Views of Indonesian consumer towards medical tourism experience in Malaysia
| Pages | 507-524 |
| Published date | 07 October 2019 |
| DOI | https://doi.org/10.1108/JABS-04-2018-0135 |
| Date | 07 October 2019 |
| Author | Harriman Samuel Saragih,Peter Jonathan |
| Subject Matter | Strategy,International business |
Views of Indonesian consumer towards
medical tourism experience in Malaysia
Harriman Samuel Saragih and Peter Jonathan
Abstract
Purpose –Indonesians are known for their unique behaviour and willingness to travel abroad for
healthcare treatments. More than half of the healthcare ‘‘tourists’’ who travel to Malaysia come from
Indonesia, followed in numbers by those in India, Japan, and China, Libya, the UK, Australia, USA,
Bangladesh and the Philippines. Malaysia is also geographically located near two Indonesian main
islands, i.e. NorthSumatera and North Kalimantan. These reasons contributeto making Indonesiaone of
the most productive healthcare consumers in Malaysia. This study aims to examine these Indonesian
consumers’ through the use of behavioural lenses to examine their medical tourism experiences in
Malaysia,its neighbouring country.
Design/methodology/approach –The theory of planned behaviour is used as the basis of these
analyses and hypotheses development. In total, 7 variables and 18 indicators that built both the
exogenous and endogenous variables were developed from previous literature. Through a purposive
sampling technique, the authors collected 200 samples of individuals where each respondent must at
least have been to Malaysiaonce for medical treatments related to a generalcheck-up, cardiovascular,
cancer, orthopaedics,nervous systems or dental problems. A partial least squares –structuralequation
modellinganalysis was carried out to examine both the measurementmodel and the structural model.
Findings –Behavioural belief positively affects the attitude of Indonesian patients and their intentions to visit
Malaysia for medical treatment, i.e. attitude, subjective norms and perceived behavioural control. Results
show that as individuals, Indonesians have a strong belief that undergoingm edicaltreatment in Malaysia will
be more favourable than having that same medical treatmentin Indonesia. The study also shows that people
who are considered important to patients, e.g. family members or relatives, significantly influence their
intention to visit Malaysian medical institutions. The authors also found that patients’ resources and
capabilities –e.g. financial strength, supporting infrastructures and time availability –areessential factors for
Indonesian patients to choose medical tourism and to visit Malaysia as their venue for medical services.
Research limitations/implications –The resultsof this study are consistent with the previous research,
which has shown thatattitude, subjective norms and perceivedbehavioural control positively affect visit
intention. The results also suggest new interesting theoretical findings that Indonesia’s medical tourist
intention to visit Malaysia is most strongly caused by subjective norms followed by individual attitudes
and perceived behavioural control, all reasons that are identical to Japanese medical tourists’ visiting
South Korea for similarpurposes. Indeed, there are similar behavioural practicesand beliefs among both
Indonesianand Japanese medical tourists,despite the gap existing in these two countries’economies.
Practical implications –The study proposes two managerial implications using its findings. First, this
study can be a basis for the Malaysian medical tourism business to better understand Indonesian medical
tourists’ behaviour when visiting their country. The study explicitly suggests that it is both collective and
individual beliefs that drive Indonesian patients, who have the sufficient resources, to visit Malaysia because
of better quality and affordability available there compared to Indonesian medical services. Second, this
study raises a fundamental question about Indonesian stakeholders in the medical industry. In the near
future, this type of medical tourism behaviourwill, without a doubt, affect the Indonesian economy at large.
Originality/value –The contributions of this studyare twofold. First, compared to previous studies that
focussed specificallyon the developed countries, this study focusseson Indonesian consumers’ point of
view as an emerging countrytowards Malaysia’s medical tourism business.Second, this study provides
quantifiableinsights on the Indonesia-Malaysiamedical tourism phenomenon, whichpreviously has been
frequentlydiscussed, but only using a qualitative exploratoryapproach.
Keywords Malaysia, Medical tourism, Indonesia, Planned behaviour
Paper type Research paper
Harriman Samuel Saragih is
based at School of
Business and Economics,
Universitas Prasetiya
Mulya, South Tangerang,
Indonesia. Peter Jonathan
is based at Universitas
Pelita Harapan, Tangerang,
Indonesia.
