본문 바로가기
KERD
논문KCI 등재

중국고객 해외의료관광국가 선택의도에 영향을 미치는 요인에 관한 연구: 구전 조절효과를 중심으로

Factors Influencing Chinese Customers’ Selection of Health Care Service Countries: Focusing on Word-of-Mouth Moderating Effects

이훈영|ZHANGJUN
한국유통과학회 (Korea Distribution Science Association)|2015.12|유통과학연구 (Journal of Distribution Science)|제13권 제12호|pp. 41-52|DOI 10.15722/jds.13.12.201512.41

0

조회

0

다운로드

9

인용

0

참고문헌

키워드

Word-of-MouthChoice IntentionMedical CharacteristicsTravel Attractiveness

초록

Purpose – Given globalization, the new niche market of medical tourism is likely to experience sustainable growth for various reasons, such as aging populations and a shift in the medical consumerism paradigm toward prevention. Importantly, understanding medical customers’ behavior is necessary to benefit from a competitive advantage in this industry. The existing research primarily accessed the key factors of medical quality and costs to explain health customers’ behavior but is limited in terms of enabling an understanding of the decision process. This limitation exists because, given the intangibility and greater associated risks in the highly professional industry of international medical tourism, most customers lack the knowledge and experience needed to evaluate the central factors—such as the medical competence of health care countries—before purchases. Therefore, they actively search for useful information through various distributions to reduce uncertainty and to make better choices. Interestingly, most of these information channels are associated with word-of-mouth (WOM). However, no evidence is found in the literature to estimate the effect of WOM in the medical tourism field. Thus, this study focuses on WOM to explore its interaction with key medical characteristic factors and the attractiveness of destinations referred to by sources. This study also affects customers’ evaluations and, in turn, influences their intention to seek health care services abroad. Research design, data, and methodology – The literature review addressed an interesting research model for estimating therelations among WOM, medical characteristics, attractiveness, and customers’ choice intention regarding international health care. In the key economic regions in China, such as Beijing, Shanghai, Jiangsu, Shandong, and Guangdong, 2,500 survey questionnaires were distributed to potential customers of different ages, education, and income levels. A resulting 1,717 (68.68 percent of the original 2,500) usable surveys were obtained for analysis. Moderated regression analysis was used to determine the effects of WOM in the decision process regarding international health care destinations. Results – The results indicate that WOM is a good moderator of the relationships between the factors evaluated by sources and customers. More importantly, the WOM effects reflect the factors of tie strength, credibility, and vividness. The results also reveal that, given the moderating role of WOM, the intention of potential Chinese customers to seek the referred health care country varies according to the medical characteristics of medical competency and reputation as evaluated by customers. In contrast, the travel attractiveness of the attractions, facilities, accessibility, and social environment are critical determinants of destination choice intention. Conclusions – The moderating role of WOM has been confirmed through the international healthcare destination selection process. Medical tourism managers should user WOM as an effective marketing tool for industry development. Specially, marketers should consider the effects of WOM determinants, such as tie strength, credibility, and vividness, to develop an effective strategy. Furthermore, this study estimates the factors that affect customers’ selection of medical tourism destinations. Health care managers or policy makers should consider a broad variety of variables that may attract more Chinese customers to international health care.

