Medikal Turizmde Hasta Memnuniyetinin ve Algılanan Değerin Davranışsal Niyet Üzerindeki Etkisinde Deneyimsel Kalitenin Aracılık Rolü
Year 2025,
Volume: 26 Issue: 26, 90 - 119, 30.06.2025
Yağmur Savaşkan
,
Şenol Çavuş
Abstract
Bu çalışmanın amacı, medikal turizm sektöründe hasta memnuniyetinin ve algılanan değerin davranışsal niyete olan etkisinde deneyimsel kalitenin aracılık rolünü belirlemektir. Araştırmanın evreni Türkiye’de sağlık turizmi yetki belgesine sahip özel hastanelerden hizmet alan turistlerdir. Evren hacminin sayıca fazla olması nedeniyle tabakalı örnekleme yöntemi ile evreni temsil edecek örneklem belirlenmiştir. Bu örneklemden veriler, 06 Ocak 2024 – 07 Eylül 2024 tarihleri arasında İstanbul ilinde sağlık turizmi yetki belgeli özel hastanelerden anket tekniği kullanılarak elde edilmiştir. Çalışma kapsamında 705 anket analiz edilmiştir. Çalışmanın sonucunda hasta memnuniyeti ile davranışsal niyet ve deneyimsel kalite arasında anlamlı bir ilişki bulunduğu belirlenmiştir. Ayrıca, hasta memnuniyetinin davranışsal niyet üzerinde pozitif ve anlamlı etkisinin olduğu ve deneyimsel kalitenin aracılık rolünün bulunduğu tespit edilmiştir.
Ethical Statement
Sakarya Uygulamalı Bilimler Üniversitesi Etik Kurulu’nun 09/06/2023 tarih ve 32/26 No’lu toplantı kararı ile etik kurul onayı alınarak (Sayı: E-26428519-044-86556) çalışma gerçekleştirilmiştir. Aynı zamanda anketlerin uygulanması için hastanelerden gerekli izinler alınmıştır.
Supporting Institution
Bu çalışmaya Sakarya Uygulamalı Bilimler Üniversitesi Bilimsel Araştırma Projeleri (BAP) Komisyon Başkanlığı (Proje No: 167-2023) maddi destek sağlamıştır.
Thanks
Sağlık turizmi ile ilgili gerekli verilerin elde edilmesinde titizlikle ilgilenen ve çalışmaya katkı sağlayan İstanbul İl Sağlık Müdürlüğü’nden Sayın Merve Demirelli, Sayın Dr. Nuran Reyhanoğlu ve Sayın Dr. Öğr. Üyesi Fatma Demirkaya’ya teşekkürlerimi sunarım.
References
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- Aliman, Nor. K. & Mohamad, W. N. (2016). Linking service quality, patients’ satisfaction and behavioral intentions: an investigation on private healthcare in Malaysia. Procedia - Social and Behavioral Sciences, 224,141–148.
- Badri, M. A., Attia, S. T. & Ustadi, A. M. (2008). Testing not-so-obvious models of healthcare quality. International Journal of Health Care Quality Assurance, 21(2), 159–174.
- Baltušytė, J. (2013). Influence of customer perceived value on behavioral intentions within medical tourism sector in Lithuania [Manuscript](Unpublished Master Thesis). International Marketing and Management. ISM University of Management and Economics, Vilnius.
- Bechel, D. L., Myers, W. A.& Smith, D. G. (2000). Does patient-centered care pay off? The Joint Commission Journal on Quality Improvement, 26(7), 400–409.
- Bintarti, S. & Kurniawan, E. N. (2017). A study of revisit intention: experiential quality and image of muara beting tourism site in Bekasi district. European Research Studies Journal, 20(2A), 521-537.
- Burtan Doğan, B. ve Aslan, A. (2019). Türkiye'de sağlık turizminin mevcut durumu ve ülke ekonomisine katkıları. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 9(18), 390-418.
- Chandrasekaran, A., Senot, C. & Boyer, K. K. (2012). Process management impact on clinical and experiential quality: Managing tensions between safe and patient-centered healthcare. Manufacturing & Service Operations Management, 14(4), 548–566.
