Nama : ………………………...................

NIM : ......../....................../PEK/..............

GISTER MANAJEMEN – KAMPUS JAKARTA

KULTAS EKONOMIKA DAN BISNIS
VERSITAS GADJAH MADA

UJIAN TENGAH SEMESTER

Mata kuliah : Business and Management
Dosen Pengajar : Naila Zulfa
Hari, tanggal : Jumat, 14 April 2023
Waktu : 19.00 WIB
Sifat Ujian : Open Book – Take Home Exam – 1 hari kerja
Pengumpulan : Sabtu, 15 April 2022, 19.00 via Simaster dan eLok

Kelas S46A SEMBA

Instruksi

Mohon menjawab pertanyaan berikut dengan mengacu pada materi kuliah, artikel
dan Youtube video yang disediakan, serta sumber dan referensi lain yang relevan.
Sumber dan referensi acuan harus disertakan dalam jawaban (in-text citation dalam
jawaban dan daftar referensi di halaman terakhir). Penggunaan Chicago
referencing style sangat disarankan.

Pertanyaan
1. Marketing
Berangkat dari pemahaman atas perilaku konsumen (pasien) Indonesia seperti
pada sumber dan referensi di bawah, berikan rekomendasi Anda strategi yang
perlu ditempuh oleh PT Bundamedik (BHMS) Tbk untuk menarik konsumen
Indonesia agar tidak berobat ke rumah sakit di negara tetangga seperti Malaysia
dan Singapore. Ilustrasikan jawaban disertai bukti, contoh dan referensi.
 Business & Management MAN5005 | MM FEB UGM Jakarta | Naila Zulfa 2023 1

Nama : ………………………...................
NIM : ......../....................../PEK/..............

2. Operation Management
Pilih dan diskusikan satu keputusan kunci dalam operation management bagi PT
Bundamedik (BHMS) Tbk agar proses pelayanan konsumen medical tourism di
Indonesia efektif dan efisien. Ilustrasikan jawaban disertai bukti, contoh dan
referensi.

3. Human Capital Management.

People adalah salah satu elemen bauran pemasaran penting bagi pemasar jasa.
Pilih dan diskusikan satu hal kunci menurut Anda dalam pengelolaan sumber
daya manusia bagi PT Bundamedik (BHMS) Tbk agar efektif dalam merebut
dan melayani pasar medical tourism di Indonesia. Ilustrasikan jawaban disertai
bukti, contoh dan referensi.

Kasus dan informasi relevant: Mohon

kunjungi konten berikut

https://www.youtube.com/watch?v=XCZvyQOp4wk - International Webinar

“Health and Medical Tourism in Indonesia: Challenges and Possibilities”
Business & Management MAN5005 | MM FEB UGM Jakarta | Naila Zulfa 2023 2
https://investor.id/market-and-corporate/287159/bmhs-dan-admedika-perluas-jangkauan-masyarakat-ke-layanan-robotic-surgery

%HULWD6DWXFRP _ %HULWD6DWX79 _ %HULWD6DWX1HZVVWDQG _ ,QYHVWRULG _ -DNDUWDJOREHLG _

¾ ˲ˀ˘ˡ˨ ʕ ˆ˜˚ˡ ˜ˡ ʳ ʶˢˡ˧˔˖˧ ˆ˘˔˥˖˛

ʻˢˠ˘ ˀ˔˥˞˘˧ ˔ˡ˗ ʶˢ˥ˣˢ˥˔˧˘ ʹ˜ˡ˔ˡ˖˘ ʵ˨ ˦ ˜ˡ˘˦˦ ʼˇ ˔ˡ˗ ˇ˘˟˖ˢ ˂˧ˢˠˢ˧˜˙ ʿ ˜˙˘˦ ˧ˬ˟˘ ʼˡ˩ ˘ˆ˧ˢ˥ˬ ʼˡ˗˘˞˦

ŏ
ʻˢˠ˘ ˀ˔˥ ˞˘˧ ˔ˡ˗ ʶˢ˥ˣˢ˥ ˔˧ ˘ ʹ˜ˡ˔ˡ˖˘ ʵ˨ ˦ ˜ˡ˘˦ ˦ ʼˇ ˔ˡ˗ ˇ˘˟˖ˢ ˂˧ˢˠˢ˧˜˙ ʿ ˜˙˘˦ ˧ˬ˟˘ ʼˡ˩ ˘ˆ˧ˢ˥ˬ ʼˡ˗˘˞˦

ʵˀʻˆ˗˔ˡʴ˗ˀ˘˗˜˞˔˃˘˥˟˨˔˦ʽ˔ˡ˚˞˔˨˔ˡˀ˔˦ˬ˔˥˔˞˔˧˞˘ʿ˔ˬ˔ˡ˔ˡ˅ˢ˕ˢ˧˜˖ˆ˨˥˚˘˥ˬ˨ˡ˧˨˞ˠ˘ˡ˗˨˞˨ˡ˚˦˞˘ˠ˔ˣ˘ˠ˕˜˔ˬ˔˔ˡˣ˔˦˜˘ˡʡ

ʵˀʻˆ˗˔ˡʴ˗ˀ˘˗˜˞˔˃˘˥˟˨˔˦ʽ˔ˡ˚˞˔˨˔ˡˀ˔˦ˬ˔˥˔˞˔˧˞˘ʿ˔ˬ˔ˡ˔ˡ
˅ˢ˕ˢ˧˜˖ˆ˨˥˚˘˥ˬ
ʽ˨ˠ˔˧ʟʤʫˀ˔˥˘˧ʥʣʥʥ˯ʤʣʭʨʤˊʼʵ
ʼˡ˗˔˛ʻ˔ˡ˗˔ˬ˔ˡ˜ʛ˛˔ˡ˗˔ˬ˔ˡ˜ʳ˜ˡ˩˘˦˧ˢ˥ʡ˖ˢʡ˜˗ʜ

-$.$57$LQYHVWRULG37%XQGDPHGLN7EN%0+6PHPEXNDNHUMDVDPDGHQJDQEHUEDJDLSHUXVDKDDQ
DVXUDQVLGDQVHMHQLVQ\DXQWXNPHQGXNXQJVNHPDSHPELD\DDQSDVLHQ6DODKVDWXNHUMDVDPD\
DQJGLODNXNDQ DGDODKGHQJDQ$G0HGLNDVHEDJDL7KLUG3DUW\$GPLQLVWUDWRU73$\
DQJKDQGDOGHQJDQEHUEDJDLNHPXGDKDQ
GDQNHXQJJXODQ\DQJGLWDZDUNDQ/HZDWNRODERUDVLLQLNHGXDSHUXVDKDDQLQJLQPHQ\
LDSNDQSHUEDLNDQVLVWHP SHPELD\DDQNHVHKDWDQGLPDVDPHQGDWDQJ
 %0+6 &KDUW ROHK 7UDGLQJ9LHZ

%0+6&KDUWROHK7UDGLQJ9LHZ

.HWXD.RQVXOWDQ0HGLV0HGLFDO$GYLVRU%RDUG$G0HGLND3URI¬,¬2¬0DUVLV6S2*.PHQMHODVNDQDGDQ\D
PHGLFDOWRXULVPGLPDVDGHSDQQDQWLQ\
DDNDQPHQJXEDKSDUDGLJPDDNDQVLVWHPDVXUDQVLNHVHKDWDQ6DODK
VDWX\
DQJGDSDWGLMXDOXQWXNPHPDMXNDQPHGLFDOWRXULVP,QGRQHVLDDGDODKPHODOXLNHKDGLUDQURERWLFV
XUJHU\
\DQJDGDGL5XPDK6DNLW%XQGD´6D\DEHUKDUDSDJDUVLVWHPKLJKWHFKQRORJ\LQLELVDPHPEXNDPDWDNLWD
VHPXDXQWXNPHPEXDWVLVWHPDVXUDQVLPDVDGHSDQ\DQJOHELKEDLNµXQJNDSQ\DGDODPNHWHUDQJDQSHUV -
XPDW

ŏ %DFDMXJD¬%XQGDPHGLN%0+66LDSNDQ5
S7 ULOLXQ8QWXN3HQ
JHPEDQ
JDQ%LVQLVQ
\DGL7 DKXQ,QL

'U,YDQ6LQL6S2*VHODNXSHORSRUURERWLFVXUJHU\GL,QGRQHVLDVHNDOLJXV.RPLVDULV8WDPD%0+6PHPEHULNDQ
SHUEDQGLQJDQPHQJHQDLSHUEHGDDQEHGDKODSURVNRSLGDQEHGDKURERWLNGDODPPHODNXNDQWLQGDNDQ
KLVWHUHNWRPLDWDXSHPEHGDKDQDQJNDWUDKLPEDLN\
DQJMLQDNKLQJJDNDQNHU3HUEDQGLQJDQLQLGLODNXNDQXQWXN
PHOLKDWDVSHNNHDPDQDQPDXSXQNRPSOLNDVL\DQJGLWLPEXONDQGDULNHGXDWHNQLNEHGDKWHUVHEXW

6HODPDLQLODQMXWGU,YDQNHDPDQDQGDQNHPDQMXUDQEHGDKURERWLN5$/+GLEDQGLQJNDQGHQJDQEHGDK
ODSDURVNRSLNRQYHQVLRQDO7/+EHOXPEDQ\
DNGLODNXNDQ.DUHQDLWXVHEXDKVWXGLNRKRUWUHWURVSHNWLIGLODNXNDQ
SDGDSDVLHQ\DQJPHQMDODQNDQWHNQLN5$/+GDQSDVLHQ\DQJPHQMDODQL7/+´+DVLOQ\D5$/+GLQLODL
OHELKDPDQGDQOD\
DNXQWXNSHQJREDWDQNDQNHUUDKLPGHQJDQPRUELGLWDVUHQGDKKLQJJDNHKXODQJDQGDUDK
\DQJOHELKVHGLNLWGLEDQGLQJNDQ7/+µMHODVGU,YDQ6LQL

%DFDMXJD¬'*160LOLN%XQGDPHGLN%0+6/D\DQL7HV&RYLG'DODP6HKDUL

'LNHWDKXLGU,YDQPHQMHODVNDQWHNQRORJLURERWLFVXUJHU\
PHPXQJNLQNDQWLQGDNDQUHSHWLWLIGDODPVXDWXRSHUDVL
GDSDWGLODNXNDQGHQJDQNHWHSDWDQ\DQJPDNVLPDOVHKLQJJDPLQLPDOLVLUSHUGDUDKDQVHUWDUDVDQ\
HULSDVFD
RSHUDVL/HZDWURERWLFVXUJHU\LQLSDUDDKOLEHGDKGDSDWPHQ\HOHVDLNDQEHUEDJDLSURVHGXUUXPLW\DQJ
QDPSDNQ\DVXOLWEDKNDQWLGDNPXQJNLQGLODNXNDQGHQJDQPHWRGHODLQ

6HEDJDLSHORSRUEHGDKURERWLNGL,QGRQHVLDVHMDNWDKXQGU,YDQPHQ\HEXWURERWLFVXUJHU\GDUL%0+6
KLQJJDNLQLVXGDKPHQDQJDQLKDPSLUNDVXVPXODLGDULNDVXVNHELGDQDQGDQNDQGXQJDQKLQJJDNDVXV
XURORJLXQWXNRSHUDVLSHQJDQJNDWDQSURVWDWURERWLN´/D\DQDQ5RERWLF6XUJHU\
VHQGLULPHUXSDNDQVDODKVDWX
&HQWUHRI([FHOOHQFHV&R(GL568%XQGD-
DNDUWDGHQJDQGRNWHUVSHVLDOLVEHUVHUWLÀNDVLURERWLFVXUJHU\µ WXWXSQ\D

