Medical Tourists’ Future Destination Choice


  • Norhaslin Abu Hassan Faculty of Hotel and Tourism, University Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
  • Mohamad Abdullah Hemdi Faculty of Hotel and Tourism, University Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia



destination image, destination choice, revisit intention, word-of-mouth


Medical tourism has become an important sector that contributed to country’s development economically.  In line with this notion, this study proposed to explore how the image of a destination could influence medical tourists in choosing a destination as their future medical and tourism destination choice.  Scholars argued that destination image had a significant relationship with behavioral intentions.  Further, destination image influence not only the decision-making process but also conditions after-decision-making behaviors of tourists.  In this study context, the future destination choice behavior referred to the intention to revisit and to spread the positive word-of-mouth.  Inbound medical tourists from private hospitals in Malaysia will be approached quantitatively by survey questionnaires.  This study will contribute to an understanding of the significant factors influencing medical tourists’ intention for future destination choice. 

Keywords: destination image; destination choice; revisit intention; word-of-mouth.

eISSN 2398-4295 © 2018. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license ( Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. 



Ahn, T., Ekinci, Y. & Li, G. (2013). Self-congruence, functional congruence, and destination choice. Journal of Business Research, 66 (6), 719–723.

Balakrishnan, M.S., Nekhili, R. & Lewis., C. (2011). Destination brand components. International Journal of Culture, Tourism and Hospitality Research, (5(1)), pp 4–25.

Bigne, J.E., Sanchez, M.I. & Sanchez, J. (2001). Tourism image, evaluation variables and after purchase behaviour: Inter-relationship. Tourism Management, 22: 6, 607– 616.

Bosnjak, M. (2010). Negative symbolic aspects in destination branding: Exploring the role of the “undesired self†on web-based vacation information search intentions among potential first-time visitors. Journal of Vacation Marketing, 16(4), 323–330.

Buhalis, D. (2000). Marketing the competitive destination of the future. Tourism Management, 21(1), 97–116.

Chen, Ching-Fu. & Tsai, D. (2007). How Destination Image and Evaluative Factors Affect Behavioral Intentions? Tourism Management, 28 (4): 1115–22.

Chi, C. G., & Qu, H. (2008). Examining the structural relationships of destination image, tourist satisfaction and destination loyalty: An integrated approach. Tourist Management, 29(4), 624–636.

Chiu, C., Hsu, M., Lai, H. & Chang, C. (2012). Re-examining the influence of trust on online repeat purchase intention: the moderating role of habit and its antecedents. Decision Support Systems, 53, 835–845.

Chomvilailuk, R., & Srisomyong, N. (2015). Three Dimensional Perceptions of Medical/Health Travelers and Destination Brand Choices: Cases of Thailand. Procedia - Social and Behavioral Sciences, 175, 376–383.

Chon, K.-S. (1991). Tourism destination image modification process. Tourism Management, 12, No. 1. pp. 68–72.

Clemes, M. D., Gan, C., & Ren, M. (2011). Synthesizing the effects of service quality, value, and customer satisfaction on behavioral intentions in the motel industry: An empirical analysis. Journal of Hospitality & Tourism Research, 35(4), 530–568. 1096348010382239

Connell, J. (2006). Medical tourism: sea, sun, sand and surgery. Tourism Management, 1093–1100.

Echtner, C. M. (1991). The measurement of tourism destination image. Unpublished MBA thesis, University of Calgary, Alberta.

Enderwick, P., & Nagar, S. (2011). The competitive challenge of emerging markets: The case of medical tourism. International Journal of Emerging Markets, 6(4), 329–350.

Fakeye, P.C & Crompton, J. . (1991). Image differences between prospective, first-time, and repeat visitors to the Lower Rio Grande Valley. Journal of Travel Research, 30(2), 10–16.

Frost & Sullivan. (2010). Malaysia’s medical tourism industry has healthy vitals. Retrieved from

Govers, R., Go, F. M., & Kumar, K. (2007). Promoting tourism destination image. Journal of Travel Research, 11(2), 199–217.

Hall, C. M., & James, M. (2011). Medical tourism : emerging biosecurity and nosocomial issues. Tourism Review.

Han, H. (2013). The healthcare hotel: Distinctive attributes for international medical travelers. Tourism Management, 36, 257–268.

