A STUDY TO ASSESS POTENTÌAL FOR SETTÌNG UP MULTÌSPECÌALTY HOSPÌTALS FOCUSED ON HEALTH TOURÌSM ÌN DELHÌ NCR

Dissertation Project Report
On
“A STUDY TO ASSESS POTENTIAL FOR SETTING UP
MULTISPECIALTY HOSPITALS FOCUSED ON HEALTH
TOURISM IN DELHI NCR”
By
SURAJ KUMAR
A01................
MBA Class of 20XX
Under the Supervision of
MS.
Assistant Professor
Department of International Business
In Partial Fulfillment of the Requirement for the Degree of
Master of Business Administration
At
AMITY BUSINESS SCHOOL
AMITY UNIVERSITY UTTAR PRADESH
SECTOR 125, NOIDA - 201303, UTTAR PRADESH, INDIA2013

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DECLARATION
Title of Project Report:
―A STUDY TO ASSESS POTENTIAL FOR SETTING UP
MULTISPECIALTY HOSPITALS FOCUSED ON HEALTH
TOURISM IN DELHI/NCR.‖
I declare that…
(a) The work presented for assessment in this Dissertation Report is my own, that it
has not previously been presented for another assessment and that my debts (for
words, data, arguments and ideas) have been appropriately acknowledged.
(b) The work conforms to the guidelines for presentation and style set out in the
relevant documentation.
Date: ………………..
SURAJ KUMAR
A01.............
MBA Class of 20XX

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CERTIFICATE
I Ms. .............................. hereby certify that Suraj Kumar student of Masters
of Business Administration at Amity Business School, Amity University Uttar
Pradesh has completed the Project Report on ― “A Study to Assess Potential for
Setting up Multispecialty Hospitals Focused on Health Tourism in Delhi/NCR.” under
my guidance.
Ms. XXXXXXXXX
Assistant Professor
Department of International Business

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ACKNOWLEDGEMENTS
On the Successful Completion of this report, I would like to express my
gratitude to everybody who assisted and guided me in completing this report and
making it a memorable and successful one.
I wish to extend my deep and sincere thanks to Ms. XXXXXXXXXX, Chair,
International Business Dept., Amity Business School, Noida, whose motivation,
constructive ideas, and vital inspiration to work hard and set high targets propelled
me to learn a lot about Medical Tourism and for her support through this analysis and
report preparation phase. The results and learning from this comprehensive research
project helped me in gaining in-depth knowledge of the subject and gave necessary
direction to my cognitive process.
I am extremely grateful to Dr. XXXXX XXXXXXX, Sr. Surgeon
(Orthopedics), AIIMS who rendered his valuable advice and kind assistance in
rendering the survey questionnaire and helped me in presenting this report
successfully.
I am thankful to Mr. XXXXX XXXXXX, Sr. Marketing Manager, Apollo
Hospitals New Delhi for providing me the opportunity to survey patients and
complete this project. I am thankful to him for sharing with me the necessary insights
about how Apollo Hospital‘s Sales & Marketing division works.
Lastly, I am beholden to my family and friends for their blessings and
encouragement and for supporting and guiding me throughout the project and thank
Dr. XXXXXXXXX, Director, Amity Business School, Amity University, Noida,
Uttar Pradesh for providing me the opportunity & means to complete this project.

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PREFACE
The underlying aim of the Dissertation on contemporary issue as an integral
part of MBA program is to give students an understanding of the challenges and
opportunities prevailing in market today. The sector under study in my project report
is Medical Tourism. This report is all about the current scenario where Medical
Tourism is no doubt a rapidly growing and attractive sector. Factors that have led to
the increasing popularity of medical travel include the high cost of health care, long
wait times for certain procedures, the ease and affordability of international travel,
and improvements in both technology and standards of care in many countries.
This report covers the scope of setting up multispecialty hospital in Delhi
focused on medical tourism along with its detailed description and analysis in Indian
context. This project includes my sincere efforts, and I affirm the findings in this
project are independent and original to the best of my knowledge and belief. I
sincerely hope that this report proves to be useful to the organizations engaged in
medical tourism and also to its readers.

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TABLE OF CONTENTS
DECLARATION....................................................................................................................... ii
CERTIFICATE......................................................................................................................... iii
ACKNOWLEDGEMENTS ........................................................................................................ iv
PREFACE................................................................................................................................ v
TABLE OF CONTENTS............................................................................................................ vi
LIST OF TABLES....................................................................................................................viii
LIST OF FIGURES................................................................................................................... ix
ABSTRACT............................................................................................................................. x
CHAPTER 1: INTRODUCTION..................................................................................................1
1.3 History of Medical Tourism..........................................................................................5
1.3.1 The History of Western Medicine in India .............................................................6
1.4 Industry background....................................................................................................8
1.4.1 Top Ten Medical Tourism Destinations in The World...........................................10
1.5 Medical Tourism in India............................................................................................13
1.6 Govt. Support & Initiatives.........................................................................................14
1.7 Health Sector Reform in India....................................................................................15
1.8 Context of Study........................................................................................................17
1.8 Scope of the Study.....................................................................................................18
CHAPTER 2: REVIEW OF THE LITERATURE ............................................................................19
CHAPTER 3: RESEARCH METHODS AND PROCEDURES .........................................................24
3.1 Research Objectives.............................................................................................24
3.2 Research Methodology..............................................................................................24
3.3 Data Collection ..........................................................................................................24
3.4 Hypothesis Used........................................................................................................25
3.5 Sampling Design ........................................................................................................25
3.6 Data Analysis.............................................................................................................25
3.7 Limitations.................................................................................................................26
CHAPTER 4: DATA ANALYSIS AND FINDINGS........................................................................27
4.1 Demographic Analysis................................................................................................27
4.1.1 Gender ...............................................................................................................27
4.1.2 Age Groups.........................................................................................................28

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4.1.3 Marital Status .....................................................................................................29
4.1.4 Nationality..........................................................................................................30
4.1.5 Education............................................................................................................31
4.1.6 Employment Status.............................................................................................32
4.1.7 Income level .......................................................................................................33
4.2 Treatment Statistics...................................................................................................34
4.2.1 Most Availed Treatment .....................................................................................34
4.2.2 Availability of Treatment in Home Country .........................................................35
4.2.3 Insurance Coverage ............................................................................................35
4.2.4 Source of Information About Indian Hospitals.....................................................36
4.2.5 Duration of Stay..................................................................................................38
4.2.6 Satisfaction Level ................................................................................................39
4.2.7 Tourism Opportunity at Destination and Visit Intention ......................................40
4.5 Crosstabs and Correlation Tests................................................................................46
4.5.1 Crosstab for gender and satisfaction level...........................................................46
4.5.2 Correlation between accreditation & affiliation and choice of destination ..........47
4.5.3 Correlation between Quality standards/hygiene in hospital and Repeat visit
intention .....................................................................................................................48
4.5.4 Correlation between Certified & Experienced Doctor and Satisfaction Level .......49
4.5.5 Crosstab- satisfaction & Nationality ....................................................................50
4.6 Summary of the Findings ...........................................................................................51
CHAPTER 5: CONCLUSIONS AND RECOMMENDATION .........................................................54
5.1 Conclusion...........................................................................................................54
5.2 Recommendations...............................................................................................55
5.3 Implications for Practice & Future Research...............................................................58
REFERENCES........................................................................................................................60
BIBLIOGRAPHY....................................................................................................................63
Books ..............................................................................................................................63
Internet Sources..............................................................................................................63
APPENDIX A: GLOSSORY ......................................................................................................64
APPENDIX B: QUESTIONNAIRE.............................................................................................66

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LIST OF TABLES
Table 4.1 Gender Ratio ............................................................................................27
Table 4.2 Different Age Groups................................................................................28
Table 4.3 Treatment Availability in Home Country...................................................35
Table 4.4 One-Sample T-Test ...................................................................................41
Table 4.5 Rotated Component Matrix.......................................................................42
Table 4.6 Factor Analysis.........................................................................................44
Table 4.7 Gender & Satisfaction Level Cross tabulation...........................................46
Table 4.8 Chi-Square Test for Gender & Satisfaction Level......................................46
Table 4.9 Correlation between Recognized international accreditations &
certifications & Visit Intention..................................................................................47
Table 4.10 Correlation Between Quality standards/hygiene in hospital & Future Visit
Intention...................................................................................................................48
Table 4.11 Correlation Between Safety & security & Future Visit Intention .............48
Table 4.12 Correlation Between Board certified doctors & Satisfaction Level..........49
Table 4.13 Satisfaction & country of residence- Cross tabulation.............................50
Table 4.14 Chi-Square Test for Satisfaction Level & Nationality ..............................50

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LIST OF FIGURES
Figure1.1 Factors Affecting Medical Tourism........................................................... 2
Figure1.2 Major Medical Tourism Destinations ........................................................ 3
Figure1.3 Classification of Health Tourism............................................................... 5
Figure1.4 Ancient Indian Surgery Process................................................................. 7
Figure1.5 World Overview of Medical Tourism........................................................ 8
Figure1.6 Worldwide Medical Tourism..................................................................... 9
Figure1.7 Medical Tourism by Country ...................................................................10
Figure1.8 Medical Travelers by Point of Origin .......................................................12
Figure1.9 Medical Tourism Worldwide....................................................................13
Figure1.10 Process of Medical Tourism ...................................................................14
Figure1.11 Cost Comparisons of Treatments Across Countries ................................18
Figure 4.1 Gender Ratio...........................................................................................27
Figure 4.2 Age Groups.............................................................................................28
Figure 4.3 Marital Status..........................................................................................29
Figure 4.4 Nationality of Respondents ....................................................................30
Figure 4.5 Education Levels of Respondents............................................................31
Figure 4.6 Employment Statuses of Respondents .....................................................32
Figure 4.7 Income Levels of Respondents................................................................33
Figure 4.8 Most Availed Treatment..........................................................................34
Figure 4.9 Insurance Coverage.................................................................................35
Figure 4.10 Source of Information ...........................................................................36
Figure 4.11 Information Search from trusted Sources...............................................37
Figure 4.12 Stay Duration........................................................................................38
Figure 4.13 Satisfaction Level..................................................................................39
Figure 4.14 Effect of Tourism Opportunity at Destination and Decision of Destination
Choice......................................................................................................................40

