Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality

Xin Shen; Azmawani Abd Rahman; Siti Suriawati Isa; Anuar Shah Bali Mahomed

doi:10.30519/ahtr.1709324

Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality

Abstract

Growth in medical tourism and healthcare demand is driving the development of medical hotels, attracting increasing scholarly attention. Yet, empirical evidence on intention to stay in medical hotels remains limited, particularly for Chinese tourists. Drawing on the Theory of Planned Behavior (TPB), this study models attitude, subjective norm, and perceived behavioral control as antecedents of desire. It also tests perceived service quality as a contextual moderator. Survey data from 238 Chinese tourists were analyzed using validated measures and structural equation modeling (SEM). Results show that desire mediates the effects of the TPB variables on intention. The desire-intention linkage strengthens at higher perceived service quality. The study refines TPB by specifying desire as a proximal mediator and by theorizing perceived service quality as a boundary condition in a China-specific setting. For managers, actionable levers include communicating assurance and cleanliness protocols in pre-stay communications, and establishing a clinical–hotel liaison for standardized briefings. Designing for privacy and caregiver support (discrete intake, spatial zoning) and improving accessibility and price transparency can also reinforce perceived behavioral control. These steps can enhance perceived service quality and facilitate the conversion of desire into booking intention.

Keywords

References

AECOM. (2020). China’s Medical Tourism Outlook. https://aecom.com
Agag, G., & Colmekcioglu, N. (2020). Understanding guests’ behavior to visit green hotels: The role of ethical ideology and religiosity. International Journal of Hospitality Management, 91, 102679. https://doi.org/10.1016/j.ijhm.2020.102679
Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In Kuhl Julius & Beckmann Jürgen (Eds.), Action control (pp. 11–39). Berlin: Springer.
Ajzen, I. (1991). The theory of planned behavior. Organizational behavior and human decision processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-T
Awang, Z. (2014). A handbook on SEM for academicians and practitioners: The step-by-step practical guides for the beginners. Bandar Baru Bangi, MPWS Rich Resources, 10(3), 32–45.
Bagozzi, R. P., & Yi, Y. (1990). Assessing method variance in multitrait-multimethod matrices: The case of self-reported affect and perceptions at work. Journal of Applied Psychology, 75(5), 547. https://doi.org/10.1037/0021-9010.75.5.547
Bagozzi, R., & Yi, Y. (1988). On the evaluation of structure equation models. Journal of the Academy of Marketing Science, 16(1), 74–94. https://doi.org/10.1007/BF02723327
Büssing, A. G., Thielking, A., & Menzel, S. (2019). Can a like save the planet? Comparing antecedents of and correlations between environmental liking on social media, money donation, and volunteering. Frontiers in Psychology, 10, 1989. https://doi.org/10.3389/fpsyg.2019.01989

