Tourism Management 34 (2013) 196e201

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Tourism Management
journal homepage: www.elsevier.com/locate/tourman

Understanding medical tourists: Word-of-mouth and viral marketing as potent

marketing tools
Eugene Yeoh a, *, Khalifah Othman b,1, Halim Ahmad c, 2
a
Centre of Graduate Studies, Universiti Selangor, Jalan Zirkon A 7/A, Seksyen 7, 40000 Shah Alam, Selangor, Malaysia
b
Institut Pengajian Eksekutif, Universiti Pertahanan Nasional Malaysia, Kem Sungai Besi, 57000 Kuala Lumpur, Malaysia
c
Faculty of Business, Universiti Selangor, Jalan Zirkon A 7/A, Seksyen 7, 40000 Shah Alam, Selangor, Malaysia

h i g h l i g h t s

< We conducted nationwide study on medical tourists in Malaysia.

< We determine the demographics of outpatient medical tourists.
< Main medical tourists are from Indonesia and Singapore.
< Medical tourists spend about seven days with at least one companion.
< Medical tourists are highly influenced by friends, family, relatives and doctor’s referral.

a r t i c l e i n f o a b s t r a c t

Article history: The medical tourism industry in Malaysia has grown drastically over the past ten years. This research
Received 16 April 2012 seeks to determine the demographics of the medical tourists that are visiting Malaysia for various
Accepted 28 April 2012 medical treatments. A nationwide questionnaire survey was carried out amongst outpatient medical
tourists from medical tourism certified hospitals. The results indicated that majority of the tourists were
Keywords: repeat tourists from Indonesia and most of these outpatient patients spend about seven days in Malaysia
Medical tourism
with at least one companion. The results also revealed that most of the tourists were influenced by
Healthcare strategy
friends, family, relatives and doctor’s referral.
Demographics
Malaysia
Ó 2012 Elsevier Ltd. All rights reserved.

1. Introduction seasons and is projected to grow at a rate of between 15 and 20 per

The medical tourism industry is a new industry and one of the
fastest growing industries globally. The global industry is expected
to generate over US$40 billion with over 780 million tourists
spreading across 96 countries (Nicolaides, 2012; Youngman, 2008).
However, Hansen (2008) and MacReady (2007) argued that the
global medical tourism size in 2006 alone was US$60 billion and is
expected to reach US$100 billion in 2012.
The industry is generally seeing an extensive migration of
patients from developed countries e such as the United States,
United Kingdom, and Australia e to less developed or under-
developed countries e such as Costa Rica, India, Hungary, and
Thailand. This trend is liken to the migration of birds during winter
* Corresponding author. Tel.: þ60 122029758.
E-mail addresses: eybc@yahoo.com (E. Yeoh), khalifahothman46@gmail.com
(K. Othman), abdulhalim5357@yahoo.com (H. Ahmad).
1
Tel.: þ60 13 351 9696.
2
Tel.: þ60 3 5522 3532.
cent annually. One of the main reasons for this migration is the
significant cost savings in the medical treatments. The savings
range between 30 and 80 per cent depending on the procedures
and the countries (Forbes, 2007, p. 21; Forgione & Smith, 2007; Hall,
2011; Horowitz, Rosensweig, & Jones, 2007; Marlowe & Sullivan,
2007; Nicolaides, 2012; Taylor, 2007; Wood, 2007).
This industry is also witnessing an increase in the number of
players globally due to the lucrative revenue. However, new
players who are hopping on the bandwagon may not necessarily
be competing for the same market but instead tapping into new
and more specialised markets. As of this writing there are 28
players in Latin Americas, Eastern Europe, Africa, and Asia Pacific
(Alleman et al., 2011; Hancock, 2006; Schult, 2006; Turner, 2007;
Woodman, 2007).
For many industry players, one of the notable problems is the
inability to predict the market size as there is no consistent defi-
nition, either at the country or provider level and the scope of the
industry varies based on the definition. One of the main reasons
why medical tourism has gained popularity is due to the cost

