Factors Determining the Impact of Medical Tourism on Sustainable Development Goals: Evidence from Multiple Medical Tourism Stakeholders

Yıl 2024, Cilt: 25 Sayı: 3, 628 - 652, 01.11.2024

Haşim Çapar , Kübra İnan

Öz

The purpose of this study is to reveal the factors that determine the impact of medical tourism on sustainable development goals (SDGs). This study was conducted in descriptive cross-sectional type with 1057 medical tourism stakeholders from five continents between July 2023 and February 2024. Data were collected with an online survey. To determine the determinants, t test, ANOVA, Pearson correlation and Multi Logistic Regression analysis were performed. Odds ratios between “Yes” and “No Idea”, efficiency and sustainability (OR=1.101), policy (OR=0.975), ethics (OR=1.035), infrastructure (OR=1.917), and caring (OR=1.045) were found to be significant. Looking at the odds ratios between “No” and “No Idea”, efficiency and sustainability (OR=1.063), policy (OR=1.022), ethics (OR=1.024), infrastructure (OR=1.081), and caring (OR=1.048) were found to be significant. The roles and participation levels of stakeholders in medical tourism have been revealed as determinants of the impact of medical tourism on SDGs.

Anahtar Kelimeler

Medical Tourism, Stakeholders, Sustainable Development Goals

Etik Beyan

For this study, the necessary ethics committee permission was obtained from Dicle University Ethics Committee with the decision dated 12.06.2023 and numbered 511191.

Destekleyen Kurum

This study was supported by the Scientific and Technological Research Council of Türkiye (TÜBİTAK) within the scope of 2209-A University Students Research Projects Support Program.

Teşekkür

We would like to thank the Scientific and Technological Research Council of Türkiye (TÜBİTAK) for its financial support for this study.

Medikal Turizmin Sürdürülebilir Kalkınma Hedefleri Üzerindeki Etkisini Belirleyen Faktörler: Çoklu Medikal Turizm Paydaşlarından Elde Edilen Kanıtlar

Öz

Bu çalışmanın amacı, medikal turizmin sürdürülebilir kalkınma hedeflerine (SKH) etkisini belirleyen faktörleri ortaya koymaktır. Bu çalışma, Temmuz 2023 ile Şubat 2024 tarihleri arasında beş kıtadan 1057 medikal turizm paydaşıyla tanımlayıcı kesitsel tipte gerçekleştirildi. Veriler çevrimiçi bir anketle toplandı. Belirleyicileri belirlemek için t testi, ANOVA, Pearson korelasyonu ve Çoklu Lojistik Regresyon analizi yapıldı. “Evet” ve “Fikrim Yok” arasında verimlilik ve sürdürülebilirlik (OR=1,101), politika (OR=0,975), etik (OR=1,035), altyapı (OR=1,917) ve önem (OR=1,045) arasındaki olasılık oranlarının anlamlı olduğu görüldü. “Hayır” ve “Fikrim Yok” arasındaki olasılık oranlarına bakıldığında, verimlilik ve sürdürülebilirlik (OR=1,063), politika (OR=1,022), etik (OR=1,024), altyapı (OR=1,081) ve bakım (OR= 1,048) anlamlı bulunmuştur. Paydaşların medikal turizmdeki rolleri ve katılım düzeyleri, medikal turizmin Sürdürülebilir Kalkınma Hedefleri üzerindeki etkisinin belirleyicileri olarak ortaya çıkmıştır.

