Competition in Medical Tourism and Consumer Spending: Evidence from Turkey’s Growing Healthcare Market

Abstract

As competition intensifies in the global medical tourism industry, countries are increasingly seeking effective marketing strategies to enhance their market share. Developing such strategies requires a comprehensive understanding of the expenditure patterns of medical tourists, particularly in emerging destinations with limited historical involvement in medical tourism. This study aims to examine the expenditure characteristics of medical tourists with respect to treatment type, gender, religion, and country of origin. Empirical data were collected from 288 medical tourists (response rate: 82%) receiving healthcare services in Turkey, an emerging hub for medical tourism. Cross-tabulation analyses and chi-square tests of independence revealed statistically significant differences in expenditures based on the aforementioned characteristics. The findings indicate that, on average, female, non-Muslim tourists from developed countries spent more than their male, Muslim, and developing-country counterparts. Additionally, aesthetic treatments accounted for the highest average expenditures among all treatment types. This study offers valuable insights into the expenditure behavior of medical tourists in Turkey, contributing to the broader understanding of competition in the medical tourism sector. These findings can inform the development of strategic roadmaps and targeted marketing approaches in emerging medical tourism markets.

1. Introduction

Medical tourism, a specialized segment within the broader tourism industry, has recently garnered significant global attention due to its potential to positively impact both tourism development and national economies (Heung et al., 2010; Hume & Demicco, 2007). Scholars generally define medical tourism as the act of traveling across national borders to receive medical treatment (Connell, 2006; Zhai et al., 2022). Traditionally, medical tourists have favored developed countries such as the United States, various European nations, and the United Kingdom (Wapner, 2008). However, in recent years, the main destinations for medical tourism have shifted toward developing countries—including Turkey, India, Cuba, Costa Rica, Thailand, Singapore, Colombia, and Malaysia (Cham et al., 2022; PBB, 2018; Rastegar et al., 2025). These countries have become increasingly attractive to international patients by offering affordable healthcare services, qualified medical personnel, advanced technological infrastructure, and the opportunity to combine treatment with leisure in destinations rich in climate diversity, natural beauty, and cultural heritage (Chang, 2022; Paniscotti, 2021).

A report by VISA and Oxford Economics estimates that approximately 11 million individuals travel abroad annually for medical services, generating around $439 billion in expenditure (OXFORDECONOMICS, 2016; VISA, 2016). These figures suggest that between 3% and 4% of the global population currently engages in medical tourism. Moreover, projections indicate that the medical tourism industry will continue to expand at an annual growth rate of 25% over the next decade. The United States and European countries remain the top spenders in this sector (Bostan & Yalcın, 2016). The global medical tourism market accounted for 21,110.54 thousand patients in 2022, and is projected to reach 71,174.94 thousand patients by 2032, registering a CAGR of 11.8% from 2023 to 2032 (Allied Market Research, 2023). This rapid growth has intensified international competition to attract medical tourists (MTA, 2025). In contrast to conventional tourists, medical tourists tend to represent a sustained source of revenue for healthcare providers (Kim et al., 2017). Compared to developed nations, healthcare facilities in developing countries can often deliver high-quality services at significantly lower costs (Alderian et al., 2024; Lunt et al., 2014). Consequently, many patients are turning to overseas providers that leverage competitive pricing strategies to gain an advantage in an increasingly saturated global market (Fuster et al., 2018)

According to rational choice theory, consumers aim to maximize their utility within the constraints of their budget (Erciş, 2014). Therefore, pricing policies are a fundamental determinant in medical tourists’ decision-making processes when selecting healthcare providers (Connell, 2013). Affordable pricing also plays a crucial role in shaping patients’ perceptions of service and medical quality, satisfaction, trust, and their intention to return for future treatment (Han & Hyun, 2015).

Despite the increasing prominence of medical tourism in developing countries, there is a noticeable gap in the literature regarding the expenditure characteristics of medical tourists, particularly in relation to treatment types and demographic variables. This information is essential for the formulation of targeted marketing strategies and competitive pricing models, especially in light of the sector’s growing competitiveness (Altunışık et al., 2014).