Abstract

Purpose – Given globalization, the new niche market of medical tourism is likely to experience sustainable growth for various reasons, such as aging populations and a shift in the medical consumerism paradigm toward prevention. Importantly, understanding medical customers’ behavior is necessary to benefit from a competitive advantage in this industry. The existing research primarily accessed the key factors of medical quality and costs to explain health customers’ behavior but is limited in terms of enabling an understanding of the decision process. This limitation exists because, given the intangibility and greater associated risks in the highly professional industry of international medical tourism, most customers lack the knowledge and experience needed to evaluate the central factors—such as the medical competence of health care countries—before purchases. Therefore, they actively search for useful information through various distributions to reduce uncertainty and to make better choices. Interestingly, most of these information channels are associated with word-of-mouth (WOM). However, no evidence is found in the literature to estimate the effect of WOM in the medical tourism field. Thus, this study focuses on WOM to explore its interaction with key medical characteristic factors and the attractiveness of destinations referred to by sources. This study also affects customers’ evaluations and, in turn, influences their intention to seek health care services abroad. Research design, data, and methodology – The literature review addressed an interesting research model for estimating therelations among WOM, medical characteristics, attractiveness, and customers’ choice intention regarding international health care. In the key economic regions in China, such as Beijing, Shanghai, Jiangsu, Shandong, and Guangdong, 2,500 survey questionnaires were distributed to potential customers of different ages, education, and income levels. A resulting 1,717 (68.68 percent of the original 2,500) usable surveys were obtained for analysis. Moderated regression analysis was used to determine the effects of WOM in the decision process regarding international health care destinations. Results – The results indicate that WOM is a good moderator of the relationships between the factors evaluated by sources and customers. More importantly, the WOM effects reflect the factors of tie strength, credibility, and vividness. The results also reveal that, given the moderating role of WOM, the intention of potential Chinese customers to seek the referred health care country varies according to the medical characteristics of medical competency and reputation as evaluated by customers. In contrast, the travel attractiveness of the attractions, facilities, accessibility, and social environment are critical determinants of destination choice intention. Conclusions – The moderating role of WOM has been confirmed through the international healthcare destination selection process. Medical tourism managers should user WOM as an effective marketing tool for industry development. Specially, marketers should consider the effects of WOM determinants, such as tie strength, credibility, and vividness, to develop an effective strategy. Furthermore, this study estimates the factors that affect customers’ selection of medical tourism destinations. Health care managers or policy makers should consider a broad variety of variables that may attract more Chinese customers to international health care.

참고문헌 (93)