- Collins, A., Medhekar, A., Wong Ho, Y. & Çobanoğlu, C. (2019). Factors influencing outbound medical travel from the USA. Tourism Review, 74(3), 463-479.
- Çam, O. ve Çılgınoğlu, H. (2021). Sağlık turizmi kapsamında medikal turizmde öne çıkan sağlık uygulamaları. Oğuzhan Sosyal Bilimler Dergisi, 3(2), 197-216.
- Demirci, Ç. (2018). Sağlık turizminde algılanan değerin müşteri tatmini ve sadakatine etkisi: sağlık turistlerine yönelik bir araştırma. (Doktora tezi). Adnan Menderes Üniversitesi, Sosyal Bilimler Enstitüsü, Aydın.
- Eggert, A. & Ulaga, W. (2002). Customer perceived value: A substitute for satisfaction in business markets?, Journal of Business & Industrial Marketing, 17(2/3), 107–118.
- Ehrbeck, T., Guevara, C. & Mango, P. D. (2008). Mapping the market for medical travel. The McKinsey Quarterly Report.
- Elwyn, G., Edwards, A., Kinnersley, P. & Grol, R. (2000). Shared decision making and the concept of equipoise: The competences of involving patients in healthcare choices. British Journal of General Practice, 50(460), 892-899.
- Globenko, A. & Sianova, Z. (2012). Service quality in healthcare quality improvement initiatives through the prism of patients’ and providers perspectives. (Master thesis). Umea Universitet, Umea School of Business and Economics, Sweden.
- Habibi, A., Ariffin, A. A. M. & Aziz, N. A. (2018). The influence of perceived benefits, perceived sacrifices and perceived value on behavioural intention in the context of medical tourism. International Journal of Services, Economics and Management, 9(3-4), 295-316.
- Hanna, S. A., Saksena, J., Legge, S. & Ware, H. E. (2009). Sending NHS patients for operations abroad: is the holiday over? Annals of The Royal College of Surgeons of England, 91, 128-130.
- Hu, S. (2005). A structural equation model of the senior citizens’ purchasing process in foodservice: Considering the quality of food, nutrition, service and entertainment in foodservice environment. (Doctoral dissertation). Oklahoma State University, USA.
- Hudak, P. L. & Wright, J. G. (2000). The characteristics of patient satisfaction measures. Spine, 25(24), 3167–3177.
- Hunter, W. C. (2007). Medical tourism: A new global Niche. International Journal of Tourism Sciences, 7(1), 129–140.
- Izadi, M., Saadat, S. H., Ayoubian, A., Dehaghi, Z. H., Karbasi, M. R.& Jalali, A. R. (2013). Health tourism in Iran; Identifying obstacles for development of this industry. Int J Travel Med Glob Health, 1(2), 89-94.
- Jaapar, M., Musa, G., Moghavvemi, S. & Saub, R. (2017). Dental tourism: examining tourist profiles, motivation and satisfaction. Tourism Management, 61, 538-552.
- Kalaycı, Ş. (2017). SPSS Uygulamalı Çok Değişkenli İstatistik Teknikleri, Ankara: Dinamik Akademi.
Korkmaz, S. (2018). Dindarlık ile ego sağlamlığı ve empati arasındaki ilişkilerin incelenmesi. Bilimname, 2018(36), 587-607.
- Levi, B. (2007). Medical tourism. Journal of Legal Medicine, 28(2), 223–245.
- Lian Chan, J. K. & Baum, T. (2007). Ecotourists' perception of ecotourism experience in Lower Kinabatangan, Sabah, Malaysia. Journal of Sustainable Tourism, 15(5), 574–590.
- Manaf, N. H. A., Maulan, S., Hussin, H., Kassim, P. N. J., Alavi, R. & Dahari, Z. (2017). Service quality, value, satisfaction and future intention in medical tourism. Journal of Tourism, Hospitality & Culinary Arts, 9(3), 42-53.
- Medical in Türkiye (2022, Eylül 09). Türkiye’de sağlık turizmi verileri. Erişim adresi https://www.medicalinturkiye.com/turkiyede-saglik-turizmi-verileri/.
