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AbstractThe Oropouche virus (OROV) is emerging as a major public health threat worldwide, yet for the Americas, it raises complex challenges that intersect with other existing arboviral threats such as Zika (ZIKV), dengue (DENV) and Chikungunya (CHIKV) viruses. Originating from Trinidad and Tobago in 1955, it has spread across the Amazonian Basin and more recently into the Caribbean (Cuba and Haiti) and Europe, highlighting the importance of air travel in its dissemination. OROV and the less studied Melao virus (MELV), pose significant laboratory diagnostic challenges particularly in regions co-endemic with other arboviral diseases, such as dengue and Zika fever. The effects of climate change, particularly in the Caribbean, may exacerbate the transmission of these viruses by exposing human exposure risk to vectors. Public health systems in the Americas are under strain due to complex clinical management of these infections necessitating enhanced surveillance, clinical vigilance, diagnostics and vector control. Vulnerable populations, including pregnant women, elderly, and young children, are at a heightened risk, which raises concerns about the impact on medical tourism in the region. To mitigate the spread and impact of OROV and MELV, recommendations include increased clinical surveillance, improved laboratory diagnostics, public health communication, and strengthened vector controls. Robust research and capacity building (including training and education) efforts are essential to address knowledge gaps and effectively manage future OROV and MELV outbreaks in the Americas. [ABSTRACT FROM AUTHOR]

Background: The Jordanian healthcare system has evolved over the past decades expanding its services, technological, and educational resources. A comprehensive view of this system is lacking. The objective of this report is to describe the structure of the Jordanian healthcare system, the challenges facing it, and the current and recommended health policies. Materials and methods: This study reviewed the current status of the Jordanian healthcare system. The following parameters were analyzed: health indicators, infrastructure, human resources, insurance system, pharmaceutical expense, health education system, and medical tourism. Data were collected from various relevant official institutions and related published literature. Results: Jordan has a young population with a median age of 23.8 years. Life expectancy is 78.8 years for females and 77.0 years for males. The Jordanian healthcare system is divided into three major categories: (1) Governmental Insurance (i.e., the Ministry of Health (MOH), the Royal Medical Services (RMS) and semi-governmental insurance); (2) Private Insurance; and (3) Refugee Insurance, including the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the United Nations High Commissioner for Refugees (NHUR). The Governmental Insurance covers 64.30% of the total population. Health expenditure is 6.37% of the gross domestic product (GDP). Pharmaceutical expenses make up 26.6% of the total national healthcare budget. Human resource assessment shows a high ratio of medical staff per 10.000 inhabitants, especially concerning physicians (31.7), dentists (7.9), and pharmacists (15.1). However, the ratio of nursing staff per 10.000 inhabitants is considered low (37.5). The Hospital bed/1000 population ratio is also relatively low (1.4). Healthcare accreditation is implemented through the Joint Commission International (JCI) accreditation which was achieved by 7 hospitals and by the National Health Care Accreditation Certificate (HCAC) achieved by 17 hospitals and 42 primary healthcare centers. Postgraduate medical education covers almost all medical and surgical fields. Medical tourism is currently well-established. Conclusions: Assessment of the Jordanian healthcare system shows high ratios of physicians, dentists, and pharmacists but a low ratio of nursing staff per 10.000 inhabitants. The hospital bed/1000 population ratio is also relatively low. Pharmaceutical expenses are significantly high and medical tourism is well-developed. [ABSTRACT FROM AUTHOR]

This article examines the concept of health tourism in orthopaedic surgery, with a focus on the UK. Health tourism refers to individuals and families traveling to other countries for medical treatment, often to access better care or avoid long wait times. The article discusses the pros and cons of health tourism, including its impact on the economy, waiting lists, quality of care, postoperative complications, doctor training, and sustainability. The author suggests involving all stakeholders in developing a viable strategy and calls for further research on the long-term effects of medical tourism. Additionally, two sources related to junior doctor pay disputes and the UK surgical workforce are provided, including a BBC News article on the 11th strike of the dispute and a report from the Royal College of Surgeons of England on the UK surgical workforce census. These sources can be helpful for library patrons researching these specific topics. [Extracted from the article]

This article explores the impact of dental tourism on UK dentistry and the National Health Service (NHS). It acknowledges concerns about foreign nationals accessing free NHS care and British residents seeking medical treatment abroad. The article highlights the lack of data on the scale and cost of health tourism to the NHS and emphasizes the potential risks to patients and the healthcare system due to lower standards of care overseas. It also discusses the challenges faced by regulators in monitoring and enforcing standards for dental providers operating outside the UK. The article calls for better legislation, enforcement, and research to address the vulnerability of UK dentistry to dental tourists. [Extracted from the article]

