Exploring the factors influencing the travel motivations of US medical tourists

Medical tourism (also called medical travel, health tourism, or global health care) is a term initially coined by travel agencies and the mass media to describe the rapidly growing practice of travelling across international borders to obtain health care. In the past decade, the attempt to achieve better health while on holiday through relaxation, exercise, or visits to spas has been taken to a new level with the emergence of developing countries as destinations for medical tourism. It has grown dramatically in recent years primarily because of the high costs of treatment in rich countries, long waiting lists, the relative affordability of international air travel, favourable economic exchange rates, and the availability of well-qualified doctors and medical staff. Keeping in mind the rapid growth of this industry, a study was conducted to shed light on the importance of different factors that influence the travel motivations of US medical tourists to international destinations.     

Critical issues in health and wellness tourism: an exploratory study of visitors to wellness centres on Gran Canaria

The growing commodification of health care and therapeutic landscape, as well as the recent growth in international demand for wellness services and treatments, has led to the proliferation of destinations and enterprises that have selected health and wellness tourism as part of their corporate strategy, including coastal tourism destinations such as the Spanish island of Gran Canaria. This study discusses the commodification of health care and landscape, the relationship between everyday life and going on holiday, as well as the motives for medical and wellness tourism. Wellness tourism development on Gran Canaria is also analysed as a case study that could prove useful for those working on diversification within coastal tourism. An exploratory study of European visitors to wellness centres on the island is also presented. Major findings and contributions relate to socio-demographic characteristics, motives for the visit to the island, the importance of the wellness offer, tourist and travel behaviour and wellness behaviour both at the destination and at the place of residence. Another contribution refers to differences in the use of wellness centres and treatments among visitors, based on their place of origin, gender, age, marital status and job situation. Management and marketing implications are also suggested.     

Wellness tourism in Sareyn,Iran: resources,planning and development

Health tourism is a broad concept that incorporates both medical and wellness tourism. Sareyn, city of Ardabil province, is one of the largest and the most diverse cities for health tourism. Although health tourism in Iran is in its infancy, it can offer new opportunities, and strengthen the overall competitiveness of Iran's tourism industry. In this paper, by using strengths, weaknesses, opportunities and threats (SWOT) analysis, the strengths and opportunities for sustainable health tourism are determined. Also, weaknesses and threats are recognized; finally, guidelines for efficiently using the strengths and transforming the weaknesses into opportunities and strengths are presented.     

A Market and Spatial Perspective of Health Tourism Destinations: The Hungarian Experience

Since health tourism is one of the most popular and most dynamically developing products of modern tourism, this paper aims at studying the characteristic features of health tourism destinations from a regional and spatial perspective. Accordingly, the authors would like to introduce a new approach of spatial and product analysis of tourism where the market and spatial relations and relevance of health tourism were analysed through the example of Hungary. Although the classic medical tourism centres were established on natural medical water basis, by today, due to product diversification, continuous innovation and the involvement of medical services into health tourism, the geographical embeddedness seems to disappear, thus basically restructuring the market. The methodological novelty of the research is that exceeding the classic supply–demand algorithm, we compiled a complex viewpoint system adequate to the specialities of the given product characteristics. In our study, the authors intend to survey the special characteristics of health tourism focusing on medical destinations through Hungarian examples since the country's leading position in the global market is well recognized, including medical services. Copyright © 2014 John Wiley & Sons, Ltd.     

Tourists' perception of health tourism before and after COVID-19

Health tourism has received increasing attention from academic researchers from a global perspective. Although mainland China (hereafter referred to as “China”) has long been recognized as a health tourism destination, its health tourism development is still in its infancy stage. Hence, to minimize the aforementioned gap, the present study explored the perception of health tourism and effective health tourism promotion methods from the perspective of tourists before and after the coronavirus disease 2019 (COVID-19) pandemic. The major findings of this study showed that tourists perceived wellness tourism and medical tourism as critical activities/components after the COVID-19 pandemic.     

Insights into domestic horse tourism: the case study of Lake Macquarie,NSW, Australia

This explorative study examined the extent and potential of horse tourism in Australia, specifically in Lake Macquarie, New South Wales. The study was based on in-depth interviews with 10 stakeholders. These stakeholders ranged from tour operators to tourists, and their experience with horse tourism was then discussed against literature. The stakeholders' main concerns and challenges indicate a gap between the demand and supply side especially for domestic tourists travelling with their own horse(s), indicating an opportunity for developing and engaging existing systems and businesses in Australia into an agenda for a horse tourism strategy.     

