AN ANALYSIS OF ATTITUDINAL LOYALTY IN SINGAPORE MEDICAL TOURISM FROM THE PERSPECTIVE OF INDONESIAN MEDICAL TOURISTS
DOI:
https://doi.org/10.46273/csryey57Keywords:
Destination Familarity , Service Quality , Destination Image , Attitudinal Loyalty, Medical TourismAbstract
The study examines the impact of destination familiarity, service quality, satisfaction, perceived value, trust, and destination image on the attitudinal loyalty of Mount Elizabeth Hospital (MEH) Singapore among Indonesian medical tourists. A quantitative study was conducted on 130 Indonesian medical tourists who live in Jakarta and have used medical services at Mount Elizabeth Hospital (MEH) Singapore within the last three months. To test the hypothesis, structural equation analysis is performed using PLS software. The findings suggest that there are positive associations between destination familiarity, destination image, and attitudinal loyalty to Mount Elizabeth Hospital (MEH) Singapore. Service quality has an indirect effect on attitudinal loyalty since satisfaction, perceived value, and trust operate as mediators. Finally, satisfaction, perceived value, and trust all have a favorable impact on Mount Elizabeth Hospital (MEH) Singapore's attitudinal loyalty.
References
Ahmed, Z., 1991. The influence of the component of a state’s tourist image on product positioning strategy. Tourism Management, pp. Vol. 12, no. 4, pp. 331-340.
Balaban, V., & Marano, C. (2010). Medical tourism research: A systematic review. International Journal of Infectious Diseases, 14, e135.
Bejou, D. & Palmer, A., 1998. Trust ethics and relationship satisfaction. International Journal of Bank Marketing, pp. Vol. 6, no. 4, pp. 170- 175.
Beladi, H., Chao, C. C., Ee, M. S., & Hollas, D. (2015). Medical tourism and health worker migration in developing countries. Economic Modelling, 46, 391-396.
Brucks, M., 1985. The effects of product class knowledge on information search behavior. Journal of Consumer Research, pp. Vol 12(1), pp. 1-16.
Cardozo, R. N., 1965. An experimental study of customer effort, expectation, and satisfaction. Journal of Marketing Research, pp. Vol. 2, no. 3, pp. 244- 249.
Chang, C. S., Chen, S. Y. & Lan, Y. T., 2013. Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters. BMC Health Services Research, pp. Vol. 13, no. 1, pp. 22–11.
Chen, J. S. & Gursoy, D., 2001. An investigation of tourist destination loyalty recommends and preferences. Journal of Contemporary Hospitality Management, pp. Vol. 13, no. 2, pp. 79.
Conell, J., 2006. Medical tourism: Sea, sun, sand and … surgery. Tourism Management, p. 27.
Crompton, J. L., 1997. An Assessment of The Image of Mexico as a Vacation Destination and The Influence of Geographical Location Upon That Image. Journal of Travel Research, pp. vol. 14, no. 4, pp. 18-23.
Department of Statistics Singapore, 2016. Singapore in Figures 2016. Singapore: Department of Statistics Singapore.
Dhae, A., 2014. Metrotvnews.com. [Online] Available at: http://rona.metrotvnews.com/read/2014/10/21/308075/tiap-tahun-600-ribu-orang-indonesia-berobat-ke-luar-negeri
Donabedian, A., 1998. The quality of care. How can it be assessed? Journal of American Medical Association, pp. Vol. 260, no. 12, pp. 1743–1748.
Echtner, M. & Ritchie, J. R., 2003. The meaning and the measurement of destination image. Journal of Tourism Studies, pp. Vol. 14, no. 1.
Ganguli, S. & Ebrahim, A. H., 2016. A qualitative analysis of Singapore's medical tourism competitiveness. Tourism Management Perspectives, pp. 78-84.
Gan, L. L. & Frederick, J. R., 2011. Medical Tourism in Singapore: A Structure-Conduct-Performance Analysis. Journal of Asia-Pacific Business, pp. Vol 12, pp. 41-170.