Using Fuzzy Importance-Performance Analysis (IPA) method, this study sought to develop a framework to identify and prioritize the factors influencing the selection of Iran by medical tourists. After a literature review, three main dimensions and 38 factors affecting tourism destination choices were identified. A Fuzzy SWARA questionnaire was used to ask experts how important each of the identified factors was to a medical tourist's choice of destination. In addition, medical tourists employed linguistic variables to assess the performance of the aforementioned factors. The results of the study revealed that "recommendations by friends and acquaintances," 'medical tourist's previous experiences, '"image/brand of the host country", "having friends or relatives in the destination country," and "international accreditation" were the top priorities for Iran's medical tourism policymakers and managers. [ABSTRACT FROM AUTHOR]

Background: In the last 30 years, significant advances have been made in pediatric medical care globally. However, there is a persistent urban‐rural gap which is more pronounced in low middle‐income countries than high‐income countries, similar urban‐rural gap exists in India. While on one hand, health care is on par or better than healthier nations thriving international medical tourism industry, some rural parts have reduced access to high‐quality care. Aim: With this background, we aim to provide an overview of the present and future of healthcare in India. Methodology: With the cumulative health experience of the authors or more than 100 years, we have provided our experience and expertise about healthcare in India in this narrative educational review. This is supplemented by the government plans and non government plans as appropriate. References are used to justify as applicable. Results: With the high percentage of pediatric population like other low to middle‐income countries, India faces challenges in pediatric surgery and anesthesia due to limited resources and paucity of specialized training, especially in rural areas. Data on the access and quality of care is scarce, and the vast rural population and uneven resource distribution add to the challenges along with the shortage of pediatric surgeons in these areas of specialized care. Addressing these challenges requires a multi faceted strategy that targets both immediate and long‐term healthcare needs, focusing on improving the facilities and training healthcare professionals. Solutions could include compulsory rural service, district residency programs, increasing postgraduate or residency positions, and safety courses offered by national and international organizations like Safer Anesthesia from Education Pediatrics, Vital Anesthesia Simulation Training, and World Federation of Society of Anesthesiologists pediatric fellowships. Conclusion: India has achieved great strides in perioperative health care and safety. It has become the major international medical industry due to high‐quality care, access and costs. Crucially, India needs to establish local hubs for pediatric perioperative care training to enhance healthcare delivery for children. [ABSTRACT FROM AUTHOR]

This study examined how demographics, past experience, and medical tourism destination familiarity influence Americans' intention to visit Cuba for medical treatments. The study revealed discrepancies in Americans' medical travel intention across demographic groups (i.e. age, education, income). The study results also indicated that Americans familiar with Cuba as a medical tourism destination and those with no medical tourism experience are more likely to travel to Cuba for medical treatment. The research findings contribute to the literature by providing insights into medical tourist behavior, incorporating public health and travel components, and offering Cuban policymakers practical implications to attract American patients. [ABSTRACT FROM AUTHOR]

Purpose – This study aims to evaluate the performance of the Czech spa industry within a dynamically changing external environment, specifically in the context of the COVID-19 pandemic. Considering the relationship between tourist attractiveness and fiscal policy effectiveness, the research explores the divergences existing among spa companies functioning across discrete spa resort categories within the Czech Republic. Methodology/Design/Approach – The research employs secondary data obtained from the State Statistical Office and the Business Register. The analysis entails an examination of the relationship between the level of tourist attractiveness and alterations in sales. Findings – The study reveals that spa resorts with higher levels of tourist attractiveness encountered a more pronounced decline in sales. Despite the notable allocation of public funds, the impact of subsidies on economic outcomes remained limited. Originality of the research – A contribution lies in its revelation of the adverse implications of over-reliance on tourism for the spa industry. The study highlights the imperative for diversification in resort portfolios. Moreover, the research offers valuable insights into the optimal allocation of subsidies, suggesting directions for more effective utilization and distribution in a manner that supports the industry's long-term sustainability and resilience. [ABSTRACT FROM AUTHOR]

The book "Digital and strategic innovation for Alpine health tourism: natural resources, digital tools and innovation practices from HEALPS2 project" explores the potential of nature-based health tourism (NHT) in the Alpine region. It emphasizes the importance of sustainable development and the responsible exploitation of natural resources. The book provides insights into the concepts, strategies, and practices of NHT, including the use of digital technology and innovative communication strategies. It is recommended reading for destination managers, developers, NGOs, government officials, researchers, and the general public interested in the sustainable development of NHT. [Extracted from the article]

