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Health-care tourism has become a major industry in the past decade. Following the increasing activity in health-care tourism, the decision-making process of consumers in choosing an international health-care facility has become increasingly important to the related parties. The present study aims to offer a holistic model of international health-care facility choice that incorporates the important dimensions by assessing the growth drivers and the alternative factors proposed in the literature and by validating them via a survey study.

The factors deemed important in the existing literature were used as the basis of a study in Turkey. In total, 65 structured interviews were conducted with health-care professionals and international health tourists to understand the perspective of the two important parties that affect policymaking.

The findings of the study support the significance of the majority of the variables proposed as important factors affecting international health-care facility choice.

The study was carried out in four large hospital chains in Turkey; however, this creates a limitation in scope and may have limited representativeness of the overall market. The model has yet to be tested on a larger scale.

There are significant differences in the opinions of professionals and international health-care tourists in terms of choice criteria. This indicates problems with health professionals’ understanding of the consumer decision process.

The study provides a model that can be used to gain insights on the consumer decision process and also provides the policymakers and stakeholders of the international health-care industry with a sound theoretical foundation to build further studies upon. Only a limited number of studies was carried out in Turkey that focus on international health-care tourism, and the present study will fill a substantial research gap.

The objective of this paper is to understand the perception of patients towards health care services in Lucknow based on the 20‐item scale

The 20‐item scale was administered to 500 users of health care centres comprising a tertiary health centre, a state medical university and two missionary hospitals in Lucknow, India.

The scale was found to be reliable to a great extent with an overall Cronbach alpha value of 0.74. “Health personnel and practices” and “health care delivery” were found to be statistically significant in impacting the perception. Respondents were relatively less positive on items related to “access to services” and “adequacy of doctors for women”. The tertiary health centre was rated poorer than the medical university and missionary hospitals.

This tool may be applied for qualitative assessment of the services of health care programmes as well as health care centres of India.

The paper draws the attention of health policy makers in considering the requirements and opinions of patients to effect substantial change and significant improvement in the quality of the health care services for better and increased utilization of the services.

The paper fulfils the need of measuring perceived quality of health care services and points out that the improvement in health care services requires immediate and urgent attention from policy makers.

This paper aims to measure the perception of patients towards quality of services in public health care centres in rural India.

A 23‐item scale that tested well for reliability and construct validity was employed for the study. Mixed sampling technique was employed to select the sample. A total of 500 respondents from Eastern, Western and Central regions of Uttar Pradesh were surveyed.

The survey instrument had an overall Cronbach's alpha value of 0.96 and was able to discern differences across various socio‐demographic characteristics of the respondents. The opinions of the respondents towards health care quality were not very favourable. Negative scores were obtained on items, “availability of adequate medical equipments” and “availability of doctors for women”. Education, gender and income were found to be significantly associated with user perception.

The current study was limited to measuring the perceived quality of health care services in public centres only. Moreover, as the study was confined to the state of Uttar Pradesh so caution has to be exercised in making generalisations for the entire nation.

Valuable insights into the quality of services at public health care centres in rural India have been provided by the study.

Knowledge about the patients' perception towards health care quality is one of the most important steps towards introducing reforms in the health care sector. Identification of areas that require immediate improvement in public health care centres provides valuable guidance to the policy makers who can devise suitable strategies to make these centres more sensitive and responsible to the needs of the rural population. This can lead to restoration of faith in public health care centres and subsequently their increased consumption.

Health tourism is a relatively new branch of international tourism that has developed more rapidly than other tourism sectors in recent years. This study aimed to investigate the effect of government supports on health tourism development by considering the mediating role of internal and external infrastructures.

The study population consisted of all experts of two hospitals in Iran, which are frequently visited by foreign tourists (N = 151). A questionnaire, developed by combining standard and researcher-made questionnaires, was used to collect the data. The confirmatory factor analysis (CFA) model was developed in SmartPLS 3 to test the hypotheses.

