This study investigates the link between COVID-19 economic policy response, the tourism industry, and digitalization by income levels. It also examines the moderating influence of income levels and digitalization on the underlying link between COVID-19 economic policy response and digitalization while controlling for the tourism sector. The results show that developing countries devoted fewer resources towards curbing the negative impact of the COVID-19 outbreak compared to developed countries. High-level of digital access in some developing countries, however, enabled them to introduce lower economic stimulus packages to lessen the impact of the outbreak on the tourism industry. The results also indicate that economies with a larger tourism sector accompanied by higher levels of digitalization devoted fewer public funds to COVID-19 economic stimulus packages. The influence of digitalization on the underlying link is, however, income level dependent. For example, developing economies that are more digitized, accompanied by having a larger tourism sector, allocated more public funds to economic stimulus packages relative to developed economies. This suggests that the pressure to introduce massive stimulus packages is lower when tourism providers are better prepared to use more digital tools during a pandemic, especially in developed economies. 

Do the size of the tourism sector and level of digitalization affect COVID-19 economic policy response? Evidence from developed and developing countries

India has emerged as a prominent medical tourism hub, yet the dynamic forces in the regional and global landscape are creating a complex balance of opportunities and risks for the Indian stakeholders. The outbreak of Corona virus pandemic in 2019 has further complicated the market dynamics for the medical tourism industry. This study aims to analyse the key driving factors for the medical tourism industry in India and the issues that Indian stakeholders should address in crafting a winning strategy. A qualitative research design was adopted, and data were collected through semi structured in-depth interviews with practitioners and senior representatives of the hospital management. The study adopted abduction logic and analysed data by means of constant comparison method. The study presents the assessment of the medical tourism industry in India and the scope of opportunity for Indian players. 

/pdf/an-assessment-of-competitiveness-of-medical-tourism-industry-3uyskawp.pdf

An Assessment of Competitiveness of Medical Tourism Industry in India: A Case of Delhi NCR

Surgical tourism is an emerging economic sector, with the most growth potential demonstrated in China's health industry before the COVID-19 pandemic. Surgical tourism accounts for a large part of medical tourism services in China, with high requirements in terms of quality and safety. By contrast, China suffers from insufficient measurement tools and theoretical research. The aim of this study was to develop a set of reliable and feasible indicators by augmenting the Donabedian model to evaluate the quality of surgical tourism services.A literature review and focus group interview were used to generate indicators for the quality of surgical tourism services. The basic framework of the evaluation system was based on the structure-process-outcome Donabedian model. The screening and weight setting were conducted through an analytical hierarchy process (AHP) and a two-round Delphi consultation with 13 panelists. The validity and reliability of experts were tested by the experts' positive coefficient, authority coefficient, and coordination coefficient. The reliability of the questionnaire was assessed by a pre-test distributed within an International Medical Department of a public hospital in China.Based on the Donabedian quality theory, a novel evaluation system of surgical tourism service institutions was constructed with three dimensions, nine first-level items and 39 second-level items. The three dimensions consisted of the structure (0.315), process (0.287), and outcome (0.398), with several indicators for each dimension and each indicator was given a weight. Of the two rounds of Delphi consultation, the response rates were 86.67% and 100%. The coordination coefficient of expert opinions in the two rounds of consultation were 0.49 and 0.65 (p < 0.05). For the empirical study, the self-evaluation score of a public hospital was 86, which could rate as a two-star institution.Our evaluation system identified three suitable quality dimensions of surgical tourism services to improve the safety and quality of practical healthcare. It reflects the access criterion of surgical tourism institutions, provides references for the best choice of surgical services for tourists, and can be applied by healthcare managers and policy makers to allocate resources more efficiently and promote more surgical tourism services with international standards. 

/pdf/how-to-evaluate-surgical-tourism-service-organizations-in-1tsx4dku.pdf

How to evaluate surgical tourism service organizations in China: indicators system development and a pilot application

Background: This study seeks to evaluate the prevalence of and the association between receiving medical care abroad and the level of trust that citizens from the Western Balkans—Albania, Bosnia and Herzegovina, Kosovo and Montenegro—have in their healthcare systems. Methods: The study is cross-sectional and was carried out during three months (July 25-October 30, 2021) through a self-reported questionnaire administered through the Google Forms platform. The study included approximately two-thousand citizens (N=2,356) aged eighteen (18) to seventy (70). Results: More than one-third (37.2%) of respondents stated that they or a relative had received healthcare services abroad during the last twelve (12) months. Citizens of Montenegro had the highest prevalence of receiving healthcare services abroad at 43.8%, followed by those from Bosnia and Herzegovina at 39%. No statistically significant difference was found in the level of trust in the healthcare system in the country between those who received healthcare services abroad (4.41±2.88) (out of 10) and those who did not (4.48±2.81) (t= -0.587, p=0.557). Conclusion: We ultimately conclude that more than one-third of the participants in our study have traveled abroad for healthcare purposes, with females, those living in urban areas, and those who have previously had a negative healthcare experience in their home country all being more likely to rely on health tourism. 

/pdf/health-tourism-prevalence-among-western-balkans-citizens-gtls7amn.pdf

Health Tourism Prevalence among Western Balkans Citizens During the COVID-19 Pandemic Period

The COVID-19 has caused a devastating impact on human life worldwide. The result has nearly frozen the cross-border traveling after travel restrictions (Ghosh, Post COVID-19 strategy to survive the tourism industry: Indian perspective. Retrieved from: https://mpra.ub.uni-muenchen.de/102808/ . Accessed 6 July 2021, 2020). Because of this pandemic, like other travel and tourism sectors, the medical tourism sector got badly affected around the world. The selling and buying of health care services across the globe were restricted which was a major setback to the medical tourism sector (Stackpole et al., Looking around the corner: COVID-19 shocks and market dynamics in US medical tourism. Int J Health Plann Manag. https://doi.org/10.1002/hpm.3259 , 2021). Similarly, the Indian medical tourism sector was also got affected because of this pandemic. It needs special attention from the medical tourism planners and competent authorities to make and/or adopt strategies for its revival. The effective planning and management of medical tourism in India are imperative during these challenging times. Because it is contributing to the Indian economy, employment, health care, tourist arrivals, destination image, etc. Hence, there is a need for proper multi-dimensional planning approaches to recover the country’s medical tourism sector where various stakeholders’ significant role is required. Therefore, this study provides some imperative planning strategies for the resumption and expansion of medical tourism in India. 

Indian Medical Tourism: COVID-19 Situation, Planning and Reviving Approaches

Patients have historically travelled from across the world to the United States for medical care that is not accessible locally or not available at the same perceived quality. The COVID-19 pandemic has nearly frozen the cross-border buying and selling of healthcare services, referred to as medical tourism. Future medical travel to the United States may also be deterred by the combination of an initially uncoordinated public health response to the pandemic, an overall troubled atmosphere arising from widely publicized racial tensions and pandemic-related disruptions among medical services providers. American hospitals have shifted attention to domestic healthcare needs and risk mitigation to reduce and recover from financial losses. While both reforms to the US healthcare system under the Biden Presidency and expansion to the Affordable Care Act will influence inbound and outbound medical tourism for the country, new international competitors are also likely to have impacts on the medical tourism markets. In response to the COVID-19 pandemic, US-based providers are forging new and innovative collaborations for delivering care to patients abroad that promise more efficient and higher quality of care which do not necessitate travel.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/hpm.3259

Irving Stackpole

Papers

Looking around the corner: COVID-19 shocks and market dynamics in US medical tourism.