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jha 2026, 28(4): 24-42 |
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Yoshari P, Jalali M, Raoofi S, Haghgoshayie E, Khodayari-Zarnaq R. Analysis of the potentials and barriers of health tourism: a qualitative Study in Maragheh, Iran. jha 2026; 28 (4) :24-42
URL: http://jha.iums.ac.ir/article-1-4641-en.html
URL: http://jha.iums.ac.ir/article-1-4641-en.html
1- Student Research Committee, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
2- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
3- Department of Health Care Management, School of Health Management and Information Sciences, Maragheh University of Medical Sciences, Maragheh, Iran.
4- Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran. ,rahimzarnagh@gmail.com
2- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
3- Department of Health Care Management, School of Health Management and Information Sciences, Maragheh University of Medical Sciences, Maragheh, Iran.
4- Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran. ,
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Table 1. Health tourism potentials in Maragheh
Table 2. General barriers for health tourism in Maragheh County
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Introduction
Health tourism has gained global recognition as a thriving industry and a strategic tool for attracting foreign investment and diversifying national economies beyond reliance on oil [1-3]. Leading countries such as Turkey, Malaysia, Singapore, and India have demonstrated success through advanced infrastructure, cost-effectiveness, and supportive policies [4-7]. Iran, and specifically Maragheh, holds significant potential due to its rich cultural heritage, natural attractions (e.g. hot springs), and available infrastructure [8-10]. However, development faces substantial challenges, including insufficient government commitment, fragmented policies, funding shortages, inadequate transportation, poor-quality accommodations, language barriers among staff, and weak marketing [11-16]. Therefore, this study aimed to identify the potentials and barriers in Maragheh's health tourism sector and propose effective strategies for its development. Implementing appropriate measures in this sector can improve infrastructure, address current challenges, attract more health tourists, and enhance Maragheh's position in this industry.
Methods
Study design: This qualitative study was conducted in 2024 using semi-structured, in-depth interviews to explore the potentials and challenges of health tourism development in Maragheh, Iran.
Participants and sampling: The study involved experts and key stakeholders in health tourism and affiliated organizations in Maragheh County. Participants were recruited through purposive sampling, followed by snowball sampling, continuing until data saturation was achieved. In total, 18 specialists and professionals in health tourism and related fields were interviewed. Initial participants assisted in identifying and recruiting other eligible individuals through the snowball sampling technique.
Inclusion criteria: Participants needed to meet the following criteria: sufficient knowledge and expertise in the field, familiarity with the Maragheh County context, at least three years of professional experience in health tourism or five years in providing services to patients and tourists, bachelor’s degree or higher, and willingness and motivation to participate in the study.
Data collection: Data were collected using a semi-structured interview guide, validated in consultations with experts. The guide was further refined following three pilot interviews. Several strategies were employed to strengthen the credibility and trustworthiness of the study, including: conducting pilot interviews, allocating sufficient time for each interview, simultaneous data collection and comparative analysis, sharing preliminary findings with participants for feedback and validation, and participating in peer debriefing sessions to discuss and refine findings.
Interviews were conducted face-to-face at times and locations mutually agreed upon by the participants and the researcher. Before each interview, the study objectives were explained, and verbal informed consent was obtained. With participants’ permission, interviews were audio-recorded, and each session lasted between 45- 60 minutes. Transcription and note-taking were completed on the same day as the interview.
Data analysis: Data were analyzed using MAXQDA software, employing thematic analysis. This systematic approach allows the identification, organization, and presentation of meaningful patterns (themes) within qualitative data.
Results
The study identified three main themes of health tourism potentials in Maragheh County: "Natural Resources," "Supporting Infrastructure," and "Healthcare Service Provision" (Table 1).
Natural resources: Maragheh County has numerous natural advantages for health tourism development. These advantages include its historical context and tourist attractions, favorable climate, and the Sahand Mountainous region. Furthermore, medicinal plants and seasonal markets, hot springs and therapeutic waters, and pristine nature with paleontological significance are other notable regional capacities.
