Table of Contents

Table of Contents...................................................................................................1

Project Aim............................................................................................................ 2

Objective................................................................................................................ 2

3. Context............................................................................................................. 2

3.1 Area of Research.......................................................................................2

3.2 India present health care out look.............................................................3

3.3 Overview of medical tourism in India........................................................3

3.4 Overview of tourism in India.....................................................................3

Literature Review...................................................................................................4

4.1 Introduction...............................................................................................4

4.2 Commercialization of Health Care.............................................................4

4.3 Socio-cultural Impacts of Tourism.............................................................5

4.4 Medical Tourism........................................................................................6

4.5 Potential markets for Medical Tourism......................................................6

4.6 Conclusion.................................................................................................7

METHODOLOGY......................................................................................................7

5.1 Introduction...............................................................................................7

5.2 Data Collection..........................................................................................8

5.3 Sample Characteristics..............................................................................8

5.4 Data Analysis............................................................................................9

Ethical Issues......................................................................................................... 9
 Project Aim

To review the opportunities for health tourism in India.

Objective

The main objectives of this research are:

• To review the tourism industry in India.

• To review the healthcare industry in India.
• To study and analyze the growth of the inbound patients to India from other
nations.
• To see an opportunity for tourism and healthcare industry as a complimentary
product
• To do a comparative study of medical tourism industry of India with other
growing nations.
• To understand the contribution of medical tourism industry towards the growth
of other sectors in India.
• To conclude as to the extent of opportunities for health tourism in India..

3. Context

3.1 Area of Research

This study will emphasize on the concept of medical tourism, its cause, demand,
importance, effectiveness and its impact on tourism and other sectors. It will also
involve understanding the contribution to country’s GDP, growth rate of ancillary
health services. The research will identify the contribution made to the employment
growth as a result of increasing jobs; study the effect on improvement in
infrastructure in healthcare industry. Besides this research will identify the impact on

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the growth in number of doctors, trained healthcare professionals. The study will also
identify the extent of growth such as hospitality, airlines, and food manufacturing
industries due to tremendous growth of medical tourism in India. The research will
bring to light the increasing pressure on the medical institutions which will have to
produce more qualified and increased number of professionals to meet the demand.
This increased demand as a result of flourishing medical tourism industry will also
present an opportunity for further improvement in R&D and more effective methods
of treatment. The research focuses mainly on some key issues, review the health
care and tourism industry in India, evaluate the reasons that why inbound patients
coming for treatment from other part of the country.

3.2 India present health care out look

The health care sector in India has increased its pace to be one of the fastest
growing industries. The privatization of the healthcare industry has carried with it
excellent facilities, considerable advancement in infrastructure offering world-class
treatments. India has a good number of top quality hospitals and treatments at very
low cost and has proved itself to be one of the best places for the medical treatment
in the world. Indian hospitals are gaining reputation internationally for standards in
healthcare industry, success rates and service levels. India has the technology and
highly skilled and experienced doctors along with state of the art facilities in
hospitals, nurses and paramedical staff to compete on a global level.

3.3 Overview of medical tourism in India

India is fast emerging as a preferred destination for medical tourism. Private medical
centres in the country stand out in all medical treatments and a large number of
patients from other nations are visiting India for treatments of ailments. Millions
throng visit every year for treatment and then recover while vacationing at the same
time. Low cost of treatment and high standard of medical care facility, along with
shorter waiting time for any treatment in India than any other part of the globe is one
of its distinct advantages. In addition, top-class medical expertise at attractive prices
is helping more and more Indian corporate hospitals to attract foreign patients.

3.4 Overview of tourism in India

The tourism industry in India is considerable and dynamic, and the country is fast
evolving as a key global destination. India’s travel and tourism industry is one of

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them most revenue generating industries in the country. A journey through Indian
States and cities highlights the cultural and the geographical diversity of India. A fair
number of business trips are also accounted for by the boom brought about by IT
companies in India which attracts foreigners to India, who will often add a weekend
break or even longer holiday.

Literature Review

4.1 Introduction

In the literature review we will discuss about the literature available on medical
tourism. Under this heading we will try to understand the relationship between
medical and tourism. The main aim of this literature review is to present a broad
definition of medical tourism and its cause and effect relationship. The research
study will then deal with few areas on medical tourism. Medical tourism is a growing
industry and relatively new topic in the health care marketing yet there has been lot
of research done on it. Medical tourism is defined as planned foreign travel for the
main purpose of obtaining high-quality, cost effective, non emergency medical
treatment. Smith & Farigone (2007) suggested that medical tourism is sometimes
considered as medical outsourcing. When the medical tourism plan includes a
vacation/tourist element. The cost of offshore medical treatment together with the
tourism experience is generally far less than the cost of domestic medical care
alone. India is considered one of the leading promoters of medical tourism and is
one of the cutting edge of medical outsourcing. Projections indicate medical tourism
will generate over one billion in revenue for the country. According to Fredrick, et al
(2006) from the McKinsey report,150,000 annually traveled for medical tourism, in
2002 in India and they estimated that medical tourism could bring as much as India
US$ 2.2 billion per year by 2012.

