioral intentions among medical travelers. A questionnaire-based survey is applied to investigate causal models (i.e., a combination of predictors) to predict satisfaction and the behavioral intentions of international patients who traveled to Cyprus. This study also conducted an in-depth interview to identify motives, complications, and conditions stimulating the behaviors of medical travelers. According to the necessary condition analysis (NCA) results, three dimensions of MTI, excluding cost, are necessary to achieve satisfaction and desired behavioral intention. Findings from interviews reveal that medical complications and legal conditions in the origin country influence medical traveler’s behaviors. The model testing results support key tenets of complexity theory and extend our knowledge of how to regulate conditions to discharge a dis/satisfied and dis/loyal patient.
Background: It is imperative that researchers studying medical tourism connect their work with policy, so that its real-world challenges can be better understood, and more effectively addressed. This article gauges the scope and evolution of policy thinking in medical tourism research through a bibliometric review of published academic literature, to establish the extent to which researchers apply public policy theories and frameworks in their investigation of medical tourism, or consider the policy imperatives of their work.
Methods: A Boolean search of the Web of Science (WoS) Core Collection was performed to identify policy-related publications on medical tourism. We analyzed the results using bibliometrics and a data visualization software called VOSviewer to identify patterns in knowledge production and underlying network linkages in policy research on the subject.
Results: Our findings suggest that only a small proportion of medical tourism research explicitly addresses policy issues or applies policy paradigms in their study approach. Field-specialized journals serving practitioners publish less research as compared to interdisciplinary social and health policy journals. Moreover, there are significant geographical and disciplinary disparities in the policy-orientation of research, and a predilection towards select policy areas such as reproductive and transplant tourism to the neglect of more holistic governance and health system considerations.
Conclusion: This article is a call to action for greater engagement by policy scholars on medical tourism, and for health researchers to more explicitly consider how their research might contribute to the understanding and resolution of contemporary policy challenges of medical tourism. Failure to clearly and consistently make the policy connection is a lost opportunity for researchers to frame the public debate, and influence policy thinking on medical tourism.
Globalization not only leads the trade and businesses across borders, countries and continents, but also bring along the emergence and development of the concept of tourism. Medical tourism enables the patients to choose medically superior countries for treatment. Being well informed and updated about the country specific developments, technological and medicinal inventions & innovations, security and privacy provisions are some of the critical success factors duly acknowledged by visitors before choosing a medical tourism destination. This research study reveals the various factors like low cost of medical expenditures, state-of-the-art medical equipment's, dual service of medical treatment plus tourism (vacation) and medical ecosystem of the host country, acknowledged by medical travelers while selecting their preferred medical tourism destination.
Medical tourism in Malaysia has grown over the years and has become a promising industry. However, due to the establishment of China’s Belt and Road Initiative (BRI), we see a spill-over effect where more Chinese people visit and seek medical treatments in Malaysia. Attracting these Chinese medical tourists has become a great competition as Malaysia is not the sole player in the South East Asia region. The objective of this study is to examine the factors influencing Malaysia as a medical tourism destination among Chinese medical tourists. Self-administered questionnaires were used to collect data from a sample of 600 respondents to test the hypothesized relationships. The data were analyzed using a structural equation modeling approach via AMOS and SPSS. The results show that country-specific factors (country knowledge, safety and security, accessibility, and price reasonableness) and social factors (word-of-mouth and social media) are significant predictors of the image of Malaysia as a medical tourism destination, which in turn, affect perceived value and intention to revisit. This study is one of the few that examines the perception of Chinese medical tourists, a lucrative market that contributes significantly to the global medical tourism industry. Theoretical and managerial implications of the research are discussed.
Uncertainties over the Wuhan 2019 Novel Coronavirus (2019‐nCoV), which has killed 1,017 people and sickened more than 43,100 as of Feb 11,1 has interrupted global trade and supply chains, depressed asset prices, and forced multinational businesses to make hard decisions with limited information. This article is protected by copyright. All rights reserved.