- Nair, A., Nicolae, M. & Narasimhan, R. (2013). Examining the impact of clinical quality and clinical flexibility on cardiology unit performance—Does experiential quality act as a specialized complementary asset? Journal of Operations Management, 31(7-8), 505–522.
- Newsome, P. R. H. & Wright, G. H. (1999). Patient management: A review of patient satisfaction: 1. concepts of satisfaction. British Dental Journal, 186(4), 161–165.
- Polat, G. (2021). Medikal turistlerin deneyimleme kalite algıları ve tavsiye etme niyeti arasındaki ilişkide müşteri güveni ve müşteri memnuniyetinin aracılık rolü. (Doktora tezi). Nevşehir Hacı Bektaş Veli Üniversitesi Sosyal Bilimler Enstitüsü, Nevşehir.
- Ramachandran, A. & Cram, N. (2005). Standards and customer satisfaction in the healthcare industry. Journal of Clinical Engineering, 30(4), 219–228.
- Rowley, J. (1999). Measuring total customer experience in museums. International Journal of Contemporary Hospitality Management, 11(6), 303–308.
- Sağlık Hizmetleri Genel Müdürlüğü Sağlık Turizmi Daire Başkanlığı (2023, Ekim 19). Sağlık turizmi yetki belgesine sahip tesisler. Erişim adresi https://shgmturizmdb.saglik.gov.tr/TR-90178/yetki-belgesi-listeleri-guncellenmistir.html.
- Schlesinger, W., Cervera-Taulet, A., ve Pérez-Cabañero, C. (2020). Exploring The Links Between Destination Attributes, Quality of Service Experience and Loyalty ın Emerging Mediterranean Destinations. Tourism Management Perspectives, 35, 1-12.
- Sekaran, U. (2003). Research Methods for Business: A Skill Building Approach. (4th ed.). USA: John Wiley and Sons, Inc.
- Singh, L. (2019). Medical tourism motivations: The driving force. Journal of Multidisciplinary Academic Tourism, 4(2), 77-86.
- Sirdeshmukh, D., Singh, J. & Sabol, B. (2002). Consumer trust, value, and loyalty in relational exchanges. Journal of Marketing, 66(1), 15–37.
- Smith, A. E. & Swinehart, K. D. (2001). Integrated systems design for customer focused health care performance measurement: A strategic service unit approach. International Journal of Health Care Quality Assurance, 14(1), 21–29.
- Soderlund, M. & Ohman, N. (2003). Behavioral intentions in satisfaction research revisited. The Journal of Consumer Satisfaction, Dissatisfaction and Complaining Behavior, 16, 53-66.
- Tabachnick, B. G. ve Linda S. F. (2001). Using Multivariate Statistics (4th ed.) Needham Heights: Mass. Ally and Bacon.
- Turizm Günlüğü (2022, Eylül 09). Türkiye sağlık turizmi merkezleri. Erişim adresi https://www.turizmgunlugu.com/2021/05/05/kultur-ve-turizm-bakanligi-turkiye-saglik-turizm-merkezleri/.
- Ünal, Ö., Akbolat, M., Amarat, M. ve Bozkurt, B. (2018). Sağlık hizmetlerinde kurumsal itibar algısının hasta memnuniyetine etkisi. International Conference on Empirical Economics and Social Sciences (ICEESS’18), Bandırma – Türkiye.27-28 Haziran.
- Vural, F., Aydın, A., Fil, Ş., Torun, S. & Vural, B. (2015). Bir devlet hastanesinde yatan hastalarda memnuniyete etki eden iki önemli faktör: İletişim ve hasta güvenlik kültürü. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi,4(3), 335-346.
- Wang, H-Y. (2012). Value as a medical tourism driver. Managing Service Quality, 22(5), 465 – 491.
- Wu, H-C., Li, T. & Li, M-Y. (2016). A study of behavioral intentions, patient satisfaction, perceived value, patient trust and experiential quality for medical tourists. Journal of Quality Assurance in Hospitality & Tourism, 1–37.
