An investigation into resilience strategies in the medical tourism supply chain

Authors

DOI:

https://doi.org/10.18778/0867-5856.34.2.01

Keywords:

coping strategies, medical tourism supply chain, recovery strategies, supply chain resilience, supply chain risks

Abstract

The present study has adopted a mixed method approach to investigate the risks occurring in the supply chain for Iranian medical tourism, and suggests resilience strategies for their prevention and improvements to the current situation. The participants were experts in the medical tourism supply chain chosen via purposive and snowball sampling. The results obtained via thematic analysis of interviews, as well as failure modes and effects analysis (FMEA) and failure analysis after occurrence (FAAO) techniques, led to identifying 75 risks which were classified into five major categories: supply, demand, internal, external and supply chain management risks. Additionally, a literature review and interview results revealed several resilience strategies categorized as pre-risk coping or post-risk recovery strategies for tackling the risks. Furthermore, the resilience number of the medical tourism supply chain increased from 0.4 (pre-risk occurrence) to 0.5 (post-risk occurrence). Implications and suggestions for future research are presented.

Downloads

Download data is not yet available.

References

Ahmadimanesh, F., Paydar, M.M., & Asadi-Gangraj, E. (2019). Designing a mathematical model for dental tourism supply chain. Tourism Management, 75, 404–417. https://doi.org/10.1016/j.tourman.2019.06.001
Google Scholar DOI: https://doi.org/10.1016/j.tourman.2019.06.001

Ali, I., Nagalingam, S., & Gurd, B. (2017, January). Supply chain resilience research: Review, trends and opportunities. In Proceedings of 31st Annual Conference of the Australian & New Zealand Academy of Management (ANZAM) (pp. 1–30). https://www.anzam.org/wp-content/uploads/2018/02/ANZAM-2017-178.pdf
Google Scholar

Andrades, L., & Dimanche, F. (2017). Destination competitiveness and tourism development in Russia: Issues and challenges. Tourism Management, 62, 360–376. https://doi.org/10.1016/j.tourman.2017.05.008
Google Scholar DOI: https://doi.org/10.1016/j.tourman.2017.05.008

Azizi Usefvand, R., Nahavandi, N., & Farzandi, G.H. (2017). The role of supply chain risk management on the efficiency of the pharmaceutical distribution companies. International Journal of Industrial Engineering and Production Management, 28(1), 119–137 [in Persian]. https://ijiepm.iust.ac.ir/article-1-1248-fa.pdf
Google Scholar

Bauer, I.L. (2017). Improving global health – is tourism’s role in poverty elimination perpetuating poverty, powerlessness and ‘ill-being’? Global Public Health, 12(1), 45–64. https://doi.org/10.1080/17441692.2015.1094109
Google Scholar DOI: https://doi.org/10.1080/17441692.2015.1094109

Benazzouz, T., Charkaoui, A., & Echchatbi, A. (2018). Risks related to the medical supply chain in public hospitals in Morocco: Qualitative study. Le Pharmacien Hospitalier et Clinicien, 54(1), 19–29. https://doi.org/10.1016/j.phclin.2018.10.058
Google Scholar DOI: https://doi.org/10.1016/j.phclin.2018.10.058

Bovy, P.H.L., & Stern, E. (1990). Route choice: Wayfinding in transport networks. Kluwer Academic Publishers.
Google Scholar DOI: https://doi.org/10.1007/978-94-009-0633-4

Burke, R.J. (2018). Human resource management in the hospitality and tourism sector. In R.J. Burke & J.C. Hughes (Eds.), Handbook of human resource management in the tourism and hospitality industries (pp. 3–59). Edward Elgar Publishing.
Google Scholar DOI: https://doi.org/10.4337/9781786431370.00007

Büyüközkan, G., Mukul, E., & Kongar, E. (2021). Health tourism strategy selection via SWOT analysis and integrated hesitant fuzzy linguistic AHP-MABAC approach. Socio-Economic Planning Sciences, 74, Article 100929. https://doi.org/10.1016/j.seps.2020.100929
Google Scholar DOI: https://doi.org/10.1016/j.seps.2020.100929

Campra, M., Riva, P., Oricchio, G., & Brescia, V. (2022). Bibliometrix analysis of medical tourism. Health Services Management Research, 35(3), 172–188. https://doi.org/10.1177/09514848211011738
Google Scholar DOI: https://doi.org/10.1177/09514848211011738