Background: Since 2006, Taiwan has actively pursued the development of its medical tourism industry. In 2013, the government sought to bolster this sector by integrating medical tourism into the Free Economic Pilot Zones. Despite narrowly missing the mark, the initiative failed to materialize into law. This qualitative study endeavors to discern the pertinent factors influencing the agenda-setting process for incorporating medical tourism into the Free Economic Pilot Zones in Taiwan. Methods: A comprehensive examination of policies concerning the legitimation of medical tourism within the Free Economic Pilot Zones was undertaken through semi-structured interviews and a thorough review of policy documents. Key informants were strategically selected using purposive and snowball sampling techniques. Thematic analysis was applied to scrutinize the amassed data and organize it within the framework of Kingdon's multiple streams. Results: In the problem stream, increasing financial strains and cost containment pressures under the National Health Insurance program have long driven health care providers to seek further opportunities in medical tourism. The existing barriers to expanding medical tourism in Taiwan included diplomatic tensions (specifically cross-strait relations), public concerns about commercialization of medical care and reduced their access to care, and legal and language barriers. Within the policy stream, factors such as franchise fees to support national health insurance, limited number of demonstration medical tourism sites and services allowed, the allowance of foreign medical personnel, regulations governing domestic physicians, the importance of demonstration, regulation, and accreditation, as well as restrictions on investment from China, were emphasized. The politics stream highlights factors such as governmental support, opposition from opposing parties, public concerns and critics from academia and non-governmental organizations, and skepticism from medical faculties. Conclusion: Acknowledging the recognized challenges in enacting the medical tourism provision of the Free Economic Pilot Zones Special Act and emphasizing the political will of leadership, a viable policy solution remained elusive. Although a window of opportunity existed for the passage of the bill, it waned as public concerns sidelined the issue from the national agenda. The Taiwan case underscores the necessity for meticulous consideration of issues, proposed solutions, and political dynamics to achieve successful policy enactment. [ABSTRACT FROM AUTHOR]

Understandings of tourists' contemporary information needs that emphasize spontaneous travel decision-making and tourism as an exclusively pleasurable experience do not account for the contexts of people with dementia and their carers, for whom travelling requires unique adaptations. Through netnography in four online fora, this paper investigates the hitherto under-researched travel information needs of informal carers of people living with dementia. The qualitative data highlights the breadth of pre-travel information needs and their strong emotional dimensions both when carers plan to travel with and without the person with dementia for whom they care. Our analysis uncovers the complex, interdependent nature of travel-related information queries which refer not only to narrow tourism themes but also to health, healthcare and social policy. This exploratory paper concludes with recommendations for addressing the travel information needs of this globally growing category of people, wherein collaboration across destinations, tourism and hospitality industries, the healthcare sector and other stakeholders may be required. [ABSTRACT FROM AUTHOR]

Background: Health tourism is an important component that may influence the direction of development in a region. Mazandarn, Iran, is recognized as a highly sustainable market in the region because of its abundant natural resources, temperate temperature, and strategic geographical location. Therefore, considering the importance of health tourism and its existing potential in Mazandaran, Iran, this study was conducted with the aim of exploring a comprehensive perspective on local drivers in community-based health tourism industry development and factors affecting the attraction of health tourism. Methods: We conducted this study in Mazandarn, Iran, using a qualitative approach. Participants included a sample of Iranian people, aged 34–54 years, with previous history of health tourism or expert in it. Participants were selected from three different categories of the community: academic professionals in health tourism, managers in health tourism, and health tourists. Data were obtained via semi-structured in-depth interviews and focus group discussions. Inductive qualitative content analysis was used to converge and compare themes through participant data. The interviews kept going until data saturation was achieved. Results: Based on our findings, we distilled local drivers in community-based health tourism industry development into five main categories and 30 subcategories: (Sharifabadi AM, Ardakani FA. A model for health tourism development using fuzzy TOPSIS and interpretive structural modeling in Yazd province. J Health Adm (JHA). 2014;17:55.) infrastructure and resources; (Hemmati F, Dabbaghi F, Mahmoudi G. Investigating the impact of Information Technology on the status of Health Tourism in Mashhad, Iran. Revista Publicando. 2018;5(15):54–65.) tourist attractions; (Sarabi Asiabar A, Rezapour A, Raei B, Tahernezhad A, Alipour V, Behzadifar M. Economic, Cultural, and Political Requirements for Medical Tourism Development in Iran: Insights from a Fuzzy Analytical Hierarchy Process Method. Med J Islamic Repub Iran. 2022;35:199.) socio-cultural contexts; (Mosadeghrad AM, Sadeghi M. Medical tourism: Reasons for choosing Iran. Payesh (Health Monitor). 2021;20(2):145–66.) economic-financial factors; and (Manna R, Cavallone M, Ciasullo MV, Palumbo R. Beyond the rhetoric of health tourism: shedding light on the reality of health tourism in Italy. Curr Issues Tourism. 2020;23(14):1805–19.) political-communicative factors. The findings of the study showed that, from the participants' point of view, although there are several strategies, such as the development of public service and tourism infrastructure, increasing tourist attractions, and formulating appropriate policies and procedures for the development of health tourism, they are also faced with many challenges, especially political, economic, and cultural challenges. Conclusion: This study showed that improving infrastructure and resources, promoting tourist attractions, informing socio-cultural contexts, improving economic and financial capacity, and developing political and communicative contexts might increase the attraction of health tourists. The suggested components are not contextually driven, although empirical outcomes may differ based on the level of service offerings in health tourism locations. [ABSTRACT FROM AUTHOR]

