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  • Volume 14 - 2009
  • Number 3: September 2009
  • Articles on Previously Published Topics
  • Medical Tourism

Medical Tourism: A New Role for Nursing?

Dr. Merav Ben-Natan is a lecturer at the Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, and an instructor at the Department of Nursing in Tel Aviv University. She received her BA and MA degrees from the Department of Nursing at Tel Aviv University, and her PhD from Haifa University. Dr. Ben-Natan’s research interests include the phenomenon of medical tourism, transcultural nursing, women’s health, and elder abuse.

Dr. Ellen Ben-Sefer received her baccalaureate degree from Boston University, her MN from the University of Western Sydney in child and family health nursing, and her PhD from Macquarie University, both in Sydney, Australia. Until recently she served as a Senior Lecturer and Coordinator of Children’s Nursing at the University of Technology in Sydney. She currently is Senior Lecturer at Schoenbrun College of Nursing, an Affiliate of Tel Aviv University, and a coordinator of research projects. When Dr. Ben-Sefer worked at Hadassah Hospital in Jerusalem a number of years ago, she often saw children coming from other countries, especially Iran in those days, but also a variety of other places and still recalls how challenging it was to care for these patients from other countries. She has recognized that today medical tourism is an emerging trend in healthcare, and that we need to take a serious look at this trend as it emerges so that our patients can receive the best care possible wherever they seek their healthcare.  

Dr. Malka (Mally) Ehrenfeld is currently the head of the department of Nursing, Tel-Aviv University in Israel, and an Associate Professor of Nursing at the University. She earned her RN at the Hadassah-Henrietta Szold School of Nursing, followed by her BA and Master of Public Health degrees at the Hebrew University in Israel. She then received her PhD from the University of Toronto in Canada. In addition to her clinical work as a nurse at the Hadassah University Hospital in Jerusalem, she has served as a founding member of the small group that opened the first generic program of nursing in Israel, and coordinator, at the Tel Aviv University, of the generic nursing program, the Master's program, and the PhD program. Later she became the director of the Department of Nursing at the School of Health Professions in the Tel Aviv University. Among her international activities, Dr. Ehrenfeld serves as the national Israeli representative for the International Council of Nurses and the Workgroup of European Nurse Researchers. She has published extensively and presented papers at national and international nursing conferences. Her specific fields of interest include nursing education, public health, and women's health with a focus on health promotion.

Medical tourism is on the rise; however this healthcare trend raises significant issues related to the safety and appropriateness of care. The purpose of this article is to provide healthcare professionals with a better understanding of the phenomenon of medical tourism. The authors will begin by reviewing the history of medical tourism, noting specific medical tourism destinations, and presenting reasons for this increase in medical tourism. Next they will discuss quality and safety issues associated with medical tourism, provide criteria to assess quality of care in other countries, and address ethical and legal consideration inherent in medical tourism. They will conclude with a consideration of the nursing role in medical tourism.

Key words : accreditation, criteria for selecting medical tourism sites, international healthcare costs, medical tourism, quality of care in medical tourism, nursing role in medical tourism

Medical tourism is on the rise; however this healthcare trend raises significant issues related to the safety and appropriateness of care. Medical tourists travel to undergo executive health evaluations, ophthalmologic care, cosmetic dentistry and oral surgery, joint resurfacing or replacement, cardiac surgery, organ and stem cell transplantation, gender reassignment surgery, and in-vitro fertilization.

Medical tourism has been defined as travel with the express purpose of obtaining health services abroad. Although medical tourism may also be defined as travel for the purpose of delivering healthcare ( Bishop & Litch, 2000 ; Comarow, 2008 ), this article will focus on medical tourism that seeks to obtain healthcare in another country.

The purpose of this article is to provide healthcare professionals with a better understanding of the phenomenon of medical tourism. The authors will begin by reviewing the history of medical tourism, noting specific medical tourism destinations, and presenting various reasons for this increase in medical tourism. Next they will discuss quality and safety issues associated with medical tourism, provide criteria to assess quality of care in other countries, and address ethical and legal consideration inherent in medical tourism. They will conclude by considering the nursing role in medical tourism.

History of Medical Tourism

...historical accounts abound with reports of those who have traveled to seek improvement for their health.  Medical tourism is not a new phenomenon. Even in ancient times, people traveled to other countries for health-related purposes ( Bookman & Bookman, 2007 ; Horowitz, Rosensweig, & Jones, 2007 ). The ancient Greeks and Egyptians went to hot springs and baths to improve their health. The first recorded case of medical tourism describes Greek pilgrims who traveled from the Mediterranean Sea to Epidaurus, a small territory in the Sardonic Gulf. It was said that this small territory was the sanctuary of Asclepius, known as the healing god. Since the 1500s India has enjoyed a rich history of providing yoga instruction as well as Ayurvedic healing to patients from around the world. In the 18th and 19th centuries, Europeans and Americans flocked to health spas and sanitariums, sometimes in remote places, in the hope that they would obtain relief from their disabling conditions, such as tuberculosis, gout, bronchitis, or liver diseases. Especially in Europe, well-to-do people, over the years, have traveled to spas to “take the waters” for various cures. In summary, historical accounts abound with reports of those who have traveled to seek improvement for their health.  

However, traveling for the purpose of receiving treatments, such as dental surgery, cosmetic surgery, and other complex procedures is a relatively new phenomenon, having begun only in the 1980s ( Horowitz  & Rosensweig, 2007 ; Smith & Puczko, 2008 ). Such travels are becoming increasingly common today, as patients seek more affordable healthcare options and/or options other than those offered in their home country.

Current Medical Tourism Destinations

Many countries today are seeking to compete successfully in the medical tourism marketplace by advertising a wide variety of medical, surgical, and dental services in comfortable, modern facilities. Table 1 lists popular medical tourism destinations around the world.

Several countries in Central and South America have developed strong reputations for cosmetic and plastic surgery and dental care ( Hancock, 2006 ; Schult, 2006 ; Woodman, 2007 ). Some destinations in Asia are particularly popular for orthopedic and cardiac surgeries. Thailand, India, and Israel are well-established medical tourism destinations, attracting large numbers of foreign patients and generating substantial revenue from the services provided. These countries have large, modern medical facilities that are staffed by well-trained physicians who perform complex procedures, such as minimally invasive/off-pump heart surgery, correction of congenital cardiac abnormalities in children, thoracic organ transplantation, and implantation of mechanical cardiac devices ( Appleby & Schmidt, 2006 ; Lancaster, 2004 ). Thailand’s international hospitals have a reputation for having modern, high-tech equipment, excellent quality medical care, and superior hospitality services ( Horowitz et al., 2007 ; Horowitz & Rosensweig, 2007 ). India has a reputation for high quality care in a number of major hospitals ( Connell, 2006 ; Horowitz & Rosensweig ); and Israel has emerged as a popular, medical tourism destination due its reputation for the high standards in the care that it offers ( Edelheit, 2008 ; Fried & Harris, 2007 ). Israel is well situated geographically with relatively easy flight access from Europe, Africa, and Asia. Many of Israel’s facilities maintain regular contacts with major medical and scientific research centers abroad; and Israel is frequently the host venue for international conferences focusing on a variety of medical topics ( Gradstein, 2008 ).

Table 1. Popular medical tourism destinations around the world.

China

Argentina

Belgium

South Africa

Australia

India

Bolivia

Germany

Israel
Jordan

Brazil
Columbia

Hungary
Lithuania

Malaysia
Philippines
Singapore
Thailand

Costa Rica
Jamaica
Mexico
United States

Poland

 

 

 

 

 

 

 

Reasons for the Increase in Medical Tourism

Medical tourism has become a US$60 billion dollar-a-year business and is growing by 20% each year ( Jones & Keith, 2006 ; MacReady, 2007 ). The spiraling high cost of healthcare, has contributed to this worldwide explosion of medical tourism (Connell, 2006 ; Garcia-Altes, 2005 ). Widespread Internet access has enabled consumers worldwide to purchase a North American or Western European standard of healthcare ( Roberts, Calhoun, Jones, Sun, & Fottler, 2000 ). MacReady predicts businesses and governments in developed countries will soon join the trend, “outsourcing” medical services to low-cost providers abroad. Other countries recognize the inadequacy of their own public health systems in meeting citizens' needs; they are piloting programs and exploring options to provide new private healthcare options.

Medical tourists believe that for a considerably lower cost and with a shorter waiting period they can obtain treatment that is equal to, if not even better than what they would receive at home. The fundamental premise of medical tourism is that the same care, or even better quality of care, may be available in other countries, and obtained at a more affordable cost than in the home country ( Medical Tourism Association, 2008 ). Medical tourists believe that for a considerably lower cost and with a shorter waiting period they can obtain treatment that is equal to, if not even better than what they would receive at home ( Horowitz & Rosensweig, 2007 ; MacReady, 2007 ).

This lower cost is especially important for a patient who does not have health insurance and for whom a procedure may be financially crippling in the home country, but affordable in another one. One such example is coronary artery bypass surgery. The estimated cost of this surgery in the United States (US), one of the countries for which such statistics are available, is US$150,000, while the total cost of surgery and a 20 day stay in India, is cited as US$10,000 ( Herrick, 2007 ).

According to the National Coalition on Health Care (NCHC), long waiting lists also serve as a catalyst for many citizens to seek care overseas. For that reason approximately 500,000 Americans alone traveled overseas in 2007 for medical treatment ( NCHC, 2007 ). Nor is this phenomenon exclusive to the US. Large numbers of Britons also seek care overseas ( Terry, 2006 ). Donnelly and Sawer ( 2007 ) reported that, in 2007, 70,000 Britons traveled overseas for treatment for diverse surgical procedures including cataracts, hip operations, and cardiac surgery.

The typical medical tourist is described as someone aged 50 years or more and in need of an elective surgical or medical procedure. Elective procedures commonly offered include rhinoplasty, dental care, fertility treatment, and breast enlargement ( Public Citizens Health Research Group, n.d. ). These patients are unwilling or unable to pay for the necessary care at home, or endure long hospital waiting times that are typical of some countries. While the patient's budget may have limits, it can accommodate travel to a developing country for good care at a reasonable price ( Horowitz & Rosensweig, 2007 ; MacReady, 2007 ).

However, medical tourism today may...include life-saving surgery, such as coronary artery bypass surgery. However, medical tourism today may also include life-saving surgery, such as coronary artery bypass surgery. The Save A Child's Heart Program at Edith Wolfson Hospital in Israel is a humanitarian program that funds cardiac surgery for children. Children from Rwanda, Lebanon, and Sudan, among other countries, are subsidized by a special fund that enables the children to receive the complex cardiac surgery in Israel that is not available in their home countries ( Leyden, 2009 ). As medical tourism increases, organ transplant tourism is also a growing phenomenon ( Cohen, 2009 ). However, receiving an organ transplant abroad does raise a number of issues, including ongoing care of the patient as well as the source of the organs used.

Another feature of medical tourism, namely distance from home, may offer desired anonymity. Some medical procedures, such as gender changes, have become small but significant parts of medical tourism, especially in Thailand, where recuperation and the consolidation of a new identity may be better experienced at a distance from standard daily life ( Connell, 2006 ).

For some countries, the rationale for engaging in medical tourism is to improve their Gross Domestic Product (GDP) as  overseas patients bring needed cash to pay for procedures. GDP is the primary indicator used to gauge the health of a country's economy ( Investopedia 2009a , 2009b , 2009c ). It represents the total dollar value of all goods and services produced over a specific time period. Another commonly cited reason to support the marketing of medical tourism is the belief that overseas patients expect an even higher standard of care than had been typical their home country, thus prompting hospitals to upgrade their institutions so as to remain competitive in a thriving market. Theoretically, the money derived from this source should be used to upgrade health services for local patients. However, that may not always be the case.

Although this business of medical tourism can provide lifesaving care, it ultimately, remains a business enterprise to import currency... As a consequence of the development of medical tourism, a number of countries actively advertise their services and have companies that specialize in arranging overseas medical care ( Cortez, 2008 ). These countries market various procedures as an attractive package that combines both hospital care and also tourist activities. They recognize that individuals and/or family members may spend additional money on tourist pursuits both while care is being provided and after the care has been completed.

Today many countries are engaged in medical tourism, and vast numbers of patients are seeking care outside their home country ( Connell, 2006 ; Cortez, 2008 ; Horowitz & Rosensweig, 2007 ). Although this business of medical tourism can provide lifesaving care, it ultimately, remains a business enterprise to import currency, especially if the procedures offered are approved by the patient’s healthcare funder/insurance provider.

Quality and Safety in Medical Tourism

Although medical tourism offers benefits for many patients, quality-of-care issues abound. Many of the hospitals that advertise heavily to medical tourists are in low-cost, developing countries that may be experiencing social, political, and cultural issues. These issues may detract from the quality of care received, thus resulting in a less than optimal environment for the medical tourist seeking quality care ( Forgione & Smith, 2007 ). However, each situation needs to be assessed individually. Donnelly and Sawer ( 2007 ) noted that patients who had undergone medical procedures in India reported that hospitals in India had already introduced screening policies for Methicillin-Resistant Staphylococcus Aureus (MRSA) which at that point in time had not yet been introduced in Britain.

Although medical tourism offers benefits for many patients, quality-of-care issues abound. Another cause for concern regarding medical tourism is the often lengthy airplane trips needed to arrive at a far-away country. These long trips have been associated with known health risks, such as lung disease and thrombosis. The lower oxygen level in airplanes could be problematic for a patient with lung disease taking a 14-hour flight to a developing country. Long flights can also contribute to the development of deep-vein thrombosis (DVT). Both of these conditions are of serious concern for surgical patients ( Patient United Kingdom, 2006 ; Reed, 2008 ).

Concerns have also been voiced regarding complications that might result from vacation activities and travel in the postoperative period. There is a need to address both the management of postoperative complications occurring after a patient leaves a foreign medical facility, and also the resulting financial costs associated with such care. These complications present difficult issues that remain unresolved and merit further investigation and discussion to better establish the true economic benefit of medical tourism for patients ( MacReady, 2007 ).

Other quality of care issues include appropriate follow-up care, as well as adequate communication between providers and patients. Provisions to assure the quality of this long-term, follow-up care, and also to provide for the cost of this care need to be considered to before undergoing procedures in other countries. Cultural barriers and language, including medical jargon, may be problematic, even with the assistance of interpreters. Serious misunderstandings may occur on both the part of the patient and the provider. Both the patient and provider need to share with each other all the necessary information before initiating the procedure designed to promote quality outcomes.

Another issue to address is the quality of the hospital environment. Patients should carefully assess the quality and the standards that they expect and have been promised. This assessment should include the environment outside the hospital. In some countries the quality of the water and the air, as well as hygienic standards, may be quite different from patients’ expectations and may compromise their convalescence. For example, the World Health Organization ( 2008 ) has reported that data collected in 2006 from 132 countries demonstrated that 31 countries (or 23.5%) have less 100% screening for at least one of four common infection markers: HIV, HBV, HCV, and syphilis. WHO noted that many countries cannot provide complete information related to the screening process; even with testing of blood products, the testing process may often be incomplete or lack a quality assurance mechanism. Thus, patients risk becoming sicker through their travel to another country, rather than gaining an improved state of health.

Guidelines for Selecting Medical Tourism Sites

Although well-trained physicians and modern, well equipped hospitals provide high quality care in a number of medical tourism destinations, medical tourists, faced with a variety of medical institutions in numerous countries around the world, may find it very difficult to identify the well trained healthcare providers and modern hospitals that consistently provide high quality care ( Aiken, Clarke, Cheung, Sloane, & Silber, 2003 ). It is a critical challenge for potential medical tourists to select the best possible destination for the specific service(s) needed. It also remains a daunting task for patients considering medical care abroad to differentiate desirable destinations from those having incompetent practitioners working in unsafe facilities. Some help may be gained from medical tourism agents who have backgrounds in healthcare, and who are knowledgeable regarding the quality and outcomes of care achieved in different countries and by different medical institution abroad.

The type of accreditation held by various institutions can provide guidance in selecting the most appropriate institution. The Joint Commission International (JCI), a subsidiary of the U.S. Joint Commission, which assesses and accredits healthcare organizations in the US, accredits international healthcare facilities and also provides educational and consulting services to hospitals around the world. The JCI has recently accredited hospitals in Turkey, Thailand, and Singapore ( MacReady, 2007 ; Medical Tourism Canada, 2004 ).The number of JCI-accredited hospitals outside of North America has increased from three accredited hospitals in 2000 to seventy one accredited facilities in 2006 ( MacReady ). Both the JCI and the International Organization of Standardization (ISO) are able to provide useful and reassuring benchmarks for patients in selecting offshore medical facilities ( Connell, 2006 ; Forgione & Smith, 2007 ; Horowitz & Rosensweig, 2007 ).

...professional websites are...helpful in identifying quality care. Certification and professional websites are also helpful in identifying quality care. The International Society of Plastic Surgery certifies approximately 1,500 surgeons in 73 countries who meet U. S. standards of care. The American Dental Association website includes information addressing travel, dental care, and dental tourism. This site provides a link to A Traveler’s Guide to Dental Care , which is available through the Global Dental Safety Organization for Safety and Asepsis Procedures ( Reed, 2008 ).

The American Medical Association (AMA) has developed guiding principles for employers, insurance companies, and other bodies that facilitate or offer incentives for care outside the US. These principles were adopted at the June 17, 2008, annual session of the AMA. The principles stipulate the following:

  • international care must be voluntary and provided by accredited institutions
  • financial incentives should not limit or restrict patient options inappropriately
  • continuity of care, including coverage of costs upon return, should be provided 
  • patients should be informed of their rights and legal recourse before travel
  • patients should have access to licensing, outcome, and accrediting information when seeking care
  • medical record transfers should comply with the Health Insurance Portability and Accountability Act guidelines
  • patients should be informed of the potential risks of combining surgical procedures with long flights and vacation activities ( Reed, 2008 ).

Jutabha ( 2007 ) recommended that professionals apply a checklist called "The Four D’s,” when investigating a hospital outside their country. These Four D’s include: Domain, Doctors, Data, and Disaster. A summary of these D’s and the other criteria we have discussed above is presented in Table 2 .

Table 2 . Criteria for Assessing Quality of Care.

Are the hospital accredited by Joint Commission International and/or the International Organization of Standardization (ISO)?

 

What various social, political, and cultural problems might exist?

 

Are infectious and parasitic diseases rates available?

How do they compare with the rates at home?

 

Who will manage the postoperative complications and the consequent costs of this care?

 

Are the facilities and infrastructure well maintained and up-to-date?

 

Are providers credentialed and board certified?

Are the nurses registered and fully trained?

 

What kinds of statistics does the institution collect?

Do they make these statistics available to potential patients and certifying agencies?

 

Are morbidity and mortality data available?

How do they compare with the rates at home?

 

Who exactly are you dealing with?

Can you visit the hospital, tour its facilities, and meet the staff?

Ethical and Legal Considerations in Medical Tourism

Despite the benefits of lower cost and decreased waiting periods for medical tourists, ethical dilemmas associated with this tourism must be acknowledged. Despite the benefits of lower cost and decreased waiting periods for medical tourists, ethical dilemmas associated with this tourism must be acknowledged. One of the most significant of these dilemmas may be the disproportionate siphoning of technology to the private sector for the care of international patients ( Morgan, 2001 ). When this happens, the local population does not benefit from the currency injected into the system because those funds must be used to continue to support the care required for international patients. The ethical principle of respect for persons may thus be violated ( Beauchamp & Childress, 2000 ).

A legal concern may be the lack of legal resources available to the medical tourist patient. Should a patient experience a preventable, adverse event as a result of receiving care overseas, there may be limits to the damage award the patient can receive. In such cases, the hospital staff may be protected from any litigation and the patient will suffer the damage with no legal recourse and no financial compensation ( Cartwright, 2000 ;  Richter, 1999 ). The principle of nonmaleficence, primum non nocere, commonly translated as "first, do no harm," is called into question in these situations ( Beauchamp & Childress, 2000 ).

The Nursing Role

Nurses have a dual role in medical tourism, namely to help clients find appropriate sites in which to obtain the desired care in other countries and also to warn clients of possible risks and ethical/legal dilemmas. Serving as a client coordinator may become a more common nursing role in medical tourism as this phenomenon expands. However, despite an extensive search, we found no literature that discusses this role in either nursing or medicine.

Considering the ethical and legal questions noted above, along with the probability that medical tourism will continue as a growth area in healthcare, it is necessary to raise important questions regarding this role. Questions to ask include the following:

  • What qualifications are required for a nurse working in medical tourism? 
  • Do these qualifications include advanced clinical skills, business skills, and a strong background in transcultural nursing?
  • What preparation should the nurse undertake for this role?
  • What are the particular challenges associated with nursing in this context?

It is important to ask whether nurses involved in medical tourism are aware of the potential medical/ethical/legal issues previously cited or whether they merely believe they are actively contributing to the care of those who would not receive needed care in their home country. Programs should be developed to better prepare nurses for the many responsibilities involved in this growing medical tourism industry. It would be reasonable to expect such a course of study would include strong transcultural elements, as well as business and management studies, and ethical and legal discussions that relate to the care of patients in such circumstances.

Programs should be developed to better prepare nurses for the many responsibilities involved in this growing medical tourism industry. Nurses who wish to learn more about medical tourism can do so in several ways. A first step would be to enhance their knowledge base and skills in business and management because medical tourism is essentially a business. Nurses interested in this field are also encouraged to search the Internet to identify hospitals that have medical tourism centers and to contact nurses that work directly in these centers. Additionally, attending conferences designed for health professionals interested in medical tourism would be a valuable step in learning more about this field. Recently there have been several conferences focusing on medical tourism for health professionals. Nurses can gain valuable information by attending the various lectures presented at these conferences and also by making contacts with others in the field to learn firsthand from professionals already experienced in medical tourism.

Summary and Conclusion

Medical tourism is likely to increase over the next decade as more patients are able to access the Internet and acquire information relevant to care offered overseas at an affordable price. While some patients will benefit immensely from treatment as a medical tourist, many legal and ethical issues will also arise. Nurses need to familiarize themselves with the benefits of medical tourism while also acknowledging its inherent dangers. Potential medical tourists will benefit from the services of a knowledgeable health professional in their home country who can discuss the many issues that relate to this medical tourism. It is expected that medical tourism will provide a new role for nurses as this healthcare trend expands around the world.

Merav Ben- Natan , RN, BA, MA, PhD E-mail: [email protected]

Ellen Ben-Sefer , RN, BS, MN, PhD E-mail: [email protected]

Malka Ehrenfeld , RN, PhD E-mail: [email protected]

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July 22, 2009

DOI : 10.3912/OJIN.Vol14No03PPT02

https://doi.org/10.3912/OJIN.Vol14No03PPT02

Citation: Ben-Natan, M., Ben-Sefer, E., Ehrenfeld, M., (July 22, 2009) "Medical Tourism: A New Role for Nursing?" OJIN: The Online Journal of Issues in Nursing , Vol. 14, No. 3.

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What Is Medical Tourism?

Medical tourism is travel for the purpose of getting medical, dental, or cosmetic treatment.  The term health tourism is similar, but health tourism includes travel for stress reduction, to visit spas, folk healing, and health-related purposes other than medical, dental, or cosmetic treatment. There are many aspects to medical tourism.

The Medical Tourism Research Center

The Medical Tourism Research Center focuses on consumers who travel from the United States to other countries for medical services -- the import side of medical tourism.  This is a phenomenon that has grown rapidly in the last few years.  There have always been foreign patients who come to the United States for the most recent medical techniques at the best American hospitals -- the export side of medical tourism.  There are a growing number of American patients who shop around for medical care within the United States -- intranational or domestic medical tourism.

(Last updated March 13, 2023)

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As a service to the medical tourism community, here is a list of current research on medical tourism (Note: includes academic papers that may not be available without paid access to paid databases):

List as of October 2021

Current research:.

THE PARADOX OF RESOLVING COMPLAINTS IN THE WELLNESS CENTER GUARANTEES PROFITABILITY

Author: Kerum, Fani1; Vukovic, Dijana2; Hunjet, Anica21 University of Applied Sciences Burgenland, Austria2 University North, Croatia

Publication info: Economic and Social Development: Book of Proceedings ; Varazdin  : 78-86. Varazdin: Varazdin Development and Entrepreneurship Agency (VADEA). (Oct 21/Oct 22, 2021)

ProQuest document link

Wellness is a relatively new phenomenon in the tourism world which, as the season expands and capacity utilization increases, becomes a strategic product and should be considered, treated and nurtured with staff, sales agents and anyone who can directly or indirectly participate in product's sales. Although the potentials of wellness and other forms of health tourism in the Republic of Croatia are insufficiently used, it can be confirmed that in the Republic of Croatia there is a complex structure of wellness tourism. The quality of service in the wellness center becomes a central determinant that can attract and retain consumer, but also irreversibly "lose" it. In order to adequately manage the quality of service in the wellness center in tourism, it is necessary to know the strategies in resolving complaints and reclamations. The aim of this paper is to determine how most consumers of wellness services are actually dissatisfied with the way of resolving a complaint. The phenomenon of the paradox of resolving complaints is the focus of this research and using the theory of the paradox of resolving complaints, the authors will assess the amount and structure of complaints in terms of outcomes, methods of procedures used in the wellness center to achieve outcomes and the nature of interpersonal procedure, complaints and reclamations. Furthermore, the paper will test the hypothesis of the interdependence between satisfaction with resolving complaints and satisfaction of consumers of wellness services.

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Subject: Sales; Complaints; Customer satisfaction; Consumers; Tourism; Personal development; Paradoxes; Pain; Rehabilitation; Quality of service; Aromatherapy; Skin; Economics; Medical tourism; Wellness programs; Oils & fats; Lifestyles; Profitability

Business indexing term: Subject: Consumers Quality of service Wellness programs; Industry: 61169 :‎ All Other Schools and Instruction

Location: Croatia

Classification: 61169: All Other Schools and Instruction

Publication title: Economic and Social Development: Book of Proceedings; Varazdin

Pages: 78-86

Publication year: 2021

Publication date: Oct 21/Oct 22, 2021

Publisher: Varazdin Development and Entrepreneurship Agency (VADEA)

Place of publication: Varazdin

Country of publication: Croatia, Varazdin

Publication subject: Business And Economics, Sociology

ISSN: 18496903

e-ISSN: 18497535

Source type: Conference Paper

Language of publication: English

Document type: Feature

ProQuest document ID: 2596079932

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/conference-papers-proceedings/paradox-resolving-complaints-wellness-center/docview/2596079932/se-2?accountid=7139

Copyright: Copyright Varazdin Development and Entrepreneurship Agency (VADEA) Oct 21/Oct 22, 2021

Last updated: 2021-11-11

Database: ABI/INFORM Collection; SciTech Premium Collection

THE IMPORTANCE OF DIGITAL TECHNOLOGIES IN THE REVIVAL OF TOURISM IN GEORGIA AND AZERBAIJAN

Author: Amanova, Lala1; Abesadze, Nino2; Abesadze, Otar31 Associate Professor at Azerbaijan State University of Economics(UNEC), Azerbaijan2 Associate Professor at I. Javakhishvili Tbilisi state University, Georgia3 Associate Professor at Georgian National University, Georgia

Publication info: Economic and Social Development: Book of Proceedings ; Varazdin  : 674-678. Varazdin: Varazdin Development and Entrepreneurship Agency (VADEA). (Jun 25/Jun 26, 2021)

Today, as never before, the use of modern technologies to solve existing problems has become urgent. The use of digital technology acquired new practical value during the Covid-19 pandemic when society faced new challenges. The fact is that the pandemic has had the strongest negative impact on the tourism sector. Therefore, in Georgia, Azerbaijan, as well as in other countries, tourism trends and key statistical characteristics have changed significantly. The revival of tourism, along with the epidemiological situation, will depend on many factors. Clearly, digital transformation, as a synthesis of advanced digital technologies combining physical and digital systems, will be crucial to shaping and realizing demand for a country s diverse tourism product. This put on the agenda the identification and analysis of the factors affecting the recovery of tourism and the expectations that we should expect after the end of the Covid-19 pandemic. We can boldly say that, today, digital technologies can be considered as a catalyst for the revival of the tourism industry and consequently the growth of Georgia's and Azerbaijan's economy. The aim of my research is to determine the impact on the expectations and prospects of the revival of the modern digital technology tourism industry in Georgia and Azerbaijan for the post-pandemic period. It will be of great importance how the popularity of Georgia and Azerbaijan will increase and their attractiveness coefficient in the digital world will increase. And, in general, what will be the response to the activities of travel companies in the post-pandemic period in terms of digital transformation. The methods of induction, deduction, observation, grouping and analysis were used in the research process. Digital technologies can be considered as a catalyst for the revival of the tourism industry and consequently the growth of the country's economy; * Digital technologies are transforming the tourism industry and introducing new tourism products and services; * Leading the way for companies to interact with customers through online marketing, social media and various applications and so on.

Subject: Pandemics; Epidemiology; Trends; Tourism; Technology; Catalysts; Deduction; Impact analysis; Digital systems; Transformation; Medical tourism; COVID-19; Coronaviruses; Globalization; Digital technology

Business indexing term: Subject: Globalization

Location: Azerbaijan United States--US Georgia

Pages: 674-678

Publication date: Jun 25/Jun 26, 2021

Document type: Journal Article

ProQuest document ID: 2556846959

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/conference-papers-proceedings/importance-digital-technologies-revival-tourism/docview/2556846959/se-2?accountid=7139

Copyright: Copyright Varazdin Development and Entrepreneurship Agency (VADEA) Jun 25/Jun 26, 2021

Last updated: 2021-07-31

HEALTH TOURISM - A CASE STUDY OF NARAYANA HEALTH, BANGALORE

Author: Nimble, O J1; Chinnasamy, A V21 Assistant Professor. Centre for Management Studies, Presidency College, Hebbal2 Assistant Professor, Government Arts College for Women, Nilakottai, India

Publication info: Parikalpana: K I I T Journal of Management ; Bhubaneswar  Vol. 17, Iss. 1,  (Jun 2021): 256-269.

Health tourism is a term that has risen from the rapid growth of industry where people from all around the world are travelling to other countries to obtain good medical care. Due to Covid-19 Pandemic, industry showed reduction in the amount of people travelled to India for medical purposes, but the domestic medical industry in India is trying best to have its share from the emerging global market. Narayana Health, Bangalore has given importance to attract international patients through various marketing methods and its low cost strategies. The present research paper aimed to find out opportunities and challenges of health tourism in Bangalore and factors that attract international patients to Narayana Health. Researchers also studied international marketing strategies followed by Narayana Health. The researcher conducted exploratory research with quantitative and qualitative variables. Using convenient sampling researcher collected primary data from 50 international Patients Collected data was analysed descriptively using SPSS. Thematic content analysis with some grounded theory was used to analyse qualitative data. NVivo12 Pro software was used for the qualitative data analysis. Results indicate Narayana Health hospital in Bangalore is attracting many international patients using unique marketing strategy and cost effective practices.

Subject: Marketing; State government; Transplants & implants; Surgery; Health care; Pandemics; Medical research; Hospitals; Ayurvedic medicine; Travel; Developing countries--LDCs; Resorts & spas; Medical tourism; Industrialized nations; Coronaviruses; Case studies; COVID-19

Business indexing term: Subject: Marketing Developing countries--LDCs Industrialized nations; Industry: 62211 :‎ General Medical and Surgical Hospitals 72111 :‎ Hotels (except Casino Hotels) and Motels

Location: India

Classification: 62211: General Medical and Surgical Hospitals; 72111: Hotels (except Casino Hotels) and Motels

Publication title: Parikalpana: K I I T Journal of Management; Bhubaneswar

Pages: 256-269

Publication date: Jun 2021

Publisher: KIIT School of Management, KIIT University

Place of publication: Bhubaneswar

Country of publication: India, Bhubaneswar

Publication subject: Business And Economics--Management

ISSN: 09742808

Source type: Scholarly Journal

DOI: http://dx.doi.org/10.23862/kiit-parikalpana/2021/v17/i1/209035

ProQuest document ID: 2553568997

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/healt h-tourism-case-study-narayana-bangalore/docview/2553568997/se-2?accountid=7139

Copyright: Copyright KIIT School of Management, KIIT University Jun 2021

Last updated: 2021-07-21

Database: ABI/INFORM Collection

WELLNESS TOURISM - MODERN FORM OF TOURISM

Author: Petroman, Cornelia

Publication info: Quaestus ; Timisoara  Iss. 18,  (Apr 2021): 321-329.

For decades, tourism research has focused on issues such as tourist benefits, tourist behavior, socio-cultural and environmental impact of tourism activities, tourist-host interaction, tourist motivation, tourism planning and development, tourist satisfaction or the economic significance of tourism in tourist destinations. The latest research trend in tourism shows that, although the economic importance of tourism is recognized, the evaluation of the value of tourism activities focuses more and more on the quality of life of tourists, their satisfaction and wellness, abstract forms of value, quality of life, sustainable business practices and the feeling of wellness. Although it has many elements in common with health tourism, this modern form of tourism, wellness tourism, differs from it being an alternative or supplement to an over-the-counter medical treatment, focusing more on the pleasure or sensations that the tourist or visitor you can feel them at a destination during your stay, adding added value to tourist products.

Subject: Quality of life; Marketing; Happiness; Resorts & spas; Medical treatment; Medical tourism; Self esteem

Business indexing term: Subject: Marketing; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels

Classification: 72111: Hotels (except Casino Hotels) and Motels

Publication title: Quaestus; Tim isoara

Pages: 321-329

Publication date: Apr 2021

Publisher: Dimitrie Cantemir Christian University, Faculty of Management in Tourism and Commerce Tourism

Place of publication: Timisoara

Country of publication: Romania, Timisoara

Publication subject: Business And Economics, Travel And Tourism, Geography

ISSN: 2285424X

e-ISSN: 23438134

ProQuest document ID: 2547076735

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/wellness-tourism-modern-form/docview/2547076735/se-2

Copyright: © 2021. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Last updated: 2021-07-02

Database: ABI/INFORM Collection; Publicly Available Content Database

Cost Optimization of the Medical Tourism Market Research Project in Poland and Turkey

Author: Chmielewski, Mariusz1; Kuczamer-Kłopotowska, Sylwia1; Boguszewicz-Kreft, Monika2; Ayci, Ali31 University of Gdansk, Poland2 WSB University in Gdansk, Poland3 Ankara Yildirim Beyazit University, Turkey

Publication info: Journal of Environmental Management & Tourism ; Craiova  Vol. 12, Iss. 2,  (Spring 2021): 552-566.

Research and development projects constitute a specific group of activities carried out in the course of scientific research. The purpose of this article was the analysis of the planned research and development project related to the research on medical services market in Poland and Turkey in the aspect of cost optimization. The analyzed project was designed to examine consumer behavior in the market of a new and growing tourism sector, i.e. medical tourism. Medical tourism is currently defined as the traveling of people to a foreign country in order to undergo planned treatment there, caused by financial or qualitative reasons or due to the unavailability of services in the country of residence. The aim of the planned research project was to compare the behavior of two different groups of stakeholders on two different markets - Polish and Turkish. Efficient implementation of a research project requires precise planning of all activities that should be conducted. The performed analysis showed that regardless of the location of the planned project, its schedule consists of similar components, but the time and costs associated with the project will be different and will largely depend on the location of the research. In the article, in order to optimize the basic parameters of a research project carried out in various destinations, a traditional project management tool, i.e. the Gantt chart, was used, and complemented with the cost gradient concept. The use of both those tools made it possible to identify activities, the change of which has the greatest impact on the cost and time optimization of the project in Poland and Turkey. The analysis of the research project carried out in various destinations showed that, regardless of the location of the research project, shortening its time is associated with a similar increase in the cost of the project, despite the fact that it concerns different activities in both analyzed cases. As a rule, the implementation of a project, including a research project, should be preceded by planning, which enables its subsequent optimization using traditional project management tools.

Subject: Gantt charts; Costs; Optimization; Market research; Project management; International organizations; Methods; Medical tourism; Research & development--R & D; Critical path

Business indexing term: Subject: Costs Market research Project management Critical path; Industry: 54191 :‎ Marketing Research and Public Opinion Polling

Location: Turkey Poland

Company / organization: Name: European Commission; NAICS: 928120; Name: Project Management Institute; NAICS: 813920; Name: European Union; NAICS: 926110, 928120

Classification: 54191: Marketing Research and Public Opinion Polling

Publication title: Journal of Environmental Management & Tourism; Craiova

Pages: 552-566

Publication date: Spring 2021

Publisher: ASERS Ltd

Place of publication: Craiova

Country of publication: Romania, Craiova

Publication subject: Environmental Studies, Travel And Tourism

ISSN: 20687729

DOI: http://dx.doi.org/10.14505/iemt.v12.2(50).25

ProQuest document ID: 2530026821

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/cost-optimization-medical-tourism-market-research/docview/2530026821/se-2?accountid=7139

Copyright: Copyright ASERS Ltd Spring 2021

Last updated: 2021-09-10

HEALTH TOURISM AND STATE SUPPORT AND INCENTIVES

Author: TENGİLİMOĞLU, Dilaver   

Publication info: Journal of Life Economics ; İstanbul  Vol. 8, Iss. 1,  (Feb 2021): 1-10.

Health tourism is the one of the sectors that has experienced an increase in service exports in recent years. As expected, globalization, development in communication technologies, development in transportation facilities and prolongation of waiting times in health services, increased cost pressures have been the most important factors in the increase in the number of health tourists and income. Health tourism, which has become one of the important issues of the country’s tourism policies, adds value to the income of the country economically and provides opportunities that include not only "health" but also other tourism activities, as a reason for the use of existing opportunities.For this high value added sector, national policies, government support and incentives play an important role in development of this sector. The number of health tourist visited our country in 2003 increased from 139.971 to 662.087 in 2019, and income increased from 203 million dollars to over one billion dollars. There has been a significant increase in the type and rate of incentives given by government. In this paper, state support and incentives in health tourism are discussed conceptually.

Alternate abstract:

Son yıllarda hizmet ihracatında artış yaşanan hizmet sektörlerinden birisi de sağlık turizmi olmuştur. Sağlık turisti sayısı ve turizm geliri artışında kuşkusuz küreselleşmenin, iletişim teknolojilerinin ve ulaşım imkanlarının gelişmesi, gelişmiş ülkelerde bekleme sürelerinin uzaması ve sağlık hizmetinde artan maliyet baskıları en önemli etken olmuştur. Ülkemizde turizm politikalarının önemli konularından birisi haline gelen sağlık turizmi, ekonomik anlamda ülke gelirine artı değer katmakta ve var olan mevcut imkanların da kullanımına sebep olarak sadece “sağlık” olarak değil diğer turizm aktivitelerini de içinde barındıran fırsatlar sunmaktadır. Katma değeri oldukça yüksek olan bu sektörün gelişiminde son yıllarda izlenen olumlu ulusal politikalar, verilen devlet destekleri ve teşvikler önemli rol oynamıştır. Nitekim 2003 yılında sağlık turizmi amacıyla ülkemizi ziyaret eden kişi sayısı 139.971 kişiden 2019 yılında 662.087 ‘e, gelir ise 203 milyon dolardan bir milyar doların üzerine çıkmıştır. Hükümet tarafından verilen teşvik türlerinde ve teşvik oranlarında önemli artışlar görülmüştür. Bu çalışmada sağlık turizmi ve gelişimi, sağlık turizminde devlet desteği ve teşvikler konuları kavramsal olarak ele alınmıştır.

Subject: Exports; Incentives; Tourism; Value; Waiting times; Medical tourism; Tourists; Health services; Communication technology; Globalization

Identifier / keyword: Health Tourism Medical Tourim State Supports Incentives Tourism

Alternate title: Sağlık   turizmi ve devlet teşvikleri

Publication title: Journal of Life Economics; İstanbul

Pages: 1-10

Publication date: Feb 2021

Section: Research Articles

Publisher: Rating Academy

Place of publication: İstanbul

Country of publication: Turkey, İstanbul

Publication subject: Business And Economics

e-ISSN: 21484139

Language of publication: Turkish

Publication history :

Milestone dates: 2021-02-11 (Published) 2021-02-11 (Created) 2020-12-20 (Submitted) 2021-02-11 (Issued) 2021-02-11 (Modified)

DOI: http://dx.doi.org/10.15637/jlecon.8.1.01

ProQuest document ID: 2575055604

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/health-tourism-state-support-incentives/docview/2575055604/se-2

Copyright: © 2021. This work is published under http://creativecommons.org/licenses/by-nd/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Last updated: 2021-10-06

Database: ABI/INFORM Collection; Coronavirus Research Database; Publicly Available Content Database; Social Science Premium Collection

CONFLICT OF LAWS IN THE DOCTOR'S CONTRACTUAL RESPONSIBILITY: A COMPARATIVE ANALYTICAL STUDY

Author: Al-Samak, Hiba Thamer Mahmood11 University of Baghdad

Publication info: Journal of Legal, Ethical and Regulatory Issues, suppl. Special Issue 6 ; Arden  Vol. 24,  (2021): 1-22.

