The purpose of this theme issue is to explore the development of health tourism in challenging times, with a particular focus on the Visegrád countries. The issue investigates the ways in which health tourism enterprises and destinations can enhance resilience, adapt to post-pandemic conditions and navigate economic, social and political uncertainties. Additionally, it highlights the role of health tourism in improving individual and community well-being while aligning with the principles of sustainable development.
This theme issue employs a thematic approach, incorporating both theoretical and empirical perspectives on health tourism development. The research articles included in this issue utilize various qualitative and quantitative methodologies, such as case studies, survey-based research and Delphi studies. The focus is on examining the sustainability and resilience of health tourism enterprises and destinations in the Visegrád countries, drawing on data from key stakeholders, including industry professionals, policymakers and researchers.
The studies presented in this theme issue identify several critical aspects of health tourism development in the Visegrád region. Key findings include (1) the increasing significance of health tourism as a tool for regional economic development and social well-being; (2) the necessity of infrastructural improvements and service diversification to attract both domestic and international tourists; (3) the role of strategic collaboration between stakeholders, including policymakers, businesses and healthcare institutions, in ensuring the long-term viability of health tourism; (4) the importance of sustainable practices in health tourism management, particularly in light of climate change and resource conservation challenges and (5) the evolving consumer behaviour patterns in the post-pandemic era, which emphasize wellness, preventive healthcare and personalized experiences.
This theme issue contributes to the growing body of literature on health tourism by addressing gaps in research related to the Visegrád countries. It provides novel insights into the resilience and adaptability of health tourism enterprises and destinations in the face of global crises and economic fluctuations. By offering strategic recommendations for policymakers, industry practitioners and researchers, this issue fosters a deeper understanding of how health tourism can drive regional development and support sustainable growth in uncertain times.
Theme editors Diana Dryglas and Melanie Kay Smith share their reflections on the significance and outcomes of the theme issue with Managing Editors Zanete Garanti and Galina Berjozkina.
Overview
Recently, the concept of health tourism has gained new momentum in tourism studies. It is held to be a very promising concept to explain how health tourism enterprises and destinations can develop, transform and be successful in the post-pandemic era. Furthermore, health tourism is recognised in this theme issue as a solution to mitigate COVID-19 impacts on individual and community health.
Why in your view is your theme issue’s strategic question important?
The issue focuses on a specific area of Europe, namely the Visegrád countries, which have been relatively under-researched in an international context. They are unique because health tourism in these countries is based on a long history and tradition of balneology, which is usually delivered in thermal spas that make use of a number of natural healing resources.
We have outlined a set of themes that add novelty to our current understanding of the topic of health tourism:
- (1)
Understanding health tourism in Visegrád countries: theoretical contributions, including comprehensive definitions and conceptual models.
- (2)
Examining the role of health tourism in improving the quality of life of citizens in the V4 region, as well as attracting international tourists for unique treatments.
- (3)
Challenges and opportunities for health tourism development during times of crisis leading to more sustainable management and greater resilience.
- (4)
Research-based case studies of health tourism management in times of uncertainty that can lead to better practice in other destinations.
- (5)
Recommendations for new approaches which are strategic, collaborative and sustainable.
Furthermore, this special issue connects to UN Sustainable Development Goals (SDGs) 3 Good Health and Wellbeing, as well as some of the SDGs that are more specifically related to sustainable tourism, e.g. SDG12 Responsible Consumption and Production or SDG13 Climate Action. Consumers have become more concerned about their health and wellness in a post-COVID era and there are close connections between sustainability and health. The use of natural resources and landscapes in a spa environment are growing in importance again as a result of these concerns. Sustainable health tourism destinations and enterprises should be aware of SDG7 actions involving Affordable and Clean Energy.
It can be concluded that the collected information that has been analysed in this theme issue is of key importance for managing health tourism more effectively in times of political change, economic instability, health crises and conflict. The challenges that are identified in the Visegrád countries are also highly relevant for countries in the wider region, especially Central and Eastern Europe and some of the Balkan and Baltic countries (i.e. those that were socialist before 1989).
Thinking about your theme issue plan and approach, what worked well?
