Factors Influencing People to Go India for Treatment Purpose

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 Research Proposal
Course: Marketing Research
Course Code: MKT414

Prepared for

Dr. Md. Abdul Momen

Assistant Professor
Department of Business Administration
East West University

Prepared by

Name ID

Md. Soudh Islam 2013-3-10-103

Tareq Ahmed 2012-1-10-069
Md Bakir Hossain 2015-1-10-272
Tasnim Sultana 2014-1-10-122
Sujan kumerMondal 2014-2-10-115

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 Letter of Transmittal

5th December, 2018

Dr. Md. Abdul Momen
Assistant Professor
Department of Business Administration
East West University

Subject: Submission of research paper on factors influencing people to go India for treatment purpose.

Dear Sir,
With humble respect, we would like to submit to you our research paper which is titled “factors influencing people
to go India for treatment purpose.” Given the opportunity to do a research on the proposed topic we would make
use of our capabilities in order to find out the factors affecting people to go India for treatment purpose. We will be
pleased to answer any kind of query you think necessary.

We sincerely hope that you will appreciate our effort and for any further queries, we would beat your disposal at
your convenience.

Sincerely yours,

Md. Soudh Islam

Tareq Ahmed

Md. Bakir Hossain

Tasnim Sultana

Sujan Kumer Mondal

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 Executive Summary

New trend is Bangladeshi people travelling India for medical service. Many countries of the South Asia and
Southeast Asia region are profiting in medical tourism but Bangladesh lags behind. Bangladesh also loses patients
to these countries. Bangladeshi Patients are willing to go India for medical treatment. The reason is higher
perceived quality of treatment. This similar treatment can be achieving more cost effectively within the country.
We all know that Bangladeshi healthcare is not without its problems and these problems and quality less health
care service are responsible for lower perception of people. The study will identify important factors for both
Bangladeshi and Indian health care service providers. Three major factors is important for medical service
providers. First one is Destination competitiveness, second one is service quality, third one is our attitude and last
one is Cost. The study findings will show those reasons which are influencing Bangladeshi patients to go India for
medical purpose. Hence, in order to keep Bangladeshi patients within the country, medical service provider should
assure proper development of local healthcare sector, Bangladesh should focus on a comparable quality healthcare
package. A questionnaire was prepared and data was collected from 200 respondents. Collected data was reliable..
We did descriptive analysis, regression analysis. We did ANOVA test, correlation analysis among different
independent variables. Finally, we proposed some factors that influence people to go to India for treatment
purpose.

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 Table of Content

CHAPTER SUBJECT Page no.

CHAPTER 1: INTRODUCTION

Background 06

Objective 07

Problem Statement 07

Significance 08

Conclusion 08

CHAPTER 2: Literature Review

Introduction 09

Destination Competitiveness 10

Service Quality 10

Tourist Attitude 11

Cost 12

Hypotheses and Conclusion 13

CHAPTER 3: Methodology

Introduction 17

Data Collection 17

Analytical Model 17

Limitation of The Study 18

Theoretical Framework and conclusion 18

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 CHAPTER SUBJECT Page no.

CHAPTER 4: INTRODUCTION ANALYSIS AND FINDINGS

Gender, Age, Marital Status 19-21

Education, Occupation, Income 22-24

Ever visited 25

Cross Tabulation 26-27

Factor Analysis Before 28-35

Factor Analysis after Elimination of 36-42

Factors
Regression 42-47

CHAPTER 5: CONCLUSION AND RECOMMENDATION

Conclusion and Recommendation 48

Chapter: 1 Introduction

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Background

Medical tourism is now a day’s faster and it is actually thousands of years old. From the 18th century wealthy
Europeans travelled to spas from Germany to the Nile. Since the early nineteenth century, when there were no
restrictions on travel in Europe, people visited neighboring countries in order to improve their health. At first, mere
traveling was considered to be a good therapy for mental and physical well-being. In the 21st century, relatively
low-cost jet travel has taken the industry beyond the wealthy and desperate. Later, mostly wealthy people began
traveling to tourist destinations like the Swiss lakes, the Alps and some more lucrative areas that provided best
medical services. Thailand, followed by India, Puerto-Rico, Argentina, Cuba and others quickly became the most
popular destinations for medical tourists. Today we have reached the era where Hospitals are more like Spas and
Spas more like hospitals.

Normally medical tourism is defined as an act of travel of patients from their home country to other destinations for
availing medical services. Medical tourism, alternatively called health tourism and wellness tourism, is a term that
has risen from the rapid growth of an industry where people from all around the world are traveling to other
countries to obtain medical, dental, and surgical care while at the same time touring, vacationing, and fully
experiencing the attractions of the countries that they are visiting. With countries like India, Mexico, Singapore,
Brazil, Argentina, Greece, Costa Rica, Dominican Republic, Peru, Hungary, Israel, Jordan, Lithuania, Malaysia,
South Africa, Thailand and the Philippines actively promoting it, its future assure to be bright. It’s actually an idea
with which a greatly lucrative potential is attached. Medical tourists are generally residents of the industrialized
nations of the world and primarily come from The United States, Canada, Great Britain, Western Europe,
Australia, and The Middle East. But more and more, people from many other countries of the world are seeking out
places where they can both enjoy a vacation and obtain medical treatment at a reasonable price.

“Medical tourism” has been a recognized market since 1980’s and is now a rapidly developing. The increase in
technological and medical research and developments, augmented product consciousness and globalization are
among the most influential trends that affect the industry. For the purpose of treatment now a day’s many people go
to the better nation. At the time of modernization with technological advancement all countries fight with the
medial issues, with the harmony of all the objectives and critical medical situation and at the same time medical
facilities should be modernized and upgraded. Country like Bangladesh in south Asia is already far behind in many
aspects, in medical sector, and its rapidly improving but there are some issues that people have to move our
neighbor country India.

Objective

General Objective:

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The very first objective of the study is to prepare a project paper on the specified topic implementing the
knowledge that has been gathered over the semester at East West University- Bangladesh from my honorable
course supervisor. The primary object of this project is to enable to learn about various factors influencing people
to go to India for treatment purpose.

Specific Objective:

 To identify the factors that influence people to go to India for treatment purpose.
 To enlighten growing medical tourism sector in India.
 To find out how India satisfying a large number of people by giving treatment.
 To find out whether India is actually an attractive place for medical tourism.
 To help Bangladeshi medical sector by this research.

Problem Statement:

We all know that Bangladesh is a densely populated developing country. This country is bordering with West
Bengal in India. A large number of people are living below poverty line. There is some improvement in primary
health care provision but still large numbers of people do not have access to medical facilities and treatment due to
overcrowding, non-availability of medical treatment, lack of qualified and experienced medical specialists and
corruption. Further, Bangladeshis people are travelling to India to receive medical treatment for diseases, as they
are seeking lower cost, high quality of health care, better access for treatment then they would receive at home. The
public hospitals suffer from full capacity problems, shortage of essential medical equipment and facilities,
diagnostic services, medicines, experienced specialist doctors and trained nurses. Every year our government
allocates large sums of money in the budget for health care, but it is in adequate to meet domestic demand for
healthcare. There is also evidence of wide spread corruption in the provision of public health as exposed by media.

Significance:
Academic Purpose: Human behavior is preceded by intentions, which are formed based on an individual’s attitude
towards the behavior and perceived subjective norms. (Fishbeinand Ajzen, 1975). And this study is based on the

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independent and dependent issues which cause peoples decision making process when they choose India for
treatment purpose. This bended approach examines the factors that inspire or influence people to choose this
country for treatment.

Practical Purpose: This research will help Bangladeshi Medical Industry to understand the factors which
influences general people to go to India for treatment purpose by which Bangladeshi Medical Industry will try to
improve these factors to attract medical tourists.