Carrera, P. M., & Bridges, J. F. (2006). Globalization and healthcare: understanding health and medical tourism. Expert review of pharmacoeconomics & outcomes research, 6(4), 447–454. https://doi.org/10.1586/14737167.6.4.447
Chadha, R. M., Paulson, M. R., Avila, F. R., Torres-Guzman, R. A., Maita, K. C., Garcia, J. P., ... & Maniaci, M. J. (2023). A virtual hybrid care hotel model supports the recovery of post-procedural patients with mild to severe systemic diseases. The American Surgeon™, 89(6), 2247-2253. https://doi.org/10.1177/00031348221082271
Chaulagain, S. (2024). Hospitality in healthcare: the impacts of utilitarian and hedonic value perceptions on behavioral intentions in the context of medical hotels. Journal of Hospitality and Tourism Insights, 7(5), 3167-3184. https://doi.org/10.1108/JHTI-10-2023-0744
Chaulagain, S., Jahromi, M. F., Hua, N., & Wang, Y. (2023). Understanding the determinants of intention to stay at medical hotels: A customer value perspective. International Journal of Hospitality Management, 112, 103464. https://doi.org/10.1016/j.ijhm.2023.103464
Chen, F. Y. (2013). The intention and determining factors for airline passengers' participation in carbon offset schemes. Journal of Air Transport Management, 29, 17–22. https://doi.org/10.1016/j.jairtraman.2013.01.001
Chen, G., Zou, M., Ran, N., Yan, B., & Li, S. (2023). The effects of environmental empathy and sustainable intelligence on wetland tourists’ revisit intention using an extended model of goal-directed behavior. Journal of Cleaner Production, 419, 138288. https://doi.org/10.1016/j.jclepro.2023.138288
Chesterton, L., Stephens, M., Clark, A., & Ahmed, A. (2021). A systematic literature review of the patient hotel model. Disability and Rehabilitation, 43(3), 317–323. https://doi.org/10.1080/09638288.2019.1628314
China.org.cn. (2025, July 6). Hainan emerges as China’s premier international medical tourism destination. https://www.china.org.cn/2025-07/06/content_117964110.shtml
Chinese Government. (2019). Chinese Government Public Policy Document. https://www.gov.cn/
Das, S. S., & Tiwari, A. K. (2021). Understanding international and domestic travel intention of Indian travellers during COVID-19 using a Bayesian approach. Tourism Recreation Research, 46(2), 228–244. https://doi.org/10.1080/02508281.2020.1830341
Fong, L. H. N., Leung, D., Ly, T. P., & Zhang, C. X. (2021). Culture mindsets and intention to stay in foreign peer-to-peer accommodation: Exploring underlying mechanisms. Journal of Hospitality and Tourism Management, 48, 110–118. https://doi.org/10.1016/j.jhtm.2021.06.002
Fornell, C., & Larcker, D. F. (1981). Structural equation models with unobservable variables and measurement error: Algebra and Statistics. Journal of Marketing Research, 18(3), 382–388. https://doi.org/10.1177/002224378101800313
Gan, L. L., & Frederick, J. R. (2011). Consumers’ attitudes toward medical tourism. SSRN Electronic Journal. https://dx.doi.org/10.2139/ssrn.1837062
George, D., & Mallery, P. (2003). SPSS for Windows step by step: A simple guide. Longman Publishers.
German, J. D., Redi, A. A. N. P., Prasetyo, Y. T., Persada, S. F., Ong, A. K. S., Young, M. N., & Nadlifatin, R. (2022). Choosing a package carrier during COVID-19 pandemic: An integration of pro-environmental planned behavior (PEPB) theory and Service Quality (SERVQUAL). Journal of cleaner production, 346, 131123. https://doi.org/10.1016/j.jclepro.2022.131123
Greco, E., Rios-Zermeno, J., Freeman, W. D., Perez-Vega, C., Ghaith, A. K., Kashyap, S., Awad, A.-W. A., Borah, B. J., Dholakia, R., Dean, J. C., Bojaxhi, E., Chadha, R. M., & Tawk, R. G. (2025). The safety and feasibility of a care hotel model in elective neuroendovascular interventions: A pilot study. Neurosurgery, 97(3), 580–587. https://doi.org/10.1227/neu.0000000000003413
Hair J. F. Jr., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis (5th ed.). Prentice Hall.
Han, H. (2013). The healthcare hotel: Distinctive attributes for international medical travelers. Tourism Management, 36, 257–268. https://doi.org/10.1016/j.tourman.2012.11.016
Han, H., & Ryu, K. (2012). The theory of repurchase decision-making (TRD): Identifying the critical factors in the post-purchase decision-making process. International Journal of Hospitality Management, 31(3), 786–797. https://doi.org/10.1016/j.ijhm.2011.09.015
Han, H., & Yoon, H. J. (2015). Hotel customers’ environmentally responsible behavioral intention: Impact of key constructs on decision in green consumerism. International Journal of Hospitality Management, 45, 22–33. https://doi.org/10.1016/j.ijhm.2014.11.004