Received 19 April 2018
Revised 20 November 2018
Accepted 3 March 2019
The authors of this study are
largely benefited from the
assistance of Research Office,
Universitas Prasetiya Mulya,
BSD.
DOI 10.1108/JABS-04-2018-0135 VOL. 13 NO. 4 2019, pp. 507-524, ©Emerald Publishing Limited, ISSN 1558-7894 jJOURNAL OF ASIA BUSINESS STUDIES jPAGE 507
Introduction
Health is an essential and valued aspect for everyone. There are people who are willing to
travel abroad and pay a significant price for bettermedical treatment. In Indonesia, this is a
common thing to do. Many Indonesians, in fact, frequently do travel outside of Indonesia to
seek medical treatments. Indonesia Services Dialog has reported that the number of
Indonesian medical tourists reached 350,000 in 2006 and rose to 600,000 by 2015 (Purba,
2017). The number of expenses incurred by those Indonesian people seeking medical
treatment abroad also reached Rp 18.2tn (the equivalent of US$1.3bn). As reported by
Meikeng (2014), more than half of the healthcare “tourists” who go to Malaysia come from
Indonesia (56.76 per cent), followed by those coming from India, Japan, China, Libya, the
UK, Australia, the USA, Bangladesh,and the Philippines. Edelman.ID (2018) added that the
regulation of the Indonesian healthcaresector, which prevents foreign doctors from working
within the country makes it more necessary for middle and upper-class people with high
buying power to choose neighbouring countries as a venue for their medical treatments.
This is due to the fact that medical treatments and services in Indonesia seem to be
unequally distributed in terms of quality and price differences (Purba, 2017;Pramudito,
2017;Pambiago, 2012). In addition, Malaysia is geographically located near two of the
Indonesian main islands, i.e. North Sumatera and North Kalimantan. These reasons
contribute to making Indonesia one of the most productive producers of healthcare
consumers in Malaysia.
Based on the above reasons, medical treatment has become one of the most emerging
business sectors, particularly in Malaysia, a neighbouring country to Indonesia. To create
more delightful experiences of healthcare services for Indonesia’s prospective patients,
attempts have been made by Malaysian medical institutions to provide added-value
services for those who do seek medical treatment in a non-local country, e.g. shuttle
services from the airport or a local city tour. Thisintegrated experience of medical treatment
and tourism experiences outside one’s home country is known as medical tourism (Hunter,
2007). However, we also found that related studies on behavioural attitudes well-supported
by robust statistical justifications among Indonesian consumers’ on the Malaysian medical
tourism point of views have not been undertaken.
On the one hand, judging by the expected increase in the number of Indonesians travelling
abroad for medical treatment, especially to Malaysia (430,000 and 600,000 in 2017)that the
medical tourism industry in Malaysia can, indeed, affect Indonesia’s economy. Based on
the given data, Indonesia will become the largest contributor to the medical tourism
industries in Malaysia compared to such tourism in other countries (IMTJ, 2017). On the
other hand, there is also opportunity for Malaysia to advance the medical tourism
experience and seek out evenmore Indonesian medical treatment seekers.
Applying these explanations, this study examined the numerous factors’ influencing
Indonesian tourists to seek medical treatment in Malaysia, using the theory of planned
behaviour (TPB) (Ajzen, 1985;Ajzen, 1991). Researchers used this conceptual framework
as the basis of this research model since that this same framework has been extensively
used by multiple studies to test and predict human behaviour, particularly in the tourism,
hospitality and healthcare industries (Lam and Hsu, 2006;Han et al.,2010;Quintal et al.,
2010;Sparks and Pan, 2009;Lee et al.,2012). Variables discussed in this study included:
behavioural beliefs that affect one’s personal attitude, normative beliefs that influences
one’s subjective norm; control beliefs on the perceived behaviour control of an individual;
which eventually will predict theintention of an individual to perform a specific action.
Judging by several reports of medical consumers in Indonesia, TPB is indeed contextual
and can be the basis of our analyses. Forexample, the Indonesian public is more confident
that medical treatments abroad will provide better treatment results. This view is related to
more sophisticated technology, complete hospital facilities, and better medical service
PAGE 508 jJOURNAL OF ASIA BUSINESS STUDIES jVOL. 13 NO. 4 2019
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