Accordingly, this study aims to address this gap by examining the expenditure characteristics of medical tourists in Turkey, a rapidly emerging player in the global medical tourism market. Using survey data, we analyze how medical tourism expenditures differ based on treatment type, gender, religion, and country of origin. The findings are expected to provide valuable insights for stakeholders in Turkey and other emerging medical tourism destinations as they seek to enhance their strategic positioning in the global market.

The remainder of this paper is structured as follows. Section 1 outlines the key factors influencing the selection of medical tourism destinations. Section 2 focuses on Turkey as a case study. Section 3 describes the research methodology, followed by the results in Section 4. The paper concludes with a discussion of the findings and their implications.

2. Factors Influencing Medical Tourism Destination Countries

Medical tourism refers to the practice of traveling abroad to receive medical treatment, often combining healthcare with tourism (Jagyasi, 2009; Kim et al., 2017; Ross, 2001). This phenomenon is increasingly prevalent as an alternative to the high cost of healthcare in patients’ home countries (Tompkins, 2010). The appeal of seeking medical procedures abroad has grown in response to rising incomes in both developed and emerging markets, improved access to information through the internet, and decreasing travel costs (Johnson & Garman, 2015).

Several factors influence patients’ choice of medical tourism destinations. These include the cost and quality of medical care, hospital accreditation, cultural distance, and cultural familiarity (Herrick, 2007; Sag & Zengul, 2019). Consequently, medical tourists—viewed as healthcare consumers—base their destination decisions on perceived risks and benefits associated with a particular country (Kang et al., 2014).

Among the most significant determinants is the cost of medical treatment. For example, Pafford (2009) emphasizes the willingness of American patients to take advantage of the financial incentives of traveling for healthcare and the support of American medical insurance companies to expand medical tourism. Competitive pricing, therefore, plays a crucial role in the success of healthcare providers in destination countries. Herrick (2007) notes that treatment costs tend to be lower in these countries due to factors such as reduced labor costs, the absence or minimization of third-party payments, limited cross-subsidization, streamlined service delivery, minimal malpractice liability, and fewer regulatory constraints (

Table 1. Reasons for Lower Prices in Hospitals in the Medical Tourism Destination Country.

Labor costs	Salaries, and other labor-related costs are lower in medical tourism destination countries than in developed countries. As a result, lower labor costs provide a competitive advantage to building and operating hospitals with fewer funds.
Less (or no) third-party payments	In developed countries, markets are less competitive when insurers or governments pay substantial medical bills. As a result, consumers primarily spend their own money and thrust the providers to compete based on price in the medical tourism destination country.
Price transparency and package pricing	Patients can make comparisons by investigating various package prices in the international healthcare marketplace.
Few cross-subsidies	In the hospital revenue cycle, hospitals use revenues from some patients’ treatments to cover some other patients. However, profit-oriented hospitals in developing countries focus on one treatment and price the service as low as possible because of competition.
Streamlined services	Medical providers customize their specialty clinics and hospitals so procedures can be performed quickly and efficiently, saving time and reducing costs.
Limited malpractice liability	Cost of physicians’ insurance policies for malpractice litigations are lower than in developed countries.
Fewer regulations	Fewer regulations allow collaborative arrangements among hospitals in developing countries.

Source: Adapted from Herrick (2007).

).

Despite the focus on cost, medical tourists also prioritize the quality of medical treatment provided by healthcare facilities (İçöz, 2009; Pafford, 2009; Smith & Forgione, 2007). Their pursuit of higher-quality care motivates healthcare providers to implement rigorous healthcare delivery and accreditation standards. To meet these expectations, providers often seek certification from international accreditation bodies such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Joint Commission International (JCI), the American Medical Accreditation Program (AMAP), the National Committee for Quality Assurance (NCQA), the American Accreditation HealthCare Commission/Utilization Review Accreditation Commission (AAHC/URAC), and the Accreditation Association for Ambulatory Healthcare (AAAHC) (Viswanathan & Salmon, 2000). For instance, in Turkey, 34 academic medical centers and hospitals have received JCI accreditation. Following initial accreditation, JCI continues to support these institutions by providing guidance and promoting ongoing performance improvement (JCI, 2023).

