The aim of this research is to understand the effect of product quality, medical price and staff skill on patient’s loyalty through cultural impact in medical tourism. In this study, three exogenous con-structs; namely product quality, medical price, and staff skill constructs were adopted to find their effects on patient’s loyalty. Meanwhile, the cultural impact is also adopted as a mediator construct. This study uses confirmatory approach as Covariance based Structural Equation Modeling (CBSEM) for testing the research hypotheses. The study explores inbound medical tourists loyalty from 324 respondents sampled comprised from different countries using stratified sampling. In terms of the direct effect, the method reveals that medical price and staff skill had positive significant effects on cultural impact and patient loyalty. In terms of indirect effect, the cultural impact mediates the relationships between product quality, medical price, and staff skills on patient’s loyalty.

India has turned out to be one of the most favorite destinations for the patients who want to undertake cost effective medical care for various medical problems and who have infuriated from the long waiting lists for medical and diagnostic procedures in their home countries. This research aims to analyze different factors along with their intensity affecting medical tourism industry in a developing country like India so that managers and policymakers can take better decisions which will help in growth & promotion of Indian health tourism market. The study has been done by performing a cross-sectional survey within major hospitals in India and exploratory factor analysis and graph theory and matrix approach have been used to evaluate the intensity of variables affecting Indian medical tourism sector. Nineteen variables have been identified through review of literature, and four factors have been extracted including cost, quality of treatment and care, availability of experts, competitive advantage and political, legal and visa related factors. With the understanding of the intensity of different variables suitable precautions can be taken by the healthcare managers so that these variables can be handled very carefully.

Medical tourism is an international phenomenon where some tourists travel long to reach treatment-therapeutic services because of high expenses, long waits, lacking in insurance, and applying services and insufficient access to health services in the destination. This industry, now, by making 60 billion dollars annually in international level, has been considered as one the most profitable markets and the number of countries to provide facilities and treatment services for foreign tourists tend to increase. Many countries provide applicable and legal plans for development of this industry. This paper aims at planning and improving medical tourism in megalopolis Shiraz. The dominating approach in the present study is developmental-applied and the method is descriptive, analytical and survey study. To analyze the data and to test the research hypothesis, the linear Pearson correlation and ANOVA were used. The results of the present study have indicated that all quality factors of treatment and tourism services, culture, facilities, medical and tourist equipment and ICT, had positive and direct correlation with developing medical tourism and the factor of price had negative and reverse correlation with it. In other words, the higher the price is, the less the medical tourism development is and vice versa. Also, the ANOVA showed that among medical tourists from various countries regarding satisfaction with the price of treatment and tourist services, the quality of treatment and tourist services, culture, facilities, medical and tourist equipment and ICT, there are significant differences and Kuwaiti tourists were the most satisfied tourists and Afghani ones were the least satisfied.

Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country & apos; s economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism potentials. In this survey, the researcher investigated the existing potentials of Zanjan province based on descriptive - analytical tourism in offering and providing medical services and accommodation. The survey reports that offered services in tourism were not acceptable and satisfactory.