Health, Wellness and Tourism: healthy tourists, healthy business ...

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ATTRIBUTES OF HEALTH AND WELLNESS TOURISM UNITS – AN IMPORTANCE-PERFORMANCE ANALYSIS Joana Alegria Quintela University of Aveiro / Dept. of Economics, Management and Industrial Engineering MA in Tourism Management and Development Campus Universitário de Santiago . 3810-193 Aveiro, Portugal joana.quintela@gmail.com Anabela Gomes Correia Polytechnic Institute of Setúbal / College of Business and Administration Campus do IPS, Estefanilha 2914-193 Setúbal, Portugal Center for Governance and Public Policy Research – University of Aveiro acorreia@esce.pt Jjoaquim Gonçalves Antunes Polytechnic Institute of Viseu / School of Technology Avenida Coronel José Maria Vale de Andrade Campus Politécnico . 3504 - 510 Viseu, Portugal jantunes@dgest.estv.ipv.pt Abstract The main objective of this study consists of identifying the attributes that please more and that are more emphasized by the users of five thermal units and a hotel with Spa situated in a Portuguese region. The empiric research consisted on the interpretation of surveys administrated to their users. The model of this study was based on Importance-Performance Analysis. Through the IPA analysis, we verified that all the attributes are concentrated on the area of the critical forces, in which the importance and performance attained high levels. Although, must still be emphasized that “Relation quality / price”, “Quality of complementary services” and “Geographic localization” are attributes that belong to the area risk/opportunity and are in its threshold, which means that Health and Wellness Tourism units managers should concentrate efforts to improve the performance of these attributes because they are very important to their users. Keywords: Health, Wellness, Tourism, Attributes, Performance, Satisfaction. Introduction The growth of Health and Wellness Tourism in Europe is clear and it is due to a number of social circumstances, such as the increase of the citizens and to the population oldness and its lifestyles. On recognizing the increase of the number of people interested in having leisure times with quality, becomes evident and necessary that the supply should give special attention to this question, as an answer to the needs and wishes of consumers, as well as the fulfillment of their satisfaction levels. This perspective is seen as a determinant factor in what concerns to the competitiveness which allows the regional development of the inner regions of Portugal, where this kind of touristic offer can mainly be found.
The study investigates the performance of the main attributes in Health and Wellness units, located in Viseu, a region in the center of Portugal, well-known by its thermal and touristic potential. The purpose of this study is employing the importance-performance analysis (IPA), a decision-making tool for service management, to assess the performance of the attributes of Health and Wellness units in Viseu region and analyze the importance those attributes have to their users. The Importance-Performance Analysis (IPA) is a technique introduced into the field of marketing by Martilla and James (1977). Although this research method has been referred mainly in marketing literature it was initially applied in the automobile sector. But in a short time the application of this technique was applied to the health sector, banking (Ennew et al., 1993), hotel industry (Martin, 1995), education and destination tourism (Hudson and Shephard, 1998). This technique identifies strengths and weaknesses of brands, products and services by comparing the two criteria that consumers use in making a choice: the relative importance of attributes and consumers’ evaluation of the offering in terms of those attributes. Once the importance and performance of each attribute have been plotted, the resulting IP space is traditionally divided into four quadrants. The priorities for improving the attributes of the service are then inferred from the quadrant where each attribute (performance, importance point) is located. Unlike SERVQUAL model created by Parasuraman, Zeithaml & Berry, (1994), which is best described as an absolute performance measure of consumer perceptions of service quality, the Importance-Performance paradigm also seeks to identify the underlying importance attributed by consumers to the various quality criteria being assessed (Sampson and Showalter 1999), constituting a tool for managerial decision making in services. Several different approaches have been used to undertake Importance-Performance Analysis (IPA), aka quadrant analysis or gap analysis. Martilla and James (1977) originally suggested that the positioning of the grid lines is a matter of judgement, because the value of IPA is in determining relative, rather than absolute, levels of importance. In some applications, the point where the quadrant grid lines cross (the cross-point) is placed in the centre of the scale used. Slack (1991) presented an IPA model that considered a relationship between importance and performance and theorized that target levels of performance for particular product attributes should be proportional to the importance of those attributes. In other words, importance is seen as viewed as a reflection of the relative value of the various quality attributes’ to consumers. According to Barsky (1995), lower importance ratings are likely to play a lesser role in affecting overall perceptions, while higher importance ratings are likely to play a more critical role in determining customer satisfaction. IPA also helps to identify which attributes, or combinations of the attributes are more influential in repeat purchase behavior and which have less impact. The information is valuable for the development of marketing strategies in organizations (Ford et al., 1991). This view is confirmed by Lovelock et al. (1998), who stated that importance-performance analysis is an especially useful.