Han, H., Back, K. J., & Barrett, B. (2009). Influencing factors on restaurant customers’ revisit intention: The roles of emotions and switching barriers. International journal of hospitality management, 28(4), 563–572. https://doi.org/10.1016/j.ijhm.2009.03.005
Han, H., Hsu, L. T. J., & Sheu, C. (2010). Application of the theory of planned behavior to green hotel choice: Testing the effect of environmental friendly activities. Tourism management, 31(3), 325–334. https://doi.org/10.1016/j.tourman.2009.03.013
Han, H., Kim, Y., Kim, C., & Ham, S. (2015). Medical hotels in the growing healthcare business industry: Impact of international travelers' perceived outcomes. Journal of Business Research, 68(9), 1869–1877. https://doi.org/10.1016/j.jbusres.2015.01.015
Hashim, N., Set, K., Nordin, A. O. S., & Mokhtar, N. F. (2025). The moderating effects of perceived risk in the water theme park industry: Applying the extended theory of planned behaviour. Journal of Tourism and Services, 16(30), 73–98. https://doi.org/10.29036/sq3e4j06
Heung, V. C., Kucukusta, D., & Song, H. (2011). Medical tourism development in Hong Kong: An assessment of the barriers. Tourism management, 32(5), 995–1005. https://doi.org/10.1016/j.tourman.2010.08.012
Hoyos Vallejo, C. A., & Chinelato, F. B. (2025). Delivering trust: How food safety performance drives loyalty across the online ordering journey. International Journal of Quality and Reliability Management, 42(1), 107–121. https://doi.org/10.1108/IJQRM-12-2023-0399
Jalali, M., Haghgoshayie, E., Janati, A., Yoshari, P., & Khodayari-Zarnaq, R. (2025). Health tourism: A global perspective on the barriers and facilitators. Discover Public Health, 22, 157. https://doi.org/10.1186/s12982-025-00545-2
Joint Commission International. (2020). Search for JCI-Accredited Organizations. https://www.jointcommissioninternational.org
Karatepe, O. M., Rezapouraghdam, H., & Hassannia, R. (2020). Job insecurity, work engagement and their effects on hotel employees’ non-green and nonattendance behaviors. International Journal of Hospitality Management, 87, 102472. https://doi.org/10.1016/j.ijhm.2020.102472
Kim, M. J., & Hall, C. M. (2021). Do perceived risk and intervention affect crowdfunder behavior for the sustainable development goals? A model of goal-directed behavior. Journal of Cleaner Production, 311, 127614. https://doi.org/10.1016/j.jclepro.2021.127614
Lee, C. K., Song, H. J., Bendle, L. J., Kim, M. J., & Han, H. (2012). The impact of non-pharmaceutical interventions for 2009 H1N1 influenza on travel intentions: A model of goal-directed behavior. Tourism management, 33(1), 89–99. https://doi.org/10.1016/j.tourman.2011.02.006
Lee, S., Bruwer, J., & Song, H. (2015). Experiential and involvement effects on the Korean wine tourist's decision-making process. Current Issues in Tourism, 20(12), 1215–1231. https://doi.org/10.1080/13683500.2015.1050362
Lee, S., Song, H., Lee, C. K., & Petrick, J. F. (2018). An integrated model of pop culture fans’ travel decision-making processes. Journal of Travel Research, 57(5), 687–701. https://doi.org/10.1177/0047287517708619
Liang, C. C., & Nguyen, T. D. (2024). Integrating Pandemic Awareness with the Theory of Planned Behavior: A Travel Intention Study. Journal of Quality Assurance in Hospitality & Tourism, 1–27. https://doi.org/10.1080/1528008X.2024.2386587
Liao, S.-H., Hu, D.-C., & Chen, C.-J. (2025). Perceived service quality and electronic word-of-mouth on food delivery services: Extended theory of planned behaviour. British Food Journal, 127(3), 1080–1097. https://doi.org/10.1108/BFJ-06-2024-0612
Lin, S.-T., & Chen, K.-S. (2025). ESG strategies in educational quality management: An empirical study on fostering student loyalty and sustainability. Sustainability, 17(8), 3723. https://doi.org/10.3390/su17083723
Maniaci, M. J., Chadha, R. M., Fazio, J. R., Maita, K. C., Love, E. A., Boyle, V. L., Heckman, M. G., Johnson, P. W., Paulson, M. R., & Forte, A. J. (2023). Surgical service and distance traveled drive patient preference for Care Hotel: A retrospective cohort study. Annals of Medicine & Surgery, 85(5), 1578–1583. https://doi.org/10.1097/MS9.0000000000000704
Masclee, G. M. C., Masclee, A. A. M., Kruimel, J. W., Conchillo, J. M., van Vliet, J., & Keszthelyi, D. (2022). Using a patient hotel: Perceptions of the quality of care by patients undergoing analysis for gastrointestinal motility disorders in the Netherlands. Journal of Patient Experience, 9.https://doi.org/10.1177/23743735221089453
