Medical Tourism Services Quality Analysis: A Systematic Review

Amin Torabipour, Mohammad Qolipour, Kamal Qolipour


Introduction: Medical Tourism is defined as providing cost–effective medical care with the assistance of the tourism industry for patients requiring surgery and other special treatment. This study was performed to systematically collect literature in the field of medical tourism and analyze the service quality of this industry for future applied research.

Materials and Methods: A systematic literature search was carried out based on four electronic databases including PubMed, Science Direct, Scopus, and ISI articles published until June 2015. Also, the references of the final selected articles were reviewed to identify the relevant articles. The searching strategies included the following combination of keywords: "medical tourism", and "service quality". Among 128 articles that were identified in the first search, 16 articles were included in the final review. One article from the selected articles was extracted and content analyses was performed in order to determine the type of intervention.

Results: Nine out of 17 articles which totally related to the research questions belonged to Scopus database. Fourteen articles were descriptive. Most of the articles were conducted in Asia (13 articles). Questionnaire method was used in eight of these papers. Ten studies were conducted in hospitals. The main topics of the studies included Servqual, the necessary changes, patient satisfaction, motivations, patients’ expectations, patients’ perceptions, patients’ concerns, and service quality factors.

Conclusion: Health care organizations are looking for various ways to assess the provided service quality and its improvement. Observing a variety of the dimensions of medical tourism service quality in order to attract more patients to the country, is a requirement to policy a country's health care system.


Keywords: Medical Tourism, Service Quality, Systematic Review

Full Text:



Connell J. Medical tourism: Sea, sun, sand and… surgery. Tourism management. 2006;27(6):1093-100.

Herrick DM. Medical tourism: Global competition in health care. National Center for Policy Analysis (NCPA), Policy Report. 2007(304):19-20.

Morovati A, Asadian F. A Model for Health Tourism Development Using Fuzzy TOPSIS and Interpretive Structural Modeling in Yazd Province. Health Management. 2014;55(17):73-88.

Taie ES. Emerging of medical tourism in Egyptian hospitals: International patient satisfaction towards nurses services quality. Global Adv Res J Manag Bus Stud. 2013;2:93-104.

Kim Y, Boo C, Kim M, editors. A framework for health tourism: a case study of Jeju province in the republic of Korea (South Korea). International CHRIE Conference-Refereed Track; 2009.

Nasirpour A, Salmani L. The role of Tehran hospitals ability in the developing medical tourism. Hospital Journal. 2010;9(3):57-67.

David F. Strategic Management. 29th, editor. Tehran: Sharif; 2014.

Haung C-Y, Wang S-P, Chiang C-W. Cost feasibility of a pre-checking medical tourism system for US patients undertaking joint replacement surgery in Taiwan. Chang Gung medical journal. 2010;33(6):684.

Bankar AP. Organisation & Management of Medical Tourism in Maharashtra. WebmedCentral PUBLIC HEALTH. 2012;3(1):WMC002844.

Huang Y-L. Forecasting the demand for health tourism in Asian countries using a GM (1, 1)-Alpha model. Tourism and Hospitality Management. 2012;18(2):171-81.

Karuppan CM, Karuppan M. Changing trends in health care tourism. The health care manager. 2010;29(4):349-58.

Tariqat M, Akhavan A, hasanzadeh A. The principles of the National Health Policy. 1th ed. Tehran: Majlis Research Center; 2008.

Mostafavi H, Shamsi E, Abbasi M. Ethics in Health Tourism. Journal of Bioethics. 2013;2(4):161-80.

Ferdosi M, Jabbari A, Keyvanara M, Agharahimi Z. A systematic review of publications on medical tourism. Director General. 2012;8(8):1169-78.

Carruth PJ, Carruth AK. The financial and cost accounting implications of medical tourism. International Business & Economics Research Journal (IBER). 2010;9(8):135-40.

Smith PC, Forgione DA. Global outsourcing of healthcare: a medical tourism decision model. Journal of Information Technology Case and Application Research. 2007;9(3):19-30.

Chomvilailuk R, Srisomyong N. Three Dimensional Perceptions of Medical/Health Travelers and Destination Brand Choices: Cases of Thailand. Procedia - Social and Behavioral Sciences. 2015;175:376-83.

Delgoshaei B, Ravaghi H, Abolhassani N. Importance-performance analysis of medical tourism in iran from medical tourists and medical services provider's perspective: 2011. Middle East Journal of Scientific Research. 2012;12(11):1541-7.

Lertwannawit A, Gulid N. International tourists' service quality perception and behavioral loyalty toward medical tourism in Bangkok Metropolitan area. Journal of Applied Business Research. 2011;27(6):1-11.

Sankrusme S. Development strategies for taking thailand's health healing tourism business into the global market. Review of European Studies. 2013;5(5):220-32.

Sarwar A. Medical Tourism in Malaysia: Prospect and Challenges. Iran J Public Health. 2013;42(8):795-805.

Sujatha S, Subhashini R. A study on quality issues in medical tourism with reference to Chennai City. International Journal of Pharmaceutical Sciences Review and Research. 2015;30(2):172-4.

Wang HY. Value as a medical tourism driver. Managing Service Quality. 2012;22(5):465-91.

Wernz C, Wernz PT, Phusavat K. Service convergence and service integration in medical tourism. Industrial Management & Data Systems. 2014;114(7):1094-106.