Supporting infrastructure: Maragheh's strategic geographical location, including proximity to Kurdish-populated cities, the borders of Turkey and Iraq, and its short distance to the provincial capital, is a strategic advantage.
Healthcare service provision: Maragheh County occupies a favorable position regarding healthcare services provision. Its strengths include the diversity and quality of diagnostic and therapeutic services, including specialized and sub-specialized facilities, advanced medical equipments, and high- capacity clinics and private practices. The completion of hospital projects (Khajeh Nasir and private hospitals) and the referral status of the county's hospitals after Tabriz have reinforced its position as the therapeutic hub for the southern regions of East and West Azerbaijan provinces.
Infrastructural barriers: In the healthcare sector, shortages of hospital beds, absence of a widespread online appointment system, and pressure from the high volume of health tourists are primary challenges. In transportation, dangerous and poorly-maintained roads (particularly the Maragheh-Hashtrud route) are problematic. Accommodation and welfare infrastructures face additional challenges, such as low hotel quality, limited lodging facilities near treatment centers, and poor maintenance of tourist attractions. Additionally, historical infrastructure (e.g., unexplored historical sites) and communication infrastructure (e.g., internet disruptions and inefficient use of the airport) are other notable obstacles.
Economic and marketing barriers: Lack of cost transparency is a major obstacle, manifesting in overcharging at hotels and for medications, and even informal payments.
Stakeholder-related barriers: Poor inter-organizational collaboration and weak coordination among different institutions are evident. The absence of a strong, specialized management team for health tourism, combined with insufficient private sector participation due to economic inefficiency and limited system thinking are other challenges. Mismanagement and insufficient commitment from senior county officials towards developing this sector have also been identified as a serious obstacle.
Government-related barriers: At the macro-policy level, service stratification persist, with the high proportion of health tourists is overlooked in allocations of financial resources, capital equipment, and medicine quotas.
Community-related barriers: Finally, a low level of tourist-friendly culture among citizens and their weak awareness of tourism benefits, coupled with the low volume of tourists, have created a vicious cycle that prevents the formation of a social foundation for the development of this industry.
Health tourism has gained global recognition as a thriving industry and a strategic tool for attracting foreign investment and diversifying national economies beyond reliance on oil [1-3]. Leading countries such as Turkey, Malaysia, Singapore, and India have demonstrated success through advanced infrastructure, cost-effectiveness, and supportive policies [4-7]. Iran, and specifically Maragheh, holds significant potential due to its rich cultural heritage, natural attractions (e.g. hot springs), and available infrastructure [8-10]. However, development faces substantial challenges, including insufficient government commitment, fragmented policies, funding shortages, inadequate transportation, poor-quality accommodations, language barriers among staff, and weak marketing [11-16]. Therefore, this study aimed to identify the potentials and barriers in Maragheh's health tourism sector and propose effective strategies for its development. Implementing appropriate measures in this sector can improve infrastructure, address current challenges, attract more health tourists, and enhance Maragheh's position in this industry.
Methods
Study design: This qualitative study was conducted in 2024 using semi-structured, in-depth interviews to explore the potentials and challenges of health tourism development in Maragheh, Iran.
Participants and sampling: The study involved experts and key stakeholders in health tourism and affiliated organizations in Maragheh County. Participants were recruited through purposive sampling, followed by snowball sampling, continuing until data saturation was achieved. In total, 18 specialists and professionals in health tourism and related fields were interviewed. Initial participants assisted in identifying and recruiting other eligible individuals through the snowball sampling technique.
Inclusion criteria: Participants needed to meet the following criteria: sufficient knowledge and expertise in the field, familiarity with the Maragheh County context, at least three years of professional experience in health tourism or five years in providing services to patients and tourists, bachelor’s degree or higher, and willingness and motivation to participate in the study.
