Tourism represents one of the most important industries in the global economy. Medical tourism is not a new phenomenon: mankind has traveled to foreign lands to access treatment for many years. Current research in information and communication technology considerably affects the tourism industry by providing innovative tools capable, on the one hand, of supporting tourists in organizing their holidays and, on the other, of supplying fast and efficient information on tourist destination. Published literature shows that many aspects of medical tourists' behavior are under-researched. One of these aspects is the impact of social media on tourists' behavior for the choice of tourist medical destination, which is the original focus of this research. This paper explores how a social network can become a strategic platform using eWOM (electronic Word of Mouth) as a tool for disseminating fast and detailed information for the choice of medical tourist destination. A survey instrument was used to collect information from Italian active users of a social network: Facebook. Data was solicited from 960 active, experienced users. The findings support the development of medical tourism communication strategies focused on the online contexts as factors capable of influencing medical tourists' behavior in a more efficient way. Implications and future research directions are discussed.
Top1. Introduction
Tourism is an important area of economic activity in both developing and developed countries. The increasing competition among tourist destinations forces the industry to define new strategies in order to improve the competitive position of each area, thus attracting more tourism flows and enhancing economic advantages (Strielkowski et al., 2012).
The complexity of the tourist market, the supply-type diversity, and the evolution of tourist buying behavior require competitive strategies in distribution and the search for constant differentiation. This key aspect of supply differentiation has been extensively analyzed by the literature on destination management (Dwyer, Forsyth & Rao, 2000; Dwyer et al., 2009; Ritchie & Crouch, 2000; Enright & Newton, 2004; Cracolici & Nijkamp, 2008; Marrocu & Paci, 2013).
Medical tourism (med-tour) is not a new phenomenon: mankind has traveled to foreign lands to access treatment for many years (Richard, Melisa, & Rupa, 2011; Abubakar & Ilkan, 2016). However, traveling from developed to developing countries to access medical services at a lower cost is a new trend (Johnson, Youngquist, Garman, Hohmann, & Cieslak, 2015; Misung, Heesup, & Tim, 2012). This has developed into a new niche market, the med-tour market, offering an optimal opportunity for the tourism industry to diversify its services. Med-tour is the process of combining products and services from the medical industry and the tourism industry together, i.e. healthcare and vacations (Lee, 2009; Misung et al., 2012). Further, World Report (2010) reported that med-tour is growing fast in emerging markets such as India, Turkey (Anadolu Agency, 2015) primarily due to a high level of healthcare infrastructure, skilled medical personnel, and lower prices compared to other med-tour destinations (Katz, 2015; Mishra & Shailesh, 2012).
Current research in information and communication technology (ICT) considerably affects the tourism sector by providing innovative tools capable, on the one hand, of supporting tourists in organizing their holidays and, on the other, of supplying fast and efficient information on tourist destination (Di Pietro et al., 2012, 2013; Di Virgilio & Di Pietro, 2014; Cracolici & Nijkamp, 2008; Marrocu & Paci, 2013; Pan & Zhang, 2011; Yoo & Gretzel, 2011).
Since the development of special characteristics of the web in terms of ease of knowledge sharing and fast messaging, web-based technologies are giving new meaning to word of mouth modalities: e-word-of-mouth communication (eWOM). It includes informal communication directed at consumers through Internet-based technology related to the usage or characteristics of particular goods and services and/or their sellers (Litvin et al., 2008; Di Pietro et al., 2012, 2013).
eWOM is capable of influencing a destination’s image by providing positive or negative comments related to tourists’ experiences. Subsequently, positive online suggestions/comments/reviews are capable of improving tourists’ perceptions of the travel product among potential users, thus online suggestions/comments provided by other users have a significant effect on the online sales of tourism products (Litvin et al., 2008; Ye et al., 2011).