Antecedents of a healthcare tourism satisfaction: A case of developing economy

• Published date: 01 May 2022
• Author: Anil Kumar,Rohit Kumar Singh,Sachin Modgil
• Date: 01 May 2022
• DOI: http://doi.org/10.1002/pa.2420

ACADEMIC PAPER

Antecedents of a healthcare tourism satisfaction: A case of

developing economy

Anil Kumar

1

| Rohit Kumar Singh

2

| Sachin Modgil

2

1

Maharana Pratap College of Management,

Bhopal, India

2

International Management Institute, Kolkata,

India

Correspondence

Sachin Modgil, International Management

Institute, Kolkata, India.

Email: s.modgil@imi-k.edu.in

The focal intent of the study is to identify the vital determinants that bring satisfac-

tion to health tourists along with their intent to visit the Indian region again. The the-

oretical construct is developed to demonstrate the association among different

dimensions toward satisfaction. Through well designed questionnaire we analyzed

375 responses through structured equation modeling. Results of the study indicate

that perceived quality of services offered drives the choice of a healthcare organiza-

tion in foreign country and helps in satisfying the patient needs. Further, findings

reveal that satisfaction of healthcare tourist does not lead to the intention of visiting

again. The study presents implications for administrators, leaders and healthcare

workers, that how they can contribute in enhancing the satisfaction of the healthcare

tourist. The commitment of healthcare systems to service quality and qualified staff

lead to healthcare tourist satisfaction. The study provides a base and reconfirm the

healthcare tourism antecedents ranging from perceived quality, experience to treat-

ment outcome.

1|INTRODUCTION

Healthcare tourism enable people travel to other countries to

seek cheaper medical treatment. The recent trend shows a rapid

development of healthcare tourism industry across borders of

countries, where tourist avail healthcare facilities during their

stay (Debata, Sree, Patnaik, & Mahapatra, 2013). Healthcare

tourism is receiving good response from researchers globally

(Connell, 2013;Han&Hwang,2018; Han & Hyun, 2015; Reddy,

York, & Brannon, 2010;Singh,2013). Healthcare tourism help

the immigrants with an opportunity to jaunt and take the

required treatment (Han, 2013). This sector is very lucrative from

view of business in developing countries as they may offer stan-

dard quality healthcare facilities at lower price and gain competi-

tive edge over other countries. (Han & Hwang, 2018;Han,Kim,

Kim, & Ham, 2015; Pan & Chen, 2014). Healthcare tourism in

recent times has emerged out as very important sector for econ-

omy of a particular country (Usmani, Akram, & Praveen, 2020).

Additionally many insurance firms also support the healthcare

tourism due to potential of savings along with luxury and private

nursing facilities (Burkett, 2007).

Healthcare tourism has emerged as an industry with rapid growth

because people travel overseas to get all kind of healthcare services

along with holiday trip for pleasure and enjoyment (Manna, Cavallone,

Ciasullo, & Palumbo, 2019). Most of the south Asian, countries includ-

ing India see the remarkable growth in the field of healthcare tourism

(Debata et al., 2013; Jain & Ajmera, 2018). Indian Healthcare tourism

is showing rapid growth with a CAGR of 18% and is expected to be

worth 9 billion by the end of 2020. Highly trained doctors, low

healthcare cost and advanced technology are the foremost causes

behind this unexpected progress of healthcare tourism in India

(Singh, 2014). India is known for yoga and has attracted tourists glob-

ally from ancient times. It is believed that Yoga is originated from

India around 5,000 years ago and it positioned itself as the spirituality

epicenter for healthcare tourism (Maddox, 2015; Telej &

Gamble, 2019). As one of the favorite destinations for healthcare

tourist, the country has positioned itself as one of the oldest and pop-

ular place (Connell, 2006). The Indian government attempt to develop

and promote the country as the best health destination globally with

low-budget and highly-trained healthcare staff due to its economic

viability for healthcare tourism (Medhekar, 2014). India grab prefer-

ence over other countries for the surgery in life threatening or critical

Received: 25 June 2020 Revised: 14 August 2020 Accepted: 19 August 2020

DOI: 10.1002/pa.2420

J Public Affairs. 2022;22:e2420. wileyonlinelibrary.com/journal/pa © 2020 John Wiley & Sons Ltd 1of16

https://doi.org/10.1002/pa.2420

diseases related to artery blockages, cardiology, cardiac valve, hip and

knee replacements, etc. The cost savings, better healthcare facilities

and an opportunity to excursion with the healthcare are the reasons

for any healthcare tourist to select the location (Cherukara &

Manalel, 2008). According to a study, the foreigners everyday travel

cost is around $31 in India as compared to $223 in United States, thus

it leads to a good amount of savings for a healthcare tourist. In addi-

tion, India has skilled, well-trained doctors and nurses those are back-

bone of any healthcare system. India claims to have around

619 hospitals accredited by National Accreditation Board for Hospi-

tals & Healthcare (NABH) and 39 by Joint Commission International

(JCI). JCI is a leading agency in the field of healthcare services all over

the globe and accreditation means that these hospitals are following

high standards and generate trust in among healthcare tourists. By

2020–2021, world's healthcare tourism market is expected to grow

from 18 to 20%. In a Healthcare Tourism Index (2016), India's placed

at fifth position all over the world.