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“A STUDY TO ASSESS POTENTIAL FOR SETTING UP MULTISPECIALTY
HOSPITALS FOCUSED ON HEALTH TOURISM IN DELHI/NCR”
Suraj Kumar
ABSTRACT
The aim of this research is to analyse the factors that determine the motivation
and behaviour of potential medical tourists in choosing a destination (India). In
pursuit of this objective, the study examines the motivation of individuals to engage in
medical tourism, their information search behaviour, their satisfaction level with
treatment & facilities in hospitals, their reliance on various information sources, and
the salient criteria they use in evaluating alternative medical-tourism destinations.
These issues are worthy of detailed study for several reasons. First, medical
tourism has the potential to be an important factor in sustaining the competitive
advantage of India in the tourism market in general, while also being a significant
revenue generating sector in its own right; indeed, the policy of the India government
envisages. Medical tourism is a relatively new phenomenon that has received very
little research attention. As a consequence, decision-makers in this field are forced to
make marketing decisions on the basis of intuition and/or relatively unreliable non-
research literature. A thorough research-based understanding of consumer behaviour
in the context of medical tourism is still lacking. It is therefore important for decision
makers to have access to a thorough research-based analysis of the salient factors that
determine the choice of a medical-tourism destination. This will help in evaluating the
potential for setting up new multi-specialty hospitals in Delhi NCR.
To address the substantive research question of identifying the salient factors
that influence the choice of a medical-tourism destination, the present study primarily
collects data from survey of medical tourists, complemented with data from secondary
sources. The population from which the sample is drawn for these surveys includes
individuals who are availing such treatment in Delhi NCR and are proficient in
English. Respondents in the final research sample are asked to answer questions that
seek to measure their attitudes, opinions, and intentions with regard to: (i) their
treatment requirement; (ii) the costs and waiting times of medical treatment provided

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in their home countries; (iii) their perceptions of risk; (iv) their familiarity with India
as a medical-tourism destination; (v) their assessment of destination attributes; (vi) the
image of India as a medical-tourism destination; and (vii) their intentions to visit India
again for the purpose of medical tourism.
Following analysis of the collected data, the study finds that individuals who
are more inclined to undertake medical tourism are those who: (i) do not have
insurance cover for such treatment; (ii) consider the cost of health-care services in
their home countries to be financially unaffordable; and (iii) consider that the waiting
time to receive desired treatment in their home countries is too long.
Medical tourists who perceive risk are found to rely more on information from
reliable & trusted sources (such as govt. tourism authorities and non-commercial
websites e.g. Websites of professional associations, and online communities and
insurance companies.
The study also finds that prospective medical tourists are particularly
motivated to consider four destination attributes in choosing a medical-tourism
destination: (i) Saving potential; (ii) Quality of care; (iii) Hygiene issues; and (iv)
Safety and security In contrast, general tourism opportunities, which have been
promoted in the past in seeking to attract medical tourists, appear to be neither
important nor unimportant to the respondents in the present study.
Apart from quality of care and cost saving, the study also finds that the image
of a destination with regard to hygiene and its image with regard to safety are also
important in choosing a medical-tourism destination. India should therefore take steps
to ameliorate any negative aspects of its image with regard to safety and/or hygiene.
From the finding of this research, implications can be drawn. The implication
for stake holders is related to the use of information source to promote a destination
for its medical tourism sector. Hospitals should leverage the quality of care according
to the acceptable standard of developed countries, as well as saving potential while
communicating that the destinations are hygienic and safe.

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CHAPTER 1: INTRODUCTION
1.1 Introduction to the Topic
Medical tourism is defined as the process of patients travelling abroad for
medical care and procedures, usually because certain medical procedures are less
available or less affordable in their own country (Voigt et al. 2010).
Over the last two decades, there have been a number of forces driving increase
in medical travel, including (Helble 2011):
Rising costs of healthcare in industrialised countries;
Differences in quality and accessibility of health services;
Information technology advances easing the access to information and knowledge
transfer;
Lower transport costs;
Reduced language barriers; and
Trade liberalisation.
As a result, countries have increasingly investigated the potential economic
benefits and public health costs of medical tourism (Smith et al. 2009). India could be
hosting 24 lakh medical tourists by 2020, almost four times the number it catered to
in 2010. And that‘s not all. The figure is projected to rise to 49 lakh tourists by 2025,
according to an estimate by Technopak.
The market size of medical value travel would cross Rs. 62,000 crore by 2020
and Rs. 2 lakh crore by 2025 from R4,500 crore in 2010, according to Technopak,
which forecasts a 30% annual growth for the industry for the next 15 years.
In the national capital region (NCR) alone, the three largest hospital chains,
Apollo Hospitals, Fortis Healthcare and Max Healthcare attended to 15,500 foreign
patients in 2010.

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Figure1.1 Factors Affecting Medical Tourism
Healthcare, like food and shelter, is a basic need of Humanity. Given the
potential India holds as a healthcare destination, the healthcare tourism sector can be a
major source of foreign exchange earnings for the country.
India‘s healthcare sector has made impressive strides in recent years and the
country is increasingly projected as a ‗healthcare hub‘. Several features have
positioned India as an ideal healthcare destination, like cost effective healthcare
solutions, availability of skilled healthcare professionals, reputation for successful

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treatment in advanced healthcare segments, increasing popularity of India‘s
traditional wellness systems and rapid strides made in information technology.
The sector is witnessing a „reverse brain-drain‟ trend, with increasing
number of specialists, who have been practicing abroad, showing keen interest to
come back and practice in India. People travel to India for availing healthcare services
for diverse reasons. While healthcare tourists from United States are primarily
reported to be travelling to India, as the cost of getting treatment in home country is
expensive, travellers from Europe are reported to be seeking healthcare services in
India due to the complexity of availing the healthcare services in their home country.
Some of the tourists from West Asia and Africa region travel to India due to
affordability of treatment and quality of services rendered.
Figure1.2 Major Medical Tourism Destinations
Traditionally most medical tourism has been from developing markets to
developed markets, as people seek better care. But the squeeze on healthcare spending
in the west is increasingly encouraging patients to travel in the other direction. In the
US, some companies and insurers already offer incentives under their insurance plans
for patients to choose cheaper hospitals and clinics abroad. An industry of medical
tourism advisers has sprung up as a result.

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At the same time, some governments in Asia, the Middle East and Eastern
Europe are seeing medical tourism as growth industry and are doing their best to
encourage investment in hospitals and clinics to attract foreign patients.
Asia now has several private hospital chains, such as Parkway Health in
Singapore and Apollo Hospitals in India, that market to them as well. But medical
tourists tend to prefer going to hospitals in their own region or time zone, which is
why countries like Hungary are the most obvious destinations for Europeans.
1.2 Defining Medical Tourism
There are many ways to define Medical Tourism which is also known as
Medical Travel, Surgical Tourism, Health Tourism, Medical Value Travel,
Health Care Abroad, Medical Overseas, Overseas Medical, and even Medical
Outsourcing and Offshore Medical. Medical Tourism can be broadly defined as
―providing cost effective private Medical care collaboration with Tourism Industry for
patients needing surgical and other forms of specialized treatment.‖
In simple words Medical Tourism is the process of travelling abroad to
receive superior medical, dental, cosmetic care by highly skilled surgeons at some of
the most modern and state of the art medical facilities in the world where the cost of
treatment is comparatively very low than their home country.
There is sometimes a distinction between „medical tourists‟ and „medical
travellers‟, where medical tourists are those who travel overseas in addition to a
planned holiday, usually for elective treatment such as cosmetic surgery or fertility
treatment – while medical travellers generally travel overseas for the sole purpose of
medical treatment, and more often than not seek more complex surgeries such as
cardiac or orthopaedic treatment.
For the purposes of this study, ‗medical tourists‘ and ‗medical travellers‘ are
used interchangeably and synonymously, referring to both groups of people, as they
both bring economic benefits to India,. However, domestic medical tourism and
Indians travelling abroad for medical care are excluded from scope.

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Wellness tourism is separate to medical tourism, and usually describes people
travelling for the purposes of maintaining or promoting their health and wellbeing.
Wellbeing services may include:
Beauty, such as body and facial treatments;
Lifestyle, such as detoxification and rejuvenation; and
Spiritual, such as meditation and yoga retreats.
This study focuses specifically on medical tourism, although it is recognised that
medical and wellness tourism are complementary and together form a broader health
tourism sector (Voigt et al. 2010).
Figure1.3 Classification of Health Tourism
1.3 History of Medical Tourism
Medical tourism is actually thousands of years old. In ancient Greece,
pilgrims and patients came from all over the Mediterranean to the sanctuary of the
healing God, Asclepius, at Epidaurus. In Roman Britain, patients took the waters at a
―Shrine Bath‖, a practice that continued for 2,000 years. From the 18th century
wealthy Europeans travelled to spas from Germany to the Nile.