Heung, V. C. S., Kucukusta, D., & Song, H. (2011). Medical tourism development in Hong Kong : An assessment of the barriers. Tourism Management, 32(5), 995–1005.

Hsu, T.-K., Tsai, Y.-F., & Wu, H.-H. (2009). The preference analysis for tourist choice of destination: A case study of Taiwan. Tourism Management, 30(2), 288–297.

Hu, Y. & Ritchie, J. R. B. (1993). Measuring Destination Attractiveness: A Contextual Approach. Journal of Travel Research, 32(2), 25–34.

Hunt, J. D. (1975). Image as a Factor in Tourist Development. Journal of Travel Research, 1–7.

J.Crompton. (1992). Structure of Vacation Destination Choice Sets. Annals of Tourism Research, 19, 420–434.

Jadhav, S., Yeravdekar, R., & Kulkarni, M. (2014). Cross-border Healthcare Access in South Asian Countries: Learnings for Sustainable Healthcare Tourism in India. Procedia - Social and Behavioral Sciences, 157, 109–117.

Jalilvand, M. R., Ebrahimi, A., & Samiei, N. (2013). Electronic Word of Mouth Effects on Tourists’ Attitudes Toward Islamic Destinations and Travel Intention: An Empirical Study in Iran. Procedia - Social and Behavioral Sciences, 81(2006), 484–489.

Jalilvand, M. R., & Samiei, N. (2012). The impact of electronic word of mouth on a tourism destination choice: Testing the theory of planned behavior (TPB). Internet Research, 22(5), 591–612. 10662241211271563

Jamaludin, M., Johari, S., Aziz, A., Kayat, K., & Yusof, A. (2012). Examining structural relationship between des- tination image, tourist satisfaction and destination loyalty. International Journal of Independent Research and Studies, 1(3)(89–96).

Ji, Yun Yu & Tae, G. K. (2012). A cross-cultural study of perceptions of medical tourism among Chinese , Japanese and Korean tourists in Korea. Tourism Management, 33(1), 80–88.

Keating, B., & Kriz, A. (2008). Outbound tourism from China: Literature review and research agenda. Journal of Hospitality and Tourism Management, 15(1), 32–41.

Keller, K. L. (2003). Strategic Brand Management: Building, Measuring, and Managing Brand Equity. (Second Edi). Pearson Education, New Jersey.

Kitapci, O., Akdogan, C., & Dortyol, İ. T. (2014). The Impact of Service Quality Dimensions on Patient Satisfaction, Repurchase Intentions and Word-of-Mouth Communication in the Public Healthcare Industry. Procedia - Social and Behavioral Sciences, 148, 161–169.

Kuenzel, S., & Katsaris, N. (2009). A critical analysis of service recovery processes in the hotel industry. TMC Academic Journal, (4(1)), 14–24.

Lam, T., & Hsu, C. H. C. (2006). Predicting behavioral intention of choosing a travel destination. Tourism Management, 27(4), 589–599.

Langvinienė, N. (2014). Changing Patterns in the Health Tourism Services Sector in Lithuania. Procedia - Social and Behavioral Sciences, 156(April), 310–316.

Lee, M., Han, H.,&Lockyer, T. (2012). Medical tourism; attracting Japanese tourists for medical tourism experience. Journal of Travel & Tourism Marketing, 29(1), 69–86.

Li, M., Cai, L. A., Lehto, X. Y., & Huang, J. (2010). A missing link in understanding revisit intention—The role of motivation and image. , , . Journal of Travel & Tourism Marketing, 27(4), 335–348. 10548408.2010.481559

Li, X., Harrill, R., Uysal, M., Burnett, T. and Zhan, X. (2010). Estimating the size of the Chinese outbound travel market: a demand-side approach. Tourism Management, Vol. 31(No. 2), pp. 250–9.

Lin, I. H. (2006). Perception of Service Failure, Service Recoveries Strategies and Behavioral Intentions of Hotel Guests in Orlando, Florida. Unpublished PhD Dissertation, Lynn University, Florida.

Liu, H. (2014). Understanding destination choice from a cultural distance perspective. Thesis.

Mansfeld, Y. (1992). From Motivation to Actual Travel. Annals of Tourism Research, 19(4): 399–419.