In addition to quality assurance, trust in healthcare providers is a critical factor for medical tourists. Earning the trust of international patients is essential for providers in destination countries. However, medical tourists may feel uneasy about receiving care from providers with different cultural or religious backgrounds, especially when those differences conflict with their own cultural expectations and religious practices. Consequently, familiarity with a patient’s religious beliefs, cultural norms, and historical background significantly influences their choice of treatment destination (Glinos et al., 2010). Cultural affinity—such as shared religious beliefs—can play an important role in determining medical tourism destinations (Esiyok et al., 2017). For example, infertile couples may prefer international fertility clinics that are sensitive to their religious and ethical concerns. In this context, religious beliefs are particularly influential in the selection of destinations for reproductive healthcare (Moghimehfar & Nasr-Esfahani, 2011).

3. Turkey as a Medical Tourism Destination

Hospitals often publicize the costs of medical procedures on their websites as part of marketing strategies targeting medical tourists. These strategies typically benchmark against pricing in advanced economies such as the United States, United Kingdom, Japan, and various European countries. For instance, data presented in

Table 2. Cost comparison between top destinations (approximate figures in us dollars).

Medical Procedure	USA	Turkey	Colombia	India	S. Korea	Mexico	Israel	Thailand	Malaysia	Singapore	Costa Rica
Heart Bypass	123,000	13,900	14,800	7900	26,000	27,000	28,000	15,000	12,100	17,200	27,000
Angioplasty	28,200	4800	7100	5700	17,700	10,400	7500	4200	8000	13,400	13,800
Hip Replacement	40,364	13,900	8400	7200	21,000	13,500	36,000	17,000	8000	13,900	13,600
Hip Resurfacing	28,000	10,100	10,500	9700	19,500	12,500	20,100	13,500	12,500	16,350	13,200
Knee Replacement	35,000	10,400	7200	6600	17,500	12,900	25,000	14,000	7700	16,000	12,500
Spinal Fusion	110,000	16,800	14,500	10,300	16,900	15,400	33,500	9500	6000	12,800	15,700
Dental Implant	2500	1100	1200	900	1350	900	1200	1720	1500	2700	800
Lap Band	14,000	8600	8500	7300	10,200	6500	17,300	11,500	8150	9200	9450
Gastric Sleeve	16,500	12,900	11,200	6000	9950	8900	20,000	9900	8400	11,500	11,500
Hysterectomy	15,400	7000	2900	3200	10,400	4500	14,500	3650	4200	10,400	6900
Breast Implants	6400	4500	2500	3000	3800	3800	3800	3500	3800	8400	3500
Rhinoplasty	6500	3100	4500	2400	3980	3800	4600	3300	2200	2200	3800
Face Lift	11,000	6700	4000	3500	6000	4900	6800	3950	3550	440	4500
Liposuction	5500	3000	2500	2800	2900	3000	2500	2500	2500	2900	2800
Tummy Tuck	8000	4000	3500	3500	5000	4500	10,900	5300	3900	4650	5000
Lasik (both eyes)	4000	1700	2400	1000	1700	1900	3800	2310	3450	3800	2400
Cornea (per eye)	17,500	7000	-	2800	-	-	-	3600	-	9000	9800
Cataract surgery (per eye)	3500	1600	1600	1500	-	2100	3700	1800	3000	3250	1700
IVF Treatment	12,400	5200	5450	2500	7900	5000	5500	4100	6900	14,900	-

Approximate retail costs. Healthcare costs will vary based upon many factors, including hospital, doctor’s experience, accreditation, and currency exchange rates—international figures based on hospital quotes in named countries.

illustrates the cost of medical procedures across leading medical tourism destinations. When comparing prices, the research indicates that the United States, Mexico, and Israel generally have higher costs than Turkey, Colombia, India, Malaysia, and Singapore. This comparison highlights the relative cost advantages of seeking medical treatment in these latter countries.

