Medical tourism plays an important role in national revenue of many countries; This industry earns about 100 billion dollars for the governments each year. However, Tourism is not developed in Iran and it is in its initial paces. As a matter of fact, the Ministry of Health recognized tourism-therapy in 2003. In addition, by doing this, rather than supporting tourism-therapy, the ministry mainly tried to create new jobs for the graduates of medical sciences. However, tourismtherapy was introduced as an independent industry in 2004 by the merger The Cultural Heritage Organization to The Iran and World Tourism. According to the planning, the Iranian government has devised plans to cover 30% of medical and health needs of the country, by the end of 4th national development program, through exporting medical products and services. Therefore, determining the obstacles in the way of optimum development of tourism-therapy industry is of great help to the country.

Introduction: Increasing pressure on available funds in health care section especially hospitals, enhances the need of analyzing different strategies in economic terms. One of the solutions for the optimal use of financial resources and potentials in hospitals and health care centers is using elements of the marketing mix. In this way we could make the best use of the resources and cause a return on investment and also generate income. Methods: This is a cross-sectional and qualitative study. To prepare checklists, author used previous studies in marketing by referring to relevant web sites and designed the first draft. In next step, Delphi’s technique was used for validity check; the checklist was sent to health care management specialists who had studied in medical tourist fields or those who lived in cities active in this field. Results: the final checklist included 8 aspects (mixes) and 79 indexes in which Product Mix had 11 indexes, Place Mix had 3 indexes, Promotion Mix had 13 indexes, Price Mix had 9 indexes, Personnel Mix had 12 indexes, Promotion Mix had 6 indexes, Physical attraction Mix had 19 indexes and Physician Mix had 6 indexes. Conclusion: this instrument could be used in various studies that could help asses’ health care units state specially hospitals so that alternatives could be considered for improvable points and make maximum use of the potentials.

Introduction: Health tourism refers to any type of travelling seeking improvement of health condition. It can be treated like a national strategy toward increase of national income. The present study is an attempt to survey the factors in development of health tourism in Iran. Methods: The study is an analytical research and data used in the study were gleaned through library resources and academic site web. In addition consultation with experts was also added. Using snowball sampling 61 of the authorities of health tourism answered the questionnaire. Finally the results were analyzed using Friedman test. Results: The findings showed that 3 main factors in development of health tourism of Iran are health tourism branding, correlation between different sections, and centralized services. Conclusion: To have all its potentials of nurse health care realized, and to meet the goals of Iran 1404 outlook program, a comprehensive and executive planning must be adopted and other requirement to emerge as a leading country in the region regarding the industry must be provided.

Introduction: Medical tourism is one of the competitive and income industries in world and has the ability to attract tourists in the health sector and international markets are totally dependent on international accreditation. This study has been done to evaluate the capabilities of active public and private hospitals in Shiraz regarding attraction of tourists’ base on accreditation standards. Methods: This is a descriptive-analytic and cross-sectional study which performed on four hospitals which were active in medical tourism in 2012. A checklist of international accreditation standards based on Joint Commission International (JCI) was applied for collecting data. Data were analyzed using descriptive analytic statistical tests. In descriptive statistics, frequency tables and standard deviation were used for scoring the hospitals. Independent student (T-test) was used to compare the mean of public and private hospitals in attracting medical tourists. Results: Hospital No.3 in the Patient-Centered Standards and Health Care Organization Management Standards was in the best position whilst hospital No.2 in the Patient-Centered Standards was in the worst state and hospital no.1 in Health Care Organization Management was in the worst position. Also there was a significant difference between public and private hospitals in attracting medical tourists according to Joint Commission International (sig=0.01). Conclusion: Shiraz hospitals have good ability to attract medical tourists; these abilities are very good in most cases and in some cases there is a need to improve. Having recognized the strengths and weaknesses of these hospitals can use SWOT analysis model, which is used in medical tourism program of some countries, for improving their abilities in attracting medical tourists.

