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Is humanity heading to immortal living? If so, what areas of society are playing an active role in achieving this? In order to understand this, the study explores the relationship between immortality and the wellness and medical tourism industry to seek potential relationships between them and ultimately, asks difficult questions about the growth of these tourism sectors and the potential need for greater regulation of them.

Taking a pragmatic philosophical approach and through the examination of refined information from secondary sources and published material and reports, the study presents original theoretical knowledge and a model exploring tourism and human immortality.

This paper argues that continued growth in the wellness and medical markets today could lead to a world where transhumanists and cyborgs are present in our world, even taking over from Homo sapiens. The study presents a model highlighting the potential role of wellness and medical tourism markets, illustrating the potential for future consumer services that could further fuel the search for immortality. Thus, how such markets and consumer desires are (in)directly supporting humanities desire for (non-human) immortal existence.

Today, individuals are driven by wellness practices and medical and cosmetic desires and are willing to travel the globe in search of companies who are either capable of carrying out the desired procedures or seeking prices more affordable to them. This research offers novel insights into these complex relationships and maps the affiliation between wellness and medical practices and the concept of immortality.

The past decade has witnessed a tremendous and progressive growth in the number of Nigerians who engage in medical tourism from Nigeria to India. Various commentators have advanced diverse reasons for this trend. However, there is a dearth of research that has sought to provide empirical insights. This paper aims to investigate the decision-making process of Nigerian medical tourists and why they prefer medical tourism to India to medical care locally.

Eight Nigerian medical tourists are interviewed on a one-on-one basis with open-ended questions using purposive criterion sampling technique from an interpretivist mind-set.

The paper identifies two major motivators, namely, inadequate medical infrastructure and poor medical, and customer service from health workers in Nigeria, which spurred medical tourism from Nigeria to India. Further, it finds that first timers premise their decisions on advice from reference groups, while previous personal experiences guide decisions on subsequent medical travels. Findings are explained using the template provided by the theory of planned behaviour.

This exploratory nature of this research provides a useful basis to elucidate the course of decision-making of Nigerian patients so that appropriate marketing communication channels can be applied. It improves the process of recruiting and engaging Nigerian patients and nurturing wholesome relationships between Nigerian patients and hospitals.

The purpose of this study is to investigate the inbound and outbound medical tourism in the UK to determine if the UK can be considered as a net exporter of health services as well as the impact of the 2007 global economic crisis, diaspora populations and the number of UK expats on medical tourism figures.

Using microdata drawn from the International Passenger Survey (2000-2016), the authors estimate the flows, number of nights and expenditure of tourists looking for medical treatment who complete international visits of less than 12 months’ duration to and from the UK. The authors also analyse the main destinations of UK residents, the country of origin of overseas residents and the particular case of British expats.

The results show the upward trend of inbound and outbound patients, the strong seasonality in outbound patients, and the significant increase in the levels of expenditure of overseas residents since 2005. Poland, France, Hungary and India are the chosen countries by UK residents to be treated, whereas Irish Republic, Spain, France, Gibraltar and the United Arab Emirates are the main countries providing inbound health patients. However, the processes of migration explain full or partly the inbound and outbound flows found for some countries.

This study offers a critical insight into inbound and outbound medical flows, demonstrating both the scope for and limitations to market development in this area.

Under the Directive 2011/24/EU, medical tourism and cross-border health are interrelated terms regarding the freedom to move to get the most accessible medical treatment into EU Member State within the defined procedures for reimbursement. Little known empirically regarding the efficiency of the cross-border health/medical tourism industry. This study aims to measure its efficiency in Europe for the years 2010-2014, by using Data Envelopment Analysis (DEA).

Data obtained from OECD and the European Core Health Indicators (ECHI), which is collecting the data through Eurostat. Eurostat collects data on health-care activities and provides data on hospital discharges, including the hospital discharges of non-residents and these include hospital discharges of in-patients and day care patients. The analysis uses “DEA.P, 2.1 for windows” by Coelli (1996).

The results show that the Members States health systems were very efficient in handling non-residents in-patients; however, when managing day cases/outpatients, the efficiency scores dropped.

The findings would have significant associations affecting intentions to revisit clinics and the destination country. In addition, will be useful to those seeking a better understanding of the cross-border health and medical tourism industry efficiency.

Extending the findings of the European Commission report (2015c) by examining how well medical tourists are informed about the decision they are making, would be of perceived value. These are important indicators at European level by helping each Member State to measure its medical tourism services.

