This thesis examines the formal and programmatic expansion of one of the most efficient generic spaces, the international airport hub, by serving the specific needs of an increasingly common mobile citizen, the medical tourist. International airport hubs are comprised of a network of interlinked corridors where large transient populations are received, held and then dispersed again. The medical tourist is a product of the rapidly increasing cost and specialization associated with medical treatment procedures. Recognizing that the density of airport hubs now rivals that of contemporary city centers, this project expands the capacity of the international airport hub, thus enabling the airport to compete for citizens in a manner similar to cities. As one iteration of a potential airport expansion system that could serve multiple mobile citizen types, this project exploits the security requirements of an existing airport and an innovative program to hypothesize a new type of airport terminal.

The purpose of this study is to investigate medical tourism in Jordan through the international patients‘ perspective. The aim is to contribute to a better understanding of international patients‘ consumption behaviour to seek medical treatment, and while at the destination. And also to better understand the medical tourists‘ perceptions of quality of healthcare services. This research was designed to facilitate the identification of the characteristics of medical tourists, their visit, their sources of information and the main pull/push factors influencing their decision to travel. Moreover, it was designed to identify the level of satisfaction held by medical tourists towards their patient experience and their satisfaction predictors, by translating, adapting and validating a patient-centred quality of care instrument and assessing its psychometric properties amongst them. This research used a mixed-methods case study approach. It was conducted in 7 private hospitals with a primary quantitative research method through 302 interviewer-administered questionnaires and descriptive quantitative statistics, Mann-Whitney U Non-Parametric Significance Tests, Principal Component Analysis (PCA) and Factor Analysis. As a complement, qualitative research through 20 semi-structured interviews and content analysis was conducted in order to provide further insights into this area of research. The findings suggest that word-of-mouth recommendations and reputation have the utmost role in informing international patients of healthcare options in Jordan. Furthermore, recommendations from family and friends are the second most important after availability of specialized treatments in influencing the 3 international patients‘ decision to seek international healthcare. Moreover, significant differences in these terms exist between first and repeat visitors, which hold important implications for tourism marketers. Further marketing implications also exist as most patients shift in the type of activities they and their companions undertake after the main treatment period is completed. In terms of satisfaction, Factor Analysis suggest that medical tourists satisfaction of quality of services in Jordan‘s hospitals is based on six predictors including nutritional care, nursing care, physician care, room atmosphere, the procedure for incoming patients and other hospital services. Both quantitative and qualitative analyses show that medical tourists are satisfied with the quality of health care services rendered to them. However, minor areas show less satisfaction. The findings raise issues regarding the recruitment of non-Arab speaking nurses. Drawing together these findings presents implications for medical tourism management, international healthcare marketing, policy-making, and continuous improvement of the services they provide.

The thesis deals with interesting field in relation to international business, with so called medical tourism. The field is introduced in the initial chapter as well as its most important world markets and consumer's characteristics are introduced. The second part of the thesis is practical and focuses on the performed research whose aim was to find out if the medical tourism generates higher profits than standard tourism, and if yes, how big is the difference.

Some tourists travel for medical reasons, and this is known as medical tourism. The growth of medical tourism is mainly spurred by globalisation and the availability of quality healthcare services in receiving countries. Once a medical need arises, a prospective medical tourist would usually search and gather information about prospective medical tourism destinations. Various push and pull factors would determine whether a destination will be selected by tourists to satisfy their medical needs. The aim of this study was thus to identify the push and pull factors of a medical tourism destination, and based on these, to measure South Africa’s performance as a medical tourism destination. Making use of a qualitative research approach, semi-structured interviews were conducted with 13 medical tourism tour operators. Content analysis was used to analyse the data. Some of the push factors identified were the cost and lack of treatment/medical services in medical tourists’ home countries, the availability of expertise and medical facilities at the receiving destination, and the wish to avoid long waiting lists. The quality of hospitals, cost of surgery, expertise of the physicians, as well as the accessibility of destinations were indicated as the pull factors. The findings also show that medical tourists seem to be more interested in the reputation of the healthcare providers and hospitals than in typical tourist activities in medical tourism destinations. The findings of this study highlight the fact that South Africa is not known as a medical tourism destination. Hence there is a need for South Africa to be promoted by government and other stakeholders as a credible, affordable and accessible medical tourism destination. The study contributes to the available literature on medical tourism but from the perspective of medical tourism tour operators as major stakeholders in the medical tourism industry. / Dissertation (MPhil)--University of Pretoria, 2020. / Tourism Management / MPhil / Unrestricted