Garvin, D., 1983. Quality on the line. Harvard Business Review, pp. Vol. 61 No. 5, pp. 65-73.
Goeldner, C. & Ritchie, J. B., 2012. Tourism. 12th ed. ed. Canada: John Willey & Sons. Inc.
Grönroos, C. (1990). Service management and marketing (Vol. 27). Lexington, MA: Lexington books.
Guiry, M., & Vequist, D. G. (2011). Traveling abroad for medical care: US medical tourists' expectations and perceptions of service quality. Health Marketing Quarterly, 28(3), 253-269.
Gursoy, D. & McCleary, 2004. Travelers Prior Knowledge and Its Impact on Their Information Search Behavior. Journal of Hospitality and Tourism Research, pp. Vol 28, no 1 pp. 28.
Hall, C. M. (2011). Health and medical tourism: a kill or cure for global public health? Tourism review, 66(1/2), 4-15.
Hampel, D. J. (1977). Consumer Satisfaction with the home buying process: Conceptualization and Dissatisfaction. Marketing Science Institute, 7.
Handayani, I., 2014. Beritasatu.com. [Online] Available at: http://www.beritasatu.com/kesehatan/203096-singapura-destinasi-kesehatan-di-asia.html
Hernández-Lobato, L., Solis-Radilla, M. M., Moliner-Tena, M. A., & Sánchez-García, J. (2006). Tourism destination image, satisfaction and loyalty: a study in Ixtapa-Zihuatanejo, Mexico. Tourism geographies, 8(4), 343-358.
Heung, V. C., Kucukusta, D., & Song, H. (2010). A conceptual model of medical tourism: Implications for future research. Journal of Travel & Tourism Marketing, 27(3), 236-251.
Hunter-Jones, P. (2005). Cancer and tourism. Annals of Tourism Research, 32(1), 70-92.
Jie, Lim Hui. 2024. Retrieved from https://www.cnbc.com/2024/02/01/singapore-tourist-arrivals-double-in-2023-thanks-to-china-indonesia-malaysia.html
Kementerian Kesehatan Republik Indonesia, 2015. Health Statistics. Indonesia: Kementerian Kesehatan Republik Indonesia.
Kim, K. H. et al., 2008. Brand equity in hospital marketing. Journal of Business Research, pp. Vol. 61, no. 1, pp. 75-82.
Kotler, P. & Keller, K. L., 2006. Marketing Management, 12th ed. Upper Saddle River, NJ: Pearson/Prentice-Hall.
Kramer, R. M., 1999. Trust and distrust in organizations: Emerging perspectives, enduring questions. In J. T. Spence (Ed.), Annual review of psychology, pp. Vol. 50, pp 569-598.
Kuo, N. T., Chang, K. C., Cheng, Y. S. & Lin, J. C., 2015. Effects of Tour Guide Interpretion and Tourist Satisfaction on Destination Loyalty in Taiwans' Kinmen Battlefield Tourism: Perceived Playfulness and Perceived Flow as Moderators. Journal of Travel and Tourism Marketing.
Lehtinen, U. & Lehtinen, J., 1982. Service Quality: A Study of Quality Dimensions. Service Management Institute.
Lertwannawit, A. & Gulid, N., 2011. International Tourists’ Service Quality Perception and Behavioral Loyalty Toward Medical Tourism in Bangkok Metropolitan Area. The Journal of Applied Business Research, pp. Vol 27, Number 6
Lewis, B. R., & Soureli, M. (2006). The antecedents of consumer loyalty in retail banking. Journal of Consumer Behaviour: An International Research Review, 5(1), 15-31.
MacReady, N. (2007). Developing countries court medical tourists. The Lancet, 369(9576), 1849-1850.
Mechinda, P., Serirat, S., Anuwichanont, J. & Gulid, N., 2010. An Examination Of Tourists' Loyalty Towards Medical Tourism In Pattaya, Thailand. The International Business & Economics Research Journal, p. 55.