Conclusion:

In summary, medical tourism now a day’s improving and increasing at the same time a growing industry for the
country itself. From the begging of the era still now it’s changing massive. People specially class level people go
abroad purpose of medical at the same time short vacation. For the purpose of treatment now a day’s many people
go to the better nation. At the time of modernization with technological advancement all countries fight with the
medial issues, with the harmony of all the objectives and critical medical situation and at the same time medical
facilities should be modernized and upgraded. And also traveling was considered to be a good therapy for mental
and physical well-being. Normally medical tourism is defined as an act of travel of patients from their home
country to other destinations for availing medical services. It also Include the both aspects both country and global.
With countries like India, Mexico, Singapore, Brazil, Argentina, Greece, Costa Rica, Dominican Republic, Peru,
Hungary, Israel, Jordan, Lithuania, Malaysia, South Africa, Thailand and the Philippines actively promoting it.
Medical tourists are generally residents of the industrialized nations of the world and primarily come from The
United States, Canada, Great Britain, Western Europe, Australia, and The Middle East. Country like Bangladesh in
south Asia is already far behind in many aspects, in medical sector, and its rapidly improving but there are some
issues that people have to move our neighbor country India. People of Bangladesh go to India for the better
treatment under medical tourism.

Chapter 2: Literature Review

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Introduction:

It is not new to venture abroad for health care from different international locations. In this new horizon, medical
tourism has great value of interest. Health tourism or medical tourism is not a very concise idea. It includes quality
health care services as well as some other facilities like better accommodation, shopping and sometimes
recreational arrangements. Desired medical destination nations are not always just western world countries. A new
angling phenomenon is people of developed and developing countries visiting medical destination countries around
the world for medical care. The major reasons for this may include lengthy waiting time to get visa or medical
services in some western countries, high expenses, and lack of medical insurance, or under-insurance. Among the
most famous medical tourism destination countries, Asian countries attract more tourists because these are less
expensive than those of other parts of the world like US or European countries. As in most Asian countries labor
cost is lower thus medical tourists or international customers can save their money from 40% up to 60%. Thus, the
success of Asian countries like India is remarkable in this medical tourism industry. India is more popular among
medical tourists interested in cardiac procedures, cancer diagnosis and treatment. Being a pioneer in the medical
tourism industry, India offers new technology, alternative and experimental treatments alongside an internationally
trained workforce who speak English. India has a broad spectrum of specializations including cardiology, cosmetic
surgery, dentistry, ophthalmology, orthopedics, transplants and assisted reproduction. Nowadays, India remains a
leading medical tourism country that promotes widely at both a governmental and private sector level as well as
offering medical visas. Cost savings are prominent as one can expect to save 58% when compared to the US or
47% for the UK.

Among other countries India is highly competitive. Medical tourism has become one of the most growing sectors
of India. The country has an annual growth rate of 30% and it is expecting to become a $2 billion industry by 2015.
The major contributing factors behind the success of India in medical tourism may include less costly skilled labor
force, latest medical technologies, standard quality medical services and facility of mass use of English language.
The only remaining problem can be its infrastructure. But Indian Government is committed to solve this by giving
it a higher priority. A study by ASSOCHAM reported that 850,000 tourists came to India in 2011 and they
forecasted, by 2015 this number may rise to 3,200,000. The most popular treatments the country provides are,
bone-marrow transplant, alternative medicine, cardiac bypass, hip replacement, and eye surgery. Chennai is the
most famous city of India for medical tourism.
Based on the present condition and future prediction India is a very successful medical destination for the world
indeed. But there is no such industry in world which is free from risk. In order to avoid vulnerability, the country
should search new competitive advantages continuously. The main focus can be on increasing the number of
medical tourists as well as maintaining and enhancing the quality of health care services at reasonable costs and
also ensuring ethical issues. It is essential to learn the factors that play the major role in order to succeed in this
industry from the point of view of medical or health tourists. Thus, other emerging countries can learn and take
proper steps accordingly. India can emphasize important issues to maintain and to enhance the prosperity of
medical tourism. (Momen, A. et al. 2014)

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The Literature review includes certain factors that influence health tourism industry in India. All these factors are
wider than the quality of service, the competitiveness of the destination and various aspects.

Destination Competitiveness
A desired destination of medical tourism should be a kind of product containing central rewards like commercial
infrastructure and environmental factors. Comparative advantage have involve climate, surroundings, flora and
fauna, while competing advantage may relate to such produced items such as health and medical care areas,
heritage/historic attractions, events, transport sites, govt. policy, the actual quality of management and skills of
workers.
Crouch et al. defined the most aggressive location, which is actually one that is liable to bring finest success; that
arranges a surrounding which is the most suitable place for the residents for a certain schedule. Hence,
competitiveness of a destination for medical tourism has to last besides, being simply cheap. In addition, it should
be socially, culturally, politically and environmentally sound and friendly. For that reason, it is always suggested
that the most acceptable desired destination could be the one where medical tourist get a friendly environment.
India has achieved a desirable position in medical tourism because of its adaptability with the changing world
demand for healthcare and its greater competitiveness. (Momen, A. et al. 2014)

Service Quality

One of the most crucial factors is the service quality provided by the destination country in medical tourism
industry. Medical tourists focus greatly on this issue. Thus, the destination country must fulfill the expectations of
the medical tourists through quality service and performance. In the service providing organizations, service quality
is proven as an important determinant of competitiveness.
Quality in service organization goes beyond the mere application of quality management into the whole
organization. Every part of the organization is very much affected and inspired by quality as the way of doing
activities. Quality is determined as a critical issue for competitive success. Quality improvement and its potentiality
in travel and tourism services are very difficult to implement as it involves people from different countries with
different cultural background and demands. However, companies can improve service quality by lowering
distribution costs and enhancing the service provided. As quality in service industry is quite different than the
quality in manufacturing industry, therefore the meaning of service quality must be defined at first. Zero defects are
treated as quality in manufacturing industry. On the contrary, three characteristics separate service industry or
tourism industry from manufacturing and these are: intangibility, perish ability and inseparability. Services are
intangibles whereas goods are tangibles. Intangibility can be clarified if the products cannot be exhibited. Perish
ability ‘involves the simultaneous production and consumption of the service. In medical tourism if any country
can provide quality healthcare services at low cost then it will definitely attract the world.

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In this sector meaning of quality service is a vast issue. It involves the quality of healthcare center as well as the
doctors and other staffs. However, healthcare is actually a very individual and critical service and it is not an easy
task to define its quality.
Human behavior can be modified through the training process. Here new and different types of capabilities can be
added. On the other hand, some capabilities which are already possessed by individuals can be extended or
enhanced. In the process of training one can learn to behave properly in different situations that ultimately
increases capabilities that reflects the nature, variability and intensity of what people are required to do.
Customer expectations involve two factors, and these factors are quality service and qualified labor force. In these
days, companies are struggling because customers are demanding high level of excellent services and skilled labor
is harder to find and keep. Baum and Hagan discussed that the lack of sustained employment, which is the
characteristic of seasonal operations, undermines the ability of operators to deliver quality, which the marketplace,
increasingly, expects. There is a great correlation between customer satisfaction and employee performance that is
well trained and qualified employees. In service industry customers evaluate quality based on the behavior and
skills of the employees. Moreover Customers take the behavior of service providers as the key influencer in order
to judge the nature of the service. Because of the variability in human beings, consistency of quality service is
difficult to ensure. Well skilled workers provide quality service if they are properly trained and perfectly
compensated.
(Momen, A. et al. 2014)

Tourist Attitude

In tourism industry customer or tourist attitude towards any destination is very important for its success. It varies
from person to person. This can be different on certain aspects like, customer group, age, gender, income, family
structure, race, culture, social class and ethnicity. Food, cloths, politics and religion are crucial factors for human
attitudes. Attitude defined as individuals’ evaluation of feelings and tendencies toward an object or an idea.
It is attitude which affects people to like or dislike something or to move towards or away from that. Thus, it is
very crucial for any business to develop positive customer beliefs or attitudes toward the product or service or
medical tourist destination. According to psychologists, attitudes are developed by individuals through the
encounters in their lifetime. Attitude is not transitory rather it lasts over time.
Evaluations of various situations defined as attitudes. Information achievements produce attitudes. Attitudes are
learned beliefs, feelings, and reaction tendencies. Minor or major decisions of consumers are affected greatly by
attitudes, such as consumers have attitudes to decide any medical tourism destination country or a specific
healthcare center within the country. (Momen, A. et al. 2014)