Nostalgia,Identity and Tourism: Bollywood in the Indian Diaspora

In today's global world of movement our personal identities are changing. So, ‘where is my “home”?’ and ‘what is my “identity”?’ have become essential questions in one's life. In recent times, more and more diasporic communities visit their homelands, perhaps to reroot their identities. This study explored the influence of Bollywood movies in the Indian diaspora's identity construction and notions of home and tourism behaviour to India. Findings revealed that the Indian diaspora's imagination of India is strongly informed by Bollywood movies. Yet, different generations of the Indian diaspora have different reasons for travelling to India. The first generation's nostalgia arises from watching Bollywood movies, and as a result, creates a motivation to travel to India. The second generation's main to travel behaviour to India is to experience the new ‘modern’ country, portrayed in the affluent surroundings of contemporary Bollywood movies. And, for those first generations, who have never seen India before, Bollywood movies enable them to romanticise their homeland and create an urge to visit India. Thus, Bollywood movies have immense importance in the Indian diaspora's identity construction, promote diaspora tourism and constitute a huge opportunity for economic development.     

Restoring tourist confidence and travel intentions after disasters: some insights from a rejoinder to a series of unfortunate events in Malaysian tourism

Many countries face a decline in tourist confidence and reduced travel intentions after disasters. However, Malaysia – a country that experienced a series of aviation tragedies throughout 2014 – encountered an overall increase in inbound tourists and monetary receipts. This article more closely examines the effects of these unfortunate events on Malaysian tourism and identifies several strategic avenues that can contribute to restoring tourist confidence and reigniting tourist interest in travelling to disaster-stricken countries.     

Understanding tourists' itineraries in emerging rural tourism regions: the application of paper-based itinerary mapping methodology to a wine tourism region in Michigan

In recent years, many rural areas have turned to tourism as a way of reviving their communities. One challenge to such efforts is that community leaders in these areas often have limited experience with tourism and consequently lack the knowledge and resources to best facilitate sustainable tourism initiatives. Moreover, an influx of tourists to an area puts new demands on infrastructure. Information about tourists' itineraries can help communities to address new challenges that result from tourism, however using emerging technologies such as GPS and Internet-based map surveys can be expensive and require expertise many rural tourism planners do not have. Paper-based itinerary mapping methodology can be a cost effective way of providing local officials, tourism planners, and businesses with important information to inform decisions about how to invest limited resources. This study applies paper-based itinerary mapping to an emerging wine tourism area in a rural county in the US state of Michigan. Because it involves tourists travelling from place to place within a region, wine tourism is particularly well-suited for itinerary mapping. Results provide specific recommendations to local officials, tourism planners, and businesses. Moreover, the study offers an example to researchers interested in conducting studies that use paper-based itinerary mapping methodology.     

Perception of medical practitioners on the importance of medical tourism services

This study (a) investigates the perception of medical practitioners regarding medical tourism, and (b) examines the differences in the perception of medical practitioners regarding the importance of the services involved. The hypotheses are focused on a series of comparisons of medical institutions that “are or are not involved in medical tourism.” The results showed that (i) professionalism of treatment is recognized as the most important factor regardless of the nature and value of the medical treatment provided while a patient travels; and that (ii) there are no significant differences in surgery, treatment, examination, in-hospital and patient room costs.     

Tourist use of public transport at destinations – a review

Understanding tourists' use of public transport (PT) at the destination is important for sustainable mobility, destination satisfaction, PT management and destination management. This paper provides an overview of research in PT and tourism since 2000. The review identifies main topics and issues including how PT is used for tourism purposes in different contexts. It also recommends policies and strategies for a modal shift to PT in tourism, and identifies potential areas for future research. The review indicates that there are differences in the level of PT use by visitors between rural and urban destinations. PT is often not favoured by visitors in remote areas, although the situation is more promising in urban destinations. However, the overall potential of PT as an alternative mode for travelling is unclear, given tourist motivations and behaviours, and provision of visitor-oriented PT services including the need for appropriate communication and social marketing strategies.     

