Improving Medical Tourism Services through Human Behaviour and Cultural Competence
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Abstract
Background: Medical tourism is a type of service sector in which there is direct interaction between healthcare practitioners and patient-customers, leading to several challenges due to cultural and social background differences. We aimed to investigate the determinants of delivering a culturally-oriented service in medical tourism sector.
Methods: Adopting an exploratory qualitative approach, interviews were conducted through a semi-structured procedure with authorities across various medical sectors in South Korea in winter 2017. Participants were all involved in and aware of the medical tourism sector, both academically and clinically. The interview transcripts were coded through a systematic thematic analysis.
Results: In order to focus on non-clinical service in medical tourism sector, and a system of cultural competence delivery, three main themes were identified: 1) The personal characteristics of doctors; 2) External supports to be provided by the associated organisations; and finally, 3) Skilfulness, which implies the culturally-oriented interaction with foreign patients.
Conclusion: Several strategies are suggested to address the non-clinical challenges and conflicts in doctor-patient interaction in the sector of medical tourism. It is likely that providing a culturally-oriented service in this sector demands for a comprehensive planning, and several strategies for implementation in order to support and train a team of skilful doctors with non-clinical characteristics. These finding will likely have insights for those organisations searching to improve their performance in the medical tourism sector.
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28. Limberger AA (2010). Impact of repeated participation in computer-based cultural competency review training on cultural competence of healthcare providers and satisfaction outcomes among their patients. Doctoral dissertation. Tui University.
29. Saha S, Korthuis PT, Cohn JA, Sharp VL, Moore RD, Beach MC (2013). Primary care provider cultural competence and racial disparities in HIV care and outcomes. J Gen Intern Med, 28:622-629.
30. Balcazar FE, Suarez-Balcazar Y, Taylor-Ritzler T (2009). Cultural competence: Development of a conceptual framework. Disabil Rehabil, 31:1153-1160.
31. Echeverri M, Brookover C, Kennedy K (2010). Nine constructs of cultural competence for curriculum development. Am J Pharm Educ, 74:181.
32. Kim‐Godwin YS, Clarke PN, Barton L (2001). A model for the delivery of culturally competent community care. J Adv Nurs, 35:918-925.
33. Burchum JLR (2002). Cultural competence: An evolutionary perspective. Nursing Forum, Wiley Online Library, 5-15.
34. Paez KA, Allen JK, Carson KA, Cooper LA (2008). Provider and clinic cultural competence in a primary care setting. Soc Sci Med, 66:1204-1216.
35. Doorenbos AZ, Schim SM (2004). Cultural competence in hospice. Am J Hosp Palliat Care, 21:28-32.
36. Weech-Maldonado R, Elliott MN, Pradhan R, Schiller C, Dreachslin J, Hays RD (2012). Moving towards culturally competent health systems: organizational and market factors. Soc Sci Med, 75:815-822.
37. Price EG, Beach MC, Gary TL, et al (2005). A systematic review of the methodological rigor of studies evaluating cultural competence training of health professionals. Acad Med, 80:578-586.
38. Beach MC, Price EG, Gary TL, et al (2005). Cultural competency: A systematic review of health care provider educational interventions. Medical Care, 43:356-73.
39. Yu JY, Ko TG (2012). A cross-cultural study of perceptions of medical tourism among Chinese, Japanese and Korean tourists in Korea. Tourism Management, 33:80-88.
40. Geva I (2018). Building international brand. Medical Korea, from challenge to chance in global healthcare. The 9th global healthcare & medical tourism conference, Seoul, South Korea pp. 76-94.
41. Kim S, Lee J, Jung J (2013). Assessment of medical tourism development in Korea for the achievement of competitive advantages. Asia Pacific Journal of Tourism Research, 18:421-445.
2. Ormond M (2014). Medical tourism. In: The Wiley-Blackwell Companion to Tourism. Ed(s), Alan A. Lew CMHaAW: John Wiley & Sons.
3. Chae DH, Kang KH (2013). Review of self-administered instruments to measure cultural competence of nurses-focused on IAPCC & CCA. J Korean Acad Nurs, 19:48-62.
4. Alizadeh S, Chavan M (2015). Cultural competence dimensions and outcomes: a systematic review of the literature. Health Soc Care Community, 24(6):117-130.
5. Mohammad Jamal K, Chelliah S, Haron MS (2016). International Patients’ Travel Decision Making Process-A Conceptual Framework. Iran J Public Healt., 45:134-45.
6. Ormond M (2008). First world treatments at third world prices’: The real cost of medical tourism. Medical tourism: A growth industry, 69:77.
7. Paez KA, Allen JK, Beach MC, Carson KA, Cooper LA (2009). Physician cultural competence and patient ratings of the patient-physician relationship. J Gen Intern Med, 24:495-498.
8. Thom DH, Tirado MD (2006). Development and validation of a patient-reported measure of physician cultural competency. Med Care Res Rev, 63:636-655.
9. Campinha-Bacote J (2002). The process of cultural competence in the delivery of healthcare services: A model of care. J Transcult Nurs, 13:181-184.
10. Ormond M (2011). 8 Medical tourism, medical exile. Real Tourism: Practice, Care, and Politics in Contemporary Travel Culture, 26:143.
11. Egnew TR (2009). Suffering, meaning, and healing: challenges of contemporary medicine. Ann Fam Med, 7:170-175.
12. Boutin-Foster C, Foster JC, Konopasek L (2008). Physician, know thyself: The professional culture of medicine as a framework for teaching cultural competence. Acad Med, 83:106-111.