(GLWRU,QGDK+DQGD\DQLLQGDKKDQGD\DQL#JPDLOFRP

6XPEHU,QYHVWRU'DLO\

ʵʴʺʼʾʴˁ ‡ †ƁȐ
EPKV EXQGDPHGLN DGPHGLND

ʵ˘˥˜˧˔ˇ˘˥˞˔˜˧
2); 2); 2); 2); 2) ;
,%6-%2/314%7 /314%78: 0-:)6%(-3 /314%7- %2%'31 4%7%2+-/0 %2'31 +6%1)(- %'31 +6%1)(-%(-+- 8 %0 +6-(383'31 &30%74368'31 +6-(-( /328%2'3-( /+1)(-%-(

'PSWI%HW

%HZIVXMWIQIRX
 2);786)2,)%08,*33()(9/%7-4%6%49%2132)=91/18)/230-*)78=0),31)=4634)68-&30%86%:)0383138-*7%-27,=4):-//3031.)3-1%+)7

&%+-/%2 1IPMLEX4SXIRWM4EWEV;MWEXE/7IEVGLIWILEXER+PSFEP&EKEMQERE4SWMWM-RHSRIWME# 0%2++%2%2/314/31)2%7-(

8%6

https://money.kompas.com/read/2020/12/25/053822626/melihat-potensi-pasar-
wisatakesehatan-global-bagaimana-posisi-indonesia?page=all

/SQTEWGSQ1SRI];LEXW2I[

9RXEVYRXYO-RHSRIWME
%OEHIQMWM

4PEXJSVQEOEHIQMWM9RMZ IVWMXEW8 EVYQEREKEVEKYREQIR] IFEVPYEWOEREXEYHMWIQMREWMLEWMPVMWIXXIVOMRMO ITEHEOLEPE ]EOPYEWYRXYOQIQFERKYR

-RHSRIWME ]ERKPIFMLFEMO

1IPMLEX4SXIRWM4EWEV;MWEXE/IWILEXER+PSFEP&EKEMQERE
4SWMWM-RHSRIWME#
/SQTEWGSQ;-&

&%+-/%2 /SQIRXEV

%HZIVXMWIQIRX

0MLEX* SXS

-PYWXVEWM 8,-2/78 3'/

)HMXSV)VPERKKE(NYQIRE
 3PIL*VERKO]7IPEQEX2); 2); 2); 2);

2);786)2,)%08,*33()(9/%7-4%6%49%2132)=91/18)/230-*)78=0),31)=4634)68-&30%86%:)0383138-*7%-27,=4):-//3031.)3-1%+)7

4)1)6-2 8%, -RKMR/IQFERKOER;MWEXE1IHMWHIQMOMERNYHYPWIFYELEVXMOIP

&%+-/%2 ]ERKXE]ERKHM/1SQTEWGSQIPMLEX4SXIRWM4TEHE%KYWXYWEWEV;MWEXE/IWILEXER+PSFEP&EKEMQERE4SWMWM-RHSRIWME#
/31)28%6

&IVMXEXIVWIFYXXIRXYXMHEOQIRKINYXOEROEVIREWINYQPELTIQIVLEXM[MWEXE
XIPELQIRKYRKOETOERFIXETEFIWEVTSXIRWM]ERKHMQMPMOM-RHSRIWMEYRXYO
QIRKIQFERKOER[MWEXEQIHMW

4EHEEOLMV2SZIQFIVPEPYWINYQPELQIHMENYKEQIQFIVMXEOERQMREX
MRZIWXSV.ITERKYRXYOQIQFERKYRJEWMPMXEWOIWILEXERHM&EPM]ERKRERXMR]E
EOERQIRNEHMTYWEX[MWEXEOIWILEXERLIEPXLXSYVMWQ

1IRXIVM&EHER9WELE1MPMO2IKEVE)VMGO8LSLMVQIR]IFYXOERFEL[E %HZIVXMWIQIRX

TIQIVMRXELXIPELQIQMPMOMXERELWIPYEWLIOXEVHM7ERYV&EPM]ERK
HMXE[EVOEROITEHEMRZIWXSV.ITERKYRXYOQIQFERKYRPE]EREROIWILEXERHM WERE

6MYLVIRHELTIQFIVMXEERQIRKIREM[MWEXEQIHMWQIHMGEPXSYVMWQ HER
[MWEXEOIWILEXERXIXETMFIPYQWIQYEWEXYTIQELEQERQIRKIREMETEEVXM
MWXMPELMWXMPELMXY8MHEONEVERKQIRMQFYPOEROIWEPELOETVELER 8)643490)6

&IVETE+ENM4SPMWM0YPYWER
&EGENYKE4IQIVMRXEL-RKMR/IQFERKOER;MWEXE1IHMW %OTSP&IVTERKOEX-THE#

(MFEGEOEPM

;MWEXEOIWILEXER
4424IVWIR6IWQM&IVPEOY
-WXMPEL[MWEXEOIWILEXERWIRHMVMHMKYREOERTIVXEQEOEPMTEHE]ERK ,EVMMRM-
QIVYNYOTEHEWIFYELXYV]ERKQIRKKYREOERJEWMPMXEWOIWILEXERWITIVXMEMV RM(EJXEV&EVERKHER
MOPMQHERPMRKOYRKEREPEQHMRIKEVE]ERKHMOYRNYRKM .EWE-RM&IFEW442
(MFEGEOEPM

'SRRIP QIRKMRHMOEWMOERFEL[EFIPYQEHEHIJMRMWM]ERKTEWXM
0YLYX&IVM/SHI&EOEP%HE
QIRKIREMMWXMPEL[MWEXEOIWILEXE
R

'PSWI%HW

%HZIVXMWIQI
RX
 /IREMOER,EVKE4IVXEPMXI
4VIQMYQ)PTMNM/K8ELYR-
RM
(MFEGEOEPM

/SVFER9RMX0MRO%<%
4VYHIRXMEPHER%-%/IQFEPM
(EXERKM3./1IRKEOY/IGI[E
(MFEGEOEPM

&SW&'%9ERK2EWEFEL]ERK
,MPERKOEVIRE7OMQQMRK/EQM
+ERXM4IVWIR
(MFEGEOEPM

7MET7MET.EHM 2]SR]E
&IWEV-RM7LMS] ERK
%OER&IVNSHSLHIRKER
3VERK/E ]E

&VEROEW8 EO/ YEX0EKM

1IREQTYRK-RM7LMS
]ERK,SOMHM&YPER%TVMP

/YRNYRKMOEREPOEREP7SRSVEMH

1SXMZEWM*IRKWLYM 8MTW&MWRMW
/IWILEXER

%HZIVXMWIQIR
7IPEMRMXYFIPYQEHESVKERMWEWMKPSFEP]ERKQIQMPMOMSXSVMXEWYRXYO
QIRIXETOERHIJMRMWMHERQIRHSVSRKTIRKKYREERMWXMPEL]ERKXITEX

,IPQ] QIVYNYO[MWEXEOIWILEXERTEHEXSTMO]ERKQIR]ERKOYX
LIEPXLGEVILIEPXLEWWIWWQIRXWYVKIV]FIEYX]LIEPMRKTPEWXMGWYVKIV]WTE
VILEFMPMXEWMHERTIR]IQFYLERHIRKEREOXMZMXEWOIWIRERKERHERVIOVIEWMHM
XIQTEXHIWXMREWM

7QMXLHER4YG^OS QIRIOEROERFEL[E[MWEXEOIWILEXERXIVHMVMEXEW
[MWEXEQIHMWHER[IPPRIWWXSYVMWQ]ERKFMEWEHMWIFYX[MWEXEOIFYKEVER
4IQFIHEERMRMFIVHEWEVOEROEVEOXIVMWXMOHERQSXMZEWMHEVM[MWEXE[ER]ERK
FIVOYRNYRK

/SVIE8SYVMWQ3VKERM^EXMSRQIRKOPEWMJMOEWMOER[MWEXEOIWILEXERXIVHMVMEXEW
HYELEP]EMXY[MWEXEQIHMWHER[MWEXEOIFYKEVER

'SRRIP OIQFEPMQIRNIPEWOERFEL[EHIJMRMWMMWXMPEL[MWEXEQIHMWFIPYQ
HMWIXYNYMHERQIQFYXYLOEROEXIKSVM]ERKPIFMLVMRGM

&IFIVETEWXYHMQIRIKEWOERFEL[E[MWEXEQIHMWQIPMTYXMSTIVEWMFIWEV
WITIVXMTIR]EOMXNERXYRKOEROIVHERHMEFIXIWWIQIRXEVE]ERKPEMR
QIR]IFYXOERTVSWIHYVVMRKERWITIVXM]SKEWTEHMIXXIVETMHERWIFEKEMR]E

7XYHMXIVOMRMQIRHYOYRKFEL[E[MWEXEQIHMWWIGEVETVMRWMTJSOYWTEHE
TIVPEOYERQIHMWHEVMTEHELMFYVER7SRK QIREQFELOERFEL[E
XIVQMRSPSKM[MWEXETEHETEWMIRWEOMX]ERKMRKMRQIQTIVSPILPE]ERERQIHMW
EHEPELWIWYEXY]ERKWIQFVSRS

0EPYFEKEMQEREHIRKER[MWEXEOIFYKEVEREXEY[IPPRIWWXSYVMWQ#-WXMPEL
[IPPRIWWTIVXEQEOEPMHMOIQYOEOERTEHESPILHSOXIV,EPFIVX0(YRRHEVM
%QIVMOE7IVMOEX

;IPPRIWWQIVYTEOERMRXIKVEWMERXEVEFEHERTMOMVERHERWIQERKEX;IPPRIWW
]ERKWIWYRKKYLR]EEOERXIVGETEMNMOEXIVNEHMOIWIMQFERKERERXEVEJMWMO
MRXIPIOXYEPIQSWMSREPWSWMEPTIOIVNEERWTMVMXYEPHEREWTIOPMRKOYRKERHEVM
7IQIRXEVERMPEMTEWEVKPSFEP[MWEXEOIFYKEVERTEHEQIRYVYX+PSFEP7TE 4SPHE&ERXIR%QEROER
7YQQMXQIRGETEMQMPMEVHSPPEV%7HERXIVYWFIVXYQFYLLMRKKEOMRM 8IVWERKOEHER8SR7SPEV

%HZIVXMWIQIRX
OILMHYTER 8EQTEOR]E-RHSRIWMEFIPYQHMTIVLMXYRKOERWIFEKEMHIWXMREWM[MWEXE
OIWILEXER]ERKQIRNERNMOER

7IWYRKKYLR]E-RHSRIWMEQIPEPYM-RHSRIWMER1IHMGEP8SYVMWQ&SEVH-18&
XIPELQIRGSFEQIRKKEVETTEWEV[MWEXEOIWILEXEROLYWYWR]EQIHMWWIGEVE
PIFMLTVSJIWMSREP

(MOYXMTHEVMPEQERMQXFMH-18&EHEPELWIFYELFEHER]ERKQIQJEWMPMXEWMHER
QIQTVSQSWMOERMRHYWXVMTIVE[EXEROIWILEXER-RHSRIWMEHIRKER
FIVOSSVHMREWMHERQIQFERKYROIQMXVEERTYFPMOFIVWEQEW[EWXEHM-RHSRIWME
4IVER0 YLYXHM&EPMO/ IREMOER
HERPYEVRIKIVM
,EVKE4 IVXEQE\
0E]ERER]ERKHMFIVMOERTYRFIVERIOEVEKEQWITIVXMYRXYO[ERMXEHEREREO
EREOJIVXMPMX]RIYVSGIRXIVTEVOMRWSRGIRXIVKIRSQMGHMEKRSWXMGSRGSPSK]HER
VSFSXMG