0261-5177/$ e see front matter Ó 2012 Elsevier Ltd. All rights reserved.
doi:10.1016/j.tourman.2012.04.010
 E. Yeoh et al. / Tourism Management 34 (2013) 196e201
advantages between the exporter country and the consumer. Apart
from cost savings, there are also other reasons for the migration e
long waiting period, uninsured procedures, uninsured patients,
better quality of care, unavailability of certain procedures (due to
ethical reasons), and specialised skills (due to home demand)
(Carabello, 2008; Connell, 2006; Ehrbeck, Guevara, & Mango, 2008;
Forgione & Smith, 2007; Freire, 2012; Gerst, 2008; Hancock, 2006;
Hopkins, Labonté, Runnels, & Packer, 2010; Horowitz & Rosensweig,
2007; Marlowe & Sullivan, 2007; Milstein & Smith, 2006; Moody,
2008; More Americans Uninsured, 2007; Record Number of Britons
Heading Abroad, 2007; York, 2008).
2. Literature review
Up until 1997, prior to the Asian Financial Crisis, Asia was the
main location of choice for most foreign capital investment,
particularly in South East Asia. As a direct result significant sums of
money poured into these countries, creating a seemingly unending
economic bubble more commonly known as the Asian Economic
Miracle. The tremendous economic growth in these countries was
also well received and highly praised by the International Monetary
Fund (IMF) and World Bank. Such investments were first seen in
the First Wave, i.e. direct investment from the Japanese in the mid
1980’s until the early 1990’s, which totalled about US$48 billion in
1996. The main beneficiaries of these foreign direct investments
(FDI) were ASEAN countries such as Singapore, Malaysia, Thailand
and the Philippines. After that, came the Second Wave, which was
chiefly driven by the financial technocrats from major international
financial houses (Bello, 1997; UNU World Industry for Development
Economies Research, 1999; Woo, 2000).
The annual growth in GDP for most of these Asian countries
before 1997 was hovering around 5e12 per cent (UNU World
Industry for Development Economies Research, 1999). At the end
of 1997 the GDP of South East Asia recorded a 4 per cent growth. By
1998 the economy in South East Asia contracted by 6.9 per cent and
about US$30 billion of capital from Indonesia, Malaysia, the
Philippines and Thailand was sacrificed to the financial crisis
(Kumar, 1999). The non-performing loans (NPL) in Asia have risen to
US$2 trillion in November 2000, which is equivalent to 30 per cent of
the region’s GDP. By 2001 the NPL was estimated at around 17 per
cent of the combined GDP e Malaysia’s NPL stood at US$43 billion
which was about 35 per cent of the GDP and Thailand’s NPL value
was US$50 billion representing 41 per cent of the GDP (UNDP, 2002).
Like any other industries the healthcare sector was not spared
from the 1997 Asian Financial Crisis. Many private-paying patients
had to switch back to the public healthcare system as many busi-
nesses were closed down or downsized or experienced drastic
cutbacks on healthcare benefits. The public hospitals in Malaysia
saw an increase in patients, at least between 10 and 18 per cent, and
the private healthcare facilities, both hospitals and general practi-
tioner clinics, on the other hand saw a dramatic decrease of
between 10% and 30% (UNFPA, 1998).
The drastic and speedy devaluation of Thai baht in July 1997 also
affected a number of other Asian currencies including Malaysian
Ringgit. Market speculation further aggravated the problem and
caused the Ringgit to fluctuate further posting serious problems in
business transactions especially in exports and imports, including
essential imports such as pharmaceuticals, medical supplies and
medical equipment. The import of pharmaceuticals alone made up