Fields of strategy, competitiveness, and international business research are evolving steadily as more vexing challenges emerge and demand innovation. Key objective of this study is to longitudinally review literature on competitiveness and innovation to identify future sustainable directions. We adapt a systematic literature review approach to discern patterns in individual fields and at the intersection. This, complemented by review of patterns of trends in contributions by select countries and longitudinal experiential view of more than a quarter century of journey of author across select countries, provided new insights. We use the insights to evolve high-potential future topics for research, clustered by contexts, theory, and practices. This review—at the interfaces of theory and practice, and fields across disciplines—will help readers understand the gaps and explore opportunities for research projects in new directions. Synthesis of findings at the interface would facilitate pathways to further research and practice to enhance competitiveness across levels and sustainability.
While travel for physical well-being has long been a practice, medical tourism is an emerging phenomenon characterized by medical care combined with holiday-making activities. The medical tourism industry has rapidly grown due to exponential growth in the number of medical tourists worldwide. Despite this upsurge in practice, less research attention has been devoted to exploring the experience and perceptions of medical tourists toward the wide range of services available to them at medical destinations. This article conceptualizes a construct called “medical tourism experience” and develops a scale that measures it. A rigorous scale development procedure is employed, and four studies are conducted. Seven dimensions of this construct are explored, namely, treatment quality, medical service quality, medical tourism expense, medical tourism infrastructure, destination appeal, destination culture, and ease of access. The results reveal considerable opportunity for marketers and policy makers to increase the attractiveness of medical destinations and gain sustainable competitive advantages.
Background
Regulation of the medical tourism and public health sectors overlap in many instances, raising questions of how patient safety, economic growth, and health equity can be protected. The case of Guatemala is used to explore how the regulatory challenges posed by medical tourism should be dealt with in countries seeking to grow this sector. Methods
We conducted a qualitative case study of the medical tourism sector in Guatemala, through reviews and analyses of policy documents and media reports, key informant interviews (n = 50), and facility site-visits. ResultsKey informants were critical of the absence of effective public regulation of the emerging medical tourism sector, noting several regulatory gaps and the importance of filling them. These informants specifically expressed that: 1) The government should regulate medical tourism in Guatemala, thought there was disagreement as to which government sector should do so and how; 2) The government has not at this time regulated the medical tourism sector nor shown great interest in doing so; and 3) International accreditation could be used to augment domestic regulation. Conclusions
The intersection of domestic and international regulation of medical tourism has been largely unexplored. This case study advances new research in this area. It highlights the need for and dearth of regulatory protections in Guatemala and lessons for other, similarly situated countries. National regulatory models from Israel and Barbados could be adapted to the Guatemalan context. Global governance could help to protect national governments from any competitive disadvantages created by regulation. Underlying the concerns over growth in medical tourism, however, is how it contributes to the ongoing privatization of health care facilities worldwide. This trend risks undermining efforts to reach targets for Universal Health Coverage and exacerbating existing inequities in the global distribution of health and wealth.
This paper intends to analyze: 1) how information sources, eWOM, and image influence the intention to visit a medical tourism destination;2) the moderating role of culture and 3) cross-cultural differences based on Hofstede’s individualism and uncertainty avoidance. A total of 534 responses were collected using a panel of internet users from six different countries and data were analyzed using structural equation modeling and a series of t-tests. The results show that information sources influence cognitive impressions and in conjunction with overall image and medical cognitive image influence the intention to visit a medical tourism destination. Furthermore, individualism and uncertainty avoidance have a moderating effect among these variables and cross-cultural differences exist in the degree of importance given to information sources, eWOM, image perceptions, and intention.