  1. Adams, E. K., "Hospital choice of medicare beneficiaries in a rural market: Why not the closest?", Journal of Rural Health, 7(2), pp.134~152 (1991)
  2. Argan, M., "Word-of-Mouth(WOM)as a tool of health communication : A case study of Turkey", Journal of Society for Development in New Net Environment in B & H, 6(1), pp.216~221 (2012)
  3. Arndt, J., "Role of product-related conversations in the diffusion of a new product", Journal of Marketing Research, 4(3), pp.291~295 (1967)
  4. Aronson, E., "Communication credibility and communication discrepancy as determinants of opinion change", Journal of Abnormal and Social Psychology, 67(1), pp.31~36 (1963)
  5. Bansal, H. S., "Word-of-Mouth process within a services purchase decision context", Journal of Service Research, 3(2), pp.166~177 (2000)
  6. Berry, W. D., "Multiple Regression in Practice" (1985), Sage
  7. Bies, W., "Medical tourism: Outsourcing surgery", Mathematical and computer modelling, 46(7), pp.1144~1159 (2007)
  8. Bone, P. F., "Word-of-mouth effects on short-term and long-term product judgments", Journal of Business Research, 32(3), pp.213~223 (1995)
  9. Boulding, W., "A dynamic process model of service quality : From expectations to behavioral intentions", Journal of Marketing Research, 30(1), pp.7~27 (1993)
  10. Brown, J. J., "Social ties and word-of-mouth referral behavior", Journal of Consumer Research, 14(3), pp.350~362 (1987)
  11. Burkett, L., "Medical tourism", Journal of Legal Medicine, 28(2), pp.223~245 (2007)
  12. Buttle, F. A., "Word-of-mouth : Understanding and managing referral marketing", Journal of Strategic Marketing, 6(3), pp.241~254 (1998)
  13. "Medical tourism and its entrepreneurial opportunities: A conceptual framework for entry into the industry" (2007)[URL]
  14. Carrera, P. M., "Globalization and healthcare : Understanding health and medical tourism", Expert Review of Pharmacoeconomics and Outcomes Research, 6(4), pp.447~454 (2006)
  15. Cheung, M. Y., "Credibility of electronic word-of-mouth : Informational and normative determinants of on-line consumer recommendations", International Journal of Electronic Commerce, 13(4), pp.9~38 (2009)
  16. Choi, K. -S., "The relationships among quality, value, satisfaction and behavioral intention in health care provider choice : A South Korea study", Journal of Business Research, 57(8), pp.913~921 (2004)
  17. "China Tourism Market Report" (2011)[URL]
  18. Connell, J., "Medical tourism : sea, sun, sand. . . surgery", Tourism Management, 27(6), pp.1093~1100 (2006)
  19. Connell, J., "Contemporary medical tourism : Conceptualisation, culture and commodification", Tourism Management, 34, pp.1~13 (2013)
  20. Duhan, D. F., "Influences on consumer use of word-of-mouth recommendation sources", Journal of the Academy of Marketing Science, 25(4), pp.283~295 (1997)
  21. Feldman, S. P., "The effect of person influence in the selection of consumer services", proceedings of the Fall conference of the American Marketing Association, pp.440~452 (1965), American Marketing Association
  22. Fishbein, M., "Predicting and Changing Behavior: The Reasoned Action Approach" (2010), Psychology Press
  23. Frenzen, J. K., "Purchasing behavior in embedded markets", Journal of Consumer Research, 17(1), pp.1~12 (1990)
  24. Gartner, W. C., "Tourism destination brand equity dimensions : Renewal versus repeat market", Journal of Travel Research, 50(5), pp.471~481 (2011)
  25. Gearing, C. E., "Establishing a measure of touristic attractiveness", Journal of Travel Research, 12(4), pp.1~8 (1974)
  26. Gilly, M. C., "A dyadic study of interpersonal information search", Journal of the Academy of Marketing Science, 26(2), pp.83~100 (1998)
  27. Godes, D., "Using online conversations to study word-of-mouth communication", Marketing Science, 23(4), pp.545~560 (2004)
  28. Gooding, S. K. S., "Quality, sacrifice, and value in hospital choice : A comparative study of rural and suburban consumer perspectives", Journal of Hospital Marketing, 13(2), pp.23~42 (2000)
  29. Goodrich, J. N., "Socialist Cuba : A study of health tourism", Journal of Travel Research, 32(1), pp.36~41 (1993)
  30. Grönroos, C., "A service quality model and its marketing implication", European Journal of Marketing, 18(4), pp.36~44 (1984)
  31. Hair, J. F. Jr., "Multivariate data analysis" (2006), Pearson Education
  32. Haywood, K. M., "Managing word of mouth communications", Journal of Service Marketing, 3(2), pp.55~67 (1989)
  33. "Chinese outbound trips quintupled in ten years with more attention on quality"[URL]
  34. Henning-Thurau, T., "Electronic word-of-mouth via consumer-opinion platforms: What motivates consumers to articulate themselves on the internet?", Journal of Interactive Marketing, 18(1), pp.38~52 (2004)
  35. Herbig, P., "The relationship of reputation and credibility to brand success", Journal of Consumer Marketing, 12(4), pp.5~10 (1995)
  36. Herr, P. M., "Effects of word-of-mouth and product-attribute information on persuasion : An accessibility-diagnosticity perspective", Journal of Consumer Research, 17(4), pp.454~462 (1991)
  37. Medical tourism: global competition in health care, "Herrick, D. M.", National Center for Policy Analysis, ~ (2007)
  38. Heung, V. C. S., "Medical tourism development in Hong Kong : An assessment of the barriers", Tourism Management, 32(5), pp.995~1005 (2011)
  39. Hu, Y., "Measuring destination attractiveness : A contextual approach", Journal of Travel Research, 32(2), pp.25~34 (1993)
  40. Hunter, W. C., "Medical tourism : A new global niche", International Journal of Tourism Sciences, 7(1), pp.129~140 (2007)
  41. Ainur Jambul, "Development of Quality Management in the Republic of Kazakhstan", The East Asian Journal of Business Management, 5(2), pp.23~29 (2015), 한국유통과학회
  42. Jin, X., "Impact of clusters on exhibition destination attractiveness : Evidence from Mainland China", Tourism Management, 33(6), pp.1429~1439 (2012)
  43. Brown, J. J., "Social ties and word-of-mouth referral behavior", Journal of Consumer Research, 14(3), pp.350~362 (1987)
  44. Yong-Min Kim, "Effects of SNS Characteristics upon Consumers’ Awareness, Purchase Intention, and Recommendation", 산경연구논집, 5(1), pp.27~37 (2014), 한국유통과학회
  45. Kisielius, J., "Examining the vividness controversy : An availability : Valence interpretation", Journal of Consumer Research, 12(4), pp.418~431 (1986)
  46. "The review of medical tourism in Korea in 2012" (2012)[URL]
  47. Kozak, M., "Benchmarking : Destination attractiveness and small hospitality business performance", International Journal of Contemporary Hospitality Management, 10(5), pp.184~188 (1998)