MHTC. (2015). Medical Health care Travel Council. Retrieved from

Milman, A. & Pizam, A. (1995). The role of awareness and familiarity with a destination: The central Florida case. Journal of Travel Research, 33(3), 21–27.

Mohamad, M., Abdullah, A. R., & Mokhlis, S. (2012). Tourists’ Evaluations of Destination Image and Future Behavioural Intention: The Case of Malaysia. Journal of Management and Sustainability, 2(1), 181–189.

Mohamad, W. N., Omar, A., & Haron, M. S. (2012). The moderating effect of medical travel facilitators in medical tourism. Procedia - Social and Behavioral Sciences, 65, 358–363.

Musa, G., Doshi, D. R., Wong, K. M., & Thirumoorthy, T. (2012). How Satisfied Are Inbound Medical Tourists In Malaysia? A Study on Private Hospitals in Kuala Lumpur. Journal of Travel & Tourism Marketing, 29(7), 629–646.

Musa, G., Thirumoorthi, T., & Doshi, D. (2012). Travel behaviour among inbound medical tourists in Kuala Lumpur. Current Issues in Tourism, (April 2013), 37–41.

Özdemir, G., & Şimşek, Ö. F. (2015). The Antecedents of Complex Destination Image. Procedia - Social and Behavioral Sciences, 175(2000), 503–510.

Pearce, P. L. (1982). Perceived changes in holiday destinations. Annals of Tourism Research, Vol. 9, No, pp. 145–164.

Ramseook-Munhurrun, P., Seebaluck, V. N., & Naidoo, P. (2015). Examining the Structural Relationships of Destination Image, Perceived Value, Tourist Satisfaction and Loyalty: Case of Mauritius. Procedia - Social and Behavioral Sciences, 175(230), 252–259.

RNCOS. (2012). Asian medical tourism analysis. India: RNCOS.

Seoho, Um. & Crompton, J. L. (1990). Attitude Determinants In Tourism Destination Choice. Annals of Tourism Research, 17, 432–448.

Sultana, S., Haque, A., Momen, A., & Yasmin, F. (2014). Factors Affecting the Attractiveness of Medical Tourism Destination : An Empirical Study on India- Review Article. Iranian Journal of Public Health, 43(7), 867–876.

Tapachai, N. & Waryszak, R. (2000). An examination of the role of beneficial image in tourist destination selection. Journal of Travel Research, Vol. 39, pp. 37–44.

Tasci, a. D. a., & Gartner, W. C. (2007). Destination Image and Its Functional Relationships. Journal of Travel Research, 45(4), 413–425.

Um, S., Chon, K., & Ro, Y. (2006). Antecedents of revisit intention. Annals of Tourism Research, 33(3), 1141–1158.

UNESCAP. (2007). Patients without borders: An overview of the medical travel industry in Asia, its challenges and opportunities. Paper Presented at the UNESCAP EGM, Bangkok Thailand. Retrieved from

Uysal, M., & Hagan, L. A. R. (1993). Motivation of pleasure travel and tourism. In M. Khan, M. Olsen, & T. Var (Eds.), Encyclopedia of hospitality and tourism. New York, NY: Van Nostrand Reinhold.

Woodside, A. G., & Lysonski, S. (1989). A General Model Of Traveler Destination Choice. Journal of Travel Research, 27(4), 8–14.

Wu, S.-I., & Chan, H.-J. (2011). Perceived service quality and self-concept influences on consumer attitude and purchase process: A comparison between physical and internet channels. Total Quality Management, 22(1), 43–62.

Yasvari, T. H., Ghassemi, R. A., & Rahrovy, E. (2012). Influential Factors on Word of Mouth in Service Industries (The case of Iran Airline Company). International Journal of Learning and Development, 2(5), 217–222.

Yeoh, E., Othman, K., & Ahmad, H. (2013). Understanding medical tourists: Word-of-mouth and viral marketing as potent marketing tools. Tourism Management, 34, 196–201.

Zhou, L. (2005). Destination attibutes that attract international tourists to Cape Town. Master Thesis. University of the Western Cape. Retrieved from




How to Cite

Abu Hassan, N., & Hemdi, M. A. (2018). Medical Tourists’ Future Destination Choice. Asian Journal of Behavioural Studies, 3(13), 117–127.