Behavioral Cultural Intelligence, Legal System, Cybersecurity and Cultural Heritage as Determinants of the Choice of Foreign Tourist Destinations

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The development of information technologies and transport services has significantly facilitated the organization of business and tourist trips to countries worldwide. Consumers’ decisions regarding which tourist destination to visit are determined by numerous factors. The research examine the effect of behavioral cultural intelligence, uncertainty avoidance, the legal system and safety, as well as cultural heritage on the choice of foreign tourist destinations. The empirical research was conducted using a survey method in the Republic of Serbia during 2024 on a sample of 388 respondents, whose responses were analyzed using the statistical software SmartPLS4. The results showed that uncertainty avoidance has a negative impact, while behavioral cultural intelligence, the legal system and safety, and cultural heritage have a positive impact on the choice of foreign tourist destinations, providing valuable information for marketers of multinational companies.

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  • Cite Count Icon 6
  • 10.5937/menhottur2101027z
Uticaj kulturalne inteligencije i nasleđa na izbor inostranih turističkih destinacija
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The Expansion of Turkey’s Medical Tourism Industry
  • Jun 15, 2022
  • Voices in Bioethics
  • Nefes Pirzada

Photo by Engin Yapici on Unsplash ABSTRACT Medical tourism has excellent potential and downfalls, which this paper will extensively cover. While medical tourism has great economic benefits to the host country and calls for the increase of professionalism and skill of physicians, it also influences doctors locating to private hospitals and skewing healthcare costs and access for locals. Given the many weights and balances to consider, the discussion of expanding this type of healthcare into Turkey is ethically needed. INTRODUCTION I watched from the hotel lobby as a group of men with surgically wrapped heads strolled in line behind a young woman; she was speaking to them in English with a heavy Turkish accent. Across the room was another group like this one, but the women had bandages on their noses. As a Turk, this sight was not new to me: over the years, I witnessed the number of foreigners coming to Turkey for medical procedures increase by tenfold. And, I began to see how savvy Turkish tourist companies became over time, creating enticing packages for people to tour the beautiful city of Istanbul while receiving a hair transplant procedure or rhinoplasty. While I understood why individuals would come to Turkey for their procedure ― lower prices, expert physicians, and a lovely tourist destination ― I began to question whether profiting from the health care of others was ethical. This paper examines whether it is ethical for Turkey to invest in a growing medical tourism field, which has the potential for significant economic benefits yet could threaten health inequalities between locals and foreigners. Further, it will outline why tourists choose Turkey as a medical tourism destination, the reasons to favor medical tourism, and the reasons to oppose it. Finally, the paper will conclude that Turkey should cultivate and invest in medical tourism, with suggestions for expanding the field into a thriving market. ANALYSIS By definition, a medical tourist is an individual who travels to a foreign country to experience both cultural tourism and medical treatment.[1] Global medical tourism is a $55billion industry, and the industry in Turkey is experiencing an annual growth rate of 22.6 percent.[2] In 2017, more than one million individuals traveled to Turkey for medical tourism, putting approximately ten billion dollars of foreign currency into the economy.[3] Medical tourists who traveled to Turkey received, on average, more than one procedure during their stay.[4] Due to the increasing demand for medical tourism, the Ministry of Health in Turkey emphasized the expansion of medical tourism in its strategic plan, implementing initiatives to grow the industry.[5] These initiatives include improving the quality of Turkish hospitals and receiving Joint Commission International (JCI) accreditation, which is an internationally recognized quality healthcare index.[6] There are multiple reasons why individuals choose Turkey as their destination for medical tourism. First, it is easy to travel to: individuals need only an E-visa, which they can easily receive through an online application.[7] In addition, Turkey has lower prices compared to the Western hemisphere.[8] The Turkish government incentivizes medical tourism through lucrative advertising specials. For example, Turkish Airlines offers discounted airline ticket prices of 50 percent for patients who demonstrate a patient admission document from a Turkish-certified health institution.[9] Private hospitals have opened advertising offices in the Ataturk airport as well.[10] Lastly, hotels and hotel chains collaborate with hospitals to offer lucrative tourist packages for patients.[11] While these perks and incentives draw people to Turkey, the lack of insurance coverage, high cost of treatment, and long wait times in their home countries are the most significant reasons that tourists choose Turkey as their medical destination.[12] Arab tourists previously traveled to the United States and the United Kingdom for medical treatment, but due to the implementation of strict travel sanctions after the September 11 attacks, they have had to look elsewhere.