Factors affecting health tourism and international health-care facility choice

The analysis of the medical tourism expansion policy in Taiwan: a policy analysis using Kingdon's multiple streams

BACKGROUND

Since 2006, Taiwan has actively pursued the development of its medical tourism industry. In 2013, the government sought to bolster this sector by integrating medical tourism into the Free Economic Pilot Zones. Despite narrowly missing the mark, the initiative failed to materialize into law. This qualitative study endeavors to discern the pertinent factors influencing the agenda-setting process for incorporating medical tourism into the Free Economic Pilot Zones in Taiwan.

METHODS

A comprehensive examination of policies concerning the legitimation of medical tourism within the Free Economic Pilot Zones was undertaken through semi-structured interviews and a thorough review of policy documents. Key informants were strategically selected using purposive and snowball sampling techniques. Thematic analysis was applied to scrutinize the amassed data and organize it within the framework of Kingdon's multiple streams.

RESULTS

In the problem stream, increasing financial strains and cost containment pressures under the National Health Insurance program have long driven health care providers to seek further opportunities in medical tourism. The existing barriers to expanding medical tourism in Taiwan included diplomatic tensions (specifically cross-strait relations), public concerns about commercialization of medical care and reduced their access to care, and legal and language barriers. Within the policy stream, factors such as franchise fees to support national health insurance, limited number of demonstration medical tourism sites and services allowed, the allowance of foreign medical personnel, regulations governing domestic physicians, the importance of demonstration, regulation, and accreditation, as well as restrictions on investment from China, were emphasized. The politics stream highlights factors such as governmental support, opposition from opposing parties, public concerns and critics from academia and non-governmental organizations, and skepticism from medical faculties.

CONCLUSION

Acknowledging the recognized challenges in enacting the medical tourism provision of the Free Economic Pilot Zones Special Act and emphasizing the political will of leadership, a viable policy solution remained elusive. Although a window of opportunity existed for the passage of the bill, it waned as public concerns sidelined the issue from the national agenda. The Taiwan case underscores the necessity for meticulous consideration of issues, proposed solutions, and political dynamics to achieve successful policy enactment.

Healthcare Facilities and Medical Tourism Across the World: A Bibliometric Analysis

This study aimed to review the literature on healthcare facilities and medical tourism from a range of nations that have established medical tourism sectors and assess the effect of healthcare facilities on medical tourism. A bibliometric study of the Scopus database was carried out by using the search terms '(Facility AND of AND healthcare) AND TITLE-ABS-KEY (health AND tourism) AND medical tourism' for the years 2012-2022. A qualitative evaluation of the literature was then performed to find and locate 92 articles. VOSviewer and NVivo 12 Plus were employed for data analysis. The findings indicated that the following trending subject keywords were used during the period in question: health (rate 1.97), medicine (rate 1.91), tourism (rate 1.70), care (rate 0.83), facilities (rate 0.64) and healthcare (rate 0.61). Furthermore, this research identified four distinct clusters: i) medical tourism, ii) healthcare quality, iii) healthcare system and iv) health services. The study found that healthcare facilities, as actors that have a role in the development of medical tourism, have not been sufficiently explored, even though there is evidence that they play a role in the growth of the sector. This result is in line with Heung's argument, which makes the same point.

Designing the competency-based training model of Iranian medical tourism

BACKGROUND

Despite the great comparative advantage of Iran in terms of infrastructure, technology, and human resources as well as the significance of medical tourism in the tourist industry, in practice, the quality of human resources has received less attention. Consequently, this study was conducted to design a model of competency-based training for Iranian medical tourism.

MATERIALS AND METHODS

This study was an exploratory mix, and the Delphi method and semi-structured interviews were used for the qualitative part of this study. In the second part, the analytical method was utilized for the quantitative part of this study.

RESULTS

The results indicated the main components of medical tourism to be public interactions and private interactions and seven subcomponents. Medical Tourism's Competency includes three main components and seven subcomponents.

CONCLUSION

Although some training separated and scattered is present in Iran's medical tourism. However, Iran requires a comprehensive training model of which its design was explained in this paper.

Coupling Coordination and Spatiotemporal Dynamic Evolution Between Medical Services and Tourism Development in China

This work constructs an evaluation index system and quantitatively explores the coupling coordination relationship between the tourism development system and the medical services system in China. Results show that the degree of coupling coordination between the tourism development system and the medical services system showed a good upward trend in China during the period 2012–2019. However, the relationship was barely balanced, with tourism development lagging. The overall layout shows a spatial pattern of “high in the north and low in the south, high in the east and low in the west.” The degree of coupling coordination tends to be randomly distributed from clustered distribution, and the cold–hot spots show a spatial development pattern of “cold in the northwest and hot in the southeast” as time passes. The power of government to regulate has always been an important mechanism affecting the degree of coupling coordination. The study aims to provide reference for the rationalization of medical tourism layout and sustainable development.

Determining public’s attitude toward medical tourism development: a scale proposal

Purpose

This paper aims to explore the public’s attitude toward medical tourism activities by developing a measurement instrument in Turkey, an emerging medical tourism destination.

Design/methodology/approach

During the development phase of the scale, 24 question pools were created. After the pilot study, data from a 20-question survey were collected from a study group consisting of Turkish citizens who received services from hospitals in the city of Ankara. Data were collected through convenience sampling of 221 study participants as they were walking in the Square of Kızılay, one of the most important centers and junction points in Turkey, between November 25, 2017, and December 27, 2017.