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Health, Wellness and Tourism: healt
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Acknowledgements TTRA Europe would
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Kai Illing, Professor, Joanneum, Au
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ELISABETH IXMEIER Elisabeth Ixmeier
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Health and Spa Tourism Business: To
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Literature Review Health and Spa To
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Yoon & Uysal (2005) stated that pus
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Push factors Internal motives - phy
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Respondents were the international
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Perceptions, learning and attitudes
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Table 2 Themes of Motivation Factor
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elaxation as this is generally the
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Oh, H. C., Uysal, M. and Weaver, P.
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According to Ajzen, “persuasive c
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Behavioural Control: Workload Lack
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A Case Study of Innovative Wellness
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RP Care is an innovative modular ex
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The introduction of its modular bus
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UNDERSTANDING THE IMPACT OF LEISURE
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development but, three years later,
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Hamer, D., & Connor, B. (2004).Trav
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URBAN ZEN - AND HOW TO EXPLORE THIS
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Health Tourism - The SPA Goers in P
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Whether we opt for more realistic s
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focused on the paradigm of wellness
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immediately followed by specific ho
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particular reference must be made o
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Tabbachi, M. (2008), “American an
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tourism is a lucrative activity for
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Functional value Functional value i
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“Before my operation, I did exten
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The table below recapitulates the m
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Herrick, D. M. (2007). Medical tour
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Cosmeceuticals in wellness tourism
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will replace chemical materials; ad
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Issues in Co-branding and Co-creati
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producers of the cosmecuticals to a
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Lee, C. L. & Decker, R. (2008). A s
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scheme, although this theoretically
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study identifying the motivation of
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highlighted by Folland et al (2001)
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ackgrounds is expected to accomplis
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Understanding mature traveller’s
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attention to the mature travellers
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Table 1 Travellers’ demographic p
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• To distinguish spring and spa t
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Budapest’s thermal spas on screen
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Budapest as film location The power
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Usually viewers attach an icon to t
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In the second part of the questionn
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Riley R. & Van Doren C. (1992) Movi
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health as “a state of complete ph
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how much exercise they get. Two-thi
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arts, comedy clubs and festivals) w
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The use of the internet in wellness
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The main characteristics of Portugu
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29 Termas de Unhais da Serra 30 Ter
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ongoing consumer and industry resea
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Name Table 2. Spa websites analysed
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more than a handful of links were o
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Health Spa and Wellness - Competiti
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The Czech Republic is rich in spas
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Foreign Exchange Receipts and Expen
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the total fertility exceeded the va
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1. Waters - the internal and extern
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• N - Postoperative and posttraum
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Foreign guests at accommodation fac
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Table 6 shows the number of guests
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M. Zuckerman defines wellness as pr
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Today´s health spa hotels are most
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without spa facilities and service
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Ten Spa Domains. Downloaded from: h
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customer is value, which at each gi
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experiences that renew the spirit.
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eigenvalue 3.668, function 2 explai
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The results of this study support t
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Smith M, & Puczko´ L (2009). Healt
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and Bushell (2009, 11) have defined
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listed reasons in more general leve
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One 54 (13.3) Yes 180 (44.3) 2-4 21
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Discussions and Conclusions The aim
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Kelly, C. & Smith, M. (2009). Holis
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While wellness tourism in Australia
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Cairns, which has been suffering fr
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significantly from there, so if the
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Other factors raised by participant
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Connell, J. (2006b). Medical touris
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The Impact of a Festive Event on Re
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The mission of the World Acadian Co
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Table 1 Positive social impacts of
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The Acadians’ quest for pride and
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Ap, J., & Crompton, J. (1998). Deve
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and other characteristics of the ho
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Figure 1). Many of the hotels take
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Target groups As shown in Figure 2,
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to have an influence on these corre
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Purification 11 Application of alte
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Mueller H. and Lanz-Kaufmann E. (20
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The term multidimensional scaling (