Cost

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Consumers are very sensitive regarding the cost of any product or service. This is true for all types of customers
especially price sensitive customers. Price of any product or service is a key element to determine the level of
satisfaction of any customer. It should not exceed the expectation of customers. In addition, competitiveness of any
product or service largely depends on the total cost to get that. It includes actual price of the product,
transportation or installation cost, physical cost or hard work to get that and social cost like getting appreciation or
criticisms from others and opportunity costs to ignore other products. In the sector of tourism, a destination can be
attractive to its tourists only when the costs of getting services are reasonable. There can be some exceptional cases
but cost affect tourist choice and satisfaction. It involves certain types of expenditures like, accommodation cost,
transportation cost, food cost, and other entertainment cost etc. Therefore, in medical tourism cost of medical
service or fees, cost of accommodation, cost of food and transportation cost are vital issues for measuring the
attractiveness of a destination. On the basis of the literatures above mentioned, figure -1 depicts the conceptual
model of the study. (Momen, A. et al. 2014)

INDEPENDENT VARIABLES DEPENDENT VARIABLE

Question:

Q1: What is the relationship between Destination Competitiveness and Medical Tourism?

Q2: What is the relationship between Tourists Attitude and Medical Tourism Destination?

Q3: What is the relationship between Service Quality and Medical Tourism Destination?

Q4: What is the relationship between Cost and Medical Tourism Destination?

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Hypothesis:

H1: Destination Competitiveness has significant influence on Medical Tourism Destination

H2: Tourist Attitude has significant influence on Medical Tourism Destination Attractiveness
H3: Service Quality has significant influence on Medical Tourism Destination Attractiveness
H4: Service Cost has significant influence on Medical Tourism Destination Attractiveness

Analytical Model
Verbal Model
The attractiveness to go to India for treatment purpose is affected by factors such as, Destination Competitiveness,
Tourist Attitude, Service Quality, and Cost. So Choosing India for treatment is a Dependent factor and Independent
factors are – Destination Competitiveness, Tourist Attitude, Service Quality and Cost

Graphical Model

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Mathematical Model

Here, according to regression equation:

Y= a₀+a₁x₁+a₂x₂+a₃x₃+a4x4

Where,
Y (dependent variable) = Attractiveness to go to India for treatment purpose
a₀, a₁, a₂, a3, a4 = model parameters to be estimated statistically
x₁, x₂, x3,x4 (independent variables) = Destination Competitiveness, Tourist Attitude, Service Quality, Cost

Conclusion:

Medical tourism is actually a different kind of market with its specialized attributes. It ranges from the core health
care services to other infrastructural facilities to other extreme point like entertainment, amusement and shopping.
In order to become a highly successful health tourism destination, it requires different types and levels of skilled
people along with quality products and services. Beside all these even the climate of the country and individual
customer attitude can tune this industry’s success. The major drawback of this industry is some kinds of
uncontrollable elements which cannot be changed. But yet there is chance to cope with them to survive and to shine
in this worldwide great sector of tourism.
Here, human resource development is a vital issue for the overall prosperity of this sector. Specialized education
can train students in way to provide value added services to the visitors and at the same time it enhances the image
of the country in the world. It includes guidance regarding ‘ethics’ and ‘subculture’. Proper training and good
rewarding system are essential to produce skilled human products. Cost is another key factor in the satisfaction of
any tourist. There should be a step to control cost and at the same time providing quality services at reasonable
price. All these efforts can make any country an attractive and competitive medical tourist destination in this time
of globalization.
The study is conducted within a short period of time thus in- depth qualitative data could not be collected to reflect
the situation more clearly. On the other hand some more relevant factors affecting the choice of medical tourist to
select any destination can be included in further research on this area of interest.

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Chapter 3: Methodology
Introduction:

This is a quantitative study. In terms of objectives, this is an exploratory study. Looking into the sampling
methodology, the population in this study is around 200 respondents. The sample in this study used Random
Sampling method.

The survey questionnaire measures psychological, social, community and societal factors which is influencing
people to go to India for treatment purpose. For data analysis we used about 6 statistical tools to get accurate result
of research findings and those are Cranach’s alpha, descriptive frequencies, Crosstabs, Paired T test, Regression
model & Correlation

Data Collection:

 Primary

Primary data collected throughout a survey of questionnaire of 200 respondents. Our respondents are
general people who had gone to India for treatment purposes. They are the people who went to India for
treatment purpose and whom work in medical sector. The survey is done by visiting medical institutes.

 Secondary

Most of the secondary sources such as overall ideas, terms, variables and sub variables collected from
different websites, international journals and articles. The study is based on primary and secondary data.
Secondary data is collected from the different journals, internet and different websites. Primary data is
gathered using Questionnaire & by surveying the people. We obtain primary data through our survey by
using a structured questionnaire as a tool for gathering data. In the first part of the questionnaire make the
question about demographic information and the second part is the multiple-choice question about the
reasons which is influencing people to go to India for treatment purpose.

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Limitation of the Study:

Limitations are obvious in any study so do here. Since this is a project based report, the limitations regarding the
project program have acted as the limitations of the study. To make a report various aspects and experience are
needed. We faced some barriers for making a complete and perfect report. These barriers or limitations, which
hinder our work, are as follows:

 Lacking of time.
 The report is 70% based on secondary data.
 Lack of knowledge about SPSS software.
 Some respondents were probably not attentive and serious about filling up the questionnaire paper.
 The overall outcome of data analysis may not be fully flawless.

We did not have so much experience for conducting research and preparing the report very frequently, though we
are in learning position.

Theoretical Framework:

For the research, our purpose is to know about the factors that influence people to go to India for treatment
purpose. It leads us to some associations which help us to come to a decision. Destination Competitiveness, Tourist
Attitude, Service Quality— these are all the issues that set the choice when people are going to make decision for
to go abroad for treatment.

Conclusion:

From secondary source we found that, many factors are influencing people to go to India for treatment purpose. We
hope that, by using those methods mention in the report and factors which already identified is helpful to complete
our survey. In our final report we add some other topic according to survey result and findings in detail.

4.0 Analysis and Findings

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4.1 Demographic Factor Analysis:

Demographic factors refer personal characteristics that are used to collect and evaluate data from the mass
population. Before conducting the research we determined some demographic factors that are gender, age, marital
status, educational level, occupation, income and if they visited India or not. All the demographic data are analyzed
by the following frequency table.

Statistics

Highest_Educ Monthly
Gender Age Marital Status ational_Level Occupation Income Ever Visited
N Valid 200 200 200 200 200 200 200
Missing 0 0 0 0 0 0 0
Mean 1.32 2.75 1.62 3.72 2.95 3.47 1.55
Median 1.00 2.00 2.00 4.00 3.00 4.00 2.00
Mode 1 2 2 4 3 1 2
Variance .219 1.055 .419 1.521 1.636 3.698 .249
Sum 264 549 323 743 590 694 310

Gender

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The following pie chart shows that in the survey of 100% respondent where 32% was female and 68% was male.
The reason between the gaps of two types of respondent is that females are less likely to go to India for treatment
purpose and medical tourism. So this survey is less likely for female.

Gender

Frequency Percent Valid Percent Cumulative Percent

Valid Male 136 68.0 68.0 68.0
Female 64 32.0 32.0 100.0
Total 200 100.0 100.0

32%

68%

Age: The following pie chart shows that the age ranges of respondents age limit. It can be seen that in 21-30 years
of people who are most likely to go to India for medical purpose and its hold 46.5% of whole respondents. Then 20

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years or below holds only 4%, 31-40 years of respondents holds 30.5%, 41-50 years of respondents holds 9% and
finally in our survey above 50 years was 10%.

