Identifying and prioritizing strategies for Iran’s medical tourism development

Document Type : Research Paper


1 Department of Tourism and Hospitality Management, Shiraz University, Shiraz, Iran

2 Department of Management, University of Isfahan, Isfahan, Iran

3 Department of Management, Shiraz University, Shiraz, Iran


Considering Iran’s potential in medical tourism and being located in one of the world's most competitive health tourism regions, the present study aims to Identify and prioritize strategies for developing medical tourism in the country. The study relied on a mixed research method. In the qualitative part, solutions for Iran’s medical tourism development were identified by interviewing activists and experts. The collected data were analyzed through the thematic analysis method. This process revealed four dimensions and 18 strategies. In the quantitative part, a  questionnaire was developed, and experts in the Iranian medical tourism industry prioritized the identified dimensions and strategies. The analysis of the data through the best-worst method clarified that, from the perspective of the practitioners, dimensions of medical tourism development in Iran were: “marketing,” “applying information and communication technologies,” “human resources development,” and “reinforcing infrastructures.”


Abadi, F., Sahebi, I., Arab, A., Alavi, A., & Karachi, H. (2018). Application of the best-worst method in the evaluation of medical tourism development strategy. Decision Science Letters, 7(1), 77-86.
Abdel-Basset, M., Mohamed, R., Zaied, A. E. N. H., Gamal, A., & Smarandache, F. (2020). Solving the supply chain problem using the best-worst method based on a novel Plithogenic model. Optimization Theory Based on Neutrosophic and Plithogenic Sets, 1-19). DOI:10.1016/B978-0-12-819670-0.00001-9
Abu Hassan, N., & Hemdi, M. A. (2016). The Influence of Destination Image on Medical Tourist’s Intention for Future Destination Choice. Environment-Behaviour  Proceedings Journal, 1(1), 178-185. DOI: 10.21834/e-bpj.v1i1.214
Abualhasani, N. (2017). Legal Features and Aspects of Medical Tourism. Bioethics and Health Law Journal, 1 (1), 35-39.
Aljumah, A. I.,  Islam, A., & Noor, I. M. (2017). Destinations of Foreign Patients Loyalty of Medical Tourism in Malaysia: Trust and Perceived Value as Moderators. Sci.Int.(Lahore), 29(3), pp. 579-587.
Alsarayreh, M. N., Mahasneh, M. S. M., & Al Nawaiseh, K. H. A. (2017). A Study of the Determinants Influencing Customer Satisfaction in the Medical Tourism Industry in Jordan. International Review of Management and Marketing, 7(3), 349-356.
Al-Talabani, H., Kilic, H., Ozturen, A., & Qasim, S. O. (2019). Advancing Medical Tourism in the United Arab Emirates: Toward a Sustainable Health Care System. Sustainability, 11 (230), 1-15. DOI: 10.3390/su11010230
Altin. U, Bektas. G, Antep. Z and Irban. A (2012). the International Patient’s Portfolio and Marketing of Turkish Health tourism. Procedia - Social and Behavioral Sciences, 58, 1004-1007.
Andreu, L., Aldás, J.,  Bigné, J. E., & Mattila, A. S. (2011). An analysis of e-business adoption and its impact on relational quality in travel agency–supplier relationships. Tourism Management, 31 (6), 777-787.
Aniza, I., Aidalina, M., Nirmalini, R., Inggit, M., & Ajeng, T. (2009). Health tourism in Malaysia: the strength and weaknesses. Journal of Community Health, 15(1), 7-15.
Arabshahi Karizi, A., & Aryianfar, M. (2013). Health tourism and medical-therapeutic tourism in Iran. Tourism Space, 3(9), 133-152.  
Arief, M., Hamsal, M., & Abdinagoro, S. B. (2022). A decade of medical tourism research: Looking back to moving forward. Journal of Hospitality and Tourism Insights (ahead-of-print).
Asadi, R., & Daryaei, M. (2011). Strategies for Development of Iran Health Tourism. European Journal of Social Sciences, 23 (3), 329-344.
