Factors Influencing Middle Eastern Medical Tourists in Thailand

This report delves into the factors influencing medical tourism, specifically focusing on Middle Eastern patients seeking healthcare in Thailand's private hospitals. The introduction highlights the increasing trend of medical tourism, driven by cost savings and access to specialized treatments. The literature review explores existing research on medical tourism, examining push and pull factors, communication challenges, service quality, and destination selection criteria. The report aims to identify the key determinants affecting Middle Eastern patients' choices when selecting Thailand as a medical destination. The objectives include understanding the concept of medical tourism, identifying influential factors, assessing the link between tourism and high-quality services, and recommending improvements for Thailand's medical tourism sector. The report discusses issues such as communication barriers, lack of experience, and the cost of medical care, providing a comprehensive analysis of the industry. This report is valuable for students studying marketing and healthcare management, providing a detailed overview of the trends and factors shaping medical tourism in Thailand.

MIDDLE EASTERN MEDICAL TOURISTS WHOM VISIT
THE PRIVATE HOSPITALS IN THAILAND

Table of Contents
INTRODUCTION ..........................................................................................................................3
LITERATURE REVIEW................................................................................................................6
RESEARCH METHODOLOGY...................................................................................................10
Introduction...............................................................................................................................10
Research philosophy.................................................................................................................10
Research design.........................................................................................................................11
Research approach....................................................................................................................11
Research strategy......................................................................................................................11
Data collection methods............................................................................................................12
Sampling...................................................................................................................................12
Data analysis.............................................................................................................................12
Validity and reliability..............................................................................................................12
Questionnaire.................................................................................................................................14
REFERENCES .............................................................................................................................17

INTRODUCTION
It has been observed that people from rich countries have started travelling to less
developed countries for inexpensive but high quality medical care (Permwonguswa and et.al.,
2016). It has also been found out that for better health care, patients from developed countries
travel to developing countries for saving cost and as a result, it aids them to get proper treatment
from the respective entities. Medical tourism is regarded as the combination of products and
services offered to the people travelling from one country to new country. It is also called as a
cost effective form of medical care for patients that mostly come from developed countries who
need specialized form of treatment. Several authors also illustrated that medical tourism is a
combination of products and services that are intended to encourage patients in preserving and
maintaining their health through a combination of vacationing and other form of recreational
activities in a different location other than home (Moghavvemi and et.al., 2017).
On the contrary, Fetscherin and Stephano, (2016), contended that medical tourism is a
type of movement of a patient to get services which further assists in recovering from illness.
The main aim of availing medical tourism is to get the medical services from abroad which are
not available in the home country. This helps the patients not only to acquire better health care
services; but also it leads to attain lower cost services. Hence, it can be said that medical tourism
is the practice of patients that seeks lower cost health care procedures in abroad often packaged
with travel and sightseeing excursions. Further, medical tourism is also getting popular because
this helps people to identify new sources of improvements in health care sector. The well being
tourism market requires the activity that maintains the state of wellness physically, mentally and
socially. However, apart from this there are several factors that influence medical tourism and
cost is one such important force. An estimated of around 46 million people in USA are uninsured
and are incapable of bearing the ever rising medical costs for themselves (Skountridaki, 2017). In
this respect, it has also been ascertained that government is unable to provide healthcare for its
residents; therefore people from USA are looking forward for different alternatives.
As per the view of Connell (2013), medical tourism is increasing in the world at a speedy
rate and thus it helps in encouraging host country to provide the best medical services for their
guest patients to provide them well quality treatment that complies to their needs. It is increasing
in developed countries and thus medical tourism is increasing which also enhances the economy