Data collection: Data were collected using a semi-structured interview guide, validated in consultations with experts. The guide was further refined following three pilot interviews. Several strategies were employed to strengthen the credibility and trustworthiness of the study, including: conducting pilot interviews, allocating sufficient time for each interview, simultaneous data collection and comparative analysis, sharing preliminary findings with participants for feedback and validation, and participating in peer debriefing sessions to discuss and refine findings.
Interviews were conducted face-to-face at times and locations mutually agreed upon by the participants and the researcher. Before each interview, the study objectives were explained, and verbal informed consent was obtained. With participants’ permission, interviews were audio-recorded, and each session lasted between 45- 60 minutes. Transcription and note-taking were completed on the same day as the interview.
Data analysis: Data were analyzed using MAXQDA software, employing thematic analysis. This systematic approach allows the identification, organization, and presentation of meaningful patterns (themes) within qualitative data.
Results
The study identified three main themes of health tourism potentials in Maragheh County: "Natural Resources," "Supporting Infrastructure," and "Healthcare Service Provision" (Table 1).
Natural resources: Maragheh County has numerous natural advantages for health tourism development. These advantages include its historical context and tourist attractions, favorable climate, and the Sahand Mountainous region. Furthermore, medicinal plants and seasonal markets, hot springs and therapeutic waters, and pristine nature with paleontological significance are other notable regional capacities.
Supporting infrastructure: Maragheh's strategic geographical location, including proximity to Kurdish-populated cities, the borders of Turkey and Iraq, and its short distance to the provincial capital, is a strategic advantage.
Healthcare service provision: Maragheh County occupies a favorable position regarding healthcare services provision. Its strengths include the diversity and quality of diagnostic and therapeutic services, including specialized and sub-specialized facilities, advanced medical equipments, and high- capacity clinics and private practices. The completion of hospital projects (Khajeh Nasir and private hospitals) and the referral status of the county's hospitals after Tabriz have reinforced its position as the therapeutic hub for the southern regions of East and West Azerbaijan provinces.
Infrastructural barriers: In the healthcare sector, shortages of hospital beds, absence of a widespread online appointment system, and pressure from the high volume of health tourists are primary challenges. In transportation, dangerous and poorly-maintained roads (particularly the Maragheh-Hashtrud route) are problematic. Accommodation and welfare infrastructures face additional challenges, such as low hotel quality, limited lodging facilities near treatment centers, and poor maintenance of tourist attractions. Additionally, historical infrastructure (e.g., unexplored historical sites) and communication infrastructure (e.g., internet disruptions and inefficient use of the airport) are other notable obstacles.
Economic and marketing barriers: Lack of cost transparency is a major obstacle, manifesting in overcharging at hotels and for medications, and even informal payments.
Stakeholder-related barriers: Poor inter-organizational collaboration and weak coordination among different institutions are evident. The absence of a strong, specialized management team for health tourism, combined with insufficient private sector participation due to economic inefficiency and limited system thinking are other challenges. Mismanagement and insufficient commitment from senior county officials towards developing this sector have also been identified as a serious obstacle.
Government-related barriers: At the macro-policy level, service stratification persist, with the high proportion of health tourists is overlooked in allocations of financial resources, capital equipment, and medicine quotas.
Community-related barriers: Finally, a low level of tourist-friendly culture among citizens and their weak awareness of tourism benefits, coupled with the low volume of tourists, have created a vicious cycle that prevents the formation of a social foundation for the development of this industry.