Travel behaviour among inbound medical tourists in Kuala Lumpur

Despite recording the highest growth among tourism sub-sectors [Dhesi, D. (2009, March 25). Medical tourism rises in Malaysia despite economic downturn. The Star Online. Retrieved from http://www.malaysiahealthcare.com/; Leonard, T. (2009, July 24). Medical tourists to bring in RM 540 million by 2010. Retrieved from http://www.malaysiahealthcare.com/; Tourism Malaysia. (2008). Profile of tourist by selected markets 2008. Kuala Lumpur: Tourism Malaysia], little is known empirically with regard to travel behaviour among inbound medical tourists in Malaysia. This study examined the demographic profile, travel motivation, healthcare consumption, and expenditure behaviour among them in Kuala Lumpur. Using the combination of purposeful and convenience sampling, a total of 138 questionnaires were completed, returned, and analysed. The majority of the respondents were female, middle aged, travelling with two others and Indonesians. Their main travel motivation factors were ‘value for money’, ‘excellent medical services’, ‘supporting services’, ‘cultural similarity’, and ‘religious factor’ in descending order of importance. Medical treatment, cosmetic procedure, surgical procedure, and medical check-up were important healthcare services sought after by the respondents. On average, medical tourists spent MYR 26,844.19 per visit, with females and tourists of European descent contributing significantly more. Tourists from ASEAN had stronger motivation of ‘cultural similarity’ compared with other tourists. This paper is unique in providing the empirical evidence of the city's unique selling points (pull factors) in attracting inbound medical tourists. It also highlights the potential economic contribution and some managerial implications in terms of marketing and product development.     

Reviewing Thailand's master plans and policies: implications for creative tourism?

This article contributes to an understanding of how creative tourism is perceived on a national level, by using Thailand as a case analysis. The primary objective of this article is to investigate Thailand's plans and policies for the creative economy at both national and ministry levels in relation to creative tourism. It also identifies how a national strategic plan can provide a blueprint for individual agency master plans to provide policy support for the development of the creative economy in the tourism sector. Thailand is chosen as an example of how government and related agencies can contribute to a national creative tourism movement in the country, especially in the light of the Tourism Authority of Thailand branding campaign to stimulate creative tourism to the destination. The qualitative research methodology through content analysis is used to scrutinise the plan and policy contents from the selected government agencies. The results demonstrate a better view of how creative tourism is positioned in the Thailand context and contribute to a policy study on the creative economy in the tourism sector as well as in creative tourism.     

Measuring underreporting in accommodation statistics: evidence from Italy

The aim of this paper is to provide a new measure of the underreporting of accommodation statistics in Italian domestic tourism. The analysis employs information from different official surveys. Following the Eurostat recommendations, we compare the Italian trips and holidays surveys and the movements in accommodation establishments, the two major official sources on tourism in Italy and on the activities of persons travelling, respectively. The analysis shows that demand-side estimates exceed accommodation statistics by 16%, on average, over the period 2007–2009 and that the underreporting rate is variable over time. The results highlight the need to explicitly consider this measurement error when analysing the tourism business cycle, forecasting tourism flows and defining tourism policy.     

Using the Delphi method to assess the potential of Taiwan's hot springs tourism sector

The purpose of the present study is to identify the various factors that influence the competitiveness of the hot springs tourism sector. The research draws on the models of Ritchie and Crouch, Dwyer and Kim, and Enright and Newton, who concluded that destination competitiveness is determined by three major components: resources and attractors, destination strategies and environments. The investigation produced both qualitative and quantitative data using the Delphi technique. An expert panel reached consensus about priorities for the development of Taiwan's hot springs tourism sector and provided written justifications for their responses. This paper reports on the qualitative findings of the three‐round Delphi survey and provides a supply‐side perspective on Taiwan's hot springs tourism sector. An examination of the expert comments concluded that the Taiwanese are increasingly concerned with good health and longevity. This emerging characteristic offers new business opportunities for the providers of hot springs tourism experiences to extend their appeal into health protection and medical treatments. However, if they are to achieve sustainable development and ensure high‐quality visitor experiences, hot springs proprietors will need to work closely with local governments and communities to promote sustainable use of natural hot springs and to conduct routine inspections of spa premises. Overall, the future of the hot springs tourism sector appears to be promising. Copyright © 2008 John Wiley and Sons, Ltd.     