7INYQPELVYQELWEOMXHERTYWEXPE]EREROIWILEXERFIVKEFYRKHEPEQ
OIQMXVEERHMOSXEOSXEWITIVXM.EOEVXE&ERHYRK7YVEFE]ELMRKKE(IRTEWEV
&EPM
,MPEPHER7MHERK-WFEX
4IVXEQEQIQTIVLEXMOERJEOXSVQIHMWHEROIFYKEVERWIGEVEWTIWMJMO*EOXSV 4IRIRXYER6EQEHLER
QIHMW]ERKHMQEOWYHEHEPELOYEPMXEWXMRKKMHEVMJEWMPMXEWOIGEOETERQIHMW ,

%HZIVXMWIQIRX
 8EQTMPER] ERKGYOYTQIREVMOHERQIRKKSHE[EPEYFIPYQGYOYTYRXYO
2); 2); 2); 2);
2);7 86)2,)%08,*33()(9/%7-4%6%49%2132)=91/18)/230-*)78=0),31)=4634)68-&30%86%:)0383138-*7%-27,=4):-//3031.)3-1%+)7
4STYPEVMXEW4YXMR1IRMRKOEX
QIRNEHMOER-RHSRIWMEWIFEKEMTMPMLER[MWEXE[ERHYRMEQIRMOQEXM[MWEXE
4 IVWIR; EVKE6YWME
OIWILEXER
&%+-/%2 1IPMLEX 4SXIRWM4 EWEV;MWEXE/ IWILEXER+PSFEP&EKEMQERE4
HEROIGYOYTERNYQPELWTIWMEPMW]ERKERHEP SWMWM-RHSRIWME# /31)28%6
(YOYRK-RZ EWMO I9OV EMRE
&EGENYKE +IRNSX;MWEXE1IHMW(EPEQ2IKIVM-RM %HETYRJEOXSVOIFYKEVER]ERKTEXYXHMTIVLEXMOEREHEPELOIWINELXIVEER
]ERK%OER(MPEOYOER
TIVMPEOYVIPEOWEWMTIRMRKOEXEROIWILEXERHEROIWIRERKER
4IQIVMRXEL

/IHYEJEOXSVIOSRSQM]EMXYQIR]ERKOYXFME]EQERJEEXHEREWYVERWM7EPEL
WEXYTIVXMQFERKERYXEQE[MWEXE[ERQIPEOYOER[MWEXEOIWILEXERHMPYEV
*EOXSVWYOWIW
RIKIVMEHEPELFME]E]ERKXIVNERKOEYREQYRQIQFIVMOERQERJEEXPIFMLFEKM
[MWEXE[ER
7IOEPMTYRHEXEQIQTIVPMLEXOERFEL[E-RHSRIWMEFYOERPELTMPMLERYXEQE
HIWXMREWM[MWEXEO IWILEXERKPSFEPTIPYERKYRXYOFIVWEMRKXIXETPELEHE
&IVETE+ENM4 SPMWM0 YPYWER /IXMKEJEOXSVFYHE]E
%OTSP&IVTERKOEX-THE#
9RXYOFIVLEWMPHEPEQTIRKIQFERKER[MWEXEO %WTIOEWTIOWITIVXMWMWXIQOIWILEXER]ERKJEQMPMEV
IWILEXER0IIHER/MQ
FELEWEHEROSQYRMOEWMVIPMKMSWMXEWMWYMWYIXMOEWIVXENEVEOHIRKERRIKEVE
QIRKIQYOEOERIQTEXOYRGMWYOWIW[MWEXEQIHMWHER[MWEXEO IFYKEVER 0MRO0MZ I7XV IEQMRK4 ERXEYER
EWEPQIRNEHMTIRIRXY.YKEXMHEOOEPELTIRXMRKQIR]ERKOYXQEOERERMOPMQ
SVERKSVERK]ERKQIPE]ERMHERWYQFIVHE]EEPEQ]ERKFIVFIHE

LXXTWXQIOSQTEWGSQYTHEXIOIQYHMERNSMR%RHELEVYWMRWXEPPETPMOEWM %RKOEX9RXYRK&YHMLEVXS.EHM
8IPIKVEQXIVPIFMLHYPYHMTSRWIP 4ERKHEQ.E]E

&EGEFIVMOYXR]E

0MFYV2EXEP4IRNYEPER4IVXEQE\8YVFSž /31)28%6(-%68-/)00%-22=%

8EO8 YRKKY7MHERK-WFEX
1EWNMH%KYRK%P% ^LEV
4EWXMOER+IPEV7LEPEX8 EVE[ML
1EPEQ-RM

8IVEOLMVOIFMNEOERTIQIVMRXELHERMRJVEWXVYOXYV,EPMRMXIVOEMXHIRKER
OIWIPEQEXEROIEQEREROIQYHELEREOWIWXVERWTSVXEWMTYFPMOHERJEWMPMXEW
]ERKR]EQER

7EQFMPFIVFIRELHMVMQIQYPMLOER[MWEXE-RHSRIWMELMRKKETERHIQMHETEX

0MRO0MZ I7XV IEQMRK

4ERXEYER,MPEPHER7MHERK
0MLEX1SRI ]7IPIRKOETR ]E
2%7-32%0

VMOMEHEOEL] KMOLPEWFERXYWE ]EFYEX

0-,%87)19 % FIPMQEOEREREOWE ]EWOVRKSNIKSRPMRI
QYPEM 'PSWI%HW

=YOMWM[EOXYPYERKHIRKER
1IRERKOER,EHMEL+STE ] (ETEXOER :SYGLIV6T
QEMR KEQIW HM
P
HMOIRHEPMOERQIRKIQFERKOER[MWEXEOIWILEXERQIRNEHMSTWMQIREVMOHER
QIRERXERKFEKMTIRKIPSPE[MWEXE

4ERHIQMXIPELQIRKMRKEXOERQERYWMEFIXETETIRXMRKR]EEWTIOOIWILEXER
FEKMOILMHYTER-RMWINEPERHIRKERXVIR[MWEXEOIWILEXER]ERKXIVYW QIRYRNYOOEROIGIRHIVYRKERQIRMRKOEXXENEQ

8ELYR]ERKWYHELHMHITERQEXEXIRXYQIRNEHMQSQIRXYQXITEXQIRYNY
TIQYPMLER]ERKWIWYRKKYLR]E/YERXMXEW[MWEXE[ER]ERKFIVXEQFELWIMVMRK
OYEPMXEW]ERKQEOMRFEMO8IXETWIQERKEXHERFIVTIRKLEVETER

%HZIVXMWIQIRX
*VERO]7IPEQEX
(SWIRXIXET.YVYWER1ERENIQIR*EOYPXEW)OSRSQM &MWRMW9RMZIVWMXEW
8EVYQEREKEVE

(ETEXOERYTHEXIFIVMXETMPMLERHERFVIEOMRKRI[WWIXMETLEVMHEVM/SQTEWGSQ
1EVMFIVKEFYRKHM+VYT8IPIKVEQ/SQTEWGSQ2I[W9THEXIGEVER]EOPMOPMRO 4ERKPMQE82-(MKYKEXOEVIRE

%HZIVXMWIQIRX
 Tourism Management 58 (2017)e154
163

Contents lists available

ScienceDirect
at

Tourism Management
j ou rn a l h o m e p a ge
ww: w. e l s e v i e r. c o m /l o c ate / to u r m an

Connecting with prospective medical tourists online: A cross-sectional

analysis of private hospital websites promoting medical tourism in
India, Malaysia and Thailand

Sedigheh Moghavvemi a, *, Meghann Ormond b, Ghazali Musa a,

Che Ruhana Mohamed Isa a, Thinaranjeney Thirumoorthi a,
Mohd Zulkhairi Bin Mustapha a, Kanagi A./P. Kanapathy a, Jacob John Chiremel Chandy a
a
University of Malaya, Malaysia b
Wageningen University, Netherlands

highlights

!! Websites of private hospitals promoting medical tourism in India, Malaysia and Thailand is examined.The content and format of 51 hospitals across five
dimensions analyzed.

Article history: Websites of private hospitals promoting medical tourism are important marketing channels for showcasing and promoting
Received 11 October 2015 destinations' medical facilities and their array of staff expertise, services, treatments and equipment to domestic and foreign
Received in revised form patient-consumers alike. This study examines the websites of private hospitals promoting medical tourism in three competing
13 October 2016 Asian countries (India, Malaysia and Thailand) in order to look at how these hospitals present themselves online and seek to
Accepted 17 October 2016 Available
appeal to the perceived needs of (prospective) medical tourists. The content and format of 51 hospitals are analyzed across
online 28 October 2016
five dimensions: hospital information and facilities, admission and medical services, interactive online services, external
activities, and technical items. Results show differences between Indian, Malaysian and Thai hospital websites, pointing to the
Keywords: need for hospital managers to improve their hospitals’ online presence and interactivity.
Content analysis © 2016 Elsevier Ltd. All rights reserved.
Hospital websites
Medical tourism
Patient
On-line search
Medical provider
! Results provide pointers for hospital managers to improve their online presence.

articleinfo abstract
 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163 155