13. Veerasoontorn R, Beise-Zee R (2010). International hospital outshopping: a staged model of push and pull factors. Int J Pharm Healthc Mark, 4:247-264.
14. Song YJ (2009). The South Korean health care system. JMAJ, 52:206-209.
15. Ormond M (2012). Claiming ‘cultural competence’: The promotion of multi-ethnic Malaysia as a medical tourism destination. In: Medical Tourism: The Ethics, Regulation, and Marketing of Health Mobility. Ed(s), Hall CMe. London: Routledge.
16. Woodman J (2009). Patients beyond borders: Everybody's guide to affordable, world-class medical travel. ed. Healthy Travel Media.
17. Davis K (1998). Race, health status, and managed health care. Cultural Competence for Health Care Professionals Working with African-American Communities: Theory and Practice. Brisbane FL, Epstein LG, Pacheco G et al. Eds:145-163.
18. Jun J (2016). Framing Service, Benefit, and Credibility Through Images and Texts: A Content Analysis of Online Promotional Messages of Korean Medical Tourism Industry. Health Commun, 31:845-852.
19. Schnitzler F (2018). The Europian view: is there a strategy for Kore to attract Europian patients and wellness tourists. The 9th Global Healthcare & Medical Tourism Conference. 9-11 May, Seoul, South Korea pp. 294-300.
20. Lin HC (2016). Impact of nurses’ cross‐cultural competence on nursing intellectual capital from a social cognitive theory perspective. J Adv Nurs, 72(5):1144-54
21. Deardorff DK (2006). Identification and assessment of intercultural competence as a student outcome of internationalization. J Stud Int Educ, 10:241-266.
22. Spitzberg B.H CG (2009). Conceptualizingintercultural competence. In: The Handbook of Intercultural Competence. Ed(s), Deardoff DK. Newbury Park: Sage, pp. pp. 2–52.
23. Podsakoff PM, MacKenzie SB, Lee J-Y, Podsakoff NP (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol, 88:879-903.
24. Luborsky MR (1994). The identification and analysis of themes and patterns. In J. F. Gubrium & A. Sankar (Eds.), Sage focus edition, Vol. 168. Qualitative methods in aging research (pp. 189-210). Thousand Oaks, CA, US: Sage Publications, Inc.
25. Charmaz K, Belgrave L (2012). Qualitative interviewing and grounded theory analysis. The SAGE handbook of interview research: The complexity of the craft, 2:347-365.
26. Glinos IA, Baeten R, Helble M, Maarse H (2010). A typology of cross-border patient mobility. Health Place, 16:1145-1155.
27. Baum T (2015). Human resources in tourism: Still waiting for change?–A 2015 reprise. Tourism Management, 50:204-212.
28. Limberger AA (2010). Impact of repeated participation in computer-based cultural competency review training on cultural competence of healthcare providers and satisfaction outcomes among their patients. Doctoral dissertation. Tui University.
29. Saha S, Korthuis PT, Cohn JA, Sharp VL, Moore RD, Beach MC (2013). Primary care provider cultural competence and racial disparities in HIV care and outcomes. J Gen Intern Med, 28:622-629.
30. Balcazar FE, Suarez-Balcazar Y, Taylor-Ritzler T (2009). Cultural competence: Development of a conceptual framework. Disabil Rehabil, 31:1153-1160.
31. Echeverri M, Brookover C, Kennedy K (2010). Nine constructs of cultural competence for curriculum development. Am J Pharm Educ, 74:181.
32. Kim‐Godwin YS, Clarke PN, Barton L (2001). A model for the delivery of culturally competent community care. J Adv Nurs, 35:918-925.
33. Burchum JLR (2002). Cultural competence: An evolutionary perspective. Nursing Forum, Wiley Online Library, 5-15.
34. Paez KA, Allen JK, Carson KA, Cooper LA (2008). Provider and clinic cultural competence in a primary care setting. Soc Sci Med, 66:1204-1216.
35. Doorenbos AZ, Schim SM (2004). Cultural competence in hospice. Am J Hosp Palliat Care, 21:28-32.
36. Weech-Maldonado R, Elliott MN, Pradhan R, Schiller C, Dreachslin J, Hays RD (2012). Moving towards culturally competent health systems: organizational and market factors. Soc Sci Med, 75:815-822.
37. Price EG, Beach MC, Gary TL, et al (2005). A systematic review of the methodological rigor of studies evaluating cultural competence training of health professionals. Acad Med, 80:578-586.
38. Beach MC, Price EG, Gary TL, et al (2005). Cultural competency: A systematic review of health care provider educational interventions. Medical Care, 43:356-73.
39. Yu JY, Ko TG (2012). A cross-cultural study of perceptions of medical tourism among Chinese, Japanese and Korean tourists in Korea. Tourism Management, 33:80-88.
40. Geva I (2018). Building international brand. Medical Korea, from challenge to chance in global healthcare. The 9th global healthcare & medical tourism conference, Seoul, South Korea pp. 76-94.
41. Kim S, Lee J, Jung J (2013). Assessment of medical tourism development in Korea for the achievement of competitive advantages. Asia Pacific Journal of Tourism Research, 18:421-445.
| Files | ||
| Issue | Vol 48 No 11 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v48i11.3517 | |
| Keywords | ||
| Medical tourism Cultural competence Human behaviour South Korea | ||
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How to Cite
1.
ROKNI L, PARK S-H, AVCI T. Improving Medical Tourism Services through Human Behaviour and Cultural Competence. Iran J Public Health. 2019;48(11):1988-1996.