In recent years, many countries have been actively promoting medical tourism to stimulate economic growth. However, the expansion of medical tourism has potentially detrimental effects for the welfare of host countries. In particular, a decline in workers’ productivity could arise as a result of a reduction in public health care provision due to the expansion of the medical tourism sector. By addressing the crowding-out effect on labor productivity, this paper sheds light on the economic impacts of medical tourism on host countries. Our empirical analysis confirms that medical tourism, on average, has a positive effect on host economies’ output growth, particularly in non-OECD countries. Nonetheless, the output contribution of medical tourism is overestimated by an average of 26.8% if the unfavorable indirect productivity effect is not taken into account.
Background
This study aimed to determine the efficient factors that potentially lead to the barriers of developing medical tourism in South Korea.
Methods
To explore the current medical tourism trend, a qualitative procedure was adopted. Besides analyzing the current situation of medical tourism in Korea through a systematic searching on the available information and publications, in-depth-interviews were conducted to collect data from relevant authorities and representatives of medical tourism associations in this country.
Results
The result revealed, although government have supported this industry, that lack of specialty and expertise among the health care practitioners in the scope of cross cultural communication, seems to be the core barrier to development of medical tourism in Korea. Demands for convenient promotional activities, policy making and action regulation are the other effective factors.
Discussion
Several strategies are required in order to address and combat these barriers, such as governmental support for cultural training, cooperative efforts to encourage health practitioners involved to enhance their cultural and linguistic competence in international scale.
The aim of this study is to examine the extended model of Theory of Planned Behaviour in predicting tourists' intention in seeking medical tourism in Malaysia. The additional variables in this model are perceived risks, perceived benefits and resource availability whereby it is predicted to have influences to the model of Theory of Planned Behaviour. Sample is drawn using a quota sampling technique. A total of 380 completed questionnaires are collected. The partial least square approach is employed so as to conduct a comprehensive and vigorous structural equation modelling analysis. The results show that perceived benefits and perceived costs are significantly related to attitude; resource availability is significantly related to perceived behavioural control; and attitude and subjective norm are significantly related to intention for medical tourism in Malaysia; however, the perceived behavioural control is found to be insignificant to intention. Attitude and subjective norm are also significantly related to intention for medical tourism in Malaysia. However, the perceived behavioural control is found to be not insignificant related to intention. The findings of this study can serve as the blueprint for future research in the similar area with reasonable modification on the model construction in order to enhance and improve the theoretical extension model of Theory of Planned Behaviour.
Medical tourists’ expectations and perceptions regarding health services have been explored by the service providers in developing countries. Patients’ perceptions in health services especially about quality might contour confidence and leads to positive behaviours with regard in choosing and using the available health care facilities provided by the developing countries. It seems that patient's voice has been noted as one of the greatest roles in designing the health care service delivery processes in the developing countries. This conceptual paper offers an in-depth literature review regarding quality and behavioural intention of the potential medical tourists and medical tourists. Based on this, contents of quality and behavioural intention are discussed.
Background: Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua’s previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context.
Methods: Employing case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua’s framework to identify overlapping and divergent issues.
Results: Many of the issues identified in Pocock and Phua’s policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework.
Conclusions: The framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework’s design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism’s development or how the specific impacts of the practice are likely to unfold.
Health and Wellness Tourism takes an innovative look at this rapidly growing sector of today's thriving tourism industry. This book examines the range of motivations that drive this diverse sector of tourists, the products that are being developed to meet their needs and the management implications of these developments. A wide range of international case studies illustrate the multiple aspects of the industry and new and emerging trends including spas, medical wellness, life-coaching, meditation, festivals, pilgrimage and yoga retreats. The authors also evaluate marketing and promotional strategies and assess operational and management issues in the context of health and wellness tourism. This text includes a number of features to reinforce theory for advanced students of hospitality, leisure and tourism and related disciplines.
Medical tourism is the practice of traveling across international boundaries in order to access medical care. Residents of low-to-middle income countries with strained or inadequate health systems have long traveled to other countries in order to access procedures not available in their home countries and to take advantage of higher quality care elsewhere. In Mongolia, for example, residents are traveling to China, Japan, Thailand, South Korea, and other countries for care. As a result of this practice, there are concerns that travel abroad from Mongolia and other countries risks impoverishing patients and their families.
