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Factors influencing outbound medical travel from the USA

Ayse Collins (Department of Tourism and Hotel Management, School of Applied Technology and Management, Bilkent University, Ankara, Turkey)
Anita Medhekar (School of Business and Law, Central Queensland University, Rockhampton, Queensland, Australia)
Ho Yin Wong (Department of Marketing, Deakin University, Melbourne, Victoria, Australia)
Cihan Cobanoglu (College of Hospitality and Tourism Leadership, University of South Florida Sarasota-Manatee, Sarasota, Florida, USA)

Tourism Review

ISSN: 1660-5373

Article publication date: 1 February 2019

Issue publication date: 19 June 2019




The purpose of this paper is to explore how Americans choose a country and medical facility to travel abroad for medical treatment based on the following factors country environment, tourism destination, medical tourism costs and medical facilities and services.


Online survey with the help of Amazon Mechanical Turk website was used for data collection, and 541 valid cases were used of American residents who had travelled abroad for medical tourism. Exploratory and confirmatory factor analyses were undertaken to validate the scales.


Findings indicated four major factors that can influence American medical tourists’ choices of medical tourism destinations. These factors are overseas’ country factors, attractiveness of tourism destination, medical tourism costs and facilities and services. Both the convergent and discriminant validities for the constructs were established. The results of the measurement-model-fit based on various measures were within the suggested cut-off values.

Research limitations/implications

Out of the 541 responses of post-travel experienced medical tourists, it is hard to tell how similar/dissimilar the participants are in terms of ranking the four factors. To be competitive to attract global medical tourists, research suggests that the five popular countries of treatment, India, China, Thailand, Mexico and Turkey, identified in this study should provide high quality of medical and tourism facilities to patients.


This study contributes to the understanding of the underlying factors, which influence American medical tourists’ choice of destinations, with validated scales. For this exploratory research, 25 new items together with 34 items from other studies were adapted.



Collins, A., Medhekar, A., Wong, H.Y. and Cobanoglu, C. (2019), "Factors influencing outbound medical travel from the USA", Tourism Review, Vol. 74 No. 3, pp. 463-479.



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