Aydin, G., & Karamehmet, B. (2017). Factors affecting health tourism and international healthcare facility choice. International Journal of Pharmaceutical and Healthcare Marketing, 11 (1), 16-36. DOI: 10.1108/IJPHM-05-2015-0018
Bagheri, M., Mobasheri, A. A., & Nikbakht, A. (2021). Identify and prioritize strategies for promoting tourism and hospitality businesses in post-COVID-19. Journal of Tourism Planning and Development, 10(36), 103-127.
Bajpai, A., & Lee, C.W. (2015). Consumer behavior in E-tourism services: A case of Taiwan. Tourism and Hospitality Management, 21(1), 1-17. DOI: 10.20867/thm.21.1.1
Baum, T (2016). Human resource issues in international tourism. Elsevier.
Baum, T., & Kokkranikal, J. (2003). Human Resource Development for Competitiveness and Sustainability: a Case Study of Indian Tourism. in kusluvan. S (Eds), Managing Employee Attitudes and Behaviors in Tourism and Hospitality Industry, New York, Nova Science Publishers, Inc. DOI: 10.1002/1522-1970(200011/12)2:63.0.CO;2-3.
Benur, A., &  Bramwell, B. (2015). Tourism product development and product diversification in destinations. Tourism Management, 50,  213-224. DOI: 10.1016/j.tourman.2015.02.005
Bramwell. B (2004). Mass tourism, diversification and sustainability in Southern Europe's coastal regions. In B. Bramwell (Ed.), Coastal mass tourism, Diversification and sustainable development in southern Europe (pp. 1-31). Clevedon: Channel View Publications.
Bramwell, B. (1998). User satisfaction and product development in urban tourism. Tourism Management, 19 (1), 35-47. DOI: 10.1016/S0261-5177(97)00091-5
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), pp. 77-101.
Connell, J. (2006). Medical tourism: sea, sun, sand and… surgery. Tourism Management, 27(6), 1093-1100.
Braun, V., & Clarke, V. (2012). Thematic analysis. In Cooper. H, Camic. P. M, Long. D. L, Panter. A. T, Rindskopf. D and Sher. K. J (Eds), APA handbook of research methods in psychology, Vol. 2: Research designs: Quantitative, qualitative, neuropsychological, and biological, pp. 57-71, Washington, DC: American Psychological Association.
Campra, M., Riva, P., Oricchio, G., & Brescia, V. (2022). Bibliometrics analysis of medical tourism. Health Services Management Research, 35(3), 172-188.
Carrera, P., & Bridges, J. (2006). Globalization and healthcare: Understanding health and medical tourism. Expert Review of Pharmacoeconomics & Outcomes Research, 6(4), 447–454. DOI: 10.1586/14737167.6.4.447
Cheng, Y., Fang, S., & Yin, J. (2022). The effects of community safety support on COVID‐19 event strength perception, risk perception, and health tourism intention: The moderating role of risk communication. Managerial and Decision Economics, 43(2), 496-509.‏
Chesser. J. W (2016). Human Resource management in a Hospitality Environment, Apple Academic Press, Inc.
Chomvilailuk, R., & Srisomyong, N. (2015). Three Dimensional Perceptions of Medical/Health Travelers and Destination Brand Choices: Cases of Thailand. Procedia - Social and Behavioral Sciences, 175, pp. 376-383. DOI: 10.1016/j.sbspro.2015.01.1213
Connell, J. (2013). Contemporary medical tourism: Conceptualization, culture and commodification. Tourism Management, 34, pp. 1-13.
Cui, F., Lin, D., & Huang, Y. (2015, March). The impact of perceived security on consumer e-loyalty: A study of online tourism purchasing. In 2015 IEEE First International Conference on Big Data Computing Service and Applications, pp. 314-322
Doshmangir, L., Doshmangir, P., Sajadi, H. S., Alizadeh, G. (2018). Analyzing Health Tourism Status in Iran. Depiction of Health, 9(2), 73-80. (in Persian).
Duman. T (2012). The value of Islamic tourism: Perspectives from the Turkish experience. Islam and Civilisational Renewal (ICR), 3(4), 718–739.
