Volume 28, Issue 4 (3-2026)                   jha 2026, 28(4): 24-42 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

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
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
Abstract:   (305 Views)
Introduction: Health tourism has emerged as an important strategy for economic diversification and attracting foreign investment, drawing global attention. Although regions such as Azerbaijan in Iran, particularly Maragheh, hold considerable untapped potential, systematic efforts to utilize these capacities remain limited. This study aimed to identify main potentials and barriers for developing health tourism in Maragheh.
Methods: This qualitative study was conducted in 2024 using semi-structured, in-depth interviews. Experts and key stakeholders in health tourism and related organizations in Maragheh County were recruited through purposive and snowball sampling until theoretical saturation. Data collection and analysis were occurred simultaneously. Thematic content analysis was applied, including transcription, initial coding, and theme development through rigorous review and consensus.
Results: The development of health tourism in Maragheh is influenced by three main domains. The county has significant potential, such as therapeutic natural resources (mineral springs), a favorable geographical location, and specialized health services. However, major obstacles, such as inadequate infrastructure for accommodation and treatment, weak marketing, lack of intersectoral collaboration, and a limited tourist-friendly culture, restrict capacity utilization. Furthermore, hospital-specific operational barriers exist, such as staff shortages, weak communication skills, financial constraints, and lack of integrated planning, clearly reflected in long waiting times due to high non-local patient admissions.
Conclusion: Despite its potential, Maragheh faces challenges in developing health tourism. Improving tourism and health infrastructure, clarifying treatment costs, fostering intersectoral collaboration, expanding marketing, attracting investors, reducing bureaucratic barriers, and enhancing security are essentials for the growth of this industry.
Full-Text [PDF 695 kb]   (149 Downloads) |   |   Full-Text (HTML)  (72 Views)  
Type of Study: Research | Subject: Health Economics
Received: 2025/04/27 | Accepted: 2026/02/20 | Published: 2026/03/7

supplement [PDF 201 KB]  (29 Download)
References
1. Bagheri A, Rousta A, Forozandeh L, Asayesh F. Marketing model of health tourism (case study: the city of Tehran). Tourism of Culture. 2023;4(13):46-61. [DOI:10.22034/toc.2023.389929.1114]
2. Eisavi M, Ranjbar Fallah M, Motaghi S, Taheri F. The impact of economic convergence between Iran and selected middle eastern countries on health tourism in Iran. Journal of Health Administration. 2025;28(1):109-19. [In Persian] [DOI:10.61882/jha.28.1.109]
3. Aydin G, Karamehmet B. Factors affecting health tourism and international health-care facility choice. International Journal of Pharmaceutical and Healthcare Marketing. 2017;11(1):16-36. [DOI:10.1108/IJPHM-05-2015-0018]
4. Ayat M, Sharifi M. Identification and evaluation of strategic factors affecting the development of health tourism. Journal of Strategic Management Studies. 2024;15(59):129-49. [In Persian] [DOI:10.22034/smsj.2023.391355.1825]
5. Aniza I, Aidalina M, Nirmalini R, Inggit M, Ajeng T. Health tourism in Malaysia: the strength and weaknesses. Journal of Community Health. 2009;15(1):7-15. Available from: https://www.semanticscholar.org/paper/Health-tourism-in-Malaysia%3A-the-strength-and-Aniza-Aidalina/c6c4cc218bcaa47cc59d2720c1f31b9e54f76820
6. Ganguli S, Ebrahim AH. A qualitative analysis of Singapore's medical tourism competitiveness. Tourism Management Perspectives. 2017;21:74-84. [DOI:10.1016/j.tmp.2016.12.002]
7. Gunaseelan S, Kesavan N. A review on medical tourism in India. Indian Journal of Public Health Research & Development. 2020;11(1):562-5. doi:10.37506/v11/i1/2020/ijphrd/193882 [DOI:10.37506/v11/i1/2020/ijphrd/193882]
