The objectives of this presentation are: To analyze the perceived risk and coping behavior of medical tourists across three stages. To identify the information source of medical tourists

1. Inbound Process of Medical Tourists in
South Korea
IMTJ Medical Travel Summit 2018
Athens, Greece
Kim, Jinjoo & Jin, Ki Nam
Dept of Health Administration
Yonsei University

2. Introduction
Literature Reviews
Methodology
Results
Conclusion
Contents

3. I. Introduction

4. 364,000 medical tourists in South Korea(2016)
From provider perspective to consumer perspective
Background

5. Pre-visit
stage
Visit stage
Post-visit
stage
Problem
recognition
Information
search
Evaluation
Purchase
decision
Three stage model of service consumption

6. Pre-visit
stage
Visit stage
Post-visit
stage
Perceived risk & coping across three stages
Perceived risk Perceived risk Perceived risk
Coping Coping Coping

7. BackgroundRisk & coping
Perceived risk
Perception of an individual about
the probability that a particular
action will lead them to a situation
exposed with danger
- performance risk
- physical risk(e.g., malpractice)
- financial risk
- social risk(e.g., social stigma)
- time risk
- psychological risk(Carroll, 2009).
Coping
Conscious efforts to reduce risk

8. The objectives of this presentation are:
1) To analyze the perceived risk and coping behavior of medical
tourists across three stages.
2) To identify the information source of medical tourists
Objective

9. II. Literature Reviews

10. Key
concepts
Motivation
Expectation
Destination
image
Risk
Purchase
intention
Choice
Key concepts in the literature on customer behavior in medical tourism
Information
System

11. III. Methodology

12. Qualitative
method
Aug. 1-7, 2013
1) Foreign
patients(10)
2) Translators(3)
Personal
interview
Objective:
identification of
perceived risk &
coping across
stages
Quantitative
method
Sept. 1 – Oct. 31,
2013
Foreign
patients(153)
- Inpatients in 5
hospitals(Seoul and
vicinity area)
- Convenience
sampling
Questionnaire
survey
Cross-sectional
data

13. Socio-demographic characteristics
(unit : frequency(%))
Socio-demographic characteristics Number %
Sex
Female 58 37.9
Male 95 62.1
Age
Under 30 24 15.7
30-29 38 24.8
40-49 35 22.9
50 and over 56 36.6
Nationality
Russian 115 75.2
Mongolian 38 24.8
(Total=153)

14. IV. Results

15. 1. Perceived Risk &
Coping across the stages

16. 1) Perceived Risk & Coping
in “pre-visit” stage

17. Perceived risk in “pre-visit” stage
(unit : frequency(%))
Perceived risk Yes
1 Financial cost 90 ( 67.7)
2 Quality of healthcare(e.g., uncertainty) 82 ( 60.7)
3 Health condition for flight 56 ( 41.5)
4 Pre-operative patient preparation(e.g., drug, document) 52 ( 38.5)
5 Reliability of hospital(e.g., contract) 52 ( 38.0)
6 Visa 52 ( 36.4)
7 Travel (e.g., flight schedule, distance) 45 ( 33.8)
8 Privacy on personal information 44 ( 33.6)

18. • Perceived risk:
“I though I just needed to have a surgery on my spine. I found
I have much more serious problem in my hip joint while I was in
this hospital. The problem was the budget that was not enough for
the surgery both hip joints..”
“What diagnosis would be made and should I undergo surgery?...
I was worried because I didn't know what decision I should make.
It was most difficult to make a decision under uncertainty.”

19. Coping in “pre-visit” stage
(unit : frequency(%))
Coping Yes
1 Taking the advice of family & friends 66 ( 46.8)
2
Seeking professional advice(e.g., MT facilitators, Hospital
coordinator)
50 ( 36.0)
3 Pre-trial(e.g., attending MT exhibition) 43 ( 30.7)
4 Searching for formal information(e.g., Website) 40 ( 28.6)
5 Comparing alternatives(e.g., country, hospitals) 28 ( 20.0)
6 Reading reviews from blog/web community 26 ( 18.6)
7 Choosing well known brand 23 ( 16.5)
8 Checking the sign of guarantee 12 ( 8.7)
9 Choosing the cheap or expensive package 7 ( 5.1)
10 Others 3 ( 2.1)

20. • Coping:
“I mainly acquired information from my mother who directly
called the Russian coordinator in this hospital whenever she had a
question. I also checked the hospital website.”
“The medical tourism facilitator helped me so much to facilitate
the contract between myself and the hospital. They also helped me
with any documents I needed to prepare.”