The main hypothesis test results indicated that government supports positively affect the development of health tourism. Internal and external infrastructures were also found to mediate the relationship between government supports and health tourism development. In addition, the sub-hypothesis test results showed that internal and external infrastructures are positively affected by government supports, which puts forth the development of health tourism. As the results explained, the most important aspects of internal infrastructures affected by government support were health service quality, cost of health services and applying advanced medical technologies, respectively. Also, different aspects of external infrastructures affected by government supports are as follows: economic, infrastructures and cultural factors.

This study is the first of its kind to examine the impact of both medical and non-medical factors on health tourism and signifies the crucial role of governments in the development of health tourism.

Poor quality of services in the health-care sector of the developing countries like Bangladesh forces affluent patients to seek advanced medical treatment from abroad. The purpose of this study is to explore the outbound medical tourists’ satisfaction and loyalty on the basis of the quality of the health-care service provided by foreign medical institutions.

The medical tourists from Bangladesh who have got medical services from Indian medical institutions were taken as a sample by applying a purposive sampling technique. For the measurement of outbound medical tourists’ satisfaction, the dimensions of the HEALTHQUAL model were adopted. A self-administrated questionnaire was the major tool for collecting data from the respondents. Using partial least square-structural equation model multivariate statistical technique and with the aid of SmartPLS software, primary data collected from 218 final respondents were analyzed.

The findings of this study reveal that four dimensions of the HEALTHQUAL model, namely, empathy, tangibility, efficiency, and safety have a significant positive impact on building medical tourists’ overall satisfaction, and then the overall satisfaction also has a positive level of significance on building loyalty towards foreign medical service providers.

The findings of this study can be a helpful instrument for the developing countries to rethink and reshuffle their own existing health-care system for providing quality medical services and at the same time, the medical tourists importing countries to sharpen their existing service quality as well as to attract more medical tourists in the future.

A handful of research has been carried out, especially focused on health-care service quality measurement and the relationship of health-care service quality with satisfaction and loyalty from the perspective of developing countries outbound medical tourists. Thus, this research work will give a flavor to think of health-care service quality in a different dimension.

A highly competitive market incentivizes private healthcare providers to deliver high quality services. The purpose of this paper is to identify the perceived expectations of a new private multi-speciality hospital in a non-metro city. To this end, the paper develops a model using identified relevant factors.

A structured questionnaire was administered to 900 people. Exploratory factor analysis and confirmatory factor analysis were then applied to the data, and partial least square-structural equation modelling was used to test the moderated mediation model.

Word-of-mouth and safety (WM) and access to the hospital and the cost of medical services are found to be important factors for the perceived expectations of the hospitals by medical facility and treatment at a hospital. High quality medical facilities can lead to improved perceived expectations of hospitals, mediated by positive WM. Levels of access to the hospital and the cost of services can significantly moderate the perceived expectations of a hospital, despite good medical facilities.

The study has implications for policymakers and hospital authorities in the context of private sector multi-speciality hospitals in non-metro cities. It will help healthcare managers and service providers to better understand customer perceived expectations, and thereby develop effective strategies for customer service. Decision-makers are encouraged to focus on positive word-of-mouth and enhancement of customer safety to bring about favourable expectations of hospitals. Beyond merely having excellent medical facilities, hospitals that ensure ease of access to the hospital and keep costs low can achieve positive consumer expectations and satisfaction levels.

The paper makes three novel contributions as follows: the mere presence of high quality medical facilities and practices does not equate to positive expectations about the hospital among the patients; access to the hospital and the cost of its services are important in bringing about positive expectations among healthcare consumers; and WM can significantly moderate positive expectations of the hospital. The authors are not aware of any of these findings being previously reported.