of the country. The needs of medical tourists who are visiting particular country for health check
up needs to have expertise in specific area and thus it increases their brand image in global world
therefore, it assists in improving brand image in market so that best results can be attained.
Medical tourists chose particular destination for their treatment and thus country needs to focus
upon providing the best quality treatment to patients so that it can be developed as a healthcare
destination. Skilled force of doctors and nurses should be appointed within hospitals so that best
care and support could be delivered to them and thus it results in enhancing country's image in
global market. However, Hanefeld and et. al., (2013), argued that the trend of medical tourism
has been increasing around the globe and thus medical travellers are encouraged to seek health
care treatment across their home country. It involves different reasons such as high quality of
health care, affordable medical expenses, short waiting time, advanced technology and facilities
etc. All such facilities attracts Middle Eastern patients to visit Thailand for medical reasons and
get better quality health care services to enhance medical tourism in the country. It assists in
increasing revenue and thus profitability aspect of firm can be improved.
As per the opinion Chuang and et. al., (2014), trend of medical tourism has been
recognised around the globe and thus medical travellers are encouraged to obtain better health
care facilities across their home country. Tourism is just not only for visiting the particular
country but it is also for medical grounds and thus it has been assessed that Middle Eastern
patients are highly diverting themselves towards Thailand for better medical treatment. Thailand
attracts around 8 lakh foreigner patients and brought 19,500 million THB. Therefore,
government of Thailand started strategic plans in regard to promote Thailand as a prime medical
tourism destination and injected around 3 billion THB in different forms such as better services,
technology improvement etc. and thus encourages medical tourists to visit the country and attain
results. However, Lunt, Mannion and Exworthy, (2013), argued that it involves different push
factors such as intrinsic desires of individuals and thus overcome factors such as long waiting
list. Further, in certain nations there is also delay in obtaining access to care in local health care
facilities which attract patients to travel to different nations and thus receive immediate treatment
to overcome health issues.
Crooks and et. al., (2015), stated that there are certain factors that affect medical
destination selection such as service quality measuring through SERVQUAL method, identifying

patients needs, innovative technology, etc. helps in improving the health care of patients. Thus, it
aids in delivering better services to the patients coming from Middle Eastern countries and
overcome their medical issues. Government of Thailand is also required to develop appropriate
legal regulations in relation to appoint skilled doctors and nurses and thus enhance the medical
treatment for patients and attaining satisfaction.
Also, it is essential for hospitals to adopt different measures such as protecting the
privacy and confidentiality of patients through providing them medical treatment and thus render
quality services to clients so that best results can be attained. Additionally, Buzinde and Yarnal
(2012), claimed that increasing in number of senior citizens who have time, money and
motivation in regard to maintain good health is considered as one of the main drivers of health
tourism sector. While, pull factors are those which possess specific elements in regard to drive
people and realise their needs and wants so that travel experience can be enhanced. However, the
main pull factor that drives health tourists to seek better health treatment in developed countries
at low cost. In present study, different factors are being analysed that affects medical destination
selection of Middle Eastern Medical tourists. Thus, they focus upon adopting different factors
that are crucial for the selection of destination for medical tourists and select the appropriate
place.
Aim: “To determine the factors that affects Medical destination section of Middle East Medical
Tourism at Thailand”
Objectives:
 To understand the concept of Medical Tourism.
 To identify the factors that affects Medical destination selection at Middle East Medical
Tourists.
 To understand the link between medical tourism and high quality services provided at
Thailand
 To recommend ways that which medical tourism can be improved at Thailand.

LITERATURE REVIEW
According to Noree, Hanefeld and Smith, 2016 “medical tourism can be determined as a
process in which people travel to other countries in order to receive medical attention or care”
(Noree, Hanefeld and Smith, 2016). This is generally done by people as to get the bets medical
attention for their health issues. This type of situation has made the policy makers to enforce
certain laws that will support the country to grow. People who are at developed countries, they
would travel developed country as they service that will be provided will be high. As per
Wongkit and McKercher, 2016 “developed countries have pursuits of treatments and that are not
available at the home town of people so they prefer to visit these countries” (Wongkit and
McKercher, 2016). In today's words, there are both quantitative and qualitative shifts towards
patients mobility and this is because people travel from less developed to developed countries
with an aim to get treatment for their health issues. There can be different reasons due to which
people prefer to visit other countries. In this context, one of the main reason is due to high
quality services. When competed with the developing countries the developed country has high
set of facilities and the treatments are provided of high quality. Moghavvemi, Ormond and
Chandy, 2017 stated that “the technology that are used at developed countries are face advance
when compared with developing countries” (Moghavvemi, Ormond and Chandy, 2017).
However, there are different set of issues that are faced when people travel to other countries for
treatment. In this context, one of the main reasons that have been faced by this area is
communication. When people travel to other countries, then they face the issue of
communication. In such type of condition, one fails to express the main issues that are faced by
them. Within the hospitality sector, it is important that doctor and patient have effective
communication so that patient can make doctor understand about the issues that are faced by
them and as per the issues doctor provide them the treatment. However, it any kind of mis
communication arises, then it affects the health of patient negatively. Similarly, there are
different type of issues that are faced due to medical tourism.
Below given are various issues that are faced by countries due to medical tourism. These
issues affect the person who perform medical tourism and get treatment. Among which issues or
risk are as follows:

