Asia Pacific University of Technology & Innovation BM031-3-2-MKIR

Contents

1.0 Executive Summary..................................22.0 Introduction and Research Background...............32.1 Statement of the Problem.........................32.2 Objectives of the Research.......................42.2.1 General Objectives............................42.2.2 Specific Objectives...........................42.2.3 Hypothesis....................................42.2.4 Research Framework............................5

3.0 Literature Review..................................63.1 Theoretical Framework............................63.2 Secondary Data...................................7

4.0 Research Design and Primary Data...................94.1 Population and Sample............................94.2 Data Collection Method..........................104.3 Measurement.....................................104.4 Data Analysis and Procedure.....................10

5.0 Benefits and Limitations of the Proposed Research. 125.1 Managerial Benefits.............................125.2 Limitations.....................................12

6.0 Conclusion........................................137.0 Harvard References................................148.0 Appendix..........................................16

1.0 Executive SummaryMalaysia aims to be a centre for healthcare excellence in

the region, and is well-known to deliver high quality

healthcare services(MHTC,2013). Given the potential of

health tourism as a foreign exchange earner, the

government has taken a series of proactive measures to

enhance Malaysia as a preferred health tourism

destination(MHTC,2013).

The research paper is divided into six parts. Part one is

executive summary whereas part two is introduction and

research background. Part three will be literature review

of theories, concepts, models and secondary data. Part

four is about research design and primary data where

convenience sampling technique will be used and

questionnaire will be designed to suite the data analysis

and procedure. Part five is benefits and limitations of

the proposed research whereas last but not least, part

six is conclusion of the research.

I would like to take this opportunity to express my

sincere gratitude to my lecturer, Mr.Gobi for his

guidance. In addition, I would like to appreciate my

family for giving motivation and support to complete my

assignment. Furthermore, I am very grateful towards my

friends who helped me in the process of collecting data

and information.

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2.0 Introduction and Research Background

2.1 Statement of the ProblemIn Malaysia’s New Economic Model (NEM), healthcare

tourism has been identified as one of the new national

key economic areas to propel the nation towards high

income status(MHTC,2013). This paper reports preliminary

results on Malaysian private hospitals’ involvement in

enhancing medical tourism. Then, what are the internal

and external critical success factors (CSFs) of

Healthcare Tourism in Malaysia?

Through the introduction of the Economic Transformation

Programme (ETP), the healthcare tourism is seen capable

to be more competitive and resilient(Deloitte,2013).

Integrative role of the public and the private sectors is

believed to be able to create a higher productivity

through the use of human resource skills and

innovation(Ministry of Health,2013). So, what is the

satisfaction level of foreign tourist towards healthcare

tourism in Malaysia?

According to the 2010 United Nations World Tourism

Organization (UNWTO) report, Malaysia ranked 9th in

international tourist arrivals, has been welcoming 24.6

million visitors. According to Deloitte Medical Tourism

report 2008, the healthcare tourism sector was observed

to increase steadily in Malaysia due to government’s

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promotion of Malaysia as an international healthcare

destination(Deloitte,2013). Therefore, how to capture

foreign tourist’s revisit intention to the healthcare

centre in Malaysia?

Synovate, the top ten marketing research company,

indicated that even though healthcare tourism was

actively promoted by government in more than ten years,

however, the participation of healthcare providers is

still left far behind(Milica & Karla,2007). Hence, how to

attract more participation of potential healthcare

providers in Malaysia?

2.2 Objectives of the Research

2.2.1 General ObjectivesThis is to study the factors that will help Healthcare

Tourism in Malaysia become successful. For the purpose of

this study, both the term healthcare tourism and medical tourism

will be used interchangeably throughout the research.

2.2.2 Specific Objectives1. To profile the internal and external critical

success factors (CSFs) of Healthcare Tourism in

Malaysia.

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2. To scrutinize satisfaction level of foreign tourist

towards healthcare tourism in Malaysia.