With all the developments in the world today, medical tourism is becoming increasingly more popular. People have discovered that there is a chance to seek medical care elsewhere than in their country of residence, often at a lower price than in that country. The fact is that people are able to travel easily between countries for that purpose nowadays, and people have started to travel for various medical treatments. Dental tourism is a phenomenon that has been growing rapidly along with medical tourism in general. The reasons why people go abroad for dental treatments are various but, in most cases, the fact is that it is possible for them to have a treatment in a country where the costs are lower than in their country of residence. It has been argued whether going abroad is really worth it even with the lower prices at the dental tourism destination and with that said it is interesting to see how the dental tourists’ experience culminates. This research’s aim is to explore how satisfied Icelandic dental tourists are with their dental experience and what effect the dental experience has on other factors of the travel and, the travel experience. This research uses a qualitative research approach where semistructured interviews were conducted in person, through a phone call and through Zoom. The participants for the research are 11 total and they were found using the convenient sampling method and they all volunteered to participate in the research. The results were not identical, but overall, the participants were satisfied with their dental experience and all of the participants were satisfied with their tourism experience. The negative dental experiences were mostly with the after-treatment stage where some participants were experiencing problems with their dental treatment. The participants that traveled to the destination in company of their family all agreed that it made the experience for them more positive to have their family as support. The participants that traveled alone had different perspectives on whether having someone to support them would have made any difference on their experience. Only one participant was not able to say that they would recommend doing dental tourism to others. All of the participants would visit the dental tourism destination again, it did not matter whether the participant had a negative experience with the dental treatment received or a positive one.