Table 1. Health tourism potentials in Maragheh
| Main theme | Subtheme | Codes | Description |
| Health tourism attraction potentials in Maragheh | Natural resources | Historical background | Potential for historical monuments, Heritage sites, Tourist attractions, and cultural backgrounds |
| Faivorable climate | Potential of the Sahand mountainous region and its favorable climate | ||
| Medicinal plants | The region's potential for medicinal plants, along with the flourishing of traditional and medicinal plant markets in May each year | ||
| Hydrotherapy | Availability of springs with therapeutic properties | ||
| Unique nature | Presence of natural attractions in the county and paleontological significance of Maragheh | ||
| Infrastructure | Geographical location | Proximity to Kurdish cities compared to Tabriz, Border proximity to Turkey and Iraq, Shorter distance to the provincial center for quality medical services | |
| Accommodation and facilities | Availability of land, rail, and air transportation infrastructure, Three traditional teahouses and four eco-tourism accommodations near therapeutic resources | ||
| Healthcare services | Diagnostic and therapeutic units | Services including angiography, heart surgery, dialysis, LDR, neonatal care, and access to physicians in hospital clinics, Completion of projects such as Khajeh Nasir and private hospitals, superior medical facilities compared to nearby cities, and trauma center services at Sina Hospital | |
| Southern province healthcare hub | Coverage of healthcare needs for the southern regions of East and West Azerbaijan Province | ||
| Advanced technology and equipment | Availability of high-tech devices, including advanced CT scans and MRI capabilities | ||
| Development trends in healthcare services | Progressive development in medical services and the provision of high-quality healthcare services |
The study identified four main barriers to provide treatment services in the hospitals of Maragheh County (Table 3).
Human resource problems: The human resource sector faces structural challenges, including shortages of specialist physicians, absence of certain essential specialties, and an insufficient number of specialists (e.g., radiologists), which limited service capacity. This situation is exacerbated by the high workload resulting from the volume of health tourists and the limited availability of experienced treatment staff.
Financial issues: Illicit payments from patients by some physicians, as a serious financial and ethical obstacle, have damaged public trust and decreased treatment costs transparency.
Healthcare service delivery problems: Inadequate coverage of treatment needs resulted by the high volume of health tourists, has led to capacity shortages in critical departments such as emergency, cardiac surgery, and angiography, resulting in long waiting lists. Additionally, hospitals lack essential equipment and operating room supplies and fail to procure certain necessary medicines for patients. Service continuity within a single hospital is and capital equipment is used inefficiently, forcing patient referrals elsewhere. Other challenges include incorrect facility location, deficiencies in information recording systems, low acceptance of health tourism within organizational culture, low hospital autonomy and the limited attention to patient satisfaction, expectations, and rights.
Stakeholder-related obstacles: Weak intra-organizational cooperation and inadequate conflict resolution, particularly among senior officials at the University of Medical Sciences, have hindered coordination between and within hospitals to address the aforementioned obstacles.
Discussion
This study aimed to identify the potentials and obstacles to the development of health tourism in Maragheh and found three sub-themes: nature and environment, infrastructure, and healthcare services. The general obstacles to health tourism were classified into five sub-themes, while hospital-related obstacles to health tourism were categorized into four sub-themes. The absence of a dedicated authority for health tourism creates significant managerial challenges, leading to uncoordinated service delivery and inefficiencies [17, 18]. Furthermore, limited healthcare capacity, characterized by shortages of specialists, medical equipment, and hospital beds, results in prolonged wait times and compromises service quality for both local and non-local patients [13-15].
Human resource problems: The human resource sector faces structural challenges, including shortages of specialist physicians, absence of certain essential specialties, and an insufficient number of specialists (e.g., radiologists), which limited service capacity. This situation is exacerbated by the high workload resulting from the volume of health tourists and the limited availability of experienced treatment staff.
Financial issues: Illicit payments from patients by some physicians, as a serious financial and ethical obstacle, have damaged public trust and decreased treatment costs transparency.