1. Introduction
Medical tourism has attracted significant attention in recent years owing
to the growing number of people from upper-income countries travelling to
lower- and middle-income countries for healthcare (Behrmann & Smith,
2010; Keckley, 2008). The internet, widely appreciated as an increasingly
important source of health and healthcare information, has played a
significant role in the development of the medical tourism industry (Hohm &
Snyder, 2015; Huang & Chang, 2012; Lunt, Hardey, & Mannion, 2010;
Maifredi et al., 2010). Patients in the United States, for example, use the
Internet not only to gather general health information (Von Knoop et al.,
2003) but also to identify the specific types of medical services available in
hospitals at home and abroad (Grigoroudis, Litos, Moustakis, Politis, &
Tsironis, 2008; Taylor, Gombeski, & Dillon, 2005). As such, the Medical
Tourism Association (2009)
156 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163
* Corresponding author.
E-mail addresses: sedigheh@um.edu.my (S. Moghavvemi), meghann.ormond@ wur.nl (M.
Ormond), ghazalimz@um.edu.my (G. Musa), cruhana@um.edu.my (C.R. Mohamed Isa),
thina15@gmail.com (T. Thirumoorthi), zulkhairi@um.edu.my (M.Z. Bin Mustapha),
kanagik@um.edu.my (K.A./P. Kanapathy), drjacob@um.edu. my (J.J. Chiremel Chandy).
http://dx.doi.org/10.1016/j.tourman.2016.10.010 0261-5177/© 2016
Elsevier Ltd. All rights reserved.
found that 49% of the American medical tourists it surveyed learned about
medical tourism via the internet and 73% sought specific information online
about care abroad prior to going abroad. Such web use attests to the
growing active participation of users/ consumers, better informed than ever
before, in caring for their own health and that of their families.
While studies suggest that high-quality online information is important to
attract medical tourists (Kim & Fesenmaier, 2008; Loda, 2011; Mason &
Wright, 2011), existing research on online medical tourism information has
focused mainly on medical travel facilitators' websites. Because medical
tourism practices are largely hospital-centric, however, the websites of
private hospitals promoting medical tourism are also significant marketing
channels for showcasing and promoting destinations' medical facilities and
their array of staff expertise, services, treatments and equipment to both
domestic and foreign patient-consumers (Mason & Wright, 2011; Turner,
2011; Woo & Schwartz, 2014). Private hospital websites which lack relevant
information and customer appeal may negatively affect medical tourists’
decision-making when it comes not only to selecting an individual hospital
but also to selecting the destination country (Everard & Galletta, 2005;
Gallant, Irizarry, & Kreps, 2006; Lindgaard, Fernandes, Dudek, & Brown,
2006; Lowry, Vance, Moody, Beckman, & Read, 2008). However, no
comprehensive study has yet been done on the content and format of
private hospital websites promoting medical tourism.
This study therefore aims to analyze the websites of private hospitals
promoting medical tourism in order to examine how such hospitals present
themselves online and seek to appeal to the perceived needs of
(prospective) medical tourists. To do this, we have studied the information
and interactivity offered by private hospital websites from three of the
world's most popular medical tourism destination countries today e India,
Malaysia and Thailand e across five dimensions: 1) hospital information and
facilities, 2) admission and medical services, 3) interactive on-line services,
4) external activities and 5) technical items (Maifredi et al., 2010). Each
dimension was derived from and evaluated based upon indicators
identified in the literature on medical tourism and healthcare provision
reviewed in the next section and then operationalized using the methods
presented in the section that follows. Our findings indicate a gap between
the information needs of (prospective) medical tourists and that which is
currently available on the websites of private hospitals promoting medical
tourism. In our discussion and conclusion, we present ways in which
medical tourism industry players can improve their online presence and
suggest future directions for study.
Before we examine the Indian, Malaysian and Thai hospital websites, let
us first provide brief vignettes of each of the countries’ experiences with
medical tourism and some of the main characteristics shaping its
promotion:
! Indianomic potential of medical tourism in 2002 and sought to- The
Indian government officially recognized the ecodevelop and promote
India as a world-class ‘global health destination’ with low-cost and
highly-specialized expertise (Medhekar, 2014). The main sources of
medical tourists are Bangladesh, the Middle East, the UK, the US,
Canada and African and other developing countries (Medhekar, 2014).
Promotional efforts to appeal to these markets exist at the hospital
(chain) level (Penney, Snyder, Crooks, & Johnston, 2011) and at the
state and municipal levels (e.g., the cities of Chennai and Bangalore
(Solomon, 2011) and the states of Goa, Kerala and Maharashtra
(Turner, 2007; Qadeer & Reddy, 2010, p. 72). However, to date, no
national booster organization exists to promote medical tourism.
Following on critiques by the Federation of Indian Chambers of
Commerce and Industry about the lack of standardized promotion of
medical tourism, the National Tourism Authority set up a Medical and
Wellness Tourism Promotion Board in 2016 to bring together
government representatives from the Ministries of Tourism and Health
as well as hospitals, hoteliers, medical experts and medical travel
facilitators (IMTJ., 2015b). It will provide financial assistance to hospitals
and medical travel facilitators (MTFs) to improve their marketing
prowess and (customer) service standards and to promote themselves
and India as a medical tourism destination to prospective consumers
and other businesses (Indian Ministry of Tourism, 2014).
! Malaysiatourism in 1998 in the wake of the Asian Financial Crisis in order-The
Malaysian government began to promote medical to diversify its healthcare
and tourism sectors. Since then, governmental and private sector actors
have not only sought to attract neighboring Indonesians e characterized by
sustained, high volumes yet low per patient expenditure e but also
higherspending medical tourists from further afield (e.g., rapidlydeveloping
South and Southeast Asian countries, oil-rich Middle Eastern countries and
high-income Anglophone countries) (Ormond, Wong, & Chan, 2014). In
addition to relaxing once strict national regulations on medical advertising in
order to facilitate marketing by the many private-sector MTFs working both
onand off-line in and outside of Malaysia, the government-initiated,
corporatized Malaysia Healthcare Travel Council (MHTC), which replaced the
National Committee for the Promotion of Medical and Health Tourism in
2009, promotes the Malaysian hospitals and clinics that it vets and endorses
for medical tourism through a dedicated website
(http://www.medicaltourism.com.my). As of 2013, there were 72 endorsed
hospitals and clinics in the country, more than double the number of
endorsed facilities in 2009 (MHTC., 2013). An array of government subsidies
and fiscal incentives available for MHTC-endorsed ‘medical tourism’ facilities
in order to bring these facilities' staff, facilities and equipment to a ‘world-
class’ level so as to appeal to medical tourists (Ormond, 2013). These
specially-designated facilities e dominated by large multinational hospital
chains, like KPJ and Pantai e comprise a range of private and corporatized
hospitals and clinics mostly concentrated in Kuala Lumpur (Selangor),
Penang, Malacca and Johor. However, even before the national government
recognized the economic potential of medical tourism, individual hospitals
and hospital chains were already actively promoting themselves as medical
tourism destinations, and some Malaysian state governments are also
involved (Ormond, 2013). Of the 881,000 foreign patients seeking treatment
in Malaysia in 2013, more than half were Indonesian, followed by smaller
numbers of Japanese, Europeans, Indians, Chinese, Americans, Australians,
Singaporeans and Koreans (http://corporate.tourism.gov.my/ Malaysia,
2014; MHTC., 2015).
! Thailand1990s and began to grow in the mid-2000s after the September- Medical
tourism to Thailand started in the early
11 events in 2001 and the 2004 tsunami (Cohen, 2008). Hosting a recorded
1.8 million foreign patients in 2013 (Bloomberg, 2014; but see Ormond &
Sulianti, 2014; for a critique of recording practices), 65% of these were from
the Asia-Pacific region, Japan and Malaysia, with the rest hailing from the
UK, Germany, Cohen (2008) Scandinavia, the US and the Middle East
(Tourist Authority of Thailand, 2013). Medical tourism is largely
concentrated in Bangkok, Phuket and Chiang Mai, with one hospital e
Bumrungrad International Hospital e accounting for nearly a quarter of all
medical tourists to the country (Connell, 2013). In addition to public and
private hospitals and clinics promoting their services, MTFs, the Tourism
Authority of Thailand, the Ministry of Public Health, the Provincial Health
Authority and the Export Promotion Board are also key players in marketing
 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163
the sector. However, Rerkrujipimol and Assenov (2011) found that the
marketing of Thailand's private-sector health services was poor in
comparison with other significant medical tourism destinations like
Singapore, India and Malaysia. Part of this is due to the fact that, unlike
India and Malaysia, where English is commonly used in and outside of the
hospital setting, the dominance of the Thai language makes it such that Thai
hospitals and clinics must create promotional materials in English and other
languages to communicate with prospective medical tourists travelling to
Thailand and foreign patients already living in Thailand (the latter
accounting for 60% of all ‘medical tourism’ to Thailand (NaRanong & Na
Ranong, 2011). Before 2010, Thailand did not have a centralized national
booster organization website to promote medical tourism. In order to quell
concerns about quality and safety, the Tourism Authority of Thailand
launched a website that year to promote Thailand as the ‘medical hub of
Asia’ and to make it easier for prospective medical tourists to find useful
and reliable information about the country's hospitals (E-Turbo News,
2010). In the wake of the political turmoil the country experienced in recent
years and following a dramatic drop in figures, the national government
launched a new online advertising campaign in 2014 to encourage medical
tourists to return to Thailand (IMTJ., 2014).
These vignettes serve to demonstrate both the provenance of foreign
patients to each of the countries examined in our study and how each
destination has a unique set of concerns and stakeholders involved in shaping
how and to whom medical tourism has been promoted to date.
2. Literature review
Growing numbers of patients and their companions are travelling to lower-
and middle-income countries in search for medical care that may be
prohibitively expensive, inadequate or unavailable in their home countries
(Connell, 2013). This movement of patients across national borders in the
pursuit of health care, which includes cosmetic and dental treatments, has
been popularly designated as ‘medical tourism’ (Turner, 2011). In turn,
governments and privatesector actors in Asia, Europe and Latin America have
begun to actively promote their countries, cities and medical facilities as
medical tourism destinations in order to boost and diversify their tourism and
healthcare offerings (Bookman & Bookman, 2007; Connell, 2006; Musa, Doshi,
Wong, & Thirumoorthy, 2012; Ormond, 2013; Reisman, 2010; Wong & Musa,
2012). The rise of medical tourism in these countries has been made possible
thanks to highly-trained medical professionals' low wages, limited medical
liability, the availability of state-of-the-art medical technology, more
affordable international transport costs, the rise of the internet, the
emergence of new companies and agents which serve as intermediaries
between international patients and hospital networks, as well as governmental
support (Suthin, Assenov & Tirasatayapitak, 2007; Ormond & Mainil, 2015, pp.
154e163).
Hospitals' medical services are generally promoted as modern, high-
technology and high quality, and mention is frequently made of doctors'
(overseas) experience in order to both legitimize medical tourism as a practice
and to market medical tourism as an option to foreign audiences (Lunt, 2011,
p. 13). Some scholars have used qualitative approaches to examining how this
occurs in promotional materials like brochures, flyers and guidebooks
produced by or in conjunction with MTFs, national booster organizations,
hospitals and clinics (Crooks, Turner, Snyder, Johnston, & Kingsbury, 2011a;
Ormond & Sothern, 2012). While Lunt and Carrera (2010) have provided an
overview of different types of medical tourism websites, most studies of the
online promotion of medical tourism to date have focused on the commercial
portals and commerce-related sites produced by MTFs. To understand how
such websites convey information about the benefits and risks of medical
procedures, frame credibility and interact with users, Cormany and Baloglu
(2011) evaluated 57 MTF websites in North America, Asia, Europe, Central and
South America, and Africa; Mason and Wright (2011) conducted a content
157
analysis of 66 MTF websites in the United States, India, Thailand and
Singapore; and Penney et al. (2011) did a thematic content analysis of 17
Canadian MTF websites, developing an inventory of informational points from
the websites themselves and counting their frequency. In addition to
information on medical procedures, doctors and facilities, this literature
suggests that other common features on MTFs’ websites include information
on hospital accreditation; costs; guidelines for international patients, medical
travel visa assistance; travel, leisure activity and accommodation booking
services; medical appointment booking; medical record handling; concierge
and translation services; in-country post-operative care/support; patient
testimonials or recommendations; and design/communication items to
demonstrate reliability like photos, videos, communication options for
enquiries (e.g., email contact, telephone number, mailing address, information
request form and real-time chat rooms), virtual tours of medical facilities and
dates of last webpage update (Fedorov et al., 2009; Lee, 2007; Penney et al.,
2011; Smith & Forgione, 2007; Taylor et al., 2005; Ye, Yuen, Qiu, & Zhang,
2008). However, these studies suggest that the content of MTF websites varies
by the country in which they are based and markets they are targeting due not
only to the special characteristics of the markets (e.g., need for translation
services in non-Englishspeaking destinations, importance of accreditation for
American patients, etc.) but also potentially to regulatory variation regarding
the promotion of medical services (e.g., prohibition of the use of patient
testimonials, etc.).
In the field of healthcare service provision, scholars have identified
categories for assessing websites’ effectiveness (see, e.g., Cyr, Bonanni,
Bowes, & Ilsever, 2005; Han & Mills, 2006; Kim & Fesenmaier, 2008; Lee &
Morrison, 2010; Loda, 2011). These include the information content, ease
of communication and marketing effectiveness, aesthetic design features
and appeal, customer service, technical and website service quality, and
website interactivity. No single set of criteria seems to outperform others;
rather, most scholars suggest that website performance evaluation criteria
can be modified to correspond with objective(s) of the study. As with the
analyses of MTF websites above, studies of healthcare service provider
websites have used content analysis to analyze the usability (e.g., attractive
design/presentation of information, ease of navigation, interactivity,
external links, and internal search capability), content (e.g., clarity of site
purpose for intended audiences; accuracy and authority of general
information, discussions, resources and support systems), and reliability
(e.g., disclaimers and HON code adherence), concluding that few websites
fulfilled the quality criteria in order to provide information sufficient to
increase their credibility among internet users (Bedell, Agrawal, & Petersen,
2004; Eysenbach,
Powell, Kuss, & Sa, 2002; Huang & Chang, 2012; Maifredi et al., 2010).
3. Methods
3.1. Study design and methods
Considering on the findings from Fedorov et al. (2009) and Penney et al.
(2011), we find that Maifredi et al.’s (2010) five categories (1) hospital
information/facilities, 2) admission and medical services, 3) interactive
online services, 4) external activities and 5) technical items best allow us to
assess the usability, content and reliability of websites belonging to private
hospitals promoting medical tourism because these categories include most
of the items that (prospective) medical tourists are identified by scholars to
consider important. Categories 1, 2 and 4 address content and reliability
and categories 3 and 5 address usability and, again, reliability. To generate
an inventory of items on websites of private hospitals promoting medical
tourism, we conducted a pilot content analysis. Following Elo and Kyngas
(2008)€ , where a set of benchmark hospitals were used to identify items
present on websites, the sample for our pilot content analysis of websites
belonging to private hospitals promoting medical tourism was derived from
Medical Travel Quality Alliance's (2014) list of the ‘world's ten best
158 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163