A lot of patients travel to receive treatment because of poor or deficient medical care, or because of the emigration of many medical qualifications. Some patients also suffer from poor care provided after returning from treatment abroad, as specialized tourism companies in some countries enable patients to access health care, which is called medical tourism. This is why many countries in the world have taken an interest in it, such as the European Union and the United States of America. We have not found international rules governing the responsibility of the doctor, but we have found only the general rules of complex responsibility in international law. The World Health Organization (WHO) has taken care of the safety of patients to increase the number of medical errors every year in the world, as legal procedures are often inadequate and the patient needs to file a complaint before or after returning home to be subject to the laws of that country, and the countries that apply the insurance system provide sufficient insurance, and insurance companies are sometimes reluctant to pay because of medical negligence. Due to the scarcity of legal studies, I examined the general rules on conflict of laws on the responsibility of doctors, a comparative study between Iraqi civil law, some state laws, international conventions, and the European directive on the safety of patients. It divided it into two research papers: the first on the rules of attribution applicable to the responsibility of the physician and divided it into two; the first on the importance of the responsibility of the physician in international law; the second on the rules of attribution applied; the second on the European Union directive on the application of patients' rights in cross-border health care; and the second on the provisions of patients' rights; and the second on cooperation between the European Union member States. She concluded that the reason for the increase in medical malpractices in the international context is that doctors are working to sign the patient waiver of his right to prosecution, and that many medical and moral damages change and worsen after his return to his homeland. She added that it is necessary to establish medical committees from the Ministry of Health to allow Iraqi patients to travel abroad, monitor their cases, and choose specialized hospitals through Iraqi embassies in those countries.

Subject: Research; Patient safety; Medicine; Cooperation; Health care; International law; Jurisprudence; Liability; Medical malpractice; Medical tourism; Medical errors

Location: United States--US India Iraq

Company / organization: Name: World Health Organization; NAICS: 923120; Name: European Union; NAICS: 926110, 928120

Publication title: Journal of Legal, Ethical and Regulatory Issues; Arden

Supplement: Special Issue 6

Pages: 1-22

Publication date: 2021

Publisher: Jordan Whitney Enterprises, Inc

Place of publication: Arden

Country of publication: United States, Arden

Publication subject: Law, Business And Economics

ISSN: 15440036

e-ISSN: 15440044

ProQuest document ID: 2600989959

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/conflict-laws-doctors-contractual-responsibility/docview/2600989959/se-2?accountid=7139

Copyright: Copyright Jordan Whitney Enterprises, Inc 2021

Last updated: 2021-11-29

Database: ABI/INFORM Collection; Healthcare Administration Database

Motivation and loyalty of Indonesian medical tourists toward Malaysian health services

Author: Morissan1; Gan, Gerald Goh Guan21 Faculty of Communication, Universitas Mercu Buana, Indonesia2 Faculty of Business, Multi media Uni versi ty, Malaysi a

Publication info: International Journal of Research in Business and Social Science ; [Istanbul  Vol. 10, Iss. 6,  (2021): 295-305.

This study aims to find out which factors, between the word of mouth (WoM) or marketing promotion programs (MPP), that drive motivation (push and pull); to explore the influence of travel motivation toward satisfaction, and to investigate the satisfaction effect of medical tourists with loyalty. This study used a survey method by distributing questionnaires to medical tourists from Indonesia (N = 152) who have visited hospitals in Malaysia for medical care at least once. Data analysis was carried out using several statistical procedures that include a multivariate test, multiple linear regression and a simple linear regression. The findings show that there is a statistically significant difference in the push and pull motives based on the influencers (WoM or MPP). The effect size of both push and pull is almost equal. The relationship between push or pull and satisfaction is also statistically significant as 41.3% of the variance in the satisfaction is explained by the push and 51.8% by pull factors. Finally, satisfaction is a significant predictor for loyalty while 90.2% of the variance in loyalty is explained by satisfaction. .

Subject: Word of mouth advertising; Marketing; Motivation; Consumers; Regression analysis; Public relations; Communication; Sales promotions; Hospitals; Travel; Literature reviews; Medical tourism; Coronaviruses; Health services; COVID-19

Business indexing term: Subject: Word of mouth advertising Marketing Consumers Sales promotions; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: Malaysia Indonesia

Classification: 62211: General Medical and Surgical Hospitals

Publication title: International Journal of Research in Business and Social Science; [Istanbul

Pages: 295-305

Publisher: Society for the Study of Business and Finance

Place of publication: [Istanbul

Country of publication: Turkey, [Istanbul

Publication subject: Business And Economics, Social Sciences: Comprehensive Works

e-ISSN: 21474478

DOI: http://dx.doi.org/10.20525/ijrbs.v10i6.1325

ProQuest document ID: 2581546671

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/motivation-loyalty-indonesian-medical-tourists/docview/2581546671/se-2?accountid=7139

Copyright: Copyright Society for the Study of Business and Finance 2021

Last updated: 2021-11-08

The Role of Health Resort Enterprises in Health Prevention during the Epidemic Crisis Caused by COVID-19

Author: Szromek, Adam R

Publication info: Journal of Open Innovation ; Basel Vol. 7, Iss. 2, (2021): 133.

The COVID-19 pandemic has reduced or even temporarily halted tourism worldwide. The lack of tourists has huge consequences not only for the tourism industry, but also for the tourism economy. Health tourism enterprises are also affected by this problem, but their situation is somewhat different from other tourism enterprises, as the relationship of these enterprises with the healthcare system provides an opportunity to continue operations, albeit in a different role than the tourism function. The diagnostic objective of this article is to assess the impact of the pandemic caused by the SARS-CoV-2 virus on the activities of tourism and medical tourism enterprises operating in spa destinations after 12 months of the pandemic situation. The cognitive objective, on the other hand, is to identify the roles that these companies play in reducing the impact of epidemic risks. The article presents the results of the research conducted in 19 tourism and medical companies, covering 115 sanatorium facilities, run in Polish health spas. The results indicate that although their economic situation is difficult, it is at the same time stable. Two reasons in particular stand out: (1) financial support from government anti-crisis programs; and (2) implementation of rapid organizational changes that enable the implementation of epidemiological prevention tasks, relieving the burden on infectious diseases hospitals by operating an isolation center, a vaccination center, or a quarantine facility for asymptomatic patients. This use of tourism infrastructure contributes to promoting it as open innovation in tourism.

Subject: Medical research; Severe acute respiratory syndrome coronavirus 2; Tourism; Infectious diseases; Leisure; Pandemics; Economic development; International organizations; Resorts & spas; Medical tourism; Viral diseases; Day spas; Coronaviruses; Spas; Health services; Epidemics; COVID-19

Business indexing term: Subject: Economic development Day spas; Industry: 92611 :‎ Administration of General Economic Programs 72111 :‎ Hotels (except Casino Hotels) and Motels

Classification: 92611: Administration of General Economic Programs; 72111: Hotels (except Casino Hotels) and Motels

Identifier / keyword: tourism management health resorts tourism spa social open innovation COVID-19

Publication title: Journal of Open Innovation; Basel

First page: 133

Publisher: MDPI AG

Place of publication: Basel

Country of publication: Switzerland, Basel

e-ISSN: 21998531

Online publication date: 2021-05-14

Milestone dates: 2021-04-23 (Received) 2021-05-13 (Accepted)

First posting date: 14 May 2021

DOI: http://dx.doi.org/10.3390/joitmc7020133

ProQuest document ID: 2576663097

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/role-health-resort-enterprises-prevention-during/docview/2576663097/se-2

Copyright: © 2021 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Last updated: 2021-09-27

Database: ABI/INFORM Collection; Coronavirus Research Database; Publicly Available Content Database; SciTech Premium Collection

MARKETING PRACTICES OF MEDICAL TOURISM OVER RECESSION AND UPSWING

Author: Sangeeta1; Kumar, Rajiv2; Dahiya, Annu11 Panipat Institute of Engineering & Technology2 Guru Jambheshwar University of Science and Technology

Publication info: Academy of Marketing Studies Journal ; Arden  Vol. 25, Iss. 6,  (2021): 1-17.

objective of the article is to provide a comprehensive model which examines the impact of cyclical variations on marketing practices of medical tourism. The model developed was validated using exploratory factor analysis and confirmatory factor analysis. Data was collected using self administered questionnaire. To test the propositions, structure equation modeling is also used. The results indicated that with respect to recession and upswing a positive effect of product, price, place, promotion, people, and Process & Physical evidence is found on marketing strategies, providing support for the proposed model. The major reason ofperforming this study is to suggest marketing mangers about most radical changes to be done during recession and changes in marketing strategies would prove profitable in future. Further research article included discussion, implications and directions for future work. Keywords:

Subject: Marketing; Medical treatment; Medical technology; Health care policy; Communication; Hospitals; Emerging markets; Travel; Developing countries--LDCs; Health facilities; Medical tourism; Health care industry; Health services; Market strategy

Business indexing term: Subject: Marketing Emerging markets Developing countries--LDCs Health care industry Market strategy; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: Thailand United States--US India Singapore Malaysia

Company / organization: Name: Agency for International Development; NAICS: 928120

Publication title: Academy of Marketing Studies Journal; Arden

Pages: 1-17

Publication subject: Business And Economics--Marketing And Purchasing

ISSN: 10956298

e-ISSN: 10956298

ProQuest document ID: 2573888969

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/marketing-practices-medical-tourism-over/docview/2573888969/se-2?accountid=7139

The future of health tourism in the industrial revolution 4.0 era

Author: Wong, Brian Kee Mun; Sarah Alia Sa’aid Hazley

Publication info: Journal of Tourism Futures ; Bingley  Vol. 7, Iss. 2,  (2021): 267-272.

Abstract: Purpose

The technological advances in the Industrial Revolution (IR) 4.0 era escalate the advancement of the healthcare industry, including the health tourism phenomenon. Based on the current trend in connected health care (e.g. mobile healthcare technology; digital health, etc.), this paper aims to propose that the distance between healthcare providers around the globe and its potential patients can be vastly reduced to almost on a real time basis.

Design/methodology/approach

A secondary literature review is conducted to identify the key development of IR 4.0 technologies in the healthcare industry and its possible trend leading the health tourism sector.

The adoption of IR 4.0 technologies is expected to make seeking treatments overseas more affordable, accessible and health records readily available on a real-time and secured basis. However, it is worth to note that the growth of health tourism raises the eyebrows of society from the security, social and economic perspectives.

Originality/value

This paper contributes to our understanding that the emergence of IR 4.0 technologies changes the landscape of the health care and health tourism industry. Continuous technology advancement is expected to further shape the future trend and escalate the commercialization aspect of the health tourism industry.

Subject: Biotelemetry; Smartphones; Competitive advantage; Medical technology; Telemedicine; Blood pressure; Sensors; Internet of Things; Rehabilitation; Travel; Medical tourism; Health care industry; Global health; Industrial Revolution; Mobility; Robotics

Business indexing term: Subject: Smartphones Competitive advantage Health care industry

Location: United States--US Abu Dhabi United Arab Emirates United Arab Em irates

Identifier / keyword: Future trends Industrial revolution Technologies Health tourism IR 4.0

Publication title: Journal of Tourism Futures; Bingley

Pages: 267-272

Number of pages: 6

Publisher: Emerald Group Publishing Limited

Place of publication: Bingley

Country of publication: United Kingdom, Bingley

Publication subject: Travel And Tourism

ISSN: 20555911

e-ISSN: 2055592X

Online publication date: 2020-05-22

Milestone dates: 2020-01-17 (Received) 2020-04-14 (Revised) 2020-04-14 (Accepted)

First posting date: 22 May 2020

DOI: http://dx.doi.org/10.1108/JTF-01-2020-0006

ProQuest document ID: 2557911941

Document URL: https://uiwtx.idm.ocl c.org/login?url=https://www.proquest.com/scholarly-journals/future-health-tourism-industrial-revolution-4-0/docview/2557911941/se-2

Copyright: © Brian Kee Mun Wong and Sarah Alia Saaid Hazley. This work is published under https://creativecommons.org/licenses/by-nc/3.0/legalcode (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Last updated: 2021-08-05

Database: ABI/INFORM Collection; Coronavirus Research Database; Publicly Available Content Database

Ekonomik kriz ve sağlık turizmi: Uluslararası Sağlık Hizmetleri Anonim Şirketi neden kuruldu?

Author: Somel, Ali11 Ondokuz Mayıs Üniversitesi, Siyaset Bilimi ve Kamu Yönetimi Bölümü, Samsun e-posta: [email protected]

Publication info: METU Studies in Development ; Ankara  Vol. 47, Iss. 2,  (Dec 2020): 205-255.

Ekonomik krizlerin ilk etkisini hissettirdiǧi alanlardan biri saǧlık hizmetleridir. Temmuz 2018de yasamayla Uluslararası Saǧlık Hizmetleri Anonim Şirketi (USHAŞ) kuruldu. Son yıllarda krizlerle birlikte saǧlık turizmi bir fırsat olarak görülmeye başlanmıştı. Saǧlık turizmini geliştirmek, Türkiyede ekonomik krize yol açan sorunlardan süreǧen cari işlemler açıǧını azaltmak için döviz gelirlerini artırma amacı taşımaktadır. Öte yandan Saǧlıkta Dönüşüm Programının devamı olan kamu-özel işbirliǧine dayalı şehir hastanelerinin kurulması, özel sektörün devlet garantisiyle dışardan borçlanmasını artırmakta ve ekonominin döviz ihtiyacını artıran dış borç sorununu şiddetlendirmektedir. USHAŞ saǧlık piyasasında şirketlere rehberlik etme amacı taşımakta ve kamu saǧlık sisteminin saǧlık turizmine kaydırılmasına hizmet etmektedir. Bunun sonucunda kriz koşullarında saǧlık turizmi özel şirketlere fırsatlar sunarken ücretli emeǧin saǧlık hizmetine erişimini zorlaştıracaktır.

Health care is one of the initial areas affected by economic crises. In Turkey in July 2018 a state corporation, the International Health Services Inc. (USHAŞ) was established. In recent years, health tourism has been seen as an "opportunity" together with the crises. The development of health tourism is considered to be a sector for earning foreign exchange in order to reduce Turkey's chronic current account deficit. On the other hand, the city hospitals constructed by public-private partnerships following the Health Transformation Program have increased the private sector's state-guaranteed external borrowing and aggravates the external debt problem of the crisis. USHAŞ aims to guide corporations in the healthcare market and serves to shift the public health care system to health tourism. Thus health tourism offers "opportunities" for corporations under conditions of crisis, while diminishing the access of working people to health care.

Subject: Medical tourism; Economic crisis; Health services

Business indexing term: Subject: Economic crisis

Location: Turkey

Alternate title: Economic crisis and health tourism: Why was the International Health Services Inc. (USHAŞ) established?

Publication title: METU Studies in Development; Ankara

Pages: 205-255

Publication year: 2020

Publication date: Dec 2020

Publisher: ODTU Iktisadi ve Idari Bilimler Fakultesi

Place of publication: Ankara

Country of publication: Turkey, Ankara

Publication subject: Business And Economics--Economic Situation And Conditions, Business And Economics--International Development And Assistance

ISSN: 10109935

ProQuest document ID: 2502929694

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/ekonomik-kriz-ve-sağlık-turizmi-uluslararası/docview/2502929694/se-2?accountid=7139

Copyright: Copyright O DTU Iktisadi ve Idari Bilimler Fakultesi Dec 2020

Last updated: 2021-09-11

Rehabilitation Tourism Opportunities in the Russian Federation for Recovering COVID-19 Patients

Author: Osadchuk, Mikhail A1; Trushin, Maxim V2; Osadchuk, Alexey M3; Mironova, Ekaterina D1; Solodenkova, Karina S1; Lazareva, Alisa E1 Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation - Sechenov University, Russia2 Kazan Federal University, Russia3 Samara State Medical University under the Ministry of Health of the Russian Federation, Russia

Publication info: Journal of Environmental Management & Tourism ; Craiova  Vol. 11, Iss. 7,  (Winter 2020): 1871-1876.

The COVID-19 pandemic determined the necessity for prompt diagnostics and optimal routing of patients, followed by rehabilitation and secondary prevention, as domestic tourism intensifies. The epidemic increased the importance of digital systems for the tourism service market. Digitalization took leading positions in the tourism industry and made market participants adapt to these changes for optimizing their activities and increasing revenues. Further development of tourism in Russia, giving the ongoing pandemic, would require digital technologies such as multilanguage informational services overcoming language barriers, digital tourist cards, mobile apps introducing cultural and national landmarks online, web services for preparing tourist routes. Judging from scientific and practical experience, we can expect that medical, social, physical and psychological rehabilitation supervised by medical personnel will improve body functioning including heart, lungs, central nervous system as well as restore patients' quality of life in general.

Subject: Infections; Patients; Social distancing; Severe acute respiratory syndrome coronavirus 2; Pandemics; Medical personnel; Epidemics; Hospitals; Electronic newspapers; Rehabilitation; Travel; Viruses; Medical tourism; Disease prevention; Coronaviruses; Intensive care; Disease control; COVID-19

Business indexing term: Industry: 62221 :‎ Psychiatric and Substance Abuse Hospitals 62211 :‎ General Medical and Surgical Hospitals 62231 :‎ Specialty (except Psychiatric and Substance Abuse) Hospitals

Location: Russia

Company / organization: Name: World Health Organization; NAICS: 923120

Classification: 62221: Psychiatric and Substance Abuse Hospitals; 62211: General Medical and Surgical Hospitals; 62231: Specialty (except Psychiatric and Substance Abuse) Hospitals

Pages: 1871-1876

Publication date: Winter 2020

DOI: http://dx.doi.org/10.14505/jemt.v11.7(471.25

ProQuest document ID: 2473426017

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/rehabilitation-tourism-opportunities-russian/docview/2473426017/se-2?accountid=7139

Copyright: Copyright ASERS Ltd Winter 2020

Characterization of the healthcare tourism in the city of Bogotá and the district of Cartagena

Author: Arias-Aragonés, Francisco José; Caraballo-Payares, Alexander Mauricio; Jiménez-Osorio, Javier Enrique

Publication info: Clio America ; Santa Marta  Vol. 14, Iss. 28,  (Nov 2020): 486-492.

El artículo caracteriza el turismo de salud con el propósito de identificar las potencialidades en las ciudades de Bogotá y Cartagena de ofertar servicios a pacientes provenientes del extranjero. Se hace un análisis comparativo entre estas dos ciudades en aras de identificar las debilidades, oportunidades, fortalezas y las amenazas que presentan. La investigación se desarrolla mediante un enfoque de investigación cuantitativo, empleando fuentes de información primaria que permitan caracterizar el sector en estas ciudades. Se encontró que, en Bogotá, se destaca la calidad de los servicios de salud, la infraestructura especializada, las acreditaciones de algunas instituciones sanitarias y la conformación del clúster de la salud como elementos competitivos. Entre tanto, Cartagena muestra precios muy atractivos; sin embargo, presenta problemas de escasez de infraestructura sanitaria y de profesionales de la salud, bajos niveles de bilingüismo y aumento de las necesidades locales de servicios de salud. Se concluye la necesidad de fortalecer la competitividad del sector en ambas ciudades, pues la tendencia apunta a un crecimiento de este tipo de turismo en los próximos años.

The article characterizes the medical tourism subsector in Bogota and Cartagena to detect potential service offers to foreign patients. We performed a comparative analysis between these two cities to identify the weaknesses, opportunities, strengths, and threats they have. The study has a quantitative research approach using primary sources of information to characterize the subsector in these cities. In Bogota, the quality of health care services, specialized infrastructure, the accreditation of some health care institutions, and the formation of the health care cluster stand out as competitive elements. Meanwhile, Cartagena shows attractive prices but has scarce health care infrastructure and health professionals, low levels of bilingual proficiency, and increased local health service needs. We conclude that there is a need to strengthen the subsector’s competitiveness in both cities, as the trend points to the growth of this type of tourism in the coming years.

Subject: Medical tourism; Health care industry; Quality of care; Comparative analysis

Business indexing term: Subject: Health care industry

Location: Cartagena Colombia Colombia Bogota Colombia

Identifier / keyword: turismo de salud servicios de salud cluster de salud mercado internacional. healthcare tourism healthcare services health cluster international market

Alternate title: Turismo de salu d en la ciudad–región de Bogotá y el distrito de Cartagena

Publication title: Clio America; Santa Marta

Pages: 486-492

Publication date: Nov 2020

Section: Artículo de Investigación Científica y Tecnológica

Publisher: Universidad del Magdalena, Revistas de la Universidad del Magdalena

Place of publication: Santa Marta

Country of publication: Colombia, Santa Marta

Publication subject: Business And Economics--Economic Situation And Conditions

ISSN: 1909941X

e-ISSN: 23897848

Online publication date: 2020-11-20

Milestone dates: 2021-10-14 (Created) 2021-02-04 (Submitted) 2020-11-20 (Issued) 2021-10-14 (Modified)

   First posting date: 20 Nov 2020

DOI: http://dx.doi.org/10.21676/23897848.3941

ProQuest document ID: 2594850532

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/characterization-healthcare-tourism-city-bogotá/docview/2594850532/se-2

Copyright: © 2020. This work is published under https://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

AROMATHERAPY AND AROMA TOURISM AS A NEW TREND OF TOURISM OFFER IN THE REPUBLIC OF CROATIA

Author: Gregoric, Marina1; Roncevic, Ante2; Bogdan, Maja31 Assistant professor at University North, 104. brigade 1, 42000 Varaždin, Croatia2 Associate professor at University North, 104. brigade 1, 42000 Varaždin, Croatia3 Polytechnic of Meðimurje in Čakovec, Bana Josipa Jelačića 22, Čakovec, Croatia

Publication info: Economic and Social Development: Book of Proceedings ; Varazdin  : 200-214. Varazdin: Varazdin Development and Entrepreneurship Agency (VADEA). (Oct 22/Oct 23, 2020)

Health tourism has deep roots both in the Republic of Croatia and in the world. It develops quickly and in a step with trends in the tourism market. It is divided into three categories: health tourism, medical tourism, and wellness tourism. Each subcategory is specific in its action and develops according to the needs of the tourist market. This paper examines the knowledge of aromatherapy and aroma cosmetics on the tourist market. It also examines the potential of natural cosmetics as a new tourism trend in the Republic of Croatia. The methods used are quantitative methods with survey research and methods of descriptors and analyses. The research paper aims to find out if there is a potential for natural cosmetics on the market, can natural cosmetics in the future replace the commercial, and learn the respondents' opinions and attitudes about natural cosmetics. The paper has obtained certain conclusions about the trend of natural cosmetics on the tourist market, important for further developing aromatherapy as an integral part of the tourism offer.

Subject: Cosmetics; Trends; Tourism; Prevention; Scientific papers; Aromatherapy; Hospitals; Resorts & spas; Outdoor air quality; Medical tourism; Aroma; Health insurance; Radiation

Business indexing term: Subject: Health insurance; Industry: 52411 :‎ Direct Life, Health, and Medical Insurance Carriers 32562 :‎ Toilet Preparation Manufacturing 62211 :‎ General Medical and Surgical Hospitals 72111 :‎ Hotels (except Casino Hotels) and Motels

Classification: 52411: Direct Life, Health, and Medical Insurance Carriers; 32562: Toilet Preparation Manufacturing; 62211: General Medical and Surgical Hospitals; 72111: Hotels (except Casino Hotels) and Motels

Pages: 200-214

Publication date: Oct 22/Oct 23, 2020

ProQuest document ID: 2462680153

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/conference-papers-proceedings/aromatherapy-aroma-tourism-as-new-trend-offer/docview/2462680153/se-2?accountid=7139

Copyright: Copyright Varazdin Development and Entrepreneurship Agency (VADEA) Oct 22/Oct 23, 2020

Last updated: 2021-09-13

Can high performance work practices and satisfaction predict job performance?An examination of the Malaysian private health-care sector

Author: Aizzat Mohd Nasurdin; Tan, Cheng Ling; Sabrina Naseer Khan

Publication info: International Journal of Quality and Service Sciences ; Bingley  Vol. 12, Iss. 4,  (2020): 521-540.

This paper aims to examine the effects of high-performance work practices (HPWPs) (participation, training and compensation) on nurses’ job performance (task and contextual) through the mediating role of job satisfaction. As nurses form the bulk of health-care professionals, their performance at work is crucial in determining patient satisfaction regarding care quality. HPWPs have been recognized as having the ability to affect employees’ work attitudes and behaviors positively. Specifically, these practices foster job performance.

Self-administered questionnaires were used to collect the survey data on 639 staff nurses working in large private hospitals in Malaysia. Data were subsequently analyzed using the partial least squares method.

The findings indicate that job satisfaction serves to mediate the relationships between the three HPWPs (participation, training and compensation) and the two dimensions of job performance (task performance and contextual performance).

Research limitations/implications

First, as all variables were measured using self-reports, a common-method bias could exist (Podsakoff et al., 2003). Hence, future researchers may want to combine self-assessments and supervisory or peer assessment to improve the validity of the outcomes. Second, the cross-sectional nature of this study limits our ability to make causal inferences. Bias could happen because the study examined both exogenous and endogenous variables at the same time. Thus, a longitudinal approach taken in the future could cross-validate the current findings and provide additional support regarding the causality of the HPWPs-job performance relationship. Third, the data were collected from staff nurses working in large private hospitals in Peninsular Malaysia. Thus, one should be careful to generalize the findings to different health-care professional groups and organizations.

Practical implications

From the practical perspective, it is evident from the findings that as job satisfaction is able to enhance job performance and given the need for nurses to provide quality health-care services, private hospital authorities concerned with encouraging greater job performance among their nursing workforce need to provide adequate support to their employees. This could be achieved through the implementation of HPWPs. Perceptions of the extent of a hospital’s HPWPs in terms of participation, training and compensation, have significant and positive effects on nurses’ level of job satisfaction. Therefore, it would be worthwhile for private hospitals to encourage more opportunities for nurses to participate in decision-making regarding their work. In addition, frequent training activities will be able to enhance nurses’ knowledge, skills and abilities, resulting in greater satisfaction

To the best of the authors’ knowledge, this is the first attempt to investigate the effects of HPWPs on nurses’ job performance in the Malaysian private health-care context. As studies using Eastern samples are relatively limited, the findings from this study would serve to expand the extant literature from a cross-cultural perspective.

Subject: Public health; Patients; Quality of service; Job satisfaction; Work environment; Medical tourism; Councils; Health care; Employees; Performance management; Nurses

Business indexing term: Subject: Quality of service Job satisfaction Work environment Employees Performance management

Location: Malaysia

Publication title: International Journal of Quality and Service Sciences; Bingley

Pages: 521-540

Number of pages: 20

Publication date: 2020

Publication subject: Communications, Business And Economics--Production of Goods And Services

ISSN: 1756669X

e-ISSN: 17566703

Online publication date: 2020-11-27

Milestone dates: 2019-06-30 (Received) 2020-05-30 (Revised) 2020-09-25 (Accepted)

   First posting date: 27 Nov 2020

DOI: http://dx.doi.org/10.1108/IJQSS-06-2019-0090

ProQuest document ID: 2469985013

Document URL: https://uiwtx.idm.oclc.org/login?url=ht tps://www.proquest.com/scholarly-journals/can-high-performance-work-practices-satisfaction/docview/2469985013/se-2?accountid=7139

Copyright: © Emerald Publishing Limited 2020

Last updated: 2021-09-09

Health-care providers perspective on value in medical travel to India

Author: Medhekar, Anita; Ho Yin Wong; Hall , John Edward

Publication info: Tourism Review of AIEST - International Association of Scientific Experts in Tourism ; Bingley  Vol. 75, Iss. 4,  (2020): 717-731.

The purpose of this paper is to explore the supply-side factors that determines the quality of global healthcare services from medical tourism healthcare providers’ (MTHP) perspective, which provide value-in-medical-travel to foreign patients/medical tourists, who travel to India for medical treatment/surgery.

The thematic content analysis of in-depth interviews with 15 senior MTHP, from 15 private hospitals in India was undertaken, to generate the themes, and identify the supply-side factors necessary for sustainable medical tourism management.

The findings conclude that MTHP ranked in ascending order, less waiting-time for surgery, healthcare quality and accreditation, staff/surgeon’s expertise, healthcare information, hospital facilities and services, patient-safety, travel-risk, surgical costs and holiday opportunity as essential factors for providing sustainable quality and value-in-medical-travel to patients.

Many private hospital spokespersons declined to be interviewed due to confidentiality and privacy policy

The findings are generalised in case of global private hospitals treating foreign patients. Policy implications suggest that private hospitals in developing countries need to focus on providing value-in-medical-travel, such as accreditation quality of healthcare, no waiting-time, patient-safety, qualified and experienced medical and non-medical staff, hospital facilities and post-surgery care with positive healthcare outcomes.

Social implications

Medical-tour facilitators, hotels and tourism sites need to collaborate with agencies to provide inclusive built environment, first-aid and wheelchair access, to medical tourists, having financial and legal implications for business.

There is little qualitative empirical research on the views of MTHP, regarding management of essential supply-side factors that provide value-in-medical-travel to attract medical tourists to India.

Subject: Innovations; Patient safety; Medicine; Regulation; Surgery; Medical technology; Accreditation; Hospitals; Public health; Quality of service; Surgical outcomes; Developing countries--LDCs; 21st century; Medical tourism; Ethics; Privacy; Cost control; Global health

Business indexing term: Subject: Quality of service Developing countries--LDCs Cost control; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: Thailand Turkey United States--US India

Company / organization: Name: Institute of Medicine; NAICS: 541714

Publication title: Tourism Review of AIEST - International Association of Scientific Experts in Tourism; Bingley

Pages: 717-731

Number of pages: 15

ISSN: 16605373

e-ISSN: 17598451

Language of publication: German; English; French

Online publication date: 2020-02-07

Milestone dates: 2019-06-28 (Received) 2019-08-21 (Revised) 2019-10-04 (Revised) 2019-11-04 (Accepted)

First posting date: 07 Feb 2020

DOI: http://dx.doi.org/10.1108/TR-06-2019-0276

ProQuest document ID: 2440602739

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/health-care-providers-perspective-on-value/docview/2440602739/se-2?accountid=7139

Database: ABI/INFO RM Collection

Fire safety management of public buildings: a systematic review of hospital buildings in Asia

Author: Naziah Muhamad Salleh; Nuzaihan Aras Agus Salim; Jaafar, Mastura; Sulieman, Mohd Zailan; Ebekozien, Andrew   

Publication info: Property Management ; Bradford  Vol. 38, Iss. 4,  (2020): 497-511.

There is increasing recognition amongst healthcare providers on the necessity to improve fire safety management in healthcare facilities. This is possibly not yet satisfactory because of recent fire incidents in Asia. This paper set out to analyse the literature because of the paucity of systematic reviews on fire safety management of public healthcare facilities and proffer preventive measures.

Thirty related studies were identified with the support of the Preferred Reporting Items for Systematic reviews and Meta-Analyses via Scopus and Web of Science databases.

Influencing factors, hindrances to fire safety management and preventive measures for fire-related occurrence in Asian hospital buildings were the three themes that emerged from the reviewed. The factors that influence fire in Asian hospital buildings were categorised into technical, management and legislation factors.

The recommendations of this paper were based on literature that was systematically reviewed but does not compromise the robustness concerning fire safety management in hospital buildings across Asian countries. Much is needed to be known regarding fire safety in healthcare buildings across Asian countries. This paper recommended exploratory sequential mixed-methods approach as part of the implications for further studies. This will allow in-depth face-to-face interviews and increase the generalisability of future findings concerning fire safety management in hospital buildings across Asian countries to a larger population.

As part of the practical implications, this paper recommends fire safety management plan as one of the practical possible measures for addressing technical, management and legislation factors. Also recommended is training and fire safety education of healthcare staff in collaboration with safety firefighters to address major issues that may arise from management factors. The government should upgrade the safety technology equipment in healthcare facilities as part of measures to mitigate issues concerning technical and legislation factors. Also, the identified factors are part of the theoretical contributions to the advancement of knowledge and this brings to the front burners new opening.

This is probably the first systematic review paper on fire safety hospital buildings in Asia.

Subject: Research; Construction; Fire protection; Safety management; Studies; Buildings; Public buildings; Regulatory reform; Databases; Health facilities; Medical tourism; Information sources; Systematic review

Business indexing term: Subject: Safety management; Industry: 92216 :‎ Fire Protection 56162 :‎ Security Systems Services

Location: India Malaysia Asia

Classification: 92216: Fire Protection; 56162: Security Systems Services

Alternate title: Fire safety management of public buildings

Publication title: Property Management; Bradford

Pages: 497-511

Publicationyear: 2020

Place of publication: Bradford

Country of publication: United Kingdom, Bradford

Publication subject: Real Estate

ISSN: 02637472

e-ISSN: 1758731X

Online publication date: 2020-05-07

Milestone dates: 2019-12-17 (Received) 2020-01-28 (Revised) 2020-03-03 (Revised) 2020-03-22 (Revised) 2020-04-14 (Accepted)

First posting date: 07 May 2020

DOI: http://dx.doi.org/10.1108/PM-12-2019-0069

ProQuest document ID: 2423725954

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/fire-safety-management-public-buildings/docview/2423725954/se-2?accountid=7139

The identity and role of stakeholders in the medical tourism industry: state of the art

Author: Kamassi, Ahmed; Noor Hazilah Abd Manaf; Omar, Azura

Publication info: Tourism Review of AIEST - International Association of Scientific Experts in Tourism ; Bingley  Vol. 75, Iss. 3,  (2020): 559-574.

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.

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.

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.

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.

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.

Subject: Patients; Travel; Medical tourism; Stakeholders; Cost control; Medical research

Business indexing term: Subject: Stakeholders Cost control

Pages: 559-574

Number of pages: 16

Online publication date: 2020-02-25

Milestone dates: 2019-01-29 (Received) 2019-03-24 (Revised) 2019-05-13 (Revised) 2019-07-17 (Revised) 2019-08-08 (Accepted)

   First posting date: 25 Feb 2020

DOI: http://dx.doi.org/10.1108/TR-01-2019-0031

ProQuest document ID: 2497169936

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/identity-role-stakeholders-medical-tourism/docview/2497169936/se-2?accountid=7139

Last updated: 2021-05-27

RURAL TOURISM IN DEVELOPMENT FUNCTION OF RURAL AREAS IN SERBIA

Author: Dašić, Dejan1; Živković, Dragan1; Vujić, Tamara21 High school of Academic Studies "Dositej", Vojvode Putnika 7, 11000 Belgrade, Serbia2 UTD Narcis Divčibare doo, Vojvode Mišića br. 2, 14000 Valjevo, Srbija

Publication info: Ekonomika Poljoprivrede ; Belgrade  Vol. 67, Iss. 3,  (2020): 719-733.

This paper analyzes past experiences and examples of good practice in the development of rural tourism, with particular reference to the potential of Serbia. The aim of this paper is multiple. Given that rural areas in Serbia face significant economic and demographic problems, rural tourism may be one of the answers to the question of how to revitalize rural areas. Tourism development in villages of Serbia can make an important contribution to job creation but also to preserving jobs for the population and increasing their interest in staying in the region and creating new business opportunities. In addition to building a positive image, economic prosperity, by investing more in this area, Serbia could solve the problem of population migration within its territory to larger cities, as well as the departure of young people from the country.

Subject: Tourism development; Young adults; Rural tourism; Medical tourism; Rural areas; Rainforests; Tourism; Job creation

Business indexing term: Subject: Job creation

Location: Montenegro Serbia

Publication title: Ekonomika Poljoprivrede; Belgrade

Pages: 719-733

Publisher: Balkan Scientific Association of Agricultural Economists

Place of publication: Belgrade

Country of publication: Serbia, Belgrade

Publication subject: Agriculture--Agricultural Economics

ISSN: 03523462

DOI: http://dx.doi.org/10.5937/ekoPolj2003719D

ProQuest document ID: 2462495533

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/rural-tourism-development-function-areas-serbia/docview/2462495533/se-2

Copyright: © 2020. This work is published under https://www.iep.bg.ac.rs/en/economics-of-agriculture (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Database: ABI/INFORM Collection; Publicly Available Content Database; SciTech Premium Collection

Comparative Analysis of the Health Care Institutions' Competitiveness Level

Author: Klapkiv, Yuriy1; Vovk, Viktoriia2; Klapkiv, Lyubov31 Assistant Professor, University of Lodz, Lodz, Poland, e-mail: [email protected] Assistant Professor, National University of Water and Environmental Engineering, Rivne, Ukraine, e-mail: [email protected] Assistant Professor, Maria Curie-Sklodowska University in Lublin, Lublin, Poland, e-mail: [email protected]

Publication info: Montenegrin Journal of Economics ; Podgorica  Vol. 16, Iss. 3,  (2020): 69-82.

The purpose of this article is the evaluation of competitive positions of Ukraine, Poland and Russia based on the economic competitiveness index at the global level and comparative analysis of the medical institutions' competitiveness indicator in these countries as one of the key indicators of the global ranking. To achieve this goal, the ranking method, the method of generalization, as well as systematic, comparative and statistical analysis were chosen. The research showed that according to the Global Competitiveness Index in 20162017, the Polish economy ranked 36th, the Russian economy - 43, and the Ukrainian - 85th place in the world ranking. According to the "health and primary education" indicator, Poland ranked 38th, Ukraine ranked 54th, and Russia ranked 62nd among all countries participating in the ranking. More dipper analysis of activity indicators of health care institutions in Ukraine, Poland and Russia showed that Poland is a leading country based on the set of key indicators, that show the health care systems' competitiveness level, Ukraine took the second place and Russia is in outsider's group. The research showed the importance of effectiveness' evaluation of the health care institutions' activity, because this help not only rank countries in the middle of the statistical sample but also focuses on stronger countries achievements, implement their experience, skills and good practices and help those healthcare institutions that occupy the top positions in the domestic markets not stop on current level.

Subject: Workforce planning; Competitive advantage; Success; Economic summit conferences; Health care policy; Transition economies; Medical tourism; Economic growth; Statistical analysis; Competition; Comparative analysis; Health care industry

Business indexing term: Subject: Workforce planning Competitive advantage Economic summit conferences Transition economies Economic growth Health care industry

Location: Russia Poland Ukraine

Publication title: Montenegrin Journal of Economics; Podgorica

Pages: 69-82

Publisher: Ekonomska Laboratorija za Istrazivanje Tranzicije

Place of publication: Podgorica

Country of publication: Montenegro, Podgorica

ISSN: 18005845

e-ISSN: 18006698

DOI: http://dx.doi.org/10.14254/1800-5845/2020.16-3.6

ProQuest document ID: 2437892461

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/comparative-analysis-health-care-institutions/docview/2437892461/se-2?accountid=7139

Copyright: Copyright Ekonomska Laborator ija za Istrazivanje Tranzicije 2020

Database: ABI/INFORM Collection; Social Science Premium Collection

Health Medical Tourism: The Present and the Future

Author: Osadchuk, Mikhail A1; Osadchuk, Alexey M2; Solodenkova, Karina S1; Trushin, Maxim V31 The First Sechenov Moscow State Medical University under the Ministry of Health of the Russian Federation, Russian Federation2 Samara State Medical University under the Ministry of Health of the Russian Federation Russia Federation3 Kazan Federal University, Russia Federation

Publication info: Journal of Environmental Management & Tourism ; Craiova  Vol. 11, Iss. 4(44),  (Summer 2020): 809-818.

Development of intergovernmental policy on health tourism is cross-industrial, with medical services acting as a promoting factor. Health tourism ideology is based on interconnection between the natural environment, transport availability, healthcare system and people. During health tourism travels people get in close contact with the environment in order to feel physical and psychological comfort without direct medical treatment. Health tourism is supposed to become the basis for alternative therapy and remain progressive. Meanwhile, dominating cultural aspects must provide competitive advantages related to non-clinical factors. Satisfactory health tourism can be achieved only with the help of a team of specialists having certain experience in both clinical and non-clinical healthcare.

Subject: Customer satisfaction; Gross Domestic Product--GDP; Culture; Medical tourism; Psychological aspects; Health care; Intergovernmental relations

Business indexing term: Subject: Customer satisfaction Gross Domestic Product--GDP

Location: Denmark Namibia

Issue: 4(44)

Pages: 809-818

Publication date: Summer 2020

DOI: http://dx.doi.org/10.14505/jemt.v11.4(44).04

ProQuest document ID: 2433185538

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/health-medical-tourism-present-future/docview/2433185538/se-2?accountid=7139

Copyright: Copyright ASERS Ltd Summer 2020

THE IMPACT OF COMPLEMENTARY MEDICINE ON SUSTAINABLE TOURISM DEVELOPMENT THROUGH EVENT AND NATURE-BASED TOURISM

Author: Krstić, Vesna1; D strok signurad strok signević, Marijana2; Trišić, Igor21 University of Kragujevac, Faculty of Hotel Management and Tourism, Vojvod strok signanska N°5a, 36210 Vrnjačka Banja; Republic of Serbia2 University of Kragujevac, Faculty of Hotel Management and Tourism, Vojvod strok signanska №5a, 36210 Vrnjačka Banja; Republic of Serbia

Publication info: Ekonomika Poljoprivrede ; Belgrade  Vol. 67, Iss. 2,  (2020): 377-390.

Z32, Q57 ABSTRACT The subject of this research is to look at the attitudes of spa tourists towards complementary medicine and the possibilities of its application within spa services. The aim of the research is to identify certain scientific results that can contribute to the creation of an adequate tourism product. In the research, a prospective study is used and it was done by applying a standardized questionnaire. Testing the correlation of the answers given was examined and shown by the Analysis The Pearson Correlation method. The obtained results confirmed the hypotheses: complementary medicine is a significant component of the sustainable development of health tourism in spa destinations in Serbia, and that the organization of an adequate complementary medicine tourism event can increase tourists' motivation for visits and their significant relation to nature-based tourism, which would significantly affect on sustainable tourism development of spa tourism. The intensification of the growth of awareness among the respondents about the importance of complementary medicine in tourism planning and development is evident, and by providing socio-cultural, economic and environmental benefits, the basic postulates of sustainable tourism development are

Subject: Motivation; Technological change; Tourists; Competitive advantage; Ecotourism; Questionnaires; Events planning; Medical tourism; Spas; Tourism; Herbal medicine; Sustainable development; Hypotheses; Tourism development; Medicine; Resorts & spas; Alternative medicine; Attitudes; Correlation analysis

Business indexing term: Subject: Competitive advantage Sustainable development; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels

Location: Serbia

Pages: 377-390

Publisher: Balkan Scientific Ass ociation of Agricultural Economists

DOI: http://dx.doi.org/10.5937/ekoPolj2002377K

ProQuest document ID: 2461608332

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/impact-complementary-medicine-on-sustainable/docview/2461608332/se-2

From the Lens of Healthcare Facilitators: A Multi-Stakeholder Involvement Model for the Medical Tourism Industry in Malaysia

Author: Yusof, Norzayana1; Rosnan, Herwina11 Universiti Teknologi MARA

Publication info: Global Business and Management Research ; Boca Raton  Vol. 12, Iss. 2,  (2020): 64-79.

