The COVID-19 pandemic significantly disrupted the medical tourism industry, leading to a decline in international travel and healthcare services. However, as the world recovers from the pandemic, understanding the factors that influence medical tourism decisions remains crucial for industry growth. This study investigates the push and pull factors that motivate individuals to seek medical treatment abroad in the post-pandemic era. By examining these factors through the lens of the push-pull theory, the research explores the motivations of people pursuing medical treatment overseas. Primary draw factors for medical tourism include economic efficiency, reduced waiting times, an extensive array of therapies, enhanced healthcare quality, attractive locations, and cutting-edge technology. Conversely, push factors compelling individuals to abandon domestic healthcare include financial obstacles, protracted wait times, restricted treatment options, substandard quality, absence of insurance, and legal constraints. The report analyses these elements to offer insights into attracting medical tourism. Furthermore, it provides a comprehensive understanding of how firms can effectively utilize both push and pull forces to attract medical tourists and address the diverse needs of a global market seeking affordable, high-quality healthcare.
Abdullah, A. R., Cheah, S., Mulia V. B., and Fatah I. A. A (2019). Factors attracting Indonesian medical tourists to Penang. African Journal of Hospitality,Tourism and Leisure, GCBSS Special Edition (2019) ISSN: 2223-814X.
Ackerman, S. L. (2010). Plastic Paradise: Transforming Bodies and Selves in Costa Rica's Cosmetic Surgery Tourism Industry. Medical Anthropology: Cross-Cultural Studies in Health and Illness, 29, 403 423.
Adhikari, S. R. (2015). Health care switching behavior of the patients in Nepal: an ordered logic model analysis. Economic Journal of Development Issues, 15(1-2), 128–147. https://doi.org/10.3126/ejdi.v15i1-2.11872
Akter, S., D'Ambra, J., and Ray, P. (2011). Trustworthiness in health information services: an assessment of a hierarchical model with mediating and moderating effects using partial least squares (PLS). Journal of the American Society for Information Science and Technology, 62 (1), 100-116.
Alnakhi, W. K., Segal, J. B., Frick, K. D., Ahmed, S., and Morlok, L. (2019). Motivationalfactors for choosing treatment destinations among the patients treated overseas from the United Arab Emirates: results from the knowledge, attitudes and perceptions survey 2012. Tropical Diseases. Travel Medicine and Vaccines 5, 18, 1-17. https://doi.org/10.1186/s40794-019-0093-9.
Al-Talabani, H., Ozturen, A., and Quasim, S. O. (4 Jan 2019). Advancing Medical Tourism in the United Arab Emirates: Toward a Sustainable Health Care System, Sustainability 2019, 11(1), 230. https://doi.org/10.3390/su11010230
Amin, G., and Rahmiati, F. (2021). How Community Based Influence Self Esteem In Rural Tourism Development, 3rd International Conference on Community Development, ICCD 2021 Vol. 3, No. 1, 40–43. https://doi.org/10.33068/iccd.Vol3.Iss1.345.
Angela, J., Suryono, I. B., and Wijaya, S. (13 Nov 2020). Profiling Indonesian Medical Tourists: A Motivation-Based Segmentation Study. Journal of Economics, Business, and Accountancy Ventura Vol. 23, No. 2, 205–217.
https://doi.org/10.14414/jebav.v23i2.2290
Bagga, T., Vishnoi, S., Jain, S., and Sharma, R. (2020). Medical Tourism: Treatment, Therapy & Tourism. International Journal of Scientific and Technology Research 9, 4447-4453. ISSN 2277-8616.
Businesswire. (2021). Global Medical Tourism Market (2021 to 2026)-Industry Trends, Share, Size, Growth, Opportunity, and Forecasts-ResearchAndMarkets.com. Retrieved from https://www.businesswire.com/news/home/20210707005561/en/Global-Medical-Tourism-Market-2021-to-2026Industry-Trends-Share-Size-Growth-Opportunity-and-Forecasts-Research AndMarkets.com
Cavusoglu, F., and Avcikurt, C. (2021). The Relationship between Personal Traits, Travel Motivation, Perceived Value and Behavioral Intention of Tourists Participating in Adventure Activities. International Journal of Disciplines In Economics and Administrative Sciences Studies (IDEAstudies). 11.391-415.
https://doi.org/10.5281/zenodo.5831677.