Cultural tourism in the context of relations between mass and alternative tourism

In the initial stage of its development, cultural tourism represented one of the alternative forms of tourism, opposed to mass tourism. The beginning of the 1990s indicates a period of transformation of cultural tourism which, unlike the original orientation towards elite clientele, found a new opportunity for development in the orientation towards the mass market. Orientation to the mass market was mainly driven by supply-oriented logic, because the creation and marketing of cultural attractions became a development option for numerous destinations. Nowadays, new cultural tourism is focused on the integration of production and consumption, and increasing linkages between suppliers and consumers. Instead of passive consumption, cultural tourists demonstrate a proactive approach to meeting their needs, wanting to actively participate in creating experiences while travelling. On the other side, suppliers focus their attention on the close interaction with consumers and co-creation of high quality experiences.     

More than medical tourism: lessons from Indonesia and Malaysia on South–South intra-regional medical travel

While scholars increasingly acknowledge that most contemporary international medical travel comprises South–South flows, these have gone curiously unexamined. Rather, policy, scholarly and media attention focuses predominantly on North–South flows of ‘medical tourists’. However, this focus diverts attention from the actual and potential impacts of South–South intra-regional medical travel flows on both their source and receiving contexts. As such, we present findings from a study examining South–South intra-regional medical travellers' motivations, preparations and practices to better understand the social, economic and political situations that condition them and their effects on the destinations that receive them. Our study of Indonesian medical travellers pursuing health care in Malaysia draws on 35 semi-structured interviews with Indonesian patients, their companions, medical staff and agents in both countries. From this, we suggest that South–South medical travellers' diverse socio-economic conditions shape decision-making and spending behaviour relative to treatment, accommodation and transport choices as well as length of stay. We identify ways in which informal economies and social care networks sustain the formal medical travel industry. Finally, we observe how medical travel increasingly serves as a means through which chronic and everyday health needs are met through temporary, visa-free intra-regional movement.     

Is tourism just another staple? A new perspective on tourism in remote regions

According to recent research, countries may have a positive image from a tourism perspective, but they may be seen as lacking from an economic or political viewpoint. As governments and destination management organisations spend large sums of money in promoting tourist attractions, the question of whether these activities also influence other aspects of a country's image becomes relevant. The objective of the research is to determine the effect of tourism promotions on the image of the country and that of the destination as two separate concepts, in the case of Israel, a country subject to continuous conflicts. A 2?×?2 quasi-experimental design is utilised to investigate the influence of tourism promotional brochures. Additionally, a comparative perspective is used to determine whether people from diverse countries and backgrounds may be affected differently by the same information. The findings confirm that tourism brochures influence not only the image of the destination, but also that of the country. These effects are found to be different for respondents from the two different countries compared. The article focuses on understanding how tourism communication strategies may also be used to improve the image of a country, with potential benefits for international marketing and international relations.     

Study of the major supply factors and business choices affecting the growth rate of wine tourism in Greece

Wine tourism is considered one of the alternative forms of tourism internationally. Wine tourism combines wine production with tourism activities, mainly in agricultural areas, as it embraces the tourism interest for wine production and the enjoyment of vineyard activities by the tourists. Greece, as a well-known tourist destination, is actually a new wine tourism area that has still a long way to go before claiming that it can render high-quality services in this very competitive sector. The objective of this paper is to examine and present the extent of wine tourism development in Greece, the characteristics as well as the main business choices related to wine tourism supply, aiming at highlighting the necessary key elements that can play a decisive role in its further growth. In terms of this paper, we attempt to examine the Greek wine producer's viewpoint of wine tourism by setting out data related to the development of the product, the satisfaction of businessmen involved, the means used to promote the product, the difficulties faced by and the expectations set by wine producers. In order to achieve the aforementioned goals, a research was conducted by means of a constructive questionnaire sent to all major Greek wine producers from April to June 2007. The participants in the wine tourism industry in the country were considered a major source of information.     

Tourism,health and income in Singapore

This paper employs Granger causality test to investigate the long‐run and the short‐run dynamic interactions among tourism, economic development and health care development in Singapore. The test reveals that there is long‐run unidirectional Granger causality from health care development to economic development and from tourism to economic development. Both health care and tourism have positive effects on economic development in the long run. In the short run, there is a unidirectional Granger causality from economic development to health care development and a bidirectional causality between health care development and tourism. Copyright © 2009 John Wiley & Sons, Ltd.