about 60 per cent of the drugs in the whole country. New, hi-tech,
and expensive institutions were affected the most (UNFPA, 1998).
This compounded problem affected many of the private hospi-
tals, as the locals were moving back to public healthcare, causing
many private hospitals to issue “code blue” signals due to low
utilisation rates in the clinics, wards, and other facilities. As a result,
197
the 1997 Financial Crisis triggered many Malaysian private hospi-
tals to target foreign patients aggressively in order to make up for
the decline. Since then, the number of medical tourists has
increased drastically as shown in Table 1.
While the data from Association of Private Hospital of Malaysia
(APHM) indicate that the numbers of medical tourists are
increasing rapidly, the resources required to promote the industry
is limited as the promotion avenues are unlimited. As such, the
objective of this paper is to identify the demographics of the
medical patients that are seeking medical treatments in Malaysia
and to identify the sources where patients are obtaining informa-
tion about the medical facilities in Malaysia.
3. Word-of-mouth communication
The terminology word-of-mouth (WOM) communication has
come a long way and there are many different definitions and
frameworks that have been proposed by many. Different words have
been used to describe the verb, such as diffusion, transmission,
communication, and dissemination of thoughts, information,
messages, opinions, evaluations, and comments between at least
two persons about some products, services, brands, and related
experiences (Dichter, 1966; Gajendra, Ye, Sun, & Li, 2012; Gupta &
Harris, 2010; Ha & Im, 2012; Shoham, Gavish, & Segev, 2012;
Soares, Pinho, & Nobre, 2012; Sweeney, Soutar, & Mazzarol, 2012).
Xu (2007) argued that individuals who are involved in such
form of communications may have direct impact on an organisa-
tion and four types of WOM publicity were proposed; consumer to
consumer which refers to communication amongst close circle,
business to consumer where employers encourages employees to
talk about the company products or services, business to business,
and facilitated business to business which produces information
sharing in industrial purchase.
But generally, the verb can be referred to as an informal (Ha &
Im, 2012; Soares et al., 2012) and personal (Arndt, 1967) form of
communication. On top of that, WOM can either be positive or
negative (Anderson, 1998; Richins, 1983). East, Hammond, and
Wright (2007) argued that there are more positive WOM rather
than negative whereas, Bailey (2004) argued that negative infor-
mation significantly influences attitude.
WOM has been given such great emphasis in recent years due to
a number of reasons such as the impact of WOM on marketing
strategy (Smith, Coyle, Lightfoot, & Schott, 2007), effect on purchase
decision by customers (Gajendra et al., 2012; Michelle, 2006; Soares
et al., 2012), source of trusted information source (Allsop, Bassett, &
Hoskins, 2007; Soares et al., 2012), and immediate feedback (Valck,
Bruggen, & Wierenga, 2009). Due to these benefits and also during
such hard times, businesses are now more akin to invest in WOM
marketing as it helps to reduce the advertising and promotional
spending and is considered a more powerful marketing tool that
produces better results (Sweeney et al., 2012).
Table 1
Malaysian medical tourism revenue.
Foreign patients Revenue (MYR)
1998 39,000 14,100,000
1999 59,926 22,400,000
2000 56,133 32,637,030
2001 76,210 44,281,751
2002 84,585 35,579,051
2003 102,946 58,900,000
2004 174,189 104,980,000
2005 232,161 150,920,000
2006 296,687 203,660,000
2007 341,288 253,840,000
Source: Cruez, 2008; EUMCI Review, 2007; MOH, 2002.
198 E. Yeoh et al. / Tourism Management 34 (2013) 196e201