Capar, H., and Aslan, O. (2020). Factors affecting destination choice in medical tourism. International Journal Travel Medical Global Health. 2020;8(2), 80-88. https://doi.org/10.34172/ ijtmgh.2020.13
Carrera, P. M., and Bridges, J. F. (2006). Globalization and healthcare: understanding health and medical tourism. Expert Review of Pharmaco economics and Outcomes Research Future Drugs, 7(1), 447- 454.
Castillo, J., and Liew, A. (1 April 2024). Global Medical Tourism: An Economist Approach to Combating Encroaching Privatization with Government Intervention.
Cham, T. H., Lim, Y., Sia, B., Hwa, C., and Ting, H. (2020). Medical Tourism Destination Image and its Relationship with the Intention to Revisit: A Study of Chinese Medical Tourists in Malaysia. Journal of China Tourism Research. 17. 1-29.
https://doi.org/10.1080/19388160.2020.1734514.
Chandran, S. D, Puteh, F., Zianuddin, A., and Azmi, N. A. (2018). Key Drivers of Medical Tourism in Malaysia. Journal of Tourism, Hospitality & Culinary Arts (JTHCA) 2018, Vol. 10 (1), 15-26.
Chen, Y., and Flood, C. M., (2023). Medical Tourism's Impact on Health Care Equity and Access in Low-and-Middle-Income Countries: Making the Case for Regulation (April 20, 2013). Journal of Law, Medicine and Ethics, Vol. 41, No. 1, Available at SSRN: https://ssrn.com/abstract=2286259
Cheng, K. M. (2016). Medical tourism: Chinese maternity tourism to Hong Kong,Current Issues in Tourism. 19, 1479-1486.
Cohen, S. A., Prayag, G., and Moital. M. (2014). Consumer Behavior In Tourism:Concepts, influences and opportunities, Current Issues in Tourism, 17:10, 872-909, https://doi.org/10.1080/13683500.2013.850064
Connell, J. (2013) Contemporary medical tourism: Conceptualization, culture and commoditization, Tourism Management, 34(1), 1?13.
Damijanic, T. A., and Luk, N. (2017). The Relationship Between Travel Motives and Customer Value Among Wellness Tourists. In: Correia, A., Kozak, M., Gnoth, J., Fyall, A. (eds) Co-Creation and Well-Being in Tourism. Tourism on the Verge. Springer,
https://doi.org/10.1007/978-3-319-44108-5_2
Drinkert, A., and Singh, N. (2017). An investigation of American medical tourists’ Post travel experience. Journal Hospital Market Management, 26(3):335–346.
https://doi.org/10.1080/19368623.2017.1241199
Drinkert, A., and Singh, N. (2017). An investigation of American medical tourists’ Post travel Experience. Journal of Hospitality Marketing & Management, 26(3), 335–346. https://doi.org/10.1080/19368623.2017.1241199
Eissler, L. A., and Casken, J. (2013). Seeking Healthcare through International Medical Tourism. Journal Nursing Scholarship, 45(2), 177–184.
Eze, F. J., Inyang, J. J., and ORJI, N. V. (2020). Determinants Of Outbound Medical Tourism: Implications For Service Marketing And Development. Geo Journal of Tourism and Geosites, 33(4spl), 1507–1512. https://doi.org/10.30892/gtg.334spl09-600.