- Wong, B. K. M. & Sa’aid Hazley, S. A. (2020). The future of health tourism in the industrial revolution 4.0 Era. Journal of Tourism Futures, 7(2), 267-272.
- Yavuz, M. C. (2018). Türkiye’de sağlık turizmi hizmetleri algısının hasta ve müşteri memnuniyeti üzerine etkisi: İç Anadolu Bölgesi örneği. (Yüksek Lisans tezi). İstanbul Gelişim Üniversitesi Sosyal Bilimler Enstitüsü, İstanbul.
- Zeithaml, V. A., Berry, L. L. & Parasuraman, A. (1996). The behavioral consequences of services quality. Journal of Marketing, 60(2), 31-46.
Intermediary Role Of Experiental Quality In The Effect Of Patient Satisfaction And Perceived Value On Behavioral Intention In Medical Tourism
Year 2025,
Volume: 26 Issue: 26, 90 - 119, 30.06.2025
Yağmur Savaşkan
,
Şenol Çavuş
Abstract
The aim of this study is to determine the mediating role of experiential quality in the effect of patient satisfaction on behavioral intention in the medical tourism sector. The universe of the research is tourists who receive service from private hospitals with health tourism authorization certificates in Türkiye. Since the universe volume is large in number, a sample that was represent the universe was determined by the stratified sampling method. Data were obtained from this sample using a survey technique between January 06 2024 and September 07 2024 from private hospitals with health tourism authorization certificates in province Istanbul. 705 surveys were analyzed within the scope of the study. As a result of the study, it was determined that there was a significant relationship between patient satisfaction, behavioral intention and experiential quality. Additionally, it was found that patient satisfaction had a positive and significant effect on behavioral intention and experiential quality had a mediating role.
References
- Abrar, K., Saeed, M. A., Ahmad, I. & Ali, S. (2020). How customer experience quality affects customer satisfaction-loyalty with moderating role of competitive choices and familiarity: Assessment of private hospitals in Pakistan. Sukkur IBA Journal of Management and Business, 7(1), 75-91.
- Aliman, Nor. K. & Mohamad, W. N. (2016). Linking service quality, patients’ satisfaction and behavioral intentions: an investigation on private healthcare in Malaysia. Procedia - Social and Behavioral Sciences, 224,141–148.
- Badri, M. A., Attia, S. T. & Ustadi, A. M. (2008). Testing not-so-obvious models of healthcare quality. International Journal of Health Care Quality Assurance, 21(2), 159–174.
- Baltušytė, J. (2013). Influence of customer perceived value on behavioral intentions within medical tourism sector in Lithuania [Manuscript](Unpublished Master Thesis). International Marketing and Management. ISM University of Management and Economics, Vilnius.
- Bechel, D. L., Myers, W. A.& Smith, D. G. (2000). Does patient-centered care pay off? The Joint Commission Journal on Quality Improvement, 26(7), 400–409.
- Bintarti, S. & Kurniawan, E. N. (2017). A study of revisit intention: experiential quality and image of muara beting tourism site in Bekasi district. European Research Studies Journal, 20(2A), 521-537.
- Burtan Doğan, B. ve Aslan, A. (2019). Türkiye'de sağlık turizminin mevcut durumu ve ülke ekonomisine katkıları. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 9(18), 390-418.
- Chandrasekaran, A., Senot, C. & Boyer, K. K. (2012). Process management impact on clinical and experiential quality: Managing tensions between safe and patient-centered healthcare. Manufacturing & Service Operations Management, 14(4), 548–566.
- Collins, A., Medhekar, A., Wong Ho, Y. & Çobanoğlu, C. (2019). Factors influencing outbound medical travel from the USA. Tourism Review, 74(3), 463-479.
- Çam, O. ve Çılgınoğlu, H. (2021). Sağlık turizmi kapsamında medikal turizmde öne çıkan sağlık uygulamaları. Oğuzhan Sosyal Bilimler Dergisi, 3(2), 197-216.
- Demirci, Ç. (2018). Sağlık turizminde algılanan değerin müşteri tatmini ve sadakatine etkisi: sağlık turistlerine yönelik bir araştırma. (Doktora tezi). Adnan Menderes Üniversitesi, Sosyal Bilimler Enstitüsü, Aydın.
