A CAUSAL RELATION MODEL OF MARKET ORIENTATION AND EXTENDED MARKET ORIENTATION AFFECTING STRATEGIC MANAGEMENT THROUGH HEALTH ESTABLISHMENTS PERFORMANCE IN BANGKOK Wirut Nakkhasin A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy (Integrated Tourism Management) The Graduate School of Tourism Management National Institute of Development Administration 2018 A CAUSAL RELATION MODEL OF MARKET ORIENTATION AND EXTENDED MARKET ORIENTATION AFFECTING STRATEGIC MANAGEMENT THROUGH HEALTH ESTABLISHMENTS PERFORMANCE IN BANGKOK Wirut Nakkhasin The Graduate School of Tourism Management Major Advisor (Assistant Professor Sangkae Punyasiri, D.B.A.) The Examining Committee Approved This Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy (Integrated Tourism Management). Committee Chairperson (Assistant Professor Pimmada Wichasin, Ph.D.) Committee (Assistant Professor Sangkae Punyasiri, D.B.A.) Committee (Assistant Professor Worarak Sucher, D.HTM.) Committee (Assistant Professor Charoenchai Agmapisarn, Ph.D.) Committee (Assistant Professor Paithoon Monpanthong, Ph.D.) Dean (Assistant Professor Paithoon Monpanthong, Ph.D.) ______/______/______ iv ABST RACT ABSTRACT Title of Dissertation A CAUSAL RELATION MODEL OF MARKET ORIENTATION AND EXTENDED MARKET ORIENTATION AFFECTING STRATEGIC MANAGEMENT THROUGH HEALTH ESTABLISHMENTS PERFORMANCE IN BANGKOK Author Wirut Nakkhasin Degree Doctor of Philosophy (Integrated Tourism Management) Year 2018 The research was done in Bangkok Thailand due to high competition and the presence of a majority of Thailand’s health establishments, which aims to 1) review market orientation, extended market orientation and strategic management affecting health establishment performance in Bangkok 2) to study the relationship between market orientation, extended market orientation and strategic management affecting health establishment performance in Bangkok 3) to investigate of concept for causal relation model of market orientation and extended market orientation affecting health establishment performance in Bangkok. The research method of this study is a mixed method research methodology, which quantitative and qualitative approaches. The population is Thailand’s health establishments managers. The sample size was 412 managers, derived using statistical methods to determine a size which yields validity and reliability. The results reveal causal relationship model between market orientation, extended market orientation, strategic management, and health establishment performance as follow structured equation: SM = 0.84MO + 0.40EMO and PER = 0.80SM v ACKNOWLEDGEMENTS ACKNOWLEDGEMENTS I would like to thank Siam University for formally sponsoring and supporting me as well as all of my colleagues. I extremely appreciate the National Institute of Development Administration (NIDA) for admitting me into this Doctor of Philosophy of Integrated Tourism Management course. I am deeply grateful to all my teachers’ Assoc. Prof. Dr. Therdchai Choibamroong, Asst.Prof. Dr. Paithoon Monpanthong, Asst.Prof. Dr. Rugphong Vonsaroj, Dr. Woraruck Sucher, Asst.Prof. Dr. Pimmada Wichasin, Asst.Prof. Dr. Charoenchai Aekmapisarn, Asst.Prof. Dr. Suwaree Namuang Asst.Prof. Dr. Chokechai Suvetvattankul, Asst.Prof. Dr. Pattriya Lukpetch, Asst.Prof. Dr. Kanokan Kaewnuch, Asst.Prof. Dr. Kassara Sukpatch, Assoc. Prof. Dr.Yothin Sawangdee, and Asst.Prof. Dr. Sutsan Suttipisan I would especially like to show my appreciation to Asst.Prof.Dr. Sangkae Punyasiri, my major advisor and Asst.Prof. Dr. Poonpong Suksawang, my co-advisor for their precious guidance, good vitalities that made this hard journey more delightful and less stressful. I would also like to thanks NIDA’s staff P’Kung, Leng, P'Nueng, P’Sa, P’Tha, and P’Oam, who continually reminded me of the administration process and encouraged me during the Ph.D. course. Let me also thank my Ph.D. classmates (NITs5) in particular, P’Pum, P’Pat, P’Mink, P’Yut, P’Kik, P’Tu, and P’Tong for all support. Additionally, I’d like to thank P’Fel, P’Porn, and P’Pratoom for your advice and health establishment managers in Bangkok, Thailand for the useful information. Most importantly my family, without them, I would never have come so far. I would like to give special thanks to them. They helped me maintain my optimism during this extensive and painful journey. vi Wirut Nakkhasin August 2019 TABLE OF CONTENTS Page ABSTRACT .................................................................................................................. iv ACKNOWLEDGEMENTS ........................................................................................... v TABLE OF CONTENTS ............................................................................................. vii LIST OF FIGURES ...................................................................................................... iv CHAPTER 1 INTRODUCTION ................................................................................... 1 1.1 Introduction ......................................................................................................... 1 1.2 Statement ............................................................................................................. 1 1.3 Significance of the Study ..................................................................................... 5 1.4 Study Objectives ................................................................................................ 12 1.5 Research Questions ............................................................................................ 12 1.6 Expected Study Results ..................................................................................... 12 1.7 Anticipated Study Benefits ................................................................................ 13 1.8 Limitation .......................................................................................................... 14 1.9 Definition of Terms ........................................................................................... 14 1.9.1 Market Orientation: .................................................................................. 14 1.9.2 Extended Market Orientation ................................................................... 15 1.9.3 Strategic Management .............................................................................. 15 1.9.4 Health Establishment Performance .......................................................... 16 1.9.5 Health Establishment (Day Spa) .............................................................. 16 1.9.6 Health tourism .......................................................................................... 17 1.9.7 Health tourism policy ............................................................................... 17 1.9.8 Thai traditional Medicine Hospital ........................................................... 17 1.9.9 Traditional Medicine Promotion .............................................................. 17 1.10 Conclusion ....................................................................................................... 18 CHAPTER 2 LITERATURE REVIEW ...................................................................... 19 viii 2.1 Introduction ....................................................................................................... 19 2.2 Health establishment Background (Spa) ........................................................... 19 2.2.1 Spa Origins ............................................................................................... 19 2.2.2 Health Establishment Classifications ....................................................... 21 2.2.3 Health establishments Treatment and Service Classification ................... 26 2.2.4 Health Establishment Treatments and Service Meanings ........................ 31 2.2.5 Thai traditional Medicine (TTM) ............................................................. 36 2.3 Market Orientation ............................................................................................ 38 2.3.1 Generation ................................................................................................ 43 2.3.2 Dissemination ........................................................................................... 46 2.3.3 Responsiveness ......................................................................................... 49 2.4 Extended Market Orientation ............................................................................ 52 2.4.1 Customers ................................................................................................. 53 2.4.2 Competition .............................................................................................. 55 2.4.3 Suppliers ................................................................................................... 56 2.4.4 Regulatory Environment .......................................................................... 58 2.4.5 Social Movements and Trends ................................................................. 59 2.4.6 Macroeconomic Factors ........................................................................... 61 2.5 Strategic Management ....................................................................................... 65 2.5.1 Prospector ................................................................................................. 65 2.5.2 Analyzer ..................................................................................................