Background: An estimated 2.2 million people from Central and Eastern Europe (CEE) live in the United Kingdom. It has been documented that CEE migrants underutilise health services in the United Kingdom and, as an alternative, seek healthcare in their home country. However, reasons for seeking healthcare abroad are not always clear. This review aims to identify the reasons for the uptake of transnational healthcare among CEE migrants resident in the United Kingdom. Methods: Informed by discussions with community members, medical stakeholders and academics, a systematic scoping review was undertaken following the nine‐stage Joanna Briggs Institute framework for scoping reviews. A search strategy with MeSH terms, where relevant, was used and adapted in five academic databases, two grey literature databases and Google Scholar. Included records encompassed four concepts: migration, CEE nationalities, UK nations and healthcare utilisation, which were written in English and published between May 2004 and 2022. Data from the literature were coded, grouped and organised into themes. Results: A total of 16 publications fulfilled the inclusion criteria. There is evidence that some CEE migrants exclusively use healthcare services in the United Kingdom. However, many CEE migrants utilise healthcare both in the United Kingdom and their country of origin. Four themes were identified from the literature as to why migrants travelled to their country of origin for healthcare: cultural expectations of medical services, distrust in the UK NHS, barriers and transnational ties. Conclusion: Push factors led CEE migrants to seek healthcare in their country of origin, facilitated by ongoing transnational ties. CEE migrants frequently combine visits to their country of origin with medical appointments. Utilising healthcare in their country of origin as opposed to the United Kingdom can result in fragmented and incomplete records of medications, medical tests and surgeries and risk of unnecessary treatments and complications. This review highlights the need for more targeted health outreach with CEE groups within the United Kingdom, as well as the need for further research on the impact of national events, for example, COVID‐19 and Brexit, on transnational healthcare‐seeking behaviours. Patient or Public Contribution: The concept for this scoping review was informed by discussions with community members, medical professionals and academics, who identified it as a current issue. The results of this scoping review were discussed with healthcare stakeholders. [ABSTRACT FROM AUTHOR]

The medical tourism industry has been observing significant developments in Iran. This country has been attracting tourists from countries in the Middle East and different regions of the world for a long time. However, nowadays, the Iran medical tourism industry faces serious barriers and challenges which deteriorate its participation in the global medical tourism market. The present article aims to investigate the barriers to the development of medical tourism in this country. In this regard, by reviewing the related literature and a weighted content validity ratio (CVR) analysis, 17 critical barriers were identified and finalised. Then, their casual relations were determined using a fuzzy cognitive mapping (FCM) methodology. The data gathered by a panel consisted of 10 experts in the field of medical tourism. The results show that five barriers, including managers' lack of knowledge, lack of strategic planning, lack of cooperation and coordination, weak government support and lack of enabling tourism sector, are considered the most important. The findings of this research provide opportunities for practitioners and policymakers to concentrate on Iran's medical tourism in order to overcome the barriers and consequently enhance the development of this lucrative industry. [ABSTRACT FROM AUTHOR]

Since the beginning of the 21st century, various tourism crisis events have negatively impacted the global tourism industry. This study proposes a research model grounded in the Stimulus–Organism–Response theory to explore how external stimuli influence individuals and help identify factors influencing elderly individuals' willingness to participate in forest-based health tourism during and after tourism crisis events, considering the global aging trend. From 20 December 2023 to 15 January 2024, we collected 429 valid questionnaires from Chinese older adult participants engaged in forest-based health tourism in Guizhou Province. Structural equation modelling (SEM) and bootstrapping techniques were employed to analyze data. The results indicate that tourism crisis events, primarily in the form of geological disasters, are significant antecedent variables influencing the willingness of Chinese older adults to engage in forest-based health tourism. Furthermore, destination image and perceived value serve as individual mediators and function as chained mediators. The results enhance our understanding of the complex relationship between tourism crisis events and the willingness of older Chinese adults to travel while also revealing deeper underlying mechanisms. [ABSTRACT FROM AUTHOR]

Currently, health tourists primarily rely on independent facilitators to manage and book their medical appointments and vacation plans. There is a notable absence of dedicated booking applications for health tourism packages. This paper proposes HealthTourismHub, an application designed to provide personalized packages that include medical appointments, accommodation options, and recommended tourism activities. It also serves as a platform for medical experts and accommodation providers, allowing health tourists to discover and connect with them, promoting local resources, and contributing to the sustainable growth of health tourism destinations. To incorporate personalization, HealthTourismHub uses an ontology that organizes medical and tourism data, along with a reasoner that generates new knowledge. This approach enables the application to offer customized packages and identify the most suitable providers for each user. Providers are strategically paired and located in close proximity, encouraging shorter travel distances and more efficient travel planning, with the package also including personalized tourism recommendations that benefit the local economy and contribute to a conscious tourism industry. A survey was conducted to assess the usability of the application and general perspectives towards health tourism, including motivations, concerns, and preferences. The results revealed an above-average SUS score, indicating that users found the application user-friendly and effective. Some areas for improvement were identified, such as error handling and additional functionalities. Nonetheless, HealthTourismHub shows great potential as a pioneer in the field of sustainable health tourism applications. [ABSTRACT FROM AUTHOR]