Specifically, Turkey offers significantly lower treatment costs for a range of procedures. For example, a heart bypass surgery that costs approximately $123,000 in the United States is priced at just $13,900 in Turkey—more than nine times less. Similarly, procedures such as hip and knee replacements, dental implants, breast augmentation, facelifts, and cataract surgeries are all substantially less expensive in Turkey. In most cases, the savings for international patients exceed 50%.

In recent years, Turkey has emerged as a prominent destination in the medical tourism sector, supported by a variety of initiatives and investments (Yazan et al., 2017). The country possesses strong potential due to its technologically advanced hospitals, government incentives (Ulaş & Anadol, 2016), well-trained medical professionals, and geographical advantages, including a diverse climate, abundance of thermal springs, and scenic natural landscapes (Altın et al., 2012). Additional benefits such as competitive pricing, safe accommodation, and efficient transportation further enhance Turkey’s appeal to international patients (Yardan et al., 2014).

Nevertheless, the Turkish medical tourism industry faces several challenges. These include limited public awareness of patient rights, insufficient foreign language proficiency among medical staff, negative perceptions of the country, economic instability, weak collaboration with foreign insurance providers, and inadequate promotional activities within the country (Ozsarı & Karatana, 2013).

According to a report on medical tourism published by the Turkish Ministry of Health, the number of international patients treated in Türkiye increased significantly between 2008 and 2014 (Yıldırım et al., 2016). However, this positive trajectory was disrupted in 2015, when the number of foreign patients declined by 20% compared to the previous year, with the downward trend continuing into 2016. The report attributes this contraction to a combination of factors, including incomplete data collection, heightened security concerns related to terrorism, and broader regional instability. Complementing these findings, subsequent scholarly studies emphasize that rising healthcare costs have also contributed to the slowdown in the growth of Turkey’s medical tourism sector (Yazan et al., 2017).

The same report (Yıldırım et al., 2016) identifies the primary source countries for medical tourists in 2016. Germany ranked first, with 21,759 of its citizens receiving healthcare services in Turkey, followed by England (8130 patients) and the Netherlands (7096 patients). The remaining countries in the top ten were predominantly from the Middle East, underscoring the region’s central role in shaping Turkey’s medical tourism market.

With regard to the types of medical services utilized by foreign patients, the report highlights emergency medicine as the most frequently demanded service in 2016, with 30,429 patients. This was followed by gynecology and obstetrics (25,505 patients), ophthalmology (22,492 patients), and internal medicine (16,005 patients). These figures indicate that both urgent healthcare needs and specialized treatments were the primary drivers of international patient mobility to Turkey during this period.

Although medical tourism has been recognized as an important source of revenue for Turkey (Kantarci & Kurban, 2014), the Ministry of Health’s Medical Tourism Report (2015–2016) does not provide data on the healthcare expenditures of international patients. The absence of such expenditure data in an emerging destination like Turkey limits the ability to conduct meaningful cross-national comparisons. To address this gap, the present study examines the spending patterns of Turkey’s medical tourists. Turkey was selected as the case study due to its recent emergence as a prominent medical tourism hub, supported by ongoing healthcare reforms and substantial investment initiatives (Sag & Zengul, 2019).

4. Method

4.1. Study Design and Sample Size

This study employed a quantitative, cross-sectional survey design targeting medical tourism patients who received care in both private and public hospitals in Turkey.

Data were collected using a questionnaire adapted from a validated instrument originally developed by Moghimehfar and Nasr-Esfahani (Moghimehfar & Nasr-Esfahani, 2011). The instrument was revised based on expert consultation and an extensive literature review (Sag & Zengul, 2019). To facilitate data collection in the native languages of the medical tourists, the finalized English version of the questionnaire was translated into Turkish, French, Persian, German, Arabic, and Russian.