Anahtar Kelimeler

Medikal Turizm, Paydaşlar, Sürdürülebilir Kalkınma Hedefleri

Kaynakça

• Adams, Krystyna, Jeremy Snyder, Valorie A. Crooks, and Rory Johnston. 2017. “Developing an Informational Tool for Ethical Engagement in Medical Tourism.” Philosophy, Ethics, and Humanities in Medicine : PEHM 12:4. doi: 10.1186/s13010-017-0045-9.
• Alexis-Thomas, Caroline. 2020. “An Examination of Issues Related to Tourism and Health and Well-Being as a Sustainable Development Goal by Tourism Providers in Tobago.” Worldwide Hospitality and Tourism Themes 12(3):293–303. doi: 10.1108/WHATT-02-2020-0006.
• Brown, Joseph, James Johnson, Margaret E. Ozan-Rafferty, Manoj Sharma, and Salvatore Barbera. 2020. “Internet Narratives Focused on Health Travelers’ Experiences in India: Qualitative Analysis.” Journal of Medical Internet Research 22(5):e15665. doi: 10.2196/15665.
• Butler, Richard W., and Adam R. Szromek. 2019. “Incorporating the Value Proposition for Society with Business Models of Health Tourism Enterprises.” Sustainability 11(23):6711. doi: 10.3390/su11236711.
• Çapar, H. 2022. “Sürdürülebilir Kalkınma Hedeflerinin Medikal Turizm Üzerindeki Etkisi: Bir Panel Veri Analizi.” Doktora Tezi, Sağlık Bilimleri Üniversitesi, İstanbul.
• Carrera, Percivil M., and John Fp Bridges. 2006. “Globalization and Healthcare: Understanding Health and Medical Tourism.” Expert Review of Pharmacoeconomics & Outcomes Research 6(4):447–54. doi: 10.1586/14737167.6.4.447.
• Collins, Ayşe, Anita Medhekar, and Zeynep Göknil Şanal. 2022. “A Qualitative Analysis of Turkish Stakeholders Perspective for Improving Medical Tourism.” International Journal of Tourism Research 24(3):487–500. doi: 10.1002/jtr.2516.
• Fox, J., and S. Weisberg. 2020. “Car: Companion to Applied Regression.”
• Gil-Lacruz, Marta, Ana Isabel Gil-Lacruz, and María Luisa Gracia-Pérez. 2020. “Health-Related Quality of Life in Young People: The Importance of Education.” Health and Quality of Life Outcomes 18(1):187. doi: 10.1186/s12955-020-01446-5.
• Hair, J. et al. 2013. "Multivariate Data Analysis: Pearson New International Edition." Seventh Edition. Harlow: Pearson Education Limited. Available at: https://www.drnishikantjha.com/papersCollection/Multivariate%20Data%20Analysis.pdf (Accessed: 14 March 2024).
• Hanefeld, Johanna, Mishal Khan, Göran Tomson, and Richard Smith. 2017. “Trade Is Central to Achieving the Sustainable Development Goals: A Case Study of Antimicrobial Resistance.” BMJ 358:j3505. doi: 10.1136/bmj.j3505.
• Hilbe, J. M. 2016. Practical Guide to Logistic Regression. Chapman and Hall/CRC.
• Hosmer, D. W. J. R., S. Lemeshow, and R. X. Sturdivant. 2013. Applied Logistic Regression. John Wiley & Sons.
• Illario, M., V. De Luca, L. Leonardini, M. Kucharczyk, A. S. Parent, C. Dantas, A. L. Jegundo, W. van Staalduinen, J. Ganzarain, L. Comisso, C. Bramezza, A. M. Carriazo, A. Maritati, G. Tramontano, P. Capozzi, E. Goossens, C. Cotrone, A. Costantini, M. Ciliberti, M. Femiano, A. d’Amore, M. Forlenza, R. Ruggiero, A. Bianchi, L. Augustin, V. Marrazzo, T. Dello Ioio, S. Capaldo, A. Crudeli, G. De Cesare, F. Cuccaro, G. Bracale, D. Tramontano, A. Postiglione, C. Matera, E. Coscioni, and J. Bousquet. 2019. “Health Tourism: An Opportunity for Sustainable Development.” Translational Medicine @ UniSa 19:109–15.
• Jabbari, Alireza, Masoud Ferdosi, Mahmoud Keyvanara, and Zahra Agharahimi. 2013. “Stakeholders’ Analysis of the Medical Tourism Industry: Development Strategies in Isfahan.” Journal of Education and Health Promotion 2:44. doi: 10.4103/2277-9531.117410.
• Johnston, Rory, Valorie A. Crooks, and Meghann Ormond. 2015. “Policy Implications of Medical Tourism Development in Destination Countries: Revisiting and Revising an Existing Framework by Examining the Case of Jamaica.” Globalization and Health 11(1):29. doi: 10.1186/s12992-015-0113-0.
• Kamassi, Ahmed, Noor Hazilah Abd Manaf, and Azura Omar. 2020. “The Identity and Role of Stakeholders in the Medical Tourism Industry: State of the Art.” Tourism Review 75(3):559–74. doi: 10.1108/TR-01-2019-0031.
• Knoke, D., Bohrnstedt, G.W. and Mee, A.P. 2002. "Statistics for Social Data Analysis 4th Edition." Belmont CA: Wadsworth Publishing.
• Labonté, Ronald, Valorie A. Crooks, Alejandro Cerón Valdés, Vivien Runnels, and Jeremy Snyder. 2018. “Government Roles in Regulating Medical Tourism: Evidence from Guatemala.” International Journal for Equity in Health 17:150. doi: 10.1186/s12939-018-0866-1.