Communication: This can be determined as one of the main issue because of which the
patient fail to make the doctor understand about the health issue which they are facing through.
Most of the countries use generally English but there are condition in which people do not
understand even that language (Masoud, Alireza and Zahra, 2013). On the other hand, there also
conditions in which patients do not understand the treatment that are provided by the doctor. In
such situation, patient do no get the meditations that had to be taken. On the other hand, id there
is effective communication, then it helps to overcome the disease that is creating issue. When
doctors are able to understand the issues, then they are able to provide the patient with proper
meditation with the help of which issues are solved.
Lack of experience: There re cases in which the treatments that are provided by other
countries are not effective. This has high negative impact over the health. Further, it raised the
risk of diseases. Further, doctors also make use of needles and it can cause issues if due to
carelessness of doctors if they use same needle again for other patients (Viladrich and Baron-
Faust, 2014). There are changes that it may cause them diseases like HIV, AIDS, etc. Doctors do
not have proper experience due to which people do not get to solve the issues because of which
they have performed medical tourism. However, when professional have proper experience, then
they are able to understand the condition of patients and are able to provide them meditations
accordingly.
Quality of services: There quality of services that are provided at developed countries by
get affected. There are different set of treatments that many have been provided at developed
countries. On the other hand, there issues when the treatment that are received from a developed
countries may not be available at home-town (Wernz, Thakur Wernz and Phusavat, 2014). This
creates an issue for the patient as it many leads to stay much more longer that the other country
until the health problem is fully cured.
Cost: The cost for all the treatment will be higher at developed countries when compared
with developing countries. There are situations in which patients visit to other countries and they
get to know the treatment will cost them highly even more that what was expected. In such
condition, it becomes difficult for the patient to make their treatment. The cost that is incurred at
developing countries are low and so all the treatments that people were not able to conduct in

their own country are performed here. This way the disease or problem is solved effectively and
efficiently.
Health affecting others: When a person visit to other country for treatments, and if he/she
happens to get affected by any type of disease, then after returning to this /her own country, it
would affect the others as well (.Lunt, Mannion and Exworthy, 2013). Or in case, the people at
developed countries may also get affected due to the disease that is with the patient who came
for treatment.
Incomplete treatments: When the treatments are not provided in full, it affects the health
of the patient and this is a type of risk that patient. People travel to other countries with an aim to
make sure that their health condition gets improved (Noree, Hanefeld and Smith, 2016).
However, when their desired do not get fulfilled, then it becomes issue for the people. The total
amount spend come up with no conclusion when the treatment provided is not complete. This
type of condition occurs when doctors do not have proper experience and they provide them
incomplete treatment. This makes the situation worse (Wernz, Thakur Wernz and Phusavat,
2014). In order to over come this type of condition, it is essential that people conduct research
and identify the area in which they can find proper treatment with the help of which the reason
for their visit can be achieved.
Developing countries like India, Nepal, Sri Lanka, do not have proper facilities or
technology that will enable to provide proper treatment and this can be determined as one of the
main reason due to which people visit to other countries (Ormond and Sulianti, 2014). As per
Noree, Hanefeld and Smith, 2014 “medical tourism provides opportunity to get away from the
daily routine and get to know the health issues and get proper treatment for it” (Noree, Hanefeld
and Smith, 2014). Each of the country have different type of treatments. For example, in India,
people travel from different parts of the world to learn yoga which is an ancient art of keeping
and maintaining healthy body. In this context, there are different other countries in which they
provide people with different set of treatment and these are the reasons due to which people
prefer medial tourism.
Another reason for their visit to other country is due to low cost of treatment. In countries
like India, Sri Lanka, Thailand, etc. the cost of treatment is low and this is another reasons due to
which people visit to other countries (Guiry and Vega, 2015). This is generally done by people