international hospitals for medical tourists'. This led us to study one
website from private hospitals in each of the following countries: Canada,
Malaysia, India, Singapore and Thailandi. The range of items identified in
our pilot content analysis led to the identification of the 38 items identified
in Table 1.
We then used purposive sampling, drawing on the list of hospitals
published on the Patients Beyond Borders website, 1 a site geared primarily
towards an English-speaking U.S. audience, to select private hospitals
promoting medical tourism in India, Malaysia and Thailand. Additional
private hospitals promoting medical tourism in the three countries were
identified through web sources linked to countries' national medical
tourism booster organizations existing in 2015 (e.g., Malaysia Healthcare
Travel Council for Malaysia 2 and Thailand Medical Tourism Portal for
Thailand3 and as such an organization did not exist in India at that time, the
following sites were used to generate a list of hospitals promoting medical
tourism: Health Tourism medical guide, 4 Surgery Tourism5 and MediConnect
India.6 From the total of 287 listed hospitals in 2014 (173 in India, 72 in
Malaysia and 42 in Thailand) that we identified, we then selected 17
hospitals from India,17 from Malaysia and 17 from Thailand for analysis,
making for a total of 51 websites (see Appendix 1). This number was
determined by the limited number of private hospitals serving medical
tourists in each country that explicitly provided information related to
medical tourism on their websites. Several of the hospitals identified for
this study are not individual hospitals but rather hospital chains (e.g., KPJ in
Malaysia) that have a single common website for all member hospitals.
Because of diverse national regulations on medical advertising that shape
what content can and cannot legally be made available on hospital
websites, we classified the websites by the country in which they are
located. We then proceeded to code each of the hospital's websites
relative to the five categories described above. Since a website's homepage
leads visitors to other pages and they are exposed to the homepage even if
they do not explore additional links (Mason & Wright, 2011), we focus our
analysis on hospital websites' homepages and, where they exist, their
medical tourism-focused pages. We also tested the functionality of all the
hyperlinks featured on the hospitals' homepages as well as their interactive
items (e.g., real-time chat rooms and e-mail addresses) to assess their
responsiveness. Due to the authors' linguistic capacities, the sample
includes only hospitals that publish information for domestic and
international patients on websites in English.
Two of the study's authors (specialized in information system and
marketing) coded the webpages separately, both deductively, based on the
abovementioned pre-defined categories and their items (see Table 1), and
inductively, in order to identify additional items relevant to hospital
webpages promoting medical tourism. They reviewed each other's results
and achieved agreement on terms used for the items identified to ensure
consistency. The coders utilized a dichotomous scale to evaluate the
webpages based on the presence (1) or absence (0) of the items listed on
the coding sheet. Inter-coder reliability was determined by Cohen's kappa
which reached an average of 0.9 for all variables. After coding concluded,
we calculated each website's sum total and percentage of items (their
‘evaluation score’) across the total number of items. We then considered
the aggregate website evaluation scores for each country (Table 2) in order
to identify similarities and differences.
This study's main objective is to assess the content, utility and reliability of
websites of hospitals promoting medical tourism. The study focuses only on
what is present or absent in the hospital websites; it does not intend to
explore medical tourists' experience with them. However, future studies may
wish to analyze the effects of this type of website as well as of other types of
websites and other media (e.g., television, radio, books and brochures) on
(prospective) medical tourists' decision-making and behavior. The findings of
this study furthermore are limited to the hospital websites sampled. However,
with future studies, researchers can use this study design and our findings as a
baseline from which to evaluate websites, adapting the items as necessary.
3.2. Context - characteristics of medical tourism promotion in the three case
study countries
For this article, we examine private hospital websites from three of Asia's
most prominent medical tourism destinations today: India, Malaysia and
Thailand. We noted the diverse ways in which medical tourism is promoted
and communicated in each of these countries in the vignettes in the
Introduction. However, we wish to point out two points common to the three
countries here that make their comparison useful. First, each country's
government has recognized medical tourism as a services export sector eligible
for fiscal incentives for acquiring and improving facilities, land, technology and
equipment, international accreditation, and participation in promotional
events. Second, hospitals promoting medical tourism are not focused solely on
medical tourists but are also used by local elites willing and able to pay for
private health care (Ormond et al., 2014; Wilson, 2011; Medhekar, 2014). As
such, hospital websites are not necessarily geared towards medical tourists
alone but also reach national audiences; thus the importance of examining
literature not only on MTF websites but also on hospital websites more
generally.
4. Results
Webpages from 51 private hospitals promoting medical tourism in India,
Malaysia and Thailand were assessed for content, usability and reliability
based on whether or not they included the earlierdescribed items related to
Maifredi et al.’s (2010) five categories.
Below, results e presented in Table 2eare discussed in detail.
4.1. Hospital information and facilities
Our study finds two significant differences in how hospital information and
facilities across the three countries are depicted online. First, countries'
specific regulations on medical advertising and consumer protection appear to
play a significant role in determining what content can(not) legally be made
available on hospital websites (Cormany & Baloglu, 2011; Ormond, 2013). For
example, Indian

1 http://www.patientsbeyondborders.com/thailand.
2 http://www.mhtc.org.my/en/medi-list.aspx.
3 http://www.thailandmedtourism.com/MedCat/67/Hospitals.
4 http://m.health-tourism.com/jci-accredited-medical-centers/.
5 http://surgerytourism.com/hospitals/jcicertified.php.
6 http://www.medicalindiatourism.com/hospitals-in-india/.
 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163 159

5. Technical items 34 Site map present

i 35 Site-wide search tool present
Hospitals included in the pilot study included: Shouldice Hospital (Canada), Fortis Hospital
36 Availability of alternative language options for
Bangalore (India), Gleneagles Hospital (Singapore), Prince Court Medical Centre (Malaysia) and
Bumrungrad International (Thailand). the website (besides English)
37 Website accessibility for people with sensorial
(88%) and Thai (71%) hospitals are far more likely to feature patient
disabilities
testimonials and survey results than their Malaysian (35%) counterparts. 38 Live (no broken) web links
Likewise, Indian (88%) and Thai (90%) hospitals more frequently illustrate their rights and obligations than their Malaysian (55%) and Thai (52%) counterparts.
webpages with photos and videos of their hospital facilities and technological These differences could be linked to nuances in each country's legislation on
equipment than Malaysian hospitals (60%). This suggests that Malaysian patient and user/consumer protection. They may also reflect variations in the
medical advertising regulations may be stricter than in India and Thailand. ways in which each country's medical tourists access information. For example,
However, while Malaysian hospitals (65%) are twice as likely to publish since the majority of medical tourists in Malaysia originate from Indonesia and
information about patient privacy than Thai hospitals (33%), Indian hospitals Singapore, they may rely less on the internet and more on alternative
(82%) far more frequently provide information about patients' information sources (e.g., seeking advice from friends/relatives and word of
Table 1
Codebook items for analysis by category.
mouth (Ormond, 2013).
Categories Corresponding items Second, hospitals differ significantly by country when it comes to
depicting non-medical services (e.g., interpretation, food and
1. Hospital Information 1 Hospital contact information (e.g., address,
and phone and email) accommodation) the hospitals may provide. Though English is widely
facilities 2 Hospital statement of purpose spoken in Indian and Malaysian hospitals but much less so in Thailand,
(e.g., mission or vision) Indian hospitals are nearly twice as likely to mention that they provide in-
3 Photos or videos featuring the hospital facilities
and technology
hospital interpreter services than their Malaysian (55%) and Thai (57%)
4 Getting to the hospital: Ground transportation counterparts. The same goes for noting that they have special menus
arrangements (e.g., pick-up from airports or home) catering to international patients' diverse palates (65% for Indian hospitals,
5 Getting to the hospital: Travel arrangements/ compared with 20% for Malaysian and 14% for Thai hospitals). This could be
bookings
6 Getting to the hospital: Entry visa assistance
due to the diversity between countries as regards the range of international
7 Getting to the hospital: Partnerships with travel patient origins and the languages they speak. Indian medical tourism
agents or hotels hospitals cater to a much broader range of peoples than do Malaysian
8 Patient privacy information hospitals, for example. Indian hospitals are also far more likely to consider
9 Patient's rights and obligations
10 Patient feedback (e.g., testimonials and survey and accommodate patients’ companions both within (82%) and outside
results) (94%) of the hospital than their Malaysian (40% and 60%, respectively) and
11 On-site language interpretation services Thai counterparts (24% and 38%, respectively). These differences may be
12 Food arrangements specific to international
due to the high number of customer-service focused International Patient
patients
13 On-site pharmacy and prescription assistance Centers in Indian hospitals compared with Malaysian and Thai hospitals.
14 On-site facilities for patients' companions (e.g.,
family lounge, accommodation within facility, etc.) 4.2. Admissions and medical services
15 Off-site accommodation arrangements for
patients' companions and outpatients
Our findings clearly demonstrate how heavily all hospitals showcase
their medical specialties, areas of excellence and the qualifications of their
2. Admission and medical 16 Estimated costs (medical and hospital fees) medical staff. However, hospitals across the three countries differ
services 17 Billing information significantly relative to the information they provide on admissions, fees
18 Health insurance accepted (incl. affiliated
and payment and post-discharge arrangements. Indian hospitals (71%) are
insurers)
19 Payment information and facilities (e.g., credit far more explicit about estimated medical and hospital fees, while
cards accepted) Malaysian (50%) and Thai hospitals (38%) are less likely to publish such
20 Foreign currency exchange information and information. Indian hospitals also are more explicit about billing (71%) and
facilities
payment information (82%) than their Malaysian (55% and 60%,
21 Inpatient accommodation
22 Medical specialties/areas of excellence respectively) and Thai (19% and 33%, respectively) counterparts. Yet,
23 Medical staff descriptions Malaysian (70%) and Thai (67%) are two times as likely to publish
24 Appointment booking information about the cost of inpatient accommodation as Indian hospitals
25 Post-discharge arrangements
(47%). These differences, again, may reflect each country's legislation on
3. Interactive online 26 Interactive tools for online enquiries
services 27 Pre-admission consultations at a distance medical advertising and healthcare user/consumer protection.
(online or by phone) As for mode of payment, Indian (76%) and Malaysian (70%) hospitals
28 Medical records available via the Internet were more likely than Thai hospitals (56%) to indicate which kinds of
29 Links to online forums for patient feedback and
social networking (e.g., Twitter and Facebook)
private insurance they accept. Most Indian hospitals (59%) also published
30 Links to additional online venues for information information about foreign currency exchange, far more than their
generated by or about the hospital Malaysian (10%) and Thai (5%) counterparts. Additionally, Indian hospitals
(e.g., YouTube and blogs) (76%) are far more likely than Malaysian (35%) and Thai (10%) hospitals to
4. External activities 31 Healthcare joint ventures, international
affiliations and overseas referral networks with other
provide information about post-discharge arrangements.
hospitals
32 Referral services for international physicians 4.3. Interactive on-line services
(via teleconference, online enquiries or phone)
33 Links to relevant agencies/tourist attractions
Our study shows that most hospital websites across the three countries
are generally weak in offering interactive online services.
However,therearesomedifferencesbetweencountries.Thoughstill quite
limited, Indian (18%) and Thai (14%) hospitals provide interactive tools for
160 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163