In this paper, we present findings from 15 interviews with Mongolian medical tourism stakeholders about the impacts of, causes of, and responses to outbound medical tourism. These findings were developed using a case study methodology that also relied on tours of health care facilities and informal discussions with citizens and other stakeholders during April, 2012.
Based on these findings, health policy changes are needed to address the outflow of Mongolian medical tourists. Key areas for reform include increasing funding for the Mongolian health system and enhancing the efficient use of these funds, improving training opportunities and incentives for health workers, altering the local culture of care to be more supportive of patients, and addressing concerns of corruption and favouritism in the health system.
While these findings are specific to the Mongolian health system, other low-to-middle income countries experiencing outbound medical tourism will benefit from consideration of how these findings apply to their own contexts. As medical tourism is increasing in visibility globally, continued research on its impacts and context-specific policy responses are needed.
Purpose
– The purpose of this paper is to identify the dimensions of service quality as well as of service loyalty in the context of medical tourism. It seeks to demonstrate the conceptualization of medical tourism service loyalty (MTSL) construct. This research also attempts to examine the effect of service quality dimensions on service loyalty dimensions of medical tourism.
Design/methodology/approach
– The dimensions of service quality as well as of service loyalty are identified using an exploratory factor analysis. Next, the reliability and validity of the quality factors and loyalty factors are established through confirmatory factor analysis using AMOS 18.0 version. The related hypotheses are tested using structural equation modeling (SEM).
Findings
– The paper identifies eight-factor construct for medical tourism service quality and three-factor construct for MTSL. It is found that the treatment satisfaction dimension of service quality has positive and significant impact on MTSL. It is also observed that, overall, medical tourism service quality has positive impact on MTSL.
Practical implications
– These dimensions of service quality should be viewed as the levers of improving perceived service quality with respect to medical tourism. Examining the service quality dimensions’ impact on customer loyalty for medical tourism sector can offer the industry valuable insights regarding which aspects of the service to focus on in order to improve medical tourist’s satisfaction and loyalty toward the firms.
Originality/value
– This paper introduces the concept of service quality and service loyalty in medical tourism sector. In conceptualizing MTSL, the authors propose an integration of behavioral measures, attitudinal measures and cognitive measures. The interrelationship between the service quality construct and medical loyalty construct was established using SEM. This is useful for the healthcare manager to measure the medical tourist’s perceptions of service quality on these dimensions as related to medical tourism performance.
Health Tourism is becoming an upward trend in our globalised world. Health tourism can be simply defined as travelling of the individuals to other countries to seek medical care. Increased health care expenses in the West and the globalisation have led individuals to seek health care in other countries that provide affordable health care. On the other hand, wellness and anti- aging practices are also gaining ground in today’s modern world. The urge to look good on individuals as a result of the existing trends in today has also led the individual to seek advice in wellness and anti-aging. The changes in life styles and health marketing policies on wellness and anti-aging practices, lack of adequate insurances, high costs and travel means have increased the interest on health tourism. Turkey is a good destination for health tourism. Because of the high quality of service provided at an affordable cost. Also, there are no long waiting lines for foreign patients; the visa procedures are easy for most of the nations. The purpose of this paper is to outline the opportunities and threats of health tourism in Turkey.
DOI: 10.5901/mjss.2013.v4n10p424
Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians' however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical issues emerging out of that and the need for understanding the linkages between public and private sectors for a more effective intervention for an equitable medical care policy.
Purpose
The novel coronavirus has not only caused significant illness and loss of life, it has caused major disruption at local, national and global levels. While the healthcare industry is experiencing growth during the pandemic, disruption to travel has affected medical tourism. This article considers the short-term factors affecting medical tourism and how they could be mitigated by incorporating technological advances to secure long-term growth.