Ezeani, J. E. (2015). Strategies for development: The role of planning in tourism. Retrieved on        April 2, 2015, from
Farmaki. A (2012). A supply-side evaluation of coastal tourism diversification: the case of Cyprus. Tourism Planning and Development, 9(2), 183-203.
Fetscherin, M., & Stephano, R. M. (2016). The medical tourism index: Scale development and validation. Tourism Management, 52, 539-556.
Gan, L. L., & Frederick, J. R. (2011). Medical tourism facilitators: Patterns of service differentiation. Journal of Vacation Marketing, 17 (3), 165–183. DOI: org/10.1177/1356766711409181
Gardiner, S., & Scott, N. (2018). Destination Innovation Matrix: A framework for new tourism experience and market development. Journal of Destination Marketing & Management, 10, 122–131. DOI: 10.1016/j.jdmm.2018.07.002
Gholipour Sooteh, R., Amiri, M., Zarghami Boroojeni, H., & Kiani Feizabadi, Z. (2018). Exploring the barriers to medical tourism in Iran with a focus on policy-making requirements. Tourism and Development Quarterly, 7(4), 38-60. [In Persian]
Guha Roy, D., Bhattacharya, S., & Mukherjee, S. (2022). Medical tourism brand equity in emerging markets: scale development and empirical validation. International Journal of Emerging Markets, Emerald Publishing Limited (ahead-of-print).
Guo, S., & Zhao, H. (2017). Fuzzy best-worst multi-criteria decision-making method and its applications. Knowledge-Based Systems, 121, 23-31. DOI: 10.1016/j.knosys.2017.01.010
Hall. C. M (1998). Introduction to Tourism: Development, Dimensions and Issues. South Melbourne, Australia: Addison Wesley Longman Limited.
Hall, C. M. (2011). Health and medical tourism: a kill or cure for global public health?. Tourism Review, 16 (1), 4-15. DOI: 10.1108/16605371111127198
Hamidizadeh, M., Javidi, H., & Mojarad, F. (2016). Competitive advantage in the Iranian medical tourism marketing: A case study of open-heart surgery and cataract surgery. Health Information Management, 13(5), 373-379. [In Persian]
Han, H. (2013). The healthcare hotel: Distinctive attributes for international medical travelers. Tourism Management, 36, 257-268.
Haque, A., Yasmin, F., & Anwar, N. (2018). Factors Determinant of Patients’ Satisfaction towards Health Tourism in Malaysia. International Tourism and Hospitality Journal, 1 (1), 1-18.
Harahsheh, S. S. (2002). Curative Tourism in Jordan and its Potential Development, Thesis for the fulfillment of MA in European Tourism Management (ETM), Bournemouth University, United Kingdom.
Harrison, J., Galland, D., & Tewdwr-Jones, M. (2021). Regional planning is dead: Long live planning regional futures. Regional Studies, 55(1), 6-18.
Henderson. J. C (2016). Halal food, certification and halal tourism: Insights from Malaysia and Singapore. Tourism Management Perspectives, 19, 160–164.
Heung, V. C. S., Kucukusta, D., & Song, H. (2011). Medical tourism development in Hong Kong: An assessment of the barriers. Tourism Management, 32, 995- 1005. DOI: 10.1016/j.tourman.2010.08.012
Hikkerova,  L. (2010). E-tourism: players and customer behavior.  Problems and Perspectives in Management, 8, 45-51.
Ho, C. I., & Lee, Y. L. (2007). The development of an e-travel service quality scale. Tourism Management, 26, 1434-1449.
IHRC (2020). Medical tourism index 2020-2021 global destination. Available at:–2021 Medical TourismIndex Overall Ranking.pdf (accessed 1 July 2021).
Illario, M., De Luca, V., Leonardini, L., Kucharczyk, M., Parent, A. S., Dantas, C., ... & Bramezza, C. (2019). Health tourism: an opportunity for sustainable development. Translational Medicine@ UniSa, 19, 109.