3. To elicit the ways to attract foreign tourist

revisit intention to healthcare centre in Malaysia.

4. To encourage participation of potential healthcare

providers in Malaysia.

2.2.3 HypothesisHI: There is a relationship between factors that will

help Healthcare Tourism in Malaysia become

successful and satisfaction level of foreign tourist

towards healthcare tourism in Malaysia.

H2: There is a relationship between factors that will

help Healthcare Tourism in Malaysia become successful and

foreign tourist revisits intention.

H3: There is a relationship between medical resources,

monetary, convenience and participation of potential

healthcare providers towards success of healthcare

tourism in Malaysia.

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2.2.4 Conceptual Framework

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MarketingPromotion(Han,2013)

MedicalResources(Han,2013) Monetary

&Convenien

ce(Heung & Kucukusta et al,2011)PersonalSecurity(Heung & Kucukusta et al,2011)

Satisfaction Level of Foreign Tourist(Teh & Chu,2012)

Foreign TouristRevisits Intention

(Teh & Chu,2012)Potential

Participation of Healthcare providers(Mahjom& Fadzilah et

al,2011)

Critical Success

Factors of HealthcareTourism in Malaysia(Mahjom&

Fadzilah et al,2011)

Figure 1: Conceptual Framework

Factors that will help Healthcare Tourism in Malaysia become successful

3.0 Literature Review

3.1 Theoretical FrameworkThe theory relevant for the research is 8P’s of service

marketing proposed by Kotler and Armstrong (2008) which

includes Product, Place, Promotion , Price People,

Process, Physical Environment, Productivity and Quality

in healthcare tourism Malaysia.

The concept is by applying push and pull strategy to

attract the tourist, and at the same time utilize the

Maslow Motivation Theory, which focuses on Physiological,

Safety, Social, Esteem and Self Actualisation(Kotler &

Keller,2012).

The model that is relevant is Boston Consulting Group

(BCG) Model(Kotler & Keller,2012). This is to classify

low or high performance of healthcare tourism depending

the market growth rate and relative market share.

According to Kotler &Keller(2012), customer-perceived-

value analysis can be used to define to provide the

consumer an overall assessment of the utility of a

product or services based on perceptions of what is

received and what is given in the medical tourism.

Roger’s Innovation Adoption Model is relevant to identify

whether medical tourism is innovators, early adopters,

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early majority, late majority or laggards(Kotler &

Keller,2012).

Segmentation, targeting and positioning concepts (Kotler

& Armstrong,2008), can be applied to enhance the quality

of the research.

Moments of truth concept which is defined by Kotler &

Armstrong(2008), are very essential in the research to

identify customers’ overall satisfaction willingness to

revisit Malaysia in the future.

3.2 Secondary DataAccording to the definition of World Tourism Organisation

(WTO), medical tourism is the tourism services based on

healthcare and nursing, sickness and health, recovery and

rehabilitation, where medical tourism contains healthcare

tourism and medical tourism(Deloitte,2013).

Gupta (2004) defines medical tourism as the provision of

cost effective medical care for patients in collaboration

with the tourism industry.

The constant change of living value has enhanced the

living styles and quality of modern people who pay more

attention to healthy life(Chaynee,2003).

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Teh & Chu(2012) outlines that pursuing health becomes the

reason for people leaving the countries to Malaysia.

Chee Heng(2007) commented that the main groups of

healthcare tourists come from the industrialized

countries of the world, especially Western Europe, Japan,

The United States, Canada and Australia, where the cost

of medical treatment is very high and waiting times for

some treatments may in some cases be months and even

years.

According to Awadzi and Panda (2006), many Third World

Countries see medical tourism as a gold mine and are

promoting it aggressively, thus also boosting competition

in the industry.