The purpose of this paper is to disseminate among concerned professionals its certain operational aspects, including some possible implications on health and medical care practices.

It is written on the basis of the author’s special study of a diverse source of information, as well as on author’s practical experience and observation in this particular area.

Special attention is paid to possible public health impacts within a broad social and economic framework, as well as to its impacts on the existing national health care systems in countries, that would possibly lead to certain degree of inequity in health at national level as an important consequence of health development progress.

Knowledge and understanding gained from this paper might be useful in the efforts to develop and manage national health care systems to ensure a reasonable balance in health status of people of all groups.

The purpose of this paper is twofold: First, it analyzes demand and supply-side factors that influence patient flows to and from Austria. Second, building on the empirical research and existing conceptualizations, the study offers a general extended framework to guide future comparative analysis.

The paper draws on multiple data sources including a literature review, secondary data, website analysis and semi-structured interviews with patients and health providers. Content analysis was carried out to identify common motives for seeking care abroad and providers' orientation towards medical travel.

Outbound medical travel is largely determined by factors of access, affordability and vicinity, while inbound medical travel is predominately driven by a lack of adequate medical infrastructure in source countries and quality, both in terms of medical and service quality. Providers distinguish themselves according to the extent they take part in medical travel.

The findings emerging from a single country case study approach cannot be generalized across settings and contexts, albeit contributing to a better understanding of current medical travel patterns in Europe.

Unlike most recent contributions, this study focuses both on inbound and outbound medical travel in Austria and investigates patient flows for distinctive treatments and drivers. While analysis of the supply-side of medical travel is often limited to tourism studies, this study provides a critical insight into developments in Europe from a health policy perspective, acknowledging that diverse medical travel patterns in Europe coexist.

The purpose of this paper is to conceptually examine the phenomenon of wellness tourism under a holistic and systemic lens, focusing on the offer system and the main components necessary for the staging of wellness experiences. This approach to holistic wellbeing within the tourism sector has led to a broadening of the type of services and experiences that make up the value propositions that can positively contribute to people’s wellbeing.

This study identifies and defines the components of wellness tourism (including sectors not traditionally associated with it) through a review and analysis of the extant literature on “wellness tourism” and “wellbeing tourism” of the past two decades; the components were classified through an open coding process.

Wellness tourism, as a broad multidimensional concept, is composed by ten different components of the offer system: hot springs, spas, medical tourism, care of the body and mind, enogastronomy, sports, nature and environment, culture, spirituality and events. Each of these categories may represent a single touristic offer targeted to specific market segments, but they may also be one of several components within an integrated mix of tourism products proposed.

A holistic view of wellness tourism has implications for strategic marketing processes. Destination Management Organizations and company managers should segment their demand according to more innovative criteria than what has traditionally been adopted for wellness in terms of health care and medical procedures. Value propositions for tourists should be wellness-driven to satisfy the growing demand for wellness/well-being and should involve the participation of all the various actors and producers within the wellness tourism offer system at wellness destinations.

康养旅游及其组成元素：一个全方位的视角

此一论文会以全面和有系统的目光, 谈及康养旅游的现象, 并集中于康养旅游的供应系统和主要组成元素。此一以全面身心健康为目的的旅游行业, 使不同服务的覆盖范围和经验得以扩而充之, 提供有利条件正面地影响着人们的身心健康。

本研究会分辨和定义康养旅游的组成元素（以及其他在传统定义上被排除的行业）, 透过重新审视和分析近20年有关于康养旅游（Wellness tourism）和健康旅游（Wellbeing tourism）的现存文献。同时, 所有元素会以开放式译码 （open coding）来分类。

康养旅游, 作为一个多元概念, 基本上与十个不同的供应行业相关：温泉, 水療, 医疗旅游, 身心护理, 饮食, 运动, 自然环境, 文化, 灵修和特办活动。不同类别的行业可以在代表市场上不同供需关系的同时, 也可以代表供应上可以有一种混合套餐供应。

以全面的目光去看康养旅游可以为市场策略定下基础。目的地管理公司（DMO）和不同的公司经理应该在分辨服务需求的时候, 多采用新颖的标准, 摒弃只包括医疗的传统健康观念。为游客订立的价值主张（Value propositions）应以全面身心健康为主导, 以满足对康养（Wellness）和健康（Wellbeing）不断上升的需求; 亦应大力度地提升所有安康旅游工作人员与顾客的互动和参与。

El turismo de bienestar y los componentes de su sistema de oferta: una perspectiva holística

Este artículo examina conceptualmente el fenómeno del turismo de bienestar desde una perspectiva holística y sistémica, centrándose en el sistema de oferta y los principales componentes necesarios para la puesta en escena de experiencias de bienestar. Este enfoque de bienestar integral dentro del sector turístico ha propiciado una ampliación del tipo de servicios y experiencias que integran las propuestas de valor que pueden contribuir positivamente al bienestar de las personas.