Design/methodology/approach
The study examines data provided by the Indian government as well as from non-government sources available in the public domain to review the impact of coronavirus disease 2019 (COVID-19) on medical tourism. The authors also examine data on technological advances in the healthcare industry that could help to reduce the impact of the pandemic.
Findings
This study’s findings show that while in-person services have been seriously impacted in the short term, technological adaptation of medical services to facilitate remote medical consultation has significantly increased. This has enlarged the business opportunities available to hospitals and general practitioners, and it could be leveraged to enhance medical tourism.
Originality/value
The article provides an analysis of the impact of the pandemic on medical tourism and how technology could be used to overcome short-term negative impacts and support longer-term development.
Patients have historically travelled from across the world to the United States for medical care that is not accessible locally or not available at the same perceived quality. The COVID-19 pandemic has nearly frozen the cross-border buying and selling of healthcare services, referred to as medical tourism. Future medical travel to the United States may also be deterred by the combination of an initially uncoordinated public health response to the pandemic, an overall troubled atmosphere arising from widely publicized racial tensions and pandemic-related disruptions among medical services providers. American hospitals have shifted attention to domestic healthcare needs and risk mitigation to reduce and recover from financial losses. While both reforms to the US healthcare system under the Biden Presidency and expansion to the Affordable Care Act will influence inbound and outbound medical tourism for the country, new international competitors are also likely to have impacts on the medical tourism markets. In response to the COVID-19 pandemic, US-based providers are forging new and innovative collaborations for delivering care to patients abroad that promise more efficient and higher quality of care which do not necessitate travel.
Medical tourism (MT) is a valuable component of many national service economies. Understanding the marketing and recruitment of MT patients is therefore an important consideration for MT providers. Research shows that word of mouth (WoM) remains the most important acquisition channel in this sector. Yet, there is only a limited understanding of antecedent factors behind a patient referral. We develop a framework for WoM, finding support for tourism factors, service quality and perceived value as key antecedents on WoM referrals. We further extend the MT literature by integrating a novel perspective on value creation that surfaces the experiences of frontline service providers for the first time. This paper incorporates two complementary studies, one with a focus on value creation, the other on perceived value. By combing the two in a mixed-methods approach, we emphasise the role of service delivery on WoM. Several implications can be drawn from the study's findings.
Purpose
This paper aims to address and identify the major stakeholders in the medical tourism industry, based on their participation in medical tourism activities and their support for medical tourism development.
Design/methodology/approach
This paper systematically reviews the content of medical tourism studies from literature to identify key stakeholders and address the roles they play in the medical tourism industry.
Findings
This study shows that the key stakeholders in the medical tourism industry are eight, namely, medical tourists, health-care providers, government agencies, facilitators, accreditation and credentialing bodies, health-care marketers, insurance providers and infrastructure and facilities. These stakeholders strongly influence medical tourists’ decision-making process in seeking medical treatment abroad. Besides, a successful medical tourism development depends greatly on the excellent partnership between all stakeholders.
Practical implications
This paper sheds light on the crucial role of these stakeholders that can be an important consideration in medical tourists’ decision-making process and industry growth. The study can facilitate policymakers in designing and developing policies to improve medical tourism practices.
Originality/value
This paper expands the knowledge about medical tourism literature by identifying and explaining the significant role of each stakeholder in the industry. The results of this paper are quite revealing to all practitioners in terms of the potential strategies and medical tourism growth. The study establishes a foundation for future medical tourism research in the rapidly growing industry.
Since initially writing on thematic analysis in 2006, the popularity of the method we outlined has exploded, the variety of TA approaches have expanded, and, not least, our thinking has developed and shifted. In this reflexive commentary, we look back at some of the unspoken assumptions that informed how we wrote our 2006 paper. We connect some of these un-identified assumptions, and developments in the method over the years, with some conceptual mismatches and confusions we see in published TA studies. In order to facilitate better TA practice, we reflect on how our thinking has evolved – and in some cases sedimented – since the publication of our 2006 paper, and clarify and revise some of the ways we phrased or conceptualised TA, and the elements of, and processes around, a method we now prefer to call reflexive TA.