  48. LaBarbera, P. A., "A longitudinal assessment of consumer satisfaction", dissatisfaction : The dynamic aspect of the cognitive process, 1983, pp.20(4), 393~404
  49. Lai, C., "Chinese outbound tourists’perceived constraints to visiting the United States", Tourism Management, 37, pp.136~146 (2013)
  50. Lane, P. M., "Hospital choice: A summary of the key empirical and hypothetical findings of the 1980s", Journal of Health Care Marketing, 8(4), pp.5~20 (1988)
  51. Litvin, S. W., "Electronic word-of-mouth in hospitality and tourism management", Tourism Management, 29(3), pp.458~468 (2008)
  52. MacReady, N., "Developing countries court medical tourists", The Lancet, 369(9576), pp.1849~1850 (2007)
  53. Mangold, W. G., "Word-of-mouth communication in the service marketplace", The Journal of Service Marketing, 13(1), pp.73~89 (1999)
  54. Mayo, E. J., "Regional images and regional travel behavior;Research for changing travel patterns: Interpretation and Utilization", Proceedings of the Travel Research Association Fourth Annual Conference, pp.211~218 (1973), University of Utah
  56. McAlexander, J. H., "Service quality measurement : Examination of dental practices sheds more light on the relationship between service quality, satisfaction, and purchase intentions in a health care setting", Journal of Health Care Marketing, 14(3), pp.34~40 (1994)
  57. Middleton, V. T. C., "Marketing in travel and tourism" (1988), Heinemann
  58. Middleton, V. T. C., "Sustainable tourism : A marketing perspective" (1998), Butterworth-Heinemann
  59. W. G. Mangold, "Word-of-mouth communication in the service marketplace", Journal of Service Marketing, 13(1), pp.73~89 (1999)
  60. Gibert A. Churchill, Jr., "A paradigm for developing better measures of marketing constructs", Journal of Marketing Research, XVI, pp.64~73 (1979)
  61. "Top 10 international markets: 2012 visitation and spending" (2012)[URL]
  62. Parasuraman, A., "A conceptual model of service quality and its implications for future research", Journal of Marketing, 49(4), pp.41~50 (1985)
  63. Parasuraman, A., "SERVQUAL : A multiple item scale for measuring consumer perceptions of service quality", Journal of Retailing, 64(1), pp.12~37 (1988)
  64. Parasuraman, A., "Alternative scales for measuring service quality : A comparative assessment based on psychometric and diagnostic criteria", Journal of Retailing, 70(3), pp.201~230 (1994)
  65. Rajasekhara Mouly Potluri, "Interactive Quality in Ethiopian Telecom’s Service Encounters: A Dyadic Perspective", 산경연구논집, 6(1), pp.27~35 (2015), 한국유통과학회
  66. Price, L. L., "Preference heterogeneity and coorientation as determinants of perceived information influence", Journal of Business Research, 19(3), pp.227~242 (1989)
  67. Ritchie, J. R. B., "Culture as determinant of the attractiveness of a tourism region", Annals of Tourism Research, 5(2), pp.252~267 (1978)
  68. Ryu, G., "Word-of-mouth transmission in setting with multiple opinions : The impact of other opinions on WOM likelihood and valence", Journal of Consumer Psychology, 19(3), pp.403~415 (2009)
  69. Saunders, D. R., "Moderator variables in prediction", Educational and Psychological Measurement, 16(2), pp.209~222 (1956)
  70. "Annual report on tourism statistics 2012" (2014)[URL]
  71. Devinder Pal Singh, "Online Shopping Motivations, Information Search, and Shopping Intentions in an Emerging Economy", The East Asian Journal of Business Management, 4(3), pp.5~12 (2014), 한국유통과학회
  72. Smith, P. C., "Global outsourcing of healthcare : A medical tourism decision model", Journal of Information Technology Case and Application Research, 9(3), pp.19~30 (2007)
  73. "Number of foreign visitor arrivals to Indonesia by country of residence, 2002-2011" (2011)[URL]
  74. "International visitor arrivals to New Zealand: December 2013" (2014)[URL]
  75. Suh, Y. K., "Preferences and trip expenditures-a conjoint analysis of visitors to Soul, Korea", Tourism Management, 25(1), pp.127~137 (2004)
  76. Sweeney, J. C., "Word-of-mouth: Measuring the power of individual messages", European Journal of Marketing, 46(1, pp.2) (2012), 237~257
  77. "China outbound tourism in 2014" (2014)[URL]
  78. Turner, L., "First world health care at third world price : globalization, bioethics and medical tourism", Biosocienties, 2(3), pp.303~325 (2007)
  79. "The Chinese Outbound Tourism Market" (2006)[URL]
  80. Vengesayi, S., "Destination attractiveness : Are there relationships with destination attributes", The Business Review, 10(2), pp.289~294 (2008)
  81. Vengesayi, S., "Tourism destination attractiveness : The mediating effect of destination support services", The Business Review, 16(2), pp.179~185 (2010)
  82. Wang, Y., "The roles of brand equity and corporate reputation in CRM : A Chinese study", Corporate Reputation Review, 9(3), pp.179~197 (2006)
  83. Wang, Z., "Health information, credibility, homophily, and influence via the internet : Web sites versus discussion groups", Health Communication, 23(4), pp.358~368 (2008)
  84. Brown, J. J., "Social ties and word-of-mouth referral behavior", Journal of Consumer Research, 14(3), pp.350~362 (1987)
  85. Wilson, E. J., "Source effects in communication and persuasion research : A meta-analysis of effect size", Journal of the Academy of Marketing Science, 21(2), pp.101~112 (1993)
  86. Ye, B. H., "Motivations and experiences of mainland Chinese medical tourists in Hong Kong", Tourism Management, 32(5), pp.1125~1127 (2011)
  87. Ye, B. H., "Motivation of medical tourists: An exploratory case study of Hong Kong medial tourists", Paper presented at the Asia Pacific Tourism Association (APTA) Annual Conference (2008)
  88. Yeoh, E., "Understanding medical tourists : Word-of-mouth and viral marketing as potent marketing tools", Tourism Management, 34, pp.196~201 (2013)
  89. Yip, W. C., "Determinants of patient choice of medical provider : A case study in rural China", Health Policy and Planning, 13(3), pp.311~322 (1998)
  90. Yu, J. Y., "A cross-cultural study of perceptions of medical tourism among Chinese, Japanese and Korean tourists in Korea", Tourism Management, 33(1), pp.80~88 (2012)
  91. Zedeck, S., "Problems with the use of"moderator"variables", Psychological Bulletin, 76(4), pp.295~310 (1971)
  92. Zeithaml, V. A., "The behavioral consequences of service quality", Journal of Marketing, 60(2), pp.31~46 (1996)
  93. Zhang, J., "The impact of psychological distance on Chinese customers when selecting an international health service country", Tourism Management, 35, pp.32~40 (2013)