Este estudio identifica y define los componentes del turismo de bienestar (incluidos los sectores no asociados tradicionalmente con él), a través de una revisión y análisis de la literatura existente sobre “turismo de bienestar” de las dos últimas décadas; los componentes se han clasificado mediante un proceso de codificación abierto.

El turismo de bienestar está compuesto conceptualmente por diez componentes diferentes de ofertas: aguas termales, spas, turismo sanitario, cuidado de cuerpo y mente, enogastronomía, deportes, naturaleza y medio ambiente, cultura, espiritualidad y eventos. Cada una de estas categorías puede representar una única oferta turística para segmentos de mercado específicos, pero también pueden ser uno de los varios componentes de una combinación integrada de productos turísticos.

Esta concepción holística del bienestar sugiere que, en el contexto de los procesos de marketing estratégico, las DMO y los gerentes de negocio deben segmentar la demanda con criterios innovadores respecto a los tradicionales de salud y médicos. Además, deben formular propuestas de turismo orientado al bienestar, valorizando los componentes de la oferta capaces de interceptar la creciente demanda de bienestar e implicando a los distintos productores del sistema de oferta de wellness que operan en los destinos de bienestar

The technological advances in the Industrial Revolution (IR) 4.0 era escalate the advancement of the healthcare industry, including the health tourism phenomenon. Based on the current trend in connected health care (e.g. mobile healthcare technology; digital health, etc.), this paper aims to propose that the distance between healthcare providers around the globe and its potential patients can be vastly reduced to almost on a real time basis.

A secondary literature review is conducted to identify the key development of IR 4.0 technologies in the healthcare industry and its possible trend leading the health tourism sector.

The adoption of IR 4.0 technologies is expected to make seeking treatments overseas more affordable, accessible and health records readily available on a real-time and secured basis. However, it is worth to note that the growth of health tourism raises the eyebrows of society from the security, social and economic perspectives.

This paper contributes to our understanding that the emergence of IR 4.0 technologies changes the landscape of the health care and health tourism industry. Continuous technology advancement is expected to further shape the future trend and escalate the commercialization aspect of the health tourism industry.

The goal of this article is to provide an overview of healthcare entrepreneurship, both in terms of its current trends and future directions.

The article engages in a systematic review of extant research on healthcare entrepreneurship using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) as the review protocol and bibliometrics or scientometrics analysis as the review method.

Healthcare entrepreneurship research has fared reasonably well in terms of publication productivity and impact, with diverse contributions coming from authors, institutions and countries, as well as a range of monetary and non-monetary support from funders and journals. The (eight) major themes of healthcare entrepreneurship research revolve around innovation and leadership, disruption and technology, entrepreneurship models, education and empowerment, systems and services, orientations and opportunities, choices and freedom and policy and impact.

The article establishes healthcare entrepreneurship as a promising field of academic research and professional practice that leverages the power of entrepreneurship to advance the state of healthcare.

The article offers a seminal state of the art of healthcare entrepreneurship research.

This study investigates the effect of COVID-19 pandemic perceived health risk on traveller's post-pandemic perception and future travel intention. The study aims to provide insight into the unprecedented COVID-19 pandemic and its potential influence on tourist behaviour.

Two hundred and forty-four responses were gathered quantitatively through an online survey. The research hypotheses were analysed using the partial least square structural equation modelling (PLS-SEM).

This study found that COVID-19 affects tourists' travel behaviour. Key findings found that perceived health risk discourages travel attitudes and eventually lessens their future travel intentions. Results also suggest future strategies/directions for restarting the tourism industry.

The study outcome assists tourism stakeholders in understanding the changes in tourist behaviour amid the heightened perceived health risk of COVID-19. Tourism policymakers and industry players should consider exploring how to mitigate similar health crises in the future.

By extending the theory of planned behaviour (TPB), this study establishes a theoretical framework in exploring the interrelationships between perceived risk, post-pandemic perception and future travel intention. This study sets a significant research agenda for future tourism research in understanding the mechanism behind health risk perceptions and tourist behaviour.