Suthin, Assenov and Tirasatayapitak (2007)journal reports

that, the reasons for healthcare tourism gaining

popularity are as follows:

1. The long waiting lists in the developed countries

2. The low cost of medical treatments in healthcare

tourism destination

3. The state of the art technology of healthcare

services which have been adapted by new service

providers

4. Affordable international air fares

5. The advance of Internet

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Malaysia offers low prices for healthcare services, and

as a predominantly Muslim country has competitive

advantages in particular in attracting patients from the

Middle East.

Malaysia has been making its mark as a choice of

healthcare tourism destination for both Muslim and Non-

Muslim foreign tourists(Mahjom & Fadzilah et al,2011).

MHTC(2013) also indicates that Malaysia expects its

medical tourism income to be round 590 million in five

years time.

They choose Malaysia because they confident with the

availability, affordability and competitiveness of

sophisticated healthcare facilities that Malaysia has

(MHTC,2013).

However, Hume and Demicco (2007) argued that growth of

medical tourism can have negative effects on the general

healthcare system of a destination. Uncontrolled growth

may place the physical and socio-psychological well being

of the local population at risk (Burkett, 2007). Most

local cannot afford and thus may not welcome- higher cost

services on offer to medical tourists, although patients

from developed countries may consider them reasonable.

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4.0 Research Design and Primary Data

4.1 Population and SampleThe population that I have selected is foreign patients

and healthcare consultants in Sunway Medical Centre in

Petaling Jaya Malaysia.

The total population size in Sunway Medical Centre is

30,000. It is assumed that there is a marginal error of

1%, standard deviation is 0.5 the confidence level of

95%. According to the formula of sample size adopted by

Govaert(2009):

Necessary Sample Size (n) = (Z-score)² * StdDev*(1-StdDev) / (margin of

error)²

Thus,

((1.96)²x0.5(0.5))/(0.01)²

=(3.8416x0.25)/0.0001

=0.9604/0.0001

=9604

Therefore, 9604 respondents are needed for the survey.

However, it is estimated the response rate will be 50%,

hence, the total number of survey participants for the

research need to be increased up to 19,208 people.

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A non-probability convenience sampling technique will be

used in this research (Govaert,2009). This sampling

research, which is preferred by many researchers, is the

most common technique in hospitality and tourism studies

as well as in consumer behaviour and marketing

research(Check Market,2011). This is because it is

impossible to measure the entire population as the size

is normally too large. Moreover, this sampling technique

is fast, inexpensive, easy and the subjects are readily

available(Check Market,2011).

Babbie (1998) postulated that occasionally it might be

appropriate to select the sample based on the

researcher’s knowledge of the population, its elements,

environments and the nature of the researcher intentions.

4.2 Data Collection MethodA quantitative approach is chosen to reduce researcher

bias and collect data that can be objectively measured

(Creswell, 2003).

A correlational design will be used to address the

primary research questions using a survey research model.

The data will be collected by questionnaire. A

questionnaire elicits responses to questions and

statements(Creswell,2003).

When closed-ended questions are used in the

questionnaire, the respondents are required to select

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from a list of answers. The rigidity of answers can be a

weakness because the researcher pattern the responses.

Nevertheless, the homogeneity of responses makes it easy

for the researcher to process the information gathered.

This study is exploratory in nature because healthcare

tourism is a new area that has not yet been fully

explored(Check Market,2011).

4.3 MeasurementA questionnaire has been designed to be distributed to

the participants in Sunway Medical Centre to analyse the

factors that will help Healthcare Tourism in Malaysia to

become successful. The questionnaire consists of three

sections: Demographic Data, Behavioural Data and

Psychographic Data. The questionnaire is attached in the

appendix.

4.4 Data Analysis and ProcedureThe statistical programme that is suitable for the

analysis and presentation of data in this research is the

Statistical Package for the Social Science (SPSS) version

20(Govaert,2009).