[13] For Arab tourists, the similarity of culture and religion in Turkey, a predominantly Muslim country, is also an enticing factor.[14] And, while Thailand and Singapore offer lower health care costs than Turkey, the shorter distance from the home country plays an important role in choosing Turkey as a medical destination.[15] European tourists choose Turkey for different reasons. For example, some surgeries conducted in Turkey are not available in Europe.[16] Patients from the Balkans and Central Asia prefer Turkey because of Turkey’s highly trained physicians and brand new, well-equipped hospitals compared to those in their home countries.[17] Interestingly, the low costs rank lower in importance than cultural similarity among those seeking care in Turkey.[18] The most important factor for choosing Turkey was quality: most tourists came from countries with a healthcare system marred by a lack of expertise or technological advancement.[19] One Turkish physician stated, “[Turkey] really ha[s] practices, doctors, services, hospitals and treatments that are above world standards in terms of health care.”[20] l. Ethical Permissibility of Medical Tourism in Turkey Health tourism has the potential to make a significant impact on the economic and social life of countries.[21] As a developing country, Turkey cannot afford to overlook this economic possibility.[22] The expansion of medical tourism in Turkey has allowed the country to reform its healthcare system into one that competes with health care quality in the Western hemisphere. Since 2010, there has been a significant increase in patients traveling to Turkey for health care.[23] The AK Party in Turkey pledged to promote health tourism in its campaign in 2011.[24] This inspired health care reform in 2013, with Turkey instituting a publicly funded and organized healthcare system.[25] In 2013, the Turkish government created publicly funded city hospitals. These hospitals were formed for medical tourism, meeting quality levels never-before-seen in the country.[26] In 2014, the Ministry of Health began granting accreditation to medical providers for medical tourism services and supporting translation services, patient transportation, and marketing.[27] Additionally, strategic initiatives were implemented to increase the number of Turkish medical school graduates.[28] The number of private medical schools increased from five before 2013 to 24 by the end of 2015.[29] A 50 percent tax reduction was granted to healthcare institutions that provided health care to foreigners.[30] Finally, Turkey began reforming hospital systems to obtain JCI accreditation. The growth of medical tourism in Turkey has resulted in positive reform of Turkey’s healthcare system. Turkey has over ten city hospitals in Istanbul, with qualified professionals proficient in English and other languages.[31] These hospitals are public and thus open and available for use by the general Turkish community, offering excellent quality health care to the country’s citizens. However, private hospitals have also flourished and, in some cases, have drained some of the doctors from public hospitals. With the increase in quality measures and regulatory healthcare committees, such as the Health Tourism Coordination Council (SATURK), Turkey’s healthcare system rivals the West's with highly trained professionals, competitive medical schools, and modern medical facilities.[32] Turkey has even reached the forefront of medical advancement: the World Eye Hospital is renowned for its cutting-edge ophthalmology services.[33] The investment in medical tourism has allowed Turkey to invest more in its private sector as well: the total expenditure on health as a proportion of the GDP rose from 2.4 percent in 1980 to 6.1 percent in 2008,[34] with an almost $2 billion national income from medical tourism in 2010. ll. Arguments Against the Ethical Permissibility of Medical Tourism in Turkey While public city hospitals were opened with the potential to support the Turkish medical tourism industry, private hospitals support 83 percent of the medical tourism market, and the gap between private and public hospitals has been growing yearly.[35] Private hospitals have mostly opened in urban areas, such as Istanbul, Ankara, and Antalya.[36] As a result, there has been a “brain drain,” in which members of the health workforce have left rural areas and have moved to urban cities where they can make larger profits from the medical tourism industry.[37] In addition, the use of public city hospitals has been met with concern regarding whether inequalities in health care between foreigners and Turkish citizens will arise. The Ministry of Health pays rent for the city hospitals in US dollars, exacerbating inflation in the Turkish lira currency and increasing reliance on high-paying medical tourists to support the public hospital system.[38] Due to this pressure, the prices for medical services are not consistently kept at affordable levels for Turkish citizens.[39] The head of The Private Hospitals and Health Institutions Association, Resat Bahat, stated, “Turkish citizens must receive priority for public resources. You cannot treat a Libyan or a Dutch when your own citizen is shaking at home with pneumonia. You [the public sector] can perhaps engage in medical tourism if you have excess bed capacity. But it is hard to do this [medical tourism] with the public sector.”[40] Rapid growth has also compromised patient safety and health care quality. While clinics must receive medical tourism certificates to provide treatment, fraud has risen.[41] In 2016, six out of ten hair transplant clinics were operating illegally.[42] These clinics offered hair transplants for as low as $800 when the treatment costs approximately $2000 i

