, pp.141-145 http://dx.doi.org/10.14257/astl.2015.114.27 SNS Information Credibility, Medical Tourism Website Credibility and Destination Image Min-sook Kim Dept. of Economic and Commerce, Keimyung University 1095, Dalseo-Gu, Daegu 704-701, KOREA kms@gw.kmu.ac.kr Abstract. The purpose of this paper is to propose a new model for enhancing medical tourism destination image by integrating the credibility of supplierbased official websites and buyer-based private SNS, which influence medical tourism destination credibility and image. Medical tourism websites provide supplier-based information storage but SNS information about Korean medical tourism contains buyer-based information. These two channels play important factors in positioning Korea as medical tourism destination. Keywords: Medical Tourism Destination Image, Medical Tourism Website, SNS information credibility 1 Introduction Medical tourism is one of the fastest growing health service sectors. Medical tourists can access to a variety of sources of information such as traditional source and Internet source in order to explore and find information on their decision to travel abroad for medical tourism destinations. Health information is critical to medical tourismrelated purchasing decision (Milstein and Smith, 2006). Most tourists proactively seek their own information to make an optimal purchasing decision. The most popular way for obtaining such information is the Internet search (Hu and Sundar, 2010). Health information on the Internet is gained from various online sources, including Website of medical tourism organization, online community where people actively exchange health information, and blogs authored by medical tourists after post-operation. Channels through which medical tourists gain information about medical tourism destination can be classified into two types. One is a supplier-based channel such as official websites of medical institutions whose information is provided by the suppliers of medical service, and the other is a buyer-based one such as personal blogs and SNS whose information is provided by the buyers of medical service. For global medical institutions to enhance their positive medical tourism destination image, the credibility of information on the both types of channels needs to be secured. After reviewing the subjective and non-official information of SNS and the objective and official information of websites, the potential tourists evaluate the credibility of medical tourism destination and hold a positive destination image. These two channels play important factors in positioning medical institutions in Korea as medical tourism destination. The purpose of this paper is to propose a new model for enhancing medical ISSN: 2287-1233 ASTL Copyright 2015 SERSC
tourism destination image by considering two types of information channels and to test its validity with empirical data from Chinese medical tourists. 2 Literature Review With the widespread usage of the Internet, SNS (e.g., twitter, Facebook, blogging) is now a popular social activity among Internet users. For example, in case of blogging, with only 10 years of development, blogs in China show an overwhelming growth potential. By the end of 2009, the number of blog users reached 221 million (CNNIC 2010). Sun et al. (2015) suggest that blogs are an important resource by which a marketing organization of medical tourism can exert an influence potential medical tourists, and by which medical tourist perceptions of place can be assessed. SNS information is an inexpensive means in gathering rich, authentic, and unsolicited customer feedbacks about visitors experiences in destinations. Thus, SNS information, such as medical tourist reviews, have a significant impact on medical tourists purchasing intention. And online user-generated review plays an important role in increasing medical tourism performance. Akehurst (2009) examined the development of user-generated content in blogs and concluded that blogs were perceived to be more credible and trustworthy than traditional marketing communications. Burgess, Sellitto, Cox, and Buultjens (2009) also found that online travel consumers considered user generated content as a supportive tool for their travel decisions. Websites are also an important marketing vehicle for global medical institutions who are attempting to attract foreigners to their medical facilities. The investors and administrators in these organizations have a significant financial interest in attracting new clients, and so they must be strategic in terms of crafting messages that will appear on their websites. Medical tourism website analysis was performed by Jin and Lee (2015). They analyzed official medical tourism websites in Thailand, Malaysia and Korea using 4 criteria (e.g., contents, convenience, design and interactivity). The contents criterion consist of general hospital and medical staff information, JCI or prestigious government accreditation, the medical cost and additional information (e.g., video, e- brochure, visa process, medical tourism process, county and culture introduction, restaurants and accommodations). User s convenience depends on website structure reflecting the menus structure, the number of menus, sitemap and subcategory as well as the convenience. The Website design includes the images, layout, and colors of words. The last criterion, interactivity includes SNS (Facebook, twitter, U-tube), information sharing, and customer support. Therefore, the aim of this study is to find out whether the information credibility of two types of channels (buyer-based private SNSs and supplier-based official websites) has a positive influence on the medical tourism destination image. 142 Copyright 2015 SERSC