Purpose: Pressure from the low utilization rate of private hospitals brought them to seek for foreign patients abroad. Over two decades, this industry has bloomed into a key source of income for Malaysia. Despite the increasing trend of revenue earned and inbound patients, a problem on industry development is detected when 'Medical' expenditure only takes up 3.7%, on average, from the Total Foreign Tourist Expenditure. Therefore, this article focuses on the interactions within the stakeholders by exploring their collectiveness in running this industry. In view of developing the medical tourism industry, this article aims to delineate the relations between the service providers in this industry by adapting the Multi-stakeholder Involvement Model (MSIM) framework. Design/methodology/approach: The researchers conducted 11 in-depth semi-structured interviews with three major stakeholders, namely private hospitals, healthcare facilitators and medical doctors. With the assistance of Atlas.ti version 8, 'codes' and 'group codes' have been established. Findings: Thus, this research unraveled the inconsistent definition of healthcare facilitators between stakeholders. Moreover, the roles of facilitators in assisting patients are deemed in diminishing in several ways. Research limitations/implications: Samples are only tight to the actual case study research. Once the researchers have reached information saturation for the original study, it marked the end of the data collection. Further, the absence of other stakeholders such as the state tourism board may have impinged the richness of this data. Moreover, this cross-sectional study barricaded the researcher from attaining a trend of behavior and perceptions between the stakeholders over a period of time. Practical implications: Through the MSIM framework, this study suggested frequent dialogues between the stakeholders to establish a transparent ecosystem for the industry with the appropriate roles and relations between them. Originality/value: This article is novel in offering new insights from the healthcare facilitators in the medical tourism industry. As this area has not been explored much, the present article adds more knowledge about the role of this stakeholder group in developing the industry.

Subject: Hospitals; Researchers; Medical tourism; Stakeholders; Councils; Chief executive officers; Expenditures; Studies; Medical research

Business indexing term: Subject: Stakeholders Chief executive officers; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: Malaysia United States--US Indonesia United Kingdom--UK

Publication title: Global Business and Management Research; Boca Raton

Pages: 64-79

Publisher: Mehran Nejati

Place of publication: Boca Raton

Country of publication: Malaysia, Boca Raton

Publication subject: Business And Economics--Personnel Management

e-ISSN: 19475667

ProQuest document ID: 2436414548

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/lens-healthcare-facilitators-multi-stakeholder/docview/2436414548/se-2?accountid=7139

Copyright: Copyright Mehran Nejati 2020

Medical Tourism in the Context of National Health Systems` Institutional Characteristics

Author: Osadchuk, M A1; Osadchuk, A M2; Trushin, M V31 I.M. Sechenov First Moscow State Medical University Russian Federation2 Samara State Medical University Russian Federation3 Kazan Federal University, Russian Federation

Publication info: Journal of Environmental Management & Tourism ; Craiova  Vol. 11, Iss. 2(42),  (Spring 2020): 229-235.

Medical tourism (MT) is a modern type of medical services outside the state of residence. It links medicine and tourism. Moreover, its availability combined with economic feasibility is the main incentive for seeking medical care outside the place of residence and is an important issue for national health systems. A noticeable MT contribution to the country's economy is possible if there is a well-thought-out infrastructure with introduction of certification procedure, a universal service and marketing system, an adequate response to the offer of additional tourism services and regulation of conditions for systematic cooperation with private intermediaries. However, the absence of interstate standards for this type of medical care leads to significant ethical, political, epidemiological and economic problems and makes it difficult to assess its professional quality. This necessitates the creation of a legal framework that takes into account the rights and responsibilities of both the medical services consumer and the host country.

Subject: Surgical outcomes; Consumers; Medical tourism; Industrialized nations; Cosmetic surgery; Ethics; Legal medicine; Popularity; Host country; Health care; Quality; Liposuction

Business indexing term: Subject: Consumers Industrialized nations

Location: United States--US

Issue: 2(42)

Pages: 229-235

Publication date: Spring 2020

DOI: http://dx.doi.org/10.14505/jemt.v11.2(42).01

ProQuest document ID: 2433188135

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/medical-tourism-context-national-health-systems/docview/2433188135/se-2?accountid=7139

Copyright: Copyright ASERS Ltd Spring 2020

Expectations from a private multi-speciality hospital: a moderated-mediation analysis

Author: Rastogi, Shailesh; Sharma, Arpita

Publication info: International Journal of Pharmaceutical and Healthcare Marketing ; Bradford  Vol. 14, Iss. 2,  (2020): 325-348.

A highly competitive market incentivizes private healthcare providers to deliver high quality services. The purpose of this paper is to identify the perceived expectations of a new private multi-speciality hospital in a non-metro city. To this end, the paper develops a model using identified relevant factors.

A structured questionnaire was administered to 900 people. Exploratory factor analysis and confirmatory factor analysis were then applied to the data, and partial least square-structural equation modelling was used to test the moderated mediation model.

Word-of-mouth and safety (WM) and access to the hospital and the cost of medical services are found to be important factors for the perceived expectations of the hospitals by medical facility and treatment at a hospital. High quality medical facilities can lead to improved perceived expectations of hospitals, mediated by positive WM. Levels of access to the hospital and the cost of services can significantly moderate the perceived expectations of a hospital, despite good medical facilities.

The study has implications for policymakers and hospital authorities in the context of private sector multi-speciality hospitals in non-metro cities. It will help healthcare managers and service providers to better understand customer perceived expectations, and thereby develop effective strategies for customer service. Decision-makers are encouraged to focus on positive word-of-mouth and enhancement of customer safety to bring about favourable expectations of hospitals. Beyond merely having excellent medical facilities, hospitals that ensure ease of access to the hospital and keep costs low can achieve positive consumer expectations and satisfaction levels.

The paper makes three novel contributions as follows: the mere presence of high quality medical facilities and practices does not equate to positive expectations about the hospital among the patients; access to the hospital and the cost of its services are important in bringing about positive expectations among healthcare consumers; and WM can significantly moderate positive expectations of the hospital. The authors are not aware of any of these findings being previously reported.

Subject: Health care; Private sector; Customer relationship management; Factor analysis; Health facilities; Hospitals; Medical tourism; Health services; Health care industry; Decision making; Studies; Classification; Safety; Mediation; Quality of service; Multivariate statistical analysis; Gross Domestic Product--GDP; Customer services; Design factors; Cities

Business indexing term: Subject: Customer relationship management Health care industry Quality of service Gross Domestic Product--GDP; Corporation: PricewaterhouseCoopers LLP

Location: United States--US India

Company / organization: Name: PricewaterhouseCoopers LLP; NAICS: 541211, 541611

Publication title: International Journal of Pharmaceutical and Healthcare Marketing; Bradford

Pages: 325-348

Number of pages: 24

Publication subject: Medical Sciences, Pharmacy And Pharmacology, Business And Economics--Marketing And Purchasing

ISSN: 17506123

e-ISSN: 175 06131

Online publication date: 2020-04-21

Milestone dates: 2019-06-02 (Received) 2019-11-05 (Revised) 2020-03-03 (Revised) 2020-03-03 (Accepted)

First posting date: 21 Apr 2020

DOI: http://dx.doi.org/10.1108/IJPHM-06-2019-0040

ProQuest document ID: 2405116611

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/expectations-private-multi-speciality-hospital/docview/2405116611/se-2?accountid=7139

Last updated: 2021-10-12

Database: ABI/INFORM Collection; Healthcare Administration Database; SciTech Premium Collection

Variables and parameters of the Kano model applied to health tourism

Author: Fabiola Saenz Blanco; Contento Sepulveda, Michael Steven; Juana Mayerly Bautista Mendoza

Publication info: Dimensión Empresarial ; Barranquilla  Vol. 18, Iss. 2,  (Mar 2020).

The health tourism sector in Colombia has been increasing its recognition at the international level, mainly for determining factors of quality and costs, which is how it becomes a significant factor for the economy measured through GDP. In this perspective, the Kano model can allow the identification of the needs and requirements of the users, in order to improve the standards and coverage currently offered by said sector.

El sector de turismo en salud en Colombia ha venido incrementando su reconocimiento a nivel internacional, principalmente por factores determinantes de calidad y costos, es así como se convierte en un factor significativo para la economía medido a través del PIB. En esta perspectiva, el modelo Kano puede permitir la identificación de las necesidades y requerimientos de los usuarios, con la finalidad de mejorar los estándares y coberturas ofrecidos actualmente por dicho sector.

O setor de turismo de saúde na Colômbia vem aumentando seu reconhecimento em nível internacional, principalmente por determinar fatores de qualidade e custos, e é assim que se torna um fator significativo para a economia medida pelo PIB. Nesta perspectiva, o modelo Kano pode permitir a identificação das necessidades e exigências dos usuários, a fim de melhorar os padrões e a cobertura atualmente oferecidos por esse setor.

Subject: Medical tourism; Economic impact; Gross Domestic Product--GDP

Business indexing term: Subject: Economic impact Gross Domestic Product--GDP

Location: Colombia

Alternate title: Variáveis e parâmetros do modelo Kano aplicado ao turismo de saúde Variables y parámetros del modelo Kano aplicado al turismo de salud

Publication title: Dimensión Empresarial; Barranquilla

Publication date: Mar 2020

Section: RESEARCH RESULTS ARTICLES

Publisher: Universidad Autonoma del Caribe

Place of publication: Barranquilla

Country of publication: Colombia, Barranquilla

ISSN: 16928563

e-ISSN: 2322956X

Language of publication: Spanish

Online publication date: 2020-03-12

Milestone dates: 2020-03-12 (Created) 2020-02-26 (Submitted) 2020-03-29 (Issued) 2020-07-08 (Modified)

   First posting date: 12 Mar 2020

DOI: http://dx.doi.org/10.15665/dem.v18i2.2292

ProQuest document ID: 2436409465

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/variables-parameters-kano-model-applied-health/docview/2436409465/se-2

Copyright: © 2020. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

A conceptual model of medical tourism service supply chain

Author: Karadayi-Usta, Saliha; SerdarAsan, Seyda

Publication info: Journal of Industrial Engineering and Management ; Barcelona  Vol. 13, Iss. 2,  (2020): 246-265.

Purpose: Medical tourism service requires involvement of multiple parties from the service network, however medical tourism is not well studied from a supply chain management perspective. This study suggests a conceptual model of medical tourism service supply chain (MTSSC) to provide a clearer understanding of its nature, and defines its business processes.

Design/methodology/approach: Triangulation which makes use of literature review, in-depth interviews, and expert evaluations was applied to develop and validate the suggested model. The proposed model is initialized based on the relevant literature. In-depth interviews were used to refine and finalize the model. Expert evaluations ensure the trustworthiness of the model and the business process definitions.

Findings: The proposed model uses a nested process structure rather than a one-dimensional supply chain model, where the assistance company maintains an intermediary role between the patient and all the service providers (e.g. medical institutions, transportation, accommodation). Additionally, the conceptual model identifies seven business processes: service design, service recovery management, customer relationship management, supplier relationship management, demand management, capacity and resource management, and service delivery management.

Practical implications: The results provide a better understanding of the MTSSC structure and processes, and a recognition of the MTSSC members. The process definitions give the members an idea about their roles in the service design and delivery in practice. Additionally, a better understanding of the system as a whole leads to better process development and control. MTSSC members may shape their organizations internally and supply chain-wide by considering this conceptual model. Moreover, the model acts as a basis for supply chain collaboration decisions.

Originality/value: The conceptual model is built upon the theories and practice of medical tourism services, supply chain management, and service operations management. This study contributes to the theory of medical tourism services management by explaining the MTSSC concepts and business processes, and extends existing knowledge.

Subject: Decision theory; Health care facilities; Customer satisfaction; Tourism; Business process management; Operations management; Triangulation; Supply chain management; Customer relationship management; Medical tourism; Resource management; Customer services; Company structure; Supply chains; Literature reviews

Business indexing term: Subject: Supply chain management Customer relationship management Operations management

Identifier / keyword: Medical tourism medical tourism service supply chain supply chain business processes triangulation conceptual model

Publication title: Journal of Industrial Engineering and Management; Barcelona

Pages: 246-265

Publisher: Vicenc Fernandez

Place of publication: Barcelona

Country of publication: Spain, Barcelona

Publication subject: Business And Economics--Management, Engineering--Industrial Engineering

ISSN: 20138423

e-ISSN: 20130953

DOI: http://dx.doi.org/10.3926/jiem.3008

ProQuest document ID: 2429887370

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/conceptual-model-medical-tourism-service-supply/docview/2429887370/se-2

Copyright: © 2020. This work is published under https://creativecommons.org/licenses/by-nc/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Last updated: 2020-08-03

Exploring Internal Benefits of Medical Tourism Facilitators' Satisfaction: Customer Orientation, Job Satisfaction, and Work Performance

Author: Park, Jung-Kun, PhD1; Ahn, Jiseon, PhD2; Han, Sang-Lin, PhD1; Back, Ki-Joon, PhD3; An, Myunga, PhD41 professor, School of Business, Hanyang University, Seoul, Korea2 senior lecturer, School of Tourism, Hospitality & Events, Taylor's University, Subang Jaya, Malaysia3 associate dean for research and graduate studies, Conrad Hilton College of Hotel and Restaurant Management, University of Houston, Houston, Texas4 lecturer, School of Business, Hanyang University, Seoul, Korea

Publication info: Journal of Healthcare Management ; Chicago  Vol. 65, Iss. 2,  (Mar/Apr 2020): 90-105.

This study examined the impact of employee satisfaction with management and coworkers on their performance as medical tourism facilitators. The proposed hypotheses were tested with structural equation modeling based on data collected from major hospitals in South Korea. Results supported assumptions that satisfaction with management is positively correlated with customer orientation and job satisfaction of medical tourism facilitators, as well as with the assumption that satisfaction with coworkers has a direct impact on customer orientation. This study has practical implications as organizations develop effective internal marketing (i.e., communication) strategies to improve the performance of medical tourism facilitators.

Subject: Travel; Medical tourism; Communication; Customer services; Corporate culture; Marketing; Customer satisfaction; Work environment; Job satisfaction; Employees; Market strategy; Hypotheses

Business indexing term: Subject: Customer services Corporate culture Marketing Customer satisfaction Work environment Job satisfaction Employees Market strategy

Publication title: Journal of Healthcare Management; Chicago

Pages: 90-105

Publication date: Mar/Apr 2020

Publisher: Lippincott Williams & Wilkins Ovid Technologies

Place of publication: Chicago

Country of publication: United States, Chicago

Publication subject: Public Health And Safety, Environmental Studies, Health Facilities And Administration, Physical Fitness And Hygiene

ISSN: 10969012

e-ISSN: 19447396

DOI: http://dx.doi.org/10.1097/JHM-D-18-00168

ProQuest document ID: 2386941476

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/exploring-internal-benefits-medical-tourism/docview/2386941476/se-2?accountid=7139

Copyright: Copyright Lippincott Williams & Wilkins Ovid Technologies Mar/Apr 2020

PRACTITIONER APPLICATION: Exploring Internal Benefits of Medical Tourism Facilitators' Satisfaction: Customer Orientation, Job Satisfaction, and Work Performance

Author: Foster, Steven C, FACHE11 president and CEO, St. Luke's Health–Patients Medical Center, Pasadena, Texas

Publication info: Journal of Healthcare Management ; Chicago  Vol. 65, Iss. 2,  (Mar/Apr 2020): 105-106.

Abstract: Organizations have spent millions of dollars to measure employee satisfaction and engagement, and thousands of research articles have subsequently analyzed the data from a variety of angles. The insights have important implications to the rapidly growing market value of medical tourism, which could reach $30 billion in 2025 (Global Market Insights, 2019). [...]the data from this study supported previously documented correlations between a highly engaged staff and a high degree of trust in management (Pech & Slade, 2006).

Subject: Medical tourism; Patient satisfaction; Job satisfaction; Employee involvement

Business indexing term: Subject: Job satisfaction Employee involvement

Pages: 105-106

DOI: http://dx.doi.org/10.1097/JHM-D-20-00002

ProQuest document ID: 2386939246

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/practitioner-application-exploring-internal/docview/2386939246/se-2?accountid=7139

Last updated: 2020-11-17

Medical tourism trends in the United Kingdom 2000-2016: Global economic crisis, migration and UK expats under consideration

Author: Pagán, Ricardo; Horsfall, Daniel

Publication info: Revista de Analisis Turistico ; Bingley  Vol. 27, Iss. 1,  (2020): 20-40.

The purpose of this study is to investigate the inbound and outbound medical tourism in the UK to determine if the UK can be considered as a net exporter of health services as well as the impact of the 2007 global economic crisis, diaspora populations and the number of UK expats on medical tourism figures.

Using microdata drawn from the International Passenger Survey (2000-2016), the authors estimate the flows, number of nights and expenditure of tourists looking for medical treatment who complete international visits of less than 12 months’ duration to and from the UK. The authors also analyse the main destinations of UK residents, the country of origin of overseas residents and the particular case of British expats.

The results show the upward trend of inbound and outbound patients, the strong seasonality in outbound patients, and the significant increase in the levels of expenditure of overseas residents since 2005. Poland, France, Hungary and India are the chosen countries by UK residents to be treated, whereas Irish Republic, Spain, France, Gibraltar and the United Arab Emirates are the main countries providing inbound health patients. However, the processes of migration explain full or partly the inbound and outbound flows found for some countries.

This study offers a critical insight into inbound and outbound medical flows, demonstrating both the scope for and limitations to market development in this area.

Subject: Sample size; Medical treatment; Medical tourism; Trends; Diaspora

Location: United States--US United Kingdom--UK

Company / organization: Name: European Union; NAICS: 926110, 928120

Identifier / keyword: Medical tourism Outbound The United Kingdom British expats Diaspora populations Inbound

Publication title: Revista de Analisis Turistico; Bingley

Pages: 20-40

Number of pages: 21

Publisher: Asociación Española de Expertos Científicos en Turismo (AECIT)

Country of publication: Spain, Bingley

ISSN: 18852564

e-ISSN: 22540644

Language of publication: Portuguese; Spanish; English

Online publication date: 2019-12-17

Milestone dates: 2019-06-09 (Received) 2019-08-12 (Revised) 2019-09-26 (Revised) 2019-10-23 (Accepted)

First posting date: 17 Dec 2019

DOI: http://dx.doi.org/10.1108/JTA-06-2019-0025

ProQuest document ID: 2604465653

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/medical-tourism-trends-united-kingdom-2000-2016/docview/2604465653/se-2

Copyright: © Ricardo Pagán and Daniel Horsfall. This work is published under https://creativecommons.org/licenses/by-nc/3.0/legalcode (the “License”). Notwithstanding the ProQu est Terms and Conditions, you may use this content in accordance with the terms of the License.

Last updated: 2021-12-09

Preliminary look at the motivators and decision-making process of medical tourists from Nigeria to India

Author: Balogun, Babatunde Abiodun

Publication info: Revista de Analisis Turistico ; Bingley  Vol. 27, Iss. 1,  (2020): 41-61.

The past decade has witnessed tremendous and progressive growth in the number of Nigerians who engage in medical tourism from Nigeria to India. Various commentators have advanced diverse reasons for this trend. However, there is a dearth of research that has sought to provide empirical insights. This paper aims to investigate the decision-making process of Nigerian medical tourists and why they prefer medical tourism to India to medical care locally.

Eight Nigerian medical tourists are interviewed on a one-on-one basis with open-ended questions using the purposive criterion sampling technique from an interpretive mindset.

The paper identifies two major motivators, namely, inadequate medical infrastructure and poor medical, and customer service from health workers in Nigeria, which spurred medical tourism from Nigeria to India. Further, it finds that first-timers premise their decisions on advice from reference groups, while previous personal experiences guide decisions on subsequent medical travels. Findings are explained using the template provided by the theory of planned behavior.

This exploratory nature of this research provides a useful basis to elucidate the course of decision-making of Nigerian patients so that appropriate marketing communication channels can be applied. It improves the process of recruiting and engaging Nigerian patients and nurturing wholesome relationships between Nigerian patients and hospitals.

Subject: Hospitals; International trade; Patient safety; Developing countries--LDCs; Medical treatment; Medical tourism; Industrialized nations; Health care delivery; Decision making

Business indexing term: Subject: International trade Developing countries--LDCs Industrialized nations; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: United States--US India Nigeria

Identifier / keyword: India Nigeria Consumer behavior Medical tourism Health-care marketing

Pages: 41-61

Online publication date: 2019-10-02

Milestone dates: 2018-09-10 (Received) 2019-05-13 (Revised) 2019-06-25 (Accepted)

First posting date: 02 Oct 2019

DOI: http://dx.doi.org/10.1108/JTA-09-2018-0021

ProQuest document ID: 2604464982

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/preliminary-look-at-motivators-decision-making/docview/2604464982/se-2

Copyright: © Babatunde Abiodun Balogun. This work is published under https://creativecommons.org/licenses/by-nc/3.0/legalcode (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

DETERMINING THE COMPETITIVENESS LEVEL AND COMPETITIVITY FACTORS OF THE THERMAL HEALTH TOURISM SECTOR OF SOUTH EGEAN THERMAL TOURISM DEVELOPMENT REGION

Author: BAYAT, Murat; YALMAN, Fuat   

Publication info: Business & Management Studies: An International Journal ; Bursa  Vol. 8, Iss. 4,  (2020): 551-578.

Bu çalışmanın amacı; Güney Ege Termal Turizm Gelişim Bölgesinin (İzmir, Manisa, Aydın ve Denizli) termal sağlık turizmi sektörünün rekabetçilik düzeyinin ve rekabetçilik faktörlerinin tespit edilmesidir. Öncelikle bölgenin termal sağlık turizmi sektörünün rekabetçilik düzeyleri tespit edilmiş, daha sonra termal sağlık turizmi sektörünün rekabetçilik faktörlerinin alt değişkenleri tanımlanmıştır. Nihayetinde ise bu rekabetçilik düzeyinin geliştirilmesi için önerilerde bulunulmuştur. Araştırmanın ana kütlesini İzmir, Manisa, Aydın ve Denizli illerinde faaliyet gösteren termal sağlık turizmi tesislerinin orta ve üst düzey yöneticileri oluşturmaktadır. Nicel araştırma yönteminin kullanıldığı araştırmada, veriler yüz yüze anket tekniği ile 400 yöneticiden toplanmıştır. Veriler SPSS ve AMOS paket programları aracılığıyla ile frekans analizleri, betimleyici istatistikler, açıklayıcı faktör analizi (AFA) ve doğrulayıcı faktör analizi (DFA) teknikleri kullanılarak yorumlanmıştır. Araştırmanın sonuçlarına göre; Güney Ege Termal Turizm Gelişim Bölgesinin Termal Sağlık Turizmi Sektörünün rekabetçilik seviyesi, elmas modeli ile yapılan analiz sonucu, orta seviyede tespit edilmiştir. Bu sonuca, incelenen dört ana değişken ve devletin sektörün rekabetçilik düzeyine yaptığı katkı düzeyleri dikkate alınarak ulaşılmıştır. Doğrulayıcı faktör analizleri yapılarak; termal sağlık turizmi sektörü rekabetçilik faktörlerin kabul edilebilir uyum indeksine sahip olduğu tespit edilmiştir. Araştırmanın değişkenleri için yapılan güvenilirlik analizinde, ölçeklerin yüksek güvenilirlik derecelerine sahip olduğu tespit edilmiştir.

The purpose of this study is to determine the competitiveness level and competitiveness factors of the thermal health tourism sector of the South Aegean Thermal Tourism Development Region (İzmir, Manisa, Aydın and Denizli). First of all, the competitiveness levels of the thermal health tourism sector of the region were determined, and then the sub-variables of the competitive factors of the thermal health tourism sector were defined. Finally, suggestions were made to improve this level of competitiveness. The universe of the research; Medium and senior managers of thermal health tourism facilities operating in İzmir, Manisa, Aydın and Denizli provinces. In the study, in which quantitative research method was used, data was collected from 400 managers using face-to-face survey technique. The data were interpreted through SPSS and AMOS package programs, using frequency analysis, descriptive statistics, explanatory factor analysis (EFA) and confirmatory factor analysis (CFA) techniques. According to the results of the research, the level of competitiveness of the Thermal Health Tourism Sector of the South Aegean Thermal Tourism Development Region was determined at a medium level as a result of the analysis made with the diamond model. This result was achieved by taking into account the four main variables examined and the level of state contribution to the sector's competitiveness. Confirmatory factor analyses are performed; It has been determined that the thermal health tourism sector has an acceptable fit index for competitiveness factors. In the reliability analysis for the variables of the study, it was determined that the scales have high reliability levels.

Subject: Medical tourism

Identifier / keyword: Termal Sağlık Turizmi Rekabetçilik Güney Ege Termal Turizm Gelişim Bölgesi Thermal Health Tourism Competitiveness South Aegean Thermal Tourism Development Region

Alternate title: GÜNEY EGE TERMAL TURİZM GELİŞİM BÖLGESİNİN TERMAL SAĞLIK TURİZMİ SEKTÖRÜNÜN REKABETÇİLİK DÜZEYİNİN VE REKABETÇİLİK FAKTÖRLERİNİN TESPİT EDİLMESİ

Publication title: Business & Management Studies: An International Journal; Bursa

Pages: 551-578

Section: Articles

Publisher: Ali Çağlar Çakmak

Place of publication: Bursa

Country of publication: Turkey, Bursa

ISSN: 21482586

Online publication date: 2020-12-13

Milestone dates: 2020-12-13 (Created) 2020-09-14 (Submitted) 2020-12-10 (Issued) 2020-12-13 (Modified)

First posting date: 13 Dec 2020

DOI: http://dx.doi.org/10.15295/bmij.v8i4.1623

ProQuest document ID: 2572526490

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/determining-competitiveness-level-competitivity/docview/2572526490/se-2

Last updated: 2021-09-21

Exploring the development of medical tourism industry in Southeast Asia region

Author: Suseela Devi Chandran; Puteh, Fadilah; Nur, Alia Azmi; Norazah Mohd Suki

Publication info: International Journal of Business Ecosystem & Strategy ; Istanbul  Vol. 2, Iss. 3,  (2020): 28-32.

Medical tourism is a global phenomenon in many parts of the world. It features an activity where individuals travel from home country to the host country to seek or receive medical healthcare. Being the third largest sector, medical tourism has a significant contribution towards economic development in the Southeast Asia (SEA) region. However, the literature review depicts a scarcity of research on niche areas among the top player in this region. This study aims to explore the development of the medical tourism industry in the SEA region. An in-depth interview with stakeholders and private hospitals were conducted and analyzed using thematic analysis coupled with document analysis from various secondary data. Four SEA regions were chosen namely Malaysia, Indonesia, Thailand, and Singapore which offer specific niche markets to promote the medical tourism industry. Interestingly, these countries are complementing and not competing with each other in the same industry. This study is vital in enriching the literature in the field of medical tourism in showcasing the niche market of medical tourism in the SEA region. This study also contributes greatly to comparative analysis between these countries in the medical tourism sector.

Location: Southeast Asia

Identifier / keyword: Healthcare services medical tourism medical tourists Southeast Asia region

Publication title: International Journal of Business Ecosystem & Strategy; Istanbul

Pages: 28-32

Publisher: Bussecon International Publishing

Place of publication: Istanbul

Country of publication: Turkey, Istanbul

e-ISSN: 26872293

Online publication date: 2020-12-22

Milestone dates: 2020-12-22 (Created) 2020-12-03 (Submitted) 2020-12-22 (Issued) 2020-12-22 (Modified)

First posting date: 22 Dec 2020

DOI: http://dx.doi.org/10.36096/ijbes.v2i3.193

ProQuest document ID: 2564491696

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/exploring-development-medical-tourism-industry/docview/2564491696/se-2

Last updated: 2021-08-26

Sağlık Turizminde İnsan Kaynakları Envanteri: Aydın İlindeki Özel Sağlık Kuruluşlarında Bir İnceleme

Author: Iyem, Burcu1; Güven, Ebru Ö2; Yilmazer, Aydın31 Sakarya Uygulamalı Bilimler Üniversitesi Turizm Fakültesi Turizm İşletmeciliği Bölümü [email protected] https://orcid.org//0000-0002-6300-13722 Dr. Öğr. Üyesi Sakarya Uygulamalı Bilimler Üniversitesi Turizm Fakültesi Turizm İşletmeciliği Bölümü [email protected] https://orcid.org//0000-0003-1298-80123 Doç. Dr. Öğretim Üyesi Sakarya Uygulamalı Bilimler Üniversitesi Turizm Fakültesi Rekreasyon Bölümü [email protected] https://orcid.org/0000-0001-8295-4745

Publication info: Third Sector Social Economic Review ; Ankara  Vol. 55, Iss. 2,  (2020): 1298-1317.

2000'li yılların ilk çeyreğinde bireyler sağlık hizmetlerini daha kaliteli, ucuz ve turizm faaliyetlerinden yararlanarak alma eğilimi içindedirler. Bu bağlamda sağlık turizmi, bireylerin bedensel ve ruhsal sağlıklarını korumak amacıyla bulundukları yerden başka bir yere gerçekleştirdikleri organize edilmiş seyahatler şeklinde tanımlanabilmektedir. İnsan kaynakları yönetimi ise işletme ile çalışanlar arasındaki süreçleri etkileyen önemli yönetsel kararlardan oluşmaktadır. Bu noktada işletmelerin hedeflerine ulaşabilmesi adına ihtiyaç duyduğu insan kaynağını yönetmesi, hizmetlerinde etkinlik ve verimliliği artırmada önemli faktördür. Bu çalışma, sağlık turizmi sektöründe hizmet veren sağlık işletmelerinde insan kaynakları envanterini Aydın İli üzerinden incelemeyi amaçlamaktadır. Bu doğrultuda çalışmada, sağlık turizminin tanımı ve kapsamı, sağlık turizmi çeşitleri, Türkiye'de ve Dünyada sağlık turizmi, sağlık turizminde insan kaynakları yönetimi süreci hakkında bilgilere kavramsal çerçevede yer verilmektedir. Çalışma kapsamında Aydın İlindeki uluslararası sağlık turizmi yetki belgesine sahip özel sağlık kuruluşlarında insan kaynakları envanteri incelenmiştir. Çalışmada nitel veri analiz yöntemlerinden yarı yapılandırılmış mülakat tekniği kullanılmıştır. Elde edilen veriler içerik analizi ile bulgulara dönüştürülmüştür ve inşan kaynakları envanteri ile işletmelerde mevcut iş görenlerin sahip oldukları ve olmaları gereken yetkinlik, beceri ve donanımlar ortaya konulmuştur.

In the first quaeter of 2000s,, individuals tend to receive health services by using higher quality, cheaper and tourism activities. In this context, health tourism can be defined as organized travels made by individuals from one place to another to protect their physical and mental health. Human resources management consists of important managerial decisions that affect the processes between the business and the employees. At this point, managing the human resources needed by the enterprises in order to reach their goals is an important factor in increasing the efficiency and efficiency in their services. This study aims to examine the human resources inventory of healthcare enterprises serving in the health tourism sector through Aydın Province. In line with this study, the definition of tourism and health coverage, type of health tourism, health tourism in Turkey and in the world, health tourism human resources are included in the conceptual framework of information management processes. Within the scope of the study, inventory of human resources in private health institutions that have international health tourism authorization certificate in Aydın Province was examined. In the study, semi-structured interview technique, which is one of the qualitative data analysis methods, was used. The data obtained were transformed into findings through content analysis, and the competence, skills and equipment that the existing employees have and should have been revealed with the inventory of built resources.

Subject: Medical tourism; Human resource management

Business indexing term: Subject: Human resource management

Location: Aydin Turkey Turkey

Alternate title: Human Resources Inventory in Health Tourism: A Study in Private Health Institutions in Aydın Province

Publication title: Third Sector Social Economic Review; Ankara

Pages: 1298-1317

Section: Araştırma Makalesi

Publisher: Türk Kooperatifçilik Kurumu (Turkish Cooperative Alliance): Third Sector Social Economic Review

ISSN: 21481237

e-ISSN: 25870114

DOI: http://dx.doi.org/10.15659/3.sektor-sosyal-ekonomi.20.06.1359

ProQuest document ID: 2478261636

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/sağlık-turizminde-i̇nsan-kaynakları-envanteri/docview/2478261636/se-2?accountid=7139

Copyright: Copyright Türk Kooperatifçilik Kurumu (Turkish Cooperative Alliance): Third Sector Social Economic Review 2020

Medikal Turizm Hizmeti Veren Sağlık Kuruluşlarının Rekabet Stratejilerinin Kurum Performansına Etkisi: İstanbul Örneği1

Author: Sancar, Tekin1; Öngel, Volkan21 İstanbul Eǧitim Araştırma Hastanesi2 Beykent Üniversitesi İktisadi ve İdari Bilimler Fakültesi İktisat Bölümü

Publication info: Third Sector Social Economic Review ; Ankara  Vol. 55, Iss. 4,  (2020): 2847-2868.

Çalışmanın amacı medikal turizm alanında hizmet veren saǧlık kuruluşlarının uyguladıkları rekabet stratejilerinin saǧlık kuruluşlarının performansına etkisinin tespit edilmesidir. Araştırma kapsamında İstanbul'daki 102 saǧlık kuruluşu araştırmanın örneklemi olarak belirlenmiştir. Araştırmanın örnekleminin seçiminde tesadüfi örneklem türlerinden kolayda örneklem tekniǧi kullanılmıştır. Veri toplama sürecinde öncelikle anket tekniǧi kullanılmıştır. Saǧlık kuruluşlarının yöneticilerine sunulan anketlerden elde edilen veriler SPSS 22 paket programı ile analiz edilmiştir. Araştırma soncunda farklılaşma stratejisinin performans üzerinde çok düşük düzeyde ve pozitif yönde bir etkisinin olduǧu tespit edilmiştir. Odaklanma stratejisi ve maliyet liderliǧi stratejisinin ise performans üzerinde herhangi bir etkisinin olmadıǧı sonucuna ulaşılmıştır. Analiz sonuçlarının anlamlandırılabilmesi için mülakat tekniǧi aracılıǧı ile yeniden veri toplanmıştır. Sonuç olarak araştırmanın nicel kısmında elde edilen sonuçlar, araştırmanın nitel kısmında da doǧrulanmıştır.

The aim of this study is to determine the effect of the competitive strategies applied by the health institutions providing services in the field of medical tourism to the performance of health institutions. 102 health institutions in Istanbul were determined as the sample of the research. In the selection of the sample, convenience sampling method, a type of random sampling technic, was used. The data obtained from the questionnaires presented to the managers of health institutions were analyzed using SPSS 22 package program. As a result of the research, differentiation strategy has a very low and positive effect on performance. It is concluded that the focus strategy and cost leadership strategy have no impact on performance. In order to make sense of the analysis results, data were collected again through the interview technique. The results obtained in the quantitative part of the study are also confirmed in the qualitative part of the study.

Subject: Medical tourism; Health care; Competition; Health care industry

Location: Istanbul Turkey Turkey

Alternate title: Effect of Competitive Strategies on The Health Performance of Health Organizations Providing Medical Tourism Services: The Case of Istanbul

Pages: 2847-2868

DOI: http://dx.doi.org/10.15659/3.sektor-sosyal-ekonomi.20.12.1475

ProQuestdocument ID: 2477284803

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/medikal-turizm-hizmeti-veren-sağlık/docview/2477284803/se-2?accountid=7139

An Integrative Review of Patients’ Experience in the Medical Tourism: The Journal of Health Care Organization, Provision, and Financing

Author: Xu, Tuzhen1;  Wang, Wanyi1; Du, Jinlan11 Texas Woman’s University, Houston, USA

Publication info: Inquiry : The Journal of Health Care Organization, Provision, and Financing; Thousand Oaks  Vol. 57,  (Jan 2020).

Medical tourism has emerged as an industry due to the constantly improved information technology and decreasing cost for transportation. Evidence on how medical tourists develop their medical travel and their experience keeps growing. This article aims to provide an integrative review to understand medical tourism from the patients’ perspective. PRISMA procedures were followed. All the literature was published from January 1, 2009, to May 4, 2019, in peer-reviewed journals in CINAHL and MEDLINE/PubMed. Johns Hopkins Nursing evidence level and quality guide were used to evaluate evidence level. Twenty-one studies including 8 quantitative, 10 qualitative, and 3 mix-method studies were reviewed. Low cost, short waiting list, quality, and procedures available were the motivators to treatment abroad. The Internet, former tourists’ testimonial, and physician and facilitators’ advice were the predominant resources consulted. Perceived value of medical quality directly affected patients’ overall satisfaction. Our integrative review has led to the identification of many factors related to medical tourist’s experience. We suggest further empirical researches on (1) the patients’ decision-making process of motivators and barriers, (2) the factors related to patients’ experience on the health care quality, and (3) the strategies to ensure the continuity of care.

Subject: Health care access; Quality of care; Boolean; Internet; Medical Subject Headings-MeSH; Hospitals; Information industry; Data analysis; Medical tourism; Health care industry; Decision making; Global health; Patient satisfaction; Nursing; Research methodology; Tourism; Data collection; Travel; Satisfaction; Literature reviews; Patients; Information technology; Information sources; Health care expenditures

Business indexing term: Subject: Health care industry; Industry: 62211 :‎ General Medical and Surgical Hospitals

Identifier / keyword: medical tourism global health experience health service medical travel

Publication title: Inquiry: The Journal of Health Care Organization, Provision, and Financing; Thousand Oaks

Publication date: Jan 2020

Publisher: SAGE PUBLICATIONS, INC.

Place of publication: Thousand Oaks

Country of publication: United States, Thousand Oaks

Publication subject: Medical Sciences, Health Facilities And Administration

ISSN: 00469580

e-ISSN: 19457243

Online publication date: 2020-06-01

Milestone dates: 2019-10-02 (Received) 2020-04-01 (Rev-recd) 2020-04-22 (Accepted)

First posting date: 01 Jun 2020

DOI: http://dx.doi.org/10.1177/0046958020926762

ProQuest document ID: 2473728849

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/integrative-review-patients-experience-medical/docview/2473728849/se-2

Copyright: © 2020. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Database: ABI/INFORM Collection; Healthcare Administration Database; Publicly Available Content Database; Social Science Premium Collection

The Role of Outpatient Care Accreditation in Enhancing Foreign Patients’ Perception of Colombian Medical Tourism: A Quasi-experimental Design: The Journal of Health Care Organization, Provision, and Financing

Author: Mario Alberto de la Puente Pacheco1; Carlos Mario de Oro Aguado1; Elkyn Lugo Arias2; Pacheco, Briyis Fontecha31 universidad del norte, Barranquilla, Colombia2 Corporación Universitaria Minuto de Dios, Uniminuto. Social Development Management Group (DESOGE) of the Economics and Business Sciences faculty, Barranquilla, Colombia3 Clinica Bonadona Prevenir, Barranquilla, Colombia

This study analyzes whether hospitals accredited by the Joint Commission International in outpatient medical care protocols located in Colombia achieve a higher quality perception from foreign patients compared to others treated in a non-accredited one. A t-test with Welch correction, chi-square test, correlation coefficient of Tau Kendall, pre-test, post-test, complementary questionnaire and a 2 focus groups were used in 178 foreign patients. It was observed that patients treated in accredited hospitals had a higher quality perception than the non-accredited group. However, it was found that an unbalanced application of the 3 variables negatively alters quality judgment. Findings contributes to understanding the Colombian medical tourism in depth using non-conventional instruments.

Subject: Ambulatory care; Research; Certification; Patients; Tourism; Insurance companies; Valuation; Communication; Accreditation; Small & medium sized enterprises-SME; Physicians; Hospitals; Variables; Developing countries--LDCs; Literature reviews; Medical tourism; Insurance coverage; Health insurance

Business indexing term: Subject: Insurance companies Valuation Small & medium sized enterprises-SME Developing co untries--LDCs Insurance coverage Health insurance; Industry: 52411 :‎ Direct Life, Health, and Medical Insurance Carriers 62211 :‎ General Medical and Surgical Hospitals

Company / organization: Name: Joint Commission International; NAICS: 813920

Classification: 52411: Direct Life, Health, and Medical Insurance Carriers; 62211: General Medical and Surgical Hospitals

Identifier / keyword: medical tourism Colombia outpatients focus groups Chi-square distributions surveys and questionnaires accreditation

Publication subject: Medic al Sciences, Health Facilities And Administration

Online publication date: 2020-11-01

Milestone dates: 2020-06-25 (Received) 2020-10-30 (Rev-recd) 2020-11-03 (Accepted)

First posting date: 01 Nov 2020

DOI: http://dx.doi.org/10.1177/0046958020976826

ProQuest document ID: 2473728789

Document URL: https://uiwtx.idm.oclc.org/l ogin?url=https://www.proquest.com/scholarly-journals/role-outpatient-care-accreditation-enhancing/docview/2473728789/se-2

Riesgos y beneficios del turismo médico en países en vías de desarrollo en el periodo 2015 a 2019

Author: Mario Alberto dela Puente Pacheco; Maury, Mauro

Publication info: Revista de Economía del Caribe ; Barranquilla  Iss. 25,  (Jan 2020): 66-81.