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  • Cite Count Icon 2
  • 10.5902/1983465965024
LGBT+ tourists’ destination choice: relationship between psychological motivations and destination image
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  • Revista de Administração da UFSM
  • Ivanete Schneider Hahn + 3 more

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장애인 관광의 선택속성요인 및 제약속성요인이 관광행동의도에 미치는 영향
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  • Institute for Euro-African Studies
  • Ye-Jin Oh + 1 more

Tourism plays a big role in practicing one's self-realization and improving the quality of life. However, the participation of the disabled in tourism faces various difficulties compared to general tourists. Therefore, the purpose of this study is to improve and improve the quality of tourism for the disabled by exploring the selection attribute factors and constraint attribute factors of tourism for the disabled. In August 2024, a panel survey was conducted through the Ministry of Rehabilitation Hospital of the National Rehabilitation Center, and a total of 150 people with disabilities in Korea responded to the questionnaire. The answered questionnaire was classified as a valid sample and analyzed through SPSS 26.0. As a result of the analysis, first, the 'tourism destination' factor among the attributes of tourists with disabilities' selection of tourist destinations affects the intention of tourism behavior for the disabled. It was found that the convenience, activity, accessibility and attractiveness of tourist destinations, and the environmental and specificity of food and beverage businesses have an effect. Second, among the factors of tourist restriction attributes of tourists with disabilities, 'institutional constraints' and 'facility constraints' affect the intention of tourism behavior for the disabled. The lack of support systems and direct help facilities for the disabled is believed to limit visits to tourist destinations. This study identifies the factors and constraints of tourists with disabilities' choice of tourist destinations and guarantees 'tourism rights' to tourists with disabilities, who are socially disadvantaged. It is of great significance in that it suggests that the tourism rights of the disabled should be protected in the future and tourist destinations should be improved in practice.

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Rural tourism is becoming an increasingly important segment of the tourism industry in the Republic of Serbia, especially in the context of the growing interest of people in spending holidays in nature and escaping urban environments. Leisure time, as a socially and economically conditioned category, plays a key role in shaping tourist behavior and destination choice. In this regard, rural areas offer specific values and experiences that meet the need for relaxation, recreation, and engagement with tradition and an authentic way of life.The aim of this paper is to examine how tourists use their leisure time in rural areas and which factors influence their motivation to stay in such environments. Particular emphasis is placed on the potential of rural tourism to contribute to local economic development. The research was conducted in the territory of Western Serbia, using a survey method and a sample of 224 respondents. Data processing was carried out in SPSS 20.0, applying descriptive statistics.The results indicate that tourists most frequently choose activities in nature, gastronomic experiences, stays at rural households, and interactions with the local population. Motivational factors such as tranquility, fresh air, homemade food, and direct contact with nature play a dominant role in destination selection. From an economic perspective, these findings highlight the significant potential for developing small family businesses, rural households, and tourism service providers in rural areas.The paper concludes that improving the offer in line with tourist expectations and supporting the development of rural tourism can represent a significant step toward sustainable economic growth and the revitalization of rural areas in Republic of Serbia.