online enquiries on their websites, while their Malaysian (0%) counterparts
do not. Though Indian hospitals (76%) are more likely to provide pre-
admission internet-based consultations than Malaysian (35%) and Thai
(10%) hospitals, Thai (29%) hospitals are more likely than Indian (12%) and
Malaysian (5%) hospitals to provide patients with their medical records via
internet.
Meanwhile, hospitals in certain countries have a more diversified social
media presence than others. For example, Indian hospitals (94%) are far
more likely provide links to additional online venues for information about
their hospitals than Malaysian (15%) and Thai (48%) hospitals. Indian (88%)
and Malaysian (75%) hospital websites are also more likely to provide links
to online forums for
Table 2
Results by country.
4.4. External activities
Our findings illustrate how hospitals in the three countries differently
articulate their international affiliations and collaborations. Indian hospitals
(71%) are far more likely to specify their healthcare joint ventures,
international affiliations and overseas referral networks with other
hospitals than their Thai (43%) and Malaysian (30%) counterparts. This
could reflect the still weak, yet growing, development of international
referral networks (Ormond & Sulianti, 2014) as well as concerns that
mentioning (and thus endorsing) other providers on one's website could
lead to competition with them for the same custom.
As for non-medical affiliations, Indian (29%) and Malaysia (25%) hospitals are

Item India Malaysia Thailand All 51 hospitals

1. Hospital Information and facilities

1 Hospital contact information (e.g., address, phone and email) 100% 100% 100% 100%
2 Hospital statement of purpose (e.g., mission or vision) 82% 80% 71% 78%
3 Photos or videos featuring the hospital facilities and technology 88% 60% 90% 79%
4 Getting to the hospital: Ground transportation arrangements (e.g., pick-up 88% 60% 38% 60%
from airports or home)
5 Getting to the hospital: Travel arrangements/bookings 82% 55% 33% 55%
6 Getting to the hospital: Entry visa assistance 88% 50% 43% 59%
7 Getting to the hospital: Partnerships with travel agents or hotels 53% 30% 33% 38%
8 Patient privacy information 53% 65% 33% 50%
9 Patient's rights and obligations 82% 55% 52% 62%
10 Patient feedback (e.g., testimonials, survey results) 88% 35% 71% 64%
11 On-site language interpretation services 94% 55% 57% 67%
12 Food arrangements specific to international patients 65% 20% 14% 31%
13 On-site pharmacy and prescription assistance 88% 35% 33% 50%
14 On-site facilities for patients' companions 82% 40% 24% 47%
(e.g., family lounge, accommodation within facility, etc.)
15 Off-site accommodation arrangements for patients' companions and 94% 60% 38% 62%
outpatients

2. Admissions and medical services

16 Estimated costs (medical and hospital fees) 71% 50% 38% 52%
17 Billing information 71% 55% 19% 47%
18 Health insurance accepted (incl. Affiliated insurers) 76% 70% 57% 67%
19 Payment information and facilities (e.g., credit cards accepted) 82% 60% 33% 57%
20 Foreign currency exchange information and facilities 59% 10% 5% 22%
21 Inpatient accommodation 47% 70% 67% 62%
22 Medical specialties/areas of excellence 100% 95% 86% 93%
23 Medical staff descriptions 100% 90% 86% 91%
24 Appointment booking 88% 65% 76% 76%
25 Post-discharge arrangements 76% 35% 10% 38%

3. Interactive online services

26 Interactive tools for online enquiries 18% 0% 14% 10%
27 Pre-admission consultations at a distance (online or by phone) 76% 35% 10% 38%
28 Medical records available via the Internet 12% 5% 29% 16%
29 Links to online forums for patient feedback and social networking (e.g., Twitter 88% 75% 57% 72%
and Facebook)
30 Links to additional online venues for information generated by or about the hospital (e.g., 94% 15% 48% 50%
YouTube and blogs)

4. External activities
31 Healthcare joint ventures, international affiliations and overseas referral networks with other 71% 30% 43% 47%
hospitals
32 Referral services for international physicians 6% 20% 0% 9%
(via teleconference, online enquiries or phone)
33 Links to relevant agencies/tourist attractions 29% 25% 10% 21%

5. Technical items
34 Site map present 88% 45% 48% 59%
35 Site-wide search tool present 82% 25% 67% 57%
36 Availability of alternative language options for the website (besides English) 24% 35% 90% 52%
37 Website accessibility for people with sensorial disabilities 0% 0% 0% 0%
38 Live (no broken) web links 82% 95% 81% 86%

patient feedback and social networking, like Twitter and Facebook, than more likely to provide links to travel agencies and tourist attractions than their
Thai hospital websites (57%). Thai (10%) counterparts. While this could indicate limited collaboration with
non-medical service providers, it could also speak to the different ways in
 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163
which hospitals promoting medical tourism may envision and wish to highlight
their connections to the travel and tourism sectors.
4.5. Technical items
Our results show that, while hospitals across the three countries actively
maintain their websites (e.g., no broken web links, etc.) for general users, they
do not go the extra mile to cater for the special needs of web users with
sensorial disabilities. Indian hospital websites were more structured so as to
ensure general users’ greater ease in reading content, providing structural
elements like a site map (88%) and site-wide search tool (82%) compared with
Malaysian (45% and 25%, respectively) and Thai (48% and 67%, respectively)
hospitals.
Linguistically, Thai hospital websites (90%) were nearly three times more
likely than their Malaysian and Indian counterparts to make alternative
language options (besides English) available for the website. Of all Thai
hospital websites studied here, only few offered a separate international
patient page (unlike India and Malaysia, where this practice was much more
common), indicating that the webpage in English is geared towards
international patients, not local health consumers, since English is a foreign
language in Thailand (unlike India and Malaysia).
5. Discussion and conclusions
This study has compared websites of hospitals promoting medical tourism
services in Thailand, India and Malaysia. In this section, we reflect on the
relationship between the results and the literature review in order to offer
insight into how medical tourism is currently being marketed online and
provide some ways in which hospitals in these countries and beyond can
improve their online presence.
As evidenced in the literature review, hospitals are not alone in promoting
medical tourism directly to consumers. Private sectorand government-led
booster organizations and medical travel facilitators (MTFs) also play a
significant role. Indeed, many of these bodies work in cooperation with
hospitals, thus partly relieving them from the burdens and challenges of
tapping into and marketing to foreign consumers. 7 In light of the diversity of
sources of information on medical tourism available to consumers, significant
concern has been raised about the lack of regulation not only of online health
information more generally (Boyer, 2013) but also more specifically on medical
tourism, given that scant independent, non-commercial information about
medical tourism exists online (Lunt, 2011). As a result, in order to protect
consumers from misleading and incomplete medical advertising, not only are
MTFs, booster organizations and hospitals promoting medical tourism liable to
the national regulatory authorities of the countries in which they are located
but they are also increasingly liable to those in the countries whose citizens
they seek to attract.8
Private hospital websites facilitate awareness among internet users about
the expertise and services on offer. On their own or in addition to medical
tourism marketing by booster organizations and MTFs, hospital websites can
serve as important marketing tools to attract local and international patients
alike (Huang & Chang, 2012; Mason & Wright, 2011; Mira, Llinas, Tom" as," &
Perez-Jover," 2006). Given that medical tourism is so hospital-centric,
interactive and informative hospital websites are crucial since (prospective)
medical tourists, largely removed from and unfamiliar with the health systems
and options available to them abroad, arguably rely more on the internet for
data gathering and decision-making than patients who are not seeking
7 Some hospitals outsource medical tourism marketing to MTFs (Ormond, 2013). 8 Consider, for
example, the UK's Advertising Standards Authority's crack-down on medical tourism agencies,
booster organizations, hospital and clinics targeting the UK outbound medical tourism market that
breach UK medical advertising standards for making ungrounded claims about quality of
(unproven) treatments and care available and trivializing the medical risks of specific types of
treatment (IMTJ., 2010, 2015a).
161
treatment abroad and are comparably more embedded in and familiar with
their healthcare system and available options.
Our study suggests that hospital websites generally performed well in
providing content that highlights what constitutes their core business: medical
facilities, equipment and staff. Hospitals use a variety of techniques to
establish their credibility among foreign audiences, including profiling their
international certifications and links to accreditation bodies; information
related to cost, healthcare quality and medical expertise (Smith & Forgione,
2007). Where possible, given different national restrictions on medical
advertising, websites included visual and textual evidence of hospitals’
excellence, strategically deploying testimonials of satisfied patients as well as
imagery of professional and hospitable staff, operating theatres, recovery
rooms, diagnostic equipment and public lounge spaces. However, they varied
significantly in terms of the information they provided on financial issues and
services available specifically for international patients and their travelling
companions. This, arguably, reflects the fact that, as noted above, hospital
websites are not the sole source of information or contact points for
(prospective) international patients. Still, some hospital websites e particularly
those from India and, to a lesser extent, from Thailand e actively blurred
distinctions between conventional hospital services and services provided by
MTFs by providing more individualized customer-centered and culturally-
sensitive guidance and support regarding non-medical concerns such as travel
and accommodation arrangements, concierge services and ground transport,
linguistic interpretation and what happens postdischarge. Yet, overall, few
hospital websites gave much attention to what happens to international
patients after they leave the hospital and return to their countries of
residence.
While we are coming to a better understanding of how medical tourism
promotional websites work and their limitations, no studies have yet
examined their role, use and impact on actual and prospective medical
tourists' healthcare consumption behavior (Lunt, 2011, p. 20). Rather, as we
have seen in the literature review, existing studies tell us how MTFs,
booster organizations and hospitals perceive the needs of medical tourists.
Our study also contributes to medical tourism literature in this way.
However, we should take into account several studies that have examined
the information preferences and travel motivations of medical tourists
around the world. Crooks et al. (2011), for example, found that Canadian
medical tourists seek information on procedures, costs, accreditation and
affiliations, accommodation and linguistic competence and rely on word-of-
mouth and patient testimonials to help them decide on the destination for
a given procedure. Musa et al.’s (2012) study of international inpatients in
private Malaysian hospitals in Kuala Lumpur found that those surveyed
were first concerned with the quality of hospitals' doctors and nurses,
followed by hospital services, atmosphere and facilities. Wong and Musa
(2012) also found that well-qualified medical practitioners and the provision
of state-of-the-art medical facilities and services were the main pull factors
attracting medical tourists to India, Malaysia and Singapore, followed by the
destination country's political and economic stability and a favorable
exchange rate. In addition, patients show interest in the location of the
destination, frequency of flights, and streamlined travel and entry
procedures (Lee, 2007). From a destination marketing perspective,
therefore, satisfying prospective and existing medical tourists' information
needs and understanding their (culturally-specific) expectations are clearly
crucial for the development of effective online marketing strategies
(D'Ambra & Mistilis, 2010).
The literature on medical tourists' information needs indicates the
significance of establishing trust between hospitals and (prospective)
healthcare consumers and, therefore, of websites demonstrating that
hospital staff, facilities and treatments are as safe and reliable as possible.
medical tourism can and should be further developed so as to
provide more reliable, credible and in-depth medical and nonmedical
information that will satisfy the needs and concerns of medical tourists of
diverse socio-economic, cultural and linguistic backgrounds and enable them
to make better-informed decisions (Lee, 2007; Mason & Wright, 2011). Our
study's findings suggest that medical advertising restrictions and consumer
protection
162 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163