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Figure 3 shows the split of bednigh
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Note: Objects: 32. Proximities: 496
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Group one account for 37% of the va
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Measurement of Tourism-oriented Asp
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Social indicator systems Social ind
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1999/2000, Table 1. presents the me
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However, according to Table 1, it a
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Since the TSTAR database does not h
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the hundred happiest settlements re
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Managing Cost, Revenue and Yield in
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Method: A Case Study Approach The a
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methodologies, and educational trav
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and times the data was collected, F
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SALA RIES AN D W AGES 18.17% PROFES
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Table 11 Treatment and revenue rate
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Measurement of the Economic Impacts
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o The macro and micro environment r
Page 233 and 234: Employment impacts During our analy
Page 235 and 236: • The examined wellness hotels we
Page 237 and 238: Total number of available beds (acc
Page 239 and 240: • Our analysis showed that new jo
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Page 243 and 244: of the area will also grow by marke
Page 245 and 246: of the case studies will be present
Page 247 and 248: The water is radio-active and conta
Page 249 and 250: Conclusions In our changing environ
Page 251 and 252: no exception. Already, patients are
Page 253 and 254: Data regarding levels of training o
Page 255 and 256: Figure 2 - Graph showing price will
Page 257 and 258: Table 13 - Typical hospital costs f
Page 259 and 260: that people willing to pay slightly
Page 261 and 262: Continue follow-up care in the UK F
Page 263 and 264: HEALTH TOURISM IN IZMIR: POTENTIAL,
Page 265 and 266: • Service provided within the ins
Page 267 and 268: Table 2 - SWOT Analysis of Health T
Page 269 and 270: 16. Increasing interest in alternat
Page 271 and 272: APPENDIX 1 Interview Questions 1. M
Page 273 and 274: point of view it means wholeness as
Page 275 and 276: Men Women International Playboy, Me
Page 277 and 278: elderly wanted to look like, to act
Page 279 and 280: Table 4. The number of experienced
Page 281 and 282: emains an open question when the sh
Page 283: Most important criteria when bookin
Page 287 and 288: The survey was distributed to 400 u
Page 289 and 290: Conclusions and Discussion In this
Page 291 and 292: A Comparative Analysis of Spa Touri
Page 293 and 294: year-long Ottoman occupation: the T
Page 295 and 296: although unintentionally, represent
Page 297 and 298: separated and I don't like being st
Page 299 and 300: Creighton, M. (1997): Consuming Rur
Page 301 and 302: Does tourism really contribute to o
Page 303 and 304: Africa (mainly Cape Verde, Angola a
Page 305 and 306: The theoretical significance of und
Page 307 and 308: Veenhoven (2005:61) “quality-of-l
Page 309 and 310: Brunt and Courtney (1999). Brunt, P
Page 311 and 312: Expectations of Health Tourists in
Page 313 and 314: 40%). Only those guests were includ
Page 315 and 316: accommodation, meals and health off
Page 317 and 318: Exploring The Relationship Between
Page 319 and 320: proposed at 1975 by Cskiszentmihaly
Page 321 and 322: Table 1 Participant information ana
Page 323 and 324: Table 3 Well-being analysis result
Page 325 and 326: Csikszentmihalyi, M.,(1990), Flow:
Page 327 and 328: evident in Ancient Greece and Rome.
Page 329 and 330: Resort spas - Sometimes called ‘a
Page 331 and 332: analytic model has several methodol
Page 333 and 334: From this survey, we selected sever
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Gulliver in the land of giants? The
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emergency cases. As the commonly kn
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Figure 1. The main factors of quali
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Surgical medical touristic market T
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• Seamless services: The professi
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of price-advantage segment. Due to
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Appendix 1. The characteristics of
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Appendix 2. The characteristics of
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Introduction Arguments for the need
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The DOSTWELL Wellness Quality Seal
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The statistics obtained from the su
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Table 1 Sample of the Classificatio
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Goebel, G., Kapfensteiner, C., Wenz
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interest activity and health and we
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performance calls for a unity of wi
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Table 2 - Learning Commitment Analy
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higher the tourists satisfaction in
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supporting factors and resources, d
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Sustainable Wellness Tourism Destin
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In tourism marketing Savonlinna has
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The role and actions of Savonlinna
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Haaga-Helia (2010). DP in Experienc
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Hall, M. (2003) Spa and Health Tour
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excellent capabilities. Despite of
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Australian Wellness Tourism Provide
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thrills and excitement which someti
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The actual responses were compared
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therapies such as Feldenkrais, acup
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Table 2: Average Number of Employee
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As expected, Day Spas and Beauty Sp
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Snoj & Mumel, 2002). Furthermore, r
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Cooper, C. P., Fletcher, J., Noble,
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The Exploration of the Perceived Tr
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The key question in market segmenta
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significantly from each other. Ther
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Table 3 Cross-table of Background o
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4. Travel benefit perception reflec
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http://www.oxfordreference.com/view
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summary or as a commonly accepted b
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Third, these proxy prototypes were
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Table 2 Main travel purpose of the
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Table 4 Non-response shares for des
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Figure 1 Image positions of five As
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Figure 2 Image positions of five Eu
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piecemeal hypothesis and an undiffe
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Taasci, A.D.A. and Kozak, M. (2006)
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Among the economic factors determin
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The demographic profile of the dent
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The main part of the tourists’ ex
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Interview II was with the Chief Den
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anchor point of the dental tourism
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The country itself could profit muc
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