This article analyzes the potential risks and advantages of a medical tourism offer in developing countries based on international health mobility dynamics. Through a comparison of secondary sources and the presentation of a case study between the UK and India, it is found that legal loopholes, deepening inequalities in access to public medical services and security uncertainty may reduce the attraction of health professionals, competition improvements, and advances in the quality of medical care.

Este artículo analizó los riesgos y beneficios potenciales de la oferta de servicios médico-turísticos desde países en vías de desarrollo a partir de una descripción de las causas de desplazamiento sanitario internacional. Por medio de una com- paración de fuentes secundarias y la presentación de un caso de estudio entre el Reino Unido y la India, se encuentra que los vacíos jurídicos, la profundización de inequidades en el acceso a servicios médicos públicos y la incertidumbre en la seguridad pueden diluir la atracción de talento de profesionales de la salud, la potenciación de ventajas competitivas y las mejoras en la calidad de la atención médica.

Subject: Developing countries--LDCs; Medical tourism; Quality of care; Health services

Business indexing term: Subject: Developing countries--LDCs

Location: India United Kingdom--UK

Identifier / keyword: Turismo médico países en vías de desarrollo movilidad sanitaria internacional

Alternate title: Risks and Benefits of Medical Tourism in Developing Countries in the Period 2015 to 2019

Publication title: Revista de Economía del Caribe; Barranquilla

Pages: 66-81

Section: Artículo de reflexión original

Publisher: Fundación Universidad del Norte

ISSN: 20112106

e-ISSN: 21459363

Milestone dates: 2020-06-17 (Submitted) 2020-08-14 (Issued) 2020-06-18 (Created) 2020-07-02 (Modified)

DOI: http://dx.doi.org/10.14482/rec.v0i25.13348

ProQuest document ID: 2456132672

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/riesgos-y-beneficios-del-turismo-médico-en-países/docview/2456132672/se-2

Copyright: © 2020. This work is published under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Determinants of technological innovations in health tourism enterprises

Author: Szymańska, Elżbieta; Panfiluk, Eugenia   

Publication info: Verslas : Teorija ir Praktika ; Vilnius  Vol. 21, Iss. 1,  (Jan 2020): 348-359.

The research problem is the implementation of technological innovations in health tourism services. The main purpose of the paper is diagnosing determinants of technological innovativeness of enterprises that provide health tourism services. Two detailed objectives were laid down – specifically, an indication of these determinants in respect of the range and type of a technological innovation. The methods applied in the research are: Delphi method, comparative analysis, the range method and the standardised interview method. In order to indicate determinants the following research techniques were used: Kruskal - Wallis test, factor analysis, analysis of medium-rank test, Spearman’s rank order correlation test. The primary result is diagnosing determinants affecting technological innovativeness of the subjects under study which are: quality of endogenous human capital of the surveyed entities and inflow of external information. The research is of ground-breaking nature since until now, technological innovations in health tourism have not been described in economy literature. The results have an impact on the development of economics and management sciences, contributing to the development of innovation theory and enterprise management. Moreover, the results potentially contribute to the practical aspect by means of their application by practitioners – organisers of health tourism.

Subject: Innovations; Technological change; Medical tourism

Identifier / keyword: some innovations radical innovations technology tourism health tourism

Publication title: Verslas : Teorija ir Praktika; Vilnius

Pages: 348-359

Publisher: Vilnius Gediminas Technical University

Place of publication: Vilnius

Country of publication: Lithuania, Vilnius

ISSN: 16480627

e-ISSN: 18224202

Language of publication: English; Lithuanian; German

Publication history:

Online publication date: 2020-01-13

Milestone dates: 2020-05-25 (Created) 2019-08-25 (Submitted) 2020-01-13 (Issued) 2020-05-25 (Modified)

First posting date: 13 Jan 2020

DOI: http://dx.doi.org/10.3846/btp.2020.11104

ProQuest document ID: 2453985961

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/determinants-technological-innovations-health/docview/2453985961/se-2

Copyright: © 2020. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Last updated: 2020-10-28

Investigating prevalence job stress and illness among hospital staff providing health tourism services (HSPHTS) in Iran

Author: Hemmati, Farhad; Dabbaghi, Fatemeh; Mahmoudi, Ghahraman

Publication info: BMC Health Services Research ; London  Vol. 20,  (2020): 1-6.

Health tourism or treatment tourism is one of threatening fields that causes (added s) increase in prevalence of job stress and illnesses among hospital staff of providing health tourism services (HSPHT). The aim of this study is to determine the prevalence of job stress and illnesses among hospitals staff of providing health tourism services in touristic cities as Tehran and Shiraz in Iran.

This cross-sectional, descriptive-analytical study was carried out among the staff of 10 hospitals providing health tourism services in cities of Tehran and Shiraz, Iran, in 2019. In these hospitals, 1250 staff were chosen by cluster sampling method from each job task as doctor, nurse, office worker, and paramedical and cleaner worker. Also, 1100 staff working in other general hospitals (non-HSPHTS) were selected as the control sample. Then, the demographic information and prevalence of job stress were gathered by Osipow job stress questionnaire and the illnesses were accumulated by self-reporting questionnaire. Finally, data were analyzed in SPSS 20 software. Chi-square and Pearson’s parametric tests were used in the study.

Prevalence of illnesses among HSPHTS was more than that in general hospitals (Pvalue < 0.05). The most prevalent illnesses were respiratory (11.08%), digestive (9.2%), and cutaneous (9.04%), respectively. Also, the prevalence of job stress among HSPHTS was more than that in general hospitals (Pvalue < 0.05). There was a significant relationship between prevalence of illnesses and job stress among the staff of hospitals and the increase in the number of visited tourists in the hospitals providing health tourism services.

Results of the study showed that the prevalence of job stress (%33.76) and illnesses (%43.66) among the HSPHTS was respectively 2 and 2.6 times more than that among the staff of general hospitals. Thus, it is necessary to observe sanitary actions and considerations more seriously in these hospitals.

Subject: Infectious diseases; Hospitals; Occupational stress; Workers; Medical tourism; Illnesses; Cooperation; Nurses; Males; Physicians; Questionnaires

Business indexing term: Subject: Occupational stress Workers; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: Iran

Identifier / keyword: Illnesses Job stress Hospitals Health tourism

Publication title: BMC Health Services Research; London

Section: Research article

Publisher: BioMed Central

Place of publication: London

Country of publication: United Kingdom, London

Publication subject: Medical Sciences

e-ISSN: 14726963

Online publication date: 2020-09-29

First posting date: 29 Sep 2020

DOI: http://dx.doi.org/10.1186/s12913-020-05761-x

ProQuest document ID: 2451844346

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/investigating-prevalence-job-stress-illness-among/docview/2451844346/se-2

Copyright: © 2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Database: ABI/INFORM Collection; Healthcare Administration Database; Publicly Available Content Database

Seyahat Acentalarında Yaşlı ve Engelli Yerli Turistlere Sunulan Hizmetlerin Değerlendirilmesi

Author: Erkiliç, Cemre Eda1; Eren, Ayşe21 Öğr. Gör. Dr. Ankara Hacı Bayram Veli Üniversitesi2 Öğr. Gör. Akdeniz Üniversitesi

Publication info: Third Sector Social Economic Review ; Ankara  Vol. 55, Iss. 1,  (2020): 564-585.

Sağlık turizmi, ekonomik etkileri ve uluslararası ticaret unsuru olması sebebiyle turizm sektörü, destinasyon yöneticileri ve sağlık işletmeleri açısından önemli bir turizm hareketidir. Çalışmanın amacı seyahat acentaları tarafından sunulan paket tur hizmetlerinde satış öncesi ve satış sonrası yaşlı ve engelli kişilerin ihtiyaçlarını, beklentilerini ve karşılaştıkları problemleri belirlemektir. Bu çalışmada nitel araştırma yöntemlerinden derinlemesine görüşme tekniği kullanılmış, seyahat acentası satış veya operasyon bölümü sorumluları ile yarı yapılandırılmış soru formu kullanılarak yüz yüze görüşmeler gerçekleştirilmiştir. Çalışma sonucunda Ankara 'da seyahat acentalarının yaşlı ve engelli kişilere özel turlar planlamadıkları tespit edilmiştir. Ayrıca, hali hazırda satışa sunulan turların planlanması aşamasında, yaşlı ve engelli kişilerin seyahatlere katılma durumları dikkate alınarak her hangi bir düzenlemenin yapılmadığı belirlenmiştir. Bununla birlikte, seyahat acentalarının yaşlı ve engelli kişileri farklı bir pazar bölümü olarak görmediği, ürün geliştirme ve çeşitlendirme çabalarının olmadığı belirlenmiştir. Çalışma sonuçlarına göre, yaşlı ve engelli kişilerin turizm hareketlerine katılma beklentilerinin karşılanması için farklılaştırılmış turistik ürünlerin hazırlanması önem arz etmektedir.

Health tourism is an important tourism movement for the tourism sector, destination managers and health enterprises, due to its economic impacts and being an international trade element. The purpose of this study is to determine the needs, expectations and problems of elderly and disabled individuals in package tour services offered by travel agencies, before and after sales. In the study, the profound interview technique which is among qualitative research methods, was used and face-to-face interviews were conducted with sales or operation representatives in travel agencies, using a semi-structured question form. As a result of the study, it was determined that travel agencies in Ankara did not plan special tours for elderly and disabled individuals. In addition it was found that no regulation was made considering the state of elderly and disabled individuals to make a journey in the planning of available tours presented for sale. It was also determined that travel agencies did not regard elderly and disabled individuals as a different market department and they had no efforts for developing and diversifying products. According to the study results, it is important to prepare diversified touristic products in order to meet the expectation of elderly and disabled individuals to participate in tourism movements.

Subject: Older people; Medical tourism; Disabled people; Travel agencies; Travel; Qualitative research

Business indexing term: Subject: Travel agencies; Industry: 62412 :‎ Services for the Elderly and Persons with Disabilities 56151 :‎ Travel Agencies

Location: Ankara Turkey Turkey

Company / organization: Name: European Travel Commission; NAICS: 926110; Name: World Tourism Organization; NAICS: 813910

Classification: 62412: Services for the Elderly and Persons with Disabilities; 56151: Travel Agencies

Alternate title: Assessing the Services Offered to Elderly and Accessible Local Tourists in Travel Agencies

Pages: 564-585

DOI: http://dx.doi.org/10.15659/3.sektor-sosyal-ekonomi.20.03.1313

ProQuest document ID: 2390153130

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/seyahat-acentalarında-yaşlı-ve-engelli-yerli/docview/2390153130/se-2?accountid=7139

Turismo de salud y redes colaborativas en innovación: caso los algodones, Baja California

Author: Zermeño Flores, Sonia Guadalupe; Carlos Mario Amaya Molinar; Tomás Jesús Cuevas Contreras

Publication info: Turismo y Sociedad ; Bogotá  Vol. 26,  (Jan-Jun 2020): 67-88.

El análisis del turismo se expresa por medio de sistemas complejos compuestos por el aglutinamiento de diversos agentes interesados, por esta razón, su funcionamiento depende de la gestión efectiva de las relaciones que se producen entre los distintos componentes del sistema turístico. Bajo este entendido, la presente investigación es un estudio de caso que busca discutir las redes de colaboración entre actores y stakeholders de turismo de salud en Los Algodones, Baja California, que han permitido la generación de innovación en productos/servicios, procesos, organización y mercadotecnia. Por lo anterior, se llevó a cabo un estudio de tipo cualitativo que consistió en el desarrollo de una mesa de discusión que reunió a agentes interesados en el sistema turístico de servicios de salud. En dicha mesa se expresaron opiniones sobre las estrategias de colaboración entre actores y stakeholders de turismo de salud y las acciones emprendidas en innovación para maximizar la competitividad y la sostenibilidad de la actividad turística. Se concluye que el turismo de salud en Los Algodones se encuentra en etapa de transición entre la cooperación y la colaboración entre agentes interesados y en proceso de consolidación como sistema abierto y altamente competitivo.

The analysis of tourism is expressed through complex systems comprised of the stringing together of various stakeholders. For this reason, its operation depends on the effective management of the relationships that occur between the different components of the tourism system. With this in mind, this research is a case study that seeks to discuss the collaboration networks between health tourism stakeholders and stakeholders in Los Algodones, Baja California, which has given way to the generation of product / service, process, organization and marketing innovation. Therefore, a qualitative study was carried out that consisted in the development of a Panel Discussion that brought together agents interested in the health services tourism system; where they expressed opinions on the strategies of collaboration between actors and stakeholders in health tourism and the innovative actions undertaken to maximize the competitiveness and sustainability of the tourism activity; concluding that health tourism in Los Algodones is in transition stages between cooperation and collaboration between interested agents and in the process of consolidation as an open and highly competitive system.

Subject: Innovations; Collaboration; Medical tourism; Tourism; Complex systems; Stakeholders

Business indexing term: Subject: Stakeholders

Location: Baja California Mexico Mexico

Identifier / keyword: Relaciones entre stakeholders; análisis de redes sociales; innovación; turismo de salud

Alternate title: Health tourism and collaborative networks in innovation: case los algodones, Baja California

Publication title: Turismo y Sociedad; Bogotá

Pages: 67-88

Publication date: Jan-Jun 2020

Section: Artículos

Publisher: Universidad Externado de Colombia

Place of publication: Bogotá

Country of publication: Colombia, Bogotá

Publication subject: Business And Economics, Travel And Tourism

ISSN: 01207555

e-ISSN: 2346206X

Online publication date: 2019-11-25

Milestone dates: 2019-11-25 (Created) 2019-11-25 (Submitted) 2019-11-25 (Modified)

First posting date: 25 Nov 2019

DOI: http://dx.doi.org/10.18601/01207555.n26.03

ProQuest document ID: 2319669301

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/turismo-de-salud-y-redes-colaborativas-en/docview/2319669301/se-2

Copyright: © 2020. This work is published under http://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and conditions, you may use this content in accordance with the terms of the License.

THE HUNGARIAN GOLF SUPPLY AND ITS DEVELOPMENT OPTIONS

Author: Kiss, Róbert11 Department of International Tourism and Hospitality, International College, I-Shou University, Kaohsiung, Taiwan

Publication info: Journal of Tourism Challenges and Trends ; Bucharest  Vol. 12,  (Dec 2019): 101-123.

The paper concentrates on one of the most popular sports in the world, golf, and its impact on the tourism industry. The fast-growing golf tourism segment seems incongruous to the controversial stagnation of Hungary, a country, where the roots of this sport had been well-destroyed by the communist regime. Nevertheless, huge efforts have been made since political change occurred in the past 30 years. Hungarian golf has remained both small-scale and independent from the international golf market despite strong diversification in the sport. This work focuses on the brief history of the sport and explains the geographical environment, its impact on the location of the golf courses, and the potential scenery that is so much a part of golf tourism in Hungary. The Hungarian golf industry and its developmental options have determined the growth directions for this activity. Based on in-depth interviews with local industry representatives, the author explains which tourism products may wish to join golf tourism, making it more popular and setting up common cause with it. The notions of health and medical tourism are explored as they become associated with golf tourism in the near future.

Subject: Golf courses; Motivation; Tourism; Political change; Participation; Leisure; Environmental impact; Recreation; Industrial development; Medical tourism; Professional golf; Popularity

Location: Hungary

Publication title: Journal of Tourism Challenges and Trends; Bucharest

Pages: 101-123

Publication year: 2019

Publication date: Dec 2019

Publisher: Journal of Tourism Challenges and Trends

Place of publication: Bucharest

Country of publication: Romania, Bucharest

Publication subject: Physical Fitness And Hygiene, Travel And Tourism

ISSN: 18449743

ProQuest document ID: 2350467406

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/hungarian-golf-supply-development-options/docview/2350467406/se-2?accountid=7139

Copyright: Copyright Journal of Tourism Challenges and Trends Dec 2019

Last updated: 2021-07-26

The Economic Determinants of the World Medical Tourism Industry Development

Author: Baiev, Victorovich1; Bakhov, Ivan Stepanovych2; Holovach, Nataliia Vasylivna3; Zgalat-Lozynska, Liybov Oleksandrivna41 National University of Food Technologies, Ukraine [email protected] Interregional Academy of Personnel Management, Ukraine [email protected] Interregional Academy of Personnel Management, Ukraine [email protected] Kyiv National University of Construction and Architecture, Ukraine [email protected]

Publication info: Journal of Environmental Management & Tourism ; Craiova  Vol. 10, Iss. 6(38),  (Fall 2019): 1392-1398.

The paper considers the main types of medical tourism - diagnostic-therapeutic, health and beauty, and health resort treatment. It specifies the basic prerequisites for development of the international medical tourism industry - cost and quality of medical services, accreditation of medical institutions in compliance with international quality standards; development of medical tourism clusters.

Subject: Plastic surgery; Physical fitness; Medical aid; Transplants & implants; Global economy; Cosmetic dentistry; Resorts & spas; Medical tourism; Dental care; Quality

Business indexing term: Subject: Global economy; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels 62121 :‎ Offices of Dentists

Location: Thailand United States--US Israel India Germany United Kingdom--UK France Ukraine

Classification: 72111: Hotels (except Casino Hotels) and Motels; 62121: Offices of Dentists

Issue: 6(38)

Pages: 1392-1398

Publication date: Fall 2019

DOI: http://dx.doi.org/10.14505/jemt.v10.6(38).22

ProQuest document ID: 2433188138

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/economic-determinants-world-medical-tourism/docview/2433188138/se-2?accountid=7139

Copyright: Copyright ASERS Ltd Fall 2019

Spatial Planning for Health Tourism Development in Belokurikha Resort

Author: Dunets, Aleksandr N1; Zh ogova, Inna G2; Akimov, Oleg S31 Department of Economic Geography and Cartography Altai State University, Russian Federation2 Department of Foreign Languages Altai State University, Russian Federation3 Post-graduate student of Department of Economic Geography and Cartography Altai State University, Russian Federation

Publication info: Journal of Environmental Management & Tourism ; Craiova  Vol. 10, Iss. 6(38),  (Fall 2019): 1331-1337.

The health tourism development is of the greatest interest for the business sector and regional authorities in Altai Krai. To a great extent, tourist attractions are maintained and operate year-round. It should be noted that it is essential for the region, located in Siberia. In fact, Belokurikha Resort is the largest recreational area in the Asian part of the Russian Federation. Development of the resort has been subjected to the limits imposed by its location in a small valley of a mountainous river. Therefore, the commercial enterprises, local government and scholars are working on projects for the development of medical tourism within neighbouring territories of the resort. The authors of this paper suggest applying the frame approach in spatial planning for the territorial tourist complex "Bolshaya Belokurikha" ("Big Belokurikha"), and the main elements that are significant for the successful implementation of tourist projects are identified within. The use of the integrated approach allows for the consideration of stakeholders' interests. To preserve the natural environment and further development of tourism, the natural park "Foothills of Altai" was established. This park is considered as a base of touristic operations. The concept and purpose of spatial development is to combine the development of medical tourism and rehabilitation into the natural environment. Currently, project proposals are being discussed by the working group of Altai Krai, and then they will be sent to the Ministry of Economic Development of the Government of the Russian Federation.

Subject: Colonies & territories; Rehabilitation; Economic development; Integrated approach; Resorts & spas; Medical tourism; Infrastructure; Tourist attractions; Labor unions

Business indexing term: Subject: Economic development Infrastructure Labor unions; Industry: 92611 :‎ Administration of General Economic Programs 81393 :‎ Labor Unions and Similar Labor Organizations 72111 :‎ Hotels (except Casino Hotels) and Motels

Location: Siberia Russia Altai Mountains

Classification: 92611: Administration of General Economic Programs; 81393: Labor Unions and Similar Labor Organizations; 72111: Hotels (except Casino Hotels) and Motels

Pages: 1331-1337

DOI: http://dx.doi.org/10.14505/jemt.v10.6(38).15

ProQuest document ID: 2433185945

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/spatial-planning-health-tourism-development/docview/2433185945/se-2?accountid=7139

Destination Management Organizations and Health Tourism Visual Identification in Central and Eastern Europe

Author: Borzyszkowski, Jacek1; Lubowiecki-Vikuk, Adrian21 WSB University in Gdansk, Management and Finance Institute2 Warsaw School of Economics, Collegium of Management and Finance, Institute of Management, Department of Consumer Behaviour Research

Publication info: European Research Studies ; Anixis  Vol. 22, Iss. 4,  (2019): 241-261.

Purpose: The purpose of this paper is to identify and diagnose the activities of national destination management organizations (DMOs) from Central and Eastern European countries (CEEC) in the scope of a visual identification of health tourism destinations. Design/Methodology/Approach: The investigations were conducted on three stages: (1) a verification was performed of the existence of national DMOs in CEEC; (2) when making targeted selection, a questionnaire interviews were performed with 16 DMO representatives; (3) desk research was conducted, i.e. an analysis of the contents of the official websites/ portals and social media of DMOs. Findings: The role of health tourism is to grow in the coming years in the opinion expressed by the DMOs examined. The organizations under examination try to address this trend by indicating that health tourism, even at its current stage, constitutes a fairly important tourism product. The current status of the visual identification of HTD created by DMOs in the states under examination is rather poor. A small part of organizations identify themselves directly with the health tourism product. A significant part of the organizations do not undertake any activities in this area. In turn, those that do undertake such activities rely primarily on fairly common elements such as: an internet website, possibly a logo and an advertising slogan. Practical Implications: The results may serve as a point of departure for taking adequate activities aimed promotion at the health tourism product not only by other national DMOs but also by similar organizations on the regional or local level. Originality/Value: The variety of health tourism products available at CEEC puts new tasks for DMOs. The article highlights the important role of the entity that is responsible for the management of the HTD brand.

Subject: Research; Medical tourism; Identification; Marketing; Developing countries--LDCs

Business indexing term: Subject: Marketing Developing countries--LDCs

Location: Eastern Europe Central Europe

Company / organization: Name: World Tourism Organization; NAICS: 813910

Publication title: European Research Studies; Anixis

Pages: 241-261

Publication date: 2019

Publisher: Professor El Thalassinos

Place of publication: Anixis

Country of publication: Greece, Anixis

ISSN: 11082976

ProQuest document ID: 2369752739

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/destination-management-organizations-health/docview/2369752739/se-2?accountid=7139

Copyright: Copyright Professor El Thalassinos 2019

Last updated: 2020-12-21

Views of Indonesian consumers towards medical tourism experience in Malaysia

Author: Harriman, Samuel Saragih; Peter, Jonathan

Publication info: Journal of Asia Business Studies ; Bingley  Vol. 13, Iss. 4,  (2019): 507-524.

Indonesians are known for their unique behavior and willingness to travel abroad for healthcare treatments. More than half of the healthcare “tourists” who travel to Malaysia come from Indonesia, followed in numbers by those in India, Japan, and China, Libya, the UK, Australia, USA, Bangladesh and the Philippines. Malaysia is also geographically located near two Indonesian main islands, i.e. North Sumatera and North Kalimantan. These reasons contribute to making Indonesia one of the most productive healthcare consumers in Malaysia. This study aims to examine these Indonesian consumers’ through the use of behavioral lenses to examine their medical tourism experiences in Malaysia, its neighboring country.

The theory of planned behavior is used as the basis of these analyses and hypotheses development. In total, 7 variables and 18 indicators that built both the exogenous and endogenous variables were developed from previous literature. Through a purposive sampling technique, the authors collected 200 samples of individuals where each respondent must at least have been to Malaysia once for medical treatments related to a general check-up, cardiovascular, cancer, orthopedics, nervous systems or dental problems. A partial least squares – structural equation modeling analysis was carried out to examine both the measurement model and the structural model.

Behavioral belief positively affects the attitude of Indonesian patients and their intentions to visit Malaysia for medical treatment, i.e. attitude, subjective norms and perceived behavioral control. Results show that as individuals, Indonesians have a strong belief that undergoing medical treatment in Malaysia will be more favorable than having that same medical treatment in Indonesia. The study also shows that people who are considered important to patients, e.g. family members or relatives, significantly influence their intention to visit Malaysian medical institutions. The authors also found that patients’ resources and capabilities – e.g. financial strength, supporting infrastructures and time availability – are essential factors for Indonesian patients to choose medical tourism and to visit Malaysia as their venue for medical services.

The results of this study are consistent with the previous research, which has shown that attitude, subjective norms and perceived behavioral control positively affect visit intention. The results also suggest new interesting theoretical findings that Indonesia’s medical tourist intention to visit Malaysia is most strongly caused by subjective norms followed by individual attitudes and perceived behavioral control, all reasons that are identical to Japanese medical tourists’ visiting South Korea for similar purposes. Indeed, there are similar behavioral practices and beliefs among both Indonesian and Japanese medical tourists, despite the gap existing in these two countries’ economies.

The study proposes two managerial implications using its findings. First, this study can be a basis for the Malaysian medical tourism business to better understand Indonesian medical tourists’ behavior when visiting their country. The study explicitly suggests that it is both collective and individual beliefs that drive Indonesian patients, who have sufficient resources, to visit Malaysia because of better quality and affordability available there compared to Indonesian medical services. Second, this study raises a fundamental question about Indonesian stakeholders in the medical industry. In the near future, this type of medical tourism behavior will, without a doubt, affect the Indonesian economy at large.

The contributions of this study are twofold. First, compared to previous studies that focused specifically on the developed countries, this study focuses on Indonesian consumers’ point of view as an emerging country towards Malaysia’s medical tourism business. Second, this study provides quantifiable insights on the Indonesia-Malaysia medical tourism phenomenon, which previously has been frequently discussed, but only using a qualitative exploratory approach.

Subject: Medical treatment; Hypotheses; Studies; Health care; Questionnaires; Variables; Medical tourism; Literature reviews; Attitudes; Norms; Consumers; Health care access; Medical research; Travel; Orthopedics; Cardiology

Business indexing term: Subject: Consumers

Location: United States--US Malaysia Indonesia

Publication title: Journal of Asia Business Studies; Bingley

Pages: 507-524

Number of pages: 18

Publication subject: Business And Economics--International Commerce

ISSN: 15587894

e-ISSN: 15592243

Milestone dates: 2018-04-19 (Received) 2018-11-20 (Revised) 2019-03-03 (Accepted)

DOI: http://dx.doi.org/10.1108/JABS-04-2018-0135

ProQuest document ID: 2321179575

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/views-indonesian-consumer-towards-medical-tourism/docview/2321179575/se-2?accountid=7139

Copyright: © Emerald Publishing Limited 2019

Image of Poland as perceived by German and British medical tourists

Author: Dryglas, Diana; Lubowiecki-Vikuk, Adrian

Publication info: Tourism Review of AIEST - International Association of Scientific Experts in Tourism ; Bingley  Vol. 74, Iss. 4,  (2019): 861-871.

The purpose of this paper is to identify Poland’s image as a medical tourism destination (MTD).

Survey data were collected from 282 German and British medical tourists, using a self-administered questionnaire. The Computer-Assisted Web Interviewing method was used to conduct the survey. Subsequently, the responses were analysed using advanced statistical tools (McNemar’s exact test, Cochran’s Q test and Chi-square test).

Before visiting Poland, the respondents perceived the country through the prism of medical attributes, whereas after the visit, they perceived it through the prism of non-medical attributes.

Identification of a set of MTD image characteristics has important implications for scholars, allowing them to understand attributes which shape projected and perceived MTD image. Such construct can also be a useful tool for marketing planners, destination managers and marketers to create an effective marketing policy and projected image of MTDs based on these features.

The study fills an important gap regarding the lack of conceptual and empirical content allowing for exploration of MTD image.

Subject: Research; Projected images; Marketing; Developing countries--LDCs; Shopping; Medical tourism; Competitive advantage; Studies

Business indexing term: Subject: Marketing Developing countries--LDCs Competitive advantage

Location: Poland

Pages: 861-871

Number of pages: 11

Online publication date: 2019-09-13

Milestone dates: 2018-07-24 (Received) 2019-04-11 (Revised) 2019-04-19 (Accepted)

   First posting date: 13 Sep 2019

DOI: http://dx.doi.org/10.1108/TR-07-2018-0105

ProQuest document ID: 2291906406

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/image-poland-as-perceived-german-british-medical/docview/2291906406/se-2?accountid=7139

Ranking model of total quality management enablers in healthcare establishments using the best-worst method

Author: Talib, Faisal    ; Asjad, Mohammad; Attri, Rajesh; Arshad Noor Siddiquee; Khan, Zahid A

Publication info: TQM Journal ; Bingley  Vol. 31, Iss. 5,  (2019): 790-814.

Recent years have witnessed a significant rise in Indian healthcare establishments (HCEs) which indicate that there is a constant need to improve the healthcare quality services through the adoption and implementation of TQM enablers. The purpose of this paper is to identify such enablers and then propose a ranking model for TQM implementation in Indian HCEs for improved performance.

The study identifies 20 TQM enablers through comprehensive literature survey and expert’s opinion, and classifies them into five main categories. The prominence of these enablers is established using a recently developed novel multi-criteria decision making (MCDM) method, i.e. best-worst method (BWM). The importance of the various main category and sub-category enablers is decided on the basis of their weights which are determined by the BWM. In comparison to other MCDM methods, such as analytical hierarchy process, BWM requires relatively lesser comparison data and also provides consistent comparisons which results in both optimal and reliable weights of the enablers considered in this paper. Further, a sensitivity analysis is also carried out to ensure that the ranking (based on the optimal weights) of the various enablers is reliable and robust.

The results of this study reveal that out of five main category enablers, the “leadership-based enablers (E1)” and the “continuous improvement based enablers (E5)” are the most and the least important enablers, respectively. Similarly, among the 20 sub-category enablers, “quality leadership and role of physicians (E14)” and “performing regular survey of customer satisfaction and quality audit (E52)” are the most and the least dominating sub-category enablers, respectively.

This study does not explore the interrelationship between the various TQM enablers and also does not evaluate performance of the various HCEs based on the weights of the enablers.

The priority of the TQM enablers determined in this paper enables decision makers to understand their influence on successful implementation of the TQM principles and policies in HCEs leading to an overall improvement in the system’s performance.

This study identifies the various TQM enablers in HCEs and categorizes them into five main categories and ranks them using the BWM. The findings of this research are quite useful for management of the HCEs to properly understand the relative importance of these enablers so that managers can formulate an effective and efficient strategy for their easy and smooth implementation which is necessary for continuous improvement.

Subject: Analytic hierarchy process; Customer satisfaction; Performance evaluation; Total quality management; Health care policy; Sensitivity analysis; Multiple criterion; Health care; Leadership; Quality management; Knowledge management; Continuous improvement; Medical tourism; Ranking; Health care industry; Decision making; Expenditures; Total quality; Physicians; Literature reviews; Research; Fuzzy sets; Hospitals; Sustainability

Business indexing term: Subject: Quality management Knowledge management Health care industry Total quality; Industry: 62211 :‎ General Medical and Surgical Hospitals

Alternate title: Ranking model of TQM enablers

Publication title: TQM Journal; Bingley

Pages: 790-814

Number of pages: 25

Publication subject: Business And Economics--Production of Goods And Services

ISSN: 17542731

e-ISSN: 1754274X

Online publication date: 2019-09-18

Milestone dates: 2019-04-30 (Received) 2019-05-30 (Revised) 2019-07-18 (Accepted)

   First posting date: 18 Sep 2019

DOI: http://dx.doi.org/10.1108/TQM-04-2019-0118

ProQuest document ID: 2306211328

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/ranking-model-total-quality-management-enablers/docview/2306211328/se-2?accountid=7139

Impact of interactive eReferral on tourists behavioral intentions

Author: Al-Htibat, Ameen; Garanti, Zanete

Publication info: Marketing Intelligence & Planning ; Bradford  Vol. 37, Iss. 5,  (2019): 527-541.

Despite recognizing the importance of eReferral in shaping tourists’ behavioral intentions, researchers have rarely explored its dynamics. In the recent years, interest in the superiority of interactive eReferral over eWOM has burgeoned, thus increasing theoretical and empirical quest, which has generated many inconsistencies. Drawing on social identity, trust transfer and social tie theories, the purpose of this paper is to explore an integrative model that investigates the impact of interactive eReferral on tourists’ engagement, eReferral sharing behavior and intention to visit. Besides the direct influences of interactive eReferral on tourists’ engagement, eReferral sharing behavior and intention to visit, the authors assess the mediating role of tourist engagement on the relationship between these concepts.

Utilizing survey data, variance-based structural equation modeling (VB-SEM) was applied to diagnose the proposed model.

VB-SEM results suggest that interactive eReferral has a positive impact on tourist engagement, eReferral sharing behavior and intention to visit. Tourist engagement mediates the link between interactive eReferral and eReferral sharing behavior, and intention to visit.

By examining the relationship between interactive eReferral, tourists’ engagement, eReferral sharing behavior and intention to visit, the model departs from existing views to shed new light on the interactivity of eReferral. Implications for marketing practices and research are discussed.

Subject: User generated content; Internet; Trust; Medical tourism; Social identity; Influence; Social classes; Social networks; Consumption

Business indexing term: Subject: Social networks Consumption

Alternate title: Impact of interactive eReferral

Publication title: Marketing Intelligence & Planning; Bradford

Pages: 527-541

ISSN: 02634503

e-ISSN: 17588049

Online publication date: 2019-03-15

Milestone dates: 2018-08-22 (Received) 2018-08-23 (Revised) 2018-10-28 (Revised) 2018-12-11 (Revised) 2018-12-20 (Revised) 2018-12-20 (Accepted)

   First posting date: 15 Mar 2019

DOI: http://dx.doi.org/10.1108/MIP-08-2018-0348

ProQuest document ID: 2259975510

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/impact-interactive-ereferral-on-tourists/docview/2259975510/se-2?accountid=7139

Strategic Analysis of Development of Medical Tourism Macro-Destinations

Author: Baiev, Vadim Victorovych1; Bakhov, Ivan Stepanovych2; Fokina-Mezentseva, Katerina3; Boretska, Nataliya31 National University of Food Technologies, Ukraine2 Interregional Academy of Personnel Management, Ukraine3 Kyiv National University of Technologies and Design, Ukraine

Publication info: Journal of Environmental Management & Tourism ; Craiova  Vol. 10, Iss. 4(36),  (Summer 2019): 801-808.

The article identifies the basic stages of the process of determining strategic objectives of a medical tourism destination. It suggests a range of tools for conducting a SWOT-analysis based on such analytical materials as Medical Tourism Index, World Economic Forum: Travel & Tourism Competitiveness Report, World Economic Forum: The Global Competitiveness Report. It also carries out a SWOT-analysis of macro-destinations of the leading countries in medical tourism.

Subject: Patients; Strategic management; Councils; Economic summit conferences; Health care; Accreditation; Leadership; Economic development; International organizations; Medical tourism; Health services; Economic analysis; Comparative analysis

Business indexing term: Subject: Strategic management Economic summit conferences Leadership Economic development Economic analysis; Industry: 92611 :‎ Administration of General Economic Programs

Location: Canada India United Kingdom--UK Australia Taiwan

Company / organization: Name: World Economic Forum; NAICS: 926110; Name: Joint Commission International; NAICS: 813920

Classification: 92611: Administration of General Economic Programs

Issue: 4(36)

Pages: 801-808

Publication date: Summer 2019

DOI: http://dx.doi.org/10.14505/jemt.v10.4(36).

ProQuest document ID: 2475527924

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/strategic-analysis-developm ent-medical-tourism/docview/2475527924/se-2?accountid=7139

Copyright: Copyright ASERS Ltd Summer 2019

The country of origin of services and consumers as the determinants of purchase intentions in medical tourism *

Author: Boguszewicz-Kreft, Monika1; Sokołowska, Katarzyna2; Magier-Łakomy, Ewa3; Janiūnaitė, Brigita41 (post-doctorate degree of Economic Sciences in Management - habilitation), Associate Professor at Faculty of Finance and Management, Flead of Marketing Department, WSB University in Gdańsk(Poland)2 (PhD of Economic Sciences in Econometrics), Assistance Professor at Faculty of Finance and Management, WSB University in Gdansk (Poland), sokkatfi) wp.pl. Main research interest: application of quantitative methods in marketing.3 (PhD in Psychology), Assistance Professor at the Department of Management, WSB University in Gdansk (Poland)4 Professor and Principal Investigator of the Research Group in Education-at the Faculty of Social Sciences, Arts and Humanities, Kaunas University of Technology (Lithuania)

Publication info: Journal of East European Management Studies ; Baden-Baden  Vol. 24, Iss. 3,  (2019): 466-483.

The aim of the study is to find the determinants of the decision to purchase medical services in other countries. The following hypothesis is tested: the image of the country of origin, the power of the country and the origin of the consumer influence the consumer's intentions to purchase medical services. An international comparison has been carried out, in which 264 respondents from Poland, Germany and Lithuania have participated. The data have been collected with the use of a questionnaire form developed by the authors, and they have been analysed with a mixed regression analysis. The results show that the readiness to purchase medical services differs, depending on the country of origin of services, the power of the country and the origin of the consumer. The results of the research can be applied in business practice and in the strategies developed by institutions shaping the image of the country and positioning it in the international context.

Subject: Medical tourism; Regression analysis; Readiness; Questionnaires; Power; Tourism; Health services; Consumers; Country of origin; Consumer behavior; Marketing; Rule of origin; Hypotheses

Business indexing term: Subject: Consumer behavior Marketing Consumers Rule of origin

Location: Lithuania Poland Germany

Publication title: Journal of East European Management Studies; Baden-Baden

Pages: 466-483

Publisher: Nomos Verlagsgesellschaft mbH und Co KG

Place of publication: Baden-Baden

Country of publication: Germany, Baden-Baden

Publication subject: Law--Corporate Law

ISSN: 09496181

e-ISSN: 18620019

DOI: http://dx.doi.org/10.5771/0949-6181-2019-3-466

ProQuest document ID: 2301882675

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/country-origin-services-consumers-as-determinants/docview/2301882675/se-2?accountid=7139

Copyright: Copyright Nomos Verlagsgesellschaft mbH und Co KG 2019

The tourism and hospitality industry in India: emerging issues for the next decade

Author: Sanjeev, Gunjan M; Birdie, Arvind K

Publication info: Worldwide Hospitality and Tourism Themes ; Bingley  Vol. 11, Iss. 4,  (2019): 355-361.

This paper aims to introduce the theme issue and strategic question: What should Indian tourism and hospitality managers focus on to stay competitive in the coming decade? It also presents an overview of recent developments in the tourism and hospitality industry and presents some statistics and trends relating to prospects for the tourism and hospitality industry in India.

Emerging trends emanate from various official reports and expert views. The paper also highlights key issues and areas for investigation by the theme issue contributors.

Strong growth is predicted for the tourism and hospitality industry and some of the underpinning issues that will influence competitiveness are the role of social media, business model innovations, risk management, talent management, valuation models, the influence of information technology, employee loyalty and design thinking in hospitality higher education.

Given the expansion occurring in the domestic market in India and the involvement of international operators in the Indian environment, this paper will be of interest to practitioners with an interest in the emerging opportunities and challenging issues related in this dynamic marketplace.

This introductory paper captures the essence of the prevailing trends in the tourism and hospitality industry as a starting point for this theme issue.

Subject: Higher education; Passports & visas; Medical tourism; Infrastructure; Hospitality industry; Employment; Foreign investment; Customer relationship management; Gross Domestic Product--GDP; Hotels & motels; Internet of Things; Data analysis; Business travel

Business indexing term: Subject: Infrastructure Hospitality industry Employment Foreign investment Customer relationship management Gross Domestic Product--GDP Hotels & motels; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels

Company / organization: Name: Organization for Economic Cooperation & Development; NAICS: 928120

Publication title: Worldwide Hospitality and Tourism Themes; Bingley

Pages: 355-361

Number of pages: 7

ISSN: 17554217

e-ISSN: 17554225

DOI: http://dx.doi.org/10.1108/WHATT-05-2019-0030

ProQuest document ID: 2288714859

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/tourism-hospitality-industry-india-emerging/docview/2288714859/se-2?accountid=7139

Medical tourism: tourists’ perceived services and satisfaction lessons from Malaysian hospitals

Author: Rahman, Muhammad Khalilur

Publication info: Tourism Review of AIEST - International Association of Scientific Experts in Tourism; Bingley  Vol. 74, Iss. 3,  (2019): 739-758.

The medical tourism industry has become one of the most profitable industries around the world wherein most countries exploit every effort to attract medical tourists to take advantage of its medical care benefits. The purpose of this study is to explore the determinants of medical tourists’ perceived services and their satisfaction for medical care in hospitals.

The quantitative method was conducted to examine the three groups of foreign travelers such as medical tourists, experts and normative medical tourists’ perceived medical services quality and satisfaction. Data from a survey of 266 respondents were analyzed using the structural equation modeling technique.

The findings of this study provide evidence that hospital accessibility and interpersonal behavior are the most critical constructs that influence medical tourists’ attributes. Additionally, medical costs and healthcare technicality have a significant relationship with the perceived services of medical tourists. The study also demonstrated that medical tourists’ satisfaction highly attributed to their perceived services towards the quality of medical care they received and experienced in the hospitals.

The results have important implications for managerial considerations at hospitals. Hospital accessibility is a crucial dimension to be measured at hospitals when measuring service quality. Service providers need to be mindful that all aspects of medical services are essential and need to be delivered satisfactorily to ensure customer satisfaction. Patients’ perceived services and their satisfaction is crucial bridge in determining the likelihood of future return among patients to the hospitals.