Age

Frequency Percent Valid Percent Cumulative Percent

Valid 20 years or below
8 4.0 4.0 4.0

21 - 30 years 93 46.5 46.5 50.5

31 - 40 years 61 30.5 30.5 81.0
41 - 50 years 18 9.0 9.0 90.0
Above 50 years 20 10.0 10.0 100.0
Total 200 100.0 100.0

4%
10%

9%

46.5%

30.5 %

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Marital Status: The following pie chart shows that respondents marital status. As our full respondent shows that
45.5% of respondent is single, 49.5% is married , 3% is divorced/ widowed. On the other hand 2% of respondent is
in the others.

Marital Status

Frequency Percent Valid Percent Cumulative Percent

Valid Single 91 45.5 45.5 45.5
Married 99 49.5 49.5 95.0
Divorced / Widowed 6 3.0 3.0 98.0
Other 4 2.0 2.0 100.0
Total 200 100.0 100.0

3% 2%

45.5%

49.5%

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Height Educational Level: The following pie chart shows that the height educational level of respondents. Here it
shows the 2.5% of respondents are ‘SSC students’, 21.5% of respondents are ‘HSC students’, 10% of respondents
are ‘Diploma/and professional degree’, 38.5% of respondents are ‘Bachelor degree’ 23% of respondents are
‘Master degree’ and finally the 4% of respondents are other so the most likely people are in bachelor degree.

Highest Educational Level

Frequency Percent Valid Percent Cumulative Percent

Valid SSC 5 2.5 2.5 2.5
HSC 43 21.5 21.5 24.0
Diploma / Professional 20 10.0 10.0 34.0
Bachelor Degree 77 38.5 38.5 72.5
Master Degree 46 23.0 23.0 95.5
Others 9 4.5 4.5 100.0
Total 200 100.0 100.0

2.5%
4%

21.5%

23%

10%

38.5%

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Occupation: The following pie chart shows that the occupation of respondents. Here in the 100% respondent
19.5% of people are doing business, 13% of respondents are in government employee, 32% of full respondents are
in privet employee, 25% are student, 9.5% are in others occupation. So the most likely option are privet employee.

Occupation

Frequency Percent Valid Percent Cumulative Percent

Valid Businessman 39 19.5 19.5 19.5
Govt. Employee 26 13.0 13.0 32.5
Private Employee 64 32.0 32.0 64.5
Student 50 25.0 25.0 89.5
Others 19 9.5 9.5 99.0
6 2 1.0 1.0 100.0
Total 200 100.0 100.0

1
%

9.5%
19.5%

25% 13%

32%

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Monthly income: The following pie chart shows that the monthly income of respondents. Here 29% of
respondents are below 10000, 6% of respondents are 10001-20000, 10.5% of full respondents are in 20001-
30000, 20% of full respondents are in 30001-40000 income level, 12.5% of full respondents are in 40001-50000,
and finally 22% of respondents are in above 50000 income level. So the most likely group was in 22%.

Monthly Income

Frequency Percent Valid Percent Cumulative Percent

Valid Below 10000 58 29.0 29.0 29.0
10001 - 20000 12 6.0 6.0 35.0
20001 - 30000 21 10.5 10.5 45.5
30001 - 40000 40 20.0 20.0 65.5
40001 - 50000 25 12.5 12.5 78.0
Above 50000 44 22.0 22.0 100.0
Total 200 100.0 100.0

22%
29%

12.5%
6%

10.5%
20%

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Ever Visited: The following pie chart shows that the ever visited experiences of respondents. Here the 45% of
respondent are visited earlier and take part in the medical tourism on the other hand 55% respondent are not visited
there and not take part in the medical tourism.

Ever Visited

Frequency Percent Valid Percent Cumulative Percent

Valid Yes 90 45.0 45.0 45.0
No 110 55.0 55.0 100.0
Total 200 100.0 100.0

45%

55%

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4.2 Cross Tabulation
Cross tabulation is comparing the relationship between two variables.

Gender * Ever_Visited Crosstabulation

There is a relationship compares between Gender and ever visited in India for treatment purpose. In this table 64
male visited and 72 male who did not visit India for treatment. Also 26 female visited and 38 female did not visit
India for treatment purpose

Gender * Ever_Visited Crosstabulation

Count
Ever_Visited
Yes No Total
Gender Male 64 72 136
Female 26 38 64
Total 90 110 200

Monthly_Income * Ever_Visited Crosstabulation

There is a relationship compares between monthly income and ever visited in India for treatment purpose.

Monthly_Income * Ever_Visited Crosstabulation

Ever_Visited
Yes No Total
Monthly_Income Below 10000 25 33 58
10001 - 20000 1 11 12
20001 - 30000 8 13 21
30001 - 40000 13 27 40
40001 - 50000 16 9 25
Above 50000 27 17 44
Total 90 110 200

26 | P a g e
 Age * Ever_VisitedCrosstabulation

There is a relationship compares between age and ever visited in India for treatment purpose.

Count
Ever_Visited
Yes No Total
Age 20 years or below 5 3 8
21 - 30 years 29 64 93
31 - 40 years 35 26 61
41 - 50 years 9 9 18
Above 50 years 12 8 20
Total 90 110 200

Occupation * Ever_VisitedCrosstabulation
There is a relationship compares between occupation and ever visited in India for treatment purpose.

Count
Ever_Visited
Yes No Total
Occupation Businessman 24 15 39
Govt. Employee 8 18 26
Private Employee 30 34 64
Student 17 33 50
Others 10 9 19
6 1 1 2
Total 90 110 200

Factor Analysis

27 | P a g e
Correlation Matrix
Correlation Matrix are determined by the squared multiple correlation of the variable itself and with the other
variables. With the Correlation Matrix we want to show the interrelationship among all the components of tourist
attitude, demography, cost, service quality, destination competitiveness.

Correlation Matrix
C_ C_ C_ C_ C_ DC DC DC DC DC SQ SQ SQ SQ SQ SQ TA TA TA TA TA
1 2 3 4 5 _1 _2 _3 _4 _5 _1 _2 _3 _4 _5 _6 _1 _2 _3 _4 _5
Correl C_ . . . . . . . . . . . . . .
1.0 -.0 -.0 -.1 -.0 -.1 .
ation 1 41 25 04 41 14 24 11 33 35 30 14 03 14 20
00 17 30 83 90 30 019
6 0 1 2 5 3 4 1 3 9 5 7 7 4
C_ . . . . . . . . . . . . . . . . .
1.0 -.0 -.0 .
2 41 47 21 14 42 11 05 31 33 16 36 32 27 12 29 00 19
00 61 64 156
6 0 7 0 5 5 3 1 8 2 5 7 6 9 1 3 4
C_ . . . . . . . . . . . . . . . . . . .
1.0 .
3 25 47 37 26 33 21 06 39 42 31 37 30 27 08 10 07 46 20 20
00 211
0 0 4 8 0 6 0 6 3 0 9 8 7 6 6 6 5 2 0
C_ . . . . . . . . . . . . . . . . . .
-.0 1.0 .
4 21 37 46 05 23 24 17 22 12 05 05 06 36 34 09 21 24 29
17 00 087
7 4 7 0 0 1 0 9 1 8 0 9 9 5 1 2 9 3
C_ . . . . . . . . . . . . . . . . .
1.0 -.0 -.0 -.0
5 04 14 26 46 26 19 23 14 27 23 30 24 44 35 14 05 39
00 05 16 93
1 0 8 7 9 1 7 5 0 5 7 8 0 4 0 8 2
DC . . . . . . . . . . . . . . . .
1.0 -.0 -.0 -.1 .
_1 41 42 33 05 26 12 20 27 14 47 39 38 17 11 26 30
00 79 86 22 048
2 5 0 0 9 1 4 3 6 8 4 2 1 3 5 9
DC . . . . . . . . . . . . . . . . . .
-.0 1.0 .
_2 11 21 23 19 12 61 07 13 00 13 10 11 26 05 29 22 32 08
30 00 328
5 6 0 1 1 3 5 0 0 8 7 1 2 6 3 6 6 5
DC . . . . . . . . . . . .
-.1 -.0 1.0 -.0 -.1 -.0 -.0 -.0 .
_3 05 06 24 23 61 04 31 07 32 07 48 08
83 79 00 24 53 64 14 32 324
3 0 1 7 3 8 9 0 4 8 0 1
DC . . . . . . . -.0 1.0 . . . . . . . . . . . .
_4 14 31 39 17 14 20 07 24 00 45 39 29 35 29 08 10 14 36 07 19 196
5 1 6 0 5 4 5 6 4 7 2 4 8 7 2 4 3 3