Websites of hospitals promoting legislation in each country play an I9. Medanta Hospital http://www.medanta.org/
http://www.narayanahealth.org/
important role here. For example, Malaysian hospitals generally cannot use
(continued )
unproven superlatives (e.g., ‘the best’, ‘the top’, etc.) to describe
Hospitals Website analyzed
themselves but have to demonstrate their excellence in other ways. As
such, indicating doctors' professional (overseas) experience, hospitals' I10. Narayana Hrudayalaya Health City
international accreditation status as well as demonstrating how the hospital
I11. Sri Ramachandra Medical Centre http://www.sriramachandra.
is embedded in international networks of medical excellence (e.g.,
edu.in/medical/new_medical_
healthcare joint ventures, international affiliations and overseas referral centre/
networks) are frequent alternative ways to demonstrate quality and I12.Fortis Escorts Heart Institute http://www.fortisescorts.in/
trustworthiness.
Another way in which to signal accountability and confidence is through I13.Dr. L H Hiranandani Hospital http://www.
hiranandanihospital.org/
the provision of interactive online services and feedback mechanisms to
I14.Fortis Hospital Bangalore http://www.fortishealthcare.
improve institutional transparency. The hospital websites in our sample com/india/hospital
appear to target people from upper- and middle-income countries and elite I15.Fortis Hospital Mumbai http://www.fortishealthcare.
from lower-income countries who are competent internet users. In light of com/india/hospitals-inmaharashtra
this, website interactivity is an important factor in influencing these
I16.Shroff Eye Hospital and LASIK centre http://www.shroffeye.org/
consumers' perceptions of trust, positive attitudes towards site content and
intention to purchase products and services (Chen, Griffith, & Shen, 2005).
I17.Rotunda: The Centre for Human http://www.iwannagetpregnant.
Improving website interactivity has the potential increase conversion rates Reproduction com/
and boost recognition (Singh, 2010). Since most (80%) internet users spend Malaysia M1. Assunta Hospital http://assunta.com.my/home/
only a few seconds viewing a site on average, first impressions of a site M2. Columbia Asia Hospital Malaysia http://www.columbiaasia.com/
influence whether users decide to continue interacting with it or to browse malaysia/
M3. Gleneagles (chain; 4 http://gleneagleskl.com.my/
another (Everard & Galletta, 2005; Lindgaard et al., 2006; Lowry et al.,
Hospitals)
2008; Peracchio & Luna, 2006; Robins & Holmes, 2008). Website structure
M4. Island Hospital http://www.islandhospital.com/
and the consistency of its content are necessary to avoid users becoming home.html
bored or confused and eventually aborting their attempt to view the M5. KPJ (chain; 25 Hospitals) http://www.kpjhealth.com.my/
information (Hasan & Abuelrub, 2011). Search tools, site maps and the
ability to use alternative languages therefore facilitate users’ interaction M6. Pantai (chain; 10 Hospitals) http://www.pantai.com.my/
with websites (Luna-Nevarez & Hyman, 2012). Providing different language
M7. Penang Adventist Hospital http://www.pah.com.my/
options also facilitates interaction between service users and providers and
enables a broader range of users to stay longer and spend more time at a
M8. Prince Court Medical Centre http://www.princecourt.com/
website. Finally, the use of aesthetically appealing items (e.g., pictures,
colors and graphical layout) generates awareness and maintain viewer M9. Tropicana Medical Centre http://www.
interest, influencing information transfer and how users judge subsequent tropicanamedicalcentre.com/
experience with and enjoyment and perceptions of reliability of a website M10. Subang Jaya Medical Centre http://www.ramsaysimedarby. asia/
(Han & Mills, 2006; Luna-Nevarez & Hyman, 2012; Van der Heijden, 2003).
M11. Sunway Medical Centre http://www.sunwaymedical.
The informational items examined in this study may help internet-savvy
com/
medical tourists reduce information asymmetry associated with seeking
M12.National Heart Institue http://www.ijn.com.my/
treatments and accommodation in unfamiliar places in allowing them
access to reliable information on hospital websites (Yu & Ko, 2012). M13.Nilai Medical Centre http://www.nilaimc.com/

Appendix 1 M14.Ramsay Sime Darby Subang Jayahttp://www.ramsaysimedarby.

Medical Centre asia/eng/company-info/facilities/
malaysia/subang-jaya-medicalcentre

Private hospitals and clinics promoting medical tourism included in the study. M15.Beacon International specialist http://beaconhospital.com.my/
Centre
Hospitals
M16.Dentalpro Dental Specialist Centre http://www.dentalpro.org/

Website analyzed
India I1. Apollo Gleneagles Hospitals, Kolkata http://kolkata.apollohospitals. com/ M17.Internationa Specialist Eye Centre http://www.isec.my/
Malaysia
I2. Apollo (chain; 25 hospitals) https://www.apollohospitals. Thailand T1. Bangkok Hospital (chain; 20 https://www.bangkokhospital.
com/ Hospitals) com/en/
I3. Artemis Health Institute http://www.artemishospitals. T2. BNH Hospital http://www.bnhhospital.com/
com/
I4. Columbia Asia India http://india.columbiaasia.com/ T3. Bumrungrad Hospital https://www.bumrungrad.com/

I5. Continental Hospitals Limited, http://www. T4. Chaophya Hospital http://www.chaophya.com/

Hyderabad continentalhospitals.com/ web_eng1/

I6. Fortis (chain; 23 Hospitals)
I7. Moolchand Medcity
I8. Max Healthcare in India
http://www.fortishealthcare. T5. Chiangmai Ram Hospital http://www.chiangmairam.com/
com/ NEW%20CMR/HOME%20Eng/ home
%20Eng.html
http://www.
T7. Phuket International Hospital http://www.
moolchandhealthcare.com/
phuketinternationalhospital.
http://www.maxhealthcare.in/ com/
T6. Praram 9 Hospital http://www.praram9.com/
 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163 163

T8. Ramkhamhaeng Hospital http://www.ram-hosp.co.th/ Han, J. H., & Mills, J. E. (2006). Zero acquaintance benchmarking at travel destination websites:
web_eng/index.htm What is the first impression that national tourism organizations try to make? International
T9. Samitivej Hospital (chain; 7 https://www.samitivejhospitals. Journal of Tourism Research, 8(6), 405e430.
Hospitals) com/ Hasan, L., & Abuelrub, E. (2011). Assessing the quality of web sites. Applied Computing and
Informatics, 9(1), 11e29. http://dx.doi.org/10.1016/j.aci.2009.03.001.
T10. Synphaet Hospital http://www.synphaet.co.th/
Hohm, C., & Snyder, J. (2015). It was the best decision of my life: A thematic content analysis of
synphaet2008/home/home_eng.
former medical tourists' patient testimonials. BMC Medical Ethics, 16, 8.
html
http://dx.doi.org/10.1186/1472-6939-16-8.
T11. Vejthani Hospital http://www.vejthani.com/
Huang, E., & Chang, C.-C. A. (2012). Patient-oriented interactive e-health tools on US hospital web
sites. Health marketing quarterly, 29(4), 329e345.
T12.Yanhee International Hospital http://yanhee.net/welcome IMTJ. (2010). New online advertising rules have implications for medical tourism marketing.
International Medical Travel Journal. http://www.imtj.com/articles/ 2010/implications-for-
T13.Piyavate International Hospital http://www.piyavate.com/ medical-tourism-marketing-30082/.
IMTJ. (2014). New medical tourism campaign launched. International Medical Travel Journal, 3
T14.TRSC International LASIK centre http://www.lasikthai.com/? April, available at: http://www.imtj.com/news/?entryid82¼439371.
ref¼do:intro
IMTJ. (2015a). Know your market… Malaysia ‘boob job’ advertisement banned in UK. International
(continued on next page) Medical Travel Journal. February, available at: http://www.imtj. com/blog/malaysia-
(continued ) boob-job-advertisement-banned-in-uk-40188/.
Hospitals Website analyzed IMTJ. (2015b). 16-point agenda to position India as a preferred medical tourism destination.
International Medical Travel Journal, 28 May, available at: https://
T15.Bangkok International Dental http://www. www.imtj.com/news/16-point-agenda-position-india-preferred-medicaltourism-
Centre thailanddentalhospital.com/ destination.
dental_hospital Indian Ministry of Tourism. (2014). Revised guidelines for the promotion of wellness and medical
T16.Preecha Aesthetic Institute http://pai.co.th/ as niche tourism products, 21 Aug., available at: http://tourism.gov.
T17.Phuket International Dental http://www.dental-phuket.com/ in/writereaddata/Uploaded/Guideline/090420140425104.pdf.
Centre Keckley, P. H. (2008). Medical tourism: Update and implications; deloitte center for health
solutions. available at: http://www.deloitte.com/assets/ DcomUnitedStates/Local
References %20assets/documents/us_chs_medicaltourism_ 111209_web.pdf.
Kim, H., & Fesenmaier, D. R. (2008). The persuasive design of destination web sites: An analysis of
Bedell, S., Agrawal, A., & Petersen, L. E. (2004). A systematic critique of diabetes on the World
first impression. Journal of Travel Research, 47, 3e13.
Wide Web for patients and their physicians. International Journal of Medical Informatics,
Lee, C. (2007). Just what the doctor ordered: Medical tourism. Monash Business Review, 3(3),
73(9), 687e694.
10e12.
Behrmann, J., & Smith, E. (2010). Top 7 issues in medical tourism: Challenges, knowledge gaps, and
Lee, J. K., & Morrison, A. M. (2010). A comparative study of web site performance. Journal of
future directions for research and policy development. Global Journal of Health Science, 2(2),
Hospitality and Tourism Technology, 1(1), 50e67.
80.
Lindgaard, G., Fernandes, G., Dudek, C., & Brown, J. (2006). Attention web designers: You have
Bloomberg. (2014). How cheap oil and fewer nose jobs hurt Thai hospital stocks. November 18 th
50 milliseconds to make a good first impression. Behaviour & Information Technology,
:available at: http://www.bloomberg.com/news/articles/201605-29/how-cheap-oil-and-
25(2), 115e126. http://dx.doi.org/10.1080/ 01449290500330448.
fewer-nose-jobs-are-hurting-thai-health-stocks.
Loda, M. D. (2011). Comparing web sites: An experiment in online tourism marketing. International
Bookman, M. Z., & Bookman, K. R. (2007). Medical tourism in developing countries. Macmillan.
Journal of Business and Social Science, 2(22), 70e78.
Boyer, C. (2013). When the quality of health information matters: Health on the net is the quality
Lowry, P. B., Vance, A., Moody, G., Beckman, B., & Read, A. (2008). Explaining and predicting
standard for information you can trust, health on the net foundation.
the impact of branding alliances and web site quality on initial consumer trust of e-
http://www.hon.ch/Global/pdf/TrustworthyOct2006.pdf.
commerce web sites. Journal of Management Information Systems, 24(4), 199e224.
Chen, Q., Griffith, D. A., & Shen, F. (2005). The effects of interactivity on cross channel
Luna-Nevarez, C., & Hyman, M. R. (2012). Common practices in destination website design. Journal
communication effectiveness. Journal of Interactive Research, 5(2), 30e44.
of Destination Marketing & Management, 1(1e2), 94e106.
Cohen, E. (2008). Medical tourism in Thailand. In E. Cohen (Ed.), Explorations in Thai tourism (pp.
Lunt, N. (2011). Medical tourism: Treatments, markets and health system implications: A
225e255) (Bingley: Emerald).
scoping review. OECD, directorate for employment, labour and social affairs.
Connell, J. (2006). Medical tourism: Sea, sun, sand and surgery. Tourism Management, 27(6),
Lunt, N., & Carrera, P. (2010). Medical tourism: Assessing the evidence on treatment abroad.
1093e1100. http://dx.doi.org/10.1016/j.tourman.2005.11.005.
Maturitas, 66(1), 27e32.
Connell, J. (2013). Contemporary medical tourism: Conceptualisation, culture and
Lunt, N., Hardey, M., & Mannion, R. (2010). Nip, tuck and click: Medical tourism and the
commodification. Tourism Management, 34(0), 1e13. http://dx.doi.org/10.1016/j.
emergence of web-based health information. The Open Medical Informatics Journal, 3,
tourman.2012.05.009.
77e87.
Cormany, D., & Baloglu, S. (2011). Medical travel facilitator websites: An exploratory study of web
Maifredi, G., Orizio, G., Bressanelli, M., Domenighini, S., Gasparotti, C., Perini, E., et al. (2010).
page contents and services offered to the prospective medical tourist. Tourism Management,
32(4), 709e716. doi http://dx.doi.org/10.1016/j. tourman.2010.02.008. Italian hospitals on the web: A cross-sectional analysis of official websites. BMC medical
informatics and decision making, 10(1), 17.
Crooks, V. A., Bristeir, J., Turner, L., Snyder, J., Casey, V., & Johnston, R. (2011). Understanding the
Mason, A., & Wright, K. B. (2011). Framing medical tourism: An examination of appeal, risk,
health and safety risks for british Columbia's outbound medical tourists. Department of
Geography, Simon Fraser University. convalescence, accreditation, and interactivity in medical tourism web sites. Journal of
Health Communication, 16(2), 163e177.
Crooks, V. A., Turner, L., Snyder, J., Johnston, R., & Kingsbury, P. (2011a). Promoting medical
Medhekar, A. (2014). Government policy initiatives for developing sustainable medical tourism
tourism to India: Messages, images, and the marketing of international patient travel. Social
industry. Journal on Business Review (GBR), 3(3). http://dl6.
Science & Medicine, 72(5), 726e732.
globalstf.org/index.php/gbr/article/download/267/283.
Cyr, D., Bonanni, C., Bowes, J., & Ilsever, J. (2005). Beyond trust: Website design preferences
Medical Tourism Association. (2009). Releases first patient surveys on medical tourism.
across cultures. Journal of Global Information Management, 13, 24e52.
Medical Tourism Magazine, 10, 34e36. Available at: http://www.
D'Ambra, J., & Mistilis, N. (2010). Assessing the e-capability of visitor information centers. Journal
medicaltourismmag.com/mta-releases-first-patient-surveys-on-medical-tourism/.
of Travel Research, 49(2), 206e215.
Medical Travel Quality Alliance's. (2014). The world's best hospitals for medical tourists.
Elo, S., & Kyngas, H. (2008). The qualitative content analysis process.€ Journal of Advanced
Available at: http://www.mtqua.org/top-10-worlds-best-hospitals-formedical-tourists-
Nursing, 62(1), 107e115.
new/.
Everard, A., & Galletta, D. F. (2005). How presentation flaws affect perceived site quality, trust, and
MHTC.. (2013). Healthcare Malaysia magazine. available at:
intention to purchase from an online store. Journal of Management Information Systems,
http://www.
22(3), 56e95.
medicaltourism.com.my/en/malaysia-healthcare-magazine/2013/Healthcare% 20Malaysia
Eysenbach, G., Powell, J., Kuss, O., & Sa, E.-R. (2002). Empirical studies assessing the quality of %20Magazine%202013_English.pdf.
health information for consumers on the world wide web: A systematic review. Journal of the MHTC.. (2015). Statistics. available at: http://www.mhtc.org.my/en/statistics.aspx.
American Medical Association, 287(20), 2691e2700. Mira, J., Llinas, G., Tom" as, O., & P" erez-Jover, V. (2006). Quality of websites in Spanish" public
Fedorov, G., Tata, S., Raveslooy, B., Dhakal, G., Kanosue, Y., & Roncarati, M. (2009). Medical travel hospitals. Informatics for Health and Social Care, 31(1), 23e44.
in Asia and the pacific: Challenges and opportunities. Bangkok: UN ESCAP. Musa, G., Doshi, D. R., Wong, K. M., & Thirumoorthy, T. (2012). How satisfied are inbound
Gallant, L., Irizarry, C., & Kreps, G. L. (2006). User-centric hospital web sites: A case for trust and medical tourists in Malaysia? a study on private hospitals in Kuala Lumpur. Journal of
personalization. E-Service Journal, 5(2), 5e26. Travel & Tourism Marketing, 29, 629e646.
Grigoroudis, E., Litos, C., Moustakis, V. A., Politis, Y., & Tsironis, L. (2008). The assessment of user- NaRanong, A., & NaRanong, V. (2011). The effects of medical tourism: Thailand's experience.
perceived web quality: Application of a satisfaction benchmarking approach. European Bulletin of the World Health Organization, 89(5), 336e344.
Journal of Operational Research, 187(3), 1346e1357.
164 S. Moghavvemi et al. / Tourism Management 58 (2017) 154e163