The study was conducted following approval from the University of Health Sciences Ankara Abdurrahman Yurtaslan Educational Research Hospital’s Expertise and Training Committee, as well as authorization from the Turkish Ministry of Health, granted on 1 January 2017. A pilot study using a convenience sample was carried out to assess the feasibility of the survey instrument.

Questionnaires were distributed via email to ten hospitals providing care to approximately 350 medical tourists. These hospitals included four public and six private institutions located in Turkey’s seven largest cities: Ankara, Istanbul, Adana, Antalya, Denizli, Erzurum, and Izmir. All participating hospitals met high standards of healthcare delivery and were accredited by the Joint Commission International (JCI).

With the support of hospital staff, including nurses and administrators, a total of 288 completed surveys were collected, yielding a response rate of 82%. Of these, 86 respondents did not provide information on healthcare expenditures, reducing the sample to 202. Further reductions in sample size occurred due to missing responses on specific survey items such as treatment type, religious belief, and sex. Consequently, the final analytical sample varied by variable, ranging from n = 172 (treatment type) to n = 202 (UN country classification).

Content validity of the survey instrument was confirmed through expert review and alignment with relevant literature. Internal consistency reliability was assessed using Cronbach’s alpha, yielding a value of 0.71, closely aligning with the reliability of the original scale (0.73) (Moghimehfar & Nasr-Esfahani, 2011).

4.2. Measures

Medical care expenditures were analyzed according to treatment type, religious affiliation, sex, and country of origin. Expenditure was measured as a categorical variable based on the total amount spent on medical treatment: $0–2500; $2501–5000; $5001–10,000; and more than $10,000. All amounts were reported in U.S. dollars (USD); however, in cases where expenditures were originally recorded in Turkish Lira or another foreign currency, they were converted to USD using the exchange rates prevailing at the time of data collection. These figures reflect only the cost of primary medical treatment and exclude expenditures related to accommodation, travel, or other tourism-related activities.

Based on established literature, medical treatments were categorized into four main groups (Technavio, 2017): Internal medicine—including internal medicine, chemotherapy, and neurology; Aesthetic/appearance-related treatments—including dental care, hair grafting, dermatology, and plastic surgery; Surgical/operational treatments—including otolaryngology, orthopedics, gynecology, general surgery, cardiovascular procedures, and ophthalmology; Emergency/outpatient care—including emergency services, routine check-ups, outpatient visits, and treatments for drug dependency.

Religious affiliation was treated as a categorical variable with the following classifications: Christian, Muslim, Jewish, and Other. Sex was recorded as either male or female. Country of origin was classified according to the United Nations’ economic development classification system (UN, 2014), which includes: Developed economy, Economy in transition, Developing economy

4.3. Analysis

Following the categorization of the data into nominal and ordinal variables, cross-tabulation with Pearson’s chi-square tests of independence was employed to examine the relationships between medical expenditure and the variables of treatment type, religious affiliation, sex, and country of origin. Cross-tabulation was chosen as the primary analytical technique because it enables the simultaneous analysis of two categorical variables to assess potential associations between them (Babbie, 2013).

Cross-tabulation organizes data into a matrix format, where one set of categorical variables is represented in rows and the other in columns. Each cell in the matrix displays the frequency of observations corresponding to the intersection of the two variables. This approach allows for a straightforward and quantitative analysis of relationships between multiple categorical variables. After constructing the cross-tabulations, Pearson’s chi-square test was applied to determine whether the observed relationships between variables were statistically significant. All statistical analyses were conducted using SPSS Statistics Version 24. A p-value of less than 0.05 was considered indicative of statistical significance.

4.4. Findings

The distribution of medical expenditures by treatment type is presented in

Table 3. Patient’s expenditure amount by treatment type in turkey (N = 172).