Purpose
The purpose of this paper is to explore the demand-side factors that influence the inbound medical tourists’ (MTs) decision to travel abroad for medical treatment/surgery.
Design/methodology/approach
The researchers conducted thematic analysis of in-depth interviews in India with 24 foreign MTs’ to generate the themes, identify factors and propose a model with hypothesis for future quantitative survey.
Findings
The findings conclude that patients ranked in ascending order less waiting time for surgery, healthcare quality and accreditation, staff/surgeons expertise, healthcare information, hospital facilities and services, patient safety, travel risk, surgical costs and holiday opportunity as important factors that influence the decision to travel abroad for medical treatment/surgery.
Research limitations/implications
Foreign patients from six private hospitals were willing to be interviewed with the permission of the hospital. Due to confidentiality and privacy policy, many hospitals declined interviews with foreign patients.
Practical implications
The findings are generalised in case of foreign patients as MTs and all private hospitals treating foreign patients in India and other global healthcare destinations. Policy implications suggest that private hospitals in developing countries need to provide first-class quality of healthcare as foreign patients look for internationally accredited quality, no waiting time, patient safety, qualified and experienced surgeons, healthcare workers education and experience hospital facilities and post-surgery care with positive healthcare outcomes.
Originality/value
There is little empirical research on the views of inbound MTs, about factors influencing their decision to travel abroad for surgery to India.
Purpose
This study examines the factors that triggered the privatisation of Bangladesh’s health sector.
Design/methodology/approach
This study follows systematic reviews in its undertaking and is based on an extensive review of both published and unpublished documents. Different search engines and databases were used to collect the materials. The study takes into account of various research publications, journal articles, government reports, policy and planning documents, relevant press reports/articles, and reports and discussion papers from the World Health Organization, the World Bank, and the Asian Development Bank.
Findings
While Bangladesh’s healthcare sector has undergone an increasing trend towards privatisation, this move has limited benefits on the overall improvement in the health of the people of Bangladesh. The public sector should remain vital, and the government must remobilise it to provide better provision of healthcare.
Research limitations/implications
The article focuses only on the public policy aspect of privatisation in healthcare of a country.
Practical implications
The article examines the issue of privatisation of healthcare and concludes that privatisation not only makes services more expensive but also diminishes equity and accountability in the provision of services. The study, firstly, makes a spate of observations on improving public healthcare resources, which can be of value to key decision makers and stakeholders in the healthcare sector. It also discourages the move towards private sector interventions.
Originality/value
This study is an independent explanation of a country’s healthcare system. Lesson learned from this study could also be used for developing public policy in similar socio-economic contexts.
Recently, medical tourism has been considered as a profitable economic sector in developing countries. In this study, we have reviewed articles from 2000 to 2017 on medical tourism marketing in Asian countries. We have found that perceived service quality and satisfaction are the most important factors to attract medical tourists. Moreover, a lack of factors like coordination among medical market stakeholders, medical services quality, insurance coverage, and effective laws are the major barriers to medical travel cited in studies. The results suggest that more specific models should be presented for Asian medical marketing, especially in niche markets of this industry.
The purpose of this paper is to analyze the evolution of medical tourism (MT) research from a longitudinal
perspective (period 1931e2016). A co-word analysis was applied to themes found in published
research listed in the Web of Science (WoS) and Scopus database services.
The results reveal six clusters of themes: a) issues regarding ethical implications, trust and accreditation;
b) health, wellness, spa tourism and service quality; c) health-related issues, medical treatments
and tourism; d) “sensitive” practices in MT; e) medical tourism destinations and marketing; and f)
globalization, policies and the effect on international patients. This study is one of the first attempts to
use a bibliometric approach and co-word analysis so as to offer powerful insight into the conceptual
structure of MT research from academic literature and to visualize all the underlying and interconnected
subfields. It also provides a guide to researchers by improving the understanding of the current state of
the art and predicting the direction of future research.