Medical Tourism Singapore. 2023. Retrieved from https://www.budgetdirect.com.sg/travel-insurance/research/medical-tourism-singapore
Milman, A. & Pizam, A., 1995. The role of awareness and familiarity with a destination: the central Florida case. Journal of Travel Research, pp. Vol. 33, no. 3, pp. 21-27.
Moorthy, S., Ratchford, B. & Talukdar, D., 1997. Consumer Information Search Revisited: Theory and Empirical Analysis. Journal of Consumer Research, pp. vol 23, no.4, pp. 263- 277.
Nguyen, T. (2016). Medical tourism: Studying the impact of motivational factors, destination image on perceived quality and overall satisfaction using SEM analysis.
Oliver, R. L. (1999). Whence consumer loyalty? Journal of marketing, 63(4), 33-44.
Oliva, T. A., Oliver, R. L., & MacMillan, I. C. (1992). A catastrophe model for developing service satisfaction strategies. Journal of marketing, 56(3), 83-95.
Oppermann, M. (1999). Predicting destination choice—A discussion of destination loyalty. Journal of Vacation Marketing, 5(1), 51-65.
Pakdil, F., & Harwood, T. N. (2005). Patient satisfaction in a preoperative assessment clinic: an analysis using SERVQUAL dimensions. Total Quality Management & Business Excellence, 16(1), 15-30.
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1985). A conceptual model of service quality and its implications for future research. Journal of marketing, 49(4), 41-50.
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). Servqual: A multiple-item scale for measuring consumer perc. Journal of retailing, 64(1), 12.
Petrick, J. F. (2002). Development of a multi-dimensional scale for measuring the perceived value of a service. Journal of leisure research, 34(2), 119-134.
Pollack, B. L. (2008). The nature of the service quality and satisfaction relationship: Empirical evidence for the existence of satisfiers and dissatisfiers. Managing Service Quality: An International Journal, 18(6), 537-558.
Rad, N. F., Som, A. P. M., & Zainuddin, Y. (2010). Service quality and patients’ satisfaction in medical tourism. World Applied Sciences Journal, 10(1), 24-30.
Rust, R. T., & Oliver, R. L. (Eds.). (1993). Service quality: New directions in theory and practice. Sage Publications.
Singapore Government, 2017. Department of Statistics Singapore. [Online] Available at: http://www.singstat.gov.sg/statistics/visualising-data/charts/visitor-arrivals
Singh, P. K., 2008. Medical Tourism. New Delhi: Kanishka Publishers
Sirdeshmukh, D., Singh, J., & Sabol, B. (2002). Consumer trust, value, and loyalty in relational exchanges. Journal of marketing, 66(1), 15-37.
Snepenger, D., Meged, K., Snelling, M., & Worrall, K. (1990). Information Search Strategies B y Destination-Naive Tourists. Journal of travel research, 29(1), 13-16.
Vries, V. D., 2016. It Takes a Big Byte to Improve Health Care, Jakarta: The Jakarta Post. Retrieved from https://www.thejakartapost.com/news/2016/03/14/it-takes-a-big-byte-improve-health-care.html
Wang, H. Y. (2012). Value as a medical tourism driver. Managing Service Quality: An International Journal, 22(5), 465-491.
Wang, H. Y., & Wang, S. H. (2013). Mainland Chinese customers' intention toward medical tourism in Taiwan. International Journal of Economics and Management Engineering, 7(2), 329-331.
Wang, Y. H. (2017). Expectation, service quality, satisfaction, and behavioral intention-evidence from Taiwan's medical tourism industry. Advances in Management and Applied Economics, 7(1), 1.
Woodhead, A. (2013). Scoping medical tourism and international hospital accreditation growth. International journal of health care quality assurance, 26(8), 688-702.
Zeithaml, V. A., Parasuraman, A., & Berry, L. L. (1985). Problems and strategies in services marketing. Journal of marketing, 49(2), 33-46.