E.-T.urbo News. (2010). TAT launches e-marketing campaign for medical tourism in Thailand, E- Dr. Sedigheh Moghavvemi is a Senior Lecturer attached to the Department of Operation and
Turbo News, 21 Oct., available at: http://www.eturbonews.com/ 19166/tat-launches-e- Management Information System. She received her PHD from Faculty of Business and
marketing-campaign-medical-tourism-thailand. Accountancy, UM.
Ormond, M. (2013). Neoliberal governance and international medical travel in
Malaysia. Abingdon: Routledge.
Ormond, M., & Mainil, T. (2015). Government and governance strategies in
medical tourism handbook on medical tourism and patient mobility.
Ormond, M., & Sothern, M. (2012). You, too, can be an international medical
traveler: Reading medical travel guidebooks Health and Place, 18(5),
935e941.
Ormond, M., & Sulianti, D. (2014). More than medical tourism: Lessons from
Indonesia and Malaysia on south-south intra-regional medical travel.
Current Issues in Tourism, 1e17. http://dx.doi.org/10.1080/13683500.2014.937324.
Ormond, M., Wong, K. M., & Chan, C. K. (2014). Medical tourism in Malaysia: Meghann Ormond is a human geographer, and her research mainly focuses on
How can we better identify and manage its advantages and transnational mobility, health and care. She's currently developing work on international
disadvantages? Glob Health Action, 7. medical travel, retirement migration, genealogy and recreational genomics. At
http://dx.doi.org/10.3402/gha.v7.25201. Wageningen University (NL)
Penney, K., Snyder, J., Crooks, V. A., & Johnston, R. (2011). Risk communication Prof Ghazali Musa is at the Faculty of Business and Accountancy, University Malaya. His area
and informed consent in the medical tourism industry: A thematic content of specialization is on Tourism.
analysis of canadian broker websites. BMC medical ethics, 12(1), 17.
Peracchio, L. A., & Luna, D. (2006). The role of thin-slice judgments in
consumer psychology. Journal of Consumer Psychology, 16(1), 25e32.
Qadeer, I., & Reddy, S. (2010). Medical tourism in India: Progress or
predicament’. Economic and Political Weekly, XLV(20), 15 May, available at: http://www.
environmentportal.in/files/Medical%20Tourism%20in%20India.pdf
Accessed 05.02.14.
Reisman, D. A. (2010). Health tourism: Social welfare through international
trade. Edward Elgar Publishing.
Rerkrujipimol, J., & Assenov, I. (2011). Marketing strategies for promoting Professor Che Ruhana Mohamed is a Dean of Faculty of Business and Accountancy, University
medical tourism in Thailand. Journal of Tourism, Hospitality & Culinary of Malaya. Her area of specialization is on Accounting.
Arts, 3(2), 95e105.
Robins, D., & Holmes, J. (2008). Aesthetics and credibility in web site
design. Information Processing & Management, 44(1), 386e399.
http://dx.doi.org/10.1016/ j.ipm.2007.02.003.
Singh, K. (2010). Top interactive Web design features. Retrieved
fromhttp://www.sitereference.com/articles/Website-Development/Top-InteractiveWeb-
DesignFeatures.html.
Smith, P. C., & Forgione, D. A. (2007). Global outsourcing of healthcare: A
medical tourism decision model.
Solomon, H. (2011). Affective journeys: The emotional structuring of Dr. Thinaranjeney A/P Thirumoorthi is a senior lecturer at the Faculty of Business and
medical tourism in India. Anthropology and Medicine, 18(1), 105e118. Accountancy, University of Malaya. Her area of specialization is on Marketing (Tourism).
Suthin, K., Assenov, I., & Tirasatayapitak, A. (2007). Medical Tourism: Can
supply keep up with the demand. Proceedings, APac-CHRIE & Asia
Pacific Tourism Association Joint Conference 2007. May 23-27 May,
2007, Beijing, China.
Taylor, J., Gombeski, W. R., Jr., & Dillon, B. W. (2005). Web wellness.
Marketing health services, 25(2), 32e37.
Tourism Malaysia.(2014). Available at: http://www.tourism.gov.my/en/intl.
Turner, L. (2007). First world health care at third world prices”:
Globalization, bioethics and medical tourism. BioSocieties, 2, 303e325.
Turner, L. (2011). Quality in health care and globalization of health services accreditation and Dr. Mohd Zulkhairi Bin Mustapha is a senior lecturer at the Faculty of Business and Accountancy,
regulatory oversight of medical tourism companies. International Journal for Quality in University of Malaya. His area of specialization is on Accounting.
Health Care, 23(1), 1e7.
Tourist Authority of Thailand. (2013). Available at: https://www.tourismthailand. org/About-
Thailand/About-TAT.
Van der Heijden, H. (2003). Factors influencing the usage of websites: The case of a generic
portal in The Netherlands. Information & Management, 40(6), 541e549.
Von Knoop, C., Lovich, D., Silverstein, M. B., & Tutty, M. (2003). Vital signs: E-health in the
United States. Boston: Boston Consulting Group, 44.
Wilson, A. (2011). Foreign bodies and national scales: Medical tourism in
Thailand.
Body & Society, 17(2e3), 121e137.
Wong, K. M., & Musa, G. (2012). Medical tourism in Asia: Thailand,
Singapore, Malaysia, and India. In C. M. Hall (Ed.), Medical tourism: Dr. Kanagi A/P Kanaphaty is a senior lecturer at the Faculty of Business and
The ethics, regulation, and marketing of health mobility (pp. 167e186). Accountancy, University of Malaya. Her area of specialization is on operation and
London and New York: Routledge. Management Information System.
Woo, E., & Schwartz, Z. (2014). Towards assessing the knowledge gap in
medical tourism. Journal of Quality Assurance in Hospitality &
Tourism, 15(2), 213e226.
http://dx.doi.org/10.1080/1528008X.2014.889516.
http://www.hospimedicathailand.com.
Ye, B., Yuen, P., Qiu, H., & Zhang, V.
(2008). Motivation of medical tourists: An exploratory
Dr. Jacob John Chiremel Chandy is attached to the Department of
case study of Hong Kong medical tourists. Bangkok,
Restorative Dentistry, Faculty of Dentistry, University of Malaya.
Thailand: Paper presented at the Asia Pacific Tourism
Association (APTA) Annual Conference.
Yu, J. Y., & Ko, T. G. (2012). A cross-cultural study of
perceptions of medical tourism among Chinese,
Japanese and Korean tourists in Korea. Tourism
Management, 33(1), 80e88.
http://dx.doi.org/10.1016/j.tourman.2011.02.002.