Keywords

1 Introduction

Travel for health purposes has led to the emergence of health tourism. According to Coghlan [1], health tourism refers to “a well-organized journey away from home country for the improvement, melioration or betterment of an individual’s mental and physical well-being”.

Medical tourism is a big part of health tourism and includes travelling to a different country from the one a person resides with a purpose to get medical treatment or investigate the possibility of such treatment. In the last two decades, there has been a rapid growth of medical tourism. Medical tourism is expanding because more and more people increasingly travel for health reasons because of cost considerations, safety, and availability of medical procedures, service quality, waiting lists or success rates [2, 3].

Europe attracts a lot of medical tourists and Greece is considered a preferred destination especially for fertility treatment. However, research on medical tourism services is limited. The purpose of this study is to investigate the inbound tourism for fertility treatment in Greece.

2 Literature Review

The World Tourism Organization and European Travel Commission [4] provides an encompassing definition of health tourism as tourism with the primary motivation of contributing to physical, mental and/or spiritual health through medical and wellness-based activities [5, 6]. A definition of medical tourism describes it as “travel to destinations to undergo medical treatments such as surgery or other specialist interventions” [7, p. 101].

Medical and wellness tourism form together health tourism [8, 9]. Medical tourism is described as a form of reactive health tourism because the aim is to treat illness whereas wellness tourism is considered proactive because it aims to prevent illness or maintain a good health without a medical procedure [9]. Therefore, medical tourism is a considerable part of the health and tourism industry and can be described as an economic activity that involves the sale of both tourism and medical services [10]. Tourism services sold include accommodation, food and beverage, transportation, and entertainment services. Such services are a source of economic growth for destinations and consequently many countries have sought to promote and expand health and wellness tourism [11]. Health tourism helps to increase foreign exchange and enhance the gross domestic product and of course expand the health care industry of a country [12, 13]. Consequently, there are more than 50 countries worldwide that have declared medical tourism as a national industry [14].

For all these reasons, in the last two decades, there has been a rapid growth of medical tourism. The global medical tourism market size was valued at USD 10.3 billion in 2022 and is expected to expand at a compound annual growth rate (CAGR) of 32.51% from 2022 to 2030 to reach USD 97.7 billion by 2030 [11]. According to global health tourism data there were over 23 million health tourists in 2019 [15] Covid-19 has decreased medical tourism considerably (86.2%) in 2020 but the market is rebounding fast [11].

Europe attracts more than 2.6 million tourists yearly, accounting for a quarter of the global health travel market [16]. Greece is one of the most preferred destinations for medical tourism and particularly for fertility treatment [16] at present and is continuously exploiting the growing global medical travel market. The medical fields that attract medical tourists to Greece include in vitro fertilization, plastic surgery, ophthalmology, dentistry, and rehabilitation as reported in Greek Travel Pages [16]. The main advantages of Greece as a medical tourism destination are a good climate, highly skilled personnel, cutting-edge medical innovations and high success rates, liberal laws and the possibility of having a beautiful vacation while undergoing treatment in a safe travel destination.

However, research on medical tourism is limited. Previous studies mainly focus on identifying sources of information for health tourism [17, 18] the perceived risks and benefits of travelling for health care [19, 20], push and pull factors that create the demand and supply for medical tourism services [9], and factors affecting the choice of a country as a medical tourism destination [9, 21, 22].

The purpose of this study is to investigate the inbound tourism for fertility treatment in Greece. Specifically, we aim to find out the typology of foreign patients that come to Greece for fertility treatment, the types of treatment they use and the success rates of each treatment, patients’ motives to travel to Greece for fertility treatment, the sources of information they use to learn about health tourism in Greece, the perceived quality of fertility treatment services, and the competitor countries that are considered by tourists as a health tourism destination.

3 Methodology

The study is quantitative and descriptive in nature. A survey with a structured questionnaire was administered to a sample of 60 women that came for fertility treatment in a fertility Centre in Crete. Data collection was done electronically through emailing the questionnaire to past patients treated at the fertility center. 60 patients responded to the survey out of 100 emailed. The sample was purposive in nature. Crete was chosen as one of the top destinations for health tourism in Greece. In fact, ancient holistic rituals and cutting-edge therapies for the skin, body, mind, and relaxation can both be found in Crete [23]. Also, the specific fertility center was chosen because the researcher had access to past patients and the centre’s customers were mostly foreign citizens. Data analysis involved descriptive statistics.

4 Results and Discussion

Results show that in terms of country of origin most patients are from Russia (26.7%), Italy (21.7%), and Netherlands (20%), followed by France (10%), Germany (10%), Turkey (5%), United Kingdom (3.3%) and Hungary (3.3%). More than half of the sample is aged 35–44 years old (58.3%) and another 21.7% is 25–34 years old.

Furthermore, health tourists surveyed came to the fertility center in Crete mainly for 3 types of treatments in vitro fertilization (IVF) using their own eggs (43.3%), ovarian rejuvenation therapy (PRP) (33.3%), and fertility treatment with sperm donation (21.7%). Also, the reasons for selecting Greece for fertility treatment are the high success rates (61.7%), the extensive positive word of mouth from other patients who have received treatment in the past (23.3%), the wide range of treatment options available (38.3%), the ease of travel (35%) and the perceived safety of Greece as a country (38.3%). In fact, for 80% of the sample Greece was their only choice for fertility treatment. No other country was considered.

Another important finding concerns the sources of information used for learning about fertility clinics available in other countries. The most important sources are the patient’s doctor or fertility specialist (40%), direct communication with a clinic (36, 7%), the internet (35%), word-of-mouth communication from past customers of clinics and information from a family member, friend or colleague who has gone through the treatment in the past. Moreover, the sample agrees that the perceived quality of services provided by the Fertility enter is high. In fact, 75% of respondents said that their treatment was effective, and that they were willing to recommend the Fertility Center of Crete to friends/relatives. Finally, 55% of respondents stayed for fertility treatment in Greece for 8–14 days and during their treatment they also had a vacation in Crete.

The findings of this study present implications for managing country image and specific businesses that want to attract medical tourists. First, it is important to note the importance of foreign doctors or fertility specialists as sources of information for appropriate places of treatment as well as the importance of personal and impersonal word of mouth (friends, family and reviews). So, businesses in this industry should reach out to medical professionals in other countries and form allegiances in order to boost sales. Also, communication efforts of clinics should be professional and use trained employees that can communicate effectively with potential customers. Furthermore, Greece should link its promotion as a destination with medical purposes and in particular promote the high success rates of medical procedures. Finally, the Greek brand should include two very important characteristics of the country, ease of travel and safety. This way, a successful Greek brand can be built in the medical community globally. Finally, the study shows that the main target market for medical services is people between 25 and 45 years old. So, targeting and promotion both of medical facilities and of the country as a medical tourism destination should be based on this target market.

5 Conclusion

This is a study limited in scope to one fertility center in Crete with a small sample. Future research can extend the sample, investigate other forms of medical procedures that attract health tourists and the factors that affect tourists in their choice of Greece and of the specific medical centers. Finally, research can focus on the optimal marketing mix of medical and tourism services for medical tourists.