8. Komeiliesfahani M, Saeedi H, Kheiri B, Abdolvand M. Presenting a model for identifying barriers to medical tourism branding in Iranian cities. Journal of Advertising and Sales Management. 2023. [In Persian] Available from: https://asm.pgu.ac.ir/article_704813_en.html
9. Azizi F, Zahedi S. Assessment of the barriers to the development of health tourism in Yazd Province, Iran. Health Information Management. 2016;12(6):799-806. [In Persian] Available from: https://him.mui.ac.ir/article_11470.html
10. Imeni Gheshlagh S, Ashghali Farahani G. Analysis of the potentials and obstacles of health tourism development in Ardabil province. Journal of Science and Engineering Elites. 2023. 8(2): 34-49. [In Persian] Available from: https://www.sid.ir/paper/1086593/en#downloadbottom
11. Meshkini A, Soltanzadeh A, Rahmati A, Zareie Y. Opportunities and threats in the development of tourism industry in the city of Maraqeh. Journal of Urban Economics and Management. 2013; 1 (1) :83-101 [In Persin] Available from: http://iueam.ir/article-1-27-en.html
12. Ghahreman N, Seyyed Mirzaie SM, Azkia M. Planning for sustainable tourism development in Maragheh city based on SWOT technique. Armanshahr Architecture & Urban Development. 2023;16(42):229-40. https://www.sid.ir/paper/1363345/en
13. Varmazyari H, Babaei M, Vafadari K, Imani B. Motive-based segmentation of tourists in rural areas: the case of Maragheh, East Azerbaijan, Iran. International Journal of Tourism Sciences. 2017;17(4):316-31. [DOI:10.1080/15980634.2017.1400807]
14. Chen YB, Flood CM. Medical tourism's impact on health care equity and access in low-and middle-income countries: making the case for regulation. Journal of Law, Medicine & Ethics. 2013;41(1):286-300. [DOI:10.1111/jlme.12019]
15. Rahman MK. Medical tourism: tourists' perceived services and satisfaction lessons from Malaysian hospitals. Tourism Review. 2019;74(3):739-58. [DOI:10.1108/TR-01-2018-0006]
16. Saki K, Varzi AM, Momeni K, Khodakaramifard Z, Zouzani MA, Jalilian H, et al. Tourists' satisfaction of hospital services in Iran: a case study of Lorestan province. Shiraz E-Medical Journal.2017;18(6):e13797. [DOI:10.5812/semj.13797]
17. Amouzagar S, Mojaradi Z, Izanloo A, Beikzadeh S, Milani M. Qualitative examination of health tourism and its challenges. International Journal of Travel Medicine and Global Health. 2016;4(3):88-91. Available from:https://pdfs.semanticscholar.org/0014/75b9b07bfe146207df9cf316be1440d11953.pdf [DOI:10.21859/ijtmgh-040304]
18. Lincoln YS, Guba EG. But is it rigorous? trustworthiness and authenticity in naturalistic evaluation. New Directions for Program Evaluation. 1986;1986(30): 73-84.‏ [DOI:10.1002/ev.1427]
19. Xu S, Zuo Y, Law R, Zhang M, Han J, Li G, et al. Coupling coordination and spatiotemporal dynamic evolution between medical services and tourism development in China. Frontiers in Public Health. 2022;10:731251. [DOI:10.3389/fpubh.2022.731251]
20. Indasah I, Amin MR. Internal and external coordination of implementation strategy branding hospital as a determiner in development medical tourism in Stone city. Journal of Community Engagement in Health. 2023;6(2):190-4. [DOI:10.30994/jceh.v6i2.495]
21. Dinu AM. The importance of transportation to tourism development. Academic Journal of Economic Studies. 2018;4(4):183-7. Available from: https://ideas.repec.org/a/khe/scajes/v4y2018i4p183-187.html
22. Norouzzadeh A, Hosseini M, Motamedi M. Analysis of communication and cultural barriers to the development of medical and health tourism using interpretive structural modeling (case study: Meshkinshahr city). Geographical Journal of Tourism Space. 2021;10(39):21-34. [In Persian] Available from: https://sanad.iau.ir/journal/gjts/Article/684760?jid=684760&lang=en
23. Nemati V, Ebrahimpour H, Babaee Y, Abbasgholizadeh N. Assessing barriers to the development of medical tourism case study: Ardabil Journal of Health. 2016;7(2):118-33. [In Persian] Available from: http://healthjournal.arums.ac.ir/article-1-910-en.html