Medical tourism is a policy area with obvious policy connotations. Drawing on public policy theories and frameworks to explore the development of medical tourism policies can give an understanding of the future development trends of the medical tourism industry. This research uses public policy research methods and analyzes the characteristics of China’s medical tourism policy texts from three perspectives: structural characteristics, evolution stages, and development process. This analysis comprehensively and scientifically reflects the status of China’s medical tourism policy. This research has shed some light on the theory and practice of medical tourism development. [ABSTRACT FROM AUTHOR]

As a new form of tourism, forest health has gradually attracted the attention of scholars and the public, becoming a new focus of research. There have been many qualitative studies on the product forms and development models of forest health tourism, but there is still a gap in the evaluation indicators and development systems for the development potential of forest health tourism. Using the research results of forest health tourism at home and abroad for reference, we will build an evaluation system for the development potential of forest health tourism, providing new research perspectives and operational practical support for the development of forest health tourism. The development potential evaluation of forest health tourism is a classical MAGDM problems. Recently, the TODIM and VIKOR technique has been employed to cope with MAGDM issues. The single-valued neutrosophic sets (SVNSs) are employed as a tool for characterizing uncertain information during the development potential evaluation of forest health tourism. In this paper, the single-valued neutrosophic number TODIM–VIKOR (SVNN–TODIM–VIKOR) technique is built to solve the MAGDM under SVNSs. In the end, a numerical case study for development potential evaluation of forest health tourism is given to validate the proposed technique. The prime contribution of this paper is managed: (1) the information entropy based on score values are constructed to obtain weight values under SVNSs; (2) an integrated SVNN–TODIM–VIKOR technique is constructed to address the MAGDM issue; and (3) an illustrative example for development potential evaluation of forest health tourism has accomplished to verify the SVNN–TODIM–VIKOR technique. [ABSTRACT FROM AUTHOR]

To achieve better biodiversity outcomes and match local governance capacity, cumulative effects assessment frameworks that combine Indigenous and western knowledge to predict future development impacts on biodiversity are needed.We developed a spatial future‐focused model informed by inclusive elicitation and strategic foresight to assess the regional cumulative effects of development on ecosystem health across the land and sea. We collaborated with three First Nations on the Central Coast of British Columbia, Canada, enabling Indigenous priorities, knowledge and values to drive the process, from the choice of priority ecosystem components (including salmon, herring, seabirds and bears), to identifying future development scenarios (based on forestry, energy/mining, tourism and salmon aquaculture sectors). Bayesian networks were populated with empirical data and expert judgement elicited from knowledge holders to predict the cumulative effects of current and future pressures on species and ecosystems.Under current conditions, the lowest probability of persistence was predicted for Pacific salmon (37%), followed by Pacific herring (43%). Under future conditions, the greatest declines in species health were associated with the intense development of mining, tourism and forestry, with up to a 54% decline from the current baseline health estimates predicted for Marbled Murrelets and old‐growth forest.Future outcomes for overall ecosystem health were predicted to be worst in scenarios with high future forestry activities (>60% decline in some areas). The continuation or development of all four industries resulted in an 8% decline overall in ecosystem health across the Central Coast. In contrast, predicted ecosystem health in the tourism economy scenario increased up to 15% in some marine areas, primarily driven by the removal of salmon aquaculture and forestry activities.Synthesis and applications. Our study demonstrates an inclusive, regional approach to assessing the cumulative effects of future development on coastal species. The novel participatory tools and predictive framework draw upon and interweave multiple forms of knowledge, enabling Indigenous values to drive the process, and appropriately integrate Indigenous knowledge into regional cumulative effects assessment. Our interactive web application provides First Nations partners access to all outputs, supporting Indigenous‐led governance and in situ ecosystem‐based management of their lands and water. [ABSTRACT FROM AUTHOR]

Cosmetic procedures are amongst the most popular procedures sought after by medical tourists. Cosmetic medical tourists utilise numerous sources of information when planning their trips including, where available, discussing their decision with previous medical tourists. Current research on online support communities has investigated the interactions of patients with various health conditions with online support; however, limited research exists on cosmetic medical tourists' participation in online support communities. Here we report findings from our qualitative interview study of Australian cosmetic medical tourists. We found that many of our participants experienced stigma regarding their intention to receive cosmetic procedures and to travel overseas from within their local social networks. Participating in online communities (Facebook groups) enabled them to access information and support from other cosmetic medical tourists. Through using public posting and messaging functionality of the communities, they performed two distinct roles in the groups that parallel the temporal transitions of their journeys: they were information and support seekers pre-surgery and information and support providers post-surgery. The reciprocity they practiced in the provider role occurred due to their desire to 'pay forward' the support they had received from others pre-surgery. This role was performed as a collective, community-based reciprocity rather than a direct mutual exchange. Some participants also transitioned their online relationships into enduing offline friendships demonstrating how online interactions may become enmeshed with broader social networks. [ABSTRACT FROM AUTHOR]