In our experience, collaboration with colleagues and experts in the field has always been beneficial. By working together, we could combine our knowledge and expertise to tackle substantive and organisational problems. Additionally, seeking feedback from peer-reviews throughout the process helped to refine the research approach and ensure its validity.
The advantage of our team was a systematic and collaborative approach, combined with strong organizational skills and attention to detail, which has proven to be effective in leading our theme issue.
How did you engage with different stakeholder groups?
As we planned this issue, our goal was to effectively reach various stakeholders through the most suitable means. We carefully selected topics and authors based on consultation with our research and writing team. Our approach ensured inclusivity of diverse stakeholder groups, resulting in each article uncovering significant insights into health tourism development from both supply and demand perspectives. Our contact with many stakeholders from Visegrád countries who specialise in health tourism and balneology contributed to a higher response rate.
What were the highlights from stakeholder group interactions?
We found that the highlights from stakeholder group interactions often revolve around collaboration and communication. Building strong relationships with stakeholders, such as scholars, practitioners, and reviewers, has been essential in gaining support for our theme issue. Additionally, involving stakeholders in the decision-making process and incorporating their feedback has led to more successful outcomes and a greater impact on the theme issue. Overall, the key takeaway from stakeholder group interactions is the importance of working together towards a common goal and fostering mutual understanding and respect.
Thinking about your peer review process: what went well and why?
One of the key reasons for this success is the involvement of highly qualified experts in the field, ensuring insightful and constructive feedback on the manuscript. Additionally, clear guidelines and criteria for evaluating submissions help ensure consistency and fairness in the review process.
Furthermore, we believe that fostering a culture of constructive criticism and open communication among reviewers, editors, and authors has been instrumental in maintaining the quality of our peer review process. Encouraging reviewers to provide specific, actionable feedback and engage in respectful discussions with authors has helped improve the overall quality of the manuscripts we received.
What are the most significant outcomes of your theme issue in terms of the contributions to knowledge and/or professional practice?
As regards the theoretical and empirical research, this theme issue contributes to the scholarly understanding of the challenges faced by managers of health tourism enterprises and destinations in the context of a global era that presents new political, environmental and social challenges.
Managing the development of health tourism in Visegrád countries in times of uncertainty is crucial for practitioners for several reasons. Firstly, the Visegrád countries - Poland, Hungary, Czech Republic, and Slovakia - experienced rapid growth in health tourism before COVID-19, and further developments are expected in the aftermath of the COVID-19 pandemic. In such times of crisis, it is essential to carry out solid research to understand the impacts of the COVID-19 phenomenon and to support managers. The health tourism industry in particular has undoubtedly been one of the hardest-hit of all sectors. As such, it is essential for practitioners to manage this sector effectively in order to navigate these uncertain and challenging times and to adapt their strategies accordingly to ensure the sustainability and resilience of the sector. Secondly, understanding new trends in health tourism will help to adapt and evolve to meet the changing demands, new customer behaviour and concerns of guests in a post-COVID-19 world. Additionally, the health tourism market is highly competitive, with many countries vying for a share of this lucrative industry. Our theme issue will offer valuable guidance to managers of health tourism enterprises and destinations in designing their own strategies to effectively achieve growth and competitiveness. In conclusion, the outcomes of this theme issue will contribute to the existing body of knowledge within the field of health tourism management, offering insights and recommendations for managers, policymakers, and industry stakeholders to navigate the current and future challenges. By understanding the dynamic nature of health tourism trends in the post-pandemic context, practitioners can facilitate the development of effective strategies that enhance growth and competitiveness in the face of unforeseen disruptions and challenges. Furthermore, the present issue will help managers of health tourism enterprises and destinations to become more aware of how to navigate an uncertain environment, to respond to new circumstances and to re-evaluate health tourism enterprises and destinations and their place in a regional and global context.
What are the implications for management action and applied research arising from your theme issue outcomes?
Our theme issue appears to be a promising area for a future research agenda. Future studies should use larger and more diverse samples and take into account additional contextual factors, such as health tourism industry category (the addition of new and other health tourism facilities) or location (conducting studies in other countries than the Visegrád countries), which may result in more detailed understandings.