Healthcare service delivery problems: Inadequate coverage of treatment needs resulted by the high volume of health tourists, has led to capacity shortages in critical departments such as emergency, cardiac surgery, and angiography, resulting in long waiting lists. Additionally, hospitals lack essential equipment and operating room supplies and fail to procure certain necessary medicines for patients. Service continuity within a single hospital is and capital equipment is used inefficiently, forcing patient referrals elsewhere. Other challenges include incorrect facility location, deficiencies in information recording systems, low acceptance of health tourism within organizational culture, low hospital autonomy and the limited attention to patient satisfaction, expectations, and rights.
Stakeholder-related obstacles: Weak intra-organizational cooperation and inadequate conflict resolution, particularly among senior officials at the University of Medical Sciences, have hindered coordination between and within hospitals to address the aforementioned obstacles.
Discussion
This study aimed to identify the potentials and obstacles to the development of health tourism in Maragheh and found three sub-themes: nature and environment, infrastructure, and healthcare services. The general obstacles to health tourism were classified into five sub-themes, while hospital-related obstacles to health tourism were categorized into four sub-themes. The absence of a dedicated authority for health tourism creates significant managerial challenges, leading to uncoordinated service delivery and inefficiencies [17, 18]. Furthermore, limited healthcare capacity, characterized by shortages of specialists, medical equipment, and hospital beds, results in prolonged wait times and compromises service quality for both local and non-local patients [13-15].
Table 2. General barriers for health tourism in Maragheh County
| Main theme | Subtheme | Codes | Description |
| General barriers for health tourism services in Maragheh county | Infrastructure | Healthcare infrastructure |
Insufficient number of hospital beds, Lack of a functional online appointment system, Limited healthcare capacity compared to other health tourism options, Restrictions imposed by non-local patients on providing healthcare services to the local population |
| Road, accommodation, and welfare infrastructure | High-risk Maragheh-Hashtrood road and weak road infrastructure connecting to nearby cities, Low standard of hotels, Absence of accommodation infrastructure near hospital, Poor maintenance of existing facilities near tourist attractions | ||
| Historical and archaeological infrastructure | Improper management and utilization of historical buildings, Inability to invest near historical sites due to a lack of archaeological exploration and studies | ||
| Communication infrastructure | Internet disruptions, Underutilization of Maragheh airport's capacity | ||
| Economic and marketing challenges | Opaque costs | Overpricing of hotel and medication costs, Additional fees charged by physicians | |
| Lack of private sector investment | Failure to attract private sector investment | ||
| Ineffective marketing in healthcare and tourism | Lack of advertising to highlight healthcare and tourism capacities of the county, Absence of a comprehensive health tourism package, No marketing efforts for tourist attractions, Absence of network marketing | ||
| Stakeholder-related challenges |
Weak inter-departmental cooperation | Lack of coordination between various organizations | |
| Absence of a strong specialized health tourism team | No dedicated and specialized team for of health tourism | ||
| Lack of private sector participation and system thinking | Limited economic feasibility for private sector investors, Lack of system thinking across different departments of the university | ||
| Mismanagement and lack of commitment by senior managers | Managerial obstacles and lack of commitment by senior officials towards health tourism | ||
| Government-related challenges | Service stratification issues | Ignoring the high proportion of non-local patients when allocating resources, Stratification issues in diagnostic and capital equipment as well as drug quotas | |
| Absence of a unified authority, complex bureaucracy, and poor oversight | No clear authority for health tourism, Complex administrative procedures for private investors or facilitator companies, Issues with currency exchange, Lack of oversight on taxi tariffs for health tourists | ||
| Lack of security and political issues | Inadequate security for foreign tourists, Politicization of the county and disregard by the provincial center for Maragheh's development | ||
| Community-related challenges | Low level of tourist-friendly culture and limited tourist volume | Insufficient tourist-friendly attitude among citizens, Weak public awareness of the advantages of hosting tourists, Low tourist influx into the city |
Poor communication between healthcare providers and patients, combined with insufficient staff training, diminishes treatment outcomes and patient satisfaction, particularly among health tourists [19-24]. Inadequate infrastructure significantly hinders health tourism development in Maragheh. Deficiencies in road networks, underutilized airport capacity, insufficient accommodation options, and poor facility maintenance collectively impair safe access and overall tourist experience [19,25,26]. Furthermore, unreliable internet connectivity limits access to medical information and communication with healthcare providers, negatively impacting health tourists' satisfaction [27-32]. Enhancing both physical and digital infrastructure including transportation networks, accommodation facilities, and stable internet access is essential for improving service delivery and positioning Maragheh as a competitive health tourism destination. Overcharging for medication and unauthorized extra fees by doctors are also significant issues that negatively impact the trust and decision-making of health tourists. Such practices can lead to distrust in the healthcare system.