Against these facts, there is fierce competition in the field of

healthcare tourism with boost in demand (Nazem &

Mohamed, 2015). The selection of a particular destination is cho-

sen by a patient or by the family on the basis of diverse factors

such as services offered, connectivity, political stability of the

region,andcrimerate(Henama&Sifolo,2020;

Mahendradhata, 2019). Thus, it is critical for all the players in the

healthcare tourism have a designed strategy to appeal potential

healthcare tourists and retaining the existing ones (Han, 2013).

The previous study suggests that to maintain the loyal customer

base is multiple times gainful than to build a new customer base

(Chiu, Hsu, Lai, & Chang, 2012). There is deficiency of empirical

readings on healthcare tourism as indicated in the previous works

(Han et al., 2015;Manaf,Hussin,Kassim,Alavi,&Dahari,2015;

Padilla-Meléndez & Del-

Aguila-Obra, 2016) and rarely a study on

healthcare tourism attempted to capture view point of health

tourists (Cheng, 2016; Manaf et al., 2015). Though, the past

researches investigated on antecedents of healthcare tourism

(Cohen, 2010), still the study on health tourists' satisfaction is

inadequate (Lunt, Mannion, & Exworthy, 2013) and this indicate

the neglect of area and the research gap particular toward satis-

faction of healthcare tourists and their intent to revisit. Measuring

revisit intention of health tourist will certainly help healthcare

institutions to improve on essential parameters, responsible for

creating patient friendly ecosystem for outstation patients. Litera-

ture suggest revisit intention is affected by number of parameters,

Kusumawati, Utomo, Suharyono, and Sunarti (2020) found that

revisit intention amongst tourist will be high if destination quality

is always well maintained. Study conducted by Hasan, Abdullah,

Lew, and Islam (2019) revealed that destination image positively

affects tourist revisit intention. Mannan, Chowdhury, Sarker, and

Amir (2019) stated that facility reputation significantly affects

tourist revisit intention. Aforementioned study suggest the impor-

tance of exploring revisit intention in different business settings

including healthcare. To fill the research gap stated above, the

current study aim to identify the elements responsible for

healthcare tourists' satisfaction and attempt has been made to

explore the reason behind tourist's intent to revisit. Thus, the fol-

lowing research questions have been proposed in light with the

above discussion:

RQ1 What are the major dimensions of consumer satisfaction in

healthcare tourism?

RQ2 How do different determinants impact healthcare tourist's

satisfaction?

RQ3 Which type of association exists between satisfaction of healthcare

tourists and their intent to revisit?

The outcomes and results enrich the existing literature in terms

of key factors motivate to satisfaction of health tourist and their

revisit intention in future. These findings will bring practical implica-

tions to healthcare tourism industry specific to India and can be

extrapolated to other countries. To answer aforementioned research

questions, a comprehensive review of literature is conducted to

extract consumer satisfaction dimensions with respect to healthcare

tourism, a theoretical construct was developed based on hypothesis.

A partial least square-structured equation modeling (PLS-SEM) was

used to estimate the impact of different dimensions on tourist satis-

faction, and further to investigate their revisit intention to a

healthcare facility.

The rest of the script is systematized as follows: First, we

described the theoretical background under Section 2. The next seg-

ment displays the hypothesis development and Section 4presents the

methodological details used in the study. Section 5highlights the out-

come analysis of our work. To this end, we presented the discussion

and conclusion in Sections 6and 7, respectively along with limitations

and scope for future research.

2|THEORETICAL BACKGROUND

Healthcare tourism refers the travel of foreigners from their home

country to other for medication and treatment (Connell, 2013).

Healthcare tourists travel to different countries for receiving treat-

ment and healthcare services due to advancements in technology

and better prices (Han, 2013). Customer satisfaction (CS) in tourism

is used both as a subjective and objective parameter. As a subjec-

tive parameter, it relates to customer needs and emotions while as

an objective parameter it shows product and service features

(Simonet, 2017). However, there is inadequate literature that can

provide all the attributes which drives CS in tourism research. Tour-

ist's CS, being multidimensional concept is influenced by its ante-

cedents and may have a positive association with revisit intention.

Table 1indicates the list of constructs and their supporting

references.

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