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This study aims to find out which factors, between the word of mouth (WoM) or marketing promotion programs (MPP), drive motivation (push and pull); to explore the influence of travel motivation toward satisfaction, and to investigate the satisfaction effect of medical tourists with loyalty. This study used a survey method by distributing questionnaires to medical tourists from Indonesia (N = 152) who have visited hospitals in Malaysia for medical care at least once. Data analysis was carried out using several statistical procedures. Firstly, a multivariate test was conducted to find out whether there is a statistically significant difference in the push and pull motives based on the influencers. Second, multiple linear regression is performed to find out the influence of push and pull variables on satisfaction. Finally, a simple linear regression is calculated to find out the influence of satisfaction on loyalty. The findings show that there is a statistically significant difference in the push and pull motives based on the influencers (WoM or MPP). The effect size of both push and pull is almost equal. The relationship between push or pull and satisfaction is also statistically significant as 41.3% of the variance in the satisfaction is explained by the push and 51.8% by pull factors. Finally, satisfaction is a significant predictor for loyalty while 90.2% of the variance in loyalty is explained by satisfaction.

Medical tourism is a global phenomenon in many parts of the world. It features an activity where individuals travel from home country to the host country to seek or receive medical healthcare. Being the third largest sector, medical tourism has a significant contribution towards economic development in the Southeast Asia (SEA) region. However, the literature review depicts a scarcity of research on niche areas among the top player in this region. This study aims to explore the development of the medical tourism industry in the SEA region. An in-depth interview with stakeholders and private hospitals were conducted and analyzed using thematic analysis coupled with document analysis from various secondary data. Four SEA regions were chosen namely Malaysia, Indonesia, Thailand, and Singapore which offer specific niche markets to promote the medical tourism industry. Interestingly, these countries are complementing and not competing with each other in the same industry. This study is vital in enriching the literature in the field of medical tourism in showcasing the niche market of medical tourism in the SEA region. This study also contributes greatly to comparative analysis between these countries in the medical tourism sector. 

Increasing globalization of the healthcare sector indicates that there are new opportunities for emerging markets to take a bigger share from the whole healthcare industry. This is realized in the form of medical tourism where people prefer to travel to different destinations to receive medical treatments and services. Medical tourists prefer to travel for several reasons like low cost, high quality care or shorter waiting periods. The industry is growing rapidly and the annual expenditure is estimated to be around US$ 30 billion at the end of 2019. The challenging amount of expenditure whets the appetite of the countries and competitiveness becomes crucial to take more market share in this respect. Therefore the factors that build up competitiveness is identified and assessed thoroughly. This paper makes a literature review on the subject and recommends a New research opportunity for Turkey in this field.