Introduction: Medical tourism is one of the branches of health tourism and has been an important issue in many developed countries during the past few years. This research has aimed to study the factors affecting the selection of the hospitals of Tehran by the medical tourists who had chosen Iran’s capital city for their treatment. Methods: The present study is a descriptive inferential cross sectional study which was conducted in the summer season of 2014 in the Tehran’s hospitals. The study population included all the reachable medical tourists who had come to the hospitals of Tehran for their treatment during the summer season of 2014. The sample of the interview section included 10-15 experts who were randomly chosen to be interviewed. The sample of the questionnaire section included 50 medical tourists who had come to Tehran’s hospitals for their treatment during the summer season of 2014 (reachable sample). The data of the present study was analyzed by the SPSS software version 20. Results: According to the results of this study it is clear that famous and reliable physicians and also low health service costs are the two most important factors attracting medical tourists to the hospitals of Tehran. Also, the location of the hospitals have proven to be acceptable for the patients. On the other hand, factors which are related to promotion and the physical evidence of hospitals were not in an acceptable condition. Conclusion: Despite having famous and reliable physicians and low health service costs in Iran, it can be said that there are still many factors such as better marketing and advertisement, international standardizations and developing recreational centers that need to be focused on, in order to gain the well-earned international position in the medical tourism industry.

Introduction: Iran has considerable potentials for growth of health tourism. However, they have not been properly realized towards national development. This paper has attempted to prioritize the development strategies of health tourism in Iran which has been conducted on the hospitals of Tehran. Methods: This study is a descriptive-analytical research. It was carried out in 2013 and the sample size was determined through snowball nonprobability sampling. A questionnaire was administered to 29 participants and the development strategies were formulated by SWOT. Results: The findings of the research showed that the weakness points of the health tourism industry override the strength points. This is while the opportunities of development are more than threats. Conclusion: One may conclude that Iran’s health tourism is in a weakness opportunity (WO) situation and needs strategies which have been specially designed for such situations. Therefore, the improvement strategies (WO) have been located in priority for the development of health tourism in Iran.

Introduction: Medical tourism is a main source of national income. Thus, evaluating the viewpoints of medical tourists about the quality of service provided by healthcare centers may be useful in planning to develop this industry. The present study aimed to measure the gap between medical tourists’ expectations and perceptions of the quality of service offered by the hospitals in Shiraz using the SERVQUAL model. Methods: This cross-sectional study was performed on 200 medical tourists referred to hospitals in the city of Shiraz which is located in the south of Iran. The subjects were selected randomly over the first 6 months of 2013. Data collection tools were a descriptive questionnaire and an adaptation of the SERVQUAL questionnaire. Results: The results showed that the mean age of medical tourists was 49.67 and most of them were from Oman. Overall, the patients’ expectations exceeded their perceptions of the provided quality of service, and all gap mean scores were negative. The largest negative gap score pertained to reliability with an overall average of -0.59, followed by responsibility, assurance, tangibility, empathy, and access to care. Conclusion: The research findings can effectively help managers identify problems with the current quality of service and improve performance so as to increase the medical tourists’ satisfaction level. Also, highlighting the most important service attributes, which are highly attractive to patients, will help authorities improve their operation performance and develop innovative ideas on both strategic and tactical levels.

Introduction: Since medical tourism is considered as an incremental activity in this sector and proper infrastructures in country to make medical tourism are lacking, announcement by authorities to provide perquisites of medical tourism to make the first clinic hotel and health town are necessary for the purpose of developing medical tourism in Iran, all of these side issues should be investigated. Methods: Cardiovascular diseases are very common because of pollution and industrial development. In this research, by extracting related studies on medical tourism and its localization, using hospitals data bank and questionnaire of 640 medical tourists, only 528 of them were approved and finally by using IBM SPSS modular 14.1 software decision tree in data algorithm, efficiency and purity level were obtained. The method for data preprocess step is utilized to extract the best model. Two preprocess steps are deleting useless and correlated features, because data should be prepared until model has the least error. Results: Among the examined algorithm including C&RT, CHAID and Multiple Linear Regression, it was shown that C&RT has the optimal results. The results obtained from this research indicate that C&RT binary decision tree has the smallest error value (0.078) and the greatest accuracy value (0.922). Conclusion: In this research, first effective factors on heart medical tourism were investigated with the help of experts in this field, then C&RT and CHASID models using Clementine software and multiple linear regression variables were compared and ranked. With respect to this algorithm, personnel behavior, social security and communication variables are respectively the most important factors for medical tourist attraction.