who are at developed countries. They have to pay less for the treatments when they get treatment
from developing countries.
Wongkit and McKercher, 2013 stated that “the quality of treatments is high and it is
beneficial for the people as they get to over come the issues that they are facing” (Wongkit and
McKercher, 2013). There are conditions in which people do not proper treatment at their own
country. In this context, people visit to developing countries in which they get proper treatment
and that also at low cost. The cost that is incurred for patients at their own country will be high
when compared to developing countries.
The waiting list will be low as there are hospitals in which the patients need not wait for
longer time to get their chance to get treatments. They just need to get an appointment and they
will be called (Wongkit and McKercher, 2016). This way they are able to get proper treatment
and that also they are provided with proper attention and ample of time to make sure that all the
issues that faced by them are looked after and treated properly.
When the services provided to people are satisfactory, then it develops positive perception
among individuals mind. The countries in which the treatments are provided are affective, then
people prefer to visit these countries. In Thailand the there is a long history of health
development. This country provide all the type of treatments in relation diseases which are not
communicable. The disease that are communicable, for those diseases, treatment is not provided.
This is done in order to reduce the risk of these diseases to get affected to the local people
(Moghavvemi, Ormond and Chandy, 2017). Due to the negative impact that are caused to local
people, there are different set of policies that are made in order to provide the health of people
and diseases like HIV, Aids do not get to local people.
As per Ormond and Sulianti, 2014 “it is essential to have mental support of the other
people like family, friends, etc.” (Ormond and Sulianti, 2014) However, this is one of the
negative impact in which people fail to get moral support from other own people. When people
visit to other countries for treatment, then they do not get the support from their family and
friends. This is a type of issues that are faced by people. In order to overcome the issues, it is
essential that patient get mental support from their friends or family and that lacks at conditions
when the treatment is to be from other country.
Nurses who are there at different other countries do not have the patients and skills to
understand the language that they speak, this type of conditions causes providing wrong

treatments and they fail to cover the lass after the meditations are provided (Moghavvemi,
Ormond and Chandy, 2017). The countries may be developing but in case of providing the
treatment or proper care to people are high. These countries highly get benefited as they get
foreign income. This positively affects the economic condition of the country. People get
adequate services for the health issues that are faced by people. When hospitals get money from
people who perform medical tourism, then they are able to update or make use of new
technology with the help of which high quality services are provided to people from other
countries.
RESEARCH METHODOLOGY
Introduction
Research methodology is considered as the one of the crucial component for investigation
and thus undertake different tools and techniques for carrying out the study. However, all such
methods are crucial and thus it helps in collecting proper responses so that different factors could
be assessed regarding selection of medical tourism destination can be identified in regard to carry
out in depth study (Daniel and Sam, 2011). Here, researcher aims to carry appropriate
philosophy, design, approach, strategy for accomplishing the research in an effective way.
Further, research would also assess different ways of collecting information and thus investigate
the results of the study.
Research philosophy
Further, it is another tool involved within research methodology that aims to develop
knowledge and sources of study. Here, it is essential for scholar to select right philosophy that
impacts upon the results of the study. Research philosophy is considered as the phenomenon that
helps in carrying out the study on specific subject matter. Here, in depth analysis has been
carried out in regard to assess the results of the study (Flick, 2011). It involves two different
types of research philosophy i.e. interpretivism and positivism. Current study adopts positivism
research philosophy that assists in completing the current research and thus assess the different
factors that affecting medical destination selection of Middle East patients.

Research design
It is stated as the overall strategy that help scholar to integrate the varied elements of the
research and undertake appropriate results. Also, it aids in ensuring the scholar regarding
identifying the research problems and obtaining best results. It also helps in preparing
appropriate outline regarding how the investigation would take place (Goddard and Melville,
2004). It involves different types of research design i.e. descriptive, exploratory and
experimental research design. Current study undertakes exploratory research design which helps
in identifying the different characteristics of population that is the part of the study. It helps in
exploring crucial facts and information in regard to identify the current issue and thus effectively
carry out the study in effective manner.
Research approach
Research approach is considered as an effective tool for carrying out the study either in
general or specific way. However, identifying the master plan assesses that selecting appropriate
method and process helps in collecting data so that bet analysis can be carried out. There are two
different types of research methods such as inductive and deductive (Kumar, 2014). Present
study focuses upon adopting deductive research approach and undertakes hypothesis testing for
checking the reliability and validity of relevant theories regarding the subject matter. It also helps
in carrying out existing theories and thus develops a specific research strategy to test the
hypothesis and thus carry out the research from particular to general.
Research strategy
Research strategy that aims to select a specific research technique or strategy to
accomplish a research in an appropriate manner. In regard to analyse different factors that aims
to selection of destination for medical tourism helps in understanding the needs and expectations
of medical tourists in relation to deliver them appropriate quality health care services to patients
(Lillis, 2008). There are two different types of research strategy that assists in identifying the
technique and thus obtain proper solution so that research issue can be overcome. These are
qualitative and quantitative. For the current study, qualitative research strategy is being selected
in regard to evaluate the responses of the patients travelling for medical tourism.

