Travel Reference
In-Depth Information
Table 1.
Medical revenue in Malaysia, 2000-2011.
act as a signal whether the customers will remain
or exit the relationship with the service provider
that is the private hospital. In addition, Zeithmal et
al. (1996) mentioned that there are two dimensions
to measure behavioral intention—favorable and
unfavorable. Favorable intentions means that the
customers will convey a positive word of mouth,
repurchase intention and loyalty (Ladhari, 2009;
Zeithaml, Berry & Parasuraman, 1996). On the
other hand, unfavorable behavioral intention tends
to spread negative word of mouth due to their
negative experiences to other customers (Caru-
ana, 2002). This will make them directly switch
their intention to competitors (Athanassopoulos,
Gounaris & Stathakopoulos, 2001).
In this situation, the relationship focuses on the
number of customer who comes back to buy and
continues to buy until it creates a positive attitude
towards the company products and services. This
will definitely will creates a customer loyalty and
repurchase intention (Zeithaml et al., 1996). Loy-
alty is defined as “a deeply held commitment to
re-buy or re-patronize a preferred product/service
consistently in the future” (Kesar & Rimac, 2011).
Repurchase-intention can be defined as customer
will maintain a relationship with the services pro-
vider (Zeithaml et al., 1996). Whereas word of
mouth can be defined as a customer will inform
positive experience of relationship with friends,
relatives or others (Woodside & Moore, 1987).
As in the hospital context, patients satisfied with
the hospital are obviously will recommend their
treatment to other patient (Finkelstein, Harper
& Rosenthal, 1999). For example Kessler and
Mylod (2011) reported that patients satisfaction
will significantly influenced the patient's intention
to return to the same hospital. In addition, if the
patient's are highly satisfied with the admissions,
facilities provided, services and other processes,
all of this will definitely lead to patient's return-
ing to the same hospital (Kessler & Mylod, 2011).
In the Asian culture, friends, relatives, colleagues
and neighbors have great influence on the cus-
tomers when it comes to making decisions regard-
ing an institutions and they are really depends on
the personal recommendation from family and
friends (Owusu-Frimpong, Nwankwo & Dason,
2010).
Year
Value (RM Million)
Growth (%)
2000
33
48.4
2001
44
35.7
2002
36
−18.7
2003
59
63.6
2004
105
78.2
2005
151
43.0
2006
204
35.0
2007
254
24.6
2008
299
17.8
2009
288
−3.7
2010
378
31.5
2011
511
34.9
Source: Medical Tourism Revenue (2012).
Table 2.
Total number of foreign patients in Malaysia.
Year
Number of Foreign Patients
Growth Rate (%)
2001
75,210
33.99
2002
84,585
12.47
2003
102,946
21.71
2004
174,189
69.20
2005
232,161
33.28
2006
296,687
27.79
2007
341,288
15.03
2008
374,063
9.60
2009
336,000
−10.18
2010
392,956
16.95
2011
583,296
48.44
Source: Medical Tourism Revenue (2012).
From the above table, it was found that even
though the number of revenue is increasing
throughout the years, unfortunately the growth
rate is very unstable and it does not exhibit a trend.
The growth rate from 2001 to 2011 is around 25.37
percent per annum (“Medical Tourism Revenue,”
2012). Table 2 shows that number of foreign
patients in Malaysia from 2001 until 2011. The
total numbers of foreign patients in Malaysia keep
increasing from 2001 until 2011 except in 2009 the
numbers decline.
2.2
Perceived destination image
Generally, it has been accepted in the literature that
image has influenced the tourist behavioral inten-
tions in choosing destination (Bigne, Sanchez &
Sanchez, 2001; Fakeye & Crompton, 1991; Lee, Lee
& Lee, 2005). Image is not only applicable to brand
but apply to company, service, person or place.
This is consistent with the concept of the product,
2 LITERATURE REVIEW
2.1
Behavioral intention
Many researchers have found various definitions
of behavioural intention (Caruana, 2002; Jacoby
& Chestnut, 1978). Zeithmal, Berry, and Parasura-
man (1996) described that behavioural intention
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