Descriptive statistics will be used to describe and

summarise the behaviour of the respondents in the

study(Govaert,2009). The descriptive statistics are based

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on frequency tables and graphical illustrations to

provide information on key demographic

variable(Govaert,2009), as well as the means and standard

deviations for the responses on the factors that will

help Healthcare Tourism in Malaysia to become successful.

Inferential statistics will be used to draw conclusions

about the reliability and generalizability of the

findings(Chun Wai,2009). The conclusions will include the

success factor of healthcare tourism as well as the

satisfaction level of foreign tourist towards heathcare

tourism in Malaysia.

The Pearson Product Moment Correlation Coefficient will

be used to indicate the degree to which two variables are

related to one another(Govaert,2009). A positive

correlation indicates a direct and positive relationship

between two variables whereas a negative correlation, on

the other hand, indicates an inverse and negative

relationship between two variables(Govaert,2009). In this

research, the method can be used to identify the

relationship between success factors of healthcare

tourism and the foreign medical tourist revisit intention

to Malaysia.

Analysis of Variance (ANOVA) will be used to analyse the

difference in success factors and participation of

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potential healthcare providers in Malaysia base on

biographical characteristics of the sample(Govaert,2009).

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5.0 Benefits and Limitations of the Proposed Research

5.1 Managerial BenefitsThe benefit that might bring to the Association of

Private Hospitals Malaysia (APHM) is to attract more

international healthcare tourists to come to Malaysia and

to motivate them to revisit their destination for further

medical healthcare services.

The second benefit is to maximize the effectiveness of

the marketers’ effort to attract new travellers and

maintain existing foreign tourists(Chao Chin, 2010).

The third benefit is to target higher income medical

tourist by focusing on specialized treatments or complex

surgery that require more higher level of expertise(Chun

Wai,2009).

The fourth benefit is to encourage investors and boost

investment in healthcare tourism, new policies and

development plans in Malaysia(Fried & Harris,2006).

The fifth benefit is to understand the overall strengths,

weaknesses, opportunities and threats(Kotler &

Keller,2012) of the healthcare tourism industry in

Malaysia.

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5.2 LimitationsThe main limitation is the small number of respondents

surveyed because the sample size could not represent the

overall population of the group(Chee Heng,2007).

Other than that, it is believed that reaching a large

number of healthcare centres will be extremely difficult

due to their busy schedules(Han,2013).

Besides that, it will be tiring to distribute the

questionnaires to the patients manually and results in

time-consuming(Han,2013).

In addition, the lack of visibility, quality and updated

data of medical tourists in Malaysia Hospitals remains a

challenge.(Heung & Fadzilah et al,2011).

Furthermore, unavailability of such data inhibits good

planning for the future, allows for insufficient

organization of scarce resources, discourage research and

mitigate proper control of the healthcare tourism

industry(Chao Chin,2010).

6.0 ConclusionIn a nutshell, the researcher, view that the factors that

will help Healthcare Tourism in Malaysia successful is

interrelated with the satisfaction level of foreign

tourist towards healthcare tourism in Malaysia.

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Not only that, there is a relationship between factors of

Healthcare Tourism become successful and foreign tourists

revisit intention. In fact, it will also influence the

potential participation of more healthcare providers to

boost the economy of Malaysia in conjunction of the New

Economic Transformation Programme (NETP).

After analysing the whole framework, critical success

factors (CSFs) will be identified to help Healthcare

Tourism in Malaysia to become more successful.

Further promotion and expansion of healthcare services

should be maximized. Meanwhile, the adoption of

appropriate laws and regulations ought to be concerned.

In healthcare tourism, there is a huge need for more

qualified and professional specialist and staff, language

training, cross cultural training and positive public

relation. This will definitely help healthcare tourism in

Malaysia to gain competitive advantage and achieve high

standards of service quality in the international

healthcare tourism arena.

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7.0 Harvard ReferencesAwadzi, W., P, A, D. and Eson. 2006. Medical Tourism:

Globalization and the Marketing of Medical Services.