- Eggert, A. & Ulaga, W. (2002). Customer perceived value: A substitute for satisfaction in business markets?, Journal of Business & Industrial Marketing, 17(2/3), 107–118.
- Ehrbeck, T., Guevara, C. & Mango, P. D. (2008). Mapping the market for medical travel. The McKinsey Quarterly Report.
- Elwyn, G., Edwards, A., Kinnersley, P. & Grol, R. (2000). Shared decision making and the concept of equipoise: The competences of involving patients in healthcare choices. British Journal of General Practice, 50(460), 892-899.
- Globenko, A. & Sianova, Z. (2012). Service quality in healthcare quality improvement initiatives through the prism of patients’ and providers perspectives. (Master thesis). Umea Universitet, Umea School of Business and Economics, Sweden.
- Habibi, A., Ariffin, A. A. M. & Aziz, N. A. (2018). The influence of perceived benefits, perceived sacrifices and perceived value on behavioural intention in the context of medical tourism. International Journal of Services, Economics and Management, 9(3-4), 295-316.
- Hanna, S. A., Saksena, J., Legge, S. & Ware, H. E. (2009). Sending NHS patients for operations abroad: is the holiday over? Annals of The Royal College of Surgeons of England, 91, 128-130.
- Hu, S. (2005). A structural equation model of the senior citizens’ purchasing process in foodservice: Considering the quality of food, nutrition, service and entertainment in foodservice environment. (Doctoral dissertation). Oklahoma State University, USA.
- Hudak, P. L. & Wright, J. G. (2000). The characteristics of patient satisfaction measures. Spine, 25(24), 3167–3177.
- Hunter, W. C. (2007). Medical tourism: A new global Niche. International Journal of Tourism Sciences, 7(1), 129–140.
- Izadi, M., Saadat, S. H., Ayoubian, A., Dehaghi, Z. H., Karbasi, M. R.& Jalali, A. R. (2013). Health tourism in Iran; Identifying obstacles for development of this industry. Int J Travel Med Glob Health, 1(2), 89-94.
- Jaapar, M., Musa, G., Moghavvemi, S. & Saub, R. (2017). Dental tourism: examining tourist profiles, motivation and satisfaction. Tourism Management, 61, 538-552.
- Kalaycı, Ş. (2017). SPSS Uygulamalı Çok Değişkenli İstatistik Teknikleri, Ankara: Dinamik Akademi.
Korkmaz, S. (2018). Dindarlık ile ego sağlamlığı ve empati arasındaki ilişkilerin incelenmesi. Bilimname, 2018(36), 587-607.
- Levi, B. (2007). Medical tourism. Journal of Legal Medicine, 28(2), 223–245.
- Lian Chan, J. K. & Baum, T. (2007). Ecotourists' perception of ecotourism experience in Lower Kinabatangan, Sabah, Malaysia. Journal of Sustainable Tourism, 15(5), 574–590.
- Manaf, N. H. A., Maulan, S., Hussin, H., Kassim, P. N. J., Alavi, R. & Dahari, Z. (2017). Service quality, value, satisfaction and future intention in medical tourism. Journal of Tourism, Hospitality & Culinary Arts, 9(3), 42-53.
- Medical in Türkiye (2022, Eylül 09). Türkiye’de sağlık turizmi verileri. Erişim adresi https://www.medicalinturkiye.com/turkiyede-saglik-turizmi-verileri/.
- Nair, A., Nicolae, M. & Narasimhan, R. (2013). Examining the impact of clinical quality and clinical flexibility on cardiology unit performance—Does experiential quality act as a specialized complementary asset? Journal of Operations Management, 31(7-8), 505–522.
- Newsome, P. R. H. & Wright, G. H. (1999). Patient management: A review of patient satisfaction: 1. concepts of satisfaction. British Dental Journal, 186(4), 161–165.