4.2 Commercialization of Health Care

According to Mackintosh (2003) Health care systems can embed and reinforce
inequality within societies or, conversely, can be a platform for the public combating
of poverty and inequality. Despite the extensive case based research and publication

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in recent years on markets in health care and the rise of the private sector (Bennett
et al (1997a) & (1997b), Bennett & Tangcharoensathien (1994), Bhatt (1993), Bloom
(1998), Leonard (2000), Segall et al (2000), Najandra et al (2001), and Turshen
(1998)), it is surprisingly difficult to find systematic comparative evidence on
ownership patterns in health care. Mackintosh (2003) suggested that
commercialization of health care includes privatisation that is the sale or transfer of
public assets to private ownership. It also encompasses the shift over time in the
balance of assets between public and private, through investment, that
characteristically results from health care market liberalisation (Semboja and
Thirkildsen 1995a).

4.3 Socio-cultural Impacts of Tourism

Brunt et al (1999) suggests that communities in many rural, coastal, and urban
destinations in Britain are affected somewhat by tourism. Its sociocultural effects in
these areas, however, are less well documented, as much of the academic literature
concentrates on the impacts in developing countries, or else evaluates them at a
more general level. Whereas, Krippendorf (1987) argues, the social effects are so
significant that they should be studied before anything else. Mathieson and Wall
(1982) point out that although many studies make passing reference to the existence
of social impacts, both positive and negative, most cast little light on their nature or
the means for their investigation.

According to Brunt et al (1999) the change in emphasis from hotel based (serviced)
accommodation to self catering having a significant bearing on the host perception of
tourism impacts. The finding here is that this change has effectively reduced the
socio-cultural impact of tourism on Dawlish's host community. The reason for this
seems to be the reduction in employment opportunities and a consequent reduction
in the community's economic dependence on tourism. Several studies have shown
that residents who are highly dependent on tourism-based employment are more
likely to exhibit favorable attitudes towards the industry (Allen and Davis(1988);
Lankford (1994); Milman & Pizam (1988); and Ryan(1991)). Murphy and Andressen
(1988) suggest that the farther the two are apart the more apathetic towards tourism
the resident becomes .However, another study conducted by Belisle and Hoy (1980)
concluded that the farther apart, the more negative the attitudes become.

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4.4 Medical Tourism
According to Caballero-Danell & Mugomba (2006) the combination of surgery and
tourism seems to be a promising relatively new type of non-exclusive niche tourism.
Factors contributing to this phenomenon include long waiting lists for surgery, costly
healthcare, a natural progression within health tourism and globalisation. The
superficial view that tourists travel solely for pleasure seems somewhat redundant
given that today there many tourism typologies; sport, leisure-seeking, religion or
pilgrim pursuits, environmental, business amongst many others. Thus it is widely
acknowledged that there are many complex reasons why people elect to travel
(Dann, (2002). Sharpley (2003) consider Globalisation and improved communication
technology as externalities within the global economy that may help to develop this
kind of tourism since people from countries outside the hosting country, where health
tourism is pursued, can access information about health treatments abroad and even
consult with doctors and experts in foreign countries by video conferencing among
many other such communication media. Where as Caballero-Danell & Mugomba
(2006) suggest that reason for the increased levels of medical tourism may be the
result of a natural progression or well being pursuits within health tourism; spa
resorts, hiking trips (though these may fall in the sport tourism segment as well),
yoga, meditation camps and boot camps or weight-loss health farms. According to
Connell (2006) the term “medical tourism” involves specific medical intervention. As
a result to set further delimitations health tourism is the overall governing spectrum
that includes both wellness tourism and medical tourism. Simply put wellness
tourism and medical tourism are both subsets of health tourism of which the latter is
the focus of this study.

4.5 Potential markets for Medical Tourism

Caballero-Danell & Mugomba (2006) commented that India is one of the countries
that have deliberately set out to be a dominant medical tourism destination.
According to Connell (2006), “India is capitalizing on its low costs and highly trained
doctors to appeal to these medical tourists”. Caballero-Danell & Mugomba (2006)
again pointed out the outcome of this deliberate policy show that in 2004 India had
1.8 million inbound medical tourists, making the industry’s contribution to the
economy an estimated USD333million. The growth of medical tourism is a growing
phenomenon in other south Asian countries such as Singapore and Thailand where

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medical tourism is used boost the arrivals to their beach resorts. Other well-
established medical tourism markets contributing to regional Asia’s dominance are
Thailand and South Korea, whose contributions are predicated to set the medical
tourism industry past the US$4 billion mark by 2012 Where as India’s medical
tourism business operations are growing at 30 per cent per year with projected
revenues of at least US$2.2 billion a year by 2012. (Asia’s Growth Industry, 2006).