Western patients are increasingly travelling to developing countries for health care and developing countries are increasingly offering their skills and facilities to paying foreign customers. The potential and implications of this international trade in medical services is explored in this book through analysis of the market.
Medical tourism, a rapidly growing market, has been recognized by many countries as a potential sector for economic diversification. Although Singapore stands out as one of the top destinations of medical tourism, investigation regarding its competitiveness has been limited and narrow in scope. This case study takes a qualitative approach to identify and analyze the factors that position Singapore as a competitive medical tourism destination.
Based on a holistic approach, this study has shown that integrating diverse strategies for medical tourism
development with sound government policies and proactive management practices have led to significant positive outcomes towards mutual success of tourism, healthcare and other economic sectors of Singapore. Additionally, the study provides strategic insights to drive lasting improvements in both public and private sectors of aspiring countries through efficient management and intelligent utilization of resources within and outside the medical tourism sector.
Purpose
The present paper aims to analyse who actually benefits from the policies to promote international trade in healthcare services through medical tourism in India. It also assesses the implications of unfettered and unchecked medical tourism for public health policy-making.
Design/methodology/approach
The research methodology adopted in this paper is inter-disciplinary (socioeconomic and legal) and includes a mix of doctrinal and empirical qualitative research.
Findings
The present paper argues that in the absence of any baseline data in the public domain on inbound traffic of tourists visiting India on medical tourism, it is difficult to assess and evaluate the private sector claims and that the absence of any format for data collection, management and analysis results in questionable accountability and institutional fragmentation and non-coordination. Furthermore, it results in asymmetrical policy-making in areas like international trade, which may have unintended negative effects for public health.
Research limitations/implications
The research findings of the present paper will also assist other developing countries considering to promote medical tourism to learn lessons from India’s experiences.
Originality/value
The present paper uses the qualitative empirical research conducted by the author to analyse the state of affair of medical tourism in India.
'Health Tourism is a fascinating read... This book provides a unique look at a rapidly emerging issue for social and public policy as well as developmental studies, and would lend itself to animated debates, particularly at the graduate level.'
Background
Medical tourism is a growing phenomenon. This review of the literature maps current knowledge and discusses findings with reference to the UK National Health Service (NHS).Methods
Databases were systematically searched between September 2011 and March 2012 and 100 papers were selected for review.ResultsThe literature shows specific types of tourism depending on treatment, eg, dentistry, cosmetic, or fertility. Patient motivation is complex and while further research is needed, factors beyond cost, including availability and distance, are clearly important. The provision of medical tourism varies. Volume of patient travel, economic cost and benefit were established for 13 countries. It highlights contributions not only to recipient countries' economies but also to a possible growth in health systems' inequities. Evidence suggests that UK patients travel abroad to receive treatment, complications arise and are treated by the NHS, indicating costs from medical travel for originating health systems.Conclusion
It demonstrates the importance of quality standards and holds lessons as the UK and other EU countries implement the EU Directive on cross-border care. Lifting the private-patient-cap for NHS hospitals increases potential for growth in inbound medical tourism; yet no research exists on this. Research is required on volume, cost, patient motivation, industry, and on long-term health outcomes in medical tourists.
There has been a growing interest in the medical tourism industry; with many countries setting up healthcare and tourism infrastructure to attract international medical travellers. Price, treatment options, and service quality emerge as three main pillars of the healthcare value proposition for all medical tourism facilities. India is one such country with many private healthcare facilities catering to the international patients. This paper identifies the characteristics shared by four key healthcare facilities, one each from Thailand, India, Singapore, and Philippines with the assumption that the practices of Asian hospitals may be adopted by all medical tourism facilities in India. With the help of brand report card suggested by Keller (2000) and the model of consumer‐perceived health services quality (O'Connor and Bowers 1990), the author has identified the dimensions of service offerings associated with medical tourism facilities, presented a corporate brand identity model and suggested the value‐proposition dimensions for medical tourism facilities. These will assist the healthcare facilities to build a strong brand and gain better understanding of their strengths.