• Lotero, A. T. C. 2022. “Medical Tourism Sustainable Development.” Retrieved April 5, 2024 (022, https://www.magazine.medicaltourism.com/article/medical-tourism-sustainable-development).
• Lunt, Neil, Richard D. Smith, Mark Exworthy, Stephen T. Green, Daniel Gary Horsfall, and Russell Mannion. 2011. Medical Tourism: Treatments, Markets and Health System Implications: A Scoping Review. OECD.
• Musavengane, Regis, and Danny Mulala Simatele. 2016. “Community-Based Natural Resource Management: The Role of Social Capital in Collaborative Environmental Management of Tribal Resources in KwaZulu-Natal, South Africa.” Development Southern Africa 33(6):806–21. doi: 10.1080/0376835X.2016.1231054.
• Önder, Hüseyin. 2020. “Bir Sürdürülebilir Kalkınma Hedefi Olarak Sağlık.” Akademia Doğa ve İnsan Bilimleri Dergisi 6(1):10–24.
• Pessot, Elena, Daniele Spoladore, Andrea Zangiacomi, and Marco Sacco. 2021. “Natural Resources in Health Tourism: A Systematic Literature Review.” Sustainability 13(5):2661. doi: 10.3390/su13052661.
• R Core Team. 2022. “R: A Language and Environment for Statistical Computing.”
• Rasoolimanesh, S. Mostafa, Sundari Ramakrishna, C. Michael Hall, Kourosh Esfandiar, and Siamak Seyfi. 2023. “A Systematic Scoping Review of Sustainable Tourism Indicators in Relation to the Sustainable Development Goals.” Journal of Sustainable Tourism 31(7):1497–1517. doi: 10.1080/09669582.2020.1775621.
• Ripley, B., and W. Venables. 2023. “Nnet: Feed-Forward Neural Networks and Multinomial Log-Linear Models. [R Package].”
• Roman, Michał, Monika Roman, and Monika Wojcieszak-Zbierska. 2022. “Health Tourism—Subject of Scientific Research: A Literature Review and Cluster Analysis.” International Journal of Environmental Research and Public Health 20(1):480. doi: 10.3390/ijerph20010480.
• Ross, Catherine E., and Marieke Van Willigen. 1997. “Education and the Subjective Quality of Life.” Journal of Health and Social Behavior 38(3):275–97. doi: 10.2307/2955371.
• Scheyvens, Regina, Anna Carr, Apisalome Movono, Emma Hughes, Freya Higgins-Desbiolles, and Jason Paul Mika. 2021. “Indigenous Tourism and the Sustainable Development Goals.” Annals of Tourism Research 90:103260. doi: 10.1016/j.annals.2021.103260.
• Scheyvens, Regina, and Emma Hughes. 2019. “Can Tourism Help to ‘End Poverty in All Its Forms Everywhere’? The Challenge of Tourism Addressing SDG1.” Journal of Sustainable Tourism 27(7):1061–79. doi: 10.1080/09669582.2018.1551404.
• Scheyvens, Regina, and Gabriel Laeis. 2021. “Linkages between Tourist Resorts, Local Food Production and the Sustainable Development Goals.” Tourism Geographies 23(4):787–809. doi: 10.1080/14616688.2019.1674369.
• Siakwah, Pius, Regis Musavengane, and Llewellyn Leonard. 2020. “Tourism Governance and Attainment of the Sustainable Development Goals in Africa.” Tourism Planning & Development 17(4):355–83. doi: 10.1080/21568316.2019.1600160.
• Suess, Courtney, Seyhmus Baloglu, and James A. Busser. 2018. “Perceived Impacts of Medical Tourism Development on Community Wellbeing.” Tourism Management 69:232–45. doi: 10.1016/j.tourman.2018.06.006.
• The Jamovi Project. 2023). "Jamovi." (Version 2.4) [Computer Software]. Retrieved from https://www.jamovi.org. Tsekouropoulos, Georgios, Anastasia Vasileiou, Greta Hoxha, Avraam Dimitriadis, and Ioannis Zervas. 2024. “Sustainable Approaches to Medical Tourism: Strategies for Central Macedonia/Greece.” Sustainability 16(1):121. doi: 10.3390/su16010121.
• United Nations. 2021. “The 17 Goals | Sustainable Development.” Retrieved April 5, 2024 (https://sdgs.un.org/goals.).
• United Nations-The World Commission on Environment and Development. 1987. Our Common Future-Brundland Report. A/42/427. United Nations.
• Uygun, Meltem. 2022. “An Evaluation of Turkey’s Health Tourism Policies Using a Social Network Analysis Approach.” The International Journal of Health Planning and Management 37(2):804–23. doi: 10.1002/hpm.3362.
• Vrontis, Demetris, Michael Christofi, Elisa Giacosa, and Francesca Serravalle. 2022. “Sustainable Development in Tourism: A Stakeholder Analysis of the Langhe Region.” Journal of Hospitality & Tourism Research 46(5):846–78. doi: 10.1177/1096348020982353.
• Yilmaz, Fatma KANTAŞ, Hasim Capar, and Canan Şeker. 2021. “Process Analysis of a Public Policy in Turkey: Medical Tourism.” Süleyman Demirel Üniversitesi Vizyoner Dergisi 12(30):417–33. doi: 10.21076/vizyoner.803981.