Treatment Type		Expenditure Amount (USA $)				Total
		Less Than $2500	$2500–5000	$5001–10,000	$10,001 and Higher
Treatment for Internal Diseases (Internal Medicine)	n	25	4	5	0	34
	%	14.5	2.3	2.9	0	19.8
Treatments for Aesthetic Appearance (dental-hair transplantation-dermatology-plastic surgery)	n	9	7	36	19	71
	%	5.2	4.1	20.9	11	41.3
Operational (Surgical) Treatments (KBB-orthopedics-gynecology-general surgery-cardiovascular surgery-eye)	n	16	3	19	16	54
	%	9.3	1.7	11	9.3	31.5
Emergency-Polyclinic-Check-up Applications (emergency-checkup-outpatient-drug dependency)	n	3	0	4	6	13
	%	1.7	0	2.3	3.5	7.6
Total	n	53	14	64	41	172
	%	30.8	8.1	37.2	23.8	100

Note: Pearson Chi-Square “Asymp. Sig. (2-sided)” value p = 0.00.

The majority of patients received aesthetic/appearance-related procedures (41%), followed by surgical treatments (32%). A smaller proportion of patients received internal medicine (20%) and emergency care (8%).

There was considerable variation in the amount spent by medical tourists. Specifically, 31% (n = 53) of respondents reported spending less than $2500, whereas 24% (n = 41) reported expenditures of more than $10,000. Statistically significant differences in expenditure were observed across treatment types (p < 0.001). Among patients who spent $2500 or less, 47% received internal medicine procedures. In contrast, among those who spent $10,000 or more, 46% received aesthetic/appearance-related treatments. These findings highlight a strong association between treatment type and level of expenditure.

Medical tourism expenditures by religious affiliation are presented in

Table 4. The relationship between religious belief and medical tourists’ expenditure (N = 182).

Religious Belief		Expenditure Amount (USA $)				Total
		$0–2500	$2500–5000	$5000–10,000	$10,000 and Upper
Christian	n	17	4	26	13	60
	%	9.3	2.2	15.4	7.1	33
Muslim	n	48	8	32	8	96
	%	26.3	4.3	17.5	4.3	52.7
Jewish	n	2	0	3	1	6
	%	1.1	0	1.7	0.5	3.2
Other	n	2	4	8	6	20
	%	1.0	2.2	4.4	3.2	11
Total	n	69	16	69	28	182
	%	37.9	8.8	37.9	15.4	100

Note: Pearson Chi-Square “Asymp. Sig. (2-sided)” value p = 0.01.

. Muslims comprised the largest group of medical tourists (53%), followed by Christians (33%). Individuals identifying with other religions accounted for 11%, while Jewish patients made up 3% of the sample. There were statistically significant differences in expenditure levels based on religious affiliation (p < 0.05). Christians had the highest proportion of patients spending more than $10,000 (46%), whereas Jewish patients had the lowest share (4%) in this expenditure category.

Expenditures by religious affiliation—Muslim versus non-Muslim—are presented in

Table 5. Medical tourism expenditures for Muslims versus non-Muslims (N = 182).

Religion Belief		Expenditure Amount (USA $)				Total
		$0–2500	$2500–5000	$5000–10,000	$10,000 and Upper
Non-Muslim	n	21	8	37	20	86
	%	11.5	4.4	20.3	11	47.2
Muslim	n	48	8	32	8	96
	%	26.3	4.4	17.7	4.4	52.8
Total	n	69	16	69	28	182
	%	38	8.8	38	15.2	100

Note: Pearson Chi-Square “Asymp. Sig. (2-sided)” value p = 0.01.

. The patient population was nearly evenly divided, with Muslims comprising 53% and non-Muslims 47% of the sample. A statistically significant relationship was found between medical expenditure and religious affiliation. Among patients who spent more than $5000 on medical procedures, the majority were non-Muslim (59%). In contrast, among those who spent $5000 or less, the majority were Muslim (66%).

The expenditure distribution based on sex (male and female) shows in

Table 6. The relationship between sex and expenditure (N = 190).

Sex		Expenditure Amount (USA $)				Total
		$0–2500	$2500–5000	$5000–10,000	$10,000 and Upper
Male	n	31	9	39	9	88
	%	16.3	4.7	20.5	4.7	46.3
Female	n	39	7	31	25	102
	%	20.5	3.7	16.3	13.2	53.7
Total	n	70	16	70	34	190
	%	36.8	8.4	36.8	17.9	100

Note: Pearson Chi-Square “Asymp. Sig. (2-sided)” value p = 0.035.