Introduction: Health tourism refers to travel for the use of services that improve or promote the physical or psychological health of an individual in a location apart from their place of residence lasting over 24 hours. Health tourism provides a sizeable share of revenues derived from the health sector in some countries. The high potential for health tourism in Iran, especially in the city of Mashhad, the need to establish a groundwork for health tourism in Iran that cannot be overemphasized. Because the transfer of knowledge and theoretical and practical synthesis are underlying concerns, this study examined how health tourism knowledge is transferred and applied from the perspective of health tourism officials and academics. Methods: This study adopted a qualitative approach based on grounded theory. Data collection was conducted through purposeful sampling using in-depth and semi-structured individual interviews. The conversations were recorded and then transcribed verbatim and finally analyzed using Strauss and Corbin’s coding paradigm and constant comparative analysis. Results: The results of interviews with 16 participants from among hospital managers, university professors and tourism and health insurance managers yielded 100 initial codes, out of which 60 conceptual labels or preliminary codes for broader concepts were extracted after repeated modification to reach conceptual density. Conclusion: Three categories having several subcategories were derived from the responses of participants: the challenges and benefits of health tourism, human interaction and communication and the impact of international standards.

Introduction: Iran offers many advantages for health tourism, e.g., low costs, high quality healthcare, qualified doctors, and abundant natural attractions, but there are also obstacles to the development of health tourism in Iran. This study aimed to identify and prioritize the barriers to health tourism in hospitals affiliated with Tehran University of Medical Sciences. Methods: This cross-sectional study was conducted in the first 6 months of 2016. Six main components were identified based on experts’ opinions; then, based on these components, a questionnaire for pairwise comparison was produced and completed by the same experts. The analytical hierarchy process (AHP) model was used to prioritize the identified factors. Results: Results showed that among the barriers to health tourism in the investigated hospitals, the most important obstacle is the unfamiliarity of medical staff with foreign languages with a weight of 0.268. Lack of manpower and inappropriate physical were ranked second and third in priority with weights of 0.214 and 0.157, respectively. Conclusion: Considering the available capacities and potentials, effective and impressive steps can be taken to economically develop the medical tourism industry in Iran.

Purpose – Health-care tourism has become a major industry in the past decade. Following the increasing activity in health-care tourism, the decision-making process of consumers in choosing an international health-care facility has become increasingly important to the related parties. The present study aims to offera holistic model of internationa health-care facility choice that incorporates the important dimensions by assessing the growth drivers and the alternative factors proposed in the literature and by validating them via a survey study.

Tourism is predicted to become the most profit-able industry of the world by 2020. Among di-verse types of tourism, medical tourism is regard-ed as one of the key areas of tourism industry in the world, which has been on rise in recent years. The revenue generated by each medical tourist is three times as high as revenue brought by ordi-nary tourists (1).
Considering the tremendous financial turnover of this industry in the world, today many developing countries in Asia, Latin America Africa are com-peting for the absorption of medical tourists. Of course, since each of these countries offers medi-cal services in a specific area, which serves as their competitive edge, it is difficult to determine the most popular medical tourist destination. Overall, major medical tourism destinations in the world are Costa Rica, Mexico, the US, Singa-pore, Thailand, Malaysia, India, Philippines, Tai-wan, South Korea and Turkey(2).

Investigating the main trends and mechanism of the medical tourism sector, have been lately an-nounced globally as a necessity due to the fast-growing changes and diverse information from around the world. The data for medical tourism are revolving globally.
Lately, the pioneers of medical tourism reported that this sector is ‘relatively short distance, cross border and diasporic’ (1). In the latest report by ‘International Medical Travel Journal’ (IMTJ) (2), also, the new transformations in this sector are announced. Based on this report in 2018, regional or domestic medical travel makes the greater proportion, and medical tourists are no longer seeking out the cheapest destination (2).

costs share was about 6 % of Iran’s Gross Domes-tic Product in 2011[1]. Health centers are facing a future in which costs will be considered as the first issue[2]. Hospitals are the most important units that offer medical and health care services, which means making new hospitals will lead to promotion of health, Prevention of diseases and access to treatment and rehabilitation services. On the other hand, due to development of sophisti-cated technology and equipment and the use of widely different specialties, building new hospi-tals would be very costly[3]. According to WHO’s report, hospital expenses include about one half of all health costs in the third world coun-tries. Hospitals share in governmental current ex-penses in health section is between 60-80 % [4]. Increasing pressure on available financial re-sources of health care units specially hospitals in-creases the necessity of analyzing different eco-nomical strategies[2].