- Polat, G. (2021). Medikal turistlerin deneyimleme kalite algıları ve tavsiye etme niyeti arasındaki ilişkide müşteri güveni ve müşteri memnuniyetinin aracılık rolü. (Doktora tezi). Nevşehir Hacı Bektaş Veli Üniversitesi Sosyal Bilimler Enstitüsü, Nevşehir.
- Ramachandran, A. & Cram, N. (2005). Standards and customer satisfaction in the healthcare industry. Journal of Clinical Engineering, 30(4), 219–228.
- Rowley, J. (1999). Measuring total customer experience in museums. International Journal of Contemporary Hospitality Management, 11(6), 303–308.
- Sağlık Hizmetleri Genel Müdürlüğü Sağlık Turizmi Daire Başkanlığı (2023, Ekim 19). Sağlık turizmi yetki belgesine sahip tesisler. Erişim adresi https://shgmturizmdb.saglik.gov.tr/TR-90178/yetki-belgesi-listeleri-guncellenmistir.html.
- Schlesinger, W., Cervera-Taulet, A., ve Pérez-Cabañero, C. (2020). Exploring The Links Between Destination Attributes, Quality of Service Experience and Loyalty ın Emerging Mediterranean Destinations. Tourism Management Perspectives, 35, 1-12.
- Sekaran, U. (2003). Research Methods for Business: A Skill Building Approach. (4th ed.). USA: John Wiley and Sons, Inc.
- Singh, L. (2019). Medical tourism motivations: The driving force. Journal of Multidisciplinary Academic Tourism, 4(2), 77-86.
- Sirdeshmukh, D., Singh, J. & Sabol, B. (2002). Consumer trust, value, and loyalty in relational exchanges. Journal of Marketing, 66(1), 15–37.
- Smith, A. E. & Swinehart, K. D. (2001). Integrated systems design for customer focused health care performance measurement: A strategic service unit approach. International Journal of Health Care Quality Assurance, 14(1), 21–29.
- Soderlund, M. & Ohman, N. (2003). Behavioral intentions in satisfaction research revisited. The Journal of Consumer Satisfaction, Dissatisfaction and Complaining Behavior, 16, 53-66.
- Tabachnick, B. G. ve Linda S. F. (2001). Using Multivariate Statistics (4th ed.) Needham Heights: Mass. Ally and Bacon.
- Turizm Günlüğü (2022, Eylül 09). Türkiye sağlık turizmi merkezleri. Erişim adresi https://www.turizmgunlugu.com/2021/05/05/kultur-ve-turizm-bakanligi-turkiye-saglik-turizm-merkezleri/.
- Ünal, Ö., Akbolat, M., Amarat, M. ve Bozkurt, B. (2018). Sağlık hizmetlerinde kurumsal itibar algısının hasta memnuniyetine etkisi. International Conference on Empirical Economics and Social Sciences (ICEESS’18), Bandırma – Türkiye.27-28 Haziran.
- Vural, F., Aydın, A., Fil, Ş., Torun, S. & Vural, B. (2015). Bir devlet hastanesinde yatan hastalarda memnuniyete etki eden iki önemli faktör: İletişim ve hasta güvenlik kültürü. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi,4(3), 335-346.
- Wang, H-Y. (2012). Value as a medical tourism driver. Managing Service Quality, 22(5), 465 – 491.
- Wu, H-C., Li, T. & Li, M-Y. (2016). A study of behavioral intentions, patient satisfaction, perceived value, patient trust and experiential quality for medical tourists. Journal of Quality Assurance in Hospitality & Tourism, 1–37.
- Wong, B. K. M. & Sa’aid Hazley, S. A. (2020). The future of health tourism in the industrial revolution 4.0 Era. Journal of Tourism Futures, 7(2), 267-272.
- Yavuz, M. C. (2018). Türkiye’de sağlık turizmi hizmetleri algısının hasta ve müşteri memnuniyeti üzerine etkisi: İç Anadolu Bölgesi örneği. (Yüksek Lisans tezi). İstanbul Gelişim Üniversitesi Sosyal Bilimler Enstitüsü, İstanbul.
- Zeithaml, V. A., Berry, L. L. & Parasuraman, A. (1996). The behavioral consequences of services quality. Journal of Marketing, 60(2), 31-46.