Consortium Journal of Hospitality & Tourism, 11 (1).

Babbie, E. R. 1998. Survey Research Methods. Belmont, Calif.:

Wadsworth Pub. Co.

Burkett, L. 2007. Medical Tourism: Concerns, Benefits and

the American Perspective. Journal of Legal Medicine, 28

(1), pp. 223-245.

Chao Chin, L. 2010. Consumers' Purchase Motivation and

Satisfaction with Health Tourism in Kenting. Taiwan

Hospitality and Tourism Journal, 3 (4), pp. 72-79.

Chaynee, W. 2003. Heath Tourism to Drive Earnings. News

Strait Times, 19 April 2003.

Check Market. 2011. Sample Size Calculator. [online] Available

at: https://www.checkmarket.com/market-research-

resources/sample-size-calculator/ [Accessed: 4 Mar

2014].

Chee Heng, L. 2007. Medical Tourism in Malaysia:

International Movement of Healthcare Consumers and

the Commodification of Healthcare. ARI Working Paper, 1

(3).

Chun Wai, W. 2009. Move to Boost Health Tourism. The Star,

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6 April 2009.

Creswell, J. W. 2003. Research Design. Thousand Oaks,

Calif.: Sage Publications.

Deloitte. 2013. Medical Tourism. [online] Available at:

http://www.deloitte.com/centreforhealthsolutions

[Accessed: 4 Mar 2014].

Fried, B. J. and Harris, D. M. 2006. Managing Healthcare

Services in the Global Marketplace. Frontiers of health

services management, 24 (2), pp. 3--18.

Govaert, G. 2009. Data Analysis. London: ISTE.

Gupta, S. 2004. Medical Tourism and Public Health. [online]

Available at:

http://pd.cpim.org/2004/05092004_snd.htm [Accessed: 4

Mar 2014].

Han, H. 2013. The Healthcare Hotel: Distinctive

Attributes for International Medical Travelers.

Tourism Management, 36 pp. 257--268.

Heung, V., Kucukusta, D. and Song, H. 2011. Medical

tourism development in Hong Kong: An assessment of

the barriers. Tourism Management, 32 (5), pp. 995--

1005.

Hume, L. F. and Demicco, F. J. 2007. Bringing Hotels to

Healthcare: a RX for success. Journal of Quality Assurance in

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Hospitality & Tourism, 8 (1), pp. 75--84.

Kotler, P. and Armstrong, G. 2008. Principles of Marketing. 8th

ed. USA: Pearson.

Kotler.P and Keller.K.L (2012) Marketing Management, 14

edn., Harlow: Pearson.

Mahjom, N., Fadzilah, N. and Alias, M. 2011. Critical

Success Factors for Bumiputera/Muslim Medical Tourism

Providers: Solution for Financing Needs Using Islamic

Financing Instruments. Prosiding Perkem, 2 (3), pp. 184-

195.

Malaysia Healthcare Travel Council. 2013. Malaysia

Healthcare. [online] Available at:

http://www.mhtc.org.my/en/index.aspx [Accessed: 4 Mar

2014].

Milica, Z. and Karla, R. 2007. Medical Tourism in Developing

Countries. New York: Palgrave.

Ministry Of Health. 2013. Annual Report 2013. Malaysia:

Ministry of Health.

Teh, I. and Chu, C. 2012. Supplementing Growth with

Medical Tourism. Synovate Business Consulting, 9 (8), pp.

10-24.

Tirasatayapitak, A., Suthin, K. and Assenov, I. 2007.

Medical Tourism in Thailand. 3rd ed. Thailand: Prince of

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Songkla University.

WTO. 2012. Tourism 2020 Vision. [online] Available at:

http://www.wto.org/ [Accessed: 4 Mar 2014].

Zikmund, W. G. 2010. Business Research Methods. Mason, OH:

South-Western Cengage Learning.

8.0 Appendixes

Questionnaire is attached at the next page.

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