Garcia-Altes A. The development of health tourism services. Annals of tourism research. 2005;32(1):262-6.

Guiry M, Scott JJ, Vequist DGt. Experienced and potential medical tourists' service quality expectations. Int J Health Care Qual Assur. 2013;26(5):433-46.

Ho LH, Yi T. Constructing Quality of Service Indicators and Improvement Strategies for Medical Tourism in Taiwan. Studies on Ethno-Medicine. 2014;8(1):23-31.

Scardina SA. SERVQUAL: a tool for evaluating patient satisfaction with nursing care. Journal of Nursing Care Quality. 1994;8(2):38-46.

Parasuraman A, Zeithaml V. SERVQUAL: A multiple-item scale for measuring customer perceptions of service quality. Journal of Retailing. 2000;64(1):12-40.

Mortazavi S, Kazemi M, Shirazi A, Aziz-Abadi A. The Relationships between Patient Satisfaction and Loyalty in the private hospital Industry. Iranian Journal of Public Health. 2009;38(3):60-9.

Pan TJ, Chen WC. Chinese medical tourists - their perceptions of Taiwan. Tourism Management. 2014;44:108-12.

Conbere P, McGovern P, Kochevar L, Widtfeldt A. Measuring satisfaction with medical case management. A quality improvement tool. AAOHN journal: official journal of the American Association of Occupational Health Nurses. 1992;40(7):333-41.

Tabibi S, Kakhani M, Gohari M, Shahri S. The Relationship Between Services Quality and patient's loyalty in Tehran Public and Private Hospitals: 2009. Hospital Journal. 2009;8(3-4):35.

Crompton JL, McKay SL. Motives of visitors attending festival events. Annals of Tourism Research. 1997;24(2):425-39.

Jafari M, Sadeghifar J, Raadabadi M, Mosavi SM, Zarnaq RK, Bahadori M. The Inquiry of International Standards for Medical Tourism: A Case Study into Hospitals of Tehran University of Medical Sciences. International Journal of Travel Medicine and Global Health. 2014;2(2):45-50.

Oh KM, Jun J, Zhou Q, Kreps G. Korean American women's perceptions about physical examinations and cancer screening services offered in Korea: The influences of medical tourism on Korean Americans. Journal of Community Health. 2014;39(2):221-9.

Rust RT, Lemon KN, Zeithaml VA. Return on marketing: Using customer equity to focus marketing strategy. Journal of marketing. 2004;68(1):109-27.

Andaleeb SS. Service quality perceptions and patient satisfaction: a study of hospitals in a developing country. Social science & medicine. 2001;52(9):1359-70.

Sahney S, Banwet D, Karunes S. An integrated framework for quality in education: Application of quality function deployment, interpretive structural modelling and path analysis. Total Quality Management & Business Excellence. 2006;17(2):265-85.

Wong A, Sohal A. Service quality and customer loyalty perspectives on two levels of retail relationships. Journal of services marketing. 2003;17(5):495-513.

Grewal I, Das JK, Kishore J. Concerns, expectations and satisfaction of medical tourists attending tertiary care hospitals in New Delhi, India. Journal International Medical Sciences Academy. 2012;25(3):151-4.

James PT. The impact of medical tourism on Thai private hospital management: informing hospital policy. Global journal of health science. 2012;4(1):127-39.

Lam SS. SERVQUAL: A tool for measuring patients' opinions of hospital service quality in Hong Kong. Total Quality Management. 1997;8(4):145-52.

Laugesen MJ, Vargas-Bustamante A. A patient mobility framework that travels: European and United States-Mexican comparisons. Health Policy. 2010;97(2-3):225-31.

Kang G-D, Jame J, Alexandris K. Measurement of internal service quality: application of the SERVQUAL battery to internal service quality. Managing Service Quality: An International Journal. 2002;12(5):278-91.

Mohammadi A, Eftekhar Ardebffi H, Akbari Haghighi F, Mahmoudi M, Poorreza A. Evaluation of services quality based on the patients'expectations and perceptions in Zanjan hospitals. Journal of School of Public Health and Institute of Public Health Research. 2004;2(2):71-84.

Han H, Hyun SS. Customer retention in the medical tourism industry: Impact of quality, satisfaction, trust, and price reasonableness. Tourism Management. 2015;46:20-9.

Horton S, Cole S. Medical returns: Seeking health care in Mexico. Social Science and Medicine. 2011;72(11):1846-52.

Abualhasani N. Legal challenges of medical tourism. Journal of Bioethics. 2014;4(15):81-100.

Guiry M, Scott JJ, Iv DGV. Experienced and potential medical tourists' service quality expectations. International Journal of Health Care Quality Assurance. 2013;26(5):433-46.

Sarwar A. Medical tourism in Malaysia: Prospect and challenges. Iranian Journal of Public Health. 2013;42(8):795-805.

Alleman BW, Luger T, Reisinger HS, Martin R, Horowitz MD, Cram P. Medical tourism services available to residents of the United States. Journal of General Internal Medicine. 2011;26(5):492-7.

Wernz C, Wernz PT, Phusavat K. Service convergence and service integration in medical tourism. Industrial Management and Data Systems. 2014;114(7):1094-106.

James PT. The impact of medical tourism on Thai private hospital management: informing hospital policy. Global journal of health science. 2012;4(1):127-39.


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

Creative Commons License
International Journal of Medical Reviews is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.