Meng, B., & Choi, K. (2016). Extending the theory of planned behaviour: Testing the effects of authentic perception and environmental concerns on the slow-tourist decision-making process. Current Issues in Tourism, 19(6), 528–544. https://doi.org/10.1080/13683500.2015.1020773
Meng, B., Chi, X., Kim, J. J., Kim, G., Quan, W., & Han, H. (2024). Traveling with pets and staying at a pet-friendly hotel: A combination effect of the BRT, TPB, and NAM on consumer behaviors. International Journal of Hospitality Management, 120, 103771. https://doi.org/10.1016/j.ijhm.2024.103771
National Health Commission of the People's Republic of China. (2020). China Health Commission Report. http://www.nhc.gov.cn
Nimri, R., Patiar, A., & Jin, X. (2020). The determinants of consumers’ intention of purchasing green hotel accommodation: Extending the theory of planned behaviour. Journal of Hospitality and Tourism Management, 45, 535–543. https://doi.org/10.1016/j.jhtm.2020.10.013
Osakwe, C. N., Hudik, M., Říha, D., Stros, M., & Ramayah, T. (2022). Critical factors characterizing consumers’ intentions to use drones for last-mile delivery: Does delivery risk matter?. Journal of Retailing and Consumer Services, 65, 102865. https://doi.org/10.1016/j.jretconser.2021.102865
Perugini, M., & Bagozzi, R. P. (2001). The role of desires and anticipated emotions in goal‐directed behaviours: Broadening and deepening the theory of planned behaviour. British journal of social psychology, 40(1), 79–98. https://doi.org/10.1348/014466601164704
Perugini, M., & Bagozzi, R. P. (2004). The distinction between desires and intentions. European Journal of Social Psychology, 34(1), 69–84. https://doi.org/10.1002/ejsp.186
Podsakoff, P. M., & Organ, D. W. (1986). Self-reports in organizational research: Problems and prospects. Journal of management, 12(4), 531–544. https://doi.org/10.1177/014920638601200408
Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903. https://doi.org/10.1037/0021-9010.88.5.879
Reddy, S. G., York, V. K., & Brannon, L. A. (2010). Travel for treatment: students' perspective on medical tourism. International Journal of Tourism Research, 12(5), 510–522. https://doi.org/10.1002/jtr.769
Sadiq, M., Adil, M., & Paul, J. (2022). Eco-friendly hotel stay and environmental attitude: A value-attitude-behaviour perspective. International Journal of Hospitality Management, 100, 103094. https://doi.org/10.1016/j.ijhm.2021.103094
Song, H. J., Lee, C. K., Kang, S. K., & Boo, S. J. (2012). The effect of environmentally friendly perceptions on festival visitors’ decision-making process using an extended model of goal-directed behavior. Tourism Management, 33(6), 1417–1428. https://doi.org/10.1016/j.tourman.2012.01.004
Tuncer, I., Unusan, C., & Cobanoglu, C. (2020). Service Quality, Perceived Value and Customer Satisfaction on Behavioral Intention in Restaurants: An Integrated Structural Model. Journal of Quality Assurance in Hospitality & Tourism, 22(4), 447–475. https://doi.org/10.1080/1528008X.2020.1802390
Verma, V. K., Chandra, B., & Kumar, S. (2019). Values and ascribed responsibility to predict consumers' attitude and concern towards green hotel visit intention. Journal of Business Research, 96, 206–216. https://doi.org/10.1016/j.jbusres.2018.11.021
Wang, L., Zhang, Q., Ding, Y. Y., & Wong, P. P. W. (2022). The Effect of Social and Personal Norm on Intention to Patronize Green Hotels: Extension of Theory of Planned Behavior. Journal of China Tourism Research, 19(2), 311–334. https://doi.org/10.1080/19388160.2022.2070567
Wu, W. (2025). China’s health service collaboration in the Guangdong–Hong Kong–Macao Greater Bay Area: Barriers and next steps. Frontiers in Public Health, 13, 1442328. https://doi.org/10.3389/fpubh.2025.1442328
Xinhua. (2024) Boao Lecheng pilot zone explores fast track into China’s medical market. China Daily. https://www.chinadaily.com.cn/a/202402/08/WS65c49669a3104efcbdaea7cb.html chinadaily.com.cn
Yeh, S. S., Guan, X., Chiang, T. Y., Ho, J. L., & Huan, T. C. T. (2021). Reinterpreting the theory of planned behavior and its application to green hotel consumption intention. International Journal of Hospitality Management, 94, 102827. https://doi.org/10.1016/j.ijhm.2020.102827
Ying, K. S., Jusoh, A., & Khalifah, Z. (2012). Service quality as moderator in the relationship between experience and value. Contemporary Management Research, 8(3), 185–194. https://doi.org/10.7903/cmr.11152