. The majority of patients were female (54%). In addition, 74% of patients spending more than $10,000 were female.

The distribution of medical expenditures based on the United Nations classification of economic development is presented in

Table 7. The relationship between united nations country classification and medical tourists’ expenditures (N = 202).

UN Country Classification		Expenditure Amount (USA $)				Total
		$0–2500	$2500–5000	$5000–10,000	$10,000 and Upper
Developed Economies	n	20	9	40	18	87
	%	9.9	4.5	19.8	8.9	43.1
Economies in Transition	n	9	2	4	9	24
	%	4.5	1	2	4.5	11.9
Developing Economies	n	36	5	23	27	91
	%	17.8	2.5	11.4	13.9	45
Total	n	65	16	67	54	202
	%	32.7	7.9	33.7	26.7	100

Note: Pearson Chi-Square “Asymp. Sig. (2-sided)” value p = 0.014.

. The majority of patients originated from developing economies (45%) and developed economies (43%), while a smaller proportion came from economies in transition (12%). A statistically significant relationship was found between expenditure level and country classification, as indicated by the chi-square test (p = 0.014). Among patients who spent $5000 or less, the largest proportion were from developing countries (44%). In contrast, among those who spent more than $10,000, the majority were from developed countries (48%). Patients from developing countries also constituted a substantial share (41%) of those spending more than $5000, closely following their counterparts from developed countries. In comparison, patients from economies in transition represented only 11% of those who spent more than $5000.

5. Conclusions and Discussion

This study analyzed the expenditure characteristics of medical tourists in Turkey based on treatment type, sex, religious affiliation, and the economic classification of their countries of origin. Understanding expenditure patterns has become increasingly critical in the medical tourism sector due to the liberalization of global healthcare markets and the need for healthcare providers to adopt competitive and efficient strategies. Gaining insights into these spending behaviors is vital for developing effective market segmentation and pricing strategies. A well-formulated marketing mix, including competitive pricing models, is essential for healthcare providers to sustain themselves in the competitive global medical tourism market.

While the existing literature provides a comprehensive overview of contextual factors influencing the global medical tourism industry—such as its drivers, opportunities, trends, and sector-specific challenges (Technavio, 2017), this study contributes to the body of knowledge by offering empirical evidence from an emerging destination: Turkey. As competition intensifies among countries vying for medical tourists, understanding expenditure patterns in emerging markets like Turkey is crucial for stakeholders aiming to formulate targeted marketing strategies.

First, the study examined patient expenditures across different treatment types. Notably, emergency and polyclinic check-ups were the least utilized and least expensive services. This suggests that most medical tourists come to Turkey for pre-planned, elective procedures rather than urgent care. In contrast, aesthetic treatments attracted the highest expenditures, aligning with Turkey’s well-established reputation in procedures such as hair transplantation, facelifts, and skin rejuvenation, consistent with trends noted in previous years (Kılavuz, 2018; Sag & Zengul, 2019).

Second, the average spending of medical tourists in Turkey was found to be comparable to that in top global medical tourism destinations. According to the 2015 Medical Tourism Association Patient Survey, international medical tourists typically spend between $3600 and $7600 per trip (Kim et al., 2017). This indicates that Turkey’s pricing is competitive globally, although it is neither the least expensive nor the top-ranked destination in terms of volume. Turkey may be leveraging a differentiation strategy by integrating healthcare with other tourism attractions such as sun, beach, and cultural heritage sites.

Third, significant differences in spending were observed based on religious affiliation. Muslim medical tourists were found to spend less than their Christian counterparts. Additionally, tourists from predominantly Christian countries (e.g., Germany, the UK, the USA, Russia) spent significantly more than those from predominantly Muslim countries (e.g., Middle Eastern nations, Azerbaijan, Pakistan). This variation may partly reflect differences in GDP per capita and the perceived affordability of Turkish healthcare services. It is also possible that higher-income patients from Muslim-majority countries prefer treatment in Western nations, leaving Turkey to attract primarily low- to middle-income patients from these regions.

