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An Examination of the Medical Tourists

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An Examination of the Medical Tourists AN EXAMINATION OF THE MEDICAL TOURISTS MOTIVATIONAL BEHAVIOR AND PERCEPTION: A STRUCTURAL MODEL By WANLANAI SAIPRASERT Bachelor of Arts in Business Administration Chiang Mai University Chiang Mai, Thailand 1993 Master of Business Administration Oklahoma City University Oklahoma City, Oklahoma 1996 Submitted to the Faculty of the Graduate College of the Oklahoma State University in partial fulfillment of the requirements for the Degree of DOCTOR OF PHILOSOPHY May, 2011 AN EXAMINATION OF THE MEDICAL TOURISTS MOTIVATIONAL BEHAVIOR AND PERCEPTION: A STRUCTURAL MODEL Dissertation Approved: Dr. Hailin Qu Dissertation Adviser Dr. Jerrold Leong Dr. Sheila Scott-Halsell Dr. Ken Eastman Dr. Mark E. Payton Dean of the Graduate College ii ACKNOWLEDGMENTS Many people deserve recognition for their significant contribution in the pursuit of my Ph. D. study and completion of this dissertation. First of all, I would like to express my sincere gratitude and respect to Dr. Hailin Qu, my academic adviser and dissertation chair for all of his expertise, advice, assistance, support, and encouragement throughout my academic program and the dissertation process. I would also like to express my sincere appreciation to the dissertation committee members. My sincere gratitude extends to Dr. Jerrold Leong, for the encouragement, guidance and kind concern throughout my graduate program. Special gratitude extends to Dr. Sheila Scott-Halsell, who always assisted me in every way. Your encouragement, guidance, kind assistance, and understanding greatly support me during the study. My sincere gratitude also extends to Dr. Ken Eastman for the valuable advice, suggestions, and generosity. I would also like to thank all the hospitals, medical staffs, and medical tourists for the contribution with the data collection process. Without their help this study would not have been possible. I deeply appreciate the scholarship provided by Chiang Mai University, the leave of absence granted by the faculty of Business Administration, Chiang Mai University and the research assistant support provided by School of Hotel and Restaurant, Oklahoma State University. iii My appreciation extends to the great faculty members and staff of School of Hotel and Restaurant Administration for the assistance during my time in the program. Special thanks to my friends and colleagues. The assistance, support, encouragement and friendship of Pimtong, Nitta, Suna, Christy, Emily, Varuree, and Kunsiree will always be remembered. Finally, I would like express my greatest gratitude to my parents whose unconditional love, understanding, support, and encouragement have given me the strength to complete the Ph. D. study. iv TABLE OF CONTENTS Chapter Page I. INTRODUCTION ......................................................................................................1 Overview and Significant of Medical Tourism .......................................................2 Background of the Problem .....................................................................................9 Purpose and Objective of the Study .......................................................................11 Significance of the Study .......................................................................................12 Definition of Terms................................................................................................14 Organization of the Study ......................................................................................16 II. REVIEW OF LITERATURE..................................................................................18 Health Tourism and Medical Tourism ...................................................................18 Medical Tourism Region .......................................................................................20 Characteristic of Medical Tourists and Determinants of Demand .........................23 Theory of Motivation .............................................................................................25 Push and Pull Motivation Factors .....................................................................25 Push and Pull Relationship ...............................................................................30 Perceived Destination Image .................................................................................31 Perceived Quality ...................................................................................................35 Perceived Value .....................................................................................................37 Overall Satisfaction ................................................................................................38 Behavioral Intention...............................................................................................40 Relationship of Perceived Quality, Perceived Value, Overall Satisfaction and Behavioral Intention...............................................................................................41 Frequent Visit.........................................................................................................47 III. METHODOLOGY ................................................................................................52 Research Design.....................................................................................................53 Research Instrument...............................................................................................53 Pilot Test ...........................................................................................................57 v Chapter Page Sampling .................................................................................................................59 Target Population ..............................................................................................59 Sample and Sample Size ...................................................................................59 Survey Administration ......................................................................................61 Data Analysis .........................................................................................................62 IV. FINDINGS .............................................................................................................76 Medical Tourist Demographic Profile ...................................................................76 Motivational Dimension ........................................................................................80 Destination Image Dimension................................................................................83 Perceived Quality Dimension ................................................................................85 Assessment of Measurement model.......................................................................87 Assessment of Structural Model ............................................................................93 Model Modification .............................................................................................101 Moderating Effect of Frequent Visit ...................................................................103 Medical Tourists Demo – Socio Graphic and Motivational Behavior ................115 V. CONCLUSION ....................................................................................................125 Discussion ............................................................................................................125 Structural Relationship of Medical Tourists Motivation and Perception ............126 Motivation and Perceived Destination Image ................................................126 Perceived Destination Image and Perceived Quality .....................................128 Mediating Role of Perceived Value and Overall Satisfaction .......................129 Future Behavioral Intention ...........................................................................131 Moderating Role of Familiarity with Destination ..........................................131 Medical Tourists Demographic Profiles and Motivational Behavior Perception ......................................................................................................133 Implication .....................................................................................................135 Limitation and Suggestion for Future Research ............................................137 REFERENCES ..........................................................................................................139 APPENDICES ...........................................................................................................154 vi LIST OF TABLES Table Page 1.1 Comparison of Medical Treatment Pricing in Selected Country ............................7 1.2 Comparison of Dental Treatment Pricing in Selected Country ..............................7 1.3 Hospital-Reported Status on Family Quality Standards ..........................................8 2.1 The Most-Traveled Health Destinations ................................................................22 2.2 Summary of Literature Examining Push and Pull Factors of Motivations ............28 2.3 Dimensions/Attributes Determining the Perceived Destination Image .................33 3.1 List of Motivational Factors and Perceived Destination Image.............................55 3.2 List of Perceived Quality of Medical Treatment ...................................................56 3.3 Reliablity of the
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