Fadda, N., and Sørensen, J. F. L. (2017). The importance of destination attractiveness and entrepreneurial orientation in explaining firm performance in the Sardinian accommodation sector. International Journal of Contemporary Hospitality Management, 29 (6), 1684–1702. https://doi.org/10.1108/IJCHM-10-2015-0546
Falk, J. H., Ballantyne, R., Packer, J., and Benckendorff, P. (2012). Travel and Learning: A Neglected Tourism Research Area. Annals of Tourism Research, 39(2), 908–927. https://doi.org/10.1016/j.annals.2011.11.01
Ferrer, M., and Medhekar, A. (2012). Key Operational Drivers In The Medical Tourism Industry. International Journal of Accounting Information Science & Leadership 5 (12)
Filep, S., and Matteucci, X. (2020). Love In Tourist Motivation And Satisfaction. Journal of Hospitality & Tourism Research, Vol. 44, No. 6, August 2020, 1026–1034 https://doi.org/10.1177/1096348020927072
Goodrich, J. N., and Goodrich, G. E. (1987). Health-care tourism - an exploratory study, Tourism Management, 8(3), 217-222.
Helble, M. (2011). The movement of patients across borders: challenges and opportunities for public health. Bulletin of the World Health Organization, 89(1), 68-72.
Heung, V. C. S, Kucukusta, D., and Song, H, (2011). Medical tourism development in Hong Kong: an assessment of the barriers. Tourism management, 2011, v. 32, no. 5, 995-1005.
Hirschmann, R. [Statisca]. (2022). Number of public and private hospitals in Malaysia 2013-2020. Retrieved from https://www.statista.com/statistics/794860/number-of-public-and-private- hospitals-malaysia/
Hollas, R. C., Jamal, T., and Woosnam, K. M. (2022). Host self-esteem in volunteer tourism, Journal of Sustainable Tourism, 30:4, 767-786. https://doi.org/10.1080/09669582.2021.1888112
Iulia-Maria, A. (2015). Building brand awareness in the medical travel market. International Journal for Responsible Tourism, 4(2), 123–135.
http://repec.turismulresponsabil.ro/RePEc/amfarchive/2015-2/2015-4-2-123-135.pdf
Hsu, C. H., and Tseng, C. H. (2017a). The influence of push and pull factors on medical tourism destination choice: An empirical study. Journal of Travel & Tourism Research, 56(3), 349-365.
Hsu, T., and Tseng, C. (2017b). The impact of service quality on consumer behavior in medical tourism. International Journal of Tourism Studies, 19(3), 178-196.
Kim, S., Arcodia, C., and Kim, I. (2019a). Critical Success Factors of Medical Tourism: The Case of South Korea. International Journal of Environmental Research and Public Health. 16, 4964, 1-15.
Kim, H. L., and Hyun, S. S. (2022). The Future of Medical Tourism for Individuals’ Health and Well-Being: A Case Study of the Relationship Improvement between the UAE (United Arab Emirates) and South Korea. Int. J.Environ. Res.Public Health 2022, 19, 5735. https://doi.org/10.3390/ijerph19095735
Lee, Y. H., and Tan, L. K. (2023). Push Motivational Factors and Medical Tourism: A Study of Malaysian Patients. Journal of Tourism Psychology, 19(1), 50-65.
Lee, C. (2007). Medical tourism, an innovative opportunity for entrepreneurs. Journal of Asia Entrepreneurship and Sustainability Volume III, Issue 1, 2007, 1-12.
Li, M. and Cai, A. L. (2013), “A sub cultural analysis of tourism motivations”, Journal of Hospitality & Tourism Research, Vol. 40, No. 1, 85-113.
Liu, I-Fan, (2020). The impact of extrinsic motivation, intrinsic motivation, and social self-efficacy on English competition participation intentions of pre-college learners: Differences between high school and vocational students in Taiwan, Learning and Motivation, Volume 72, 2020, 101675, ISSN 0023-9690, https://doi.org/10.1016/j.lmot.2020.101675.
Lim, H. C., and Ng, S. M. (2023). Pull Motivational Factors and Their Influence on Medical Tourism in Malaysia. Asia-Pacific Journal of Health Management, 12(2), 150-16.
Lunt, N., Horsfall, D., and Hanefeld, J. (2016). Medical tourism: a snapshot of evidence on treatment abroad. Maturitas, 88(6), 1-27.
https://doi.org/10.1016/j.maturitas.2016.03.001
Manon, H., Powell-Jackson, T., Goodman, C., Hasbullah, T., and Wiseman, V. (2021). Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities. International Journal for Equity in Health. 20. https://doi.org/10.1186/s12939-021-01577-1.
Mattoo, A., and Rathindran R., (2006). Measuring Services Trade Liberalization and Its Impact on Economic Growth: An Illustration. Journal of Economic Integration, 2006, Vol. 21, 64-98.
Masoud, F., Alireza, J., Mahmoud, K., and Zahra, A. (2013). A systematic review of publications studies on medical tourism, Journal of Education and Health Promotion; Vol. 2, 1-5.
Md-Zain, N. A., Connell, J., Mohd Zahari, M. S., and Hanafiah, M. H. (2022). Intra-Regional Medical Tourism Demand in Malaysia: A Qualitative Study of Indonesian Medical Tourists' Rationale and Preferences. The Malaysian Journal of Medical Sciences: MJMS, 29(2), 138–156. https://doi.org/10.21315/mjms2022.29.2.13
Moreno, L., Ramon, A., and Pedreno, A. (2015). The Development of Low-Cost Airlines and Tourism As A Competitiveness Complementary Effects, Evolution And Strategies. Journal of Spatial and Organizational Dynamics, Volume III, Issue 4,263-264.
Musa, G. Thirumoorthi, T. and Doshi, D. (2012). Travel behavior among inbound medical tourists in Kuala Lumpur. Current Issues in Tourism, 15(6), 525-543.
Nwobodo, S. (2020). Medical tourism in Malaysia: an investigation of the destination branding factors and its influence on the behaviour of medical tourists, 1-192. [Unpublished doctoral dissertation]. Swinburne University of Technology
Peters, C and Sauer, K. (2011). A Survey of Medical Tourism Service Providers. Journal of Marketing Development and Competitiveness. 5(3). 117-126.
Rageth, O. (2023). Women, leisure and tourism. Self-actualization and empowerment through the production and consumption of experience, Leisure Studies, 42:4, 644-645. https://doi.org/10.1080/02614367.2022.2138514
Ramli, A. R. (23 January 2015). October Tourist Arrivals Show Positive Growth. Retrieved from https://www.tourism.gov.my/media/view/october-tourist-arrivals-show-positive-growth.
Roman, M., Roman, M., & Wojcieszak-Zbierska, M. (2022). Health Tourism-Subject of Scientific Research: A Literature Review and Cluster Analysis. International journal of environmental research and public health, 20(1), 480.
https://doi.org/10.3390/ijerph20010480
Rusman, A., and Fiona, J. (2018). NTP boosts medical tourism. Available at https://www.nst.com.my/news/nation/2018/04/362247/ntp-boosts-medicaltourism <22 March 2021>
Sarantopoulos, I., and Demetris, L. (2015), "The Contribution of Medical Tourism to the Economic and Regional Development in Greece", International Journal of Management and Applied Research, Vol. 2, No. 2, 73-84.
Saragih, H. S., and Jonathan P. (2019). Views of Indonesian Consumer Towards Medical Tourism Experience in Malaysia, Journal of Asia Business Studies Vol. 13 No. 4, 507-524. https://doi.org/10.1108/JABS-04-2018-0135.
Sarwar, A. (2013). Medical Tourism in Malaysia: Prospect and Challenges, Iran Journal Public Health. 42(8), 795–805.
Simkova, E., and Jindrich, H. (2014), Motivation of Tourism Participants, Social and Behavioral Sciences,Vol. 159, 660 -664. https://doi.org/10.1016/j.sbspro.2014.12.455
Su, L., and Hsu, M. K. (2013). Service fairness, consumption emotions, satisfaction, and behavioural intentions: the experience of Chinese heritage tourists. Journal of Travel and Tourism Marketing. 30 (8), 786–805.
https://doi.org/10.1080/10548408.2013.835228
Sultana, S., Md. Emran Hossain, M. E., Khan, M. A., Saha, S. M., Amin, M. R and Prodhan, M. M. H (15 Jan 2024). Effects of healthcare spending on public health status: An empirical investigation from Bangladesh. Heliyon, Volume 10, Issue 1, 2024, e24268, ISSN 2405-8440, https://doi.org/10.1016/j.heliyon.2024.e24268.