Io, M. U., and Hallo, L. (2012). A comparative study of tour guides’ interpretation: The case of Macao. Tourism Analysis, 17,153-167. DOI: 10.3727/108354212X13388995267788
Ismail, N, Masron, T., & Ahmad, A. (2014). Cultural Heritage Tourism in Malaysia: Issues and Challenges. SHS Web of Conferences 12, 010 59, 2- 8. DOI: 10.1051/shsconf/20141201059
Istar, E. (2016). health tourism in Turkey: a Study on Newspapers. International Journal of Health Management and Strategies Research, 1 (3), 26- 35.
Jallad, A. (2000). Environment and Curative Tourism, Alam Al Kutub, 1st edition, Cairo, Egypt.
Janusz. G. K and Bajdor. P (2013). Towards to Sustainable Tourism Framework, Activities and Dimensions. Procedia Economics and Finance, 6, 523 – 529.
Jiang, L., Wu, H., & Song, Y. (2022). Diversified demand for health tourism matters: From a perspective of the intra-industry trade. Social Science & Medicine, 293, 114630.‏
Johnston, R., Crooks, V. A., & Ormond, M. (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), 1-13.
Kim, S., Arcodia, C., & Kim, I. (2019). Critical Success Factors of Medical Tourism: The Case of South Korea. International Journal of Environmental Research and Public Health, 16 (4964), 1-15.
Kumar, J., & Hussian, K. (2016). Factors affecting medical tourism destination selection: A Malaysian perspective. International Interdisciplinary Business-Economics Advancement Journal, 1(1), 1-10. DOI: 10.5038/2640-6489.1.1.1000
Lee, M., Han, H., & Lockyer, T. (2012). Medical Tourism—Attracting Japanese Tourists For Medical Tourism Experience. Journal of Travel & Tourism Marketing, 29 (1),  69-86.
Lončarić, D., Lončarić, D., & Markovic, S., (2015). Health Tourism, Customer Satisfaction and Quality of Life: The Role of Specialty Hospitals. 3rd International Scientific Conference Tourism in Southern and Eastern Europe 2015: Sustainable Tourism, Economic Development and Quality of Life,  Opatija.
Maguire, M., & Delahunt, B. (2017). Doing a Thematic Analysis: A Practical, Step-by-Step Guide for Learning and Teaching Scholars. The All Ireland Journal of Teaching and Learning in Higher Education (AISHE-J), 8 (3), pp. 3351-33514.
Mahdavi, Y., Mardani, Sh., Hashemidehaghi, Z., & Mardani, N. (2013). The Factors in Development of Health Tourism in Iran. International Journal of Travel Medicine and Global Health, 1 (3), 113-118.
Mahmoudifar, Y., Tabibi, S., Nasiripour, A. A., & Riahi, L. (2016). Factors Affecting Development of Medical Tourism Industry in West Azerbaijan Province of Iran. International Journal of Health Studies, 2 (4), 25-31.
Mason, P. (2003). Tourism Impacts, Planning and Management. Butterworth-Heinemann, An imprint of Elsevier.
Medical Association of Iran. (2020). The number of general practitioners, specialists and sub-specialists. /fa/temp.php? page=15&id=175&type=1.  [In Persian]
Moraru. A. D (2011). development  and  diversification of services- an approach at  tourism  services  level in Romanian. Annales Universitatis Apulensis Series Oeconomica, 13 (1), 127-133.
Najafi Nasab. M, Agheli. L, Andrade. M. V, Sadeghi. H, Faraji Dizaji. S (2018). Determinants of Medical Tourism Expansion in Iran: Structural Equation Modeling Approach, Iranian Journal of Economic Studies, 7 (2), 169-189.
Nikraftar, T., Hosseini, E., & Moghadam, A. (2016). Identifying policy-making requirements in medical tourism in Iran. Public Policy-Making Quality, 2(2), 141-156. [In Persian]
Noori, G., Taghizadeh, Z., & Shirani, Z. (2012). Exploring the role of Iran in therapeutic tourism in the Islam world with a focus on nature therapy: Functions, challenges, strategies. Tourism Space, 1(3), 1-19. [In Persian]
Peršić, M., Živadinov, I. P., & Vlašić, D. (2018). Health tourism development research framework at the destination level. Tourism & Hospitality Industry, Congress Proceedings, 320-345.