In Malaysia, hospital branding is critical to recruiting medical tourists. Reputation, service quality, and word-of-mouth influence hospital branding. Thus, hospitals and the healthcare tourism sector must understand these elements to gain a competitive edge in the global market. This study investigated the effect of hospital advertising factors on healthcare tourists' behavioural intentions (BI) in Malaysia, with emphasis on clarifying the nature of hospital brand image and hospital brand trust. Additionally, the study assessed how perceived standards and satisfaction stimulate favourable BI among healthcare tourists. This study used the quantitative research-based deductive approach, where hospitals in Malaysia were the target sector. The results demonstrated that accessibility, cost, and a good web presence influenced hospital marketing for medical tourism. Furthermore, the characteristics of safety and security and effective advertising enhance trust. Moreover, patient satisfaction is critical to reduce the divide between service standards and BI, which emphasises the necessity of prioritising patients in medical facilities. Nevertheless, the findings were time-sensitive and not adjusted for healthcare tourism sector alterations or customer habit variations over time. [ABSTRACT FROM AUTHOR]

There are various types of tourism depending on the motivation for travel, one of which is health tourism. Health tourism has grown significantly in recent years due to the spread of machine life and psychological pressures. This type of tourism includes individuals and groups who travel for medical treatment, such as using mineral and warm waters, spending time in recovery, and so on. As one of the natural resources, hot springs are a part of health tourism that are used to treat various medical conditions. The current research focuses on the hot springs of East Azerbaijan province. The study is descriptive-analytical in terms of methodology and applied in terms of purpose. Due to its geographical location, climatic features, and geological and tectonic conditions, East Azerbaijan province is considered one of the important centers of hot springs, which are concentrated around Sahand mountain and Bozgoush mountain range in the northeast of Kalibar. This research uses the Comanescu method, library research, Internet-based surveys, documentary studies, and surveys of 20 experts from the Regional Water Organization and the Provincial Tourism Department, Motalleq Hot Springs, Bostan Abad, Asbforoushan, Allah. Haq, Isti Su Liqvan, Yel Sui, Top Tapan, and Dash Alti were selected and evaluated. In order to evaluate the selected hot springs based on the Comanescu method, the scientific, cultural, economic, managerial, and aesthetic values of the springs were examined. The results revealed that the Motalleq Hot Spring, with a total score of 86, has the highest score among the eight selected springs. The Asbforoushan hot spring comes in second with 84 points, the Yel Sui hot spring comes in third with 82 points, and the Top Tapan hot spring has the least points with 65. [ABSTRACT FROM AUTHOR]

Objective(s): Health tourism is a branch of the tourism industry that is of interest to many countries of the world due to its high demand and good income. Therefore, considering the importance of health tourism and the existing potential in Mazandaran province, this study was conducted with the aim of identifying and analyzing the factors affecting the development of the health tourism industry in Mazandaran province. Methods: The present study was conducted using a qualitative method with a content analysis approach. For this purpose, 17 health tourism industry experts and health tourists were selected using the purposeful sampling method. Semi-structured interviews were used to collect data. The interviews were conducted until we reached a point of theoretical data saturation. Results: The findings showed that the health tourism industry in Mazandaran province is affected by structural, process and contextual factors. The structural factors included issues related to infrastructures, potentials/attractions, institutional factors, and expert human resources for health tourism destination. The process factor included issues related to drivers of health tourism, provision of health services and destination situational factors. The contextual-field factor included issues related to sociocultural contexts, potentials and attractiveness of tourism, and economic capacity. Conclusion: Despite the importance of services related to health tourism and considering the increasing demand of this industry, travelers who travel to Mazandaran province need a variety of services, and the need to pay attention to quality service development in tourism destinations is evident. Therefore, the provision of other essentials for health tourists such as infrastructure, destination attractions, financial capacities, sociocultural conditions, human resources, situational factors are the requirements for the development of this industry. [ABSTRACT FROM AUTHOR]

Due to the COVID-19 epidemic, visitors' worries about health and safety in tourist destinations have become paramount. Consequently, this research aims to evaluate the impact of health and safety considerations on visitors' satisfaction. It also examines the influence of health consciousness and satisfaction on visitors' willingness toward robot-delivered tourism and hospitality services usage and the impact of destination healthcare system and satisfaction on loyalty intentions. Applying a quantitative-based methodology, 650 responses were collected from domestic tourists visiting Egyptian tourism destinations using multiple non-probability sampling techniques. Using PLS-SEM, the results articulated that emotional well-being, perceived safety, and perceived green image positively impacted visitors' satisfaction, which in turn, positively affected their willingness toward service robot's usage and loyalty. Tourists' health consciousness also positively affected their satisfaction and intentions to use robot-delivered services. Additionally, destination healthcare system significantly influenced visitors' satisfaction and loyalty intentions. Theoretical and managerial contributions as well as future research are outlined. [ABSTRACT FROM AUTHOR]