The virtual world has created new terminologies related to WOM Table 2
marketing such as viral marketing, word-of-mouse, and click-of- Summary responses to the questionnaire survey.

mouse. The actual definitions of these terminologies are still being Responses Frequency Percentage
debated. Further distinction is being made on general online and Valid 470 89.69
social media environments. Due to the vague definitions (Mills, 2012) Invalid
argued that if the term is used specifically for the social medial Residing in Malaysia for 39 7.44
more than 1 year, for work,
environment then four key factors e spreadability, propagativity,
MM2H programme, or for
integration, and nexus e should be incorporated into the definition. education purposes
Yang (2011) argued that since patients are more proactive these Below 18 years old 7 1.34
days, the main source of information will definitely have to come Malaysian citizens 7 1.34
from personal experience, WOM, and advertisement from organi- Incomplete responses 1 .19
Total 524 100.00
sations. However, Campbell (2012) argued that organisations with
a lot of positive WOM will have better short- and long-term profits
Table 3
thus, creating sustainable and better growth rate. In such cases, the
Demographic by nationality, gender, and age.
sales force team may become optional.
In the context of medical tourism, Lee, Han, and Lockyer (2012) Demographic variable Frequency Percentage
in their research, amongst Japanese medical tourists, found that Nationality (n ¼ 439)
positive WOM was important to ensure the survival of the South Indonesia 317 72.21
Singapore 101 23.01
Korean healthcare providers as this helps providers to create better
Others 21 4.78
marketing strategy. Ko and Kim (2011) also concurred with the fact Gender (n ¼ 424)
that providers should take all measures to ensure that negative Male 186 43.87
WOM be minimised to ensure re-patronage in the hospitals. Female 238 56.13
Age (n ¼ 441)
Srivastava and Mahajan (2011), on the other hand, concluded that
18e30 75 17.00
WOM marketing may be considered as the best advertising tool 31e45 184 41.72
that dental setups could take advantage off. 46e60 153 34.69
Considering the importance of WOM marketing in the medical >60 29 6.58
industry, understanding the demographics and sources amongst
the medical tourists that are visiting Malaysia is vital. This is to Resident holders, respondents who are residing in Malaysia due to
ensure that the right message is formulated and the source(s) used work, study, or Malaysian My Second Home (MM2H) programme,
in transmitting the message(s) is/are effective. These are some of and respondents who are below 18 years of age.
the ways to ensure the survival and sustainability of the industry. The respondents consisted of medical tourists from 19 coun-
tries; the largest was from Indonesia with 72.2%, followed by
4. Method Singapore with 23.0%, and other (which comprised of Japan, China,
Vietnam, Cambodia, Korea, US, Africa, Sweden, Canada, Thailand,
Cluster sampling was employed and each of the medical tourism Australia, France and Germany) with 4.8%. There were 43.9% male
certified hospitals was considered as a cluster. Invitation letters were respondents and 56.1% female respondents who responded to the
sent to all the clusters e 35 medical tourism certified hospitals. survey. The largest age group was between 31 and 45 with 41.7%,
However, only seven clusters responded to participate in this research. followed by age group between 46 and 60 with 34.7%, and followed
Over 2000 questionnaires were circulated amongst these clusters. The by age group between 18 and 30 with 17.0%. The average age was
questionnaires were left with the Marketing or Customer Service
Department. These heads of department were then responsible to Table 4
Breakdown of medical procedures.
circulate the questionnaire to the respective clinics. Each cluster was
enrolled at different time due to the late response to the invitation and Demographic variable Frequency Percentage
was given a period of two months to complete the survey. The whole Medical Procedure (n ¼ 470)
duration of the survey was about four months in total. Blood (Haematology) 62 6.8
Bone (Orthopaedic) 81 8.9
Out of 2000 questionnaires only 524 questionnaires were
Cancer (Oncology) 55 6.0
returned. There were five inclusion criteria; they were 18 years of age Child (Paediatrics) 41 4.5
or older, fluent in English and/or Bahasa Indonesia, non-Malaysian Diabetes/Thyroid (Endocrinology) 26 2.8
who were receiving outpatient medical attention from one of the Ear-Nose-Throat (Otolaryngology) 36 3.9
medical tourism certified hospitals, visited Malaysia for medical Eye (Ophthalmology) 75 8.2
Female related (Obstetrics and Gynaecology) 45 4.9
purposes with or without tourism activities, and participated in this
Fertility 21 2.3
survey for the first time. On the other hand, the exclusion criteria Heart (Cardiology) 68 7.4
included residence in any parts of Malaysia for more than 12 months Kidney (Renal) 56 6.1
(unless for certain unforeseen medical circumstances), foreign Liver (Hepatobiliary) 60 6.6
students who were pursing their studies in Malaysia, expatriates or Nerves (Neurology) 44 4.8
Screening e Health and Medical 56 6.1
diplomats based in Malaysia for some form of work related duties, Skin (Dermatology) 45 4.9
not directly associated with the medical personnel, and not part of Stomach related (Gastroenterology) 33 3.6
any charity missions or sponsored patients by the hospitals. Surgery 63 6.9
Urinary related (Urology) 16 1.7
Cosmetic 12 1.3
5. Results
Dental 14 1.5
Others 6 .7
Table 2 represents the overall responses to the questionnaire Number of procedures sought
survey where 54 respondents were rejected because of various Blank 25 5.32
reasons such as currently residing in Malaysia for more than 1 year, 1 310 65.96
2 67 14.26
respondents who are Malaysian citizens or Malaysian Permanent >2 68 14.46
 E. Yeoh et al. / Tourism Management 34 (2013) 196e201 199

Table 5 Table 7
Medical tourists pattern. Characteristics of a medical tourist.

Demographic variables Frequency Percentage Demographic variable Frequency Percentage