관련 논문AI추천

The Word-of-Mouth Effects on the Chinese Customers’ Choice Intention of Medical Tourism DestinationHoon-Young Lee, ZHANGJUN한국유통과학회 · 유통과학연구2016 · 제14권 제7호A Study of the Impact of Medical Characteristics and Travel Attractiveness on Chinese Customers when Selecting an International Medical Tourism Destination이훈영, ZHANGJUN한국기업경영학회 · 기업경영연구2015 · 제22권 제3호중국인 의료관광 수요자의 국가 선택에 영향을 미치는 요인 분석장심, 장혜정경영연구원 · 의료경영학연구2015 · 제9권 제1호문화적 유사성이 의료관광산업에 미치는 영향에 관한 연구이훈영, ZHANGJUN한국유통과학회 · 산경연구논집2018 · 제9권 제1호The Effect of Medical and Tour Quality on Perceived Value, Satisfaction, and Word of Mouth - Chinese Customers Perspective -김성은경영연구원 · 의료경영학연구2014 · 제8권 제3호중국인 의료관광객의 의료기관서비스품질 지각이 의료관광 만족도와 충성도에 미치는 영향김윤경관광경영학회 · 관광경영연구2018 · 제22권 제6호

이 간행물의 다른 논문 (11건)

How a Luxury Brand Can Enhance its Product Attractiveness in Retail Environment?안성숙, 이정훈pp. 5-11Government Support for Entrepreneurship Damage to Small Retail Traders from Large Wholesalers’ Online Business Expansion서창수, 서근하, 김미구pp. 13-21Convergence of Consumer Hygiene Awareness on Coffee Smell, Price, and Shops, Customer Satisfaction, and Repurchases김영선, 권이승, 권우택pp. 23-31매실의 소비자 구매의식과 구매특성 분석조성주, 조용빈, 김미옥pp. 33-40사회적경제와 소비자 관점의 공유가치창출(CSV) 연구김영신, 이영일pp. 53-63
원문 보기