21. 2) Perceived Risk & Coping
in “visit” stage

22. Perceived risk in “visit” stage
(unit : frequency(%))
Perceived risk Yes
1 Food 81 ( 60.4)
2 Additional cost 77 ( 60.2)
3 Pain & uncertainty 63 ( 50.4)
4 Cultural differences 63 ( 47.4)
5 Time(e.g., overstay) 58 ( 46.0)
6 Communication 57 ( 42.9)
7 Hospital facility 43 ( 33.1)
8 Contract 42 ( 33.3)
9 Malpractice 38 ( 30.4)
10 Security & privacy 37 ( 28.2)
11 Customer service 34 ( 26.0)
12
Local environment (e.g., natural disaster,
political turmoil) 34 ( 25.8)

23. • Perceived risk:
“I fully trust them because the doctors in this hospital made an
accurate diagnosis on me and explained my condition clearly.”

24. Coping in “visit” stage
(unit : frequency(%))
Coping Yes
1 Searching for information 38 ( 37.3)
2
Asking for help(e.g., from family, medical tourism
facilitators, informal network in destination country) 35 ( 34.3)
3 Stopping treatment 13 ( 12.7)
4 Demanding a refund 9 ( 8.8)
5 Confirming contract 5 ( 4.9)
6 Claiming recovery 4 ( 3.9)
7 Others 21( 20.6)

25. • Coping:
“Whenever I needed to answer to a question, I tried to search
for it on the internet. It was convenient to use the internet in this
hospital. But honestly, there was not enough information on the
internet.”
“My mother who came with me, is a medical doctor in Russia.
So she asked questions and concerns from her professional
perspective, and tried to figure it out. It really helped me a lot.”
“I was worried about not having any family traveling with me
as a caregiver. But I've been relieved because this hospital has
provided me with a medical interpreter/caregiver, who takes care
of me. I am really appreciative for that.”

26. 3) Perceived Risk & Coping
in “post-visit” stage

27. Perceived risk in “post-visit” stage
(unit : frequency(%))
Perceived risk Yes
1 Physical recovery from treatment 58 ( 47.9)
2 Time (for recovery) 52 ( 44.7)
3 Malpractice 45 ( 36.3)
4 Extra cost(e.g., for follow-up care) 43 ( 35.5)
5 Health condition for flight 39 ( 32.2)
6 Missing documents(e.g., medical records, receipt) 37 ( 31.1)
7 Stress(e.g., social stigma, self-derogation) 35 ( 29.9)

28. • Perceived risk:
“I am not sure whether I can stick to the follow-up care instructions.
In case of malpractice, I don't know how I deal with the problem
because I have no idea about any medical law or regulation processes in
Korea.”
“I though I just needed to have a surgery on my spine. I found I
have much more serious problem in my hip joint while I was in this
hospital. The problem was the budget that was not enough for the
surgery both hip joints..”

29. Coping in “post-visit” stage
(unit : frequency(%))
Coping Yes
1 Making a copy of documents(e.g., medical records) 48 ( 51.6)
2 Gathering information for follow-up care 42 ( 43.3)
3 Getting contact information 29 ( 30.9)
4 Others 5 ( 5.4)

30. 2. Information source

31. Information source
(unit : frequency(%))
Information source Yes
1 Family & friends 86(57.3)
2 Medical tourism facilitators 54(36.0)
3 Website 53(35.3)
4 Online community or blogs 26(17.3)
5 Physician’s advice in home country 16(10.7)
6 TV 4( 2.7)
7 Magazine 1( 0.7)
8 Other sources 8( 9.8)

32. Information source by nationality
(unit : frequency(%))
Information source
Russians
(115)
Mogolians
(38)
Chisquare
test
1 Family & friends 65(57.0) 21(58.3) 0.02
2 Website 49(43.0) 4(11.1) 12.16***
3 Medical tourism facilitators 47(41.2) 7(19.4) 5.64*
4 Online community or blogs 24(21.1) 2( 5.6) 4.59*
5 doctor 9( 7.9) 7(19.4) 3.83
6 TV 4( 3.5) - 1.3
7 Magazine 1( 0.9) - 0,32
8 Other sources 8( 7.0) 4(11.1) 0,65

33. V. Conclusion

34. 1. Different risks perceived across three stages
2. Common form of coping = information searching
3. Variation of information searching behavior across
nationality

35. Thank you
Ki Nam Jin
Dept of Health Administration
Yonsei University
Korea