Proceed with caution: Potential challenges and risks of developing healthcare tourism in Indonesia

Exploring the Potential of a Multi-Level Approach to Advance the Development of the Medical Tourism Industry in Indonesia

Nowadays, the global medical tourism market size has grown quite rapidly, with a projected increase of 21.1% between 2021 and 2028. This study aimed to explore barriers and potential strategies for the development of medical tourism in Indonesia. A qualitative case study design was employed, where 8 respondents were selected using an expert sampling method from various groups according to the helix framework, including academics, government, professional organizations, the private sector, and the media. Data was collected through document analysis and in-depth interviews, and was analyzed manually using an inductive thematic content analysis approach. Limitations to the development of Indonesian medical tourism are related to regulations concerning medical tourism, the number of health services, distribution, supporting resources, public trust, and competition. At the institutional level, the challenges comprise services and products, hospital facilities, supporting facilities, and marketing processes. Furthermore, at the micro level, the low competency of both health and non-health workers persist as an obstacle. The potential strategy at the macro level include the development of robust marketing and branding strategies, health infrastructure, and resources. At the institutional level, it was necessary to develop related products and services provided, improve quality, and focus on branding and marketing strategies. Additionally, improving human resource skills was needed at the micro level.

Medical tourism among Indonesians: a scoping review

BACKGROUND

International medical travel or medical tourism is not a new phenomenon in many countries, including among Indonesians. Indonesia is reported as a major source of patients from the lower, middle, to upper classes for its neighbouring countries. This scoping review aims to synthesise evidence on supporting factors for Indonesians taking medical tourism and what needs to be improved in Indonesia's health system.

METHODS

We conducted a scoping review guided by a framework provided by Arksey and O'Malley. We systematically searched existing literature from 5 databases, including MEDLINE, PubMed, Scopus, ProQuest, and Wiley. Data were extracted based on study details, study design, characteristics of participants and results. Analysis followed the three-stage procedure outlined by Thomas and Harden: (1) coding the text line by line, interpreting the data and identifying concepts or themes; (2) developing descriptive themes by grouping similar concepts in theme and subtheme and (3) generating analytical themes by reviewing preliminary themes and discussing the addition or revision of themes.

RESULTS

A total of 25 articles were included in this review. The review highlights a broad range of facilitators for medical tourism among Indonesians: (i) availability of health services, medical specialities, and person-centred care, (ii) region adjacency, transport, and health agency, (iii) affordability of medical treatment, (iv) religious and socio-cultural factors, and (v) reasons patients reported distrust in Indonesian doctors.

CONCLUSION

The findings indicate improvements in the Indonesian health system are necessary if the increasing rates of international medical tourism by Indonesian people are to change. Addressing the factors identified in this scoping review through avenues including policy may increase people's satisfaction and trust towards health care and treatment in Indonesia, thereby reducing the number of Indonesian people taking medical tourism.

Destination brand equity and tourist's revisit intention towards health tourism: an empirical study

Purpose

This paper aims to investigate the relationship between destination brand equity and tourist's revisit intention towards health tourism destinations. The study also examines the mediating effect of destination brand association between destination-based brand equity and travellers' revisit intention for health tourism destinations.

Design/methodology/approach

A survey instrument is used to examine the relationships in the proposed model using the co-variance-based structural equation modelling (SEM) technique. The collected primary data from two hundred forty-six respondents (n = 246) are analysed to test the relationship amongst exogenous, mediating, moderating and endogenous constructs articulated in the proposed structural model.

Findings

Empirical findings reveal that destination brand equity influences the revisit intention of a traveller for health tourism via destination brand association. The perceived trust, reliability and soft issues of a traveller moderate the relationship between destination brand equity and destination brand association. Enduring travel involvement also proves a significant moderation effect on the relationship between destination brand association and the revisit intention of a traveller for a health tourism destination.

Practical implications

This paper is an initial attempt to develop and empirically examine a conceptual model of the intention of a traveller to revisit a health tourism destination in a dynamic process of information search using the data collected from current travellers after medical tourism-related trips. Results suggest that stakeholders must focus on hedonic and utilitarian factors of the destination that are recognised by travellers to encourage revisit for medical tourism.

Originality/value

Although there have been numerous studies on health tourism. However, to the best of the authors' knowledge, this research is a pioneer in the healthcare tourism literature that links destination brand equity, brand association and revisit intention of a traveller for health tourism. These findings extend the knowledge of how healthcare tourism that is embedded with destination brand equity and destination brand association. The study findings potentially benefit the marketers for gaining competitive advantages through considering the experience of a traveller.

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.