STEP analysis and health tourism development in Malaysia - Theory and Practice in Hospitality and Tourism Research - page 264

potential foreigner's patient. This is further sup-
ported by Garcia-Altes (2005) who stated that tour-
ist patients were seeking medical treatment in other
countries as they are facing affordability problem
to get the same treatment in their home country.
Apart from that, lack of insurance coverage to cer-
tain diseases has led to the mushrooming of health
tourism development to the countries that offered
health tourism services such Malaysia.
In addition to that, the notion of health tourism
is receiving its support due to the high medical cost
in the developed country that forced their patient
to find alternatives to treat their medical predica-
ments (Garcia-Altes, 2005). Lower health care cost
which can be found in most of developing coun-
tries such as Malaysia, Thailand and India has lure
most of this patient's group to get treatment in the
respective countries that offered health tourism to
the foreigners (Chinai & Goswami, 2007; Gupta,
2008). However, more efforts need to be done by
the host countries, to combat the skeptic view in
convincing the potential visitors about the quality
of medical services offered are of the same level
with the patient's home country.

Therefore, patient preferences and need should
be highlighted in delivering the healthcare. This is
supported by Zhang, Dixit, and Friedmann (2010)
who emphasized the need to attain customer satis-
faction is vital in ensuring high profitability to the
organization.
Demographic trends, population shift to the
major cities, life expectancy, lifestyle, consumer
preferences and expectation are among the factors
representing social factors that might influence the
healthcare organization (Harris & Associates, 2006;
Piggot, 2000). Consumer preference is assumed as
one of the important criteria to be considered in
offering medical tourism services to the poten-
tial foreign patients. The quality of medical serv-
ices offered need to be on par with what has been
offered by the developed countries. It was found
that the booster of medical tourism especially in
lower and middle countries is due to the increas-
ing awareness of the level of quality possessed by
the healthcare providers (Crooks, Turner, Snyder,
Johnston & Kingsbury, 2011). More healthcare
providers are keen to acquire appropriate quality
certification as one of the assurance to the poten-
tial patient of their ability in the services offered.
This has led to the major shifting in the perception
of the good and services offered by the lower and
middle income countries are of inferior in term of
quality (Johnston, Crooks, Snyder & Kingsbury,
2010).

1.2 Gaps in health tourism development
Medical tourism is one of the potential generat-
ing income sectors contributing to the growth of
Malaysia's economy. Even though the medical tour-
ism has boomed since late 1990s, fewer efforts were
seen from the government to further commercialize
the potential of health tourism. Due to this, Malay-
sia potential of being the leader of the health care
provider in the Southeast Asia might be surpassed
by the neighboring countries such as Thailand and
Singapore. Venturing in medical tourism can be
thought as having the twofold objectives. Medical
tourism will simultaneously provide two sources
of income to the country through healthcare and
tourism services. This study is sought to examine
the utilization of STEP analysis to measure the
possible factors that influence the development of
medical tourism in Malaysia. The outcome of this
research is hoped to provide the policy maker per-
tinent information and ways to enhance the medi-
cal tourism activities in the country thus pave the
formulation of parallel policy by the government
to promote medical tourism to the highest extent.

2.2 Technology
The modern technology helped healthcare to get
through of its evolution. The two sectors in medi-
cal tourism, which are medicine and tourism, rely
heavily on the Internet to spread information
(Bookman & Bookman, 2007). When potential
tourist patients hit the web, they are posted with
plethora of hospitals to choose from. It is also
noted that rapid advancement in technology and
lower cost has attracted thousands of health visi-
tors to receive medical treatment abroad (Carruth
& Carruth, 2010). An immense number of medi-
cal tourists come to seek medical care to develop-
ing countries that not only offering vast medical
specialties and skills, but also the state of the art
medical technology that were offered. However,
several essentials issues need to be addressed such
as training and development as this will accultur-
ate the utilization of modern technology among
medical personnel (McNish, 2002). In addition,
it was suggested that tax relief should be initi-
ated and given to the hospitals that offer medical
tourism to support the need for the latest medical
equipment technology (Aniza, Aidalina, Nirma-
lini, Inggit & Ajeng, 2009). Consumer expectation
regarding technological usage and advances as well

2 LITERATURE REVIEW

2.1 Social
The change in people preferences does influence
the changes and values about the services delivery
in healthcare industry, which indirectly impacts
medical tourism development (Piggot, 2000).