Drivers of medical tourism intention toward private hospitals in Bangkok
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Abstract
Medical tourism has re-emerged as a dynamic segment of the global healthcare and tourism industries, particularly in leading Asian hubs such as Bangkok. This study aims to examine the determinants of Medical Tourism Intention (MTI) toward private hospitals in Bangkok by developing and empirically validating an integrated structural model. Drawing upon service quality theory, destination image literature, and value-based consumer behavior frameworks, the conceptual model incorporates Healthcare Service Quality (HSQ), Destination Image (DI), Cost Advantage (CA), Trust in Medical Provider (TR), Perceived Value (PV), and Medical Tourism Intention (MTI). A quantitative research design was employed using a cross-sectional survey of 520 international medical tourists and prospective foreign patients who had received, or intended to receive, treatment at private hospitals in Bangkok. Data were analyzed using covariance-based Structural Equation Modeling (SEM) to assess both measurement and structural components. Confirmatory factor analysis (CFA) demonstrated strong convergent validity, discriminant validity, and internal consistency across all constructs, with standardized factor loadings ranging from 0.71 to 0.91. The measurement and structural models exhibited satisfactory goodness-of-fit indices (χ²/df = 2.34, GFI = 0.91, CFI = 0.95, TLI = 0.94, RMSEA = 0.053, SRMR = 0.046), confirming model adequacy. Structural path analysis revealed that Healthcare Service Quality (β = 0.42), Destination Image (β = 0.31), and Cost Advantage (β = 0.18) exert significant positive direct effects on Trust in Medical Provider. Trust, in turn, demonstrated a strong direct effect on Perceived Value (β = 0.63), establishing it as a critical mediating mechanism. Perceived Value emerged as the most proximal determinant of Medical Tourism Intention (β = 0.72), fully mediating the relationships between trust and behavioral intention. Indirect effect analysis further indicated that Healthcare Service Quality exerts the strongest total influence on Medical Tourism Intention through sequential mediation (TR → PV), followed by Destination Image and Cost Advantage. The findings contribute to medical tourism theory by integrating healthcare performance attributes and destination-related factors within a unified SEM framework at the urban level. Practically, the results highlight the strategic importance of enhancing service quality and institutional trust to strengthen perceived value and reinforce Bangkok’s competitiveness in the global medical tourism market.
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