Service quality in medical tourism: An application on medical tourist loyalty in Turkey

Recently, it has been observed that patients coming from different countries for medical tourism prefer Turkey to receive medical services (aesthetic surgery, medical treatments, dental treatments, eye surgeries and other health services). Türkiye is becoming an increasingly attractive destination for medical tourism. Medical tourist loyalty is one of the most crucial points for destination preferences. Retaining existing medical tourists and attracting new ones through them is a desirable situation for every country and every company engaged in medical tourism activities. It is also less costly. Tourist loyalty, quality service delivery and patients' satisfaction with the quality of service provided are very important for the success of medical tourism. In this research, the degree of relationship between perceived service quality as the independent variable and medical tourist loyalty as the dependent variable was determined. As intermediary variables between these two concepts, the mediating effect of "trust in digital communication channels" and "adequacy of the price or price of the service" as indicators of trust in the institution providing the service and the country in which the institution is located were examined. In other words, the main purpose is to understand and examine the structure and effect of these two factors (price and trust in digital communication channels), taking into account the independent variable perceived service quality, and thus to investigate their mediating role in ensuring medical tourist loyalty. A survey form was used as a data collection tool. Field research was conducted by distributing survey forms to 500 patients, and 474 responses were received. For this reason, 474 surveys, representing 94.8% of the number of surveys distributed, were evaluated for statistical analysis. Within the framework of the findings, first of all, a significant and positive relationship was found between perceived service quality and medical tourist loyalty. In this context, as the second finding, the existence of a direct positive relationship between the concepts of trust in digital communication channels (DIKG), affordability of the service offered (FU), perceived service quality (AHK) and medical tourist loyalty (MTS) was determined. The third finding is that the concepts of FU and DICG play a mediating role in the relationship between AHK and MTS. In other words, AHK guaranteed the intermediary role of FU and DIKG. In this context, 3 of the sub-hypotheses of the H1 hypothesis were accepted and 2 of them were rejected, therefore the H1 hypothesis was partially accepted. Hypotheses H2, H3, H4, H5, H6, H7a, H7b, H8, H9, H10 and H11 were all accepted. In summary, it was concluded that the factors "trust" and "price" have a mediating effect on the relationship between perceived service quality and medical tourist loyalty. In addition to all these findings, the trust in digital communication channels for the formation and maintenance of medical tourist loyalty gives an idea to future service providers, researchers and medical tourists about the importance of market research regarding the affordable price policies offered.