Une littérature de fond sur le tourisme médical a été attribuée aux motivations des touristes médicaux. Des académiciens ont étudié les expériences des touristes médicaux et leur niveau de satisfaction. Néanmoins, le lien entre ces deux concepts a rarement été examiné dans la littérature sur le tourisme médical. Ainsi, cette étude examine les motivations des touristes médicaux destinées pour le tourisme médical et l’effet de ces motivations sur leur perception de la qualité, de la satisfaction, et de l’intention de revisiter. En outre, l’étude vise à explorer les différentes caractéristiques des touristes médicaux qui rendent à des classements différents. L'objectif est d'étudier les caractéristiques qui attirent les touristes médicaux vers la destination, pour améliorer leurs expériences et leurs satisfactions en matière de tourisme médical. De manière empirique, cette étude privilégie la destination touristique médicale, au niveau commercial et national pour un niveau mondial, en abordant les motivations et les perceptions des touristes médicaux. Les fondements théoriques sont tirés de la théorie «push» et «pull», du processus de prise de décision en cinq étapes, en plus des théories issues de la qualité de perception des services et la satisfaction de la littérature. Un cadre conceptuel a été développé pour illustrer la relation entre les variables de l’étude. Les motivations ont été classées en attirer «push» et pousser «pull». Les motivations d'attirer ont été classées en motivations associées à la destination, aux attributs médicaux, à la commodité et au prix. La qualité perçue a été classée en médecine et touristique. Méthodologiquement, l’étude incorpore une approche de triangulation où les données primaires ont été collectées auprès de fournisseurs impliqués dans le tourisme médical via des entretiens et auprès de touristes médicaux via une enquête. Huit entretiens ont été menés avec des fournisseurs de tourisme médical dans les pays d’étude, afin d’obtenir des informations approfondies sur le sujet et de procéder à une vérification plus approfondie du développement des connaissances quantitatives. Au total, 212 réponses ont été obtenues à partir de l’enquête pour vérifier le modèle quantitatif en utilisant le modèle d’équation structurel. D'autres techniques d'analyse des données ont été utilisées, principalement l'Analyse Factorielle Exploratoire et l'Analyse Factorielle Confirmatoire. Les résultats apportent un soutien à certaines relations hypothétiques. Les motivations d'attraction associées aux attributs médicaux affectent la qualité médicale perçue et les motivations d'attraction associées à la destination, aux attributs médicaux et à la commodité affectent la qualité touristique perçue. La qualité perçue à la fois médicale et touristique influe sur la satisfaction, tandis que la satisfaction affecte l’intention de la visite. Les constatations étendent également les applications des théories sous-jacentes pour expliquer le comportement des consommateurs dans le tourisme médical. Les principales théories comprennent un processus de prise de décision en cinq étapes et une théorie de la qualité du service de désaccord. Les implications de la recherche s'étendent au niveau de l'entreprise et au niveau national. Les résultats peuvent aider les gestionnaires impliqués dans les entreprises de tourisme médical, notamment les cliniques, les centres médicaux, les hôtels et les agences de voyages, à réaffecter leurs ressources et à mettre en œuvre les pratiques recommandées susceptibles d'améliorer leurs performances et d'attirer d'autres touristes. Au niveau national, les conclusions sont importantes pour les décideurs clés dans les domaines du tourisme et de la santé. Les résultats et les recommandations peuvent aider à accroître l’attractivité de la destination et à améliorer l’expérience du tourisme médical, ce qui se traduirait par des avantages économiques pour la destination dans son ensemble. / A substantive literature of medical tourism has been attributed to medical tourists' motivations. Academicians have studied medical tourists' experiences and resulting satisfaction level. Nevertheless, the link between these two concepts has seldom been examined in medical tourism literature. Thus, this study examines medical tourists’ motivations for medical tourism destination, the effect of those motivations on their perception of quality, satisfaction and intention to revisit. In addition, the study aims to explore the various characteristics of medical tourists which yields in classifying them into different segments. The objective is to investigate the attributes that attract medical tourists to the destination as well as possible ways to enhance their medical tourism experience and satisfaction. Empirically, the study aims to promote the medical tourism destination at business and national levels to a world-class level by addressing the motivations and perceptions of medical tourists. Theoretical foundations are drawn from push-pull theory, five steps decision-making process, in addition to theories from service perceived quality and satisfaction literature. A conceptual framework was developed to illustrate the relationship between the study variables. The motivations were classified into push and pull. Pull motivations were classified into motivations associated with the destination, medical attributes, convenience and with price. Perceived quality was classified into medical and touristic. Methodologically, the study incorporates a triangulation approach where primary data were collected from suppliers involved in medical tourism via interviews and from medical tourists via survey. Eight interviews were conducted with suppliers of medical tourism in destination of study to obtain an in-depth insight into the subject matter as well as for further verification of quantitative knowledge development. A total of 212 responses were obtained from the survey for verification of the quantitative model using Structural Equation Modeling. Other data analysis techniques were employed, primarily Exploratory Factor Analysis and Confirmatory Factor Analysis. The findings provide support to some hypothesized relationships.The pull motivations associated with medical attributes affect perceived medical quality and the pull motivations associated with destination, medical attributes and convenience affect perceived touristic quality. Both medical and touristic perceived quality affect satisfaction while satisfaction affected intention to revisit. The findings as well extend the applications of the underpinned theories in explaining consumer behavior in medical tourism. The main theories include five steps decision-making process and disconfirmation service quality theory. The implications of the research extend to business level and national level. The results can help managers involved in medical tourism businesses including clinics, medical centers, hotels and travel agencies to reallocate their resources and implement the recommended practices that can improve their performance and attract additional medical tourists. On a national level, the findings are significant to key decision makers in the fields of tourism and healthcare. The outcomes and recommendations can assist in increasing the attractiveness of the destination and improving the medical tourism experience which would result in economic benefit to the destination as a whole.