1. MEDICAL TOURIST SATISFACTION AND DISSATISFACTION WITH DENTAL CARE SERVICES: AN EXPLORATORY CASE STUDY
OLIVER KESAR, PhD, Associate Professor
JOSIP MIKULIĆ, PhD, Associate Professor
Faculty of Economics & Business, Zagreb, Croatia

2. PRESENTATION STRUCTURE
Introduction
HEALTH TOURISM: CONCEPTUAL FRAMEWORK
TRENDS IN MEDICAL TOURISM DEVELOPMENT
MEASURING PATIENT SATISFACTION IN HEALTH CARE DELIVERY
RESEARCH METHODOLOGY AND DATA SOURCE
RESULTS AND INTERPRETATION
Conclusion

3. Introduction
Health tourism  an increasingly important aspect of contemporary tourism development.
Among the most promising tourism products, according to Croatia’s Strategy of tourism development.
Convergence of health care and tourism systems has created a variety of health-related tourism services and packages.
The focus of the research  Dental tourism.

4. thalassotherapy tourism
1. HEALTH TOURISM: CONCEPTUAL FRAMEWORK
1: Healing/hospital/
sanatorium
tourism
2: Spa/thermal/
thalassotherapy tourism
HEALTH TOURISM
3: Wellness
tourism
4: Medical
tourism
Dental tourism

5. 2. TRENDS IN MEDICAL TOURISM DEVELOPMENT
Many reasons why people travel abroad for health care: dentistry, cosmetic/aesthetic, cardiac, bariatric, eye or orthopaedic surgery, IVF, transplantation, diagnostics, etc.
Increasing number of countries have adjusted their health-care, tourism and legal systems to attract foreign patients.
Tremendous growth of medical tourism is supported by: 1) GATS, 2) global health insurance and 3) the Internet.
Rising awareness of negative aspects, ethical issues and controversies.

6. 3. MEASURING PATIENT SATISFACTION IN HEALTH CARE DELIVERY
SERVQUAL – the most frequently used approach.
Growing interest in using nonlinear and asymmetric approaches relationship between attribute- and dimension-level satisfaction and overall satisfaction.
The Kano model  three-factor approach of measuring customer (patient) satisfaction: 1) satisfiers, 2) dissatisfiers and 3) hybrid attributes.

7. 4. RESEARCH METHODOLOGY AND DATA SOURCE
Objective: to determine elements/attributes of dental care services that contribute most to creation of dental tourist satisfaction
Elements/attributes examined:
1) Acceptability of prices;
2) Honoring scheduled appointments and deadlines;
3) Completeness of service program;
4) Quality of product/services;
5) Information availability about clinic and services;
6) Staff professionalism and competence.

8. 4. RESEARCH METHODOLOGY AND DATA SOURCE
Sample size: 253 international patients (48% from Italy, 44% from the UK, and 8% from Slovenia).
Time frame: February 2017
Instrument: Self-completion questionnaire (SCQ).
Analysis approach includes:
Impact (determinance)-asymmetry analysis, and
Impact-range analysis.

9. 5. RESULTS AND INTERPRETATION
All examined dental service attributes have a larger potential to create dissatisfaction than satisfaction.

10. 5. RESULTS AND INTERPRETATION
4) Quality of product/services (IA4= -0.42; RIOS4= 1.93), and 6) Staff professionalism and competence (IA6 = -0.33; RIOS6: 1.57)  attributes with strong potential to create patient΄s dissatisfaction with delivered service.
2) Honoring scheduled appointments and deadlines (IA2-0.21; RIOS2= 0.73), and 5) Information availability about clinic/services (IA5 = -0.26; RIOS5: 0.82)  attributes with relatively low potential to create dissatisfaction.

11. 5. RESULTS AND INTERPRETATION
1) Acceptability of prices (IA1= -0.11; RIOS1= 0.62)  relatively balanced potential to create satisfaction and dissatisfaction.
3) Completeness of the service program (IA3= -0.07; RIOS3: 1.13), only attribute that could be referred as a hybrid attribute  balanced potential to create satisfaction and dissatisfaction.

12. CONCLUSION
Zagreb is an emerging dental tourism destination with high quality of dental care services.
Main target market: developed EU countries.
Quality of product/services and Staff professionalism and competence are the most influential attributes of dental service that create overall patient΄s experience.
Dental service prices, if transparently communicated, have low influence on patient΄s experience.

13. Thank you for your attention!
Oliver Kesar & Josip Mikulić
Department of Tourism, Faculty of Economics & Business, University of Zagreb, Croatia
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