This study has managed to convincingly secure findings to provide useful information and understanding of the hospital accessibility and interpersonal manner of healthcare professionals at hospitals in Malaysia. Particularly, when any hospital offers quality services, they must consider the reasonable medical expenses that can be affordable by the average people and update their medical equipment that is necessary for technical and diagnostic purposes. By ensuring these, they can attract medical tourists.

Subject: Hospitals; Health care expenditures; Quality of service; Developing countries--LDCs; Professionals; Medical tourism; Industrialized nations; 20th century; Medical personnel; Patients; Internet

Business indexing term: Subject: Quality of service Developing countries--LDCs Professionals Industrialized nations; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: Malaysia India Indonesia

Pages: 739-758

Online publication date: 2019-05-30

Milestone dates: 2018-01-14 (Received) 2018-06-05 (Revised) 2018-06-25 (Revised) 2018-11-04 (Revised) 2019-02-20 (Revised) 2019-04-03 (Accepted)

   First posting date: 30 May 2019

DOI: http://dx.doi.org/10.1108/TR-01-2018-0006

ProQuest document ID: 2242776479

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/medical-tourism-tourists-perceived-services/docview/2242776479/se-2?accountid=7139

Factors influencing outbound medical travel from the USA

Author: Collins, Ayse; Medhekar, Anita; Ho Yin Wong; Cobanoglu, Cihan

Publication info: Tourism Review of AIEST - International Association of Scientific Experts in Tourism ; Bingley  Vol. 74, Iss. 3,  (2019): 463-479.

The purpose of this paper is to explore how Americans choose a country and medical facility to travel abroad for medical treatment based on the following factors country environment, tourism destination, medical tourism costs and medical facilities and services.

Online survey with the help of Amazon Mechanical Turk website was used for data collection, and 541 valid cases were used of American residents who had travelled abroad for medical tourism. Exploratory and confirmatory factor analyses were undertaken to validate the scales.

Findings indicated four major factors that can influence American medical tourists’ choices of medical tourism destinations. These factors are overseas’ country factors, attractiveness of tourism destination, medical tourism costs and facilities and services. Both the convergent and discriminant validities for the constructs were established. The results of the measurement-model-fit based on various measures were within the suggested cut-off values.

Out of the 541 responses of post-travel experienced medical tourists, it is hard to tell how similar/dissimilar the participants are in terms of ranking the four factors. To be competitive to attract global medical tourists, research suggests that the five popular countries of treatment, India, China, Thailand, Mexico and Turkey, identified in this study should provide high quality of medical and tourism facilities to patients.

This study contributes to the understanding of the underlying factors, which influence American medical tourists’ choice of destinations, with validated scales. For this exploratory research, 25 new items together with 34 items from other studies were adapted.

Subject: Research; Transplants & implants; Medical treatment; Surgery; Uninsured people; Accreditation; Diagnostic tests; Nursing care; International trade; Health care expenditures; Developing countries--LDCs; Health facilities; Medical tourism; Literature reviews; Reputations; Quality; Internet; Medical technology; Health care policy; Hospitals; Ethics

Business indexing term: Subject: Uninsured people International trade Developing countries--LDCs; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: Thailand Mexico Turkey United States--US India Singapore

Pages: 463-479

Number of pages: 17

Online publication date: 2019-02-01

Milestone dates: 2018-06-15 (Received) 2018-09-20 (Revised) 2018-11-28 (Revised) 2018-11-28 (Accepted)

   First posting date: 01 Feb 2019

DOI: http://dx.doi.org/10.1108/TR-06-2018-0083

ProQuest document ID: 2242775625

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/factors-influencing-outbound-medical-travel-usa/docview/2242775625/se-2?accountid=7139

SPA TOURISM IN ROMANIA - THE ANALYSIS OF A CONTRADICTORY PHENOMENON

Author: Curta, Nora Codruţa

Publication info: Quaestus ; Timisoara  Iss. 14,  (Apr 2019): 101-115.

Romania holds one third of Europe's spa resources. However, the Romanian spa tourism is declining, after the glory that it witnessed in the 70s and 90s of the last century, and the country has disappeared from the top of the international spa resorts. The purpose of this paper is to analyze the current situation of spa tourism, taking into account the Master Plan for the Development of Balneary Tourism, proposed by the Government. At the same time, it shows interest in the way it aligns with the new trends in the world market - health tourism, wellness tourism, spa tourism and anti-aging tourism. The Romanian spa resorts, once the real "pearls of Europe ", are in a process of continuous transformation. Their revitalization according to current standards will bring Romania to the international tourism map.

Subject: Resorts & spas; Tourism; Aging; Personal health; Budgets; Hotels & motels; Financial analysis; Associations; International organizations; Medical tourism

Business indexing term: Subject: Budgets Hotels & motels; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels 81391 :‎ Business Associations

Location: Eastern Europe Romania France Europe

Classification: 72111: Hotels (except Casino Hotels) and Motels; 81391: Business Associations

Publication title: Quaestus; Timisoara

Pages: 101-115

Publication date: Apr 2019

ProQuest document ID: 2278866784

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/spa-tourism-romania-analysis-contradictory/docview/2278866784/se-2

Copyright: © 2019. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

BALNEARY TOURISM IN ROMANIA - TRENDS AND PERSPECTIVES

Author: Popșa, Roxana Elena

Publication info: Quaestus ; Timisoara  Iss. 14,  (Apr 2019): 176-183.

Currently, the potential of spa resorts is constantly developing, contributing actively to the enrichment of tourism resources. In this sense, the balneary tourism is considered the oldestform of tourism in our country due to the high volume of natural reserves and the therapeutic qualities they hold. Thus, because of the capacity to restore and rejuvenate health, balneary tourism represents an important pillar of the tourism industry, especially since Romania owns 30% of the European spa resources, concentrated in 29 tourist resorts of national interest and 32 of local interest. Considering these aspects, the present paper aims to provide an overview on the main coordinates of balneary tourism in Romania.

Subject: Resorts & spas; Tourism; Industrywide conditions; Health; Sulfur; Iodine; Medical tourism; Length of stay; Trends; Sodium; Natural resources

Business indexing term: Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels

Location: Romania

Pages: 176-183

ProQuest document ID: 2278866074

Document URL: https://uiwtx.idm.oclc.org/logi n?url=https://www.proquest.com/scholarly-journals/balneary-tourism-romania-trends-perspectives/docview/2278866074/se-2

The Attractiveness of Poland as a Medical Tourism Destination from the Perspective of German and British Consumers

Publication info: Entrepreneurial Business and Economics Review ; Krakow  Vol. 7, Iss. 2,  (2019): 45-62.

Objective: The aim of the article is an assessment of the attractiveness of Poland as a medical tourism destination (MTD). Research Design & Methods: Survey data were collected from 282 German and British tourists, using a self-administered questionnaire. The Computer-Assisted Web Interviewing method was used to conduct the survey. Subsequently, the responses were analysed using advanced statistical tools (McNemar's exact test, Cochran's Q test snd Chi-square test). Findings: The results indicated that tourists from Western Europe are currently more interested in using medical services in Central and Eastern Europe countries (CEEC) than in the past. Out of CEEC, Poland was the most frequently chosen MTD. Associations with Poland as a MTD were affected by such socio-demographic factors as age and nationality. Implications & Recommendations: Identification of the growing importance of Poland as a MTD, as well as socio-demographic factors affecting the choice of Poland as a MTD have important implications for scholars, allowing them to understand how medical tourists evaluate the attractiveness of MTDs in Poland, and can be a useful tool for marketing planners, destination managers and marketers to create an effective marketing policy of MTDs in Poland. Contribution & Value Added: The study fills an important gap regarding the lack of empirical content allowing for the exploration of the attractiveness of MTDs in Poland.

Subject: Medical tourism; Travel; Tourist attractions; Health services; Marketing; Entrepreneurship; Corporate image; Patient satisfaction; Sociodemographics

Business indexing term: Subject: Marketing Entrepreneurship Corporate image; Industry: 56152 :‎ Tour Operators

Classification: 56152: Tour Operators

Publication title: Entrepreneurial Business and Economics Review; Krakow

Pages: 45-62

Publisher: Cracow University of Economics

Place of publication: Krakow

Country of publication: Poland, Krakow

ISSN: 2353883X

e-ISSN: 23538821

DOI: http://dx.doi.org/10.15678/EBER.2019.070203

ProQuest document ID: 2264566378

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/attractiveness-poland-as-medical-tourism/docview/2264566378/se-2

Copyright: © 2019. This work is published under NOCC (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Patients’ intent to revisit with trust as the mediating role: lessons from Penang Malaysia

Author: Salmi Mohd Isa; Grace Sze Sze Lim; Phaik Nie Chin

Publication info: International Journal of Pharmaceutical and Healthcare Marketing ; Bradford  Vol. 13, Iss. 2,  (2019): 140-159.

This study aims to examine hospital image, perceived medical quality, relationship marketing and word-of-mouth as the determinants of patients’ intent to revisit private hospitals in Penang, based on the theory of planned behavior.

A quantitative study comprising a self-administered questionnaire was distributed to domestic and international patients at the airport, private hospitals and hotels located in Penang. The partial least squares structural equation modeling (PLS-SEM) approach was used to analyze and test the research hypotheses.

The results show that cognitive components (i.e. hospital image and perceived medical quality) do not have any significant influence on patients’ intent to revisit, while affective components (i.e. relationship marketing) and behavioral components (i.e. word-of-mouth) are important in increasing patients’ intent to revisit private hospitals in Penang, Malaysia. Trust has no significant mediating effect between predictor variables and patients’ intent to revisit, but it has significant association with affective and behavioral components.

The findings provide insights to medical marketing teams in promoting and increasing patients’ intent to revisit their respective hospitals and for the governments to sustain and enhance medical tourism in their countries.

This study is one of the few studies that looks at the relationship between hospital image, perceived medical quality, relationship marketing, word-of-mouth and patients’ intent to revisit private hospitals in Penang, Malaysia. This study also explored the direct and indirect effects of trust on patients’ intent to revisit that was still limited.

Subject: Word of mouth advertising; Medical imaging; Relationship marketing; Brand image; Hospitals; Medical tourism; Airports; Quality; Tourism; Plastic surgery; Marketing; Brand loyalty; Perceptions; Hypotheses; Studies; Health care; Airport siting; Medical referrals; Quality of service; Literature reviews; Image quality; Cognitive ability; Patients; Hotels; Attitudes; Variables

Business indexing term: Subject: Word of mouth advertising Brand image Marketing Brand loyalty Quality of service

Location: Thailand Malaysia United States--US Penang Malaysia

Pages: 140-159

e-ISSN: 17506131

Online publication date: 2019-06-07

Milestone dates: 2017-10-08 (Received) 2018-03-17 (Revised) 2018-06-07 (Revised) 2018-06-12 (Revised) 2019-04-10 (Accepted)

   First posting date: 07 Jun 2019

DOI: http://dx.doi.org/10.1108/IJPHM-10-2017-0056

ProQuest document ID: 2241309382

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/patients-intent-revisit-with-trust-as-mediating/docview/2241309382/se-2?accountid=7139

The Effect of Understanding Companion's Needs, Companion's Satisfaction, Companion's Delight towards Behavioral Intention in Malaysia Medical Tourism

Author: Mohamad, Wan Normila1; Omar, Azizah2; Kassim, Normalini Md21 Universiti Teknologi MARA, Negeri Sembilan, Malaysia Email: [email protected] Universiti Sains Malaysia, Minden, Malaysia

Publication info: Global Business and Management Research, suppl. Special Issue; Boca Raton  Vol. 11, Iss. 2,  (2019): 370-381.

Purpose: Medical tourist needs their companion for the continuation of care, safety reason coupled with decision-making, and comfortableness. The study investigates the effect of understanding companion's need, companion's satisfaction, companion's delight on behavioral intention in medical tourism. Design/methodology/approach: A cross-sectional study has been conducted in four private hospitals in Malaysia involving 438 patient's companion using purposive and judgmental sampling and analyzed using the Statistical Package for Social Science (SPSS) software for windows (20) and Partial Least Squares (PLS). Findings: Understanding companion's need, companion's satisfaction, and companion's delight are proven to have a significant effect towards behavioral intention. Companion is seen as an important contributor and indicator used in assessing the quality of service in private hospitals. Research limitations/implications: Many studies in the past focused on the patient's perspective and tend to neglect the presence of the patient's companion. Positive experience through companion's satisfaction, delight, and needs will project positive advertisement on the quality of service provided by the private hospitals. Practical implications: This study's significant credence is to provide practical information and valuable recommendation in the development of actions for the healthcare service provider and the Malaysian Health Tourism Council. Originality/value: This study is one of the first to introduce the importance and significance of addressing companion's delight in the medical tourism industry as they could relay positive word-of-mouth and promotion towards sustainability of medical tourism industry.

Subject: Patients; Perceptions; Councils; Medical technology; Decision making; Hospitals; Medical tourism; Emotions; Critical care; Customer services; Corporate culture; Brand loyalty; Marketing; Quality of service; Health care industry; Economic growth; Emergency medical care; Hypotheses; Nurses; Patient satisfaction

Business indexing term: Subject: Customer services Corporate culture Brand loyalty Marketing Quality of service Health care industry Economic growth; Industry: 62211 :‎ General Medical and Surgical Hospitals 62191 :‎ Ambulance Services

Location: India Singapore Malaysia

Classification: 62211: General Medical and Surgical Hospitals; 62191: Ambulance Services

Supplement: Special Issue

Pages: 370-381

ProQuest document ID: 2236674867

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/effect-understanding-companions-needs/docview/2236674867/se-2?accountid=7139

Copyright: Copyright Mehran Nejati 2019

PUBLIC RELATIONS AS A TOOL FOR DEVELOPING MEDICAL TOURISM USING THE ISTRA HOTEL IN VARAŽDIN AS AN EXAMPLE

Author: Hunjet, Anica1; Zerjavic, Dorotea; Kozina, Goran11 University North, Varaždin

Publication info: Economic and Social Development: Book of Proceedings ; Varazdin  : 317-332. Varazdin: Varazdin Development and Entrepreneurship Agency (VADEA). (Mar 21/Mar 22, 2019)

Over the last decade, medical tourism has proved itself as a powerful driver of tourism traffic, attracting tourists who consider both quality and value when making a purchase decision. Due to its highly favorable geographical location and good transport connections with other parts of the country (and the world), Northwest Croatia is gradually becoming the hotspot for medical tourism in Southeast Europe. The paper explores medical tourism in order to establish how the globalization and the 21st century technological advances have facilitated the development of public relations, thereby enhancing community cohesion, information exchange, communication, and connectivity. In today's environment, public relations have become highly important for further development of medical tourism. The paper focuses on medical tourism and the Istra Hotel. It defines the concept of public relations in practice; investigates the process and activities involved in public relations and marketing; describes the main features and characteristics of medical tourism; analyzes the strategic plan for the development of medical tourism using the Istra Hotel as an example; describes the state of medical tourism in Croatia and looks at the competition; examines the marketing environment; proposes the strategy and manner in which public relations should function; explores consumer behavior; and identifies target consumer groups. A survey of consumer opinions and attitudes towards hotels and medical tourism has been conducted.

Subject: Geographical distribution; Tourists; Communication; Globalization; Medical tourism; Tourism; Public relations; Consumer groups; Marketing; Cooperation; Market research; Target recognition; Hotels; Geographical locations; Decision making; Hotels & motels; Art galleries & museums; Rehabilitation

Business indexing term: Subject: Globalization Hotels & motels Marketing; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels 71211 :‎ Museums

Company / organization: Name: Polyclinic; NAICS: 621111

Classification: 7211 1: Hotels (except Casino Hotels) and Motels; 71211: Museums

Pages: 317-332

Publication date: Mar 21/Mar 22, 2019

ProQuest document ID: 2199759731

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/conference-papers-proceedings/public-relations-as-tool-developing-medical/docview/2199759731/se-2?accountid=7139

Copyright: Copyright Varazdin Development and Entrepreneurship Agency (VADEA) Mar 21/Mar 22, 2019

Role of Digital Marketing to Enhance Medical Tourism in Hospitals of Dubai

Author: Subramaniam, Ram Kumar; Singhal, Aishwarya; Hopkinson, Paul

Publication info: International Conference on Tourism Research  : 330-337,XII.: Academic Conferences International Limited. (Mar 2019)

An emerging trend in the burgeoning healthcare industry the term medical tourism (MT) refers to patients travelling to other countries to obtain medical treatments, with UAE being fifth most sought after MT destination. To gain competitive advantage in this billion-dollar industry, marketers have now begun to use Digital Marketing (DM) predominantly to connect and build long term relationships with customers, spread product/service awareness, acquire feedback and provide customer support in this technological era. Marketers however, find a gap in developing effective DM strategies specifically targeting MT patients in the relentless healthcare market influenced by various external forces. The main aim of the study is to identify the role of DM in MT and more specifically how it can be leveraged to attract international patients to Dubai. The research employs Game theory (GT) and Network theory (NT) in relation to use of an agent/facilitator and social media (SM) respectively. In addition, the study also evaluates the importance of DM strategies followed by different internationally accredited hospitals to create awareness and recommends a systematic DM customer journey map useful for creating systematic DM strategy for MT marketing to achieve better results. 12 marketing professionals working for Hospitals/Clinics in Dubai were interviewed. Findings reveal a positive impact of DM to boost MT, it's helpful in creating strong brand image and impacts consumer decision making of choice of destination by MT patients. We also found that responsive websites, effective email marketing, Social media marketing (SMM), video marketing, content and influencer marketing are most effective strategies. Moreover, the research identifies 6 emergent themes which will provide hospitals with a better understanding of how to re-evaluate the impact of their existing DM strategies in consumer decision making about MT destinations. Finally, the study offers practical recommendations for healthcare marketers to enhance admission of medical tourism patients.

Subject: Patients; Internet; Decision making; Medical tourism; Information sources; Quality; Social research; Competition; SWOT analysis; Customer services; Consumers; Competitive advantage; Influencer marketing; Market research; Social networks; Interactive marketing; Digital marketing; Health care industry; Cost control; Search engines; Game theory

Business indexing term: Subject: SWOT analysis Customer services Consumers Competitive advanta ge Influencer marketing Market research Social networks Interactive marketing Digital marketing Health care industry Cost control; Industry: 54191 :‎ Marketing Research and Public Opinion Polling 33361 :‎ Engine, Turbine, and Power Transmission Equipment Manufacturing

Location: Thailand United States--US India Dubai United Arab Emirates Singapore United Arab Emirates

Classification: 54191: Marketing Research and Public Opinion Polling; 33361: Engine, Turbine, and Power Transmission Equipment Manufacturing

Publication title: International Conference on Tourism Research

Pages: 330-337,XII

Publication date: Mar 2019

Publisher: Academic Conferences International Limited

Place of publication: Reading

Country of publication: United Kingdom

ISSN: 25163612

ProQuest document ID: 2288608028

Document URL: https://uiwtx.idm.oclc.org/logi n?url=https://www.proquest.com/conference-papers-proceedings/role-digital-marketing-enhance-medical-tourism/docview/2288608028/se-2?accountid=7139

Copyright: Copyright Academic Conferences International Limited Mar 2019

Last updated: 2021-09-20

Factors influencing inbound medical travel to India

Author: Medhekar, Anita; Ho Yin Wong; Hall, John Edward

Publication info: Journal of Health Organization and Management ; Bradford  Vol. 33, Iss. 2,  (2019): 155-172.

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.

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.

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.

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.

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.

There is little empirical research on the views of inbound MTs, about factors influencing their decision to travel abroad for surgery to India.

Subject: Cancer; Transplants & implants; Medical treatment; Destinations; Health care policy; Patients; Uninsured people; Developing countries--LDCs; Private hospitals; Hospitals; Medical tourism; Expertise; Industrialized nations; Quality of care; Postoperative care; Quality; Surgeons; Safety measures; Social responsibility; Plastic surgery; Patient safety; Health care; Infrastructure; Tourists; Confidentiality; Surgery; Medical personnel; Medical research; Privacy; Permission; Accreditation; Ethics

Business indexing term: Subject: Uninsured people Developing countries--LDCs Industrialized nations Social responsibility Infrastructure; Industry: 62211 :‎ General Medical and Surgical Hospitals 62231 :‎ Specialty (except Psychiatric and Substance Abuse) Hospitals

Location: Thailand United Kingdom--UK Oman United States--US India

Classification: 62211: General Medical and Surgical Hospitals; 62231: Specialty (except Psychiatric and Substance Abuse) Hospitals

Alternate title: Inbound medical travel to India

Publication title: Journal of Health Organization and Management; Bradford

Pages: 155-172

Publisher: Emerald Group Publishing Limite d

ISSN: 14777266

e-ISSN: 17587247

Online publication date: 2019-02-11

Milestone dates: 2018-08-18 (Received) 2018-10-29 (Revised) 2018-10-29 (Accepted)

   First posting date: 11 Feb 2019

DOI: http://dx.doi.org/10.1108/JHOM-08-2018-0234

ProQuest document ID: 2203069156

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/factors-influencing-inbound-medical-travel-india/docview/2203069156/se-2?accountid=7139

Database: ABI/INFORM Collection; Healthcare Administration Database; Social Science Premium Collection

Measuring the efficiency of medical tourism industry in EU member states

Author: Androutsou, Lorena; Metaxas, Theodore

Publication info: Revista de Analisis Turistico ; Bingley  Vol. 26, Iss. 2,  (2019): 115-130.

Under the Directive 2011/24/EU, medical tourism and cross-border health are interrelated terms regarding the freedom to move to get the most accessible medical treatment into EU Member State within the defined procedures for reimbursement. Little known empirically regarding the efficiency of the cross-border health/medical tourism industry. This study aims to measure its efficiency in Europe for the years 2010-2014, by using Data Envelopment Analysis (DEA).

Data obtained from OECD and the European Core Health Indicators (ECHI), which is collecting the data through Eurostat. Eurostat collects data on health-care activities and provides data on hospital discharges, including the hospital discharges of non-residents and these include hospital discharges of in-patients and day care patients. The analysis uses “DEA.P, 2.1 for windows” by Coelli (1996).

The results show that the Members States health systems were very efficient in handling non-residents in-patients; however, when managing day cases/outpatients, the efficiency scores dropped.

The findings would have significant associations affecting intentions to revisit clinics and the destination country. In addition, will be useful to those seeking a better understanding of the cross-border health and medical tourism industry efficiency.

Extending the findings of the European Commission report (2015c) by examining how well medical tourists are informed about the decision they are making, would be of perceived value. These are important indicators at European level by helping each Member State to measure its medical tourism services.

Subject: Health care access; Travel; Holidays & special occasions; Medical treatment; Medical tourism; Nonresidents; Cooperation; Communication; Efficiency

Location: Europe

Company / organization: Name: European Commission; NAICS: 928120; Name: European Parliament; NAICS: 921120; Name: European Union; NAICS: 926110, 928120

Identifier / keyword: Data envelopment analysis (DEA) Efficiency Health and medical tourism Cross-border health care

Pages: 115- 130

Milestone dates: 2019-02-13 (Received) 2019-05-14 (Revi sed) 2019-06-12 (Revised) 2019-06-24 (Accepted)

DOI: http://dx.doi.org/10.1108/JTA-02-2019-0006

ProQuest document ID: 2604466236

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/measuring-efficiency-medical-tourism-industry-eu/docview/2604466236/se-2

Copyright: © Lorena Androutsou and Theodore Metaxas. This work is published under https://creativecommons.org/licenses/by-nc/3.0/legalcode (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Influential Article Review - Patient-Centered Medical Tourism

Author: Webb, Gertrude; Mcdonald, Duane

Publication info: American Journal of Management ; West Palm Beach  Vol. 19, Iss. 6,  (2019): 1-28.

This paper examines healthcare. We present insights from a highly influential paper. Here are the highlights from this paper: This study empirically examines the effects of medical tourists' experience of the decision-making process through a patient's prior, actual, and post experience after having received the medical services. The research model and associated hypotheses were tested using a structural equation modeling based on data collected from 188 medical tourists who received care in Busan, South Korea. The findings of the study indicate that patients' experience in medical tourism pre-search (reputation, searching information, and communication) has a partially positive effect on their experience (costs, care quality, and supporting system and/or information) and patients' current experience during the medical tour process has a positive effect on post-experience (relationship building, recommendation, and feedback). The results of this study provide new insights about how key players (e.g., hospitals, medical travel agencies, hotels, and the medical tourists themselves) in medical tourism can effectively help managers identify medical tourists' needs based on the decision-making process of prior, current, and post-experience of medical tourists. For our overseas readers, we then present the insights from this paper in Spanish, French, Portuguese, and German.

Subject: Customer services; Patients; Medical equipment; Travel; Travel agencies; Medical treatment; Medical tourism; Medical technology; Hypotheses; Health care; Reputations; Decision making

Business indexing term: Subject: Customer services Travel agencies; Industry: 56151 :‎ Travel Agencies 33451 :‎ Navigational, Measuring, Electromedical, and Control Instruments Manufacturing

Location: South Korea

Classification: 56151: Travel Agencies; 33451: Navigational, Measuring, Electromedical, and Control Instruments Manufacturing

Publication title: American Journal of Management; West Palm Beach

Pages: 1-28

Publisher: North American Business Press

Place of publication: West Palm Beach

Country of publication: United States, West Palm Beach

ISSN: 21657998

Language of publication: English; Spanish; French; German

ProQuest document ID: 2519439776

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/influential-article-review-patient-centered/docview/2519439776/se-2?accountid=7139

Copyright: Copyright North American Business Press 2019

Last updated: 2021-11-16

Why medical tourists choose Turkey as a medical tourism destination?

Author: Sag, Ilhan; Zengul, Ferhat Devrim

Publication info: Journal of Hospitality and Tourism Insights ; Bingley  Vol. 2, Iss. 3,  (2019): 296-306.

The purpose of this paper is to determine the relationships between the health tourists’ perceptions on decisive factors (i.e. experience, technological infrastructure, flight distance, legal and moral restrictions, touristic attractions, religious similarity, waiting time and price of health tourism) and Turkey as their choice of healthcare tourism destination.

The data for this empirical study were collected from 288 patients in Turkey, all of whom being health tourists from various countries. Descriptive statistics and Kruskal–Wallis difference tests were utilized for analyses.

Statistically significant differences were found among health tourists in regards to the geographical regions of their residence. These finding suggest that differences among health tourists in regards to the geographical regions of their residence contributed to the healthcare tourists’ behaviors and health tourism market segmentations in Turkey.

Among the constraints of the study are the time and funding limitations coupled with the limitations on the scale development attempts in the health tourism literature and limitation and biases related to primary data collection. Despite all these limitations, by being the first study exploring the health tourism market segmentations in Turkey, this study contributes to the literature about the perceptions of health tourists and their reasons in choosing Turkey as a health tourism destination.

Determining the Turkey’s health tourism market segmentations will generate the positive effect on the target market which is currently heterogeneous for health tourism operators and intermediary institutions. Moreover, this knowledge would allow the target market to be divided into homogeneous groups, with different marketing mixes for each group. Homogenized groups exhibit unified purchasing behaviors for their needs. Therefore, it is very important for health tourism operators and intermediary institutions to know how the preferences of health tourists from different geographical regions vary.

The paper fulfills a need for advancing the knowledge on the decisive factors in determining Turkey as the health tourism destination by revealing perceptions of health tourists from various geographical regions. This information is very valuable for the Turkey’s healthcare tourism marketing managers who desire to implement the strategies to achieve competitive advantage in the global health tourism market.

Subject: Marketing; Consumers; Surgery; Health care; Decision making; Travel; Developing countries--LDCs; Health facilities; Medical tourism; Resorts & spas

Business indexing term: Subject: Marketing Consumers Developing countries--LDCs; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels

Location: Thailand Turkey United States--US India Singapore Costa Rica Malaysia Cuba

Alternate title: Turkey as a medical tourism destination

Publication title: Journal of Hospitality and Tourism Insights; Bingley

Pages: 296-306

ISSN: 25149792

e-ISSN: 25149806

Online publication date: 2018-11-22

Milestone dates: 2018-05-25 (Received) 2018-07-23 (Revised) 2018-08-31 (Revised) 2018-09-13 (Revised) 2018-09-17 (Accepted)

   First posting date: 22 Nov 2018

DOI: http://dx.doi.org/10.1108/JHTI-05-2018-0031

ProQuest document ID: 2447267575

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/why-medical-tourists-choose-turkey-as-tourism/docview/2447267575/se-2?accountid=7139

Copyright: © Emerald Publishing Limited 2018

The role of relationship marketing in behavioral intentions of medical tourism services and guest experiences

Author: Bruno Miguel Sousa; Alves, Gisela Maria

Publication info: Journal of Hospitality and Tourism Insights ; Bingley  Vol. 2, Iss. 3,  (2019): 224-240.

This paper entails a reflection on medical tourism services and guest experiences. The purpose of this paper is to analyze how relationship marketing relates to other relevant variables in consumer’s behavior applied to medical tourism contexts and guest experiences. This study aims at discussing the customer's behavior in healthcare management and medical tourism contexts and addresses the predisposition for the destination and the influence of relationship marketing on behavioral intentions.

The paper starts from a conceptual framework based on relationship marketing theory. From this theoretical base, the concepts of trust, commitment and cooperation and behavioral intentions are derived. A theoretical model is developed specifying antecedents of satisfaction and loyalty in healthcare management and medical tourism contexts.

The conceptual model shows that tourist destinations in the context of healthcare and medical tourism can be managed together with the study of the tourist consumer behavior and should focus on aspects that reinforce relationship marketing to the site, as planning services excellence, communication strategies, promotion services, integrated experiences and combating seasonality.

This study has already identified that the global movement of tourism is seemingly showing an increased focus on the niche product or niche service. In this case, the question seems to be whether the further growth in demand for healthcare management and medical tourism – as a niche tourism example – products will continue until they take a form of mass tourism. The new vogue of medical tourism forces to challenge and re-visit the power relationships that exist within contemporary tourism and the host–guest relationship.

Subject: Research; Market segments; Marketing; Travel; Community; Medical tourism; Resorts & spas; Health care; Globalization; Interdisciplinary aspects

Business indexing term: Subject: Market segments Marketing Globalization; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels

Alternate title: Role of relationship marketing

Pages: 224-240

Online publication date: 2019-07-30

Milestone dates: 2018-05-30 (Received) 2018-07-25 (Revised) 2018-09-07 (Revised) 2018-10-17 (Accepted)

   First posting date: 30 Jul 2019

DOI: http://dx.doi.org/10.1108/JHTI-05-2018-0032

ProQuest document ID: 244 7267175

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/role-relationship-marketing-behavioural/docview/2447267175/se-2?accountid=7139

Last updated: 2021-05-29

Disaster communication: An analysis of the digital communication strategies used by the medical tourism industry during the 2017 Caribbean hurricane season

Author: Mason, Alicia; Flores, Lynzee; Liu, Pan; Tims, Kenzie; Spencer, Elizabeth; T Gabby Gire

Publication info: Journal of Hospitality and Tourism Insights ; Bingley  Vol. 2, Iss. 3,  (2019): 241-259.

The purpose of this paper is to understand the crisis communication strategies used by the Caribbean medical tourism industry in the 2017 hurricane season, and also evaluate the quality of the disaster communication messages delivered via digital mediums.

This study includes a comprehensive, qualitative content analysis of 149 risk and crisis messages from 51 healthcare organizations distributed through digital media. The medical tourism providers (MTPs) include hospitals, medical tourism facilitators, practitioners/private physicians, specialty clinics, and dental and cosmetic providers.

Nearly half of the MTPs included in the data set delivered no post-disaster information to external audiences. The most prominent post-disaster message strategy utilized was conveying operational messages. Furthermore, an unexpected finding was the sheer magnitude of unrelated health-oriented and promotional destination marketing content disseminated before, during and after these events.

This analysis excludes internal organizational channels of communication which may have been used to communicate risk and crisis messages during these events (i.e. employee e-mails, announcements made through intercom systems, etc.). Our analysis does not include content disseminated through medical tourism forums (i.e. Realself.com, Health Traveler’s Forum, FlyerTalk Forum).

Small-scale MTPs can improve on any weaknesses through proactive planning and preparation by creating organizational goals to complete basic crisis communication training courses and in doing so support the applied professional development of disaster and crisis responders in the Caribbean region. Second, MTPs exposed to similar risks of natural disasters may use these findings for comparative analysis purposes to support their own organizational planning. Finally, this study supports the continued utility of the National Center for Food Protection & Defense guidelines for analyzing and evaluating organizational performance.

Currently, much of the academic scholarship of applied disaster communication narrowly focuses on the response strategies of one organization, or analyzes one social media platform at a time (i.e. Twitter). A strength of this analysis is the inclusion of an organizational sector (i.e. Caribbean medical tourism providers) and the range of platforms from which the content was captured (e.g. websites, org. blogs and social media networks).

Subject: Patients; Infrastructure; Communication; Floods; Accreditation; Hospitals; Public health; Content analysis; Disasters; Medical tourism; Storm damage; Rain; Digital technology

Business indexing term: Subject: Infrastructure; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: United States--US Canada Dominica Dominican Republic Puerto Rico Cuba Barbuda Virgin Islands-US Bahamas

Alternate title: Disaster communication

Pages: 241-259

Number of pages: 19

Online publication date: 2019-03-20

Milestone dates: 2018-03-31 (Received) 2018-06-11 (Revised) 2018-08-11 (Revised) 2018-08-13 (Revised) 2018-08-26 (Accepted)

   First posting date: 20 Mar 2019

DOI: http://dx.doi.org/10.1108/JHTI-03-2018-0021

ProQuest document ID: 2447266971

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/disaster-communication/docview/2447266971/se-2?accountid=7139

Attitude towards alternative medicinal practices in wellness tourism market

Author: Sethumadhavan Meera; Vinodan, A

Publication info: Journal of Hospitality and Tourism Insights ; Bingley  Vol. 2, Iss. 3,  (2019): 278-295.

Recently, wellness tourism has gained popularity in alternative medicinal practices. Alternative medicinal practices are mostly endemic and have evolved through generations, transmitted and propagated through formal and informal modes. The purpose of this paper is to investigate the possibility of developing alternative medicinal practices in the wellness tourism market in the context of Kalari practices – oldest martial art system of the world based at Kerala, India.

Study employed an exploratory sequential method consisting of in-depth interviews with practitioners and questionnaire survey with 356 tourists. Confirmatory factor analysis has been done to confirm the latent variables of attitude towards alternative medicinal practices in wellness market.

Study results indicate that there are five latent constructs consisting of physical, psychological, emotional, social and personal evolved around 26 indicators.

This study will introduce an innovative product line for customers as it will provide enhanced opportunities for wellness and will result in indigenous knowledge protection and marketing.

The present study gives immense scope for appreciation of effectiveness of martial art practices across world and promotion of wellness tourism through alternative medicinal practices, which could be slightly modified and replicated by considering local specific medicinal practices.

This study makes the first attempt to investigate attitude towards alternative medicinal practices, especially martial art practices, in the context of wellness market.

Subject: Physical fitness; Medical tourism; Resorts & spas; Spirituality; Yoga; Self esteem; Lifestyles

Company / organization: Name: International Spa Association; NAICS: 813910

Alternate title: Alternative medicinal practices

Pages: 278-295

Online publication date: 2019-05-02

Milestone dates: 2018-06-29 (Received) 2018-07-25 (Revised) 2018-09-28 (Revised) 2018-11-12 (Revised) 2018-12-28 (Revised) 2018-12-28 (Accepted)

   First posting date: 02 May 2019

DOI: http://dx.doi.org/10.1108/JHTI-06-2018-0037

ProQuest document ID: 2447266893

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/attitude-towards-alternative-medicinal-practices/docview/2447266893/se-2?accountid=7139

Medical tourism: strategies for quality patient/guest experiences

Author: Kucukusta, Deniz; Hudson, Simon; DeMicco, Frederick J

Publication info: Journal of Hospitality and Tourism Insights ; Bingley  Vol. 2, Iss. 3,  (2019): 221-223.

Abstract: [...]better data becomes available, we will make this forecast: through 2025, expect medical tourism to grow by 20 percent per year, reaching 60m people and a market value in the neighborhood of $260bn (DeMicco et al., 2018). [...]MTPs outside of the Caribbean region exposed to similar environmental risks of natural disasters (i.e. hurricanes, earthquakes, typhoons and tsunamis) may use these findings for comparative analysis purposes to support their own organizational planning. Results confirm that in addition to the wellness services and amenities, the service product uniquely contributes to psychological well-being. [...]the study provides a theoretical framework for measuring the outcomes of a stay at a wellness destination.

Subject: Marketing; Travel; Medical tourism; Surgery; Communication; Health care

Business indexing term: Subject: Marketing

Location: Turkey India

Alternate title: Guest editorial

Pages: 221-223

Number of pages: 3

Online publication date: 2019-09-10

   First posting date: 10 Sep 2019

DOI: http://dx.doi.org/10.1108/JHTI-08-2019-090

ProQuest document ID: 2447266860

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/medical-tourism-strategies-quality-patient-guest/docview/2447266860/se-2?accountid=7139

CZYNNIKI ROZWOJU TURYSTYKI MEDYCZNEJ W POLSCE *

Author: Demków, Katarzyna1; Sulich, Adam21 Politechnika Wrocławska2 Uniwersytet Ekonomiczny we Wrocławiu

Publication info: Zarzadzanie Publiczne ; Kraków  Iss. 48,  (2019): 271-284.

The article discusses the issue of the development of medical tourism in Poland, in particular, the factors determining this development. It is a form of tourism that is becoming more and more popular not only in Poland but also in other countries around the world. The article is an analysis of the perspectives for the development of medical organizations offering medical treatment in Poland. The article assumes that the development of this selected branch of tourism entails investments and innovations also in the area of medical services and medicine. The method adopted in the article is the analysis of the results of research and existing data regarding the prices of medical operations and procedures in Poland, Germany, the USA, and the United Kingdom. The article aims to present the development factors of Polish medical tourism.

W artykule poruszono problematykę rozwoju turystyki medycznej w Polsce, w szczególności czynników determinujących ten rozwój. Jest to forma turystyki coraz bardziej popularna nie tylko w Polsce, ale także w innych krajach świata. Artykuł stanowi analizę perspektyw rozwoju organizacji medycznych oferujących leczenie w ramach turystyki medycznej w Polsce. W pracy założono, że rozwój tej gałęzi turystyki pociąga za sobą inwestycje i innowacje również w obszarze usług medycznych i medycyny. Metodą przyjętą w artykule jest analiza porównawcza danych zastanych dotyczących cen operacji i zabiegów medycznych w Polsce, Niemczech, Stanach Zjednoczonych i Wielkiej Brytanii. Celem artykułu jest przedstawienie czynników rozwoju polskiej turystyki medycznej.

Subject: Studies; Medical tourism; Medical procedures; Medical treatment; Tourism; Prices; Innovations; Health services

Alternate title: Factors of the development of medical tourism in Poland

Publication title: Zarzadzanie Publiczne; Kraków

Pages: 271-284

Publisher: Jagiellonian University-Jagiellonian University Press

Place of publication: Kraków

Country of publication: Poland, Kraków

Publication subject: Public Administration

ISSN: 18960200

e-ISSN: 20843968

Language of publication: Polish

DOI: http://dx.doi.org/10.4467/20843968ZP.19.019.11939

ProQuest document ID: 2418817709

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/czynniki-rozwoju-turystyki-medycznej-w-polsce/docview/2418817709/se-2?accountid=7139

Copyright: Copyright Jagiellonian University-Jagiellonian University Press 2019

Last updated: 2021-09-23

BOARD FINANCIAL EDUCATION AND FIRM PERFORMANCE: EVIDENCE FROM THE HEALTHCARE SECTOR IN NIGERIA

Author: Erin, Olayinka1; Arumona, Jonah2; Onmonya, Lucky3; Omotayo, Vincent41 Covenant University2 Bingham University3 Institute of Development Finance and Project Management4 Wesley University

Publication info: Academy of Strategic Management Journal ; Arden  Vol. 18, Iss. 4,  (2019): 1-14.

This study examines the relationship between board financial education and firm performance of companies operating in the healthcare sector in Nigeria. The study investigates six (6) listed firms in the healthcare sector for the period from 2011 to 2017. Board financial education variables were proxy by bachelor's degree in finance related courses (BScFin), a postgraduate degree in finance related courses (PGFin) and professional qualification in finance related courses (POFin) while the study controlled for other variable which is the firm size (FMZ). Firm performance was measured using the return on assets (ROA). The fixed effect model of the multiple regression analysis was adopted in testing the three hypotheses developed in this study. The empirical result revealed that all the explanatory variables have a positive and significant relationship with firm performance. This result emphasizes the relevance of financial education for board members irrespective of their educational background. We, therefore, recommend that financial literacy should be considered as a primary prerequisite for appointments to corporate boards. Also, basic financial training should be a top priority for all firms to assure optimum financial performance. This study provides original insight into board financial education variables that affect the performance of firms operating in the healthcare sector in Nigeria. The study's finding carries significant importance for company executives, regulatory authorities, policymakers, and future researchers.

Subject: Research; Health care policy; Studies; Sustainability; Variables; Progress reports; Medical tourism; Education; Social responsibility; Return on assets; Qualifications; Gross National Product--GNP; Stockholders; Earnings per share; Accounting; Financial literacy; Corporate governance; Health care industry; Performance management; Boards of directors; Corporate objectives

Business indexing term: Subject: Social responsibility Return on assets Qualifications Gross National Product--GNP Stockholders Earnings per share Accounting Financial literacy Corporate governance Health care industry Performance management Boards of directors Corporate objectives

Location: Nigeria

Publication title: Academy of Strategic Management Journal; Arden

Pages: 1-14

ISSN: 15441458

e-ISSN: 19396104

ProQuest document ID: 2294442083

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/board-financial-education-firm-performance/docview/2294442083/se-2?accountid=7139

Copyright: Copyright Jordan Whitney Enterprises, Inc 2019

HEALTH TOURISM MARKET IN POLAND AND CROATIA – FINANCIAL EFFECTS AND POTENTIALS

Author: Dragičević, Daniel; Paleka, Hana

Publication info: Tourism in South East Europe .. ; Opatija  Vol. 5,  (2019): 219-232.