The results also confirm the need to study how changes in government policies, currency fluctuations, and economic downturns affect the demand for health tourism services, as well as the ability of healthcare providers to attract and retain international health tourists. In addition, future research on managing health tourism may solve the following research problems:
- (1)
Which internal and external factors mediate the revival of the health tourism industry (medical, spa and wellness) in a changing world of complex realities?
- (2)
What tools/strategies should be used by stakeholders for recovering and/or transforming the health tourism industry (medical, spa and wellness) in the post-crisis scenario?
- (3)
What are new approaches/goals for recovery and transformation of the health tourism industry (medical, spa and wellness)?
- (4)
How can new technologies be used to create new business models, forecast new business scenarios, build resilience, and understand risks using innovative business intelligence solutions for destinations and health tourism providers (medical, spa, wellness), as well as catering to changes in consumer behaviour and likely interaction modes?
- (5)
What are barriers and stimulators to transform the health tourism industry (medical, spa and wellness) in the post-crisis scenario?
- (6)
What is the role of (digital) information and knowledge in shaping health tourism enterprises and destination resilience?
- (7)
What is the role of different actors and institutions (networks) in health tourism growth?
- (8)
Which factors can contribute to making the health tourism industry sustainable enough to bounce back in the post-COVID-19 times?
- (9)
How can the health tourism industry use this crisis as an opportunity to take a more sustainable approach?
Overall, by focusing on these research directions, we can gain valuable insights into how to effectively manage the development of health tourism in the global context, even in challenging times. These findings can help policymakers, healthcare providers, and health tourism professionals make informed decisions to support the growth and sustainability of the industry.
Having served as a WHATT theme editor, what did you enjoy about the experience?
We found that collaborating with a dynamic writing team was both stimulating and enjoyable. It was empowering to realize that our collective experience, connections, and expertise could be combined to conduct what we consider to be meaningful and significant applied research. Through regular informal meetings, our shared passion for the topic and mutual goal for change fostered strong bonds among us as academic colleagues as well as between scholars and practitioners. This experience has not only inspired us, but also motivated us to continue working together on future research, projects, and activities.
About the theme editors
Dr Diana Dryglas is a researcher and academic teacher at the Faculty of Management at the AGH University of Krakow, Poland. Associate Professor of Economics in the field of management sciences based on a dissertation Designing a health tourism product structure model in the process of marketing management (2018). She is also author of the books Shaping the tourism product of spa resorts in Poland (2006), Process of developing a strategy for economic change management in a commune: A case study of the Krynica-Zdrój spa commune (Poland) (2016), as well as co-author of Determinants of the functioning and development of spa resorts in Europe: a case study of Poland (2017). She has published numerous scientific articles and chapters relating to health tourism, spas, wellness and wellbeing in journals with global reach (e.g. Journal of Travel and Tourism Marketing, Journal of Destination Marketing and Management). She has been working on many projects in this field. Active participant of national and international conferences and congresses on economy and management in health tourism, and in particular management of spa resorts (e.g. ESPA Congress). For many years she has cooperated with the Association of Polish Spa Communes, as well as since 2020 she has been a member of Hot Springs Initiative at the Global Wellness Institute.
Dr Melanie Kay Smith is an associate professor at Budapest Business University, Hungary. She is co-author of the books Health and Wellness Tourism (2008) and Health, Tourism and Hospitality: Spas, Wellness and Medical Travel (2013), as well as co-editor of The Routledge Handbook of Health Tourism (2016) with Dr László Puczkó. She co-authored The Spa Manager’s Essential Guide and co-edited A Research Agenda for Tourism and Wellbeing. She has worked for more than 20 years on issues relating to health tourism, spas, wellness and wellbeing. She has lectured extensively on these subjects in Hungary, Estonia, Austria, Germany and Switzerland and has published many books, journal articles and chapters in these areas (more than 40). In addition, she has been an Expert Advisor for the Global Spa Summit, GIFTS of Health, ETC/UNWTO, as well as working on projects in the Baltic States and Balkan countries. She also chaired a Working Group for an EU-funded four year COST project on Tourism, Wellbeing and Ecosystem Services She has been an invited Keynote Speaker at international Health and Wellness Conferences in numerous countries.
Funding: This research was funded by the AGH University of Krakow (No. 16/16.200.396 B510).
