Professional Documents
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Health Tourism Segment PDF
Health Tourism Segment PDF
Health Tourism Segment PDF
Research Institute for Leisure and Tourism, University of Berne, Engehaldenstrasse 4, CH-3012 Bern, Switzerland
Tel: (031) 631 37 11; Fax: (031) 631 34 15; E-mail: fif@fif.unibe.ch
Prof. Dr. Hansruedi Mueller got his degrees can host cure and wellness guests at the
in economy and business administration. He same time, these two segments have to be
is head of the Research Institute for Leisure considered separately when deciding on the
and Tourism at University of Berne/ marketing strategy. We therefore assume
Switzerland. His major research interests that wellness is pursued solely by "healthy"
focus on quality management, eco-manage- people, the prime aim being prevention.
ment, input-output-analysis, theory of leisure, "Normal cure guests" aim to heal their illness.
tourism policy.
Social contacts
Mind:
mental
activity/
education
Body:
physical
Health: Self- fitness/
nutrition/ responsibility beauty
diet care
Relaxation:
rest/
meditation
Environmental
sensitivity
tourism
other business
tourism health tourism day trips
tourism
healthy ill
It is even harder to demarcate the supply exercise, relaxation and beauty, but to
side, because various requirements can be different extents and in varying combinations
met by the same provider. In particular, cure (see, for instance12-15).
institutions can house both cure and wellness
guests offering them similar services, or at METHODOLOGICAL APPROACH
least a similar infrastructure, plus their know-
Because the topic of wellness is complex,
how. In our view, wellness hotels must have
multidisciplinary and new for tourism, the
a comprehensive health infrastructure as well
following study is of an exploratory nature.
as a good guest-care range. In other
Figure 3 sets out the methodological steps,
countries, wellness cooperations in the hotel
some of which are not dealt with in this
industry have different criteria which are
article. The main ones are, however,
controlled, though not in Switzerland. These
described briefly below.
are criteria for such things as nutrition,
Exploratory
telephone survey
in the hotel industry
Importance-
Performance-
Analysis (IPA)
Market
situation
analysis
The first research objective: defining and characteristics as well as about areas specific
delimiting the terms “wellness” and to wellness. The questionnaire return rate for
“wellness tourism” was mainly pursued the survey was 69% which is very high for
through analysis of literature and market research. The following comments
stress on cluster analysis because it is a
discussion with experts. The second and
convenient method to explore a new market.
third goal, creating transparency in the Interestingly it is in the German speech area
wellness tourism market and positioning not so often used for the tourism industry.
of the wellness niche were reached
through various market analysis Cluster analysis
methodes described below. Finally the From the information provided by hoteliers
aim of determining missing instruments of about the importance of wellness-services,
quality management was deducted from we were able to classify the various types of
all findings. products (see below). Cluster analysis is
frequently used in market research for the
In particular, the market analysis of the classification of objects. The catch-all term
wellness tourism market included compre- "cluster analysis" covers a great variety of
hensive empirical surveys. On the basis of methods and algorithms for identifying groups
the definition of wellness tourism, the of very similar objects. This heuristic proce-
analysis of services was confined to the hotel dure allocates objects to groups (clusters) on
industry and was carried out in two steps to the basis of their similarity, whereby the
guarantee as broad-based a research cluster should be as internally homogeneous,
approach as possible. In a first step, a and externally as easy to distinguish from
representative random survey of some 400 other clusters, as possible16. The procedure
middle-class and luxury hotels in Switzerland developed by Punj/Stewart17 is often applied
looked at the importance of wellness. In a in market research literature. The procedure
second step, the total of providers of health used here is also based on the findings of
tourism (covering cure and wellness tourism) other authors18-21.
were surveyed as comprehensively as
possible and asked about hotel and guest
6
In addition, over 400 guests in selected between 0.7 and 0.8 but were nevertheless
wellness hotels offering comprehensive taken into account separately in the cluster
wellness services were asked about their analysis to avoid losing too much information.
reasons, expectations and level of satisfac-
tion, as well as about their attitudes to health. The two variables "attractive surroundings/
Cluster analysis was also used to segment location of hotel" and "tranquil, relaxing
the guests for a better understanding of the atmosphere" had to be treated as constant
market and target-group-oriented recommen- characteristics (ie. characteristics with the
dations. The five steps used in the cluster same value for numerous guests). Both areas
analysis are briefly described below: were rated as not so important or totally
unimportant by only 1% of guests so were not
a) Selection of the active variables taken into account in the cluster analysis.