4.6 Conclusion
The most crucial part involved in Medical Tourism is the decision making process
that is made complex by the sensitive nature of the product – shopping for surgery
abroad. For potential entrants to gain a significant market share insight on what
motivates the consumer to choose to a cardiac surgery for example in India over the
cardiac surgery in US will provide insight on what are considered value added
benefits in the medical tourism. This research will look into the needs for evidences
which medical outsourcing integrated with tourism will have on the treatment cost,
access to facilities and how it will enhance the quality of health care.

METHODOLOGY
5.1 Introduction
This section will seek to explain the many ways in which data would be collected,
sample size, the data analysis method and the limitations of the methodology. The
art of research as a scientific investigation could be defined as a scientific and
systematic search for pertinent information on specific topic (Kothari, 2005). The
data analyzed will be qualitative in nature. A qualitative research is one in which the
inquirer often makes knowledge claims based primarily on constructivist perspective
or participatory perspective or both (John, 2003). According to Bryman & Bell (2007)
there are five major types of qualitative research; Ethnography/participant
observation, Qualitative interviewing, focus group, language-based approach and
collective of texts and documents. Gummesson (2000) argues that qualitative
methodology provide powerful tools for research in management and business
subjects. He added that universities and business schools often oppose their use
and classify them as second-rate arguing that qualitative methods are used only to a
limited degree. Smith et. al. (2003) also buttressed on the way qualitative data is
analyzed. They pointed out that either the researcher goes by numbers or goes by

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feel and intuition aiming to produce common or contradictory themes and patterns
from the data which can be used as a basis of interpretation. The main emphasis of
the project would be mostly based on feel and ideas observed with the analyzed
data.

5.2 Data Collection

For this research the data will be collected through administered questionnaires,
these questionnaires, 300 in number, will be sent to India through e-mail. The
number of questionnaires will represent a sample of the whole population. By using
questionnaires it will provide the fastest means of reaching a large sample and for
this research a larger sample would allow the researcher to analyze the response of
a many respondents. As I will be collecting data from these identified respondents it
will be easier to analyze the collected data because questionnaires will restrict the
responses to a large extent. Furthermore, questionnaires are the most often used
technique because many people are aware of this method of data collection and
everyone has had some kind of previous experience of filling up a questionnaire. As
a result it will not make them feel alienated when they are asked to respond using a
questionnaire. By using a questionnaire it would be very easy for me to eliminate the
middle man bias, the opinion of the researcher is not dominant and the response of
the respondent is free from any sort of bias. When respondents receive a
questionnaire it is up to them to fill it whenever they want to there is no pressure of
time they can fill it whenever they are free.

The reason for approaching the research study only through desk based research
and structured interviewing is because the data from the results of feasibility study
on the target audience conducted would be primarily used to gauge and understand
the requirement. There is no further study required to understand the needs of the
audience as the project focuses more on the medical tourism in India which requires
more study from existing research theories & concepts.

5.3 Sample Characteristics

I have been in the medical industry from last 9 years; worked with public and private
hospitals. This experience will help me in gaining the access with the well known
hospitals and health care agents in India. The sample will consist of 300
respondents. The Research (both qualitative and quantitative) will be undertaking

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with consideration of the patients from abroad, drawn from different hospitals in
different parts of cities in India as well as medical doctors would also be interviewed
from different hospitals. A letter will be sent to all the respondents before the
questionnaires are sent to them. The letter will contain a brief on the topic and the
purpose of the research, the letter will inform them about the dates when the
questionnaires will be delivered and a date will be mentioned on which they would be
expected to return the filled questionnaire.

5.4 Data Analysis

The data will be analyzed by using Microsoft excel and statistical package for social
sciences. The first data feeding will be done through Microsoft excel and then for the
statistical analysis statistical package for social sciences will be used. Once the data
has been collected through questionnaires they will be coded and the data will be fed
through Microsoft excel. With the help of statistical package for social sciences,
regression analysis, mean, median and mode will then be calculated.

Ethical Issues
Research ethics relates to questions about how we formulate and clarify our
research topic, design our research and gain access, collect data, process and store
our data, analyze data and write up our research findings in a moral and responsible
way (Saunders, M et. al., 2007)

The possible circumstances were ethical issues could arise when handling the
project are

• Protection of the confidentiality of data provided, such as the feasibility data

findings, documents obtained from the organisation and confidential information
obtained from the internet over secured gateways. All data collected for this
purpose would be used judiciously and either returned back to the source or
destroyed at the end of the project.
• Privacy of participants attending the interviews – The privacy of participants
involved if it is requested by them would be maintained as a matter of great
importance.
• The necessary consent would be obtained from each participants before an
undertaking each interview

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 • Extra caution would be employed to avoid causing embarrassment; stress to
the participants due to the way the interview is being conducted.
• All stakeholders would be informed before any information is shared over the
internet or any other electronic medium where possibility of data violation could
be raised

The above but covers the major ethical issue concerning this project study.

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