Purpose - In recent decades, health tourism has developed as a strong trend, parallel with another global megatrend - the growing popularity of health awareness. Health tourism market, in the European Union, is a new and robust niche, with an estimated 56.0 million domestic and 5.1 million international arrivals in 2014. The purpose of this paper is to describe the main characteristics and to analyze some of the challenges of developing health tourism in Poland and Croatia. Also, the financial effects of these health tourism markets are compared and evaluated. Methodology - The comparative analysis of secondary data, including the statistics of health tourism financial effects in Poland and Croatia, is done. The methodology of the paper also includes description and analysis of the current strengths, weaknesses, opportunities and threats through a SWOT analysis of Polish and Croatian health tourism. Findings - Research results show that there is reasonable ground to state that health tourism in Poland and Croatia can be a strong take-off point for their tourism in general, as well as an export product of particular significance for these countries. However, there are still many obstacles in this journey. Contribution - This paper aims to draw the attention to research gap and strengthens the call for more empirical and statistical research on the role, development as well as economic outcomes of health tourism in European Union, and especially Poland and Croatia.

Subject: Research; Health care policy; Public health; Researchers; Medical tourism; Resorts & spas; Marketing; SWOT analysis; Gross Domestic Product--GDP; Health care; Comparative analysis

Business indexing term: Subject: Marketing SWOT analysis Gross Domestic Product--GDP; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels

Location: Croatia United States--US New York Poland Europe

Company / organization: Name: United Nations--UN; NAICS: 928120; Name: World Tourism Organization; NAICS: 813910; Name: World Travel & Tourism Council; NAICS: 813910; Name: European Union; NAICS: 926110, 928120

Classification: 72111: Ho tels (except Casino Hotels) and Motels

Publication title: Tourism in South East Europe ...; Opatija

Pages: 219-232

Publisher: University of Rijeka, Faculty of Tourism & Hospitality Management

Place of publication: Opatija

Country of publication: Croatia, Opatija

ISSN: 18484050

Source type: Trade Journal

DOI: http://dx.doi.org/10.20867/tosee.05.5

ProQuest document ID: 2294370389

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/trade-journals/health-tourism-market-poland-croatia-financial/docview/2294370389/se-2?accountid=7139

Copyright: Copyright University of Rijeka, Faculty of Tourism & Hospitality Management 2019

ACCOUNTING INFORMATION FOR MANAGING SUSTAINABLE HEALTH-TOURISM PRODUCT IN THE TOURISM DESTINATION

Author: Peršić, Milena; Halmi, Lahorka

Publication info: Tourism in South East Europe .. ; Opatija  Vol. 5,  (2019): 547-566.

Purpose - The purpose of this paper is to explore the adaptation of integrated reporting (IR) model to the specifics of health-tourism services in the tourism destination, with a particular emphasis on complying with the stakeholders' attitudes, sustainability development and corporate governance principles. Design - After the introduction and the literature review, the content will be focused on testing the hypothesis "Information provided by integrated reporting (IR) system is relevant in assessing recognition and competitiveness of destination's health-tourism product", and for preparing IR model for health-tourism destination. Methodology - Spearman's correlation coefficient will be used to prove the hypothesis based on the results of survey conducted in 2018 in the tourism destination Kvarner, which has been recognized in the Croatian strategic documents as the destination with great potential for health tourism development. Approach - To apply a methodological framework of integrated reporting (IR) to the specifics of health-tourism services in the tourism destination, adhering to the principles of corporate governance (destination is considered as a corporation). Findings - Designing management information system relevant to short- and long-term decision making, according to the destination management and the stakeholders' specific needs. Originality of the research - Originality can be recognized as a theoretical contribution to the strategic accounting through developing the specific model of integrated reporting for healthtourism products in the health-tourism destination. This approach is also relevant from the practical point of view because it shows how to recognize capitals on the input side (natural, financial, manufactured, intellectual, human, social and relationship), and how to set up a business model that would create added value.

Subject: Integrated approach; Medical tourism; Literature reviews; Trends; Hypotheses; Quality; Sustainability; Accounting; Information systems; Corporate governance; Day spas; Resorts & spas; Growth rate

Business indexing term: Subject: Accounting Information systems Corporate governance Day spas; Corporation: Deloitte Touche Tohmatsu Ltd; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels

Location: Croatia Europe

Pages: 547-566

DOI: http://dx.doi.org/10.20867/tosee.05.4

ProQuest document ID: 2294370350

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/trade-journals/accounting-information-managing-sustainable/docview/2294370350/se-2?accountid=7139

Last updated: 2021-10-13

LIMITATIONS AND DEVELOPMENT OPPORTUNITIES OF DENTAL TOURISM: THE CASE OF CROATIA

Author: Peručić, Doris11 Edward Bernays University College Ratkajev prolaz 8, 10000 Zagreb, Croatia

Publication info: Ekonomski Vjesnik ; Osijek  Vol. 32, Iss. 1,  (2019): 93-104.

Many countries are developing dental tourism as a major segment of the growing medical tourism in the world. In Europe dental tourists represent more than 30% of all medical tourists. The objective of this paper is to understand dental tourism in Croatia from the perspective of dental providers by identifying limitation and opportunities in providing dental tourism services. In order to get an overview of the dental market in Croatia from the clinics involved, two researches were conducted. The first was conducted by a systematic review of leading private dental clinics websites and the second via an online survey in October 2018. The findings show that Croatia's market identity is based mainly on excellent price-quality ratio of products and services in dental care, staff competence, high professional standards, lower prices and quality of support services. According to the opinion of dental clinics managers, the main limitations on the development of dental tourism in Croatia are lack of EU funding and incentive measures for the development of medical tourism, inadequate promotion of dental tourism, and lack of strategic planning and development vision at the national level. For further development it is extremely important to carry out accreditation and international certification of clinics and to continuously invest in employee training, quality of services and equipment/technology. The findings also point out that Croatia must build competitive advantage on dental treatment with tourism experience as a product. The quality of Croatian supporting tourist facilities add value to the core product and help to differentiate it from the competition.

Mnoge zemlje razvijaju dentálni turizam kao značajan segment rastućeg medicinskog turizma u svijetu. U Europi dentalni turisti čine vise od 30% ukupnog broja medicinskih turista. Cilj rada je analizirati razvijenost dentalnog turizma u Hrvatskoj sa stajališta pružatelja stomatoloških usluga identificiranjem ograničenja i mogućnosti za pružanje usluga dentalnog turizma. Kako bi se dobio uvid u razvijenost tržišta dentalnog turizma u Hrvatskoj provedena su dva istraživanja. Prvo istraživanje provedeno je sustavnim pregledom internetskih stranica vodećih privatnih dentalnih klinika, a drugo putem online ankete provedene u listopadu 2018. godine. Nalazi istraživanja ukazuju da se tržišna prepoznatljivost Hrvatske uglavnom temelji na izvrsnom odnosu cijene i kvalitete dentalnih usluga/proizvoda, stručnom osoblju, visokim standardima, nižim cijenama i kvaliteti dodatnih usluga. Prema mišljenju mendžera dentalih klinika glavna ograničenja razvoja dentalnog turizma u Hrvatskoj su: nedostatak natječaja za dodjelu bespovratnih sredstava iz EU fondova i izostanak poticajnih mjera za razvoj medicinskog turizma, zatim nedostatna promocija dentalnog turizma i nedostatak strateškog planiranja i razvojne vizije na nacionalnoj razini. Za razvoj dentalnog turizma izuzetno je važno provesti akreditaciju i meðunarodno certificiranje klinika i kontinuirano ulagati u usavršavanje zaposlenika, kvalitetu usluge i opremu/tehnologiju. Nalazi takoðer ukazuju da Hrvatska svoju konkurentsku prednost treba graditi na kvaliteti dentalno turističkog proizvoda. Kvaliteta usluga/ sadržaja uključenih u turistički dio boravka daje dodanu vrijednost osnovnom proizvodu i omogućuje da se diferencira od konkurencije.

Subject: Medical tourism; Dental care; Systematic review; Clinics; Quality of service; Competitive advantage; Cost control; Success; Trends; Aging; Access to information; Prices; Travel; Dentistry; Qualitative research; Competition

Business indexing term: Subject: Quality of service Competitive advantage Cost control

Alternate title: OGRANIČENJA I PERSPEKTIVE RAZVOJA DENTALNOG TURIZMA, PRIMJER HRVATSKE

Publication title: Ekonomski Vjesnik; Osijek

Pages: 93-104

Publisher: J.J. Strossmayer University of Osijek, Faculty of Economics

Place of publication: Osijek

Country of publication: Croatia, Osijek

ISSN: 0353359X

e-ISSN: 18472206

ProQuest document ID: 2251628654

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/limitations-development-opportunities-dental/docview/2251628654/se-2

Copyright: © 2019. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Perceived cultural differences in healthcare for foreign patients visiting South Korea: tool development and measurement

Author: Sung, Sumi; Park, Hyeoun-Ae

Publication info: BMC Health Services Research ; London  Vol. 19,  (2019).

We developed a 41-item tool measuring cultural differences in healthcare as perceived by foreign patients visiting South Korea.

The tool was tested on 256 foreign patients who visited three tertiary hospitals in Seoul, South Korea. Content validity was explored by two physicians and eight nurses working in an international healthcare department. Structural validity was tested via exploratory factor analysis and by testing two hypotheses: (1) there are perceived cultural differences between the South Korean healthcare and those of foreign patients’ home countries (one-sample t-test); and, (2) Perceived cultural differences vary among language groups (analysis of variance). We also calculated Cronbach’s alpha.

The content validity index of the tool was 0.97. Exploratory factor analysis identified seven significant factors: hospital care and services, food, the healthcare system, communication, the healthcare facility, religion, and cultural values. The overall Cronbach’s alpha for the tool was 0.96, indicating very high internal consistency. We found that foreign patients visiting South Korean hospitals perceived that the healthcare culture differed significantly from that of their home country. The perceived cultural differences varied significantly by language group.

Conclusions

Nurses can use our new tool to understand the cultural differences of foreign patients and provide them with culturally competent nursing care.

Subject: Language; Validity; Culture; Health care policy; Communication; Values; Nursing care; Medical research; Nutrition; Hospitals; Cultural differences; Medical tourism; Multiculturalism & pluralism; Biological variation; Spirituality; Nurses; Patient satisfaction; Arabic language; Religion

Business indexing term: Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: United States--US South Korea

Company / organization: Name: Oxford University Press; NAICS: 511130, 611310

Identifier / keyword: Culturally competent healthcare Nursing care Medical tourism Cultural differences Tool development

Online publication date: 2019-03-28

Milestone dates: 2018-11-22 (Received) 2019-02-20 (Accepted)

First posting date: 28 Mar 2019

DOI: http://dx.doi.org/10.1186/s12913-019-3965-9

ProQuest document ID: 2211406059

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/perceived-cultural-differences-healthcare-foreign/docview/2211406059/se-2

Copyright: © 2019. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

The attitudes of education, tourism and health sector managers in Northern Cyprus towards Education on Health Tourism

Author: Savaşan, Ahmet1; Yalvaç, Mesut2; Uzunboylu, Hüseyin3; Tuncel, Ediz11 Department of Educational Administration, Supervision, Planning and Economics, Atatürk Faculty of Education, Near East University, Nicosia, Cyprus2 Department of Nutrition and Dietetics, Faculty of Health Sciences, Near East University, Nicosia, Cyprus3 Atatürk Faculty of Education, Near East University, Nicosia, Cyprus

Publication info: Quality and Quantity, suppl. Supplement ; Dordrecht  Vol. 52, Iss. 1,  (Dec 2018): 285-303.

This study aims to determine the attitudes of the shareholders in the health tourism sector in Northern Cyprus towards Education on Health Tourism and to constitute a basis for an educational model to be developed for health tourism. Qualitative (analytic) and descriptive, documentary source analysis, sampling and statistical methods, face-to-face interviews data collection technique were used in this study. The study population consists of the managers working in education, tourism and health sectors in Northern Cyprus. Using the simple random sampling, 310 people were selected and interviewed. A questionnaire with two sections was used to collect data. The first section included questions about participants’ introductory characteristics, and the second section was the Attitude towards Education on Health Tourism Scale. This scale was prepared in accordance with a literature review related to education on health tourism and to interviews performed with the experts from the education, tourism and health fields. The Scale was passed validity and reliability tests and was used in this study. The statements the participants agreed with most were: “Intermediate staff working in health, accommodation, transportation and other relevant sectors should be provided in-service training on health tourism” in the education subdimension.

Subject: Health education; Transportation; Literature reviews; Health behavior; Medical tourism; Education; Stock markets; Training; Tourism; Health services; Data collection; Health; Experts; Inservice training; Questionnaires; Random sampling; Attitudes; Interviews; Reliability; Shareholders

Location: Cyprus

Publication title: Quality and Quantity; Dordrecht

Supplement: Supplement

Source details: Special Issue: Quality in Education: The role of research and practices

Pages: 285-303

Publication year: 2018

Publication date: Dec 2018

Publisher: Springer Nature B.V.

Place of publication: Dordrecht

Country of publication: Netherlands, Dordrecht

Publication subject: Sociology--Abstracting, Bibliographies, Statistics, Statistics

ISSN: 00335177

e-ISSN: 15737845

Online publication date: 2017-10-17

Milestone dates: 2017-10-13 (Registration)

   First posting date: 17 Oct 2017

DOI: http://dx.doi.org/10.1007/s11135-017-0612-6

ProQuest document ID: 2157776970

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/attitudes-education-tourism-health-sector/docview/2157776970/se-2?accountid=7139

Copyright: Quality & Quantity is a copyright of Springer, (2017). All Rights Reserved.

Last updated: 2021-08-16

DEVELOPMENT OF DENTAL TOURISM IN CROATIA

Author: Hunjet, Anica1; Kustelega, Lea; Kozina, Goran1 University North, Varaždin [email protected]

Publication info: Economic and Social Development: Book of Proceedings ; Varazdin  : 307-325. Varazdin: Varazdin Development and Entrepreneurship Agency (VADEA). (Nov 15/Nov 16, 2018)

Health tourism is a form of tourism in which an individual temporarily changes his or her place of residence to a more favorable climate or bathing location for preventive, curative or rehabilitative health care. There are three forms of health tourism: wellness, curative tourism and medical tourism. Medical tourism entails organized traveling for the improvement of human health through certain medical interventions. It occurs mostly in medical offices, clinics and hospitals. Dental tourism is a form of medical tourism and it entails the traveling of a patient from the home country to obtain a dental health service. The analysis of all aspects related to the sector of dental tourism in Croatia reveals the direction of development of dental tourism in Croatia. This paper shows how dental tourism is involved in the marketing mix through its four main components. It considers ethical and safety issues which are very important in providing such services. Based on the analysis and the conducted research, one can conclude that Croatia has the necessary prerequisites for this kind of tourism. This paper presents the development of dental tourism, analysis of possibilities and factors which affect the development of dental tourism in Croatia.

Subject: Bathing; Dental health; Health; Nonresidents; Tourism; Health care; Hospitals; Medical tourism; Dental care; SWOT analysis; Marketing; Transportation services; Distribution channels; Transplants & implants; Prostheses; Surgery; Dentists; Health care expenditures

Business indexing term: Subject: SWOT analysis Marketing Transportation services Distribution channels; Industry: 62211 :‎ General Medical and Surgical Hospitals 62121 :‎ Offices of Dentists

Classification: 62211: General Medical and Surgical Hospitals; 62121: Offices of Dentists

Pages: 307-325

Publication date: Nov 15/Nov 16, 2018

ProQuest document ID: 2139470185

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/conference-papers-proceedings/development-dental-tourism-croatia/docview/2139470185/se-2?accountid=7139

Copyright: Copyright Varazdin Development and Entrepreneurship Agency (VADEA) Nov 15/Nov 16, 2018

Customization in medical tourism in the Philippines

Author: Rydback, Michelle; Hyder, Akmal S

Publication info: International Journal of Pharmaceutical and Healthcare Marketing ; Bradford  Vol. 12, Iss. 4,  (2018): 486-500.

Focusing on customization, this paper aims to examine how service providers market health care in emerging markets through medical tourism.

Using a qualitative method, researchers conducted 18 semi-structured interviews with managers from five health-care providers and supporting organizations in the Philippines. For analysis, data from the service providers are compared.

Customization is found to play crucial role in offering health-care services. The customization takes place by adapting to emotional, social and cultural needs; alleviating knowledge asymmetry; and moderating the negative impact of the unfamiliar context experienced by international patients.

Research/limitations implications

The empirically grounded theoretical framework needs to be tested in different contexts for generalization.

The study focuses on understanding and responding to the needs of international patients, also demonstrating that health-care marketing must be developed through a joint effort by both the medical and business sides of health-care providers.

The paper acknowledges the need for health-care marketing and the novel role of health-care providers.

Using a marketing lens, this study sheds light on the underexplored industry of medical tourism.

Subject: Research; Customer services; Consumer behavior; Medical research; Health; Accreditation; Health care; Patients; Social networks; Medical tourism; Tourism; Customization; Emerging markets; Data processing; Marketing; Consumers; Web sites; Studies; Employees; Multiculturalism & pluralism

Business indexing term: Subject: Customer services Consumer behavior Social networks Marketing Consumers Employees Emerging markets

Location: Philippines

Pages: 486-500

Publication date: 2018

Online publication date: 2018-11-01

Milestone dates: 2017-07-10 (Received) 2018-04-19 (Revised) 2018-08-27 (Accepted)

   First posting date: 01 Nov 2018

DOI: http://dx.doi.org/10.1108/IJPHM-07-2017-0035

ProQuest document ID: 2132741881

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/customization-medical-tourism-philippines/docview/2132741881/se-2?accountid=7139

India’s rural healthcare systems: structural modeling

Author: Kumar, Dinesh1    1 Ajay Kumar Garg Engineering College, Ghaziab ad, India

Publication info: International Journal of Health Care Quality Assurance ; Bradford  Vol. 31, Iss. 7,  (2018): 757-774.

The purpose of this paper is to identify factors related to rural healthcare services and establish a hierarchical model for the effective rural healthcare management in India.

A questionnaire survey identified and correlated numerous factors related to the Uttarakhand rural healthcare systems. Experts opinion were translated into a reachability matrix and an interpretive structural model. A fuzzy matriced impacts croises-multiplication applique and classment (FMICMAC) analysis arranged the factors as hierarchical stages using their driving power.

The interpretive structural and FMICMAC hierarchical models suggest four key driving factors: diseases, climatic conditions, population growth and political pressure.

Despite numerous issues, rural healthcare services can be improved by considering key driving factors that could be used as a prediction tool for policy makers.

Results demonstrate that population control, coordinating services with local bodies and rural health center annual maintenance can be game changers toward better healthcare services.

Subject: Administrative expenses; Fuzzy; Medical wastes; Health centres; Experts; Health care policy; Population control; Driving; Hospitals; Questionnaires; Population growth; Medical tourism; Health care industry; Patient satisfaction; Medicine; Rural health care; Multiplication; Power; Rural communities; Rural areas; Quality of care; Policy making; Infrastructure; Supply chains; Inventory management; Inventory; Pharmacists

Business indexing term: Subject: Health care industry Infrastructure Supply chains Inventory management Inventory; Industry: 62211 :‎ General Medical and Surgical Hospitals

Publication title: International Journal of Health Care Quality Assurance; Bradford

Pages: 757-774

Publication subject: Public Health And Safety, Medical Sciences, Health Facilities And Administration

ISSN: 09526862

e-ISSN: 17586542

Milestone dates: 2017-02-03 (Received) 2017-11-10 (Revised) 2017-12-29 (Accepted)

DOI: http://dx.doi.org/10.1108/IJHCQA-02-2017-0020

ProQuest document ID: 2124679986

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/india-s-rural-healthcare-systems-structural/docview/2124679986/se-2?accountid=7139

Analysis of the Colombian Medical Tourism Industry from a Systemic Competitiveness Approach

Author: Mario Alberto De la Puente   

Publication info: Dimensión Empresarial ; Barranquilla  Vol. 16, Iss. 2,  (Sep 2018): 111-122.

This research article analyzes the role of the central government of Colombia in the strategy for the improvement of the medical tourism industry through a critical approach of the traditional model of competitiveness. Based on a mixed method, the feasibility of the associative systemic competitiveness model and its effectiveness on the quality of medical services offered to foreign patients is determined. The proposal for the implementation of systemic competitiveness model improves the perception of quality of medical services by foreign patients. In order to implement the proposed model, it is recommended the expansion of free taxation zones, the proliferation of medical service clusters and the strengthening of strategic alliances with international operators.

Este artículo de investigación analiza el papel del gobierno central de Colombia en la estrategia de posicionamiento del turismo médico a través de un enfoque crítico del modelo tradicional de competitividad. Con base en un método mixto, se determina la viabilidad del modelo asociativo de competitividad sistémica y su efectividad en la calidad de los servicios ofrecidos a pacientes extranjeros. La propuesta para la implementación del modelo de competitividad sistémica mejora la percepción de la calidad de los servicios médicos por parte de pacientes extranjeros. Para implementar el modelo propuesto, se recomienda la expansión de las zonas libres de impuestos, la proliferación de clústeres de servicios médicos y el fortalecimiento de alianzas estratégicas con operadores internacionales.

Este artigo de pesquisa analisa o papel do governo central da Colômbia na estratégia para a melhoria da indústria do turismo médico através de uma abordagem crítica do modelo tradicional de competitividade. Com base em um método misto, determina-se a viabilidade do modelo associativo de competitividade sistêmica e sua efetividade na qualidade dos serviços médicos oferecidos a pacientes estrangeiros. A proposta de implementação do modelo de competitividade sistêmica melhora a percepção da qualidade dos serviços médicos por pacientes estrangeiros. Para implementar o modelo proposto, recomenda-se a expansão de zonas de tributação livre, a proliferação de clusters de serviços médicos e o fortalecimento de alianças estratégicas com operadores internacionais.

Subject: Medical tourism; Federal government; Competition

Identifier / keyword: Systemic competitiveness Medical tourism Government role Traditional competitiveness model Heath tourism

Alternate title: ANÁLISIS DE LA INDUSTRIA DEL TURISMO MÉDICO COLOMBIANO DESDE UN ENFOQUE DE COMPETITIVIDAD SISTÉMICA ANÁLISE DA INDÚSTRIA DO TURISMO MÉDICO COLOMBIANO DE UMA ABORDAGEM DE COMPETITIVIDADE SISTÊMICA

Pages: 111-122

Publication date: Sep 2018

Online publication date: 2018-07-20

Milestone dates: 2018-07-20 (Created) 2017-11-22 (Submitted) 2018-09-09 (Issued) 2019-11-30 (Modified)

   First posting date: 20 Jul 2018

DOI: http://dx.doi.org/10.15665/dem.v16i2.1503

ProQuest document ID: 2437127071

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/analysis-colombian-medical-tourism-industry/docview/2437127071/se-2

Copyright: © 2018. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

What Influences The Behavioral Intention In Medical Tourism? A Threat and Coping Perspective

Author: Seow, Ai Na1; Choong, Yuen Onn1; Chan, Ling Meng11 Universiti Tunku Abdul Rahman, Malaysia

Publication info: Global Business and Management Research, suppl. Special Issue ; Boca Raton  Vol. 10, Iss. 3,  (2018): 866.

Purpose: This study aims to evaluate the threat appraisals with regards to perceived threat on health, and the coping appraisals in relation to perceived efficacy and response cost from international tourists on their behavioral intention in receiving medical services abroad Design/methodology/approach: A total of 265 responses were analyzed via partial least squarestructural equation modeling to assess on measurement model and structural model. Findings: From the findings, it is evident and accentuated that perceived severity, perceived vulnerability, perceived respond efficacy, and perceived self-efficacy are significantly predicting on international tourists' behavioral intention in medical tourism. Several implications emphasizing on the adoption of PMT on tourists' behavioral intention are identified. Research limitations/implications: The research ascertained that both perceived threat and perceived efficacy play an important in influencing international tourists' intention to seek medical tourism in Malaysia. Practical Implications: It provides insights that the Ministry of Health, healthcare centre or association should ensure the quality and advancement of facilities, infrastructures, healthcare centre environment as well as technologies are up to the international level whereby this would enhance the international tourists' efficacy and confident in Malaysia's healthcare services. Originality/value: This study has contributed a better understanding on the decision making process and determinants to influence the international tourists to select Malaysia as their medical tourism destinations.

Subject: Medical tourism; Motivation; Behavioral psychology; Health services; International trade; Gross Domestic Product--GDP; Cost control; Research; Personal health; Medical screening; Decision making

Business indexing term: Subject: International trade Gross Domestic Product--GDP Cost control

First page: 866

Publisher: Me hran Nejati

ProQuest document ID: 2159614267

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/what-influences-behavioural-intention-medical/docview/2159614267/se-2?accountid=7139

Copyright: Copyright Mehran Nejati 2018

The agony of choice for medical tourists: a patient satisfaction index model

Author: Rosenbusch, Jana; Ismail, Ida Rosnita; Ringle, Christian Marc

Publication info: Journal of Hospitality and Tourism Technology ; Bingley  Vol. 9, Iss. 3,  (2018): 267-279.

Grounded on substantial theories and service concept models, this paper aims at proposing a novel patient satisfaction index (PSI) model. This model allows for identifying the key sources of patient satisfaction and for comparing performance results across hospitals competing on the national and international health-care market. The PSI is also an important benchmark instrument for medical tourism.

The PSI model was initially tested in hospitals in a developed country (the German hospital market). A total of 1,281 complete patient responses were analyzed by means of partial least squares structural equation modeling (PLS-SEM).

This model’s sources of competitive advantage – doctors’ and nurses’ interaction quality, environmental quality and outcome quality – mostly explain patient satisfaction, which is the key target construct. The results also reveal that the doctors’ and nurses’ interaction quality is the most salient driver of patient satisfaction.

The proposed PSI model can be generally applied to facilitate the comparison of hospitals on a regional, national and even an international level. In addition, the PSI model helps health-care management facilities prioritize their service components’ improvement (e.g. to attract more medical tourists).

Medical tourists are confronted with a variety of health destinations and may find it difficult to choose an appropriate region and health-care provider. This study contributes to medical tourism research by developing a general patient satisfaction index model for medical tourists.

Subject: Quality of service; Developing countries--LDCs; Medical tourism; Studies; Employees; Hospitality industry; Patient satisfaction; Hotels & motels; Research; Food; Communication; Hypotheses; Health care; Physicians; Hospitals; Empathy; Nurses; Environmental quality

Business indexing term: Subject: Quality of service Developing countries--LDCs Employees Hospitality industry Hotels & motels; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels 62111 :‎ Offices of Physicians 62211 :‎ General Medical and Surgical Hospitals

Classification: 72111: Hotels (except Casino Hotels) and Motels; 62111: Offices of Physicians; 62211: General Medical and Surgical Hospitals

Publication title: Journal of Hospitality and Tourism Technology; Bingley

Pages: 267-279

Number of pages: 13

Publication subject: Travel And Tourism, Computers--Internet

ISSN: 17579880

e-ISSN: 17579899

Online publication date: 2018-07-05

Milestone dates: 2017-10-02 (Received) 2017-12-18 (Revised) 2018-02-06 (Revised) 2018-02-12 (Accepted)

   First posting date: 05 Jul 2018

DOI: http://dx.doi.org/10.1108/JHTT-10-2017-0107

ProQuest document ID: 2150330832

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/agony-choice-medical-tourists-patient/docview/2150330832/se-2?accountid=7139

Socio-economic preconditions of resort agglomerations development in the south of Russia

Author: Oborin, Matvey S1; Kozhushkina, Irina2; Gvarliani, Tatyana2; Ivanov, Nikolay31 Perm Institute (branch) of the Plekhanov Russian University of Economics, Perm, Russia, Department of World and Regional Economics, Economic Theory, Perm State National Research University, Perm, Russia, Department of Management and Technology in Tourism and Service, Sochi State University, Sochi, Russia and Department of Management, Perm State Agro-Technological University, Perm, Russia2 Department of Finance, Credit and World Economy, Sochi State University, Sochi, Russia3 Lomonosov Faculty of Economics, Moscow State University, Moscow, Russia

Publication info: Worldwide Hospitality and Tourism Themes ; Bingley  Vol. 10, Iss. 4,  (2018): 467-477.

This paper aims to analyze the modern problems and the main trends of development of the health-improving tourism sector in the southern part of Russia and to identify significant factors in overcoming the complex challenges related to specific socio-economic conditions in the study area.

The material that served as the basis of the study comprises statistical data from the Southern Federal District and its subjects, as well as data about the development of tourism infrastructure on the official websites of governments, Ministry of Tourism and the population of the Southern Federal District. This information was systematized from a number of perspectives, including identification of the chronology of health-improving tourism infrastructure development in the chosen territory, as well as the advantages and disadvantages in this area. Based on the results of the study, the authors also developed some recommendations to overcome existing inactive trends in the field of health tourism.

This paper sheds light on the understanding of the challenges and changes that took place in the resort agglomerations of the south of Russia in terms of current issues and those that must be addressed in the coming years. It was concluded that health tourism in the south of Russia has old traditions based on the natural resource potential of territories that are included in the composition of the Southern Federal District. At the same time, the authors came to the conclusion that, unfortunately, not resort agglomerations are fully utilized. Furthermore, some historic resorts were not well maintained by local authorities and have suffered more recently because of lack of investment. At present, the financial results of health resorts and others related to health-improving tourism are precarious as most operations are unprofitable, and so complex decisions are needed to address the underlying problem of resource optimization because of the important social and economic role of the cities in this region. They have special natural and resource potential and preserve traditions related to health-improving tourism.

The paper provides a conceptual analysis based on limited empirical data combined with some directions for further research.

The paper attempts to reveal the impact of social, economic and geopolitical factors, both negative and positive, on the development of the health-improving tourism segment, restructuring of the Russian tourism market and the emergence of promising opportunities and new directions for development. The findings also provide insights for practitioners and researchers, and the tourism industry can draw on this analysis to guide the development of strategy, increase investment attractiveness, make more effective use of the natural resource potential and maintain pressure on government partners to provide support to tourism.

Subject: Tournaments & championships; Population; Recreation; Holidays & special occasions; Mineral water; Tourism; Soccer; Music festivals; Natural resources; Studies; Infrastructure; Geopolitics; Hospitality industry; Economic development; Hotels & motels; Medical tourism; Resorts & spas; Qualitative research; Cities

Business indexing term: Subject: Infrastructure Hospitality industry Economic development Hotels & motels; Industry: 92611 :‎ Administration of General Economic Programs 72111 :‎ Hotels (except Casino Hotels) and Motels 31211 :‎ Soft Drink and Ice Manufacturing

Location: Russia Crimea

Classification: 92611: Administration of General Economic Programs; 72111: Hotels (except Casino Hotels) and Motels; 31211: Soft Drink and Ice Manufacturing

Pages: 467-477

DOI: http://dx.doi.org/10.1108/WHATT-04-2018-0024

ProQuest document ID: 2117743692

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/socio-economic-preconditions-resort/docview/2117743692/se-2?accountid=7139

Last updated: 20 21-09-09

The Impact of OD Intervention on High Performing Teams in a Hospital

Author: Kamolsiri, Pimpawat, PhD1; Tayko, Perla Rizalina M, PhD11 Assumption University of Thailand

Publication info: Organization Development Journal ; Chesterland  Vol. 36, Iss. 2,  (Summer 2018): 51-74.

The exponential growth in Information and Technology (IT) is resulting in drastic changes to our lives. The ability to deal with a massive influx of information, the ability to embrace changes as well as the ability to work collaboratively with others has become crucial for everyone to develop. Organizations that will be able to thrive in this new environment must enhance their employees' work-related knowledge and their ability to think holistically. The purpose of this study is to determine the impact of Organization Development Interventions (ODI) on human information processing skills set and team competency of high performing teams. The study focuses on enhancing individual competency with two important skills which are then maximized to create teams that deliver the best results. The study was conducted in the Thai hospital industry where the landscape has transformed into an ultra-competitive and fast-changing system. This is the result of the increasing trend of the average life expectancy and the rapid growth of medical tourism in Thailand. Today, healthcare professionals must develop mastery in the 21st century skillset, cultivate a teamwork mindset, and demonstrate learning agility in order to become a high performing interdisciplinary team. From the organization assessment, it indicated the need for Organization Development Interventions (ODI) in enhancing individuals' thinking process and teamwork skills to develop a high performing team. The target respondents for this Action Research consisted of 50 employees who are supervisor level and above across all departments in the hospital. The intervention's results revealed that Organization Development Interventions (ODI) created a positive impact on employees both personal and professional. The intervention enhanced their thinking ability and mindsets as well as improved their team competency skills which resulted in better organization performance. Moreover, the quantitative analysis showed that there is a positive relationship between thinking ability, teamwork skills and team performance.

Subject: Health education; Life expectancy; Teams; Brain research; Intervention; Hospitals; Nursing administration; Teamwork; Information processing; 21st century; Medical tourism; Literacy; Competence; Health care; Learning; Ability; Quantitative analysis; Action research; Group performance; Tourism; Medical personnel; Interdisciplinary aspects; Information technology; Organization development; Human resources; Health care industry; Employees; Professionals; Communication; Patients

Business indexing term: Subject: Organization development Human resources Health care industry Employees Professionals; Industry: 62211 :‎ General Medical and Surgical Hospitals

Location: Thailand United States--US India Asia

Company / organization: Name: Association of Southeast Asian Nations--ASEAN; NAICS: 928120; Name: World Health Organization; NAICS: 923120

Publication title: Organization Development Journal; Chesterland

Pages: 51-74

Publication date: Summer 2018

Publisher: International Society for Organization Development, Inc.

Place of publication: Chesterland

Country of publication: United States, Chesterland

Publication subject: Business And Economics--Management, Business And Economics--Personnel Management

ISSN: 08896402

ProQuest document ID: 2099388819

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/impact-od-intervention-on-high-performing-teams/docview/2099388819/se-2?accountid=7139

Copyright: Copyright International Society for Organization Development, Inc. Summer 2018

The exponential growth in Information and Technology (IT) is resulting in drastic changes to our lives. The ability to deal with a massive influx of information, the ability to embrace changes as well as the ability to work collaboratively with others has become crucial for everyone to develop. Organizations that will be able to thrive in this new environment must enhance their employees' work-related knowledge and their ability to think holistically. The purpose of this study is to determine the impact of Organization Development Interventions (ODI) on human information processing skills set and team competency of high-performing teams. The study focuses on enhancing individual competency with two important skills which are then maximized to create teams that deliver the best results. The study was conducted in the Thai hospital industry where the landscape has transformed into an ultra-competitive and fast-changing system. This is the result of the increasing trend of the average life expectancy and the rapid growth of medical tourism in Thailand. Today, healthcare professionals must develop mastery in the 21st century skillset, cultivate a teamwork mindset, and demonstrate learning agility in order to become a high performing interdisciplinary team. From the organization assessment, it indicated the need for Organization Development Interventions (ODI) in enhancing individuals' thinking process and teamwork skills to develop a high performing team. The target respondents for this Action Research consisted of 50 employees who are supervisor level and above across all departments in the hospital. The intervention's results revealed that Organization Development Interventions (ODI) created a positive impact on employees both personal and professional. The intervention enhanced their thinking ability and mindsets as well as improved their team competency skills which resulted in better organization performance. Moreover, the quantitative analysis showed that there is a positive relationship between thinking ability, teamwork skills and team performance.

Empirical research on CBBE scale for medical tourism

Author: Diya Guha Roy; Mukherjee, Srabanti; Bhattacharya, Sujoy

Publication info: International Journal of Pharmaceutical and Healthcare Marketing ; Bradford  Vol. 12, Iss. 3,  (2018): 348-370.

The medical tourism market across the globe lacks a consolidated, standard customer-based brand equity (CBBE) scale till the present day. The purpose of this research is to theorize a scale with probable existing dimensions and based on prior literature adding culture and infrastructure/superstructure as new components for global comparison among BRICS and SAARC nations. This empirical research initiates laying the foundation of deriving a unified scale.

Extensive literature reviews from leading academic journals, books, and web information were used to theoretically propose the scale. R (an open-source coding language) was used for quantitative analysis.

Culture (environment index) and infrastructure/superstructure (industry/economic index) were found to be relevant in the context of CBBE scale for medical tourism. The other dimensions are brand awareness, brand association, perceived quality and loyalty.

The research literature was fragmented because of international scopes of medical tourism destinations as well as a variety of medical services offered. The dynamic nature of this industry, which is dependent on several factors such as healthcare, cost, related services, tourism etc. made it difficult to access the real contribution of individual items.

This paper proposes the foundation to develop a CBBE scale for medical tourism in India, adding culture and infrastructure/superstructure as new dimensions. It opens doors for new research with scale refining, branding assessment and fine-tuning items for the new dimensions.

This research is the first of its kind to create a standard CBBE scale for developing countries. It has added a new set of literature and consolidated prior contextual works on culture and infrastructure in reference to medical tourism. The questionnaire is of practical value to hospitals. The interview transcript is novel in nature for future works.

Subject: Customer services; Culture; Medical research; Health care; Infrastructure; Brand equity; Transcription; Brand image; Developing countries--LDCs; Medical tourism; Health services; Empirical analysis; Books; Tourism; Quantitative analysis; Cognition & reasoning; Literature reviews; Marketing; Brand loyalty; Associations; Quality of service; Economic analysis; Market research; Gross Domestic Product--GDP

Business indexing term: Subject: Customer services Brand equity Brand image Developing countries--LDCs Marketing Brand loyalty Infrastructure Quality of service Gross Domestic Product--GDP; Industry: 81391 :‎ Business Associations

Location: Malaysia India

Classification: 81391: Business Associations

Pages: 348-370

Number of pages: 23

Online publication date: 2018-07-27

Milestone dates: 2017-12-11 (Received) 2018-05-24 (Revised) 2018-06-04 (Accepted)

   First posting date: 27 Jul 2018

DOI: http://dx.doi.org/10.1108/IJPHM-12-2017-0074

ProQuest document ID: 2089855958

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/empirical-research-on-cbbe-scale-medical-tourism/docview/2089855958/se-2?accountid=7139

Modelling the factors affecting Indian medical tourism sector using interpretive structural modeling

Author: Jain Vineet; Ajmera Puneeta11 Amity University Haryana, Gurgaon, India

Publication info: Benchmarking ; Bradford  Vol. 25, Iss. 5,  (2018): 1461-1479.

Medical tourism encourages the traveling of patients, expert healthcare professionals and promotes cross-border trade in healthcare services. The Indian medical tourism sector is facing new challenges as well as certain ethical and legal issues because of continuous market changes and patient’s requirements while at the same time advancements in current health services have also been observed. It is therefore very important to understand and address the issues of the medical tourists. The purpose of this paper is to evaluate the important factors which can make India an affordable medical tourism destination.

In this paper, the factors influencing Indian medical tourism sector have been explored by conducting literature review, they are ranked according to the results of a questionnaire-based survey and further analyzed by using the interpretive structural modeling (ISM) approach. The mutual relationships between these factors were identified to develop an ISM model so as to find out the important factors which can make India an affordable place for medical tourism.

The results of the survey and the model show that cost of medical procedures, facilitation, and care, the infrastructure of Indian hospitals, clinical excellence and the competence of doctors and staff are the top-level factors.

It is very important to address the concerns of the patients coming to a developing country like India for availing medical services. This research has evaluated the important factors which can make India an affordable medical tourism destination.

This research assesses the effects of globalization on delivery of healthcare services in India by conducting a critical analysis of the medical tourism industry by collecting original data from the international patients coming to India for different types of medical procedures so that a comprehensive model can be prepared which will help the hospitals and policymakers to improve the processes related to medical tourism.

Subject: Doctors; Medical research; Medical treatment; Trends; Health care; Modelling; Hospitals; Tourism; Patients; Legal issues; Ayurvedic medicine; Medical tourism; Globalization; Literature reviews; Developing countries--LDCs; Health services; Industrialized nations; Health care industry; Professional ethics; Market penetration; Infrastructure; Pricing policies; Travel

Business indexing term: Subject: Developing countries--LDCs Industrialized nations Health care industry Professional ethics Globalization Market penetration Infrastructure Pricing policies; Industry: 62211 :‎ General Medical and Surgical Hospitals

Publication title: Benchmarking; Bradford

Pages: 1461-1479

ISSN: 14635771

e-ISSN: 17584094

DOI: http://dx.doi.org/10.1108/BIJ-03-2017-0045

ProQuest document ID: 2057355042

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/modelling-factors-affecting-indian-medical/docview/2057355042/se-2?accountid=7139

Sağlık Turizmi ve Turistin Sağlığı Uygulamalarının Hasta Faturaları ve Teşhis İlişkili Gruplara Göre Maliyet Analizi *

Author: Top, Mehmet1; Aslan, Hüseyin2; Zengin, Nurullah31 Doç. Dr., Hacettepe Üniversitesi İİBF Sağlık İdaresi Bölümü Öğretim Üyesi. [email protected] Hacettepe Üniversitesi Sosyal Bilimler Enstitüsü Sağlık Yönetimi Doktora Programı Öğrencisi [email protected] Pr of. Dr., Ankara Numune Eğitim ve Araştırma Hastanesi [email protected]

Publication info: Finans Politik & Ekonomik Yorumlar ; Istanbul  Vol. 55, Iss. 640,  (Jun 2018): 9-25.