28 | P a g e
 DC . . . . . . . . . . . . . . . . . .
1.0 -.0 .
_5 24 33 42 22 27 27 13 04 45 19 22 31 32 17 13 27 05 32
00 25 122
3 8 3 9 0 3 0 8 6 7 1 4 8 2 1 1 0 5
SQ . . . . . . . . . . . . . . . .
-.0 -.1 1.0 -.0 .
_1 11 16 31 12 14 00 39 19 30 22 09 12 15 33 06 05
05 53 00 77 122
4 2 0 1 6 0 4 7 7 1 7 1 0 5 4 6
SQ . . . . . . . . . . . . . . . .
-.0 1.0 -.1 -.1 .
_2 33 36 37 05 23 47 13 29 22 30 60 42 14 02 26 18
64 00 08 14 018
1 5 9 8 5 8 8 7 1 7 0 4 1 9 1 6
SQ . . . . . . . . . . . . . . . .
-.0 1.0 -.0 -.1 -.0
_3 35 32 30 05 30 39 10 35 31 22 60 59 24 01 22 29
14 00 48 21 48
3 7 8 0 7 4 7 2 4 1 0 5 5 8 9 6
SQ . . . . . . . . . . . . . . . .
-.0 1.0 -.0 -.0 .
_4 30 27 27 06 24 38 11 29 32 09 42 59 23 08 26 29
32 00 82 90 065
9 6 7 9 8 2 1 4 8 7 4 5 4 5 2 2
SQ . . . . . . . . . . . . . . . . . .
-.0 1.0 .
_5 14 12 08 36 44 17 26 31 08 17 14 24 23 38 10 10 17 30
77 00 027
5 9 6 9 0 1 2 9 8 2 1 5 4 5 2 9 9 2
SQ . . . . . . . . . . . . . . . . . .
-.0 1.0 -.0
_6 03 10 34 35 11 05 07 10 13 12 02 01 08 38 13 16 19 17
61 00 59
7 6 5 4 3 6 0 7 1 1 9 8 5 5 9 2 8 6
TA . . . . . . . . . . .
-.0 -.0 -.0 -.0 -.0 -.1 -.0 -.0 1.0 .
_1 07 09 29 32 14 15 10 13 43 57 05
90 64 16 86 25 08 48 82 00 521
6 1 3 4 2 0 2 9 4 3 4
TA . . . . . . . . . . . . . . . . . . .
1.0 .
_2 14 29 46 21 14 26 22 07 36 27 33 26 22 26 10 16 43 37 29
00 396
7 1 5 2 0 5 6 8 4 1 5 1 9 2 9 2 4 4 8
TA . . . . . . . . . . . . .
-.1 -.1 -.1 -.1 -.0 1.0 -.0 .
_3 00 20 24 05 32 48 07 05 06 17 19 57 37
30 22 14 21 90 00 31 581
3 2 9 8 6 0 3 0 4 9 8 3 4
TA . . . . . . . . . . . . . . . . . .
-.0 1.0 -.0
_4 20 19 20 29 39 30 08 08 19 32 05 18 29 29 30 17 05 29
31 00 73
4 4 0 3 2 9 5 1 3 5 6 6 6 2 2 6 4 8
TA . . . . . . . . . . . . . . . .
-.0 -.0 -.0 -.0 1.0
_5 01 15 21 08 04 32 32 19 12 12 01 06 02 52 39 58
93 48 59 73 00
9 6 1 7 8 8 4 6 2 2 8 5 7 1 6 1

29 | P a g e
Sig. C_ . . . . . . . . . . . . . . . . . . .
.
(1- 1 00 00 40 28 00 33 00 02 00 05 00 00 00 02 30 10 01 03 00
394
tailed) 0 0 8 1 0 7 5 0 0 4 0 0 0 1 1 2 9 3 2
C_ . . . . . . . . . . . . . . . . . . .
.
2 00 00 00 02 00 05 22 00 00 01 00 00 00 03 19 18 00 48 00
014
0 0 1 4 0 2 8 0 0 1 0 0 0 5 6 3 0 2 3
C_ . . . . . . . . . . . . . . . . . . .
.
3 00 00 00 00 00 00 20 00 00 00 00 00 00 11 06 14 00 00 00
001
0 0 0 0 0 1 1 0 0 0 0 0 0 4 9 3 0 2 2
C_ . . . . . . . . . . . . . . . . . . .
.
4 40 00 00 00 24 00 00 00 00 04 21 24 16 00 00 10 00 00 00
112
8 1 0 0 1 1 0 8 1 5 0 2 5 0 0 1 1 0 0
C_ . . . . . . . . . . . . . . . . . . .
.
5 28 02 00 00 00 00 00 02 00 47 00 00 00 00 00 41 02 20 00
095
1 4 0 0 0 3 0 0 0 0 0 0 0 0 0 0 4 9 0
DC . . . . . . . . . . . . . . . . . . .
.
_1 00 00 00 24 00 04 13 00 00 02 00 00 00 00 05 11 00 04 00
250
0 0 0 1 0 4 2 2 0 0 0 0 0 8 7 3 0 3 0
DC . . . . . . . . . . . . . . . . . . .
.
_2 33 05 00 00 00 04 00 14 03 49 02 06 05 00 21 00 00 00 11
000
7 2 1 1 3 4 0 7 4 9 6 5 9 0 6 0 1 0 5
DC . . . . . . . . . . . . . . . . . . .
.
_3 00 22 20 00 00 13 00 36 24 01 18 42 32 00 16 00 13 00 12
000
5 8 1 0 0 2 0 6 9 6 3 1 6 0 3 0 7 0 7
DC . . . . . . . . . . . . . . . . . . .
.
_4 02 00 00 00 02 00 14 36 00 00 00 00 00 10 06 02 00 15 00
003
0 0 0 8 0 2 7 6 0 0 0 0 0 8 7 3 0 4 3
DC . . . . . . . . . . . . . . . . . . .
.
_5 00 00 00 00 00 00 03 24 00 00 00 00 00 00 03 36 00 24 00
043
0 0 0 1 0 0 4 9 0 3 1 0 0 8 3 5 0 0 0
SQ . . . . . . . . . . . . . . . . . . .
.
_1 05 01 00 04 47 02 49 01 00 00 00 00 08 14 04 01 00 18 21
043
4 1 0 5 0 0 9 6 0 3 0 1 6 1 5 8 0 4 7
SQ . . . . . . . . . . . . . . . . . . . .
_2 00 00 00 21 00 00 02 18 00 00 00 00 00 02 34 06 00 05 00 399
0 0 0 0 0 0 6 3 0 1 0 0 0 3 2 4 0 5 4