The issued constitutional complaint involved a medical dispute over a chronically demented patient whose son was attempting to end his father's ineffective treatment. The plaintiff claimed the hospital had not obtained his father's consent to use life-supporting equipment to keep him alive, resulting in an injury to his fundamental rights to dignity, life and body integrity, and sought damages from the hospital based on the right of inheritance. According to the German Federal Constitutional the state's duty to protect the life of the people is limited to the autonomy of the people, and once a patient has self-determined his or her own death, medical treatment beyond that will would be liable. However, the rights to dignity, life and the body integrity are highly personal rights that cannot be inherited, and therefore the present claim is not justified. [ABSTRACT FROM AUTHOR]

In response to heightened competition among destinations vying for medical tourists, these destinations have prioritized improving their image. Although several scales exist to assess destination images, there is a scarcity of scales specifically tailored to measure the image of medical tourism destinations. To address this gap, a thorough scale development process was employed, resulting in the creation of a second‐order model known as the medical tourism destination image scale. This scale explores four dimensions: quality of doctors and hospitals, ease of travel and safety, variety of treatment, and communication. The findings underscore the significant potential for marketers and policymakers to enhance the attractiveness of medical tourism destinations. [ABSTRACT FROM AUTHOR]

Although the potential of the health tourism to support economic growth can be based on strong theoretical foundations, it is also argued that this tourism type may hinder economic growth by weakening labor productivity. On this basis, the present study aims to examine the effect of health tourism on economic growth. The study uses panel data fixed effects method with Driscoll–Kraay standard errors and dataset of 72 countries. The findings strongly supported that health tourism boosts economic growth. To be more precise, it was estimated that a one‐point increase in health tourism revenues, expressed as a percentage of gross domestic product (GDP) of personal health travel exports, causes an increase of 4.9345 in GDP growth rate and 4.2558 in per capita GDP growth rate. Furthermore, the negative growth effect of health tourism through labor productivity, which is theoretically proposed and expressed as crowding‐out effect, was not supported by the findings. [ABSTRACT FROM AUTHOR]

This article presents a methodological framework that can be used to evaluate interventions in border regions. The case study was SIS-Fronteiras: a Brazilian project to support municipalities providing healthcare for economic migrants from neighbouring countries. This article uncovers important opportunities and challenges during the implementation of this project. The project failed partly because of inadequate management of resources. Future policies in regions with significant trans-border flows (for example between the USA and Mexico in North America; and across some European and Asian borders) should incorporate mechanisms of cross-border governance, co-operation and co-financing to increase the chances of success. ABSTRACT This study evaluates Brazil's Integrated Border Health System (SIS-Fronteiras). First, propensity score matching and difference in differences techniques were applied to analyse the health indicators of the 588 municipalities in the border strip of Brazil. Second, the authors conducted and analysed 23 interviews and 12 focus groups. The results suggest that the inadequacy of the governance model explains the failure to improve healthcare conditions in these areas. This article contributes to deepening our understanding of public policies and, in particular, public health interventions in border regions. [ABSTRACT FROM AUTHOR]

Abstract Background The Jordanian healthcare system has evolved over the past decades expanding its services, technological, and educational resources. A comprehensive view of this system is lacking. The objective of this report is to describe the structure of the Jordanian healthcare system, the challenges facing it, and the current and recommended health policies. Materials and methods This study reviewed the current status of the Jordanian healthcare system. The following parameters were analyzed: health indicators, infrastructure, human resources, insurance system, pharmaceutical expense, health education system, and medical tourism. Data were collected from various relevant official institutions and related published literature. Results Jordan has a young population with a median age of 23.8 years. Life expectancy is 78.8 years for females and 77.0 years for males. The Jordanian healthcare system is divided into three major categories: (1) Governmental Insurance (i.e., the Ministry of Health (MOH), the Royal Medical Services (RMS) and semi-governmental insurance); (2) Private Insurance; and (3) Refugee Insurance, including the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the United Nations High Commissioner for Refugees (NHUR). The Governmental Insurance covers 64.30% of the total population. Health expenditure is 6.37% of the gross domestic product (GDP). Pharmaceutical expenses make up 26.6% of the total national healthcare budget. Human resource assessment shows a high ratio of medical staff per 10.000 inhabitants, especially concerning physicians (31.7), dentists (7.9), and pharmacists (15.1). However, the ratio of nursing staff per 10.000 inhabitants is considered low (37.5). The Hospital bed/1000 population ratio is also relatively low (1.4). Healthcare accreditation is implemented through the Joint Commission International (JCI) accreditation which was achieved by 7 hospitals and by the National Health Care Accreditation Certificate (HCAC) achieved by 17 hospitals and 42 primary healthcare centers. Postgraduate medical education covers almost all medical and surgical fields. Medical tourism is currently well-established. Conclusions Assessment of the Jordanian healthcare system shows high ratios of physicians, dentists, and pharmacists but a low ratio of nursing staff per 10.000 inhabitants. The hospital bed/1000 population ratio is also relatively low. Pharmaceutical expenses are significantly high and medical tourism is well-developed.