Fourth, although the sample included an almost equal number of Muslim and non-Muslim patients, non-Muslim medical tourists were found to spend more than their Muslim counterparts. As a predominantly Muslim country with a secular constitution, Turkey offers a healthcare system that is accessible and inclusive of all religious groups. According to the literature, familiarity with a destination’s religious beliefs, culture, or historical context significantly influences individuals’ decisions regarding medical treatment abroad (Glinos et al., 2010). Therefore, Turkey’s medical tourism sector could benefit from emphasizing cultural and religious commonalities in its marketing strategies and outreach efforts.

Fifth, when examining spending based on the UN’s economic classifications, tourists from developed and developing economies spent similar amounts, whereas those from economies in transition spent less. This indicates that stakeholders in Turkey’s medical tourism industry may benefit from targeting developed and developing markets to maximize revenue.

According to rational choice theory, consumers select product or service combinations that maximize their utility within the constraints of a limited budget (Erciş, 2014). In the context of this study, utility refers to the preferences of medical tourists, specifically the extent to which medical services satisfy their needs. Cost is widely recognized as a key determinant in the selection of medical tourism destinations (Carmen & Iuliana, 2014; Connell, 2013; Lunt et al., 2014). Drawing on both the existing literature and publicly available pricing data, our findings indicate that while Turkey offers competitive prices in comparison to other medical tourism destinations, it is neither the lowest-cost option in the region nor the leading global destination. Nonetheless, the spending patterns observed among medical tourists in this study reflect the principles of rational choice theory, as patients appear to seek an optimal balance between cost and perceived benefit when choosing Turkey as a treatment destination.

Although this study focuses specifically on Turkey, its findings contribute meaningfully to the global medical tourism literature. A growing body of research in this field can assist prospective patients in making informed healthcare choices, potentially increasing the volume of international patients. This growth could, in turn, have significant implications for the healthcare systems of host countries, affecting service delivery, quality of care, and healthcare costs.

These insights contribute to a deeper understanding of consumer behavior and competitive dynamics within the medical tourism sector. Importantly, the expenditure patterns identified in this study can inform strategic planning and the development of targeted marketing initiatives to enhance Turkey’s positioning in the global medical tourism landscape.

6. Practical Implications

The findings of this study provide valuable practical implications for stakeholders in the medical tourism industry, particularly in emerging destinations like Turkey. The results reveal that female, non-Muslim medical tourists from developed countries tend to spend more during their visits, suggesting that healthcare providers and facilitators should tailor their marketing strategies and service offerings to meet the specific needs and expectations of these high-spending segments. Culturally sensitive care, multilingual support, and personalized experiences could enhance patient satisfaction and encourage longer stays or repeat visits. Additionally, identifying spending differences by treatment type enables hospitals and clinics to strategically design service packages—especially for higher-spending procedures such as aesthetic or dental treatments—by integrating premium accommodation, recovery support, or tourism activities. These insights also guide policymakers and destination managers in creating targeted promotional campaigns and allocating resources more effectively to attract the most profitable visitor profiles. Lastly, stronger collaboration between the healthcare and tourism sectors through integrated service models can enrich the overall experience for medical tourists while maximizing economic benefits for the country.

7. Limitations and Future Research

This study is subject to several limitations, including constraints related to time, funding, and primary data collection. One notable challenge was that some medical tourists were reluctant to disclose the cost of their treatments, likely due to privacy concerns. Despite these limitations, the study offers meaningful insights into the expenditure patterns of medical tourists in Turkey.

Future research could explore the broader economic impact of medical tourism on host countries, particularly how this revenue stream affects native populations and local healthcare systems. Additionally, comparative studies involving other medical tourism destinations could offer more comprehensive insights into expenditure patterns across different countries. Qualitative studies would also be valuable in understanding patients’ perceptions of pricing strategies employed by destination countries and healthcare providers. Such investigations could further illuminate the role of value perception and decision-making in medical tourism.