30 | P a g e
 SQ . . . . . . . . . . . . . . . . . . .
.
_3 00 00 00 24 00 00 06 42 00 00 00 00 00 00 40 25 00 04 00
250
0 0 0 2 0 0 5 1 0 0 1 0 0 0 0 2 1 4 0
SQ . . . . . . . . . . . . . . . . . . .
.
_4 00 00 00 16 00 00 05 32 00 00 08 00 00 00 11 12 00 10 00
180
0 0 0 5 0 0 9 6 0 0 6 0 0 0 6 4 0 3 0
SQ . . . . . . . . . . . . . . . . . . .
.
_5 02 03 11 00 00 00 00 00 10 00 14 02 00 00 00 07 06 00 00
350
1 5 4 0 0 8 0 0 8 8 1 3 0 0 0 5 3 6 0
SQ . . . . . . . . . . . . . . . . . . .
.
_6 30 19 06 00 00 05 21 16 06 03 04 34 40 11 00 02 01 00 00
202
1 6 9 0 0 7 6 3 7 3 5 2 0 6 0 5 1 3 6
TA . . . . . . . . . . . . . . . . . . .
.
_1 10 18 14 10 41 11 00 00 02 36 01 06 25 12 07 02 00 00 22
000
2 3 3 1 0 3 0 0 3 5 8 4 2 4 5 5 0 0 5
TA . . . . . . . . . . . . . . . . . . .
.
_2 01 00 00 00 02 00 00 13 00 00 00 00 00 00 06 01 00 00 00
000
9 0 0 1 4 0 1 7 0 0 0 0 1 0 3 1 0 0 0
TA . . . . . . . . . . . . . . . . . . .
.
_3 03 48 00 00 20 04 00 00 15 24 18 05 04 10 00 00 00 00 33
000
3 2 2 0 9 3 0 0 4 0 4 5 4 3 6 3 0 0 4
TA . . . . . . . . . . . . . . . . . . .
.
_4 00 00 00 00 00 00 11 12 00 00 21 00 00 00 00 00 22 00 33
154
2 3 2 0 0 0 5 7 3 0 7 4 0 0 0 6 5 0 4
TA . . . . . . . . . . . . . . . . . . . .
_5 39 01 00 11 09 25 00 00 00 04 04 39 25 18 35 20 00 00 00 15
4 4 1 2 5 0 0 0 3 3 3 9 0 0 0 2 0 0 0 4

KMO and Bartlett's Test

KMO & Bartlett‘s test plays an important role for accepting the sample adequacy. KMO basically describes that
the total no of respondents are adequate or not for the study. The range for KMO is 0 to 1. On the other hand,
Bartlett‘s test refers the respondents are significant or not. To find out the significance level, a benchmark should
be followed to get accurate result and it is done by comparing with alpha value .05. If significance value less than .
05 null hypothesis will be rejected and if it is greater than .05 null hypothesis is accepted.

31 | P a g e
 KMO and Bartlett's Test
Kaiser-Meyer-Olkin Measure of Sampling Adequacy.
.804
Bartlett's Test of Sphericity Approx. Chi-Square 1513.869
df 210
Sig. .000

Communalities
This is the proportion of each variable‘s variance that can be explained by the factors. The Extraction value in the
table represents which questions are not associated with the study. The highest range for extraction value is 1. It is
better to have the greater value which is very close to 1.

Communalities
Extractio
Initial n
C_1 1.000 .397
C_2 1.000 .643
C_3 1.000 .673
C_4 1.000 .701

32 | P a g e
 C_5 1.000 .646
DC_1 1.000 .504
DC_2 1.000 .619
DC_3 1.000 .752
DC_4 1.000 .504
DC_5 1.000 .472
SQ_1 1.000 .554
SQ_2 1.000 .574
SQ_3 1.000 .673
SQ_4 1.000 .571
SQ_5 1.000 .614
SQ_6 1.000 .632
TA_1 1.000 .732
TA_2 1.000 .632
TA_3 1.000 .710
TA_4 1.000 .401
TA_5 1.000 .691
Extraction Method:
Principal Component
Analysis.

Total Variance Explained: How many variables we really expect for our research is described by the total
variance explained. The total column of the total variance explained gives the eigenvalue, the % of variance
column gives the ratio of the variance accounted for by each component in all of the variables; the cumulative %
column gives the percentage of variance accounted for by the first 8 components to the total variance

Total Variance Explained

Extraction Sums of Squared Rotation Sums of Squared
Initial Eigenvalues Loadings Loadings
% of Cumulative % of Cumulative % of Cumulative
Component Total Variance % Total Variance % Total Variance %
1 5.003 23.822 23.822 5.003 23.822 23.822 3.275 15.597 15.597
2 3.114 14.830 38.652 3.114 14.830 38.652 2.798 13.325 28.922

33 | P a g e
3 2.062 9.820 48.472 2.062 9.820 48.472 2.440 11.619 40.540
4 1.425 6.786 55.258 1.425 6.786 55.258 2.390 11.381 51.921
5 1.091 5.195 60.453 1.091 5.195 60.453 1.792 8.532 60.453
6 .998 4.751 65.204
7 .905 4.307 69.511
8 .790 3.760 73.271
9 .671 3.193 76.464
10 .644 3.067 79.531
11 .551 2.623 82.154
12 .506 2.410 84.564
13 .482 2.293 86.857
14 .440 2.096 88.953
15 .424 2.018 90.971
16 .396 1.885 92.856
17 .358 1.704 94.560
18 .345 1.641 96.202
19 .300 1.427 97.629
20 .256 1.217 98.847
21 .242 1.153 100.000
Extraction Method: Principal Component Analysis.

Component Matrixa

In case of component matrix, one component should be matched with only one variable. If it does not happen then
there must be some problem. The objective of component matrix is to illustrate these problematic components to us
so that we can eliminate them from our questionnaire.

Component Matrixa
Component
1 2 3 4 5
C_1 .432 -.397 -.124 .185 .054
C_2 .588 -.193 -.186 .188 -.436
C_3 .683 .018 -.204 -.138 -.382
C_4 .451 .302 .398 -.335 -.369

34 | P a g e
 C_5 .515 .046 .607 -.100 -.039
DC_1 .584 -.340 -.011 .202 .078
DC_2 .367 .507 .097 .457 -.094
DC_3 .200 .671 .257 .423 -.132
DC_4 .573 -.051 -.293 -.291 -.050
DC_5 .599 -.095 -.019 -.146 -.286
SQ_1 .375 -.061 -.428 -.463 .109
SQ_2 .603 -.368 -.118 .192 .155
SQ_3 .635 -.374 .010 .226 .281
SQ_4 .589 -.306 .035 .225 .282
SQ_5 .438 .197 .580 .089 .198
SQ_6 .291 .194 .431 -.485 .298
TA_1 .190 .692 -.283 -.061 .364
TA_2 .612 .271 -.349 -.179 .172
TA_3 .222 .795 -.156 -.020 .057
TA_4 .512 -.087 .333 -.105 .100
TA_5 .282 .591 -.475 .191 .022
Extraction Method: Principal Component Analysis.
a. 5 components extracted.

Rotated Component Matrixa

Rotated Component Matrix is used to eliminate problematic components from the questionnaire. This process is
done by Varimax method. By rotating the whole component matrix table again and again, we come to a final
conclusion. The main purpose of this kind of rotation is to eliminate the most problematic ones and keeping the
most important ones which can best describe the whole phenomena. After using the rotation component matrix, we
have found out some pairs of variables to explain our Dependent variable.

Rotated Component Matrixa

Component
1 2 3 4 5
C_1 .587 -.084 -.055 .195 -.059
C_2 .403 -.034 -.105 .664 .166

35 | P a g e
 C_3 .243 .199 .104 .751 -.013
C_4 -.187 .062 .606 .521 .155
C_5 .188 -.098 .717 .212 .207
DC_1 .661 -.039 .102 .232 .023
DC_2 .126 .383 .109 .138 .653
DC_3 -.109 .360 .199 .043 .754
DC_4 .280 .285 .111 .492 -.300
DC_5 .261 .036 .214 .596 -.034
SQ_1 .160 .345 .029 .329 -.548
SQ_2 .724 .026 .043 .210 -.058
SQ_3 .797 .014 .165 .096 -.025
SQ_4 .731 .038 .178 .063 .010
SQ_5 .237 .076 .664 -.055 .330
SQ_6 -.044 .168 .746 -.047 -.208
TA_1 -.085 .838 .087 -.113 .043
TA_2 .281 .634 .142 .323 -.164
TA_3 -.230 .750 .136 .100 .259
TA_4 .332 -.015 .513 .166 .006
TA_5 .019 .745 -.216 .184 .234
Extraction Method: Principal Component Analysis.
Rotation Method: Varimax with Kaiser Normalization.a
a. Rotation converged in 19 iterations.

AFTER ELIMINATION OF FACTORS

Correlation Matrix

Correlation Matrix are determined by the squared multiple correlation of the variable itself and with the other
variables. With the Correlation Matrix we want to show the interrelationship among all the cost, destination
competitiveness, service quality and tourist attitude.