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In the 21st century, relatively low-cost air travel has taken the industry
beyond the wealthy and desperate. Later, mostly wealthy people began travelling to
tourist destinations like the Swiss lakes, the Alps and special tuberculosis
sanatoriums, where professional and often specialized medical care was offered. In
this century, however, Medical Tourism expanded to a much larger scale.
Thailand, followed by India, Puerto-Rico, Argentina, Cuba and others
quickly became the most popular destinations for Medical Tourists, complicated
surgeries and dental works, kidney dialysis, organ transplantation and sex changes
topped the list of the most popular procedures. From Neolithic and Bronze age where
in people used to visit neighboring countries for Minerals and Hot Springs , today we
have reached the era where Hospitals are more like Spas and Spas more like hospitals.
Countries that actively promote medical tourism include Cuba, Costa Rica,
Hungary, India, Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium,
Poland and Singapore are now entering the field. South Africa specializes in medical
safaris-visit the country for a safari, with a stopover for plastic surgery, a nose job and
a chance to see lions and elephants.
1.3.1 The History of Western Medicine in India
Medical systems spread to India through Arab, Portuguese, Dutch and British
traders. The first western hospital was established by the Portuguese in the late 1490s
to treat injured members of the military (Baru 1998, Rajasekharan Nair 2001). The
services of European doctors were popular amongst local nobility, acting as a form of
international diplomacy, which helped the formation of more cordial relationships
between the British and local elites. European physician‘s new knowledge of disease
and treatments was valued at the very least because of its exoticism, if not its
superiority to the techniques of indigenous practitioners (Kochhar 1999). Myth
recounts the free succession of trading rights were granted to the East India Company
in Bengal, in gratitude for the treatment by a European physician of the Mughal
emperor Shahjahan‗s favourite daughter following a fire (Kochhar 1999,
Rajasekharan Nair 2001).
European doctors were initially interested in learning about indigenous
medicine herbs and plants and many sought the treatment of indigenous doctors for
local fevers (Arnold 1993, Varier 2002, Hardiman 2007). Both systems shared

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humoral understandings of the body and disease until the late 19th century (Kochhar
1999, Bala 1991, Leslie 1976). Western medicine‗s advantage over indigenous
systems was therefore initially in surgery. In the modern period surgery was not
practiced by indigenous healers, generally considered as defiling work, practiced only
by barber surgeons (Arnold 1993). However, between 600- 800 BC the famous
ayurvedic physician, Sushruta performed plastic surgery (e.g. nose reconstruction,
cataract operations, laparotomy (abdominal surgery) vesicle lithotomy (removal of
bladder stones), and also described diabetes (Raju 2003).
Figure1.4 Ancient Indian Surgery Process
Painting of Susruta circa 600 BC, performing a skin graft on a burn victim,
hallowed in India as the father of modern surgery. The painting is still an important
part of the visual imagery of the modern medical profession, painted on a large mural
in the local medical college and also circulated in printed calendars given to doctors
by pharmaceutical companies.

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1.4 Industry background
Medical tourism is on the rise with more people from the United States,
Europe and the Middle East seeking Indian hospitals as a safe alternative but low cost.
Like estimates measuring the global size of medical tourism, estimates of the size of
the Indian medical tourism markets are varied. McKinsey and Co., in collaboration
with the Confederation of India Industries (CII), estimated that in 2005, 150,000
medical tourists travelled to India and this was expected to increase by 15% each year
(Confederation of Indian Industries and Mckinsey and Co. 2002 cited in Hazarika
2010). However, other estimates placed inbound medical tourism at approximately
half a million foreign patients by 2004 and in 2005-06, another report placed industry
estimates closer to one million (ESCAP 2009 and Gupta 2008). By 2014, the industry
has been predicted to grow to $US 1 billion (Confederation of Indian Industries and
Mckinsey and Co. cited in ESCAP 2009).
Figure1.5 World Overview of Medical Tourism
Medical tourists in India come from the Middle East, the UK, Canada and
other developing countries, injecting $US 480 million into the economy in 2005
(The Indus View 2007). According to Gupta (2008), the Taj Medical Group

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receives 200 enquiries a day from around the world and arranges packages for 20 to
40 Britons per month to have operations in India. India captures the market through
its low cost procedures ranging from heart surgery, joint replacements, hip
resurfacing, cataract operations, cosmetic surgery, dentistry and gallstone removal.
Figure1.6 Worldwide Medical Tourism
India‘s main strengths lie in its low wages, thereby making it one of the
cheapest medical tourism destinations in Asia. Combined with its high prevalence
of English language and high quality of medical professionals, India is one of the
most popular destinations for medical tourism. The medical profession in India also
has strong networks with the US, with around 30,000 doctors working in the US
originating from India (Singh 2009).

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Figure1.7 Medical Tourism by Country
1.4.1 Top Ten Medical Tourism Destinations in The World
1. Brazil: Home to the highest per capita number of practicing cosmetic doctors in the
world. Brazil attracts tourists not only to Sao Paulo and Rio de Janeiro, but also to
smaller cities, including Porto Alegre and Santos. Common procedures, such as
tummy tucks, breast augmentations, facelifts and rhinoplasty, run $3,000 to $6,500.
2. Costa Rica: Nearly 15% of international tourists visiting this ecological paradise
take advantage of its medical services, mainly cosmetic surgery and dental care. San
Jose and its surrounding area are home to hundreds of board-certified doctors,
surgeons and dentists. Costa Rica is one of the top five medical tourism destinations
for Americans.
3. Hungary: Long known for its mineral springs, lakes, baths and spas, Hungary has
more dentists per capita than any other country. They are found not only in Budapest,
but also in a small town of 30,000 (Mosonmagyaróvár) near the Austrian border,
which has 160 dental offices. Many European Union visitors come here for major
dental care, including cosmetic oral surgeries, full-mouth restorations and implants.

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4. India: More Americans travel here for cardiac and orthopedic procedures than for
all other treatments combined. India offers top private hospitals, especially in the
larger cities of Bangalore, Delhi, Chennai and Mumbai. Medical travel to India is
growing by 30% a year, thanks to increasing numbers of Americans, Canadians and
Europeans—especially those seeking expensive cardiac and orthopedic surgeries.
These often cost tens of thousands of dollars less here than in their home countries.
5. Malaysia: With more than a quarter of a million medical travelers each year,
Malaysia compares favorably to India, Thailand, and neighboring Singapore in terms
of its medical facilities, skill and costs. As well as having special burn treatment
centers, Malaysian hospitals have created ―well-man‖ and ―well-woman‖ packages
that include extensive, low-cost physicals and tests promoting preventive care. A
battery of tests, including blood work, bone density scan, chest X-ray and treadmill,
usually runs just $340, compared to $2,500 in the U.S.
6. Mexico: Its convenient location is the top draw for most Mexico-bound health
travelers. More than 70% of Mexico‘s U.S. patients reside in California, Texas or
Arizona. Patients from San Diego, Los Angeles, Phoenix, Tucson and Brownsville
make the two- to six-hour drive across the border to a clinic, stay a couple of nights in
a hotel and then return Stateside. Many come each year for checkups, dental
cleanings, physicals and other treatments that cost much less than in the U.S. The
added benefit, of course, is minimal travel.
7. Singapore: A medical tourism veteran, this tiny Asian nation—with a population
of four-and-a-half million—has a health care system that the World Health
Organization ranks as the best in Asia and sixth best in the world. It‘s no wonder that
Singapore attracts many international patients. Singapore‘s specialties cover a broad
range, including cardiology and cardiac surgery, gastroenterology, general surgery,
hepatology, neurology, oncology, ophthalmology, orthopedics and stem cell therapy.
Recent additions include the $300-million Biopolis, a seven-building, 2-million-
square-foot biotechnology research center that opened in late 2003.
8. South Korea: One of the worlds‘s most technologically and scientifically
advanced nations. South Korea has earned a reputation for spinal surgeries, cancer
screenings and treatments and cosmetic surgeries. Many South Korean hospitals are
fully digitized, with electronic health records as the standard. Daegu, in the center of

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the nation, hosts a well-known herbal medicine market dating to the 17th century. On
the southern seacoast, Busan attracts many medical travelers to the local Hanyang
University Medical Center for low-cost, comprehensive health screenings.
Figure1.8 Medical Travelers by Point of Origin
Source: Ehrbeck et al. (2008).
Note: Based on McKinsey and Company’s interviews with providers and patient-level data.
9. Thailand: An established leader in cosmetic surgery, with an excellent medical
infrastructure. Thailand turned the crash of its baht currency in the late 1990s into
economic opportunity by attracting patients from nearby Japan, Vietnam, China and
South Korea. Eventually, Westerners joined the flow to Bangkok and Phuket,
primarily for elective surgeries whose low cost more than makes up for the long flight
and other travel expenses.
10. Turkey: Medical tourists may be surprised to know that this Eurasian country is
home to more JCI-accredited health care facilities than any nation outside the U.S.
Health care costs compare extremely well even to those in Asia, and the medical
system has plenty of doctors who are Western-trained and fluent in English.

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Figure1.9 Medical Tourism Worldwide
1.5 Medical Tourism in India
Health and medical tourism is perceived as one of the fastest growing
segments in marketing ‗Destination India‘ today. While this area has so far been
relatively unexplored, we now find that not only the ministry of tourism, government
of India, but also the various state tourism boards and even the private sector
consisting of travel agents, tour operators, hotel companies and other accommodation
providers are all eying health and medical tourism as a segment with tremendous
potential for future growth.