Findings

The content validity of the scale was assessed by expert opinion. The scale reliability is high with Cronbach’s α (0.908). A factor analysis was performed to assess the factor structure of the scale. The Kaiser–Meyer–Olkin measure of sampling adequacy (0.895) and Bartlett’s test (χ2 = 2,020.967; p = 0.001) were applied to determine the conformity of the scale of factor analysis. Exploratory factor analysis with Varimax rotation was performed to determine the factor structure of the scale. The 20 questions loaded under three factors: “contribution to the country,” “anxiety in getting services” and “service justice”. These factors explained approximately 55% of the total variance. Confirmatory factor analysis was performed with goodness-of-fit index (0.877), Bentler comparative fit index (0.909) and root mean square error of approximation index (0.069) to determine the validity of the factor structure, and the results indicated that the three-factor model is an acceptable level. All the results show that this new scale is valid and reliable in measuring the public’s attitude toward the development of medical tourism in Turkey.

Originality/value

The public’s attitudes on the medical tourism scale show that, as a measurement tool, it can be used validly and reliably in determining the public’s attitudes toward medical tourism.

Driving Factors of the Health and Wellness Tourism Industry: A Sharing Economy Perspective Evidence from KPK Pakistan

In the recent years, the health and wellness tourism industry has become one of the new emerging industries in Pakistan. In terms of the sharing economy, the driving mechanism of the health and wellness tourism industry has undergone significant changes. Based on a combination of theoretical and practical research, the paper explores the dynamic system and mechanism of innovation development of health and wellness in the tourism industry in Pakistan. Firstly, it theoretically constructs the driving factors in four aspects, which include market demand, industrial supply, infrastructure, and external environment. Secondly, taking Khyber Pakhtunkhwa province (KPK) as an example, it uses the entropy method and Grey relational analysis to test the driving factors system. The empirical results show that four aspects jointly influence the innovation of the health and wellness tourism industry in Pakistan. Finally, this study discusses several practical implications for the development of the health and wellness tourism industry of KPK for academics, policymakers, business owners, and scholars, with recommendations for future research.

Effect of the event strength of the coronavirus disease (COVID-19) on potential online organic agricultural product consumption and rural health tourism opportunities

The coronavirus disease (COVID-19) outbreak has raised consumer concerns about health. By employing 306 online questionnaires, we identify COVID-19's effect on online organic agriculture product consumption and rural health tourism intention based on stimulus-organism-response theory and event system theory by incorporating risk information disclosure of COVID-19 as the moderating variable and health consciousness and risk perception as the mediating variables. These findings suggest that considering the impact of COVID-19 can help focus the production and online sales of organic agricultural products, the establishment and improvement of rural health facilities, and the marketing of rural health tourism.

Does healthcare service quality affect outbound medical tourists’ satisfaction and loyalty? Experience from a developing country

Purpose

Poor quality of services in the health-care sector of the developing countries like Bangladesh forces affluent patients to seek advanced medical treatment from abroad. The purpose of this study is to explore the outbound medical tourists’ satisfaction and loyalty on the basis of the quality of the health-care service provided by foreign medical institutions.

Design/methodology/approach

The medical tourists from Bangladesh who have got medical services from Indian medical institutions were taken as a sample by applying a purposive sampling technique. For the measurement of outbound medical tourists’ satisfaction, the dimensions of the HEALTHQUAL model were adopted. A self-administrated questionnaire was the major tool for collecting data from the respondents. Using partial least square-structural equation model multivariate statistical technique and with the aid of SmartPLS software, primary data collected from 218 final respondents were analyzed.

Findings

The findings of this study reveal that four dimensions of the HEALTHQUAL model, namely, empathy, tangibility, efficiency, and safety have a significant positive impact on building medical tourists’ overall satisfaction, and then the overall satisfaction also has a positive level of significance on building loyalty towards foreign medical service providers.

Practical implications

The findings of this study can be a helpful instrument for the developing countries to rethink and reshuffle their own existing health-care system for providing quality medical services and at the same time, the medical tourists importing countries to sharpen their existing service quality as well as to attract more medical tourists in the future.

Originality/value

A handful of research has been carried out, especially focused on health-care service quality measurement and the relationship of health-care service quality with satisfaction and loyalty from the perspective of developing countries outbound medical tourists. Thus, this research work will give a flavor to think of health-care service quality in a different dimension.

Barriers to Medical Tourism Development in the United Arab Emirates (UAE)

Medical tourism is a thriving industry. Many destinations now seek to attract more medical tourists. The United Arab Emirates (UAE) is no exception. As one of the most important pillars of the UAE’s economy, tourism is considered a high priority. However, medical tourism in the UAE is still developing. This paper addresses the main challenges for medical tourism in the UAE and proposes methods to enhance its development. This research utilized qualitative analysis. Twelve professionals in medical tourism were interviewed to provide data. The data were then analyzed using NVivo 12 software. Our results indicate that the key barriers to medical tourism development in the UAE are high costs of medical tourism services, lack of marketing activities, lack of collaboration between medical and tourism service providers, and so forth. Although initiatives from the UAE government are very encouraging, more efficient medical care supply networks, tourism suppliers and intermediaries should be established to ensure its growth. This research could influence national tourism policies in the UAE as well as regional alliances in all Gulf Cooperation Council (GCC) and the Middle East and North Africa (MENA) countries.