Correlation Matrix
C_2 C_3 DC_2 DC_3 SQ_2 SQ_3 SQ_4 TA_1 TA_3 TA_5
Correlation C_2 1.000 .474 .113 .052 .362 .324 .273 -.069 .000 .155
C_3 .474 1.000 .214 .058 .377 .305 .275 .071 .198 .210

36 | P a g e
 DC_2 .113 .214 1.000 .613 .138 .108 .112 .293 .327 .328
DC_3 .052 .058 .613 1.000 -.064 -.014 -.032 .324 .480 .324
SQ_2 .362 .377 .138 -.064 1.000 .600 .425 -.107 -.113 .018
SQ_3 .324 .305 .108 -.014 .600 1.000 .595 -.046 -.120 -.048
SQ_4 .273 .275 .112 -.032 .425 .595 1.000 -.081 -.089 .065
TA_1 -.069 .071 .293 .324 -.107 -.046 -.081 1.000 .574 .521
TA_3 .000 .198 .327 .480 -.113 -.120 -.089 .574 1.000 .581
TA_5 .155 .210 .328 .324 .018 -.048 .065 .521 .581 1.000
Sig. (1- C_2 .000 .056 .233 .000 .000 .000 .167 .498 .014
tailed) C_3 .000 .001 .206 .000 .000 .000 .157 .002 .001
DC_2 .056 .001 .000 .025 .064 .058 .000 .000 .000
DC_3 .233 .206 .000 .183 .422 .327 .000 .000 .000
SQ_2 .000 .000 .025 .183 .000 .000 .066 .056 .398
SQ_3 .000 .000 .064 .422 .000 .000 .257 .045 .250
SQ_4 .000 .000 .058 .327 .000 .000 .126 .105 .178
TA_1 .167 .157 .000 .000 .066 .257 .126 .000 .000
TA_3 .498 .002 .000 .000 .056 .045 .105 .000 .000
TA_5 .014 .001 .000 .000 .398 .250 .178 .000 .000

KMO and Bartlett's Test

KMO & Bartlett‘s test plays an important role for accepting the sample adequacy. KMO basically describes that
the total no of respondents are adequate or not for the study. The range for KMO is 0 to 1. On the other hand,
Bartlett‘s test refers the respondents are significant or not. To find out the significance level, a benchmark should
be followed to get accurate result and it is done by comparing with alpha value .05. If significance value less than .
05 null hypothesis will be rejected and if it is greater than .05 null hypothesis is accepted.

KMO and Bartlett's Test

Kaiser-Meyer-Olkin Measure of Sampling Adequacy.
.707
Bartlett's Test of Sphericity Approx. Chi-Square 655.093
df 45

37 | P a g e
 Sig. .000

Here the hypothesis is-

H0: Total number of respondents is not significantly adequate for the study.
H1: Total number of respondents is significantly adequate for the study.

Since, the value of significance level is .000 is less than alpha value .05, therefore, the alternative hypothesis is
accepted which means that our respondent groups- parents group and adolescents group are significant and 71%
adequate for the research according to KMO measure of Sampling Adequacy. We can continue our further research
with these respondent groups.

Communalities
This is the proportion of each variable‘s variance that can be explained by the factors. The Extraction value in the
table represents which questions are not associated with the study. The highest range for extraction value is 1. It is
better to have the greater value which is very close to 1.

Communalities
Extractio
Initial n
C_2 1.000 .528
C_3 1.000 .612
DC_2 1.000 .749
DC_3 1.000 .763

38 | P a g e
 SQ_2 1.000 .629
SQ_3 1.000 .694
SQ_4 1.000 .552
TA_1 1.000 .581
TA_3 1.000 .729
TA_5 1.000 .678
Extraction Method:
Principal Component
Analysis.

Here we can see that, in the communalities table the extraction value of all components are less than 1. In this
phase we didn‘t eliminated those components which are less than 0.5 rather we primarily marked the components
because there is a problem and kept for further analysis in a broader extent.

Total Variance Explained:

How many variables we really expect for our research is described by the total variance explained. The total
column of the total variance explained gives the eigenvalue, the % of variance column gives the ratio of the
variance accounted for by each component in all of the variables; the cumulative % column gives the percentage of
variance accounted for by the first 3 components to the total variance

Total Variance Explained

Extraction Sums of Squared Rotation Sums of Squared
Initial Eigenvalues Loadings Loadings
% of Cumulative % of Cumulative % of Cumulative
Component Total Variance % Total Variance % Total Variance %

39 | P a g e
1 2.870 28.700 28.700 2.870 28.700 28.700 2.668 26.678 26.678
2 2.627 26.268 54.967 2.627 26.268 54.967 2.268 22.676 49.353
3 1.019 10.188 65.155 1.019 10.188 65.155 1.580 15.802 65.155
4 .897 8.970 74.125
5 .586 5.860 79.985
6 .527 5.274 85.259
7 .479 4.790 90.050
8 .437 4.365 94.415
9 .291 2.913 97.328
10 .267 2.672 100.000
Extraction Method: Principal Component Analysis.

Component Matrixa

In case of component matrix, one component should be matched with only one variable. If it does not happen then
there must be some problem. The objective of component matrix is to illustrate these problematic components to us
so that we can eliminate them from our questionnaire.

Component Matrixa
Component
1 2 3
C_2 .527
C_3 .520 .439
DC_2 .684 .519
DC_3 .635 .497

40 | P a g e
 SQ_2 .732
SQ_3 .752
SQ_4 .665
TA_1 .594 -.444
TA_3 .688 -.465
TA_5 .705
Extraction Method: Principal
Component Analysis.
a. 3 components extracted.

Here, we have use the component matrix in order to find out the problematic variables of our questionnaire and we
have taken the suppress value absolute below 0.43.
We can see that all the components are distributed in a scattered way. In many cases, one component is belonged in
two variables. This situation is known as cross loading process. From the component matrix table still we can’t
decide which components we should accept and which components we should eliminate from our research
questionnaire. To solve the problem again we followed another statistical procedure and that is Rotated Component
Matrix.

Rotated Component Matrixa

Rotated Component Matrix is used to eliminate problematic components from the questionnaire. This process is
done by Varimax method. By rotating the whole component matrix table again and again, we come to a final
conclusion. The main purpose of this kind of rotation is to eliminate the most problematic ones and keeping the
most important ones which can best describe the whole phenomena. After using the rotation component matrix, we
have found out some pairs of variables to explain our Dependent variable.

Rotated Component Matrixa

Component
1 2 3
C_2 .662
C_3 .651

41 | P a g e
 DC_2 .808
DC_3 .809
SQ_2 .783
SQ_3 .789
SQ_4 .711
TA_1 .711
TA_3 .800
TA_5 .804
Extraction Method: Principal
Component Analysis.
Rotation Method: Varimax with
Kaiser Normalization.
a. Rotation converged in 5 iterations.

From the rotated component matrix above, we found

C_2: I consider transportation cost is important element for choosing India for treatment purpose.
C_3: Accommodation cost influences me to choose India for Treatment purpose.

DC_2: According to me climate plays another important role in choosing India for medical tourism.

DC_3: I prefer entertainment facilities as important factor that makes India attractive for medical tourism.

SQ_2: Reliability has significant influence on medical tourism.

SQ_3: I think quality assurance is vital element for choosing India for treatment purpose.
SQ_4: I consider responsiveness is an important factor that influences me to choose India for medical tourism.
TA_1: I think culture is an important factor for choosing India for medical tourism.
TA_3: I consider religion has impact to choose India for medical tourism destination.
TA_5: According to me political factor is important for choosing India as a medical tourism destination.
We have included these components in our research questionnaire and rest of the components has been rejected in
order to conduct an authentic research.

Regression

42 | P a g e
Regression analysis is a set of statistical processes for estimating the relationships among variables. It includes
many techniques for modeling and analyzing several variables, when the focus is on the relationship between a
dependent variable and one or more independent variables (or 'predictors'). Regression analysis is widely used for
prediction and forecasting, where its use has substantial overlap with the field of machine learning. Regression
analysis is also used to understand which among the independent variables are related to the dependent variable,
and to explore the forms of these relationships. In restricted circumstances, regression analysis can be used to infer
causal relationships between the independent and dependent variables. However this can lead to illusions or false
relationships, so caution is advisable.