24. Uzoni M. Medical tourism and language barriers in healthcare. Buletin Stiintific, seria A, Fascicula Filologie. 2020;29(1):111-20. Available from: https://www.ceeol.com/search/article-detail?id=920141
25. Ormond M, Lunt N. Transnational medical travel: patient mobility, shifting health system entitlements and attachments. Journal of Ethnic and Migration Studies. 2020;46(20): 4179-92. [DOI:10.1080/1369183X.2019.1597465]
26. Gül T, Özdal Değirmencioğlu A, Bulut B, Dağ E, Baştürk YA, Dağlı M. Health service quality and patient communication in medical tourism. Journal of Tourismology. 2022;8(1):115-37. [DOI:10.26650/jot.2022.8.1.1059252]
27. Giampiccoli A, Saayman M. Community-based tourism, responsible tourism, and infrastructure development and poverty. African Journal of Hospitality, Tourism and Leisure. 2017;6(2):1-28. Available from: https://www.researchgate.net/publication/315821708
28. Xiong Y, Tang X. Tourism during health disasters: exploring the role of health system quality, transport infrastructure, and environmental expenditures in the revival of the global tourism industry. PloS One. 2023;18(9):e0290252. [DOI:10.1371/journal.pone.0290252]
29. Shepherd RJ, Yu L. Heritage management, tourism, and governance in China: Managing the past to serve the present: Springer Science & Business Media. New York: Springer; 2013. p. 36-73. [DOI:10.1007/978-1-4614-5918-7]
30. Katsoni V, Koliopoulos T. Innovative airport designs' infrastructures to support an integrated sustainable tourism policy for sustainable development and public health protection. Turystyka i Rozwój Regionalny. 2020 (13):43-57. [DOI:10.22630/TIRR.2020.13.4]
31. Mason AM, Spencer E. Health communication: insights for quality hospitality bridging healthcare (H2H) delivery in medical tourism. Medical Tourism and Wellness, DeMicco, F. Editor, Apple Academic Press, 2017. p. 127-45. [DOI:10.1201/9781315365671-8]
32. Ayuningtyas D, Ariwibowo DA. The strategic role of information communication technology in succeeding medical tourism. Enfermería Clínica. 2020;30:170-3. [DOI:10.1016/j.enfcli.2020.06.039]
33. Szymańska E, Panfiluk E. Determinants of technological innovations in health tourism enterprises. Business: Theory and Practice. 2020;21(1):348-59. [DOI:10.3846/btp.2020.11104]
34. Pocock NS, Phua KH. Medical tourism and policy implications for health systems: a conceptual framework from a comparative study of Thailand, Singapore and Malaysia. Globalization and health. 2011;7(1):12. [DOI:10.1186/1744-8603-7-12]
35. Xu T, Wang W, Du J. An integrative review of patients' experience in the medical tourism. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2020;57:0046958020926762. [DOI:10.1177/0046958020926762]
36. Crooks VA, Kingsbury P, Snyder J, Johnston R. What is known about the patient's experience of medical tourism? a scoping review. BMC Health Services Research. 2010;10(1):266. [DOI:10.1186/1472-6963-10-266]
37. Raoofi S, Khodayari-Zarnaq R, Vatankhah S. Hospital's challenges in providing healthcare services to medical tourists: a phenomenological study at the national level. Health Scope. 2023;12(2):e132433. [DOI:10.5812/jhealthscope-132433]
38. Shubtsova LV, Kostromina EA, Chelyapina OI, Grigorieva NA, Trifonov PV. Supporting the tourism industry in the context of the coronavirus pandemic and economic crisis: social tourism and public-private partnership. Journal of Environmental Management and Tourism. 2020; 11(6): 1427-34. [DOI:10.14505/jemt.v11.6(46).13]
39. Poloie K, Fazli S, Darvish F, Baiat R, Ghaderi E. Prioritizing factors affecting the development of health tourism industry in Iran in the 1414 horizons with the approach of interpretive structural modeling. Journal of Tourism and Development. 2019;8(3):1-29. https://www.itsairanj.ir/article_96153_en.html
40. Najjari H, Didehkhani H, Mostaghimi M, Hosseini SM. Identifying and prioritizing the dimensions of medical tourism with emphasis on technological entrepreneurship. Journal of Health Administration. 2021;24(1):11-22. http://jha.iums.ac.ir/article-1-3410-en.html [DOI:10.52547/jha.24.1.11]