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Czynniki ekonomiczne warunkujące aktywność i destynacje turystyczne chicagowskiej Polonii
  • Sep 27, 2017
  • Studies of the Industrial Geography Commission of the Polish Geographical Society
  • Kamila Ziółkowska-Weiss

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Conditioning Activity and Tourist Destination of the Chicago Polonia in Light of Literature and Research
  • Mar 31, 2018
  • Folia Turistica
  • Kamila Ziółkowska-Weiss

Purpose. Presentation of activity and the choice regarding tourist destination of the Chicago Polonia. Discussing the determinants of the tourist activity in the light of literature and creating one’s own model of activity and tourist destination for the whole American population. Method. Desk research – studies of foreign and Polish literature. Empirical research concerning tourist activity and the choice of destination by the Chicago Polonia in the form of a survey questionnaire. The research group included 1,014 people divided into 7 age sub-groups. The applied methods and statistical techniques: chi2, degree of freedom (df) and level of statistical significance (alpha). Findings. In all age groups, the factors deciding about tourist activity of the respondents and the choice of tourist destination include: the price, the cost of the trip, in second place – development of tourist facilities and in the third– fashion. The largest barrier in undertaking tourist activity for the Chicago Polonia is lack of free time (37.6%), financial barrier (31.4%) and occupational work (17.4%). Individuals who form a single-person household do not travel more often than those who run multi-person households. Research limitations and conclusions. The empirical research included only American Poles living in the Great Chicago Metropolitan Area and not the whole population of American Poles. Practical implications. The research presents the level and nature of participation in tourism of the Chicago Polonia as well as characteristics of seven factors which mutually interact and influence activity and tourist destination of them. Originality. There is a large research group. Creating one’s own model of tourist activity including internal (demographic, social, cultural, economic) and external factors (geographical, political and legal , organization of tourism). Type of paper. The article presents the results of empirical research and contains a review nature of the tourist activity models known in the subject literature.

  • Research Article
  • Cite Count Icon 154
  • 10.1016/j.jbusres.2011.09.009
Self-congruence, functional congruence, and destination choice
  • Oct 26, 2011
  • Journal of Business Research
  • Taehong Ahn + 2 more

Self-congruence, functional congruence, and destination choice

  • Research Article
  • 10.35498/kotes.2023.se1.21
OTT플랫폼 성장에 따른 스크린 투어리즘(screen tourism) 활성화 방안
  • Jan 31, 2023
  • Journal of Tourism Enhancement
  • Ye-Ji Choi + 1 more

The OTT platform is distributed worldwide and allows tourists of various forms, including language and race, to reach tourist destinations. Those contribute to the success of the content leading to an interest in the filming location. This phenomenon increased the interest of foreign tourists in Korean culture and had a ripple effect on the selection of tourist destinations for Korean tourists who had slowed down due to the pandemic. In this study, four activation measures were suggested as follows through preliminary research data and case analysis, such as the growth of the OTT industry and screen tourism cases. First, developing various Korean cultural contents (K-culture) is necessary. Second, it is necessary to come up with a solution to over-tourism. Third, policies and administrative support related to the OTT platform are needed. Fourthly, the development of a Barrier-Free tourism sector is needed. Fifth, it is necessary to establish a sustainable tourism development governance system. In this study, we tried to analyze how the growth of the OTT industry affects consumers’ choice of tourist destinations and to derive implications for ways to revitalize tourist destinations exposed to the platform. With this study as an opportunity, a continuous activation plan and policy for the occurrence of screen tourism through the growth of the Korean OTT platform should be prepared.

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  • Cite Count Icon 3
  • 10.3390/su142113818
The Impact of High-Speed Rail Systems on Tourist Attractiveness in Italy: Regression Models and Numerical Results
  • Oct 25, 2022
  • Sustainability
  • Mariano Gallo + 1 more

This paper evaluates the impact of high-speed rail systems on tourist attractiveness in Italy. The analysis is carried out with reference to provincial capitals, only some of which are served by high-speed railway lines. To achieve this objective, two multiple linear regression models were specified and calibrated, which relate arrivals and presences in accommodation facilities to several factors that could influence the tourist destination: cultural, historical, and monumental heritage, commercial activities, recreational activities, accessibility, etc. Both models showed that the availability of high-speed railway services is an important factor in the choice of tourist destination, being, moreover, the only accessibility variable found to be significant; furthermore, the elasticity of tourist demand to this factor was significant too.

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