Seeking medical treatment in Malaysia for the first time (n ¼ 434) Number of guest accompanying patient (n ¼ 470)
Yes 172 39.63 0 124 26.38
No 262 60.37 1 66 14.04
Medical treatment sought in Malaysia in the past 3 years (n ¼ 341) 2 105 22.34
1 28 8.21 3 90 19.15
2 93 27.27 >3 85 18.09
3 78 22.87 Length of stay (n ¼ 347)
4 27 7.92 1 day 7 2.02
5 36 10.56 2 days 30 8.65
6 50 14.66 3 days 63 18.16
>6 29 8.50 4 days 51 14.70
Countries visited for medical tourism (n ¼ 62) 5 days 32 9.22
Singapore 40 64.52 6 days 11 3.17
Indonesia 6 9.68 7 days 77 22.19
Thailand 3 4.84 >7 days 76 21.90
Korea 2 3.23
Japan 2 3.23
Others 9 14.52 was 30.8%, between MYR5001 and MYR10,000 was 22.8%, and
more than MYR10,000 was 12.4%. Medical tourist who came by self
was 26.4%. Table 6 represents the sources that influenced the
around 43 years old. Table 3 represented the frequency distribution
medical tourists to seek medical treatment in Malaysia and the
of the responses by nationality, age, and gender.
outpatient medical expenses incurred by the medical tourists.
There were 21 medical procedure options for the medical
Those who came with one companion was 14.0%, with two
tourists to choose. From these 21 procedures, the top five most
companions was 22.3%, with three companions was 19.1%, with
commonly sought after medical procedures were orthopaedic
four companions was 10.6%, with five company was 4.5%, and more
(8.9%), ophthalmology (8.2%), cardiology (7.4%), surgery (6.9%), and
than five company was 3.1%. The average number of persons
haematology (6.8%). Majority of the medical tourists are in Malaysia
accompany the medical tourist was 2 persons. The average length
for single procedure (7.0%) and dual procedures (14.3%). Table 4
of stay of these tourists (medical tourists and companion(s)) was 9
represented the breakdown of medical procedures.
days; majority stayed for seven days (22.2%), more than seven days
Out of 434 medical tourists, 172 (39.6%) sought medical treat-
(21.9%), followed by three days (18.2%), and four days (14.7%).
ment for the first time whereas 262 (60.4%) were returning patients.
Table 7 represented the characteristics of the medical tourist e
In the past three years the number of medical tourist that visited
source of obtaining information about the medical tourism
Malaysia for once were 28, twice were 93, and thrice were 78.
industry in Malaysia, medical expenses, number of people accom-
Besides Malaysia, there was at least one tourist who has visited three
panying the medical tourist, and length of stay in Malaysia.
other countries besides Malaysia for medical treatment, and at least
five have visited two other countries besides Malaysia for medical
treatment. Table 5 represent the pattern of medical tourists. 6. Conclusion
A large majority of the medical tourists were referred by friends
(44.5%), family members (37.7%), and doctors (24.5%). Other sour- From the results it is clear that Malaysia is predominantly
ces also played an important part but to lesser impact in attracting exporting the medical services to Indonesians and Singaporeans,
medical tourists to Malaysia. Majority of the tourist were influ- who collectively make up 95% of the patient pool. These patients are
enced by at least one source (67.5%) and two sources (24.1%). The clearly influenced by three main sources; friends (209 responses),
average medical expense was about MYR6500. Medical tourist who family or relatives (177 responses), and doctors (115 responses). On
spent below MYR1000 was 34.0%, between MYR100 and MYR5000 top of that, the patients were influenced by one (67.5%) or two
(24.1%) sources. This may be an indication that the hospital
Table 6 management has to improve the service quality and customer
Sources and medical expenses. satisfaction in order for them to increase the number the loyalty and
Demographic variable Frequency Percentage word-of-mouth recommendation by satisfied patients. The results
How did you hear about Malaysia? (sources) also indicated that over 60% of the patients were returning patients.
Family/Relatives (n ¼ 470) 177 37.66 This is relatively a healthy sign as it indicates that almost every one
Friends (n ¼ 470) 209 44.47 of the medical tourist that has consumed the medical facilities in
Doctor referral (n ¼ 470) 115 24.47
Malaysia has “brought” another new medical tourist into Malaysia.
Agents (n ¼ 470) 36 7.66
Website (n ¼ 470) 23 4.89 Also, the healthcare providers may consider a paradigm shift in
Magazine (n ¼ 470) 13 2.77 running their businesses; from transaction to relationship, from
Exhibition (n ¼ 470) 25 5.32 customers into partners, and from long-term relationship into
Media (n ¼ 470) 49 10.43 commitments (Raju, Lonial, & Gupta, 1995). Jacob (1994) argued
Others (n ¼ 470) 2 .43
Number of sources (n ¼ 449)
that “a 5% decrease in the customer defection rate can boost profits
1 303 67.48 from 25% to 95%.” Swanson and Kelley (2001) pointed out three
2 108 24.05 potential impacts in retaining customers 1) reduced expenses in
3 28 6.24 replacing customers, 2) realistic expectations or demands from re-
>3 10 2.23
patronage due to familiarity, and 3) better response from
Medical expenses (n ¼ 438)
<MYR1000 149 34.02 employees who serve familiar customers. In addition to that, Slater
MYR1000eMYR5000 135 30.82 and Narver (2000) argued that the cost of attracting a new
MYR5001eMYR10000 100 22.83 customer is five times higher than retaining existing customers.
>MYR10000 54 12.33 Apart from that the demographics also indicate the top three
(1 MYR ¼ .3266 USD). medical treatment amongst these Indonesians and Singaporeans
200 E. Yeoh et al. / Tourism Management 34 (2013) 196e201

