The Impact of Social Influence, Information Quality and Online Forum Features on the Credibility of Doctors and Hospitals for Medical Tourism Services

The Impact of Social Influence, Information Quality and Online Forum Features on the Credibility of Doctors and Hospitals for Medical Tourism Services

Charlie C. Chen (Department of Computer Information Systems, Walker College of Business, Appalachian State University, Boone, NC, USA), Makoto Nakayama (College of Computing and Digital Media, DePaul University, Chicago, IL, USA) and Peter Ractham (Thammasat Business School, Thammasat Universtiy, Bangkok, Thailand)
DOI: 10.4018/IJHISI.2015100102
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Medical tourism, especially cosmetic surgery to South Korea, is increasingly popular amongst Thai youths. Like many other youths around the world, they can obtain the relevant information from a variety of sources, including web discussion forums. These are the most frequently used information sources that people use to explore the feasibility of having cosmetic surgery overseas. However, it is not empirically clear how much influence these forums have on youth, or what impact social influence, the quality of information and the forum's features (e.g., doctor information, before/after surgery pictures, clinic/hospital information, surgery information and chat rooms) have on the credibility of doctors and hospitals. This study conducted a number of field experiments and collected data from 233 discussion threads on top 3 online discussion forums that were ranked by 207 business school students. The results show that the reliability of web information is critical in enhancing the credibility of both doctors and hospitals. In addition, the credibility of doctors depends on the forum that is used to find information about surgery, as well as social influence. The credibility of hospitals, on the other hand, is not influenced by the social influence of a consumer's peers. Instead, their credibility is increased by the forum's use of before/after surgery pictures, clinical information and information about doctors. Future research may investigate further how different forum features and the web media can have an impact on the credibility of doctors and hospitals.
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Medical tourism is the movement of patients across borders in the pursuit of cost-effective medical treatment and health, according to OIED (Lunt, 2011). It is fast becoming a new international business trend because of its attractiveness to tourists who need cost-effective medical services. For instance, spinal surgery costs a patient about $70,000 in the U.S., but the same procedure, plus a five-day stay in a private room, would cost only $4,700 in a reputable international hospital in Bangkok, Thailand (Smith, 2012). The greater the price difference between these care services in home and foreign country, the more likely it is that medical tourism services will thrive. Cosmetic surgery, dentistry and orthopaedics are among the most popular services proactively sought by American patients. This is a 100-billion dollar industry and there are currently about 20 million medical tourists who account for 2% of world tourism and 4% of hospital admissions in the world (Andio Freire, 2012).

Asian countries, such as India, the Philippines, South Korea and Thailand, enjoy a competitive price advantage and so are emerging as popular destinations for medical tourism (Yu and Ko, 2012). Having medical treatment in Asia can save a person up to 33% in costs, compared to the U.S. (Mun and Musa, 2012). The medical tourism industry in Asia is expected to reach $8.5 billion by 2013 (Global Information, 2012). South Korea has the highest per capita cosmetic procedures in the world in 2010 and is one of the leading destinations for cosmetic surgery from overseas (Economist Online, 2012). According to the International Society of Aesthetic Plastic Surgery (ISAPS), people from those Asian nations are also the top consumers of cosmetic surgeries in the world (ISAPS, 2011).

Apart from these cost advantages, medical tourism poses some unique challenges for consumers because of the healthcare regulatory and legal concerns across borders (Terry, 2007) that create both geographical and psychological distances between consumers and healthcare provider locations (Zhang, Seo and Lee, 2013). Given these challenges, consumers rely on information that is available on the web. In general, more than 80% of internet users are turning to online health information forums for answers to their questions before taking any concrete action (Fox, 2006).

Although online health forums are proliferating, it is uncertain whether they are an effective medium for consumers and healthcare service providers. Firstly, the identity of forum posters is often not fully disclosed. Secondly, descriptions of patient experience may not be comprehensive and can miss out some critical information. Thirdly, reviews of doctors and hospitals can be biased, as highly satisfied or dissatisfied patients post them. Fourthly, it is unclear how much social influence and other factors have an impact on the use of online discussion forums and if this affects the intention of users to adopt medical tourism services. Fifthly, medical tourists often express anxiety about receiving medical tourism services from a foreign doctor in a foreign facility. Increasingly, the impact that online discussion forums have on the credibility of doctors and hospitals may play an important role in the decision that prospective medical tourists make.

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