41. Esfandnya A, Mirahmadi SM, Ghorbani H. Proposing a model to improve the competitiveness of Iran's medical tourism industry. International Journal of Travel Medicine and Global Health. 2023;11(3). [DOI:10.30491/IJTMGH.2023.401599.1365]
42. Debata BR, Patnaik B, Mahapatra S, Sreekumar. Development of an instrument for measuring service quality of medical tourism in India. International Journal of Indian Culture and Business Management. 2011;4(6):589-608. [DOI:10.1504/IJICBM.2011.042909]
43. Banevicius S. The phenomenon of health tourism organizational cooperation in Nordic countries. Nordic Coastal Tourism: Sustainability, Trends, Practices, and Opportunities: Springer; 2024. p. 273-87. [DOI:10.1007/978-3-031-73187-7_17]
45. Mazroui nasrabadi E, Mohammadipour E. A conceptual model of critical success factors in improving the resilience of the health tourism supply chain: a case study. Journal of Health Administration. 2022;25(2):9-25. [DOI:10.22034/25.2.9]
46. Kiss K. The challenges of developing health tourism in the Balkans. Tourism: An International Interdisciplinary Journal. 2015;63(1):97-110. Available from: https://hrcak.srce.hr/137486
47. Frey N, George R. Responsible tourism management: the missing link between business owners' attitudes and behaviour in the Cape Town tourism industry. Tourism Management. 2010;31(5):621-8. [DOI:10.1016/j.tourman.2009.06.017]
48. Flaherty GT, Maxemous KK, Nossier RE, Bui YG. The highs and lows of drug tourism: a travel medicine perspective. Journal of Travel Medicine. 2017;24(6):tax068. [DOI:10.1093/jtm/tax068]
49. Labonté R, Runnels V, Crooks VA, Johnston R, Snyder J. What does the development of medical tourism in Barbados hold for health equity? an exploratory qualitative case study. Global Health Research and Policy. 2017;2(1):5. [DOI:10.1186/s41256-017-0025-z]
50. Liu IC, Chen CC. Cultural issues in medical tourism. American Journal of Tourism Research. 2013;2(1):78-83. http://www.worldscholars.org/index.php/ajtr/article/view/318 [DOI:10.11634/216837861302318]
51. Vatankhah S, Vasokolaei G, Turani S, Raoofi S, Rahimi S. Evaluation of international patient department performance and its effect on medical tourists attraction among hospitals affiliated to medical sciences universities in Tehran city. Journal of Hospital. 2019; 17 (4) :91-97 [In Persian] Available from: http://jhosp.tums.ac.ir/article-1-6029-en.html
52. Agyapong A, Afi JD, Kwateng KO. Examining the effect of perceived service quality of health care delivery in Ghana on behavioural intentions of patients: the mediating role of customer satisfaction. International Journal of Healthcare Management. 2018;11(4):276-88. [DOI:10.1080/20479700.2017.1326703]
53. Ghaffari M, Moeini H, Jafari F. Presenting a three-steps framework of facilitators role in development of health tourism in the city of Isfahan. Journal of Urban Tourism. 2023;9(3):47-61. [DOI:10.22059/JUT.2022.328174.936]
54. Darwazeh D, Clarke A, Wilson J. Framework for establishing a sustainable medical facility: a case study of medical tourism in Jordan. World. 2021;2(3):351-73. [DOI:10.3390/world2030022]
55. Mason A. Overcoming the "dual-delivery" stigma: a review of patient-centeredness in the Costa Rica medical tourism industry. International Journal of Communication and Health. 2014; 4: 1-9. Available from: https://digitalcommons.pittstate.edu/communication_faculty/12/
56. Bulatovic I, Iankova K. Barriers to medical tourism development in the United Arab Emirates (UAE). International Journal of Environmental Research and Public Health. 2021;18(3):1365. [DOI:10.3390/ijerph18031365]
57. Momeni K, Janati A, Imani A, Khodayari-Zarnaq R. Barriers to the development of medical tourism in East Azerbaijan province, Iran: a qualitative study. Tourism Management. 2018;69:307-16. [DOI:10.1016/j.tourman.2018.05.007]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2026 CC BY-NC 4.0 | Journal of Health Administration

Designed & Developed by : Yektaweb