Healthcare service quality studies primarily examine the relationships between patients ' perceived quality and satisfaction with healthcare services, clinical effectiveness, service use, recommendations and value for money. These studies suggest that patient-independent quality dimensions (structure, process and outcome) are antecedents to quality. The purpose of this paper is to propose an alternative by looking at the relationship between hospital atmosphere and healthcare quality with perceived outcome.

Data were collected from Finland, India, Nigeria and the People ' s Republic of China. Regression analysis used perceived outcome as the dependent variable and atmosphere and healthcare service quality as independent variables.

Results showed that atmosphere and healthcare service quality have a statistically significant relationship with patient perceived outcomes.

The sample size was small and the sampling units were selected on convenience; thus, caution must be exercised in generalizing the findings.

The study determined that service quality and atmosphere are considered significant for developing and developed nations. This result could have significant implications for policy makers and service providers developing healthcare quality and hospital atmosphere.

Studies concentrate on healthcare outcome primarily regarding population health status, mortality, morbidity, customer satisfaction, loyalty, quality of life, customer behavior and consumption. However, the study exposes how patients perceive their health after treatment. Furthermore, the authors develop the healthcare service literature by considering atmosphere and perceived outcome.

This paper aims to explore the public’s attitude toward medical tourism activities by developing a measurement instrument in Turkey, an emerging medical tourism destination.

During the development phase of the scale, 24 question pools were created. After the pilot study, data from a 20-question survey were collected from a study group consisting of Turkish citizens who received services from hospitals in the city of Ankara. Data were collected through convenience sampling of 221 study participants as they were walking in the Square of Kızılay, one of the most important centers and junction points in Turkey, between November 25, 2017, and December 27, 2017.

The content validity of the scale was assessed by expert opinion. The scale reliability is high with Cronbach’s α (0.908). A factor analysis was performed to assess the factor structure of the scale. The Kaiser–Meyer–Olkin measure of sampling adequacy (0.895) and Bartlett’s test (χ² = 2,020.967; p = 0.001) were applied to determine the conformity of the scale of factor analysis. Exploratory factor analysis with Varimax rotation was performed to determine the factor structure of the scale. The 20 questions loaded under three factors: “contribution to the country,” “anxiety in getting services” and “service justice”. These factors explained approximately 55% of the total variance. Confirmatory factor analysis was performed with goodness-of-fit index (0.877), Bentler comparative fit index (0.909) and root mean square error of approximation index (0.069) to determine the validity of the factor structure, and the results indicated that the three-factor model is an acceptable level. All the results show that this new scale is valid and reliable in measuring the public’s attitude toward the development of medical tourism in Turkey.

The public’s attitudes on the medical tourism scale show that, as a measurement tool, it can be used validly and reliably in determining the public’s attitudes toward medical tourism.

The purpose of this paper is to find out whether there are any significant gaps in perceptions of quality of care between patients and healthcare providers in Ghana’s hospitals.

A cross-sectional survey of patients seeking outpatient consultations in 17 general hospitals in Ghana was conducted. A total of 818 patients and 152 hospital managers were interviewed. A 22-item quality of care scale was used in data collection. Data were analysed with the aid SPSS version 20. Summary statistics and t-test were used to analyse the data.

There was a significant difference in the overall perception of quality of care between patients and healthcare providers (Patients: M=89.11, SD=11.457; Providers: M=94.60, SD=10.922; t (845) −4.956, p < 001, two-tailed). Also, 18 items out of the 22-item quality of care scale showed significant difference between patients and providers. However, levels of quality of care is generally rated fairly favourably by both category of respondents.

Further study is required to explore the reasons for the perceived quality gaps between patients and healthcare providers.

Management of hospitals need to evaluate patients’ perceptions of quality of care to inform measures aimed at improving quality of care, since what they may consider as good quality service may be rated less favourably by patients.

Comparing perceptions of quality between patients and healthcare providers is important in order adopt measures to address any differences in perceptions of quality between the two stakeholders. To the best of the author’s knowledge no study has been conducted in Ghana to that effect.