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Purpose

This study aims to explore the consumer perceptions of cognition and intention to visit pilot zone of international medical tourism as emerging, developed medical tourism destinations.

Design/methodology/approach

Using a survey-based quantitative method, based on a survey of 439 tourists who have cross-border travel experience, the partial least squares approach was performed to test the hypotheses.

Findings

The results show that internal factors had a stronger influence on destination image compared to external factors. Among different factors, preferential policies had the greatest impact on intention to visit. Perceived quality had a stronger effect on intention to visit than preference. Geographical distance had a varied effect, with those furthest away in Northeast China showing greater intention to visit compared to closer regions.

Originality/value

This study explores the impact of multidimensional destination perception on medical tourists’ behavioural intention in emerging destinations by integrating the push-pull theory and theory of planned behaviour and tests how geographical distance affects intention to visit emerging destinations. Using China international medical tourism pilot area as a typical case of medical tourism emerging destinations for empirical analysis. This research offers guidance for branding and marketing strategies, contributes to a deeper understanding of medical tourists’ destination choices, enriches the theoretical explanation of emerging destination choice in medical tourism and provides valuable insights for destination recovery.

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