Transparent tariffs and strict oversight of physicians’ practices can prevent excessive charges and enhance trust among health tourists [33-36]. In line with this study, Raoofi et al. identified the unclear guidelines on medical and pharmaceutical service tariffs for health tourists and the absence of structured service packages as fundamental challenges in the provision of healthcare services to health tourists [37].
Transparent tariffs and strict oversight of physicians’ practices can prevent excessive charges and enhance trust among health tourists [33-36]. In line with this study, Raoofi et al. identified the unclear guidelines on medical and pharmaceutical service tariffs for health tourists and the absence of structured service packages as fundamental challenges in the provision of healthcare services to health tourists [37].
Table 3. Hospital-related obstacles to health tourism in Maragheh
| Main theme | Subtheme | Codes | Description |
| Challenges in providing healthcare services in hospitals | Human resource issues | Shortage of specialist doctors | Lack of certain medical specialties in the county and an insufficient number of radiology specialists, Increased workload for hospital staff due to non-local patients, Insufficient number of experienced healthcare personnel |
| Weak communication skills | Poor interpersonal communication skills between healthcare staff and patients | ||
| Deficiencies in patient education and low effectiveness of training programs | Issues related to patient education, such as the lack of educational materials, pamphlets, or guides in a language understandable to patients, Low effectiveness of in-service training programs for staff | ||
| Financial issues | Under-the-table payments | Doctors charging unauthorized additional fees from patients | |
| Challenges in healthcare service provision | Inadequate coverage for population needs | Limited capacity to meet the healthcare needs of the population due to hospital overcrowding with non-local patients, Inadequate capacity in emergency, cardiac surgery, and angiography departments, Long waiting lists, Lack of attention to patient satisfaction and expectations, Failure to respect patient rights | |
| Shortage of equipment and unavailability of certain medications | Insufficient essential equipment and operating room supplies, Lack of procurement of certain medications for patients by hospitals | ||
| Incomplete service chain | Lack of continuity in the provision of healthcare services within a single hospital | ||
| Failure to properly manage resources | Inefficient utilization of capital equipment, leading to patient referrals to other hospitals, Lack of effective measures in the field of health tourism, Absence of planning for health tourism, Lack of patient involvement in their treatment process, Complex administrative bureaucracy for procuring medical equipment, Poor maintenance of hospital buildings and equipment | ||
| Incorrect facility location | Poorly chosen locations for healthcare facilities | ||
| Deficiencies in information systems | Incomplete recording of patient information in hospital and governmental systems | ||
| Low acceptance of health tourism in organizational culture | Poor acceptance of health tourism within the organizational culture of hospitals | ||
| Weak autonomy of hospitals | Hospitals have limited autonomy and freedom to engage in medical tourism. | ||
| Stakeholder-related issues | Lack of intra-organizational cooperation | Insufficient collaboration among senior university officials in resolving conflicts within and between hospitals |
Limitations
This study has two main limitations. First, although the qualitative design provides in-depth understanding, it limits the generalizability of the findings. Second, focusing solely on expert perspectives may overlook the actual experiences and expectations of health tourists. To address these limitations, future research could use mixed-methods approaches, combining qualitative insights with quantitative surveys to enhance generalizability and include patient perspectives through direct interviews with health tourists to better understand their experiences and service expectations.