Abstract Background Since 2006, Taiwan has actively pursued the development of its medical tourism industry. In 2013, the government sought to bolster this sector by integrating medical tourism into the Free Economic Pilot Zones. Despite narrowly missing the mark, the initiative failed to materialize into law. This qualitative study endeavors to discern the pertinent factors influencing the agenda-setting process for incorporating medical tourism into the Free Economic Pilot Zones in Taiwan. Methods A comprehensive examination of policies concerning the legitimation of medical tourism within the Free Economic Pilot Zones was undertaken through semi-structured interviews and a thorough review of policy documents. Key informants were strategically selected using purposive and snowball sampling techniques. Thematic analysis was applied to scrutinize the amassed data and organize it within the framework of Kingdon's multiple streams. Results In the problem stream, increasing financial strains and cost containment pressures under the National Health Insurance program have long driven health care providers to seek further opportunities in medical tourism. The existing barriers to expanding medical tourism in Taiwan included diplomatic tensions (specifically cross-strait relations), public concerns about commercialization of medical care and reduced their access to care, and legal and language barriers. Within the policy stream, factors such as franchise fees to support national health insurance, limited number of demonstration medical tourism sites and services allowed, the allowance of foreign medical personnel, regulations governing domestic physicians, the importance of demonstration, regulation, and accreditation, as well as restrictions on investment from China, were emphasized. The politics stream highlights factors such as governmental support, opposition from opposing parties, public concerns and critics from academia and non-governmental organizations, and skepticism from medical faculties. Conclusion Acknowledging the recognized challenges in enacting the medical tourism provision of the Free Economic Pilot Zones Special Act and emphasizing the political will of leadership, a viable policy solution remained elusive. Although a window of opportunity existed for the passage of the bill, it waned as public concerns sidelined the issue from the national agenda. The Taiwan case underscores the necessity for meticulous consideration of issues, proposed solutions, and political dynamics to achieve successful policy enactment.

The aim of this study is to determine the factors that prevent the development of medical tourism in Antalya. To explore the current medical tourism trend, a qualitative procedure was adopted. Besides analyzing the current situation of medical tourism in Antalya through a systematic searching on the available information and publications, in-depth interviews were conducted to collect data from relevant authorities and representatives of medical tourism associations in this country. The data were derived from interviews with 42 key informants. Data analysis of the study was conducted through employing the software NVivo-11. Data gathered at the end of the study were grouped into 8 main themes and 40 sub-themes. The results show that insurances, language and communication, management, policies and rules, prices and treatments, structural, transfer and terminology problems are the main barriers to the development of medical tourism. Several strategies are required in order to address and combat these barriers, such as governmental support, ethical practices, pricing and enhance personnel linguistic competence on an international scale. In this context, the study is expected to contribute to national and regional planning on medical tourism.

Introduction: Health tourism, defined as travels aimed to improve the physical and mental health of individuals, is growing day by day in parallel with developing technology and transportation. Factors influencing the preference of Türkiye in health tourism include cost, tourism opportunities, and cultural characteristics, as well as health facilities, staff, doctors, and the quality level of service. Due to the focus of human health, the service delivery which is very sensitive should be carried out by qualified workforce. With their role in protecting patients from unnecessary tests and treatments and facilitating effective participation in clinical decision-making processes, family physicians are also involved in the health tourism process and advocate. It is aimed to improve the service provision both qualitatively and quantitatively to meet the predicted increase in the health tourism sector in our country. In line with the realization of these goals, education and training activities offered by higher education institutions come into prominence. It’s aimed in our study to quantitatively investigate the adequacy of education in the field of health tourism in our country and to assess it in light of current data.Methods: The data of the cross-sectional and descriptive study were collected during the 2023-2024 academic years. Education programs and the number of students in the field of health tourism between 2018-2023 at 18 institutions under the Council of Higher Education (YOK) and The Measuring, Selection and Placement Center (OSYM) were examined. Obtained data were brought together with health tourism data published by the Turkish Statistical Institute (TUIK), the International Health Services Inc. (USHAS), and the Association of Turkish Travel Agencies (TURSAB).Results: In Türkiye, for the first time in 2014, associate degree education started to be provided in the " Health Tourism Business" department within the Vocational School. This department, which is available in 9 universities today, has the highest percentage among associate degree preferences. Master's degree program level trainings in health tourism continue in 9 universities across 3 different departments: "Health Tourism", " Health Tourism Business " and "Health Tourism Management". Doctoral level education is provided in 1 university in the department of "Health Tourism". It is observed that the number of students and graduates enrolled in education programs in the field of health tourism is increasing every year. On the other hand, there is still no undergraduate program in this field in Türkiye. According to the data published by TUIK and USHAS, the number of visitors coming to our country for health tourism and the value of income is increasing every year. On the contrary, the number of students and graduates has not increased at the same rate in recent years.Conclusions: The number of programs and quotas in the field of health tourism opened in universities is gradually increasing. However, when evaluated together with the increase in the number of visitors coming to our country for health tourism over the years, it has been revealed that the number of qualified staff trained to meet the increasing need is still not at the desired level.