Linear Regression: Linear regression was the first type of regression analysis to be studied rigorously, and to be
used extensively in practical applications.[4] This is because models which depend linearly on their unknown
parameters are easier to fit than models which are non-linearly related to their parameters and because the
statistical properties of the resulting estimators are easier to determine.

Variables Entered/Removed

From the table above shows that our three independent variables remain exist that we developed before conducting
the survey. There is no variable to remove. It indicates that the three of our independent variables- Tourist attitude,
service quality, Destination competitiveness.

Variables Entered/Removeda

Model Variables Entered Variables Removed Method

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1 Tour_Attitu_Fact,
Serv_Qual_Fact, . Enter
Desti_Compet_Fact, Cost_Factb
a. Dependent Variable: Medi_Tour_Attract_India_Fact
b. All requested variables entered.

Model Summary

Model Summary

Std. Error of the

Model R R Square Adjusted R Square Estimate

1 .563a .317 .303 .54209

a. Predictors: (Constant), Tour_Attitu_Fact, Serv_Qual_Fact, Desti_Compet_Fact, Cost_Fact

Model Summary table provides information about regression line „s ability to account for the total variation in the
dependent variable. It explains whether the independent variables are able to judge the dependent variable or not.
Model summary is comprised with R, R Square, adjusted R Square and Std. Error of the Estimation.

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R Square: R square statistic is a measurement of how well the model is fitting the actual data and variability in the
data that is explained by this model. The number is between 0 to 1. A number near 0 represents a regression that
doesn't explains the variance in the dependent variable well and a number close to 1 does explain the variance in
the dependent variable that means the observations are predicted exactly. The model shows the value of R Square
is .317 that means Tourist attitude, service quality, Destination competitiveness factors can explain 38% of the total
variance which is the benchmark for R Square and the rest 54% is influenced by some other factors that we have
not considered in our research. So, this factors or variables would be considered for further research.

Adjusted R Square: The adjusted R square is like R square with an adjustment to account for the number of
predictors in the model. Here, the adjusted value is .313 which is slightly reduced from .317 because it is adjusted
after justifying the errors.

Standard Error of the Estimate: Standard error of the estimate is the measure of dispersion or variability of
predictions in a regression. The small value of std. Error of Estimate represents that observed values are fairly close
to the regression line and the larger value indicates observed values are far away from the Model

ANOVAa

Analysis of Variance (ANOVA) tests the hypothesis and is used to determine whether the null hypothesis will be
accepted or rejected. Here our hypothesis is:

 H0: Independent variables don‟t have the exploratory power to explain the dependent variable.
 H1: Independent variables have the exploratory power to explain the dependent

ANOVAa

Model Sum of Squares df Mean Square F Sig.

1 Regression 26.578 4 6.645 22.611 .000b

Residual 57.303 195 .294

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 Total 83.881 199

a. Dependent Variable: Medi_Tour_Attract_India_Fact

b. Predictors: (Constant), Tour_Attitu_Fact, Serv_Qual_Fact, Desti_Compet_Fact, Cost_Fact

Decision about the hypothesis depends on P-value (level of significance) by comparing the alpha value (.05). ANOVA is
basically the justification of P-value and the justification will be based on the following criteria:
If P value< α, H0 is rejected.
If P value> α, H0 is accepted.

From the ANOVA table, level of significance is .000 which is less than .05. Since, the null hypothesis is rejected and our
alternative hypothesis that is independent variables have the exploratory power to explain the dependent variable will
be accepted.

Coefficientsa

Decision about the hypothesis depends on P-value (level of significance) by comparing the alpha value (.05).
ANOVA is basically the justification of P-value and the justification will be based on the following criteria:

If P value< α, H0 is rejected.
If P value> α, H0 is accepted.

From the ANOVA table, level of significance is .000 which is less than .05. Since, the null hypothesis is rejected
and our alternative hypothesis that is independent variables have the exploratory power to explain the dependent
variable will be accepted.

Coefficientsa

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 Standardized
Unstandardized Coefficients Coefficients

Model B Std. Error Beta t Sig.

1 (Constant) 1.498 .284 5.273 .000

Cost_Fact .158 .061 .175 2.597 .010

Desti_Compet_Fact -.045 .038 -.079 -1.172 .243

Serv_Qual_Fact .336 .061 .371 5.534 .000

Tour_Attitu_Fact .211 .042 .345 5.059 .000

a. Dependent Variable: Medi_Tour_Attract_India_Fact

Coefficient determines the specific relationship among the independent variables and dependent variable. It exactly
describes in which extent a specific factor can affect a dependent variable. In this research we have three
independent variables. By analyzing the coefficients, we can find out those variables which have a great impact on
influence. Level of significance will determine the exact variables for the study. The analysis of the result is
described in the following Hypothesis for all variables:

 H0: Tourist attitude, service quality, destination competitiveness, cost factors do not have any influence on
working class people to go for mobile banking.
 H1: Tourist attitude, service quality, destination competitiveness, cost factors have an influence on working
class people to go for treatment purpose in India.

Here, level of significance for tourist attitude, service quality, destination competitiveness, cost factors are .000
which is less than alpha value .05.

Tourist attitude sig. value: .000 < .05; H0 rejected.

Service quality Factor: sig: value .000 < .05; H0 rejected.
Destination competitiveness: sig. value .243 > .05; H0 Accepted.
Cost factor: sig. value .010 < .05; H0 rejected.

Therefore, except destination competitiveness we considered all factors as variables because it rejected the null
hypothesis that means our alternative hypothesis is true. We conclude that Tourist Attitude, Service Quality and
Cost have more influence on people to go to India for treatment purpose.

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Beta value of Service Quality Factor is .371 > Beta value .345 Tourist Attitude Factors and Beta value .175
Cost Factors

Since Service Quality have larger Beta value than Cost and Tourist Attitude Factors. Thus, it can be said that
Service Quality influences more people to go to India for medical tourism.

5.0 Conclusion and Recommendation

In summary, medical tourism now a day’s improving and increasing at the same time a growing industry for the
country itself. From the begging of the era still now it’s changing massive. People specially class level people go
abroad purpose of medical at the same time short vacation. For the purpose of treatment now a day’s many people
go to the better nation. At the time of modernization with technological advancement all countries fight with the
medial issues, with the harmony of all the objectives and critical medical situation and at the same time medical
facilities should be modernized and upgraded. And also traveling was considered to be a good therapy for mental
and physical well-being. Normally medical tourism is defined as an act of travel of patients from their home
country to other destinations for availing medical services. It also Include the both aspects both country and global.
With countries like India, Mexico, Singapore, Brazil, Argentina, Greece, Costa Rica, Dominican Republic, Peru,

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Hungary, Israel, Jordan, Lithuania, Malaysia, South Africa, Thailand and the Philippines actively promoting it.
Medical tourists are generally residents of the industrialized nations of the world and primarily come from The
United States, Canada, Great Britain, Western Europe, Australia, and The Middle East. Country like Bangladesh in
south Asia is already far behind in many aspects, in medical sector, and its rapidly improving but there are some
issues that people have to move our neighbor country India. People of Bangladesh go to India for the better
treatment under medical tourism.

References:

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2. Kabene, SM, Orchard , C, Howard , JM, Soriano , MA and Leduc, R 2006 , The
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3. Goodwin C, Ross I (1990). Consumer evalua-tions of responses to complaints: what’s fair and why? J.
Cons Market, 7 (2): 39-47

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4. Hosseini H (2010). Strategies to contain the high and rising costs of health: Will they increase existing
health care disparities and are they ethical?Humanomics, 26 (2): 112-123.

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6. Snyder, J, Dharamsi, S and Crooks, VA 2011,”Fly-By medical care: Conceptualizing the

global and local social responsibilities of medical tourists and physician voluntourists”, Globalization and
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