Guest clustering was based on their infor-
c) Exploratory analysis of the data
mation about theimportance of wellness
structure with hierarchical cluster
components and parameters for their stay in
analysis
the hotel. Although the specialist literature
mostly recommends for market segmentation Punj/Stewart recommend a combination of
the criterion of product-specific benefits ex- hierarchical and non-hierarchical methods 14.
pected15, this criterion is not suitable for The advantage of hierarchical approaches is
wellness holidays. First, because wellness that it is not necessary to determine an
holidays are a new product about which adequate number of clusters from the outset.
guests' ideas may vary considerably, and On the contrary, they help to determine an
second because this literature refers to intermediate result which can be used to
physical commodities. Consequently, it is select the number of clusters and to detect
hard to survey expectations of product- one-off deviations.
specific benefits and such surveys are hardly
comparable from guest to guest. As hierarchical cluster analysis can only pro-
cess about 100 cases, exploratory analysis of
Use patterns are not a very meaningful seg- the total quantity of data was not possible.
mentation criterion either, because they only Consequently several random samples were
apply to the present stay and are therefore taken from roughly 30% of the remaining 344
influenced by factors such as the time avail- cases and analyzed using the hierarchical
able, weather, personal state of mind/health, method. The tree diagrams and agglo-
accompanying persons, etc. Thus, the impor- meration step tables favoured a four-cluster
tance assigned to wellness elements and solution.
parameters should be preferred as an active
segmentation variable, because it expresses d) Determination of the grouping solution
general preferences and can be surveyed in using "k-means" cluster analysis as
a more discriminating fashion (by individual well as significant difference between
elements and parameters). The other the groupings and checking of the
variables surveyed can be used to describe solution
the segments.
The non-hierarchical cluster approach
suggested in specialist literature is the k-
b) Avoiding of implicit weightings
means variant17. Based on the hierarchical
between the active variables and
cluster analysis findings and on comparison
elimination of constant characteristics
of the k-means cluster analysis findings with
The active variables must be statistically three, four or five clusters, the four-cluster
independent of each other, otherwise implicit solution was confirmed.
weightings occur. The independence test
showed that the variables "Contact addres- To ascertain significant differences between
ses for health services at home" and "Health the groups, the "Tamhanes T2" post-hoc test
programs/tips for home“ obtain a Spearman was used to establish median comparisons
ranking correlation coefficient of 0.9. This which make it possible to compare several
means that they virtually express the same groups simultaneously. Tamhanes T2 is
guest preferences so were grouped for the based on the t-test and has the advantage
cluster analysis to prevent implicit weightings. that the variances within the clusters need
Other variables too correlate with values not be the same22.
7
quadrant borders is at the discretion of the
Using f-values, the variance analysis shows surveyor.
what variables contribute to the cluster
formation and how much. In this case, these Average guest satisfaction values were
values were the competence of the health entered on the x-axis, and their importance
professionals, their availability, information assessments on the y-axis. Variables with an
and explanations, steam bath, medical super- importance value over 3 and a satisfaction
vision/physiotherapy, wide selection of health value under 5 reveal weaknesses. Those with
products as well as tips/programmes for back an importance value over 3 and a satisfaction
home. value over 5 point to strengths (see Figure 7).
Sauna
Solarium
Sport/Fitness
Steam bath
Swimming pool
Whirlpool
Med. centre
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
The replies from the hotels surveyed showed with cultural interests are lacking (see Illus.
that a wide range of wellness amenities is 5). Only 14% of 3 to 5 star hotels offer all four
available, though the products required for a wellness services (healthy nutrition, exercise,
holistic wellness approach in respect of relaxation and culture).
relaxation (need for destressing) and guests
Healthy nutrition
Massage
Supervised Sport
Culture
Relaxation
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
3
Importance of wellness factors
SoftwareWH
Hardware WH
2
Cure institutions
"Fake" WH
0
know-how medical ind. care information relaxation beauty courses wellness
supervision facilities
A rough distinction can be made between the Switzerland in order to cover a representative
types according to the importance attached to group of wellness hotel guests. Two thirds of
medical supervision as well as to wellness the interviewees were women and one third
infrastructure and software elements such as men, with an average age of approximately
information about health topics or individual 53 and above-average education. 90% of the
care. Significantly, the largest group of "soft- guests surveyed came from Switzerland and
ware wellness hotels" attaches much impor- 10% from Germany, a result which has to do
tance to individual care and information for with the language used for the survey
guests as well as to comprehensive further (German) and its timing (Autumn 1998). On
training. Medical supervision and health average, guests spent about 8 days in the
know-how as well as opportunities for hotel. For almost half of them, the main
relaxation also rank high. The predominant reason for the stay was recreation, while one
factor for "hardware wellness hotels" is fifth wanted to do something for their health
wellness facilities, while for "traditional and 14% were in the hotels for a cure or
medical cure institutions", medical and convalescence. These data are fairly
individual care in tandem with health know- respresentative for the “typical” wellness
how are rated as important, with wellness guest in Switzerland, according to the prior
infrastructure being manifestly less important. collected opinions of hotelmanagers.
The smallest group– the "fake wellness
hotels" – has neither software products nor The Importance Performance Analysis shows
highly rated facilities. where the strengths and weaknesses of the
wellness hotels lie (Figure 7). The strengths
mainly have to do with a hotel's atmosphere
Demand in wellness tourism and its surroundings/ location. What is more,
More than 400 Wellness guests were wellness hotels would be well advised to
surveyed in 8 different wellness hotels with a provide their guests with a swimming pool.
comprehensive product range. The hotels Weaknesses take the form of no non-
were chosen according to the prior collected smoking areas, insufficient information about
answers from the survey of health tourism health topics, inadequate relaxation and
providers. They were located all over cultural facilities as well as a lack of health
tips the guest can use back home.