3 A Conceptual Framework and Hypotheses As shown in <Figure 1>, a conceptual framework is developed to figure out whether information credibility about medical tourism destination of SNS as well as website has a positive impact on medical tourism destination credibility and image. As you can see in Figure 1, the influencing factors on SNS information credibility are consisted of three components, that is, consensus, vividness and professionalism. The effecting elements on medical tourism websites credibility include reputation, accreditation, patient testimonials and physician expertise. Fig. 1. A framework of SNS credibility, website credibility, destination credibility and destination image Cheng (2003) defined consensus as the extent to which more than two people agree on the product and service performance. Elliot (2002) argued that the degree of agreement by other consumers to be standard of judgement of the reliability. Chiou and Bickart (2002) also indicated that the usefulness and validity of online word of mouth were judged by the degree of agreement cited by other consumers. This ensures that the consensus is used to cue the consumer to verify the feedback of the other consumers. Thus, information credibility increases if there are lots of reviews and more comments posted by many people. On the basis of the above discussion, the following hypothesis is developed. H1: The higher the level of observed support in terms of consensus for Korea as medical tourism destination will have a positive impact on medical tourism destination image. According to Taylor and Thompson (1982), vividness refers to information characteristics achieved by qualities of a message that enhance imagination. Kim, Kardes, Copyright 2015 SERSC 143
Herr (1991) has shown that vivid information has more influence on consumer s perception than non-vivid information. Thus we expect that vividly presented information has more impact on the perceived medical tourism destination credibility. H2: The higher level of vivid information about Korea as medical tourism destination will have a positive impact on medical tourism destination credibility. The impact of professionalism of SNS information has been explored by researchers. Professionalism can be defined as delivering information that is precise and usable (Hovland e t al., 1953). Appelman and Sundar(2015) developed the scale to measure message credibility and suggested that the aura of professionalism is a significant predictor of message credibility. They mentioned that perceived expertise of the story and its apparent sense of impact also appear to factor into user conceptions of message credibility. H3: The higher level of professional information about Korea as a medical tourism destination will have a positive impact on medical tourism destination credibility. A good reputation is a powerful means for persuasion. Consumers can infer the quality of the contents of a website based on reputation. Therefore, a reputable website is more readily accepted by consumers than a lesser known website. Similarly, Chih (2013) suggested that the credibility effect is higher for websites with established reputations that for those without established reputations. H4: The reputation of Korean medical tourism website will have a positive impact on medical tourism destination credibility. To establish the credibility of the medical tourism websites, the accreditation of the provider or facility should be a major concern for medical tourists when they choose a hospital (Manson and Wright, 2011). International accreditation organizations exist offering insight into the educational, skill, knowledge, and background of facilities and practitioner. One of them, The Joint Commission International is considered to be the gold standard for international credentialing. Its seal is considered to be an internationally sign of a hospital that operates with the highest standards. H5: The medical tourism website delivering the accreditation information will have a positive impact on medical tourism destination credibility. Manson and Wright (2011) suggested that other credibility appeal such as testimonials and information about physician and organizational expertise and background appear to be common ways to addressing credibility issues among consumers. The ways in which medical tourism websites establish and advertise credibility to audiences has not be examined in previous research. H6: The medical tourism website delivering the patients post-operational testimonial information will have a positive impact on medical tourism destination credibility. 144 Copyright 2015 SERSC
H7: The medical tourism website delivering the medical staff s expertise and background information will have a positive impact on medical tourism destination credibility. Medical tourism destination credibility is defined as the believability that the medical tourism destination management is willing and capable of delivering on its promises related to a specific medical tourism destination (Veasna et al, 2013). Thus, it has been suggested that perceived medical tourism destination credibility can build medical tourism destination image. If Korea as a medical tourism destination is believable, trustworthy, and delivers what it promises, then she can build medical tourism destination image. H8: Medical tourism destination credibility will have a positive impact on medical tourism destination image. 4 Conclusion The major contribution of this study is the development of a new model explaining how the buyer-based private SNS information credibility and the supplier-based official website credibility affect medical tourism destination credibility and image. On the managerial front, these findings of the study contribute to the development of medical tourism destination image through Internet marketing strategy and SNS information activities. Thus, online marketer should consider emphasizing online strategy that invoke risk reduction or saving on information costs in order to successfully position Korea as a credible medical tourism destination. References 1. Hu, Y. and Sundar, S.S.: Effects of Online Health Sources on Credibility and Behavioral Intentions, Communication Research, Vol. 37, No. 1, pp.105-132. 2. Li, X. and Wang, Y.: Depicting image of China as a Tourism Destination: A Travel Blog Approach, Paper presented at the 16 th Graduated Students Research Conference, Houston, TX. (2011) 3. Manson, A. and Wright, K.B.: Framing Medical Tourism: An Examination of Appeal, Risk, Convalescence, Accreditation, and Interactivity in Medical Tourism Website, Journal of Health Communication, Vol. 16, pp.163-177 (2011) 4. Milstein, A. and Smith, A.: America s New Refugees: Seeking Affordable Surgery Offshore, New England Journal of Medicine, Vol. 355, pp.1637-1640 (2006). 5. Sun, M., Ryan, C. and Pan, S.: Using Chinese Travel Blogs to Examine Perceived Destination Image: The Case of New Zealand, Journal of Travel Research, Vol. 54, No. 4, pp.543-555. Copyright 2015 SERSC 145