Conclusion
Despite Maragheh’s considerable potential for health tourism, its development faces substantial systemic and strategic challenges. Key obstacles include deficiencies in infrastructure, limited marketing, weak inter-organizational collaboration, and hospital operational challenges. Addressing these challenges requires upgrading tourism and health infrastructure to international standards, establishing transparent pricing structures, enhancing stakeholder coordination, attracting private investment, improving managerial efficiency, and strengthening security measures. Implementing these strategies is crucial for leveraging Maragheh's capacities and positioning it competitively in the regional health tourism market.
Online supplements
Interview guide
Declarations
Ethical considerations: The research protocol was approved and supported by Research Ethics Committees of Tabriz University of Medical Sciences (IR.TBZMED.REC.1400.418).
Funding: This research was supported by Tabriz University of Medical Sciences under grant number 67392. The funding source had no role in the design, conduct, data collection, analysis, or publication.
Conflicts of interests: The authors declare that there are no conflicts of interest regarding the research, authorship, and publication of this article.
Authors’ contribution: PY: Study design, data analysis, writing–original draft, data collection, final approval; MJ: Study design, data analysis, writing–original draft, data collection, final approval; SR: Study design, data analysis, final approval; EH: Study design, data analysis, final approval; RKZ: Study design, data analysis, writing–original draft, final approval. All authors have read and approved the final version of the manuscript.
Consent for publication: Not applicable.
Data availability: Reasonable requests for data access will be considered by the corresponding author.
AI deceleration: None.
Acknowledgments: The authors would like to extend their gratitude to all colleagues who contributed to the development and execution of this study.
This study has two main limitations. First, although the qualitative design provides in-depth understanding, it limits the generalizability of the findings. Second, focusing solely on expert perspectives may overlook the actual experiences and expectations of health tourists. To address these limitations, future research could use mixed-methods approaches, combining qualitative insights with quantitative surveys to enhance generalizability and include patient perspectives through direct interviews with health tourists to better understand their experiences and service expectations.
Conclusion
Despite Maragheh’s considerable potential for health tourism, its development faces substantial systemic and strategic challenges. Key obstacles include deficiencies in infrastructure, limited marketing, weak inter-organizational collaboration, and hospital operational challenges. Addressing these challenges requires upgrading tourism and health infrastructure to international standards, establishing transparent pricing structures, enhancing stakeholder coordination, attracting private investment, improving managerial efficiency, and strengthening security measures. Implementing these strategies is crucial for leveraging Maragheh's capacities and positioning it competitively in the regional health tourism market.
Online supplements
Interview guide
Declarations
Ethical considerations: The research protocol was approved and supported by Research Ethics Committees of Tabriz University of Medical Sciences (IR.TBZMED.REC.1400.418).
Funding: This research was supported by Tabriz University of Medical Sciences under grant number 67392. The funding source had no role in the design, conduct, data collection, analysis, or publication.
Conflicts of interests: The authors declare that there are no conflicts of interest regarding the research, authorship, and publication of this article.
Authors’ contribution: PY: Study design, data analysis, writing–original draft, data collection, final approval; MJ: Study design, data analysis, writing–original draft, data collection, final approval; SR: Study design, data analysis, final approval; EH: Study design, data analysis, final approval; RKZ: Study design, data analysis, writing–original draft, final approval. All authors have read and approved the final version of the manuscript.
Consent for publication: Not applicable.
Data availability: Reasonable requests for data access will be considered by the corresponding author.
AI deceleration: None.
Acknowledgments: The authors would like to extend their gratitude to all colleagues who contributed to the development and execution of this study.
Type of Study: Research |
Subject:
Health Economics
Received: 2025/04/27 | Accepted: 2026/02/20 | Published: 2026/03/7
Received: 2025/04/27 | Accepted: 2026/02/20 | Published: 2026/03/7
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