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Figure1.10 Process of Medical Tourism
India is considered the leading country promoting medical tourism-and now it
is moving into a new area of "medical outsourcing", where subcontractors provide
services to the overburdened medical care systems in western countries. India's
National Health Policy declares that treatment of foreign patients is legally an
"export" and deemed "eligible for all fiscal incentives extended to export
earnings." Government and private sector studies in India estimate that medical
tourism could bring between $1 billion to $2 billion US into the country by 2012.
The reports estimate that medical tourism to India is growing by 30 per cent a year.
1.6 Govt. Support & Initiatives
As a condition of structural adjustment, government expenditure on social
sectors had to be curtailed (Patnaik 1999). In the state sector, any further expansion of
curative services became dependent on private capital and cost recovery
mechanisms in order to promote efficiency. A paradigm shift in health policy has
occurred - from a more inclusive ideology of health care as a right to be claimed by
all citizens from the state; to health care as a commodity, as access to health services
is increasingly predicated upon the ability of users to pay for services.
The government of India has introduced incentives to encourage medical
tourism in India including increasing depreciation rates (from 25% to 40%) to allow

P a g e | 15
old equipment to be replaced by new equipment sooner, and expedited visas for
medical tourists. Medical tourism is viewed as an export industry; hence lower
import duties on specified medical equipment have been introduced to encourage
the sector. Prime land has also been offered at subsidised rates to encourage the
development of health infrastructure for medical tourists (Gupta 2008).
The government is of the belief that the revenues earned through medical
tourism will help improve the capacity and quality of domestic healthcare services.
However, research shows the contrary is occurring. For example, private hospitals
have been known to refuse treatment for patients from lower socioeconomic
backgrounds free of charge despite agreeing to do so as a condition of receiving
government subsidies (Gupta 2008).
In addition, medical tourism has profit maximisation as its key goal,
meaning that the health sector is increasingly focused on implementing advanced
technologies for those who can afford them and not expanding programs for those
who are unable to pay. For example, the National Health Policy notes acute
shortages in community services medical personnel who can treat the main burden of
communicable disease among the domestic population (such as tuberculosis) and non-
communicable diseases, such as cardiovascular disease, diabetes and asthma
(National Health Policy 2002). To address quality and safety concerns, sixteen
Indian hospitals are now JCI accredited under the hospital program and one is
accredited under the ambulatory care program.
1.7 Health Sector Reform in India
Since 1991, the government‗s commitment to provide for the health care needs
of its citizens have declined, as the World Bank has played a greater role in
developing India‗s health service provision (Rao 1999, Baru 1998, Qadeer et al. 2001,
Jeffery and Jeffery 2008). Support for the private sector became a condition of
structural adjustment programmes, as state provision was branded as costly and
inefficient (Rao 1999, Jeffery and Jeffery 2008). Government spending on health
care fell from its low base of 1.3 per cent in 1991, to 0.9 per cent, making India the
sixth lowest country in the world for state expenditure on health care - ahead of only
Burundi, Myanmar, Pakistan, Cambodia and Sudan (Sengupta and Nundy 2005).

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In India, privatization has increased the scope for private investment in
public managed institutions and the wider growth and support for the private sector.
Advocates argue public-private partnerships can increase efficiency and reduce the
financial burden of private health care on the poor (Raman and Björkman 2008).
In the private sector, economic reforms have strengthened alliances between
the state and business, as governments enhanced the attractiveness of investment in
health and welfare provision to private interests. In India, subsidies and significant
concessions (e.g. in tax rates, utilities bills, land acquisition, import duties on medical
equipments and loans) have been granted to the corporate sector. For example, the
national government offered 100 per cent equity to foreign hospital companies to
invest in India (Baru 1998:38). Although concessions were granted on the condition
that 40 percent of outpatient and 25 per cent of inpatient beds are reserved for
poor patients, observers note corporate hospitals have not fulfilled these social
responsibilities (Qadeer and Reddy 2006, Lefebrve forthcoming).
The Indian health care market is estimated to be worth US$ 18.7 billion and as
the employer of over four million people; it is the largest service sector of the
economy (WHO 2008). In 2005, health expenditure accounted for 5 per cent of GDP,
and strong growth is further predicted at an annual rate of 15 per cent over the next
four years. The industry was pioneered by Dr Prathap Reddy, a cardiologist trained
in the United States, who founded the first Apollo hospital in Chennai in 1983. In
ensuring the success and expansion of Apollo group, Dr Reddy created vital networks
and vision to build the wider industry. By regularly travelling to the United States to
meet with organisation such as the Hospital Corporation of America and other key
Non-Resident Indian doctors, he was able to stimulate significant international
interest, strengthening the growth of international hospital partnerships, expertise and
finance to fund and manage new hospital projects (Lefebvre in press).
Management consultancy firms have also played a vital role in generating
wider interest in the Indian health care industry, collating data and projecting
ambitious growth figures, to attract venture capitalists from the UK and US to
invest in the Indian health care market (e.g. Price Waterhouse Coopers 2007, CII-
McKinsey 2002). Inter-sectoral linkages have developed as US and UK-led hedge

P a g e | 17
funds, which have out-sourced financial services to India, invest in new corporate
hospitals. According to industry reports, the corporate sector has a relatively small
penetration, covering only 7 per cent of the local health care market, highlighting the
possibilities for rapid expansion (CII-McKinsey 2002). Market intelligence reports
have therefore been important to increase hype surrounding the sector, producing
optimistic estimates for its growth in order to attract further finance and investment.
1.8 Context of Study
Medical tourism as a term of tourism has risen rapidly in recent decades. One
of the major reasons for medical tourism is to get low cost and world-class medical
treatment in countries like India, Thailand, South America, Singapore, and Malaysia.
Health and medical tourism is perceived as one of the fastest growing segments in
marketing ‗Destination India‘ today. In recent years, availability of latest medical
facilities and technological advancement in developing countries like India making
these countries as the hot zones for medical tourism.
As a rule of thumb in medical tourism, people are not only aspiring better
treatments for their ailments but are also looking at the holistic well-being. They
want to recover, relax, rejuvenate, rejoice and more over get away from the
routine. Thus, Medical Tourism offers a synergy of healthcare, tourism and
hospitality, proving to be an attractive and energetic health package for the people.
India offers World Class medical facilities, comparable with any of the
western countries. India has state of the art hospitals and the best qualified
doctors, despite the lowest cost in all kind of medical interventions compared with
other developing countries. Other advantages of Medical Tourism in India include no
waiting list, & less chance of resisted infections compared to UK or other western
countries.

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Figure1.11 Cost Comparisons of Treatments Across Countries
1.8 Scope of the Study
Collecting data from the existing multispecialty and super specialty hospitals
in Delhi NCR.
Study the potential or favorable condition to establish multi-specialty hospital
providing satisfactory services to the NRI patients who already took and are
taking treatment in the hospitals.
The study aims to provide feedback to the industry with regard to: (1) India as
an attractive destination to visitors from foreign countries and (2) Marketing
and promotion of Indian tourism in foreign countries.
Further, the findings of the study are expected to provide critical inputs in
suggestions of specific measures to promote Indian medical tourism in foreign
countries.

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CHAPTER 2: REVIEW OF THE LITERATURE
Dindayal Swain and Suprava Sahu (2008) - “Opportunities and Challenges
of Health Tourism in India.‖ In their study they said that the medical industry on a
commercial platform with tourism is a new and upcoming industry and needs to be
explored. States like Karnataka, Kerala, Delhi, West Bengal and Maharastra are trying
their best to woo foreign patients to India and to be amongst the most favourable
health destination. There is a need for constant endeavor for other states to try their
best to nurture themselves in this field and contribute to GDP by providing quality
service. For example the FICCI and CII have taken the lead by setting up a task force
for the promotion of health and medical tourism in Maharastra. According to CII
India has the potential to attract 2 billion tourists per annum which could contribute $
5 billion to the economy. India is not having only the expertise professionals but also
has strong infrastructure to support the medical tourism industry. There is no doubt
that India can be the leader in providing medical toursm by 2012.
Anand N. Badwe, Purushottam A. Giri, Ramchandra G. Latti (2012) -
“Medical Tourism in India: A new avenue.” In their research work they found that
medical tourism is attracting attention of travelers from all over the globe. It combines
a travel at ease and availing medical health care facility at low cost as per traveler‘s
own choice. World class medical health care is available in some of the Asian
countries, such as India, Philippines and Singapore etc. Medical tourism has become
one of the major industries in recent times. Medical Tourism India (Health Tourism
India) is a developing concept whereby people from world over visit India for their
medical and relaxation needs. Most common treatments are heart surgery, knee
transplant, cosmetic surgery and dental care. The reason India is a favourable
destination is because of its infrastructure and technology in which is in par with
developed countries. India has some of the best hospitals and treatment centers in the
world with the best facilities.
Dutta Saptarshi, Sengupta Mukul, Rout Susanta Kumar (2010) - “Scope
and Management of Medical Tourism in India.” The study says that healthcare, like
food and shelter, is a basic need of Humanity. Given the potential India holds as a
healthcare destination, the healthcare tourism sector can be a major source of foreign

P a g e | 20
exchange earnings for the country. India‘s healthcare sector has made impressive
strides in recent years and the country is increasingly projected as a ‗healthcare hub‘.
Several features have positioned India as an ideal healthcare destination, like cost
effective healthcare solutions, availability of skilled healthcare professionals,
reputation for successful treatment in advanced healthcare segments, increasing
popularity of India‘s traditional wellness systems and rapid strides made in
information technology. The sector is witnessing a ‗reverse brain-drain‘ trend, with
increasing number of specialists, who have been practicing abroad, showing keen
interest to come back and practice in India. Such developments further enhance the
potential of India as a ‗healthcare hub‘ of the world. People travel to India for availing
healthcare services for diverse reasons. While healthcare tourists from United States
are primarily reported to be traveling to India, as the cost of getting treatment in home
country is expensive, travelers from Europe are reported to be seeking healthcare
services in India due to the complexity of availing the healthcare services in their
home country. Some of the tourists from West Asia and Africa region travel to India
due to affordability of treatment and quality of services rendered. A section of tourists
from different parts of the world travel to India for traditional healthcare services,
such as Ayurveda and Yoga.
Dr. Lee Christine (2006) - “Medical tourism, an innovative opportunity for
entrepreneurs.” This paper explores and critically analyses the issues surrounding
medical tourism in today‘s environment. Similar to tourism ventures, there are many
entrepreneurial opportunities associated with this emerging healthcare industry. Asian
countries have a competitive advantage in this industry because of the support and
promotion of this industry by their governments. There are medical enterprises in
countries such as India, Thailand, Singapore and Malaysia that have invested in
attracting tourists for this specialist market. As the costs of medical treatment and
hospital queues gradually increase in western countries, the demands for medical
services in developing countries are gradually increasing. This paper concludes that
this form of tourism will certainly become more significant in the near future.
Therefore, Asian countries specializing in attracting medical tourists create new
entrepreneurial activity that can lead to a profitable and sustainable tourism industry
in the region.

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Ramesh U & Kurian Joseph (2011) - “A study to develop an advanced
marketing strategy for wellness tourism in Kerala based on the prevailing scenario.”
The research paper enquires into the current infrastructure and the market potential of
Ayurveda based wellness tourism offered at Kerala in attracting international medical
tourists. The study was carried out with an objective to analyze the strength,
weakness, opportunities and threat of alternative health care industry in Kerala.
Related data were collected from the Directorate of Tourism, Govt. of Kerala, etc.
Among the classified health care units, selected ones were visited and primary data
were collected from domestic/international medical tourists on acquiring prior
permission from the respective management. The chief operating managers, resident
doctors and masseurs of the wellness centers were also interviewed to arrive at the
final judgment. Simple random sampling has been adopted in interviewing the
medical tourists from the selected locations.
Upadhyay Pooshan (2011) - "Comparative and competitive advantages of
globalised India as a medical tourism destination.” This paper deals with the in depth
study of the comparative and competitive advantages of India as world class medical
tourism destination as viewed from the perspective of an all encompassing
globalization process across emerging economies. Medical tourism is a new term but
not a new idea; patients have long travelled in search of better care. There are various
reported instances of ancient pilgrims and patients flocking Greece, to the sanctuary
of the healing God. Affluent Europeans are reported to visit health resorts in North
Africa as early as the 18th century. Cross border travel for health reasons is a $40
billion market and growing at over 15% a year, thus promising to open new vistas for
the uncanny to tap it. Preliminary research of this subject area revealed significant
material related to ―health-care tourism‖ and ―wellness tourism‖ both of which aren‘t
mutually exclusive to the scope of medical tourism.
Dr. Dawn Suman K. & Pal Swati (2011) - "Medical tourism in India: issues,
opportunities and designing strategies for growth and development" This research
works explores opportunities, discusses its key challenges and designing the suitable
strategies for developing medical tourism in India.. It is based on a review of the
literature, including published research, web sites, newspapers, and the travel and
tourism magazines that carry medical tourism related information. This helps to
design the strategies being used for promoting medical tourism in India. This research

P a g e | 22
work also strives to understand why some developing countries like India are more
successful in promoting medical tourism than others. In other words, it also
emphasizes over the competitive advantages of India over other countries. Lastly, it
gives an approximate comparison of the cost of medical treatments offered in India,
USA, Thailand and Singapore.
Mohd Jamal Alsharif, Ronald Labonté and Zuxun Lu (2010) - "Patients
beyond borders: A study of medical tourists in four countries." This exploratory study
assesses the experiences of medical travelers seeking out of country health care in
four destination countries: India, China, Jordan and the United Arab Emirates. It aims
to identify the source countries of medical travelers, to understand their reasons for
seeking out-of-country care, the type of services they obtained, and their level of
satisfaction with the experience. Cost, physician and facility reputation and hospital
accreditation were ranked as the most important factors in choosing out-of-country
care. Wait times at home or lack of access to care were important motivations for
international medical travel. Patient assessment of treatment outcomes is as high as
might be found in similar assessments in high-income country facilities. Certain forms
of treatment sought by respondents (i.e. organ transplantation) raise specific ethical
concerns. Also of concern is that the present health systems in all four countries fail to
adequately meet the health needs of their population (notably poorer groups).
Evidence and inference strongly suggest that access to health care for poorer groups
will worsen in these countries as medical tourism increases, at least in the short term,
raising generic ethical and policy challenges over the extent to which access to
essential health care by poorer persons is compromised by the public subsidization or
promotion of medical tourism.
Bankar Anil P (2012) - "Potential for Promoting Medical Tourism in
Maharashtra." This paper explores medical tourism industry and driving factors and
organisation & management of medical tourism in the state of Maharashtra. The
discussion is framed about cost effectives in medical tourism comparison with abroad
and other states in India with Maharashtra. Maharashtra is known as the only tourist
state in India having four world heritage monuments i.e. Ajanta caves, Ellora,
Elephanta caves, and Chhatrapati Shivaji Terminus. Now the period of globalisation
Maharashtra is also ahead in health care, Maharashtra has one of the best qualified
professionals in each field and this fact has now been realized the world over

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regarding medical facilities. Maharashtra has the most competent doctors and world
class medical facilities with most competitive charges for treatment of certain medical
problems. After carving niche for itself on the global tourism map, Maharashtra is
now looking for creating a new identity by offering best health services to tourist.
Undoubtedly a lot in the recent days and experts are comparing it as one of the best
emerging medical tourism destination. After Bangalore, Delhi, Kolkata, Kerala in
India, Maharashtra has better scope in medical tourism in the coming decade, be it a
Ayurvedic, Homeopathy, Allopathic medicines local doctors are second to none.

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CHAPTER 3: RESEARCH METHODS AND
PROCEDURES
3.1Research Objectives
1. To find out which kind of medical treatment is mostly preferred by the
patients coming to India for medical tourism.
2. To specify criteria that prospective medical tourists use to evaluate medical
tourism destinations.
3. To find out the factors, which attracts patients to seek treatment in India?
4. To find out the satisfaction level of patients treated in the multi-specialty
hospitals in India.
3.2 Research Methodology
Research was explorative and descriptive in nature. Research was done mainly
to understand the satisfaction level of the patients and by this way understanding the
competition and also need gaps so that better services can be developed. Initially the
study was done on the different hospitals and services provided by them. Descriptive-
To gauge the mind set and view points of the patients pertaining to their preferences
& satisfaction.
3.3 Data Collection
Primary and secondary research, primary sources included survey of patients
undertaking treatment in multi-specialty hospitals and telephone interviews with
industry experts. Secondary sources information and data was collected from various
printable and non-printable sources like search engines, News websites, Government
Websites, Trade Journals, Magazines, Newspapers, Trade associations, Books,
Industry Portals, Industry Associations, etc.
Data was collected by survey method using a structured questionnaire in
physical form. Sample size of 50 patients of different nationality was taken for study.

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3.4 Hypothesis Used
Hypothesis Ho1: Accreditation & affiliation of hospitals with international medical
councils has no influence on decision of medical tourists on choice of destination.
Hypothesis Ha1: Accreditation & affiliation of hospitals with international medical
councils has positive influence on decision of medical tourists on choice of
destination.
Hypothesis Ho2: The image of a destination with regard to hygiene, safety and
security has a no effect on medical tourist‘s intention to visit.
Hypothesis Ha2: The image of a destination with regard to hygiene, safety and
security has an effect on medical tourist‘s intention to visit.
3.5 Sampling Design
Convenient Judgment Sampling was done to collect data from industry people
& foreign nationals coming for treatment.
3.6 Data Analysis
Analysis of data was primarily conducted on SPSS (Statistical Package for
Social Sciences). Frequency and cross tabulation analysis was conducted as required.
Segmentation of the entire sample was carried out on SPSS.20 using parameters like
traveler‘s age, occupation, education, annual income, expenditure on visit, etc. in
order to give a detailed description of the travelers‘ profile.

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3.7 Limitations
As with all research, this study has certain acknowledged limitations. These
limitations can be summarized as follows:
Sample Size – Due to time and cost constraints sample size of only 50 patients was
taken.
Language Problem- Since patients coming from middle-east countries were not very
competent at English, some of them were excluded from sample.
Choice of Population - The population selected was limited to the places in Delhi
NCR. Hence results would have altered if some other population had been selected.
Inherent Discrepancies in the Questionnaire - The questionnaire might be having
some undetectable errors and limitations, which could shape the responses into a
particular fashion. No pre-test was done before the circulation of the questionnaire.
Bias in Response - The data is entirely based on responses given by respondents
which may be biased due to their personal bias in replying the questions. They may
not be very serious or interested in replying the questions and take it very lightly, due
to which data may not be very accurate.
Negligence by Respondents - People were not willing to answer the entire
questionnaire due to the less time available to them. Many were reluctant in divulging
their financial details.
Despite these limitations, it is the contention of this study that the findings
remain valuable for medical tourism promotion organisations and health-care
providers in India.

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CHAPTER 4: DATA ANALYSIS AND FINDINGS
During the survey a data of 50 respondents was collected analyzed using SPSS.20.
4.1 Demographic Analysis
4.1.1 Gender
Table 4.1 Gender Ratio
Table 4.1
Gender
Frequency Percent Valid Percent Cumulative
Percent
Valid
Male 30 60.0 60.0 60.0
Female 20 40.0 40.0 100.0
Total 50 100.0 100.0
Interpretation:
60% of respondents were male & 40% were female as represented by pie chart below.
Figure 4.12 Gender Ratio

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4.1.2 Age Groups
Table 4.2 Different Age Groups
Frequency Percent Valid Percent Cumulative
Percent
Valid
18-30 Years 4 8.0 8.0 8.0
31-45 Years 9 18.0 18.0 26.0
46-60 Years 21 42.0 42.0 68.0
61 Years &amp above 16 32.0 32.0 100.0
Total 50 100.0 100.0
Interpretation:
Maximum respondents (42%) were of age group 46-60 years followed by 32%
of respondents above 60 years.
Figure 13 Age Groups

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4.1.3 Marital Status
Figure 14.3 Marital Status
Interpretation:
Maximum respondents fell in married category followed by singles and
widowed constituted 18% of total respondents.

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4.1.4 Nationality
Figure 15 Nationality of Respondents
Interpretation:
Most of the patients were from America as can be seen in the pie chart which
was 30%. It was followed by Australians (18%) and Europeans (16%). Africans and
patients from Middle East countries had a share of 12% each. Rest of 12% comprised
of people from neighboring countries like Bangladesh, Sri Lanka and Nepal.

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4.1.5 Education
Figure 16 Education Levels of Respondents
Interpretation:
Most of the respondents (30%) held a Bachelor‘s Degree. 22% had Master‘s
Degree and 20% of them had Doctorate. 18% hold a College Diploma and 10% had
education up to High School.

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4.1.6 Employment Status
Figure 17 Employment Statuses of Respondents
Interpretation:
Majority (28%) of the patients were business owner. 26% were employed with
Govt. Organizations. 22% were having Corporate/Private Firm job. 20% were
freelance professionals and only 4% were unemployed.

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4.1.7 Income level
Figure 18 Income Levels of Respondents
Interpretation:
Most of the patients (22%) fall in Income bracket of USD 60,000 to 100,000
followed by USD 100,001 to 200,000 and more than USD 200,001 both 20%.

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4.2 Treatment Statistics
4.2.1 Most Availed Treatment
Figure 19 Most Availed Treatment
Interpretation:
Cardiovascular is the most (24%) availed treatment followed by Bone Marrow
transplant (18%). Patients coming for Orthopedic surgery were 16% of total sample
size. Gastro Intestinal & Respiratory Disorder patients were 10% each in sample size.
Opthalmic patients were 8% and Cancer 6%. Dental & Cosmetic Surgery had a share
of 4% each.

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4.2.2 Availability of Treatment in Home Country
Table 4.3 Treatment Availability in Home Country
T Frequency Percent Valid Percent Cumulative
Percent
Valid
Yes 24 48.0 48.0 48.0
No 14 28.0 28.0 76.0
Don’t know 12 24.0 24.0 100.0
Total 50 100.0 100.0
Interpretation:
Of all the patients who come for treatment in India, 48% have the treatment
available in their home country, 28% do not have access to such treatment in their
home country and 24% are unaware of the availability.
4.2.3 Insurance Coverage
Figure 20 Insurance Coverage
Interpretation:
52% said that the treatment they require is not covered by their insurance plan
while 36% said that it was partially covered. 12% of patients have the insurance
coverage of the treatment but they opted for treatment in India.

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4.2.4 Source of Information About Indian Hospitals
Figure 21 Source of Information
Interpretation:
The primary source of information about the hospital was Travel & tour
agency (28%) which means Hospitals have strong tie-up with these tour operators
abroad. Websites followed the league at 24%. Magazines & newspaper accounted for
16% and Relatives & friends 14%. Direct campaign & promotion was a source of
information to only 12% of total medical tourists.

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Figure 22 Information Search from trusted Sources
Interpretation:
Most of the patients (58%) agreed that they would prefer to seek information
from trusted sources like tourism authorities and non- commercial websites. Whereas
24% don‘t really feel the need to seek information from tourism authorities‘ Govt.
bodies.

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4.2.5 Duration of Stay
Figure 23 Stay Duration
Interpretation:
Most of the patients (38%) have plans to stay between 7-14 days followed by
32% who are expecting to spend 3 to 7 days in India for treatment. 18% of them are
staying for more than 2 weeks while 12% will stay for less than 3 days.

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4.2.6 Satisfaction Level
Figure 24 Satisfaction Level
Interpretation:
Most of the patients (40%) said that they are highly satisfied with the
treatment given here and 36% said they are satisfied. Only 12% of the patients were
dissatisfied with the treatment given in India. Yet another 12% were unsure and gave
neutral reaction to this question.

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4.2.7 Tourism Opportunity at Destination and Visit Intention
Figure 25 Effect of Tourism Opportunity at Destination and Decision of Destination
Choice
Interpretation:
Tourism opportunity at destination does not seem to have an effect on decision
to visit a particular destination. As can be seen from the bar chart 50% agree with the
statement and rest 50% either disagree or remain neutral.

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4.3 One Sample T-Test for Factors
Table 4.4 One-Sample T-Test
Test Value = 0
t df Sig. (2-tailed) Mean Difference 95% Confidence Interval of the
Difference
Lower Upper
Cost of treatment: 10.589 49 .000 1.520 1.23 1.81
Waiting time: 17.088 49 .000 4.200 3.71 4.69
Language problem: 18.479 49 .000 4.920 4.38 5.46
Facilities, quality standard
and hygiene of hospitals:
16.364 49 .000 4.060 3.56 4.56
Experience & certification of
doctors:
16.413 49 .000 4.020 3.53 4.51
Safety & security of
destination:
22.663 49 .000 5.140 4.68 5.60
International accreditation of
hospital:
15.670 49 .000 4.200 3.66 4.74
Interpretation:
Since the P value is < 0.05 the mean difference values are significant. So, we
can say that Cost of treatment (Mean difference=1.52) is most important factor for
deciding a destination for treatment. Closely followed by Experience & certification of
doctors (Mean=4.02). Facilities, quality standard and hygiene of hospitals ranks 3rd
for decision
making while there is a tie at 4th
position between International accreditation of hospital &
Waiting Time. Language Problem ranks as 5th
most important factor for selecting
India. Safety & security of destination ranks at 6th
position and considered least important
factor once they decide to go for India for treatment.

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4.4 Factor Analysis for finding important factors
Table 4.5 Rotated Component Matrix
Component
1 2 3 4 5 6 7 8
Competitive/Low cost of
Treatment:
.590 .498 .113 -.015 .040 .173 -.185 -.111
Board certified doctors with
prerequisite training and their
qualification and years of
global experience:
.139 .343 .428 -.226 .284 .566 .089 -.153
Minimal or no waiting list: .106 .196 .045 .841 -.091 .197 .084 .055
World Class Medical
Facilities/Infrastructure:
.733 -.020 .106 .024 .041 -.043 .069 -.018
Accommodation, food and
hospitality:
.064 -.070 -.013 .015 .869 .017 .107 .082
Availability of medical visa
without hassles:
.236 .244 .529 .089 .097 .161 .463 -.113
No language/communication
problem:
.170 .026 .861 .175 -.023 .052 -.154 .184
Recognized international
accreditations &
certifications:
.575 .016 .446 .312 -.043 -.053 .197 .041
Availability of easy finance &
insurance by hospitals:
.256 -.153 .270 .562 .338 -.188 -.167 .161
Quality standards/hygiene in
hospital:
.365 -.051 .007 -.117 -.416 .092 .591 -.152
Safety & security during
transit and stay:
-.039 -.018 -.053 .101 .207 .057 .716 .176
Social & political structure of
destination:
-.131 -.216 .044 .194 -.133 .845 .007 .141
Popularity of medical tourism
destination:
.147 .492 -.356 .229 .063 .073 -.194 .512
Accessibility/connectivity of
destination (Direct flights):
.351 -.282 .057 .252 .389 .205 -.014 .250
Cultural & social
relativity/similarity with
destination country:
-.109 -.109 .184 -.016 .123 .037 .159 .869
Patient testimonials- before &
after pictures, blogs, etc:
.013 -.633 .012 -.116 .072 .045 .072 .154

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International standard
hospitals with high treatment
success rates:
.480 .062 -.071 .068 .297 .594 .301 -.060
Local conveniences,
transportation services,
attractions:
.015 .723 .255 .049 -.060 -.126 .365 .216
Transparency- clear price list,
services included in the
package:
-.195 .280 .184 .591 .401 .071 .213 -.314
Extraction Method: Principal Component Analysis.
Rotation Method: Varimax with Kaiser Normalization.
a *Rotation converged in 25 iterations.

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Table 4.6 Factor Analysis
Factor
(% Variance)
Factor
Interpretation
Loading Variables Included in factor
F1 Qualifiers
0.733
World Class Medical
Facilities/Infrastructure.
0.59 Competitive/Low cost of Treatment.
0.575
Recognized international accreditations &
certifications.
F2 Comforters
0.723
Local conveniences, transportation
services, attractions.
-0.633
Patient testimonials- before & after
pictures, blogs, etc.
F3 Boosters
0.861 No language/ communication problem.
0.529
Availability of medical visa without
hassles.
F4 Promoters
0.841 Minimal or no waiting list.
0.591
Transparency- clear price list, services
included in the package.
0.562
Availability of easy finance & insurance
by hospitals.
F5 Facilitators
0.869 Accommodation, food and hospitality:
0.389
Connectivity of destination (Direct
flights).
F6 Assurers
0.845 Social & political structure of destination.
0.594
International standard hospitals with high
treatment success rates.
0.566
Board certified doctors with prerequisite
training and their qualification and years
of global experience.
F7 Intimidators
0.716 Safety & security during transit and stay.
0.591 Quality standards/hygiene in hospital.
F8 Reinforcers
0.869
Cultural & social relativity/similarity with
destination country.
0.512 Popularity of medical tourism destination.
Interpretation:
These 8 components consist of 19 factors and their loadings are given below: All
factors have loading greater than 0.50 which means values are significant.
Component 1
This component includes 3 factors. World Class Medical Facilities/Infrastructure
(0.733), Competitive/Low cost of Treatment (0.59) and Recognized international
accreditations & certifications (0.575).

P a g e | 45
Component 2
This component includes two factors in which Local conveniences, transportation
services, attractions has factor loading of 0.723. And patient testimonials- before &
after pictures, blogs, etc. has a loading of -0.633. Both factors are negatively related.
Component 3
This component consists of 2 factors. No language/ communication problem (0.861)
Availability of medical visa without hassles (0.529).
Component 4
This component includes 3 factors. Minimal or no waiting list (0.841), Transparency-
clear price list, services included in the package (0.591). Availability of easy finance
& insurance by hospitals (0.562).
Component 5
This component includes 2 factors- Accommodation, food and hospitality (0.869).
Accessibility/connectivity of destination (Direct flights) (0.389).
Component 6
This Component has 3 factor loading which are Social & political structure of
destination (0.845), International standard hospitals with high treatment success rates
(0.594) and Board certified doctors with prerequisite training and their qualification
and years of global experience (0.566).
Component 7
This Component has 2 factors which are Safety & security during transit and stay
(0.716) & Quality standards/hygiene in hospital (0.591).
Component 8
This component includes 2 factors- Cultural & social relativity/similarity with
destination country (0.869) and Popularity of medical tourism destination (0.512).
The resultant important factors for choice of destination are:
World Class Medical Facilities/Infrastructure.
Competitive/Low cost of Treatment.
Recognized international accreditations & certifications.

P a g e | 46
4.5 Crosstabs and Correlation Tests
4.5.1 Crosstab for gender and satisfaction level
Table 4.7 Gender & Satisfaction Level Cross tabulation
Count Please indicate your gender Total
Male Female
I am satisfied with the
treatment given here
Strongly Disagree 2 6 8
Disagree 2 2 4
Neutral 7 2 9
Agree 10 3 13
Strongly Agree 9 7 16
Total 30 20 50
Interpretation:
By looking at the table we can say that maximum respondents have agreed or
strongly agreed with the statement which means that patients coming to India are by
& large satisfied with the treatment given here. Majority of male (10 out of 30) agree
that they are satisfied with the treatment while majority of female (7 out of 30)
strongly agree that they are satisfied with the treatment.
Table 4.8 Chi-Square Test for Gender & Satisfaction Level
Value df Asymp. Sig. (2-
sided)
Pearson Chi-Square 7.080
a
4 .132
Likelihood Ratio 7.249 4 .123
Linear-by-Linear Association 1.991 1 .158
N of Valid Cases 50
a. 5 cells (50.0%) have expected count less than 5. The minimum
expected count is 1.60.
Interpretation:
However by looking at the chi-square table we can conclude that there is no
significant association between gender and satisfaction level since the p
value=0.132>0.05.

P a g e | 47
4.5.2 Correlation between accreditation & affiliation and choice of destination
Hypothesis Ho1: Accreditation & affiliation of hospitals with international medical
councils has no influence on decision of medical tourists on choice of destination.
Hypothesis Ha1: Accreditation & affiliation of hospitals with international medical
councils has positive influence on decision of medical tourists on choice of
destination.
Table 4.9 Correlation between Recognized international accreditations &
certifications & Visit Intention
Recognized
international
accreditations &
certifications
I consider
myself to be
familiar with
India as a
medical tourism
destination
Recognized international
accreditations &
certifications
Pearson Correlation 1 .694
Sig. (2-tailed) .034
N 50 50
I consider myself to be
familiar with India as a
medical tourism destination
Pearson Correlation .694 1
N 50 50
Interpretation:
Since the p value is < 0.05, we can reject the null hypothesis. This implies that
there is a positive correlation (Pearson Correlation=0.694) between Accreditation &
affiliation of hospitals with international medical councils and decision of medical
tourists on choice of destination.

P a g e | 48
4.5.3 Correlation between Quality standards/hygiene in hospital and Repeat visit
intention
Hypothesis Ho2: The image of a destination with regard to hygiene, safety and
security has a no effect on medical tourist‘s intention to visit.
Hypothesis Ha2: The image of a destination with regard to hygiene, safety and
security has a positive effect on medical tourist‘s intention to visit.
Table 4.10 Correlation Between Quality standards/hygiene in hospital & Future Visit
Intention
Quality
standards/hygie
ne in hospital
I will come here
again in future if
I need any
treatment
Quality standards/hygiene in
hospital
N 50 50
I will come here again in
future if I need any treatment
N 50 50
Interpretation:
Since the p value is < 0.05 we can say that there is positive correlation
(Pearson Correlation=0.621) between Quality standards/hygiene in hospitals and
likelihood of repeat visit in future for treatment by patients.
Table 4.11 Correlation Between Safety & security & Future Visit Intention
Safety &
security during
transit and stay
I will come here
again in future if
I need any
treatment
Safety & security during
transit and stay
N 50 50
I will come here again in
future if I need any treatment
N 50 50

P a g e | 49
Interpretation:
Since the p value is < 0.05 we can say that there is positive correlation
(Pearson Correlation=0.589) between Safety & security during transit & stay and
likelihood of repeat visit in future for treatment by patients.
Hence we can reject the null hypothesis and accept the alternate hypothesis,
which implies that- ―The image of a destination with regard to hygiene, safety and
security has a positive effect on medical tourist‘s intention to visit.‖
4.5.4 Correlation between Certified & Experienced Doctor and Satisfaction Level
Table 4.12 Correlation Between Board certified doctors & Satisfaction Level
Board certified
doctors with
prerequisite
training and
their
qualification and
years of global
experience
I am satisfied
with the
treatment given
here
Board certified doctors with
prerequisite training and
their qualification and years
of global experience
N 50 50
I am satisfied with the
treatment given here
N 50 50
Interpretation:
Since the p value is < 0.05, we will reject the null hypothesis and alternate
hypothesis will be accepted. We can say that there is positive correlation (Pearson
Correlation=0.574) between (a) Board certified doctors with prerequisite training and
their qualification and years of global experience and (b) Satisfaction level of patients
with treatment given.

P a g e | 50
4.5.5 Crosstab- satisfaction & Nationality
Table 4.13 Satisfaction & country of residence- Cross tabulation
What is your country of residence? Total
Banglade
sh/Nepal/
Sri Lanka
United
States
Europe Africa Austral
ia
Middle
East
I am satisfied with
the treatment given
here
Strongly
Disagree
1 2 3 0 1 1 8
Disagree 0 0 0 2 1 1 4
Neutral 0 5 1 0 1 2 9
Agree 3 3 0 2 4 1 13
Strongly
Agree
2 5 4 2 2 1 16
Total 6 15 8 6 9 6 50
Table 4.14 Chi-Square Test for Satisfaction Level & Nationality
Value df Asymp. Sig. (2-
sided)
Pearson Chi-Square 23.210
a
20 .279
Likelihood Ratio 26.866 20 .139
Linear-by-Linear Association .584 1 .445
N of Valid Cases 50
a. 30 cells (100.0%) have expected count less than 5. The minimum
expected count is .48.
Interpretation:
The p value=0.278 is > 0.05, which means there is no significant relationship
between country of origin & satisfaction level of patients.

P a g e | 51
4.6 Summary of the Findings
The major findings:
Cardiovascular is the most (24%) availed treatment followed by Bone Marrow
transplant (18%). Patients coming for orthopedic surgery were 16% of total
sample size. Gastro Intestinal & Respiratory Disorder patients were 10% each
in sample size. Ophthalmic patients were 8% and Cancer 6%. Dental &
Cosmetic Surgery had a share of 4% each.
Of all the patients who come for treatment in India, 48% have the treatment
available in their home country, 28% do not have access to such treatment in
their home country and 24% are unaware of the availability.
52% said that the treatment they require is not covered by their insurance plan
while 36% said that it was partially covered. 12% of patients have the
insurance coverage of the treatment but they opted for treatment in India.
The primary source of information about the hospital was Travel & tour
agency (28%) which means Hospitals have strong tie-up with these tour
operators abroad. Websites followed the league at 24%. Magazines &
newspaper accounted for 16% and Relatives & friends 14%. Direct campaign
& promotion was a source of information to only 12% of total medical
tourists.
Most of the patients (58%) agreed that they would prefer to seek information
from trusted sources like tourism authorities and non- commercial websites.
Whereas 24% don‘t really feel the need to seek information from tourism
authorities‘ govt. bodies.
Most of the patients (38%) have plans to stay between 7-14 days followed by
32% who are expecting to spend 3 to 7 days in India for treatment. 18% of
them are staying for more than 2 weeks while 12% will stay for less than 3
days.
Most of the patients (40%) said that they are highly satisfied with the
treatment given here and 36% said they are satisfied. Only 12% of the patients
were dissatisfied with the treatment given in India. Yet another 12% were
unsure and gave neutral reaction to this question.

P a g e | 52
Cost of treatment is the most important factor for deciding a destination for
treatment. Closely followed by Experience & certification of doctors.
Facilities, quality standard and hygiene of hospitals ranks 3rd
for decision
making while there is a tie at 4th
position between International accreditation
of hospital & Waiting Time. Language Problem ranks as 5th
most important
factor for selecting India.
There is no significant association between gender and satisfaction level.
There is a positive correlation between Accreditation & affiliation of hospitals
with international medical councils and decision of medical tourists on choice
of destination.
There is positive correlation between Quality standards/hygiene in hospitals
and likelihood of repeat visit in future for treatment by patients.
The image of a destination with regard to hygiene, safety and security has a
positive effect on medical tourist‘s intention to visit.
There is positive correlation between (a) Board certified doctors with
prerequisite training and their qualification and years of global experience and
(b) Satisfaction level of patients with treatment given.
There is no significant relationship between country of origin & satisfaction
level of patients.
60% of respondents were male & 40% were female.
Maximum respondents (42%) were of age group 46-60 years followed by 32%
of respondents above 60 years.
Maximum respondents fell in married category followed by singles and
widowed constituted 18% of total respondents.
Most of the patients were from America as can be seen in the pie chart which
was 30%. It was followed by Australians (18%) and Europeans (16%).
Africans and patients from Middle East countries had a share of 12% each.
Rest of 12% comprised of people from neighboring countries like Bangladesh,
Sri Lanka and Nepal.
Most of the respondents (30%) held a Bachelor‘s Degree. 22% had Master‘s
Degree and 20% of them had Doctorate. 18% hold a College Diploma and
10% had education up to High School.

P a g e | 53
Majority (28%) of the patients were business owner. 26% were employed with
Govt. Organizations. 22% were having Corporate/Private Firm job. 20% were
freelance professionals and only 4% were unemployed.
Most of the patients (22%) fall in Income bracket of USD 60,000 to 100,000
followed by USD 100,001 to 200,000 and more than USD 200,001 both 20%.

P a g e | 54
CHAPTER 5: CONCLUSIONS AND
RECOMMENDATION
5.1Conclusion
India is in an advantageous position to tap the global opportunities in the medical
tourism sector. Given the satisfaction level of patients with the treatment & facilities
given in hospitals we can conclude that there remains a huge potential untapped for
setting up multi-specialty hospitals in Delhi NCR. Also the patients showed a positive
response for visiting India again for similar purposes.
Delhi is one of the most developed cities as well as the capital of India. With its sub-
urban areas like Gurgaon & Noida which are growing rapidly, it provides the best
opportunity to set up multispecialty hospitals catering to medical tourists. Delhi has
been in the forefront of healthcare development in the country. Delhi NCR also has
the largest private health sector in India whose reach is quite extensive.
The Tertiary healthcare service in Delhi NCR has witnessed an enormous growth in
infrastructure in the private sector. The private sector which was very modest in the
early stages has now become a flourishing industry equipped with most modern state-
of-art technology at its disposal. It is estimated that 75-80% of healthcare services and
investment in Delhi are now provided by the private sector such as the Apollo, Fortis,
Max, Wockhardt, Moolchand and the Escorts group.
Some of the hospitals in Delhi NCR are accredited by the national and international
accreditation body like, NABH, QCI, ISO, JCI. Delhi has to-notch centre for knee
replacement surgery, hip replacement surgery open-heart surgery, cosmetic surgery
and cancer therapy, and virtually all of clinics are equipped with the latest electronic
and medical diagnostic equipment. Moreover there is an assurance that patients will
get personalized care and hospitality. Doctors in Delhi are proficient in English most
even provide interpreters to cut across language barriers while the patient stays at
hospitals; they take care to see that the visit becomes a pleasant experience. Cost
effectiveness is one of the most important driving factors for medical tourist in Delhi.
The cost of treatment is very low compare to US, UK and any other city in India.

P a g e | 55
5.2Recommendations
Medical Tourism is undoubtedly, a trend than is still in its process but it has enormous
potential for growth and development in India. Delhi NCR too can benefit from this
trend of Medical Tourism for which the following recommendations have been
suggested.
(1) Role of Government
The government of India must act as a regulator to institute a uniform grading and
accreditation system for hospitals to build consumers‘ trust. It should also acts as a
facilitator to encourage private investment in medical infrastructure and policy-
making for improving medical tourism. The government should actively promote
FDI (Foreign direct investment) in healthcare sector as well as also enacts conducive
fiscal policies- providing low interest rate loans, reducing import/excise duty for
medical equipment.
(2) Medical Visas:
The government should reduce barriers in getting medical visa and institute visa-on-
arrival for patients and also can create medical attachés to Indian embassies that
promote health services to prospective India visitors.
A simplified system of getting medical visas should be developed in order to make
travel across borders smoother. Visas can be extended depending on the condition of
the patients. The procedures for obtaining medical visa, the subsequent registration
and visa extension procedures are complicated and time consuming. There is a need to
simplify and speed up these procedures to make India a more attractive medical
tourism destination.
(3) Legal Hurdles:
The Indian legal infrastructure is not at all geared up to handle healthcare specific
litigations in a speedy manner. Though there exists a mechanism to deal with medical
insurance related cases, their redressal is much time consuming. There should be one
special regulatory body for monitoring and controlling medical tourism operation in
India.

P a g e | 56
(4) Marketing Strategy:
Another major hurdle is poor marketing strategies. Many small-scale India healthcare
organizations emphasize India as cheaper destination, but there is a significant
distinction in what is cheap and what value is for money. India has a long way to
go to establish itself as a leading medical tourism brand that can offer high quality
healthcare at affordable prices, with an additional pull factor being its attractive
tourism activities.
(5) Setting Up National Level Bodies:
To market India‘s specialized healthcare products in the world and also address the
various issues confronting the corporate healthcare sector, leading private hospitals
across the country are planning to set up a national-level body on the lines of National
Association of Software and Service Companies (NASSCOM), the apex body of
software companies in the country. . It is therefore essential to form an apex body for
health tourism. The main agenda for apex body could include:
(a) Building the India Brand Abroad: Classify the target consumer segments based
on their attractiveness and position the India Brand based on the three main value
propositions– high quality service, value for money and destination diversity. An
integrated marketing Communications campaign using print, media and road shows
should be developed.
(b) Promoting Inter-Sectoral Coordination: The body should take up the
responsibility of aligning the activities of various players– Tourism Department,
Transport Operators, Hotel Associations, Escorts personnel etc.
(c) Information Dissemination using Technology: It should set up a portal on
medical tourism in India targeted at sharing information and enabling online
transactions.
(d) Standardization of Services: It should also focus on establishing price parity
for similar kinds of treatments in various hospitals and ensure the hospitals adhere
to high hygiene and quality standards.

P a g e | 57
(6) Integrate vertically:
Various added services may be offered to the patients. For example, hospitals may
have kiosks at airports, offer airport pickups, bank transactions, or tie-ups with
airlines for tickets and may help facilitate medical visas by the government.
(7) Accreditation:
At present there are only 16 hospitals in India which are accredited by JCI i.e. Joint
Commission International which is the global arm of US based joint commission on
the accreditation of healthcare organizations and has accredited hospitals in Europe,
America, Asia, and Middle-East. And out of these 16 hospitals, 03 hospitals are in
Delhi NCR. The JCI accreditation to hospitals in India would help as a symbol of trust
& benchmark for medical tourists worldwide.
(8) Partnership:
One major obstacle that is impeding the uninhibited growth of the global medical
tourism sector is a lack of PPP Public Private Partnership and of a one brand
initiative. Singapore, Malaysia, Korea and several other countries have established
boards formed by tourism authorities, chambers of commerce, ministries of health and
private organisations with one shared objective. In India, there is lack of a single,
unified body that works towards a common goal.
(9) Joint Ventures / Alliances:
To counter increasing competition in medical tourism sector, Indian hospitals should
tie-up with foreign institutions for assured supply of medical tourists. Specifically
they may tie-ups with capacity constrained hospitals and insurance providers. For
example Mohali‘s Fortis Hospital has entered into a mutual referral arrangement with
the Partners Healthcare System, which has hospitals like Brigham Women‘s Hospital
and Massachusetts Hospital in Boston under its umbrella, to bring patients from the
US (Kohli 2002). The Apollo group has also tied up with hospitals in Mauritius,
Tanzania, Bangladesh and Yemen. As a part of this policy of promoting public and
private initiatives, the Indian travel industry and tour operators have also design
packages that include air travel, hotel accommodation, and surgery expenses,

P a g e | 58
claiming savings. They may also operate jointly to facilitate travel for medical
services.
(10) Promotion: Other than the central government‘s list of hospitals for medical
tourism on the web, the medical tourism may also get promoted through popular
magazines, tourist guide books, business magazines and journals on tourism.
Textual and video testimonies of cured foreign patients and administrators
describing the excellence of the treatment, the low cost, the professional approach, the
technical expertise, the affectionate and caring doctors and staff, and the cutting edge
technology are all displayed on hospital web sites as evidence of efficiency.
5.3 Implications for Practice & Future Research
The following suggestions can be implied for practice on the basis of survey
results:
1. Here majority of the patients are from US, UK and Australia. So hospitals should
try to capture the number of patients from other than these countries.
2. The majority of the patients are coming for the Cardiac, Orthopedic and Gastro
Intestinal diseases, so our hospitals should develop super specialty ward and
department to capture more number of patients.
3. Our hospitals should develop alternative therapy ward or department like
Ayurveda, Yunani, Spa and Yoga along with the rehabilitation centers.
4. To increase the Advertisement of the Hospitals by using different media.
5. As most of the patients are satisfied with the Treatment and Facilities provided by
the hospitals, so hospitals should maintain them.
6. For patients who are dissatisfied with the treatment and facilities, hospitals should
try to know the reasons behind the dissatisfaction.

P a g e | 59
The findings of the study provide implications of interest to future research in
this area. The following suggestions for future research are made:
Because each developing country has a different health-care system, separate
studies of potential medical tourists from various countries should be
conducted to establish research findings relevant to the effective marketing of
medical tourism in various source markets.
To gain a more comprehensive understanding of the image of India as a
medical tourism destination, further research is required with regard to all
destination attributes included in this study (quality of care, saving potential,
tourism opportunity, accessibility, image regarding hygiene, and image
regarding safety, security, etc). In addition, the image of India with regard to
these factors should be compared against its competing medical tourism
destinations.

P a g e | 60
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Baru , R. V. (2000) : ―Privatisation and Corporatisation‖, Seminar , 489 , pp.
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Best of India, A Country Forever…A Story Forever, The Express group, India
Development Series, 10th March, 2010 edition, page number 1 & 3
Blouin C. Drager, N. & Smith, R. (2006): ―International Trade in Health
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Bookman, M. & Bookman, K. (2007) : ―Medical Tourism in Developing
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Carrera , P.M. & Bridges J.F.P (2006) : ―Globalisation and Healthcare :
Understanding Health and Medical tourism‖, Expert review of
Pharmacoeconomics and Outcomes Research , 6(4), pp.447-454
CII-McKinsey (2002): ―Health Care in India: The Road Ahead‖, CII,
McKinsey and Company and Indian Healthcare Federation, New Delhi
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Tourism Management, 27 (6), pp. 1093-1100.
Dindayal Swain and Suprava Sahu (2008) [Conference on Tourism in India –
Challenges Ahead, 15-17 May 2008, IIM, Part XI – Health, Spiritual and
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Dogra, Sapna (2003): ―Can Delhi Be a Successful Model for Medical
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expresshealthcaremgmt.com/20030915/focus01. Shtml

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