are orthopaedic (8.9%), ophthalmology (8.2%), and cardiology
(7.4%). At the moment Malaysia only has specialised hospitals for
two of the medical treatments e Tun Hussein Onn Eye Hospital for
ophthalmology cases and Institut Jantung Negara for cardiology
cases. Setting up an orthopaedic national centre may be a good
approach to train more orthopaedic specialists and expose them to
more high tech procedures such as Birmingham hip replacement,
and cartilage knee transplant, and computer-assisted total joint
replacement. This will also be beneficial to all Malaysians.
These specialised hospitals may consider becoming clinical
trial centres in medical and biomedical researches considering
that the make up of the population in Malaysia comprises of most
major Asian people groups. Also, these hospitals can conduct
a number of large scale time-series studies (cohort and/or cross-
sectional) that may rival other international landmark studies
such as the United Kingdom Prospective Diabetes Study and Dia-
betes Control and Complication Trial.
Other important statistics include the age group, number of
guest(s) accompanying the medical tourist, and length of stay in
Malaysia. Majority of these medical tourists are between the ages of
31 and 45 years old and are here on their own. However, over 70% of
the medical tourists are here with at least one guest. Further to that
the research also revealed that most of the tourists and guests
would stay for 7 days (22.2%). Such information is extremely useful
for the travel and hospitality industry. Thus, driving the private
sector to develop more products and services to cater for the needs
of these tourists; be it psychocentric or allocentric tourists. These
data is also useful for the government do other planning; be it
short-, mid-, or long-term planning.
While this research has revealed more information about the
demographics of medical tourists and also the sources used, this is
not indicative that the hospital management team should neglect
other forms of communication mix such as advertising (above- and
below-the line) and trade shows. This research merely suggests
that WOM communication may have better impact on the type of
medical tourists that are coming to Malaysia. In fact, the private
hospital management may consider taking advantage of the
relaxed regulations by the Lembaga Iklan Ubat (Medical Advertising
Board) permitting hospitals to advertise. This may be a good
strategy to penetrate other untapped markets.

Appendix A

SECTION B: DEMOGRAPHICS
1. Your nationality

2. Country that you are residing in now

3. What medical procedure are you seeking from this hospital in this trip? (please check the
relevant boxes)
Blood Bone Cancer Child related
Diabetes / Thyroid Ear-Nose -Throat Eye Female related
Fertility Heart Kidney Liver
Nerves Screening Skin Stomach related
Surgery Urinary related Cosmetic surgery Dental
Others (specify)

4. Is this your first time seeking medical treatment out of your home country? ( ) Yes ( ) No

5. If no, how many times have you sought medical treatment in Malaysia in the past three years
(please check only one)
( ) 1 ( ) 2 ( ) 3 ( ) 4 ( ) 5 ( ) 6 ( ) 7 ( ) 8 ( ) 9 ( ) 10 ( ) more than 10

6. Besides Malaysia and your home country which other countries have you gone to seek medical
treatment? ____________________________________

7. How did you hear about the medical services in this hospital? (please check the related boxes)
Family / Relatives Friends Doctor referral Agents
Website Magazine Exhibition Media
Others (specify)

8. What is your estimated medical expenditure (please check only one)

Below RM1,000 RM1,000– 5,000 RM5,001 – 10,000 more than RM10,000

9. How many people accompanied you for this trip? __________________

10. How long will you be staying in Malaysia ______________________days / weeks / months

11. Age Group ( ) below 18 ( ) 18 – 30 ( ) 31 – 45 ( ) 46 – 60 ( ) above 60

12. Gender ( ) male ( ) female

13. Religion ( ) Islam ( ) Christian ( ) Buddha ( ) Hindu ( ) Others

14. What is your total annual household income bracket? (please check only one)
Less than RM25,000 RM25,000 – RM50,000 RM50,001– RM75,000
RM75,001– RM100,000 More than RM100,000
 E. Yeoh et al. / Tourism Management 34 (2013) 196e201 201

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