Details

Primary Language

English

Subjects

Tourism (Other)

Journal Section

Research Article

Authors

Xin Shen ^*
0009-0001-6470-4897
China

Azmawani Abd Rahman
0000-0002-7590-6427
Malaysia

Siti Suriawati Isa
0000-0003-4036-6536
Malaysia

Anuar Shah Bali Mahomed
0000-0003-2478-9811
Malaysia

Early Pub Date

June 12, 2026

Publication Date

-

Submission Date

June 10, 2025

Acceptance Date

March 19, 2026

Published in Issue

Year 2026 Number: Advanced Online Publication

DOI

https://doi.org/10.30519/ahtr.1709324

IZ

https://izlik.org/JA55LU65AB

Cite

RIS / Bibtex

APA

Shen, X., Abd Rahman, A., Isa, S. S., & Mahomed, A. S. B. (2026). Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality. Advances in Hospitality and Tourism Research (AHTR), Advanced Online Publication. https://doi.org/10.30519/ahtr.1709324

AMA

1.Shen X, Abd Rahman A, Isa SS, Mahomed ASB. Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality. Advances in Hospitality and Tourism Research (AHTR). 2026;(Advanced Online Publication). doi:10.30519/ahtr.1709324

Chicago

Shen, Xin, Azmawani Abd Rahman, Siti Suriawati Isa, and Anuar Shah Bali Mahomed. 2026. “Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality”. Advances in Hospitality and Tourism Research (AHTR), no. Advanced Online Publication. https://doi.org/10.30519/ahtr.1709324.

EndNote

Shen X, Abd Rahman A, Isa SS, Mahomed ASB (June 1, 2026) Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality. Advances in Hospitality and Tourism Research (AHTR) Advanced Online Publication

IEEE

[1]X. Shen, A. Abd Rahman, S. S. Isa, and A. S. B. Mahomed, “Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality”, Advances in Hospitality and Tourism Research (AHTR), no. Advanced Online Publication, June 2026, doi: 10.30519/ahtr.1709324.

ISNAD

Shen, Xin - Abd Rahman, Azmawani - Isa, Siti Suriawati - Mahomed, Anuar Shah Bali. “Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality”. Advances in Hospitality and Tourism Research (AHTR). Advanced Online Publication (June 1, 2026). https://doi.org/10.30519/ahtr.1709324.

JAMA

1.Shen X, Abd Rahman A, Isa SS, Mahomed ASB. Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality. Advances in Hospitality and Tourism Research (AHTR). 2026. doi:10.30519/ahtr.1709324.

MLA

Shen, Xin, et al. “Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality”. Advances in Hospitality and Tourism Research (AHTR), no. Advanced Online Publication, June 2026, doi:10.30519/ahtr.1709324.

Vancouver

1.Xin Shen, Azmawani Abd Rahman, Siti Suriawati Isa, Anuar Shah Bali Mahomed. Chinese Tourists’ Intention to Stay in Medical Hotels: Moderating Role of Service Quality. Advances in Hospitality and Tourism Research (AHTR). 2026 Jun. 1;(Advanced Online Publication). doi:10.30519/ahtr.1709324