Pessot, E., Spoladore, D., Zangiacomi, A., & Sacco, M. (2021). Natural resources in health tourism: A systematic literature review. Sustainability, 13(5), 2661.‏
Rahman, M. K. (2019). Medical tourism: tourists’ perceived services and satisfaction lessons from Malaysian hospitals. Tourism Review, 74 (3), 739-758.
Rajabi, M., & Shiri Tarzam, A. (2009). Salt tectonics and its geomorphic impacts in Azerbaijan Province, Iran: A case study of salt domes in the north-west of Tabriz. Geography and Development, 7(16), 47-70.
Ridderstaat, J., Singh, D., & DeMicco, F. (2019). The impact of major tourist markets on health tourism spending in the United States. Journal of Destination Marketing & Management, 11, 270-280. DOI: 10.1016/j.jdmm.2018.05.003
Sakhdari, K., Seyedamiri, N., Rejaeain, A., & Sakhdari, J. (2019). Identifying institutional factors affecting using entrepreneurship opportunities in the Iranian health tourism: A case study of Tehran province. Tourism Social Studies Bi, 7(13), 81-100. [In Persian]
Saarinen. J; Rogerson. C. M and Hall. C. M (2018). Tourism Planning and Development, Contemporary Cases and Emerging Issues. Routledge.
Savasan, A.,  Yalvac, M., &  Tuncel., E. (2017). Statistical reasoning for developing an attitude scale for health tourism stakeholders in North Cyprus context. Procedia Computer Science, 120, 196-203. DOI: 10.1016/j.procs.2017.11.229
Scheyvens. R (2011). The challenge of sustainable tourism development in the Maldives: Understanding the social and political dimensions of sustainability. Asia Pacific Viewpoint, 52 (2), 148–164.
Statistical Centre of Iran. (2020). Statistical data and information: Health and treatment. Available at [In Persian]
Suess, C., Baloglu, S., & Busser, J. A. (2018). Perceived impacts of medical tourism development on community wellbeing. Tourism Management, 69, 232-245.
Taghavifard, M., & Asadian-Ardakani, F. (2016). Proposing an electronic tourism model through interpretive-structural modelling. Tourism Management Quarterly, 33, 19-39. [In Persian]
Taş, M. A., & Çakir, E. (2022). A Hybrid Fuzzy MCDM Approach for Sustainable Health Tourism Sites Evaluation. In Handbook of Research on Advances and Applications of Fuzzy Sets and Logic (pp. 77-104). IGI Global.‏
Tavakoli, N., & Mohammadian, S. (2016). Investigating and prioritizing the factors affecting health tourism absorption. Scientific Journal of IRI Medical Council, 34(1), 69-76. [In Persian]
The International Union for Official Tourism Organization (IUOTO) (1973). IUOTO Publications, Geneva, Switzerland.
Uygun, M. (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), 804-823.‏
Vaezi, R., Chegin M., & Aslipour, H. (2018). Challenges of policy-making in the field of Iranian health tourism based on the thematic analysis method. Tourism Studies Quarterly, 13 (41), 1-40. [In Persian]
Weiler, B., & Ham, S. H. (2002). Tour guide training: A model for sustainable capacity building in developing countries. Journal of Sustainable Tourism, 10(1), 52–69.
 Yousaf, S., & Xiuchen, F. (2018). Halal culinary and tourism marketing strategies on government websites: A preliminary analysis. Tourism Management, 68, 423–443. DOI: 10.1016/j.tourman.2018.04.006
Zargaran, A., Daneshamooz, S., & Mohagheghzadeh, A. (2011). Medical sciences education in ancient Persian. Education in Medical Sciences, 11(2), 103-110. [In Persian]
 Zhang, W., Qin, Z., & Tang, J. (2022). Economic benefit analysis of medical tourism industry based on markov model. Journal of Mathematics,1-9.
Zarei, A., & Maleki, F. (2019). Asian medical marketing, a review of factors affecting Asian medical tourism development. Journal of quality assurance in hospitality & tourism, 20(1), 1-15.
Zhong, L., Deng, B., & Sun, S. (2020). China’s Health Tourism and Marketing. Research Square, Available at: