Elsevier

Tourism Management

Volume 36, June 2013, Pages 257-268
Tourism Management

The healthcare hotel: Distinctive attributes for international medical travelers

https://doi.org/10.1016/j.tourman.2012.11.016Get rights and content

Abstract

Despite rapid growth in the medical/healthcare-tourism industry, research on the concept of the healthcare hotel, which can be a significant part of this industry, is rare. This study was designed to identify the distinctive attributes of a healthcare hotel—those facets unlikely to be available in regular medical clinics—and to test the role of these identified attributes in building visit intention among international travelers by considering the impact of perceptions/cognitions, affect, and trust. Qualitative and quantitative approaches generated three dimensions (monetary and convenience advantages, personal security, and availability of products/services) involving 23 attributes and validated the assessment tool for them. The results from the structural model revealed that the proposed relationships among study variables are positively and significantly associated. In addition, perceptions/cognitions, affect, and trust were found to be mediators in the proposed theoretical framework. Implications related to the identified attributes and tested relationships are discussed.

Highlights

► The distinctive attributes of a healthcare hotel were identified. ► The importance of personal security among the healthcare-hotel attributes was notable. ► Perceptions and cognitions, affect, and trust were found to be significant mediators.

Introduction

In the past few decades, medical tourism, which enables patient-customers to receive quality effective medical treatment/healthcare via international travel, has been one of the most popular and fastest-growing trends in both the healthcare and tourism industries (Deloitte, 2008; Yu & Ko, 2012). Recent studies have estimated that the worldwide medical-tourism industry generates nearly $60 billion per year, growing at a rate of about 20% annually (Heung et al., 2011; Yu & Ko, 2012). In addition, international trades related to medical/healthcare products and services are considered an emerging lucrative sector in many countries, particularly in developing countries (Bookman & Bookman, 2007; Heung et al., 2011). In this regard, more and more destination countries have been actively promoting medical tourism in their countries by increasing their variety of medical/healthcare locations and improving related products/services for international travelers (Crozier & Baylis, 2010; Heung et al., 2011). Another method for increasing medical tourism has been to link these tourism activities with medical/healthcare clinics of excellence in many places (Whittaker, 2008).

In medical-travel destinations in both less-developed and more-developed countries, the prevalence of medical/healthcare clinics is clearly on the rise. However, from international patient-customers' perspective, the “Achilles' heel,” or major weaknesses, of existing medical/healthcare/esthetic clinics are minor conveniences (e.g., time and effort spent finding various types of treatment centers individually or the difficulty in locating a hotel for accompanying family/friends), relatively weak continuity of care, insufficient availability of hotel-type rooms and F&Bs while/after receiving treatment, miscommunication, etc (Gan & Frederick, 2011; Heung et al., 2011; Reddy, York, & Brannon, 2010). As a superior proxy, a healthcare hotel, which combines hotel, hospital, and healthcare/esthetic centers, may overcome such weaknesses, fulfilling international customers' needs and wants. For instance, when compared to offerings at regular medical/healthcare clinics, international customers may enjoy superior conveniences (e.g., receiving various medical treatments/healthcare services at a single location or being able to stay in the same facility with family/friends), more reliable post-care services in a hotel if needed, more comfortable hotel room products with better-quality F&Bs, and more effective communication thanks to same-language staff with adequate medical/healthcare knowledge (Docrates, 2011; GHN, 2011; Hwang, 2011; Medical Hotels, 2011; Sheehan-Smith, 2006). Despite these types of benefits, however, customers remain poorly acquainted with the concept and distinctive characteristics of healthcare hotels. This ignorance is likely due to the fact that there are so few such facilities, but the practice of medical tourism is catching on, and hence more research is warranted in this area.

In addition, numerous researchers have identified the perceptions, cognitions, affect, and trust-related matters that influence travelers' and lodging customers' decision-formation (e.g., Baloglu, 1999; Jani & Han, 2011; Kim & Han, 2008; Han, Hsu, & Lee, 2009; Han & Back, 2008). In particular, perceptions and cognitions (e.g., image and value) have been verified by researchers as crucial concepts for anticipating intention, while affect and trust have long been considered major concepts in the prediction of traveler decisions and behaviors (Baloglu, 1999; Han & Back, 2008; Han et al., 2009; Jani & Han, 2011; Kim & Han, 2008). However, relatively little research has considered these critical variables together to explain international travelers' decision-making processes, particularly in the medical-travel industry. Further, no researcher has ever examined or identified healthcare-hotel attributes and their impact on such variables in building international customers' intentions to stay in a healthcare hotel.

For these reasons, this study was designed to (1) use both qualitative and quantitative approaches to identify the distinctive attributes of a healthcare hotel, (2) validate such attributes using both exploratory and confirmatory analytic approaches, (3) test a model to investigate associations among the identified attributes, perceptions and cognitions, affect, trust, and intention to visit a healthcare hotel when traveling abroad for medical treatment/healthcare, and (4) examine the mediating impact of the study variables in building visit intention. The present study begins with a literature review describing healthcare hotels and reviewing the proposed variables. Thereafter, the methodology and findings from the data analyses are presented, followed by a discussion involving theoretical and practical implications and study limitations.

Section snippets

The healthcare hotel and its characteristics

Since the healthcare hotel remains one of the least well-known types of destinations in the hotel industry, a depiction/conceptualization of a healthcare hotel is still rare in the academic literature. Nonetheless, based on its characteristics and functions, it would be rational to describe a healthcare hotel as a lodging operation that includes hospital and various healthcare/esthetic facilities within a single property (Docrates, 2011). In this regard, a healthcare hotel can also be known as

Qualitative phase of the study

Since no previous studies have examined the attributes of a healthcare hotel, a qualitative approach was employed to identify them. We looked for possible attributes that are distinctive from those of regular medical/healthcare clinics, as judged from an international tourist's perspective. A focus group discussion and literature review were used to identify or discover unexplored characteristics and underlying factors for a particular product or service (Han, Back, & Barrett, 2010; Han, Back,

Exploratory factor analytic approach

An Exploratory Factor Analysis (EFA) using principal component analysis and the Varimax rotation method was conducted to determine the underlying dimensions of the attributes of a healthcare hotel. The value of the Kaiser-Meyer-Olkin Measure of Sampling Adequacy was .952 and the Bartlett's test of Sphericity was significant (p < .001), both verifying the adequacy of EFA use (George & Mallery, 2001). The summary of the EFA findings is presented in Table 1. Three inclusive factors that had

Summary of the results

Due to the lack of existing research on healthcare hotels, the present study was designed to identify the distinctive attributes of these hotels from international patient-tourists' perspectives. A conceptual model was developed that involved such attributes and other critical variables in travelers' decision-making processes. The attributes were identified and validated through both qualitative and quantitative approaches. The proposed model, which involved theoretical relationships among

Heesup Han is an Associate Professor in the College of Hospitality and Tourism Management at Sejong University, Korea. His research interests include medical tourism, green hotels, and hospitality and tourism marketing. His papers have been selected as the most downloaded and read articles in many top-tier hospitality and tourism journals. Heesup Han was selected by the International Biographical Center (IBC) to be the Top 100 Educators – 2011 in the arena of hospitality and tourism, and

References (70)

  • L. Sheehan–Smith

    Key facilitators and best practices of hotel-style room service in hospitals

    American Dietetic Association

    (2006)
  • J. Yu et al.

    A cross-cultural study of perceptions of medical tourism among Chinese, Japanese and Korean tourists in Korea

    Tourism Management

    (2012)
  • A. Yuksel et al.

    Destination attachment: effects on customer satisfaction and cognitive, affective and conative loyalty

    Tourism Management

    (2010)
  • H. Assael

    Consumer behavior and marketing action

    (1984)
  • S. Aydin et al.

    Customer loyalty and the effect of switching costs as a moderator variable: a case in the Turkish mobile phone market

    Marketing Intelligence & Planning

    (2005)
  • K. Back et al.

    A brand loyalty model involving cognitive, affective, and conative brand loyalty and customer satisfaction

    Journal of Hospitality and Tourism Research

    (2003)
  • R.P. Bagozzi et al.

    On the evaluation of structural equation models

    Journal of the Academy of Marketing Science

    (1988)
  • S. Baloglu

    A path analytic model of visitation information involving information sources, socio-psychological motivations, and destination image

    Journal of Travel & Tourism Marketing

    (1999)
  • S. Baloglu et al.

    A model of destination image formation

    Annals of Tourism Research

    (1999)
  • M.Z. Bookman et al.

    Medical tourism in developing countries

    (2007)
  • G.A. Churchill

    Marketing research: Methodological foundations

    (1995)
  • G.K.D. Crozier et al.

    The ethical physician encounters international medical travel

    Journal of Medical Ethics

    (2010)
  • L.L.P. Deloitte

    Medical tourism: Consumers in search of value

    (2008)
  • Docrates

    Healthcare hotel Helsinki

    (2011)
  • P. Doney et al.

    An examination of the nature of trust in buyer–seller relationships

    Journal of Marketing

    (1997)
  • L. Dube et al.

    Multiple roles of consumption emotions in post-purchase satisfaction with extended service transactions

    International Journal of Service Industry Management

    (2000)
  • J.K. Ford et al.

    The applications of exploratory factor analysis in applied psychology: a critical review and analysis

    Personnel Psychology

    (1986)
  • C. Fornell et al.

    Evaluating structural equation models with unobservable variables and measurement error

    Journal of Marketing Research

    (1981)
  • B. Fried et al.

    Managing healthcare services in the global marketplace

    Frontiers of Health Services Management

    (2007)
  • L.L. Gan et al.

    Medical tourism facilitators: patterns of service differentiation

    Journal of Vacation Marketing

    (2011)
  • S. Ganesan et al.

    Dimensions and levels of trust: implications for commitment to a relationship

    Marketing Letters

    (1999)
  • D. George et al.

    SPSS for Windows

    (2001)
  • D.W. Gerbing et al.

    An updated paradigm for scale development incorporating unidimensionality and its assessment

    Journal of Marketing Research

    (1988)
  • GHN

    Global healthcare network

    (2011)
  • J.F. Hair et al.

    Multivariate data analysis

    (1998)
  • Cited by (118)

    • Toward understanding healthcare hospitality and the antecedents and outcomes of patient-guest hospital-hotel choice decisions: A scoping review

      2023, International Journal of Hospitality Management
      Citation Excerpt :

      Despite comfortable accommodation and medically equipped comfortable vehicles for patient movement, insights filtered from medical and wellness tourism literature unravel the paramount importance of quality medical treatments, in terms of advanced medical facilities, doctors’ qualifications, personalized attentive medical care, and accreditation of hospitals, for the best healthcare outcome and quick recovery during recuperation (Majeed et al., 2017, 2018), which may ultimately improve PGE in the context of hospital-hotels. A hospital-hotel presents a bigger picture of healthcare hospitality due to the provision of not only aesthetic healthcare services, such as YOMERE (yoga, meditation, recreation) (Majeed and Kim, 2022), but also surgical interventions, such as heart transplants, knee replacements, emergency rooms, cosmetic surgeries, and cancer treatment, alongside personalized attentive care from doctors and paramedical staff and in parallel to hotel-like comfort and services (Han, 2013; Majeed and Kim, 2022; Majeed et al., 2017, 2020). Thus, the budding knowledge of healthcare hospitality sheds light on the important role of alternative health treatments, conventional medical treatments, and hotel-like service (including service providers’ attentive and caring attitude), all under one roof as in a hospital-hotel, to improve PGE.

    View all citing articles on Scopus

    Heesup Han is an Associate Professor in the College of Hospitality and Tourism Management at Sejong University, Korea. His research interests include medical tourism, green hotels, and hospitality and tourism marketing. His papers have been selected as the most downloaded and read articles in many top-tier hospitality and tourism journals. Heesup Han was selected by the International Biographical Center (IBC) to be the Top 100 Educators – 2011 in the arena of hospitality and tourism, and recognized by the American Biographical Institute (ABI) to be the Man of the Year – 2011 in hospitality and tourism.

    View full text