Carvalho, H., Maleki, M., & Cruz-Machado, V. (2012). The links between supply chain disturbances and resilience strategies. International Journal of Agile Systems and Management, 5(3), 203–234. https://doi.org/10.1504/IJASM.2012.047653
Google Scholar DOI: https://doi.org/10.1504/IJASM.2012.047653

Carvalho Remigio, H.M.L. (2012). Modelling resilience in supply chain [Doctoral dissertation]. The Universidade Nova de Lisboa’s Repository. http://hdl.handle.net/10362/8949
Google Scholar

Davoudi, M., & Hasanabadi, D. (2020). Health tourism qualification in urban income stabilization, case study: Tehran. Journal of Tourism & Hospitality Research Islamic Azad University, Garmsar Branch, 7(4), 23–41. https://journals.iau.ir/article_675742_0133c664deda61612445a1ef988882db.pdf
Google Scholar

de la Hoz-Correa, A., Muñoz-Leiva, F., & Bakucz, M. (2018). Past themes and future trends in medical tourism research: A coword analysis. Tourism Management, 65, 200–211. https://doi.org/10.1016/j.tourman.2017.10.001
Google Scholar DOI: https://doi.org/10.1016/j.tourman.2017.10.001

de Souza, V., Bloemhof-Ruwaard, J., & Borsato, M. (2019). Exploring ecosystem network analysis to balance resilience and performance in sustainable supply chain design. International Journal of Advanced Operations Management, 11(1–2), 26–45. https://doi.org/10.1504/IJAOM.2019.098525
Google Scholar DOI: https://doi.org/10.1504/IJAOM.2019.10019916

Doshmangir, L., Doshmangir, P., Sajadi, H.S., & Alizadeh, G.A. (2018). Analyzing health tourism status in Iran. Depiction of Health, 9(2), 73–80 [in Persian]. https://doh.tbzmed.ac.ir/Article/doh-217
Google Scholar

Elleuch, H., Hachicha, W., & Chabchoub, H. (2014). A combined approach for supply chain risk management: Description and application to a real hospital pharmaceutical case study. Journal of Risk Research, 17(5), 641–663. https://doi.org/10.1080/13669877.2013.815653
Google Scholar DOI: https://doi.org/10.1080/13669877.2013.815653

Fan, Y., & Stevenson, M. (2018). A review of supply chain risk management: Definition, theory, and research agenda. International Journal of Physical Distribution & Logistics Management, 48(3), 205–230. https://doi.org/10.1108/IJPDLM-01-2017-0043
Google Scholar DOI: https://doi.org/10.1108/IJPDLM-01-2017-0043

Farrokhvar, P. (2013). Patient risk and data standards in healthcare supply chain [Graduate theses and dissertations]. University of Arkansas, ScholarWorks@UARK. https://scholarworks.uark.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1916&context=etd
Google Scholar

Folkman, S., & Lazarus, R.S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21(3), 219–239. https://www.doi.org/10.2307/2136617
Google Scholar DOI: https://doi.org/10.2307/2136617

Ghaderi, Z., Hatamifar, P., & Khalilzadeh, J. (2018). Analysis of tourist satisfaction in tourism supply chain management. Anatolia: An International Journal of Tourism and Hospitality Research, 29(3), 433–444. https://doi.org/10.1080/13032917.2018.1439074
Google Scholar DOI: https://doi.org/10.1080/13032917.2018.1439074

Gholami, M., Keshtvarz Hesam Abadi, A.M., Milady, S., & Gholami, M. (2020). A systematic review of the factors affecting the growth of medical tourism in Iran. International Journal of Travel Medicine and Global Health, 8(1), 1–12. https://doi.org/10.34172/IJTMGH.2020.01
Google Scholar DOI: https://doi.org/10.34172/ijtmgh.2020.01

Habibi, A., Mousavi, M., Jamali, S.M., & Ale Ebrahim, N. (2022). A bibliometric study of medical tourism. Anatolia: An International Journal of Tourism and Hospitality Research, 33(3), 415–425. https://doi.org/10.1080/13032917.2021.1954042
Google Scholar DOI: https://doi.org/10.1080/13032917.2021.1954042

Hall, C.M., Safonov, A., & Naderi Koupaei, S. (2023). Resilience in hospitality and tourism: Issues, synthesis and agenda. International Journal of Contemporary Hospitality Management, 35(1), 347–368. https://www.doi.org/10.1108/IJCHM-11-2021-1428
Google Scholar DOI: https://doi.org/10.1108/IJCHM-11-2021-1428

Hohenstein, N.-O., Feisel, E., Hartmann, E., & Giunipero, L. (2015). Research on the phenomenon of supply chain resilience: A systematic review and paths for further investigation. International Journal of Physical Distribution & Logistics Management, 45(1/2), 90–117. https://doi.org/10.1108/IJPDLM-05-2013-0128
Google Scholar DOI: https://doi.org/10.1108/IJPDLM-05-2013-0128

Jaberidoost, M., Nikfar, S., Abdollahiasl, A., & Dinarvand, R. (2013). Pharmaceutical supply chain risks: A systematic review. DARU Journal of Pharmaceutical Sciences, 21(1), Article 69. https://doi.org/10.1186/2008-2231-21-69
Google Scholar DOI: https://doi.org/10.1186/2008-2231-21-69

Jiang, Y., Ritchie, B.W., & Verreynne, M.-L. (2019). Building tourism organizational resilience to crises and disasters: A dynamic capabilities view. International Journal of Tourism Research, 21(6), 882–900. https://doi.org/10.1002/jtr.2312
Google Scholar DOI: https://doi.org/10.1002/jtr.2312

Jones, P., & Wynn, M.G. (2019). The circular economy, natural capital and resilience in tourism and hospitality. International Journal of Contemporary Hospitality Management, 31(6), 2544–2563. https://doi.org/10.1108/IJCHM-05-2018-0370
Google Scholar DOI: https://doi.org/10.1108/IJCHM-05-2018-0370

Kaczmarek, T., Perez, K., Demir, E., & Zaremba, A. (2021). How to survive a pandemic: The corporate resiliency of travel and leisure companies to the COVID-19 outbreak. Tourism Management, 84, Article 104281. https://doi.org/10.1016/j.tourman.2020.104281
Google Scholar DOI: https://doi.org/10.1016/j.tourman.2020.104281

Kumar, A., Zavadskas, E.K., Mangla, S.K., Agrawal, V., Sharma, K., & Gupta, D. (2019). When risks need attention: Adoption of green supply chain initiatives in the pharmaceutical industry. International Journal of Production Research, 57(11), 3554–3576. https://doi.org/10.1080/00207543.2018.1543969
Google Scholar DOI: https://doi.org/10.1080/00207543.2018.1543969

Lambaino, N.K. (2019). Influence of risk mitigation strategies on supply chain resilience in the petroleum industry in Kenya [Thesis]. Jomo Kenyatta University of Agriculture and Technology Digital Repository. http://ir.jkuat.ac.ke/handle/123456789/5121
Google Scholar

Liu, Y., Xiao, T., Fan, Z.-P., & Zhao, X. (2017). Pricing, environmental governance efficiency, and channel coordination in a socially responsible tourism supply chain. International Transactions in Operational Research, 26(3), 1025–1051. https://www.doi.org/10.1111/itor.12489
Google Scholar DOI: https://doi.org/10.1111/itor.12489

Loh, C.-P.A. (2015). Trends and structural shifts in health tourism: Evidence from seasonal time-series data on health-related travel spending by Canada during 1970–2010. Social Science & Medicine, 132, 173–180. https://doi.org/10.1016/j.socscimed.2015.03.036
Google Scholar DOI: https://doi.org/10.1016/j.socscimed.2015.03.036

Lubowiecki-Vikuk, A., Budzanowska-Drzewiecka, M., Borzyszkowski, J., & Taheri, B. (2023). Critical reflection on VUCA in tourism and hospitality marketing activities. International Journal of Contemporary Hospitality Management, 35(8), 2983–3005. https://doi.org/10.1108/IJCHM-04-2022-0479
Google Scholar DOI: https://doi.org/10.1108/IJCHM-04-2022-0479

Mandal, S., & Saravanan, D. (2019). Exploring the influence of strategic orientations on tourism supply chain agility and resilience: An empirical investigation. Tourism Planning & Development, 16(6), 612–636. https://doi.org/10.1080/21568316.2018.1561506
Google Scholar DOI: https://doi.org/10.1080/21568316.2018.1561506

Meneghel, I., Martínez, I.M., Salanova, M., & de Witte, H. (2019). Promoting academic satisfaction and performance: Building academic resilience through coping strategies. Psychology in the Schools, 56(6), 875–890. https://doi.org/10.1002/pits.22253
Google Scholar DOI: https://doi.org/10.1002/pits.22253

Momeni, K., Janati, A., Imani, A., & Khodayari-Zarnaq, R. (2018). Barriers to the development of medical tourism in East Azerbaijan province, Iran: A qualitative study. Tourism Management, 69, 307–316. https://doi.org/10.1016/j.tourman.2018.05.007
Google Scholar DOI: https://doi.org/10.1016/j.tourman.2018.05.007

Nikraftar, T., Hosseini, G., & Moghadam, A. (2016). Identify factors affecting medical tourism attraction in Iran. Journal of Health Administration, 20(67), 64–74 [in Persian]. http://jha.iums.ac.ir/article-1-2138-fa.html
Google Scholar

Okafor, L., Khalid, U., & Gopalan, S. (2022). COVID-19 economic policy response, resilience and tourism recovery. Annals of Tourism Research Empirical Insights, 3(2), Article 100073. https://doi.org/10.1016/j.annale.2022.100073
Google Scholar DOI: https://doi.org/10.1016/j.annale.2022.100073

Paraskevas, A., & Arendell, B. (2007). A strategic framework for terrorism prevention and mitigation in tourism destinations. Tourism Management, 28(6), 1560–1573. https://doi.org/10.1016/j.tourman.2007.02.012
Google Scholar DOI: https://doi.org/10.1016/j.tourman.2007.02.012

Pfohl, H.-C., Gallus, P., & Thomas, D. (2011). Interpretive structural modeling of supply chain risks. International Journal of Physical Distribution & Logistics Management, 41(9), 839–859. https://doi.org/10.1108/09600031111175816
Google Scholar DOI: https://doi.org/10.1108/09600031111175816

Pournader, M., Kach, A., & Talluri, S. (2020). A review of the existing and emerging topics in the supply chain risk management literature. Decision Sciences, 51(4), 867–919. https://doi.org/10.1111/deci.12470
Google Scholar DOI: https://doi.org/10.1111/deci.12470

Raja Sreedharan, V., Kamala, V., & Arunprasad, P. (2019). Supply chain risk assessment in pharmaceutical industries: An empirical approach. International Journal of Business Innovation and Research, 18(4), 541–571. https://doi.org/10.1504/IJBIR.2019.098769
Google Scholar DOI: https://doi.org/10.1504/IJBIR.2019.098769

Ramirez de Arellano, A.B. (2011). Medical tourism in the Caribbean. Signs: Journal of Women in Culture and Society, 36(2), 289–297. https://doi.org/10.1086/655908
Google Scholar DOI: https://doi.org/10.1086/655908

Rao, S., & Goldsby, T.J. (2009). Supply chain risks: A review and typology. The International Journal of Logistics Management, 20(1), 97–123. https://doi.org/10.1108/09574090910954864
Google Scholar DOI: https://doi.org/10.1108/09574090910954864

Ravansetan, K. (2017). Design of resilient comprehensive model and determination and prioritization of resilient strategies by FMEA and FDANP techniques in IRAN KHODRO Company [Unpublished doctoral dissertation, University of Mazandaran].
Google Scholar

Ritchie, B.W., & Jiang, Y. (2019). A review of research on tourism risk, crisis and disaster management: Launching the annals of tourism research curated collection on tourism risk, crisis and disaster management. Annals of Tourism Research, 79, Article 102812. https://doi.org/10.1016/j.annals.2019.102812
Google Scholar DOI: https://doi.org/10.1016/j.annals.2019.102812

Scholten, K., Sharkey Scott, P., & Fynes, B. (2014). Mitigation processes – antecedents for building supply chain resilience. Supply Chain Management: An International Journal, 19(2), 211–228. https://doi.org/10.1108/SCM-06-2013-0191
Google Scholar DOI: https://doi.org/10.1108/SCM-06-2013-0191

Secundo, G., Toma, A., Schiuma, G., & Passiante, G. (2019). Knowledge transfer in open innovation: A classification framework for healthcare ecosystems. Business Process Management Journal, 25(1), 144–163. https://doi.org/10.1108/BPMJ-06-2017-0173
Google Scholar DOI: https://doi.org/10.1108/BPMJ-06-2017-0173

Senbeto, D.L., & Hon, A.H.Y. (2020). Market turbulence and service innovation in hospitality: Examining the underlying mechanisms of employee and organizational resilience. The Service Industries Journal, 40(15–16), 1119–1139. https://doi.org/10.1080/02642069.2020.1734573
Google Scholar DOI: https://doi.org/10.1080/02642069.2020.1734573

Sharma, G.D., Thomas, A., & Paul, J. (2021). Reviving tourism industry post-COVID-19: A resilience-based framework. Tourism Management Perspectives, 37, Article 100786. https://doi.org/10.1016/j.tmp.2020.100786
Google Scholar DOI: https://doi.org/10.1016/j.tmp.2020.100786

Silva, J., Araujo, C., & Marques, L. (2020). Siloed perceptions in pharmaceutical supply chain risk management: A Brazilian perspective. Latin American Business Review, 21(3), 223–254. https://doi.org/10.1080/10978526.2020.1731315
Google Scholar DOI: https://doi.org/10.1080/10978526.2020.1731315

Thierry, M., Salomon, M., Van Nunen, J., & Van Wassenhove, L. (1995). Strategic issues in product recovery management. California Management Review, 37(2), 114–136. https://doi.org/10.2307/41165792
Google Scholar DOI: https://doi.org/10.2307/41165792

Truong Quang, H., & Hara, Y. (2017). Risks and performance in supply chain: The push effect. International Journal of Production Research, 56(4), 1369–1388. https://doi.org/10.1080/00207543.2017.1363429
Google Scholar DOI: https://doi.org/10.1080/00207543.2017.1363429

Tukamuhabwa, B., Stevenson, M., & Busby, J. (2017). Supply chain resilience in a developing country context: A case study on the interconnectedness of threats, strategies and outcomes. Supply Chain Management: An International Journal, 22(6), 486–505. https://doi.org/10.1108/SCM-02-2017-0059
Google Scholar DOI: https://doi.org/10.1108/SCM-02-2017-0059

Tukamuhabwa Rwakira, B. (2015). Supply chain resilience: A case study analysis of a supply network in a developing country context [PhD thesis]. Lancaster University Management School, CORE. https://core.ac.uk/reader/42415900
Google Scholar

Vishnu, C.R., & Regikumar, V. (2016). Reliability based maintenance strategy selection in process plants: A case study. Procedia Technology, 25, 1080–1087. https://doi.org/10.1016/j.protcy.2016.08.211
Google Scholar DOI: https://doi.org/10.1016/j.protcy.2016.08.211

Vishnu, C.R., Sridharan, R., Ram Kumar, P.N., & Regi Kumar, V. (2020). Analysis of the operational risk factors in public hospitals in an Indian state: A hybrid DEMATEL–ISM–PROMETHEE approach. International Journal of Health Care Quality Assurance, 33(1), 67–88. https://doi.org/10.1108/IJHCQA-06-2018-0156
Google Scholar DOI: https://doi.org/10.1108/IJHCQA-06-2018-0156

Vishwakarma, V., Prakash, C., & Barua, M.K. (2016). A fuzzy-based multi criteria decision making approach for supply chain risk assessment in Indian pharmaceutical industry. International Journal of Logistics Systems and Management, 25(2), 245–265. https://doi.org/10.1504/IJLSM.2016.078915
Google Scholar DOI: https://doi.org/10.1504/IJLSM.2016.078915

Wang, H.-Q., Gao, X., & Wang, S.-S. (2013). Research on risk identification and control of medicine supply chain. In R. Dou (Ed.), Proceedings of 2012 3rd International Asia Conference on Industrial Engineering and Management Innovation (IEMI2012) (pp. 367–377). Springer. https://doi.org/10.1007/978-3-642-33012-4_37
Google Scholar DOI: https://doi.org/10.1007/978-3-642-33012-4_37

Wang, L. (2018). Research on risk management for healthcare supply chain in hospital [PhD thesis]. Liverpool John Moores University Research Online. https://researchonline.ljmu.ac.uk/id/eprint/9195/
Google Scholar

Wasswa, J.H., & Namulindwa, A. (2020). Assessment of health supply chain risks in Uganda: The case of Uganda health supply chain project. International Journal of Science and Research (IJSR), 9(3), 9–11. https://www.ijsr.net/getabstract.php?paperid=SR20227201353
Google Scholar

Webster, V., Brough, P., & Daly, K. (2016). Fight, flight or freeze: Common responses for follower coping with toxic leadership. Stress and Health, 32(4), 346–354. https://doi.org/10.1002/smi.2626
Google Scholar DOI: https://doi.org/10.1002/smi.2626

Zamora, J., Adarme, W., & Arango, M. (2013). Supply risk analysis: Applying system dynamics to the Colombian healthcare sector. Ingeniería e Investigación, 33(3), 76–81. https://doi.org/10.15446/ing.investig.v33n3.41050
Google Scholar DOI: https://doi.org/10.15446/ing.investig.v33n3.41050

Downloads

Published

2024-07-25

How to Cite

Mohammadipour, E., & Mazroui Nasrabadi, E. (2024). An investigation into resilience strategies in the medical tourism supply chain. Turyzm/Tourism, 34(2), 7–34. https://doi.org/10.18778/0867-5856.34.2.01

Issue

Section

Articles