Data collection methods
Data collection is considered as an effective approach which helps in assessing the ways
of collecting information in relation to overcome the research problem. There are numerous ways
available for collecting data such as primary and secondary sources. For primary data collection
sources, questionnaire is formed and responses are collected from respondents. While, secondary
sources of information involves different sources such as journals, internet, books and
newspapers etc. for collecting information from respondents (Sobh and Perry, 2006). Through
collecting the information from respondents it assists in obtaining crucial data regarding the
factors that affect the medical tourists for selection of destination and thus make effective
decision to attain success.
Sampling
Sampling is considered as the part in which a proportion of sample population is being
selected from target market and thus collect responses from them. However, the researcher aims
to collect suitable responses from the sample population in regard to identify the factors that
affects the medical tourists for selecting destination in Thailand (Vaivio, 2008). There are two
different types of techniques for selecting sample i.e. probability and non probability method.
Here, scholar undertakes random sampling method for selecting the population and thus focuses
upon identifying best results from the study. While, the selection of sample size will be 50
respondents who are medical tourists and thus they are selected for carrying out the study.
Data analysis
It is another crucial tool that helps in examining the information through using
appropriate data analysis tool. Further, using appropriate data analysis tool would result in
examining the information and interpreting the results so that best results can be attained. In the
current study, research strategy used is qualitative technique and thus for this thematic analysis is
being carried out that helps in preparing themes and evaluating the results. Through such strategy
it results in examining the subjective information through preparing graphs, pie charts and
diagrams helps in carrying out best results (Whiteley and Whiteley, 2006).
Validity and reliability
It can be considered that validity and reliability are considered as one of the crucial factor
that helps in identifying the issue occurred in research and overcome the same. Validity is

considered as the best way that helps scholars in carrying out data analysis and thus collect
information in an effective way. It is essential for them to provide the best reliable and useful
information so that it should not give unreliable information to scholar (Daniel and Sam, 2011).
Also, collecting information from different secondary data sources and thus it should be reliable
so that not fake information is being collected which is not useful for study.

Questionnaire
Q1. Name: ________
Q2. Age: _____
Q3. Do you visit Thailand's for treatment?
 Yes
 No
Q4. Number of visits to Thailand' for treatment?
 Once
 Twice
 Thrice
 More than thrice.
Q6. Mode of transportation?
 Air
 Water
 Land
Q7. Medical treatments that you have undergone?
 Orthopedics
 Cardio
 Neuro
 Dental care
 Cosmetics surgery
 Ophthalmology treatment

Q8. Do you evaluate information about the hospital?
 Yes
 No
Q9. Do you agree that medical services in Thailand are much better as compared to other
countries?
 Highly agree
 Agree
 Highly disagree
 Disagree
 Neutral
Q10. Do you think that medical cost is worth as per the services provided by the specific
countries?
 Yes
 No
 Do not know
Q11. Which of the following is the most important factor that drives you to visit Thailand for
medical services?
 Cost
 Proper treatment by the medical practitioners
 Association of other facilities
Q12. Do you agree that service quality of Thailand health care sector is much better as compared
to other countries?
 Highly agree
 Agree

 Highly disagree
 Disagree
 Neutral
Q13. How much you prefer to visit different countries for medical tourism?
 Highly preferable
 Sometimes
 Never
Q14. Does that provide all type of treatments through which people care for their health issues?
 Yes
 No
Q15. What are the issues that are faced by people in medical tourism?
 Communication
 Food
 Currency issues

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