Sung, E., and Ozuem, W. (2015). Customer-Perceived Value of Medical Tourism. In book: Current Issues and Emerging Trends in Medical Tourism, 58-78.
Tan, A. M., and Wong, S. Y. (2023). The Mediating Role of Consumption Value in the Relationship between Motivational Factors and Medical Tourism in Malaysia. Journal of Consumer Behavior, 18(3), 220-235
Tseng, H. (2013). Medical health care tourism: Why patients go overseas and what nurse practitioners need to know? International Journal of Healthcare Management 6(2), 39-55.
Walker, J. R., and Walker, J. T. (2010). Tourism: Concepts and practices. Upper Saddle River, NJ: Pearson Education.
Wan, C. (11 Jan 2017). ‘Malaysia Truly Asia’ campaign delivers in tourist arrivals. Retrieved from https://www.travelweekly-asia.com/DestinationTravel/Malaysia-Truly-Asia-campaign-delivers-in- tourist- arrivals.
Wang, J. R., Yu, T. P., and Wu, W. M. (2015). A new alternative of Penghu’s winter tourism: A study of the international healthcare-tourism. Leisure Research Leisure Study, 5(4), 32–49. https://doi.org/10.29518/LS
Widiyastuty, F., Suryawati, C., and Arso, S. P. (31 March 2023). Why People in Entikong Distric Sanggau Regency Seeking Medical Treatment to Sarawak, Malaysia, Jurnal Kesehatan Komunitas,Keskom.2023;9(1):115-121. https://doi.org/10.25311/keskom.Vol9.Iss1.1412
Xiaoqing, P., and Moreira, J. P. (2018). Outbound medical tourists from China: An update on motivations, deterrents, and needs, International Journal of Healthcare Management 11(3), 1-10.
Yang. (24 Apr 2024). Global medical tourism market size 2024-2029. Available at https://www.statista.com/aboutus /our-research-commitment.
Ying, K. S., and Krishnapillai, G. (2018). Young Domestic Tourists - Are They Motivated to Travel? Advanced Science Letters, 24(5), 3444-3449.
Yousefi, M., and Marzuki, A. (2015). An Analysis of Push and Pull Motivational Factors of International Tourists to Penang, Malaysia. International Journal of Hospitality & Tourism Administration, 16(1), 40–56.
Yoon, Y., and Uysal, M. (2005). An examination of the effects of motivation and satisfaction on destination loyalty: A structural model. Tourism Management, 26(1), 45–56.
Yousaf, A., Amin, I., and Santos, J. (2018). Tourist's Motivations to Travel: A Theoretical Perspective on Existing Literature. Tourism and Hospitality Management. 24. 1-15. https://doi.org/10.20867/thm.24.1.8.
Zolfagharian, M., Rajamma, R. K; Naderi, I; and Torkzadeh, S. (2018). Determinants of Medical Tourism Destination Selection Process, Journal of Hospitality Marketing & Management, 1-36. https://doi.org/10.1080/19368623.2018.1444527
Zotova, O. Y., and Karapetyan, L. V. (2018). Psychological security as the foundation of personal psychological wellbeing (analytical review), Psychology In Russia: State of the Art Volume 11, Issue 2, 100-113. https://doi.org/10.11621/pir.2018.0208.
Chang, Y. C., & Ayob, N. H. (2024). Medical Tourism Travel Motivations: The Push and Pull Driving Forces. International Journal of Academic Research in Business and Social Sciences, 14(11), 1770–1787.
Copyright: © 2024 The Author(s)
Published by Knowledge Words Publications (www.kwpublications.com)
This article is published under the Creative Commons Attribution (CC BY 4.0) license. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this license may be seen at: http://creativecommons.org/licences/by/4.0/legalcode