Purpose ‐ This study contends that customers' perceived value can drive medical tourism. To demonstrate this, the purpose of this paper is to propose and test a research model capturing elements of perceived benefits and sacrifice that, by affecting the perceived value of medical tourism products, influence the buying intention of potential customers. Design/methodology/approach ‐ Potential medical tourists from China are tapped due to their cultural similarity to Taiwan, and the absence of a language barrier. Data from 301 usable questionnaires were tested against the research model using the structural equation modeling approach. Findings ‐ The results indicated that perceived value was a key predictor of customer intentions. As for benefits, perceived medical quality, service quality and enjoyment were critical components that significantly influenced the perception of value. Regarding sacrifice, the effects of perceived risk on perceived value were significant. Research limitations/implications ‐ This study targeted potential medical tourists. Therefore, a validation using another large sample gathered elsewhere is required to generalize the findings. Practical implications ‐ The findings can assist governments in developing policies that promote medical destination and provide insights into research on how destination countries can make medical tourism a win/win option for themselves and international patients. Originality/value ‐ The proposed model is original; unlike most prior papers which take a conceptual approach to medical tourism, this study contributes to an understanding of the factors that influence the travel intentions of medical tourists through its empirical investigation, and especially in its targeting of customers' value perception.
Medical tourism, combining the very polarized purposes of pleasurable travel and potentially stressful health care services, is an emergent and growing business worldwide. Medical tourism patients are willing to travel abroad to seek better quality, lower cost, domestically unavailable, no wait-time destinations for non-emergency medical care. There are numerous related studies in the academic literature that are substantiated with multidisciplinary and diverse backgrounds. This study uses the main path analysis, a unique quantitative and citation-based approach, to analyze the significant development trajectories, important literature, and recent active research areas in medical tourism. We find that there are two distinctive development paths: one path focuses more on the evolution of medical tourism, the motivation factors, marketing strategies, and economic analysis; the other path emphasizes organ transplant and related issues. These two paths eventually merge to a common node in the citation network, which foretells transplantation to beautification as the future research direction trend.
Doctors within the NHS are confronting major changes at work. While we endeavour to improve the quality of health care, junior doctors' hours have been reduced and the emphasis on continuing medical education has increased. We are confronted by a growing body of information, much of it invalid or irrelevant to clinical practice. This article discusses evidence based medicine, a process of turning clinical problems into questions and then systematically locating, appraising, and using contemporaneous research findings as the basis for clinical decisions. The computerisation of bibliographies and the development of software that permits the rapid location of relevant evidence have made it easier for busy clinicians to make best use of the published literature. Critical appraisal can be used to determine the validity and applicability of the evidence, which is then used to inform clinical decisions. Evidence based medicine can be taught to, and practised by, clinicians at all levels of seniority and can be used to close the gulf between good clinical research and clinical practice. In addition it can help to promote self directed learning and teamwork and produce faster and better doctors
China's natural and cultural resources are the foremost offerings of the country's wellness tourism sector. Although wellness tourism in China is in its infancy, it can offer new opportunities in, and strengthen the overall competitiveness of, China's tourism industry. To achieve this, the assessment and development of wellness tourism resources in China are required. This study examines the potential for wellness tourism development in terms of resources and promotion from the point of view of wellness tourism experts. It surveys professionals working in tourism, health and education in China. The results reveal that environmental assets, including fresh air, clean water and natural features, are considered the most important attributes for the development of wellness tourism in China and that the promotion of wellness tourism can best be achieved through advertising in mass media, governmental support and organizing new regional events. The study implications and future research directions are discussed. Copyright © 2012 John Wiley & Sons, Ltd.