Figure 7: Importance performance of wellness hotels
6
Atmosphere
Surroundings/location
Additional services Swimming pool
Non-smoking areas
5 Opening hours
Care Whirlpool
Nutrition Competence
Wellness package Availability
4 Sport Steam bath
Importance
Information Sauna
Choice
3
Culture
Beauty
1
4 5 6
Satisfaction
The cluster analysis came up with four guest wellness facilities such as a whirlpool, steam
segments: "demanding health guests", bath, sauna and swimming pool. Other
"independent infrastructure users", "care- wellness amenities such as healthy nutrition,
intensive cure guests" and "undemanding relaxation or culture are less important. This
recreation guests". The main distinguishing group of independent infrastructure users is
characteristics are the importance of software the only one with a majority of men (54%)
and/or wellness facilities as well as the who are usually on holiday with their
relevance of the recreation and/or health partners. The average age for this group is
promotion motive (see Figure 8). 49 and at 80%, the proportion of graduates or
those with a higher professional qualification
At around 40%, demanding health guests are is exceptionally high, while the average stay
the largest group, attaching great importance of 6.5 days is by far the shortest.
to care and information as well as pro-
fessional competence and comprehensive Care-intensive health guests account for
wellness amenities. Women make up more about one fifth. They cited healing/therapy/
than three quarters of this group and their convalescence as the main reason for their
average age of just under 48 is the lowest. stay, and health promotion was another
One third of these guests spend their holiday important factor for them. Consequently, they
alone, and just one quarter with their partner. attach great importance to medical com-
In this group, the main reason given for the petence as well as to individual care and
stay – promoting health – was of above- advice. About 60% of this group are women,
average importance. with an above-average proportion of singles,
and the average age is around 53. At slightly
Just under one quarter of guests, as over 10 days, care-intensive health guests
independent infrastructure users, attach no had the longest average stays.
great importance to guest care, information or
professional know-how but greatly appreciate
Figure 8: Importance of wellness components and parameters as seen by guests
11
5
Importance of wellness factors
Demanding
3 Care-intensive
Independent
Undemanding
2
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tip
Undemanding recreation guests ranked the although both can be hosted in the same
importance of nearly all the particular well- hotel.
ness components and parameters lowest. At
14%, they were the smallest guest group. Further recommendations can be set out for
More than half of these guests give wellness hotels, spa resorts, tourist asso-
recreation and relaxation as the main reason ciations, health insurance companies, tourism
for their stay. The wellness infrastructure, and health policy-makers on the following
guest supervision or information are not areas:
important for this group, which appreciates a
swimming pool above all else. Health - Quality management
promotion or convalescence is not relevant - Target markets
for these guests whose most frequent - Supply shaping
objective is to enjoy themselves and let - Pricing
themselves be pampered. Undemanding - Communication
recreation guests have the highest average - Distribution
age (approximately 58), and the percentage - Cooperations
of women (a good 50%) is below average.
The average stay for this group of guests is Special emphasis is placed on quality
just under 9 days and in an above-average management. Top quality is vital as a
number of cases, this time is spent with their response to international competition and
partner or family members. rivals within the wellness market in order to
satisfy high guest expectations. A minimum
CONCLUSIONS wellness infrastructure, the corresponding
services and qualified staff are a prerequisite
for comprehensive wellness quality, and
For the first time in the German speech area
desirable basic requirements include a swim-
the widely used term “wellness” is defined
ming pool, sauna, whirlpool or steam bath,
and differentiated from the term “cure”. One
facilities for healthy nutrition, physical fitness,
of the most important conclusions of the
relaxation and mental activity as well as the
market analysis in the wellness tourism
presence of at least one wellness pro-
industry is the need for a clear demarcation
fessional (doctor, physiotherapist, wellness
of the wellness concept from the cure. For
trainer or sports instructor) to provide
marketing strategies it is essential, that those
individual care and advice. Hotel owners can
two guest segments are handled separately,
refer to the EFQM Model for Business
12
Excellence for controlling quality-relevant well as making cooperation more attractive
processes25. A long checklist with for partners in the health-policy sector.
suggestions for wellness management,
based on the nine model criteria, was For future research the most interesting topic
specially adapted to wellness requirements. would be the question of how wellness
programs during vacation affect health
Having done the “homework” of implementing behavior of wellness guests. Findings that
quality management instruments in the prove the positive impact of wellness
hotels, the hotel industry should then programs are a necessary argument for
emphasize on reforming the existing health tourism to get health insurance and
marketing cooperation. A professional office other health policy actors interested in the
should succeed in getting high quality possible health promotion instrument
standards held and only admit those hotels to wellness program.
the cooperation which meet the standards.
Only consistently high quality offers can
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