Sağlık turizmi gelişmekte olan ülkeler için önemli bir ekonomik potansiyeldir ve küresel olarak ciddi uygulamalar söz konusudur. Sağlık turizmi hastaları kaliteli sağlık hizmetini uygun fiyatlarla kullanmayı araştırmaktadır. Türkiye'de sağlık turizminde maliyet analizi çalışması sınırlıdır. Bu araştırma ile Türkiye'nin önemli eğitim ve araştırma hastanelerinden birisi olan Ankara Numune Eğitim ve Araştırma Hastanesi'nde 2015 dönemi için sağlık turizmi ve turistin sağlığı kapsamında gelen, ayakta ve yatarak sağlık hizmeti alan hastaların hastane faturaları ve TİG'e (Teşhis İlişkili Gruplar) göre maliyet analizi ve karşılaştırılması amaçlanmıştır. Araştırma geriye dönük ve kesitsel tanımlayıcı bir araştırmadır. Bu hastaların cinsiyet, ülkeler, tedavi gördüğü branşlar, teşhis gruplarına yönelik tanımlayıcı analizler yapılması amaçlanmıştır. Araştırma verisi ilgili hastanenin üst kademe yönetiminden gerekli resmi yazışmalar ile elde edilmiştir. Maliyet analizi Sağlık Bakanlığı tarafından belirlenen sağlık turizmi ve turistin sağlığı fiyatlandırması ve TİG fiyatlarına göre yapılmıştır. 2015 yılında ilgili hastaneye sağlık turizmi uygulamaları kapsamında toplam 752, turistin sağlığı kapsamında ise 279 yurt dışı hastası gelmiştir. Hasta fatura tutarlarının TİG'e göre düzenlenen tutarlardan çoğunlukla yüksek olduğu bulunmuştur. Bu araştırma hastane yöneticileri ve sağlık turizmi profesyonellerine katkı sağlayabilir.

Health tourism has an important economic potential for developing countries and serious implications for health care across the globe. The patients in health tourism are seeking high-quality medical care at affordable prices. There is little research about the cost analysis in health tourism in Turkey. The purpose of this study was to investigate costs analysis in health tourism and tourist's health implications according to hospital invoices and DRG (diagnosis related groups) in Ankara Numune Training and Research Hospital. This study is retrospective and descriptive research. These patients in 2015 were analyzed in terms of gender, inpatient and outpatient patients, countries, medical branch, and diagnosis groups. Data in this study was obtained from top management in related hospital. Cost analysis was estimated according to health tourism and tourist health's prices of Ministry of Health and DRG prices. There were 752 patients under health tourism, 279 patients under tourist health in related hospital in 2015. In general invoice totals were higher according to hospital prices than according to DRG. This study could contribute to hospital administrators and health tourism professionals.

Subject: Studies; Diagnosis related groups--DRGs; Medical tourism; Cost analysis; Billings

Business indexing term: Subject: Cost analysis Billings

Alternate title: Cost Analysis in Health Tourism and Tourist's Health Implications According to Treatment Billing and Diagnosis Related Groups (DRGs)

Publication title: Finans Politik & Ekonomik Yorumlar; Istanbul

Pages: 9-25

Publication date: Jun 2018

Publisher: Finans Politik & Ekonomik Yorumlar

ISSN: 13077112

ProQuest document ID: 2117778887

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/sağlık-turizmi-ve-turistin-sağlığı/docview/2117778887/se-2?accountid=7139

Copyright: Copyright Finans Politik & Ekonomik Yorumlar Jun 2018

Quality measurement of Indian commercial hospitals – using a SERVQUAL framework

Author: Sadia Samar Ali1; Basu, Arati2; Ware, Nilesh31 College of Engineering for Girls, King Abdul-Aziz University, Jeddah, Saudi Arabia2 Department of Economics, New Delhi Institute of Management, New Delhi, India3 Defence Institute of Advanced Technology, Pune, India

Publication info: Benchmarking ; Bradford  Vol. 25, Iss. 3,  (2018): 815-837.

The purpose of this paper is to understand and compare the level of patients’ expectations of healthcare services and their perceived performance. The paper also provides insights into the specific service factors and quality of hospital services which are required to meet the needs of Indian patients.

A total of 210 exit interviews were conducted using a structured questionnaire addressing the probable factors of quality related to healthcare services in a five-point Likert scale. The survey was conducted among the patients recently discharged and about to be discharged from private hospitals of Delhi and NC. A set of questionnaires is administered to collect responses on expected and perceived service qualities.

The paper reviews and discusses the importance of service quality for Indian patients using the SERVQUAL gap model as the measure of service quality. The results gave an overview of the perspectives of Indian patients on the quality of service in private hospitals. Patients indicated best satisfaction in some dimensions of services, namely, the tangible dimension of “hospitals provide ample parking spaces,” empathy dimension of “Doctors are never too busy to respond to my request”, assurance dimension of “I can depend on Doctor/Nurse,” and in the responsiveness dimension of “employees always communicate truly” on hospital matters.

The first limitation is in the scope of sample, that is research findings are limited to Delhi. The second limitation is that the research should have been done in two parts, that is by contacting the patient before they take the services and after the service encounter. Third limitation – for a better understanding, the analysis should have been performed on the gap between the patient’s perception and the perception of the medical service provider about the customer’s perception.

This research would be beneficial to healthcare organizations to do their best to achieve greater patient satisfaction. The findings of the paper that, for all dimensions, the patient’s perception is always higher than the expectation suggests that in the Indian healthcare segment, there is a need of dissemination of information regarding the most modern medical facilities.

This current research is concluded with the suitability of a model that can be used to find the levels of patient satisfaction for healthcare services. The present study is based on primary data and offers a systematic procedure that could form the cornerstone for providing further insights into the conceptual and empirical comprehension of patients perceived service quality and its constituents. The current emergency medicine patient’s service dilemmas are a complex interaction of patients and physician factors specifically targeting efficiency and patient satisfaction. The awareness of these issues particular to the emergency patient can help to maximize efficiency, minimize subsequent medico-legal risk and improve patient care if a tailored management plan is formulated.

Subject: Doctors; Emergency medical services; Medical research; Patients; Hospitals; Empirical analysis; Patient satisfaction; Quality assessment; Health care; Perception; Customer services; Health services; Quality of care; Brand loyalty; Quality of service; Customer satisfaction; Corporate image; Economic development; Internal customers; Health care industry; Research; Medical tourism; Literature reviews

Business indexing term: Subject: Brand loyalty Quality of service Customer services Customer satisfaction Corporate image Economic development Internal customers Health care industry; Industry: 92611 :‎ Administration of General Economic Programs 62211 :‎ General Medical and Surgical Hospitals

Classification: 92611: Administration of General Economic Programs; 62211: General Medical and Surgical Hospitals

Pages: 815-837

Milestone dates: 2016-05-01 (Received) 2017-03-30 (Revised) 2017-05-19 (Accepted)

DOI: http://dx.doi.org/10.1108/BIJ-05-2016-0060

ProQuest document ID: 2081580777

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/quality-measurement-indian-commercial-hospitals/docview/2081580777/se-2?accountid=7139

Spatio-Temporal Dynamics of the Global Medical Tourism

Author: Chistobaev, Anatoliy I1; Semenova, Zoya A21 Saint Petersburg State University, Russia [email protected] Saint Petersburg State University, Russia [email protected]

Publication info: Journal of Environmental Management & Tourism ; Craiova  Vol. 9, Iss. 2(26),  (Spring 2018): 267-275.

The study focuses on the emergence and development of medical tourism at the global and country levels. Article provides a definition of a medical tourism, reveals the stages of its formation - from the origin at ancient cultures to modern high technologies of biomedicine. The country ranking results held on the basis of an integrated index, featuring the assessment of the level of equipment at the medical infrastructure, the maintenance of hospitals, the availability of qualified specialists is discussed. The best practices of medical tourism are analyzed. It is shown that due to lower prices and higher service quality, the geographic vector of those wishing to receive treatment abroad is shifting to Asian countries. The need to strengthen the attention of government agencies to the development of medical tourism in the public and private health sectors is noted.

Subject: Geography; Geopolitics; Health care policy; Studies; Public health; Integrated approach; Resorts & spas; Medical tourism; SWOT analysis; Marketing; Infrastructure; Environmental management; Globalization; Health care; Physicians; Regions; Rehabilitation; Regional studies

Business indexing term: Subject: SWOT analysis Marketing Infrastructure Environmental management Globalization; Industry: 72111 :‎ Hotels (except Casino Hotels) and Motels 54162 :‎ Environmental Consulting Services 62111 :‎ Offices of Physicians

Location: Thailand Malaysia

Classification: 72111: Hotels (except Casino Hotels) and Motels; 54162: Environmental Consulting Services; 62111: Offices of Physicians

Issue: 2(26)

Pages: 267-275

Publication date: Spring 2018

DOI: http://dx.doi.org/10.14505/jemt.v9.2(26).06

ProQuest document ID: 2078757458

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/spatio-temporal- dynamics-global-medical-tourism/docview/2078757458/se-2?accountid=7139

Copyright: Copyright ASERS Ltd Spring 2018

Regionalizing Health Security: Thailand's Leadership Ambitions in Mainland Southeast Asian Disease Control

Author: Wenham, Clare11 Assistant Professor of Global Health Policy in the Department of Health Policy, London School of Economics and Political Science, United Kingdom

Publication info: Contemporary Southeast Asia ; Singapore  Vol. 40, Iss. 1,  (Apr 2018): 126-151.

Since the emergence of HIV/AIDS and SARS, Thailand has understood the security threat posed by disease and has responded by investing in the country's disease control infrastructure, such as through the development of the Field Epidemiology Training Program (FETP), improving pandemic preparedness, and collaborating with other states, international organizations, non-governmental organizations and private initiatives to ensure health security. This has led to the creation of a multi-stakeholder subregional governance network for disease control. However, underpinning this network is the individual transformation of Thailand, which, beyond acting as a norm entrepreneur, has scaled up its activities in disease control to become a would-be leader in disease control in mainland Southeast Asia. By using Lake's conceptions of hierarchy and Nolte's understanding of regional power, this article shows how Thailand has taken on this leadership role and has been able to dominate the normative processes of subregional disease control and in doing so has strengthened its own economic and national security. Moreover, this article draws conclusions for regional governance more broadly, through examining power dynamics between states within the arrangement.

Subject: Entrepreneurship; Infectious diseases; Acquired immune deficiency syndrome--AIDS; Human immunodeficiency virus--HIV; Training; Leadership; Influenza; National security; International organizations; Medical tourism; Global health; Severe acute respiratory syndrome; Networks; Regional security; Power; Pandemics; Epidemiology; Governance; Disease control; Health care policy; Regional government; Health initiatives; Infrastructure; Transformation; Entrepreneurs; Economic policy; International relations; Threats; Hierarchies; Nongovernmental organizations--NGOs; Preparedness

Business indexing term: Subject: Entrepreneurs Leadership Economic policy International relations; Industry: 92611 :‎ Administration of General Economic Programs 92811 :‎ National Security

Location: Thailand United Kingdom--UK Asia Southeast As ia

Company / organization: Name: World Health Organization; NAICS: 923120; Name: Association of Southeast Asian Nations--ASEAN; NAICS: 928120

Classification: 92611: Administration of General Economic Programs; 92811: National Security

Publication title: Contemporary Southeast Asia; Singapore

Pages: 126-151

Publication date: Apr 2018

Publisher: ISEAS - Yusof Ishak Institute

Place of publication: Singapore

Country of publication: Singapore, Singapore

Publication subject: History--History Of Asia, Political Science

ISSN: 0129797X

e-ISSN: 1793284X

DOI: http://dx.doi.org/10.1355/cs40-1f

ProQuest document ID: 2026950676

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/regionalizing-health-security-thailands/docview/2026950676/se-2

Copyright: Copyright ISEAS - Yusof Ishak Institute Apr 2018

Last updated: 2021-10-14

Database: ABI/INFORM Collection; Military Database; Social Science Premium Collection

Considering the Tax Benefits of Medical Tourism: Additional Savings for Taxpayers Seeking Care Abroad: Certified Public Accountant

Author: Hart, Dana L; Slater, Robert; Kavan, C Bruce

Publication info: The CPA Journal ; New York  Vol. 88, Iss. 3,  (Mar 2018): 48-52.

Medical tourism refers to traveling to a foreign destination for the purpose of receiving medical treatment. Americans are traveling abroad in record numbers to take advantage of cost savings associated with medical services and procedures. Medical expenses, whether incurred abroad or within the United States, may provide significant taxpayer benefits as well. The authors describe various tax considerations associated with medical tourism.

Subject: Drugs; Travel; Transplants & implants; Medical tourism; Medical treatment; Surgery; Savings accounts; Cost control; Taxpayers; Heart surgery; Hospitals; Licenses; Meals; Caregivers

Business indexing term: Subject: Savings accounts Cost control Taxpayers; Industry: 62211 :‎ General Medical and Surgical Hospitals

Publication title: The CPA Journal; New York

Pages: 48-52

Publication date: Mar 2018

Section: DEPARTMENTS | Federal Taxation

Publisher: New York State Society of Certified Public Accountants

Place of publication: New York

Country of publication: United States, New York

Publication subject: Business And Economics--Accounting

ISSN: 07328435

ProQuest document ID: 2185798100

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/considering-tax-benefits-medical-tourism/docview/2185798100/se-2?accountid=7139

Copyright: Copyright New York State Society of Certified Public Accountants Mar 2018

THE ROLE OF PSYCHOLOGICAL CAPITAL ON NURSING PERFORMANCE IN THE CONTEXT OF MEDICAL TOURISM IN MALAYSIA

Author: Nasurdin, Aizzat Mohd1; Ling, Tan Cheng1; Khan, Sabrina Naseer11 Universiti Sains Malaysia

Publication info: International Journal of Business and Society ; Sarawak  Vol. 19, Iss. 3,  (2018): 748-761.

The rising importance of medical tourism to a country's economic growth has necessitated the need for healthcare employees particularly those from the private sector to always perform at their best level. Since nurses represent the largest workforce component in healthcare, their performance would have a salient impact on international patients' perception of service quality and satisfaction. Psychological capital has been identified as a contributor to employee job performance. Hence, the purpose of this study is to examine the effects of four psychological capital dimensions (self-efficacy, hope, resilience and optimism) on nurses' job performance (task performance and contextual performance). Statistical analysis using Partial Least Squares (PLS) conducted on the questionnaire data from 639 staff nurses working in private hospitals in Malaysia revealed that all psychological capital dimensions except for resilience have positive effects on the two forms of job performance. Finally, finding implications, limitations, future research suggestions and conclusion are proffered.

Subject: Patients; Medical tourism; Medical treatment; Nurses; Competition; Competitive advantage; Employees; Gross National Income--GNI; Quality of service; Developing countries--LDCs; Industrialized nations; Chief executive officers; Health care industry

Business indexing term: Subject: Competitive advantage Employees Gross National Income--GNI Quality of service Developing countries--LDCs Industrialized nations Chief executive officers Health care industry

Publication title: International Journal of Business and Society; Sarawak

Pages: 748-761

Publisher: Universiti Malaysia Sarawak

Place of publication: Sarawak

Country of publication: Malaysia, Sarawak

ISSN: 15116670

ProQuest document ID: 2393110443

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/role-psychological-capital-on-nursing-performance/docview/2393110443/se-2?accountid=7139

Copyright: Copyright Universiti Malaysia Sarawak 2018

LINKING SOCIAL SUPPORT, WORK ENGAGEMENT AND JOB PERFORMANCE IN NURSING

Publication info: International Journal of Business and Society ; Sarawak  Vol. 19, Iss. 2,  (2018): 363-386.

This study aims to first, explore the differential effects of three forms of social support (perceived organizational support, perceived supervisory support, and perceived peer support) on nurses' job performance, and second, test the mediating role of work engagement in the social support-job performance relationship. Survey data was gathered from 639 staff nurses from nine private hospitals in Malaysia. Partial least squares technique was used to test the research hypotheses. Results showed that of the three forms of social support, peer support alone has a direct and positive effect on job performance. Further, the results supported the role of work engagement as a mediator in the relationships between the three forms of social support and performance.

Subject: Research; Patients; Social exchange theory; Social support; Health care policy; Personal health; Peer tutoring; Medical tourism; Nursing; Quality; Nurses; Health services; Clinical outcomes; Employees; Health care industry; Supervisors

Business indexing term: Subject: Employees Health care industry Supervisors

Pages: 363-386

ProQuest document ID: 2392466906

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/linking-social-support-work-engagement-job/docview/2392466906/se-2?accountid=7139

An Assessment of Competitive Factors in Medical Tourism: New Research Opportunity for Turkey

Author: Ege, Seyda Dundar1; Uslu, Yeter Demir11 Department of Health Management, Istanbul Medipol University, Istanbul, Turkey

Publication info: International Journal of Research in Business and Social Science ; [Istanbul  Vol. 7, Iss. 2,  (2018): 14-21.

Increasing globalization of the healthcare sector indicates that there are new opportunities foremerging markets to take a bigger share from the whole healthcare industry. This is realized in the form of medical tourism where people prefer to travel to different destinations to receive medical treatments and services. Medical tourists prefer to travel for several reasons like low cost, high quality care or shorter waiting periods. The industry is growing rapidly and the annual expenditure is estimated to be around US$ 30 billion at the end of 2019. The challenging amount of expenditure whets the appetite of the countries and competitiveness becomes crucial to take more market share in this respect. Therefore the factors that build up competitiveness is identified and assessed thoroughly. This paper makes a literature review on the subject and recommends a New research opportunity for Turkey in this field.

Subject: Women's health; Medical treatment; Cross cultural studies; Travel; Medical tourism; Expenditures; Competitive advantage; Market research; Developing countries--LDCs; Health care industry; Market shares; Marketing; Infrastructure; Emerging markets; Cost control; Medical technology; Hospitals; Health care expenditures; Patients

Business indexing term: Subject: Competitive advantage Market research Developing countries--LDCs Health care industry Market shares Marketing Infrastructure Emerging markets Cost control; Industry: 54191 :‎ Marketing Research and Public Opinion Polling 62211 :‎ General Medical and Surgical Hospitals

Location: Thailand Mexico Turkey United States--US India Singapore Costa Rica Malaysia Asia Panama South Korea

Classification: 54191: Marketing Research and Public Opinion Polling; 62211: General Medical and Surgical Hospitals

Pages: 14-21

DOI: [http://dx. doi.org/10.20525/ijrbs.v7i2.876]http://dx. doi.org/10.20525/ijrbs.v7i2.876

ProQuest document ID: 2203089613

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/assessment-competitive-factors-medical-tourism/docview/2203089613/se-2?accountid=7139

Copyright: Copyright Society for the Study of Business and Finance 2018

Turismo medico en la ciudad de barranquilla: análisis de contexto para la creación de un clúster

Author: Beatriz Díaz Solano; Delio Triviño Orozco; Divina Ovalle Alvarez

Publication info: Revista de Economía del Caribe ; Barranquilla  Iss. 21,  (Jan 2018): 129-157.

The purpose of this article is to give an overview of medical tourism in Barranquilla, as a base from which to create a cluster. The study used a mixed methodology, using in depth interviews with relevant players and working with secondary sources in order to evaluate the extent and quality of medical services. A principal result was the identification of only three accredited health care institutions in the entire city, out of 390 medical facilities. There exists a culture of self-sufficiency and individual service not conducive to group formation. In addition, the level of bilingualism is insufficient for medical tourism needs. Relevant conclusions are that a greater number of accredited medical facilities are needed, as well as a region wide view of tourism that allows for the formation of relevant complimentary services.

Este artículo propone la caracterización del sector turismo

médico de la ciudad de Barranquilla, como diagnóstico para la

conformación de un clúster. Se basó en una metodología mixta,

realizando entrevistas a profundidad a diferentes actores claves

del sector y trabajando con información de fuentes secundarias

que permitieron caracterizar la amplitud y calidad de los servicios

prestados. Como principales resultados fue posible identificar que

solo se cuenta con tres (3) instituciones de salud acreditadas, en

la ciudad Barranquilla, de 390 habilitadas. Existe una cultura

empresarial individualista en el sector y el nivel de bilingüismo

es deficiente para el servicio de turismo en salud. Como conclusiones

relevantes se expone la necesidad de contar con un mayor

número de entidades acreditadas, así como una visión turística

de región que permita el encadenamiento de servicios complementarios

de turismo.

Subject: Health facilities; Medical tourism; Culture

Identifier / keyword: Turismo Médico Clúster Competitividad Desarrollo Regional

Alternate title: medical tourism in the city of Barranquilla: a contextual analysis for the implementation of a cluster

Pages: 129-157

Publication date: Jan 2018

Section: Artículo científico

ProQuest document ID: 2064345399

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/turismo-medico-en-la-ciudad-de-barranquilla/docview/2064345399/se-2

Copyright: Copyright © 2018. This work is licensed under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Kazakistan - Türkiye Sağlık Turizmi: Sağlık Sektörlerine Bakış ve Potansiyeller 1,2

Author: Öğüt, Kaan1; Yeşilyurt, Serkan2; Yurtseven, Çağlar31 Asst. Prof., PhD., Bahcesehir University, Faculty of Economics Administrative and Social Sciences, Istanbul, Turkiye, [email protected] (ORCID ID : 0000-0002-3090-003X)2 Lecturer, Bahcesehir University, Faculty of Economics Administrative and Social Sciences, Istanbul, Turkiye, [email protected] (ORCID ID : 0000-0002-4462-6238)3 Asst. Prof., PhD., Bahcesehir University, Faculty of Economics Administrative and Social Sciences, Istanbul, Turkiye, [email protected] (ORCID ID : 0000-0002-8397-6740)

Publication info: Business and Economics Research Journal ; Bursa  Vol. 9, Iss. 1,  (2018): 57-74.

This study comparatively analyzes the two rising members of the Turkish world, Kazakhstan and Turkey, in terms of the health statuses of its citizens and health sectors. It unfolds the general health structure of both countries with a comparative perspective and sets out the potential in the health tourism from Kazakhstan to Turkey using economic method. The study projects the number of health tourists who can come to Turkey from Kazakhstan and the income that can be obtained from this tourism under different scenarios. Every year, according to Turkstat, Turkey accommodates 3.2%, of the Kazakhstan health tourism market departing from Kazakhstan, which grows, in terms of World Health Organization, on average 12% yearly. The original finding of the study is the calculation by utilizing the S growth method that how much additional income and added value can be created in the case of Turkey raising its share in Kazakhstan health tourism market. Health tourism is one of the priority areas for the Turkish economy and is developing rapidly. It is estimated that this priority area will be able to contribute close to $ 3 billion to direct income and $ 6 billion to GSHY by 2030, with an exponential growth that can be initiated by effective promotional and marketing activities for the Kazakhstan market.

Subject: Studies; Medical tourism; Comparative analysis; Priorities

Location: Kazakhstan Turkey

Alternate title: Health Tourism between Kazakhstan and Turkey: Outlook on Health Sectors and Potentials

Publication title: Business and Economics Research Journal; Bursa

Pages: 57-74

Publisher: Adem Anbar

e-ISSN: 13092448

DOI: http://dx.doi.org/10.20409/berj.2018.93

ProQuest document ID: 2003276039

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/kazakistan-türkiye-sağlık-turizmi-sektörlerine/docview/2003276039/se-2?accountid=7139

Copyright: Copyright Adem Anbar 2018

The perceived role of Islamic medical care practice in hospital: the medical doctor’s perspective

Author: Rahman, Muhammad Khalilur1; Zailani, Suhaiza1; Ghazali Musa11 Faculty of Business and Accountancy, University of Malaya, Kuala Lumpur, Malaysia

Publication info: Journal of Islamic Marketing ; Bingley  Vol. 9, Iss. 1,  (2018): 2-18.

This study aims to investigate the perceived role of the Islamic medical care practice of Muslim doctors in Malaysian Muslim-friendly private hospitals.

Data were collected through self-administered questionnaires voluntarily submitted by the respondents. The survey covered selected major Muslim-friendly private hospitals in the country in the states of Kedah, Johor, Penang, Selangor, Kelantan, and Kuala Lumpur. The non-probability purposive sampling was used, as the respondents and locations of the survey areas were predetermined.

Five dimensions of the Muslim-friendly medical care practice were identified, namely, medical etiquettes, physical examination, proper cleansing process of blood and body fluids, proper handling and treatment of infectious diseases and doctors’ advice to Muslim patients. The findings also indicate that the scale development analysis produced excellent results which can be used for reproducible or repetitive medical care purposes and for integration facts and figures for inclusion into wider medical care policy and practices.

The results from the study can further develop Islamic medical care practices and enable medical service providers to upgrade their performances to an enviable strategic status.

Islamic medical care is a new mode of healthcare service market, as there are very few studies on this topic from the perspective of Muslim patients or no obvious facts are known. This study has first explored Muslim doctors’ perceived role in Islamic medical care practice in Malaysian Muslim-friendly private hospitals. This empirical study can immensely contribute to the further development of Islamic medical care practice for Muslim doctors in particular and for the Muslim-friendly hospital service marketing strategy in general.

Subject: Religion; Medical tourism; Islamic law; Studies; Spirituality; Physicians; Patients; Etiquette; Culture; Medical ethics; Research centers; Muslims; Values; Health care; Hospitals; Islamic life & ethics; Medical practices

Business indexing term: Industry: 62111 :‎ Offices of Physicians 62211 :‎ General Medical and Surgical Hospitals

Location: Malaysia Kuala Lumpur Malaysia

Company / organization: Name: University of Malaya; NAICS: 611310

Classification: 62111: Offices of Physicians; 62211: General Medical and Surgical Hospitals

Publication title: Journal of Islamic Marketing; Bingley

Pages: 2-18

ISSN: 17590833

e-ISSN: 17590841

Milestone dates: 2016-01-22 (Received) 2017-01-06 (Revised) 2017-01-23 (Accepted)

DOI: http://dx.doi.org/10.1108/JIMA-01-2016-0006

ProQuest document ID: 1999517265

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/perceived-role-islamic-medical-care-practice/docview/1999517265/se-2?accountid=7139

Financial Returns of Pharmaceutical American Depository Receipts (ADRs): Do They Perform Better than U.S. Pharmaceuticals or S&P 500?

Author: Nandy, Subhashis1; Sussan, Fiona11 Center for Global Business and Information Technology Research, School of Advanced Studies, University of Phoenix

Publication info: Review of Integrative Business and Economics Research ; Hong Kong  Vol. 7, Iss. 2,  (2018): 18-30.

Abstract: [...]surgeons or robots do perform remote tele-surgeries and together they will have a dramatic impact on the healthcare industry worldwide. [...]although 3-year has been viewed as a long-term window for market timing strategy, we believe there are situations that portfolio managers will buy-and-hold ADRs longer than 3 years. [...]there is added value to investigate industry- specific performance of ADRs. [...]from medium annual return presented in the fifth column in the same Table reported six (five) ADRs having positive (negative) returns, and three (two) U.S. pharmaceutical firms have positive (negative) returns.

Subject: Surgeons; Financial analysis; Hypothesis testing; Researchers; Ratios; Medical tourism; Research & development--R & D; Pharmaceuticals; Surgery; Hypotheses; Studies; Drugs; Mutual funds; Pharmaceutical industry; International finance; Health care industry; Treasury bills; Portfolio management; Stock exchanges; Institutional investments; Capital markets; Securities markets; Expected utility; Asset management; New stock market listings; Market timing

Business indexing term: Subject: Mutual funds Pharmaceutical industry International finance Health care industry Treasury bills Portfolio management Stock exchanges Institutional investments Capital markets Securities markets Expected utility Asset management New stock market listings Market timing; Industry: 52599 :‎ Other Financial Vehicles 52591 :‎ Open-End Investment Funds 62111 :‎ Offices of Physicians 32541 :‎ Pharmaceutical and Medicine Manufacturing

Company / organization: Name: New York Stock Exchange--NYSE; NAICS: 523210

Classification: 52599: Other Financial Vehicles; 52591: Open-End Investment Funds; 62111: Offices of Physicians; 32541: Pharmaceutical and Medicine Manufacturing

Publication title: Review of Integrative Business and Economics Research; Hong Kong

Pages: 18-30

Publisher: Society of Interdisciplinary Business Research

Place of publication: Hong Kong

Country of publication: Hong Kong, Hong Kong

ISSN: 24146722

e-ISSN: 23041013

ProQuest document ID: 1969778454

Document URL: https://uiwtx.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/financial-returns-pharmaceutical-american/docview/1969778454/se-2?accountid=7139

Copyright: Copyright Society of Interdisciplinary Business Research 2018

  • Anil Punamchand Bankar

Anil Punamchand Bankar

Anil Punamchand Bankar IP Learning FZ LLC

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  • College of Applied Health Sciences
  • Ajman, United Arab Emirates
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phd in medical tourism

Medical tourism

Patient, organisational and system-level perspectives, groups related to this event.

Centre for Health Informatics

Centre for Health Systems and Safety Research

Centre for Healthcare Resilience and Implementation Science

Thursday, 6 August 2015

Medical Tourism: patient, organisational and system-level perspectives

‘Medical tourism’ is a type of patient or consumer mobility whereby individuals travel outside their own country of residence with the primary intention of receiving medical (usually elective surgery) treatment, incurring out-of-pocket and third-party payments. The medical tourism industry is almost entirely unregulated and this has potential risks for those travelling abroad. Drawing upon the results of a funded study the seminar outlines evidence concern.

  • Who goes where, and for what.
  • Patient motivation and decision-making.
  • Issues relating to quality, safety and risk.
  • Implications for local and destination health systems.

Speaker profile

Neil Lunt

Neil Lunt is Reader in Social Policy, Department of Social Policy and Social Work, University of York. He was lead on an NIHR-funded project ‘Inward and outward implications for the NHS of Medical Tourism’ (2011-2014).

He has interests in the organisation, management and delivery of health and social services, and the global mobility of patients, professionals and families.

He has published on these and related issues in a range of journals including Social Science & Medicine , British Medical Journal and Policy & Politics . He is co-editor of the Handbook of Medical Tourism and Patient Mobility (Elgar, 2015).

Date: 6 August 2015

Time: 12-1 pm

Venue: Level 1 Seminar Room, 75 Talavera Road

Chairperson: A/Prof David Greenfield

Content owner: Australian Institute of Health Innovation Last updated: 11 Mar 2024 7:03pm

phd in medical tourism

PhD Dissertation Topic Ideas on Medical Tourism

Medical Tourism is the process of travelling outside to receive medical treatment. Initially, the term applied to patients travelling from less-developed areas to developed countries in need of services that were not available in their home countries (1) .

phd in medical tourism

Medical tourism and its importance:

Today, we’re seeing Qualitative and Quantitative changes in patient migration as patients move from more developed to less developed countries searching for health care. The comparatively low cost of treatments in less developed countries, the proliferation of low-cost airlines, and improved marketing and online patient awareness about medications’ availability are behind this medical services transition (2) .

Introduction

Medical tourism is rising in importance as a business and as a field of study in academia. Hospital tourism is a form of healthcare tourism where patients can access medical facilities outside their home country for treatment or recovery (3) . Even though medical tourism and healthcare tourism are often used interchangeably, healthcare tourism is an umbrella word that includes medical tourism and thermal health tourism, spa-wellness tourism, and elderly/disabled tourism. Cardiovascular surgery, radiotherapy, organ transplantation, miscarriage and IVF therapies, aesthetic/plastic surgery, dialysis treatment, and dental and eye care are also examples of Medical Tourism Services (4) .

Review of medical tourism topics for PhD Dissertations

1. The Picture of Medical Tourism Destinations and the Plan to Return: A Review of Chinese Medical Tourists in Malaysia

Huei Cham et al. (2021)

The medical tourism industry’s increasingly competitive nature has pressured destination marketers to continuously attract new international medical tourists and revisit the future destination.
2. Impacts of Service Quality, Satisfaction and Trust on the Loyalty of Foreign Patients in Malaysian Medical Tourism

Aljumah et al. (2020)

This study will be beneficial to the Malaysian medical tourism hospitals’ management to improve their service quality and service delivery by making a customised plan. By having an efficient service delivery directed to the foreign patient tourists, the foreign patients’ loyalty could be improved for the Malaysia hospitals
3. Data mining network text study of medical tourism in newspapers: the case of South Korea

. S et al. (2019)

Therefore, future studies should collect and analyse data that reflect medical tourists’ direct experiences from SNS, such as Twitter, blogs, and Facebook. Additionally, because not all newspaper articles on medical tourism were collected, there are limitations concerning the generalisation of this study’s results to perceptions of medical tourism.
4. Medical Tourists’ Future Destination Choice

Abu Hassan et al. (2018)

The results of this study will underline that destination marketers must take particular consideration of the image factor as this will affect tourists’ future destination choice. Interestingly, the research will uncover the dimensions of Malaysia’s destination image manifested by underlying factors of tourism destination attractions and medical healthcare attractions.

  Current researches in medical tourism

Medical tourism (MT) is an essential part of many countries’ service economies. As a result, understanding the targeting and recruiting of MT patients is crucial for MT providers. Health tourism (MT) is becoming a more important feature of many countries’ service economies. Health treatment has been successfully packaged and sold in both industrialised and emerging environments. The range of remedies available varies from bariatric care and fertility therapy to several cosmetic and non-essential procedures. Medical tourists seek healthcare abroad for several reasons, including consistency, the pace of access to care, and even tourism activity linked to the medical facility’s location (5) .

The majority of study has concentrated on the reasons of people who engage in medical tourism, also known as “medical tourists.” the relative cost of domestic treatment (broadly described as ‘cost savings’); the comparative waiting period for domestic treatment (‘long waiting lists’); healthcare quality; a variety of facilities and choice; Inadequate or non-existent insurance; right to protect confidentiality and privacy; cultural affinity in terms of language, norms, faith, and food; access to the most cutting-edge technology and treatments; therapies inaccessible (‘circumvention tourism’) or unaffordable in their home countries; mistrust and unfamiliarity with the receiving country’s healthcare systems (6)

Further Research of PhD topic on medical tourism

Medical tourism is growing in importance, and tourism companies cannot continue to ignore it.

  • The variables that influence medical tourists’ choice (e.g., adequate sample size) of destinations can be studied using quantitative approaches to assess the market for medical tourism.
  • Medical tourism supply in a given region or nation may be examined using qualitative approaches. (e.g. highly trained health workers)
  • To expose the current situation in a given region or area, a combined analysis encompassing both supply and demand viewpoints and using both qualitative and quantitative methods may be conducted.
  • A longitudinal study of a specific medical tourism destination will allow for a more in-depth examination of both supply (e.g. countries  provide universal healthcare) and demand over time (e.g. shifts within nations).
  • A cross-cultural analysis of the medical tourism industry in two or more regions or countries may be conducted (7) .

Conclusion:

Even though medical tourism, a growing and profitable tourism industry, has gotten a lot of attention in recent years, particularly in developed countries, only a few academic studies on the topic have been written. The purpose of this thesis is to afford a detailed theoretical context for future studies, given the lack of scholarly literature in this field.

We consider using both Qualitative and Quantitative Methods to validate the model in every medical tourism destination. The findings will aid in revealing the current state of affairs in the goal. They will provide invaluable information to private and public sector players in the medical tourism industry (8) .

  • Tat-Huei Cham, Yet-Mee Lim, Bee-Chuan Sia, Jun-Hwa Cheah & Hiram Ting (2021) Medical Tourism Destination Image and its Relationship to Revisit: A Study of Chinese Medical Tourists in Malaysia, Journal of China Tourism Research, 17:2, 163-191,
  • Aljumah, A., M. T. Nuseir, and A. Islam. “Impacts of service quality, satisfaction and trust on the loyalty of foreign patients in Malaysian medical tourism.”  International Journal of Innovation, Creativity and Change 2 (2020): 451-467.
  • Hassan, Norhaslin Abu, and Mohamad Abdullah Hemdi. “Medical Tourists’ Future Destination Choice.”  Asian Journal of Behavioural Studies 13 (2021): 117-127.
  • Kim, Sohyeon, and Won Seok Lee. “Network text analysis of medical tourism in newspapers using text mining: The South Korea case.”  Tourism Management Perspectives 31 (2020): 332-339.
  • Karadayi Usta, Saliha, and Seyda SerdarAsan. “A conceptual model of medical tourism service supply chain.”  Journal of Industrial Engineering and Management 2 (2020): 246-265.
  • J., Praveenkumar, K., & Vinayagamoorthi, G. (2019). Medical tourism in India. International Journal of Recent Technology and Engineering, 8, 695-698.
  • Al-Talabani, H., Kilic, H., Ozturen, A., & Qasim, S.O. (2019). Advancing medical tourism in the United Arab Emirates: Toward a sustainable health care system. Sustainability (Switzerland), 11(1).
  • Abadi, F.A., Sahebi, I.G., Arab, A., Alavi, A., & Karachi, H. (2018). Application of best-worst method in evaluation of medical tourism development strategy. Decision Science Letters, 7, 77-86.

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  • Rom J Ophthalmol
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Medical tourism in ophthalmology - review

Consuela-mădălina gheorghe.

* Department of Marketing and Medical Technology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

Victor Lorin Purcărea

Iuliana-raluca gheorghe.

During the last decade, it seems that we have witnessed an upsurge in medical tourism and its documentation. Definitions often refer more to the terms themselves rather than to the medical tourists and frequently approach discussions using the principles of motivation, procedures, and tourism.

The aim of this review was to investigate the existing literature on medical tourism in health care services, and in Ophthalmology, and to assess whether the principles of medical tourism are successfully applied in health care services, with a specific interest in Ophthalmology services.

Introduction

Literature on medical tourism and especially medical tourism in ophthalmology is scarce, the most common articles and research being the ones related to Dental Medicine, Cardiology, and Plastic Surgery services.

Medical tourism is an umbrella concept used to describe receiving medical care abroad and is defined as the act of leaving one’s own country in order to receive treatments and care overseas or domestically [ 1 ].

Since the internet has the particularity of connecting “customers” to “sellers” in healthcare-related services, online advertising emerged and contributed significantly to the development of various types of tourism. Consequently, the key motivators for medical tourism in ophthalmology are reflected in the availability of information about the treatment and surgeries. Additionally, decisions to purchase ophthalmological care abroad are influenced by the rising cost and the consumerism in the industrialized nations, but the subjective perceptions of the expenses must also be taken into consideration. The healthcare industry considers patient satisfaction as the key component of any medical system, which is based on high quality and innovation [ 1 ].

Moreover, it is argued that medical tourism or medical travel, as it is also referred to, has appeared in the late twentieth century [ 2 ]. However, not all the information about medical tourism is useful or reliable.

Health tourism has hundreds of years of history but has been replaced, at present, by medical tourism, which has rapidly expanded in the last quarter of the century and deals with patients travelling abroad to health centers for medical treatment [ 3 ].

At the same time, medical tourism can be explained as the travel abroad with the aim of benefiting from non-emergency medical services [ 4 ].

The current trend of medical travel dates to Antiquity everywhere in the world. Evidence suggests that various hill tribes from present-day Switzerland traveled to the former German and French colonies to rest at hot springs that, in their opinion, had therapeutic properties. The hot springs and Greek medical facilities were the first hubs dedicated to medical tourism. By that time, yoga and ayurvedic remedies were well established and were receiving a lot of attention in the Western world. The Industrial Revolution accelerated the introduction of new technology and advancements in the medical industry. By the end of the 20th century, the United States had become a major destination for patients traveling abroad for medical care. As the twenty-first century drew near, the medical tourism business become increasingly integrated and coordinated, and was recognized as an independent domain [ 5 ].

The growing trend of medical tourism has started in the late 1990s, when patients started to move to India, Thailand, and Mexico to benefit from cheaper health services than in their own countries.

Medical tourism is considered an economic issue both at the system and individual levels. The decision of the patient to engage in medical tourism refers to the unsatisfied needs in terms of the type of the services being looked for and the way the treatment is applied [ 6 ].

Some authors argue that medical tourism is a form of globalization because its implications remain unknown, although it has both risks and benefits. Basically, it exists due to the high-care costs, long waiting periods or lack of access to new therapies in developed countries [ 7 ]. These are the motivations that convince people to travel to less developed countries for medical assistance.

What is clear is that the concept has an increasing relevance for the two fields, medicine, and tourism, as both use common concepts, as for instance, reputation and images to improve revenues and raise employment in the field [ 8 ].

Although medical tourism has been limited to cosmetic and plastic surgery and dental procedures in the last decades, it has recently expanded to almost all medical specialties, including ophthalmology. It seems that ophthalmology has the most advanced technology of all medical specialties in the world. A raise in demand has been registered for refractive procedures and oculofacial plastic surgery. Also, the countries that are often chosen as destinations for eye procedures are Turkey and Spain.

Romania is mainly known for the SPA like resources, and thermal baths. In addition to being a destination for medical tourism and a source for other medical destinations, primarily West European nations, Romania reflects European trends of increasing patient mobility in search of affordable medical care [ 9 ].

The Romanian Medical Tourism Association claims that the following procedures are appealing to foreign patients: dental work, cosmetic surgery, ophthalmology/ LASIK surgery, interventional cardiology, orthopedic surgery, other surgeries, CT and MRI scans, or SPA treatments for post-surgical recovery [ 10 ]. Bucharest and other important towns in the country, served by functional airports like Cluj-Napoca, Timișoara, Târgu Mureş, Sibiu, Constanța, are the most frequented cities for medical tourism [ 11 ].

As mentioned previously, medical tourism has similarities to and connections with the tourism sector. Diaspora travelers are only vaguely familiar with what is available back “home”, and depending on the seriousness of the surgery, many rely almost completely on word of mouth. Since the internet has taken over, most medical tourism guidebooks that were produced in the middle and late 2000s have not been updated. Although the internet has become essential for marketing, it only predominates in surveys of populations that are not necessarily planning to travel for medical purposes [ 2 ] or in regions where the medical tourism sector is just starting to emerge [ 2 ].

Most prospective patients visit the websites of hospitals and clinics before choosing one, and health providers frequently advertise online. The availability of procedures, dependability, quality, and cost are their main concerns; however, the last one is largely emphasized, except for Asia (where prices are cheaper), on the theory that most prospective patients have already learned about it. Technology-based images of modernity, cleanliness, and apparent efficiency predominate.

Most websites are in the English language and offer information on a variety of procedures, fees, accreditation and affiliations, knowledgeable personnel, opulent wards and accommodations, patient testimonials, and multilingual proficiency. In any type of marketing, technological progress is rarely disregarded [ 2 ].

Medical tourism has been highly influenced by advancements in technology and the quality of life.

Moreover, ophthalmological treatments in Romania are an effective way to recover following a surgery, as they are more affordable than in other industrialized nations and offer a wide range of medical tourism amenities.

The advantages of medical tourism and clearly of medical tourism in ophthalmology are related to cost effectiveness, insurance incentives, luxury and private nursing, vacation in a foreign country and bypassing the rules and regulations.

Cost effectiveness represents the most common reason for seeking cheaper medical care. Regarding insurance incentives, due to observable savings, many insurance organizations have started to promote medical tourism. Only few patients, who are having medical treatments are attracted to the SPA-like centers and treatments that some remote hospitals offer because they can get an advantage and be cared without having to pay extra for travel, surgery, etc. People can combine medical and recreational travel, which is another important factor in medical tourism. Moreover, there are very few medical procedures that are not permitted in the countries where they are performed. Some patients choose to have their surgery performed abroad to avoid following local regulations set forth by the government, insurance company, or hospital [ 5 ].

Disadvantages

Among the disadvantages of medical tourism are the medical, legal and the ethical risks. Risks associated with medical tourism exist and are not present when patients are treated in their homes. Patients frequently travel for medical treatment to countries with significantly different infectious disease epidemiologies than the ones they are from. Form a legal perspective, if a patient experiences a negative result from treatment as a result of a medical error, how would they be able to seek recourse, given the lack of internationally regulated rules pertaining to medical tourism? Numerous ethical dangers can be found in the workplace, when traveling, and afterwards during individual medical operations and rehabilitation. It is important to note that several brokers are engaged in the process of planning the trip and the treatment, and they frequently do not give customers enough information about the procedure and the potential consequences [ 12 ].

Medical Tourism – a business opportunity

Medical tourism can be regarded as a good business opportunity from which the following stakeholders can benefit: medical organizations, patients, travel agencies, national governments, etc.

The field of medical tourism is thought to be worth $100 billion. Very little is known about the primary forces behind medical tourism and how nations are viewed as medical tourism destinations, even though there are a rising number of people, businesses, and governments engaging in it [ 13 ].

During the period 2020-2025, the global medical tourism industry is anticipated to expand at a compound annual growth rate (CAGR) of 8.5 percent. The market is expected to rise as a result of reasons such as increasing healthcare costs in developed countries, new technology, high standards of care around the world, likelihood of having health insurance, and medical tourism advertising [ 5 ].

Since it serves as a hub for information exchange between potential patients and providers across continents, the Internet has had a significant impact on the industry’s growth [ 14 ].

Rules for the patients who resort to medical tourism

When they decide to travel abroad, patients should consider some very important rules such as analyzing all the destinations available that treat the specific medical condition, trying to estimate the cost for consultation and possible surgery, in case it is needed, verifying the professionality of the doctor, verifying if the hospital or medical organization is accredited and has a good reputation, finding information regarding the cleanliness standards, being ensured from a medical point of view before leaving the native country, etc. However, there are also some rules regarding what the patients should not do, while on a medical treatment abroad: should refrain from doing physical exercises that involve physical force, should not leave the country without a consent from the caring doctor/ surgeon, should refrain from any physical activity and rest after any procedure, should not consider only the costs, should have a two-way communication with the doctor/ surgeon, should make reservations in advance, etc.

To conclude, patients should make an appropriate planning and research when deciding to resort to medical tourism.

Reasons for choosing medical tourism in ophthalmology

Patients choose to travel for ophthalmological procedures because they can benefit from the latest technology, advanced treatments, best health care and medical services.

Some of the most important destinations for medical tourism in ophthalmology are Turkey, India, Singapore, etc., and the most common procedures are cataract surgery, corneal transplant surgery, laser eye surgery, glaucoma surgery and treatment, artificial intraocular lens implantation, etc.

Since there is a great deal of variability, it is challenging to define medical tourism, and more in-depth research is needed for most medical tourism services categories. Even while some in the industry prefer the seriousness, accountability, and reliability connected with “medical travel” or “medical migration”, it is still a niche within tourism.

Strengthening the strategic marketing of medical tourism in ophthalmology and travel companies toward sustainable health tourism, it might significantly improve a country’s brand and help to prolong the seasonality of tourism activities.

Furthermore, several sociocultural impacts need to be analyzed, such as making health care less affordable for local patients and/ or moral and ethical concerns about certain treatment methods. Another area of concern, before traveling for medical tourism, relates to the legal issues of risk, liability, and malpractice.

Conflict of Interest statement

The authors state no conflict of interest.

Acknowledgements

Sources of Funding

Disclosures

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Article Contents

Introduction, medical tourism-related infectious diseases, cosmetic tourism, organ transplantation, limitations, acknowledgement, conflict of interest.

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Infectious complications related to medical tourism

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Androula Pavli, Helena C Maltezou, Infectious complications related to medical tourism, Journal of Travel Medicine , Volume 28, Issue 1, January 2021, taaa210, https://doi.org/10.1093/jtm/taaa210

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Medical tourism has been increasing dramatically globally, with people travelling from developed countries to low-income or middle-income countries, often to avoid high costs or long delays associated with seeking healthcare in their countries of origin. The current review summarizes healthcare-related infections associated with medical tourism, focusing on cosmetic surgery and organ transplantation.

A systematic MEDLINE and PubMed search from January 2010 to December 2019 yielded 80 relevant articles, including 49 articles on medical tourism-related infections focusing on cosmetic surgery and organ transplantation, which were included in this reviews.

The literature reveals specific types of cross-border, healthcare-related infections depending on medical intervention. Destinations include low-income countries such as countries of Asia and the Indian subcontinent, middle-income countries including Central and South America, and high-income countries such as the United States and Europe. In terms of type of infections, in 36 (68%) and 15 (28.3%) studies, wound and blood-borne infections were documented, respectively, while in 21 studies (58.3%) non-tuberculous mycobacteria were isolated, including Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium senegalense and Mycobacterium fortuitum. The choices of medical tourists could have significant consequences for them and their home countries, including infectious complications and importation of pathogens, particularly antibiotic-resistant microorganisms, with public health implications.

There is a need for public health strategies in order to prevent morbidity and mortality as well as future management and education of patients engaging in medical tourism.

Medical tourism has been increasing dramatically over the past two decades as a result of globalization, with an estimated 4 million medical tourists annually. 1–4 Medical tourism is defined as ‘international travel with the purpose of obtaining health care for a variety of reasons’. 1 , 5 The concept of medical tourism is certainly not new; ancient Greeks travelled to Asklepieia from all over Greece and Asia Minor, seeking remedies from Asclepius for various illnesses. 6 The most popular medical services include organ transplantation, cosmetic surgery, dental services, bariatric medicine and infertility treatment. The majority of patients often seek healthcare in their World Health Organization (WHO) region of residence; however, travellers visiting friends and relatives may combine medical treatment with family visits. 4 Common destinations mainly include low-income countries such as countries of East and Southeast Asia (e.g. Thailand) and the Indian subcontinent (e.g. India, Pakistan) and middle-income countries such as Central America (e.g. Mexico), South America (e.g. Ecuador) and the Caribbean but also some high-income countries including European countries and the United States. 7

Reasons for medical tourism may relate to cost, long waiting lists or delays, legal and cultural constraints in the home country (e.g. termination of pregnancy, in vitro fertilization); the lack of availability of certain treatments in the country of residence and an interest in combining a medical treatment with an exotic vacation. 1–3

A major challenge of medical tourism includes the insurance portability. In many health institutions, medical professionals providing services to medical tourists are highly skilled and often trained in high-standard medical institutions in developed countries. Foreign institutions are increasingly cooperating with medical schools in terms of education and training. An important advantage of these services is the lower cost. 4 , 7

Despite efforts to understand the cost and benefit to countries experiencing inflows and outflows of patients seeking cross-border healthcare, information about the volume of patient flows and economic expenses, as well as the role of private service providers and brokers and marketing, remain uncertain. 8–10

Globalization of cross-border healthcare is associated with cultural, ethical, legal, financial and medical consequences, including infections. 5 , 10–13 Medical tourists are a vulnerable, sentinel population, who may import infections from the destination countries to their home countries, including emerging, multi-drug resistant (MDR) infections, which in turn constitute a significant public health risk for their home countries. 14 , 15 The current review aims to address the scale and impact of infectious complications in the context of medical tourism, focusing mainly on the most common treatments such as cosmetic surgery and organ transplantation.

A MEDLINE and PubMed search were conducted for articles published from January 2010 to December 2019, using combinations of the following keywords: medical tourism, medical tourism-related infections, cosmetic surgery, MDR organisms, transplant tourism and cross-border healthcare. We read the abstracts of a total of 127 articles found and selected 80 articles based on their relevance. Of them, 49 original articles concerned infectious complications in relation to cosmetic surgery and organ transplantation. The article selection procedure was focused mainly on cosmetic and transplant tourism since most of the data available about infectious complications were related to cosmetic surgery and organ transplantation. During the article screening process, articles focusing on medical tourism-related issues other than infections, such as the financial, ethical and social impact in the home country, were excluded. Evaluation of the quality of the included studies was based on the fact that only peer-reviewed studies published in core medical journals pertaining to infectious complications were selected. In addition, data from review articles referring to medical tourism and implications on infectious diseases and national healthcare systems, as well as information from relevant international websites such as the WHO and the Centres for Disease Control and Prevention (CDC), were used. English and Danish language articles presenting original data on medical tourism-related complications and implications on infectious diseases and healthcare systems were selected for review.

In terms of complications of medical tourism, data were selected mainly about infectious diseases. Medical tourism was defined in accordance with the CDC as follows: ‘international travel with the purpose of obtaining health care for a variety of reasons, such as lower cost, a combination of medical care with a vacation, a preference for care from health professionals who share the individual’s culture, or a procedure or treatment not available in their country of residence.’ 5

The most common categories of procedures that medical tourists pursue include cosmetic surgery, organ and tissue transplantation, bariatric surgery and dental care. 1 , 2 Medical and surgical procedures in medical tourists performed overseas may be associated with infectious complications due to lack of maintenance of facilities’ accreditation or provider’s licensure or maintaining formal medical record privacy or security policies or adequate patient outcome data. 1 , 5 Furthermore, equipment and devices, drugs and medical products used overseas might not be subject to the same regulatory scrutiny as in the country of residence, and also, some drugs may be counterfeit or otherwise ineffective (e.g. expired, contaminated or inappropriately stored). 5

Medical tourists are at risk for healthcare-related infections (e.g. wound, blood-borne and nosocomial infections) and also travel-related infections as a result of exposure to diseases that are endemic to the host country, including malaria, yellow fever, chikungunya and dengue fever. 1 , 5

Infectious complications account for the most common complications among medical tourists. Infections transmitted through medical procedures performed abroad include wound infections, transplant-related infections and acquisition of blood-borne infections, such as hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV), as well as MDR infections. 14–66

Healthcare-related infectious complications may occur early or late, with subsequent public health consequences if pathogens spread during care or after returning home. Travellers and people visiting friends and relatives who require care during travel may be exposed to similar risks (incidental medical tourist). 2 , 5

Multidrug-resistant infections

MDR infections have been increasing worldwide. The highly resistant pathogens include carbapenem-resistant Enterobacteriaceae and non-tuberculous mycobacteria (NTM). The latter are abundant in various environments and behave as opportunistic pathogens, causing localized (skin and soft tissues, lymph nodes, bones, lungs) or disseminated infections, and are more common in several countries where medical tourists are treated, such as Dominican Republic, Mexico, Brazil, Ecuador, Venezuela, India, China, Vietnam, Thailand, Turkey and Tunisia. 39 , 42 , 66–73 NTM are emerging pathogens, which have become increasingly more common in medical tourists. 42 According to recent studies, MDR pathogens of public health concern in medical tourists seeking medical treatment abroad or requiring emergency management for an acute medical condition include: (i) Gram-negative bacilli such as Acinetobacter species, bacteria harbouring Klebsiella pneumoniae carbapememase (KPC) and New Delhi metallo-beta-lactamase (NDM) and bacteria harbouring extended-spectrum beta-lactamases enzymes; (ii) Gram-positive organisms such as methicillin-resistant Staphylococcus aureus , vancomycin-resistant Enterococci and hypervirulent Clostridium difficile and (iii) acid-fast bacilli NTM. 66–73

Healthcare-associated MDR-bacterial infections are greatly heterogeneous. Even ubiquitous nosocomial microorganisms such as S. aureus and K. pneumoniae will harbour vastly different antimicrobial resistance patterns, depending on the area of acquisition. Unsuspected MDR pathogens may have multi-level implications: (i) decreased survival due to inadequate empirical antimicrobial treatment of severe bacterial infection at the patient level; (ii) development of nosocomial outbreaks from patients who serve as index cases at an institutional level and (iii) global transmission of antimicrobial resistance in community microorganisms as a result of inadvertent human carriage at the community level. 67

Cosmetic tourism characterizes a phenomenon of people travelling abroad for aesthetic surgery. The most common procedures include breast and gluteal augmentation, abdominoplasty, liposuction, eyelid surgery and rhinoplasty. 41 , 44 , 74–76 Cosmetic surgery procedures hold a special position among the different types of medical tourism, and they are very popular for different reasons including the low cost as most of the cosmetic procedures have to be paid out of the patient’s own pocket either in their home countries or at destination. Usually, such patients originate from highly industrialized countries and are willing to accept certain risks in order to undergo aesthetic procedures in less developed countries. 44 According to the global statistics released in 2018 by the International Society of Aesthetic Plastic Surgery, 10 607 227 aesthetic surgical procedures were recorded, with breast augmentation surgery being the most requested cosmetic surgical procedure followed by liposuction, eyelid surgery, abdominoplasty and rhinoplasty; the majority of these procedures are performed in the USA, Brazil and Mexico. 76 According to a recent study, most medical procedures performed in medical tourists are carried out in South America, followed by Southeast and Central Europe. 44

The most common complications after cosmetic surgery include infections. Infections after breast implantation occur in 2–3% of aesthetic procedures and acute infections may occur within the first month after the procedure. Bacteria isolated include S. aureus and S. epidermidis , Streptococci, Enterobacteriaceae and Pseudomonas spp. 31 Emerging microorganisms in surgical site infections 41 , 44 also include rare microorganisms such as NTM, which are an emerging pathogen group that has become increasingly more common in patients seeking surgical cosmetic procedures abroad. 19 , 42 , 73 The results of a recent study about returned travellers hospitalized in Finland showed invasive surgical procedures abroad in tropical rather than temperate countries as independent risk factors for colonization with MDR-bacteria. 74

Organ transplantation is an established form of treatment which is considered as the best and often the only life-saving therapy for end-stage organ failure. According to WHO Global Observatory on Donation and Transplantation, more than 130 000 solid organ transplants are performed worldwide, which represent <10% of the global need. However, there is a huge discrepancy in the availability and access to services due to the variation in organ donation between WHO regions. 77 As a result of acute organ shortage, mortality rates of people that are on waiting lists increase or people are forced to receive an organ through illegal and unethical pathways. 78

Potential organ recipients are increasingly travelling abroad for organ transplantation for financial reasons and to decrease the waiting period. 78 , 79 In countries where payment for organ donation is legal, donor screening may be limited; therefore, the risk of acquisition of infections such as HBV, HCV, CMV and HIV increases. 78 , 79 In addition, this group of travellers may be exposed to the risk of acquiring travel-related diseases, such as tuberculosis, malaria, dengue fever, Chagas disease and leishmaniasis, which may be endemic in destination countries. 50–55 Transplant patients are also at risk for Strongyloides stercoralis infection, which is endemic in the tropics and subtropics and may cause hyperinfection syndrome and disseminated disease in immunocompromised patients. 80 Donor-derived infections can be categorized into two categories including ‘expected’ and ‘unexpected’ infections; expected infections pose a known, modest risk to organ recipients and can usually be detected with available laboratory tests and are mostly treatable. 78 Unexpected infections are travel associated and related to recent outbreaks at destination such as outbreaks of Chikungunya, Zika virus, West Nile virus for which diagnostic tests and treatment may not be available at the time of detection. 79 Unexpected and novel infections are estimated to occur in <1% of organ transplant recipients. 78 Immunocompromised recipients may develop severe infection from pathogens with low native virulence, which may serve as new novel or uncommon infections in the community after return. 78

Organ donors or so-called transplant tourists may often become colonized with highly resistant microorganisms, including vancomycin-resistant staphylococci, and MDR Enterobacteriaceae, including isolates that produce NDM-1, leading to bacteria resistant to a wide range of antimicrobial agents. NDM was first identified in India in 2008 and has since been detected in many countries. 76 , 77 This resulted in decreased efficacy of almost all β-lactam antimicrobials, including the carbapenems limiting therapeutic options. Transplant tourists might also be responsible for the transmission of new MDR organisms to other patients during hospitalization, which may propagate large outbreaks of infection. 76 , 77

Table 1 summarizes 49 recent studies in medical tourists with infectious complications according to the procedure performed, focusing on cosmetic surgery and organ transplantation. Breast cosmetic surgery was the most common cosmetic procedure, accounting for 19 (70.4%) cosmetic surgery studies, whereas renal transplantation for 18 (81.8%) organ transplantation studies. Regarding the type of infections, in 36 (68%) and 15 (28.3%) of studies, wound and blood-borne infections were documented, respectively. Multidrug-resistant microorganisms were reported in 21 (58.3%) of all studies reviewed, including NTM such as M. abscessus, M. chelonae, M. senegalense and M. fortuitum.

Medical tourism related infectious complications (2010–2019)

Publication (reference)DateCountry of origin of the studyCountry of destinationProceduresInfectious complications (other than SSI)Wound infection-Causative agent/s
Cosmetic
Parel-Amini . 2019SwitzerlandNorth Africa, Europe, South America, USABreast augmentationNASSI (71% of cases)
and —MDR organisms (47%) including ESBL (extended-spectrum beta-lactamases)-, , , , and sp.
Pereira . 2018IrelandBrazil, Japan, Italy, MexicoWomen: Breast augmentation surgery, liposuction and eyelid surgery
Men: Blepharoplasty, gynecomastia, rhinoplasty
Other procedures: Gluteal lift, abdominoplasty, facelift, buttock augmentation, labiaplasty
NASSI
and
Brightman . 2018AustraliaEurope, South America, South East AsiaBreast augmentationSepsisSSI
Thineshkumar . 2018DenmarkTunisiaIris implantationBilateral eye infection
Gaines . 2018USADominican RepublicCosmetic surgical procedure, unspecifiedNASSI
NTM
Jensen . 2018DenmarkIndiaBreast surgeryBreast infection
Ovadja . 2018NetherlandsDominican Republic/BrazilAbdominoplasty and breast augmentation
A revision augmentation mastopexy (redo Bilateral mamma augmentation)
NASSI
(atypical),
Wilde . 2018United KingdomJordanAnterior chamber iris implantation–bilateral bright ocular implantationUveitis, bacterial keratitisNA
Llenas-García . 2018SpainEcuadorAbdominoplasty, mammoplastyNASSI
NTM
Klein . 2017SwitzerlandSouth America, South East, Central and South Europe, Asia, AfricaBreast surgery (62.4%), body contouring procedures (15.6%), injections with botulinum toxin or fillers (12.8%), facial surgery (4.6%)NASSI (26%)
Cusumano . 2017USADominican RepublicBilateral mastopexy, abdominoplasty, liposuction, bilateral breast augmentationAbdominal wall abscessSSI
Green . 2017New YorkDominican RepublicBilateral breast reductionSkin and soft tissue infectionsRG-NTM
Singh . 2016USADominican Republic, MexicoBreast augmentation, mastopexy, liposuction, bilateral buttock fat injections, abdominoplastyBreast and buttock abscessSSI
RG-NTM:
Rodríguez . 2016ColombiaVenezuelaDermolipectomy, breast augmentationNASSI
sp
Cai . 2016Baltimore (USA)Dominican RepublicAbdominoplasty (41%), liposuction (27%), breast augmentation (14%), breast reduction (9%) and rejuvenation surgery (9%)NASSI
Sharma . 2016USADominican RepublicAbdominoplastyAbdominal abscessSSI
RG-NTM
Schnabel . 2016USADominican RepublicCosmetic surgery-unspecifiedNASSI
Livingston . 2015AustraliaThailandBreast augmentation, labiaplasty, gender reassignment surgery, chin lift, mastopexy, abdominoplasty, brachioplasty, liposuctionNASSI
) and ( ) A fungus was isolated in 1 patient
Yau . 2015AustraliaThailandThread facial rejuvenationFacial abscessSSI
Rüegg . 2015SwitzerlandMexicoBilateral breast implants, left, abdominal liposuction, gluteal lipofillingImplant infection, gluteal abscessSSI
subsp. spp. and
Hui . 2015AustraliaVietnam, China, MexicoBreast augmentation and reduction, liposuction, gluteal lipofilling, fetal stem cell transfusionSubcutaneous abscessSSI
subsp.
Schlarb . 2015GermanyTurkeyAbdominoplastyAbdominal abscessSSI
Zosso . 2015SwitzerlandDominican RepublicLiposuction and liposculptureNASSI
and
Maurer . 2014SwitzerlandDominican Republic, Ecuador, MexicoAbdominal liposuction, breast augmentation, breast reduction, abdominoplastySubcutaneous and deep tissue abscessSSI
subsp. subsp. sp. and ( group)
Schnabel . 2014USADominican RepublicLiposuction, breast augmentation, abdominoplastySurgical wound abscessSSI
Tran . 2014USAMexicoAbdominoplasty, liposuction, buttock fat grafting, mastopexy-augmentationCellulitisSSI
Miyagi . 2012UKEurope, India, Southeast Asia, Middle EastBreast augmentation and reduction, facelift, blepharoplasty, liposuction, abdominoplastyPeritonitisSSI
Organ transplantation
Al Salmi . 2018OmanPakistan, China, Iran, Iraq, Egypt, OmanRenal transplantationInvasive fungal infections (IFIs); Aspergillus species (Aspergillus flavus, Aspergillus fumigatus, Aspergillus nidulans and Aspergillus nigricans) and zygomycetesNA
Al Bugami . 2018Saudi ArabiaChina, Egypt, Iran, Jordan, PakistanRenal transplantationUTI, bacteraemia, Polyoma BK, CMV, fungal infection, HCV, HBV infectionsSSI
Amira . 2017NigeriaIndia, Pakistan, EgyptRenal transplantationInfections (42%): sepsis, urinary tract infection, community-acquired pneumonia, wound infection, pulmonary tuberculosis, CMV, HCV infectionNA
Prasad . 2016CanadaSouth Asia, East Asia, Africa, West Asia, South AmericaRenal transplantationFungal sepsis, cerebrospinal abscess, HBV, HCV infection, pulmonary tuberculosis, extended spectrum beta-lactamase urosepsisSSI
Bonares . 2016CanadaPanama CityProsthetic device (prosthetic vascular and bone graftProsthetic device infectionSSI
Jung . 2015KoreaKorea Renal transplantationCMV infection, BK viremia
Kendall . 2015USAThailandFetal stem cellsSubcutaneous and cutaneous nodules–PanniculitisSSI
and
Althaf . 2014Saudi ArabiaChinaRenal transplantationChronic hepatitis HCV infectionNA
Tsai . 2014TaiwanChinaRenal transplantationBKV infection, Pneumocystis jiroveci pneumonia, tuberculosis and lung fungal infection, bacteraemia (Gram-negative bacilli, )NA
Gomez . 2013USANARenal transplantationDonor-derived opportunistic filamentous fungal infections (DDFFIs)
. (most common organism)
NA
Anker . 2012Saudi Arabia, Taiwan, Hong Kong, Singapore, Europe, USA, UK, CanadaIndia, China, PakistanRenal transplantationCMV, HBV, HCV, HIV, UTI, tuberculosisSSI
Adamu . 2012Kingdom of Saudi Arabia, NigeriaPakistan, Egypt, Philippines, ChinaRenal transplantationInfections (42.2%): UTI, CMV, genital herpes and Varicella virus infection. Isolates of UTI included , (ESBL-producing), and SSI
, and
Cha . 2011KoreaMiddle and South East AsiaRenal transplantationViral infections (EBV, CMV, HSV, BK)
Bacterial infections (respiratory, Genitourinary, GI)
Fungal infections
Protozoa, Mycobacterium
SSI
Tsai . 2011TaiwanChinaRenal transplantationHBV and HCV-related hepatocellular carcinomaNA
Kwon . 2011KoreaChinaRenal or liver transplantationInfection (21.5%): CMV 4.8%, pneumonia (bacterial, tuberculosis, ) 4.6%, UTI 3.9%, HZV 2.1%, BK virus nephropathy 2.1%, pyelonephritis 0.2%SSI (3.7%)
Polcari . 2011USAChina, Pakistan, India, PhilippinesRenal transplantation (purchased)HBV infection , NA
Ivanovski . 2011North MacedoniaPakistanRenal transplantationHCV, CMV, UTI ( or )SSI
Alghamdi . 2010Saudi ArabiaPakistan, Philippines, Egypt, United States, China, Iran, Lebanon, Jordan, SyriaRenal transplantationCMV, HCV infection, UTINA
Allam . 2010EgyptChinaLiver transplantationSepsis, HBV, CMV, EBV infectionsNA
Schiano . 2010USAChinaLiver transplantationSepticemia, biliary sepsis (liver abscess)NA
Yakupoglu . 2010TurkeyEgyptRenal transplantationPyelonephritisSSI
Majid . 2010United Arab EmiratesPhilippines, Pakistan, India, Iran, Syria, Jordan, Lebanon, Egypt, Singapore, Germany, UK, FranceRenal transplantationEBV, CMV, Varicella, HZV
Bacterial UTI
Septicemia
NA
Publication (reference)DateCountry of origin of the studyCountry of destinationProceduresInfectious complications (other than SSI)Wound infection-Causative agent/s
Cosmetic
Parel-Amini . 2019SwitzerlandNorth Africa, Europe, South America, USABreast augmentationNASSI (71% of cases)
and —MDR organisms (47%) including ESBL (extended-spectrum beta-lactamases)-, , , , and sp.
Pereira . 2018IrelandBrazil, Japan, Italy, MexicoWomen: Breast augmentation surgery, liposuction and eyelid surgery
Men: Blepharoplasty, gynecomastia, rhinoplasty
Other procedures: Gluteal lift, abdominoplasty, facelift, buttock augmentation, labiaplasty
NASSI
and
Brightman . 2018AustraliaEurope, South America, South East AsiaBreast augmentationSepsisSSI
Thineshkumar . 2018DenmarkTunisiaIris implantationBilateral eye infection
Gaines . 2018USADominican RepublicCosmetic surgical procedure, unspecifiedNASSI
NTM
Jensen . 2018DenmarkIndiaBreast surgeryBreast infection
Ovadja . 2018NetherlandsDominican Republic/BrazilAbdominoplasty and breast augmentation
A revision augmentation mastopexy (redo Bilateral mamma augmentation)
NASSI
(atypical),
Wilde . 2018United KingdomJordanAnterior chamber iris implantation–bilateral bright ocular implantationUveitis, bacterial keratitisNA
Llenas-García . 2018SpainEcuadorAbdominoplasty, mammoplastyNASSI
NTM
Klein . 2017SwitzerlandSouth America, South East, Central and South Europe, Asia, AfricaBreast surgery (62.4%), body contouring procedures (15.6%), injections with botulinum toxin or fillers (12.8%), facial surgery (4.6%)NASSI (26%)
Cusumano . 2017USADominican RepublicBilateral mastopexy, abdominoplasty, liposuction, bilateral breast augmentationAbdominal wall abscessSSI
Green . 2017New YorkDominican RepublicBilateral breast reductionSkin and soft tissue infectionsRG-NTM
Singh . 2016USADominican Republic, MexicoBreast augmentation, mastopexy, liposuction, bilateral buttock fat injections, abdominoplastyBreast and buttock abscessSSI
RG-NTM:
Rodríguez . 2016ColombiaVenezuelaDermolipectomy, breast augmentationNASSI
sp
Cai . 2016Baltimore (USA)Dominican RepublicAbdominoplasty (41%), liposuction (27%), breast augmentation (14%), breast reduction (9%) and rejuvenation surgery (9%)NASSI
Sharma . 2016USADominican RepublicAbdominoplastyAbdominal abscessSSI
RG-NTM
Schnabel . 2016USADominican RepublicCosmetic surgery-unspecifiedNASSI
Livingston . 2015AustraliaThailandBreast augmentation, labiaplasty, gender reassignment surgery, chin lift, mastopexy, abdominoplasty, brachioplasty, liposuctionNASSI
) and ( ) A fungus was isolated in 1 patient
Yau . 2015AustraliaThailandThread facial rejuvenationFacial abscessSSI
Rüegg . 2015SwitzerlandMexicoBilateral breast implants, left, abdominal liposuction, gluteal lipofillingImplant infection, gluteal abscessSSI
subsp. spp. and
Hui . 2015AustraliaVietnam, China, MexicoBreast augmentation and reduction, liposuction, gluteal lipofilling, fetal stem cell transfusionSubcutaneous abscessSSI
subsp.
Schlarb . 2015GermanyTurkeyAbdominoplastyAbdominal abscessSSI
Zosso . 2015SwitzerlandDominican RepublicLiposuction and liposculptureNASSI
and
Maurer . 2014SwitzerlandDominican Republic, Ecuador, MexicoAbdominal liposuction, breast augmentation, breast reduction, abdominoplastySubcutaneous and deep tissue abscessSSI
subsp. subsp. sp. and ( group)
Schnabel . 2014USADominican RepublicLiposuction, breast augmentation, abdominoplastySurgical wound abscessSSI
Tran . 2014USAMexicoAbdominoplasty, liposuction, buttock fat grafting, mastopexy-augmentationCellulitisSSI
Miyagi . 2012UKEurope, India, Southeast Asia, Middle EastBreast augmentation and reduction, facelift, blepharoplasty, liposuction, abdominoplastyPeritonitisSSI
Organ transplantation
Al Salmi . 2018OmanPakistan, China, Iran, Iraq, Egypt, OmanRenal transplantationInvasive fungal infections (IFIs); Aspergillus species (Aspergillus flavus, Aspergillus fumigatus, Aspergillus nidulans and Aspergillus nigricans) and zygomycetesNA
Al Bugami . 2018Saudi ArabiaChina, Egypt, Iran, Jordan, PakistanRenal transplantationUTI, bacteraemia, Polyoma BK, CMV, fungal infection, HCV, HBV infectionsSSI
Amira . 2017NigeriaIndia, Pakistan, EgyptRenal transplantationInfections (42%): sepsis, urinary tract infection, community-acquired pneumonia, wound infection, pulmonary tuberculosis, CMV, HCV infectionNA
Prasad . 2016CanadaSouth Asia, East Asia, Africa, West Asia, South AmericaRenal transplantationFungal sepsis, cerebrospinal abscess, HBV, HCV infection, pulmonary tuberculosis, extended spectrum beta-lactamase urosepsisSSI
Bonares . 2016CanadaPanama CityProsthetic device (prosthetic vascular and bone graftProsthetic device infectionSSI
Jung . 2015KoreaKorea Renal transplantationCMV infection, BK viremia
Kendall . 2015USAThailandFetal stem cellsSubcutaneous and cutaneous nodules–PanniculitisSSI
and
Althaf . 2014Saudi ArabiaChinaRenal transplantationChronic hepatitis HCV infectionNA
Tsai . 2014TaiwanChinaRenal transplantationBKV infection, Pneumocystis jiroveci pneumonia, tuberculosis and lung fungal infection, bacteraemia (Gram-negative bacilli, )NA
Gomez . 2013USANARenal transplantationDonor-derived opportunistic filamentous fungal infections (DDFFIs)
. (most common organism)
NA
Anker . 2012Saudi Arabia, Taiwan, Hong Kong, Singapore, Europe, USA, UK, CanadaIndia, China, PakistanRenal transplantationCMV, HBV, HCV, HIV, UTI, tuberculosisSSI
Adamu . 2012Kingdom of Saudi Arabia, NigeriaPakistan, Egypt, Philippines, ChinaRenal transplantationInfections (42.2%): UTI, CMV, genital herpes and Varicella virus infection. Isolates of UTI included , (ESBL-producing), and SSI
, and
Cha . 2011KoreaMiddle and South East AsiaRenal transplantationViral infections (EBV, CMV, HSV, BK)
Bacterial infections (respiratory, Genitourinary, GI)
Fungal infections
Protozoa, Mycobacterium
SSI
Tsai . 2011TaiwanChinaRenal transplantationHBV and HCV-related hepatocellular carcinomaNA
Kwon . 2011KoreaChinaRenal or liver transplantationInfection (21.5%): CMV 4.8%, pneumonia (bacterial, tuberculosis, ) 4.6%, UTI 3.9%, HZV 2.1%, BK virus nephropathy 2.1%, pyelonephritis 0.2%SSI (3.7%)
Polcari . 2011USAChina, Pakistan, India, PhilippinesRenal transplantation (purchased)HBV infection , NA
Ivanovski . 2011North MacedoniaPakistanRenal transplantationHCV, CMV, UTI ( or )SSI
Alghamdi . 2010Saudi ArabiaPakistan, Philippines, Egypt, United States, China, Iran, Lebanon, Jordan, SyriaRenal transplantationCMV, HCV infection, UTINA
Allam . 2010EgyptChinaLiver transplantationSepsis, HBV, CMV, EBV infectionsNA
Schiano . 2010USAChinaLiver transplantationSepticemia, biliary sepsis (liver abscess)NA
Yakupoglu . 2010TurkeyEgyptRenal transplantationPyelonephritisSSI
Majid . 2010United Arab EmiratesPhilippines, Pakistan, India, Iran, Syria, Jordan, Lebanon, Egypt, Singapore, Germany, UK, FranceRenal transplantationEBV, CMV, Varicella, HZV
Bacterial UTI
Septicemia
NA

BK virus, BK is the abbreviation of the name of the first patient whom the virus was isolated from; EBV, Epstein–Barr virus; HZV, Herpes Zoster virus; M.: Mycoplasma , SSI, skin site infection, S.: Staphylococcus , UTI, urinary tract infection.

a If causative agent available.

b Medical tourists from Mongolia.

More than 55% (27/49) of the studies reviewed concerned cosmetic surgery; in 24 (89%) of them, wound infection was documented. In 19 of these studies, NTM were isolated including M. abscessus, M. chelonae, M. senegalense and M. fortuitum. The majority of these medical tourists sought cosmetic treatment in the Caribbean such as Dominican Republic (41%); countries of South America such as Brazil, Venezuela and Ecuador (30%) and Central America including Mexico (22%) followed by Southeast Asia (18.5%) ( Table 1 ).

Out of 22 studies, which concerned solid organ transplantation in our review, kidney transplantation accounted for 18 (81.8%) of them; in the current review, CMV infection was reported in 11 (50%) of the studies, followed by HCV (8 studies; 36.4%) and HBV (6 studies; 27.3%). Other infections included viral infections such as herpes simplex virus (HSV), Epstein–Barr virus, as well as bacterial and fungal infections ( Table 1 ). The majority of destinations where medical tourists received organ transplants included the Indian subcontinent (59%), in particular, Pakistan (41%), followed by China (50%) and Southeast Asia (36.4%) ( Table 1 ).

Medical tourists’ motivation includes factors such as cost, perceived quality, familiarity, long waiting lists or delays in treatment or the lack of availability of certain treatments in the country of origin. 1 , 2 However, medical tourism may lead to unintended and undesired effects upon healthcare systems of patients’ country of origin with significant public consequences, including the use of healthcare facilities in their home countries for the treatment of postoperative, or other complications, including infections. 3 Medical tourists planning to travel abroad for treatment should seek pre-travel counselling by a travel health consultant familiar with their medical condition and medication. It is recommended that pre-travel assessment be included in the patients’ education before receiving any treatment abroad. 5 Patients contemplating medical tourism should be advised of procedure-associated as well as specific travel-related risks. Surgical tourists should be made aware of the infectious disease risks associated with overseas hospital care, differences in antimicrobial stewardship between hospitals in developed and developing countries and the risk of colonization which may lead to hospital-acquired infections during travel or to the spread of resistant bacteria to vulnerable individuals in returned tourists. 1 , 42 Patients planning to undertake surgical procedures abroad should be aware of their home country’s guidelines and informed about the quality of care, adherence to protocols and provision of perioperative and postoperative care, which may be different at medical tourism destinations. 42 In particular, for transplant recipients, information should be available about screening standards for potentially transmissible infections as well as the donor exclusion criteria at destination. 78

Problem identification is difficult in medical tourists who receive medical and surgical treatment in different countries and institutions. Therefore, improvement of communication between public health authorities, clinical centres and patients is crucial, in order to keep continuity of care of medical tourists who may be followed up on a different continent by different clinical teams unaware of places of medical and surgical care. 1 Adequate standards for investigation and reporting, terminology and data sharing of potentially transmitted infections will improve the safety of medical tourism related healthcare services.

A major challenge for a health professional is to understand or suspect medical tourists if they do not claim the purpose of their travel, in particular when travellers are planning procedures such as female genital mutilations. 81 Increasing awareness and systematic education on medical tourism related problems is crucial for health professionals in order to address these issues. Travel health consultants should take a proactive attitude and ask about medical tourism. However, it is important to develop a trusted relationship first to discuss sensitive topics and provide culturally sensitive person-centred care, allowing sufficient time during consultations. 81

Several studies of transplant centres revealed significant rates of vaccine preventable and travel-related infections in transplant recipients during foreign travel and a lack of pre-travel counselling and interventions. 5 , 38 , 39 , 41 , 43 , 46 Such travellers receive treatment in areas endemic for vaccine-preventable diseases (e.g. hepatitis B, varicella). 5 , 38 , 39 , 41 , 43 , 46 , 78 The higher risk of infection during periods of greater immunosuppression in transplant patients is well known; therefore, patients should be discouraged from travelling to such areas. 82

Pre-travel consultation is recommended for all medical tourists at least 4–6 weeks prior to travel and should include advice on vaccine-preventable diseases and malaria prophylaxis based on individual travel itineraries as well as information on modifiable risks and exposures such as food and water safety, and insect bite prevention as well as non-infectious diseases. 5 , 82 Any current medical conditions should be well controlled, and medical tourists should make sure that they have enough medication for the duration of their trip. Medical tourists should be up to date with routine vaccinations, including hepatitis B and varicella vaccines. 5 In terms of transplant recipients, immune response after vaccination may be low, although they may still be partially protected and it may wane more rapidly, resulting in a need for further booster vaccination. Live vaccines are contraindicated in transplant recipients; therefore, they should not be administered the yellow fever vaccine, measles vaccine, BCG vaccine or live oral vaccines, including oral polio and oral typhoid. Patients travelling to countries where proof of yellow fever immunization is required should travel with an official waiver or documentation of prior vaccination. 5 Since live attenuated vaccines are contraindicated after solid organ transplantation, it is important to assess the need for such vaccination and to be administered before transplantation if possible. Immune globulin administration for passive immunization should be considered for urgent, last minute-travellers. Malaria prophylaxis should be chosen based on country specific guidelines and considering the possibility of drug interactions with immunosuppressant agents. 82 Upon returning home, patients should be aware to seek medical attention if they become ill with signs and symptoms of infection.

The limitations of this review include its narrow focus placed only on publications in relation to infectious complications of certain procedures searched on MEDLINE and PubMed. We recognize that there is the possibility of the risk of bias assessment, given our selection criteria. In addition, data about infectious complications in relation to common procedures in medical tourists, such as bariatric surgery and dental treatment, as well as the comparison of infectious complications following medical tourism between low-income, middle-income and high-income countries is also limited. This review does not include information about acute medical or surgical interventions provided to travellers during emergency situations while abroad. Further research into a wider range of medical interventions would be useful, which may provide more implications about medical tourism.

This literature review of infections affecting travellers undergoing surgical procedures abroad demonstrated a wide range of infectious complications as a result of patients’ engagement in such procedures, in particular MDR infections. The globalization of healthcare and travelling to countries with high prevalence of MDR infections has been identified as a risk factor for the acquisition of such infections. Acquisition of other infections such as CMV, HBV, HCV, HIV and HSV, as well as travel-related infections due to current outbreaks or endemic diseases at destination, has also been documented. These findings support the need for improved public health strategies aiming at prevention of morbidity and mortality, as well as the future management and education of patients engaging in medical tourism.

We thank Panagiota Isari for administrative assistance.

There is no conflict of interest to declare.

No funding was received for this work.

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    PHD Chamber of Commerce & Industry is excited to announce its upcoming Medical & Wellness Tourism summit scheduled for 18 th November 2023 at HiiMS, Sudhigram, Meerut. The summit promises to bring together industry experts, healthcare professionals, policymakers, and stakeholders to explore, collaborate, and innovate in the ever-expanding world ...

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