Developing an Indigenous Model of Customer Experience in Health Tourism in Mazandaran Province Using an Exploratory Mixed-Methods Approach

Authors

    Sasan Isazadeh Nesheli Department of Business Management, Sha.C., Islamic Azad University, Shahrood, Iran.
    Mohammad Reza Rostami * Department of Business Management, Sha.C., Islamic Azad University, Shahrood, Iran. drrostami@iau.ac.ir
    Seyed Hossein Hosseini Department of Business Management, Sha.C., Islamic Azad University, Shahrood, Iran.

Keywords:

Customer Experience, Health Tourism , Indigenous Model, Mixed-Methods Approach, Mazandaran Province

Abstract

The present study aimed to design and explain an indigenous model of customer experience in health tourism in Mazandaran Province using an exploratory mixed-methods approach. Given the growing competition among medical centers and the critical importance of patient experience in retaining and attracting health tourists, there is a need for a localized model that aligns with the country’s cultural and organizational conditions. The research was conducted in two stages. In the qualitative stage, the thematic analysis method was used to extract the main dimensions and components of customer experience. In the quantitative stage, the proposed model was tested using confirmatory factor analysis. The statistical population in the qualitative stage consisted of 18 experts in the field of health tourism and managers of medical centers who were selected through purposive sampling. In the quantitative stage, data were collected from 384 health tourist patients. The findings revealed that the final model comprises four main dimensions—quality of medical services, emotional experience, cultural–social experience, and process convenience—along with twelve sub-indicators. This model can serve as a framework for assessing and enhancing customer experience in Iran’s health tourism industry.

References

Alipuri, E., Alipour, A., & Behrmand, S. (2016). Strategic planning of health tourism in line with the sustainability of the residential system of desert and desert areas, a case study (Isfahan province). 4th International Conference on Civil Engineering, Architecture and Urban Development with Sustainable Development Approach,

Ananchenkova, P. I. (2021). The impact of COVID-19 pandemic on medical tourism development. Problemy Sotsial'noi Gigieny, Zdravookhraneniiai Istorii Meditsiny, 29(2), 203-205. https://doi.org/10.32687/0869-866x-2021-29-2-203-205

Aramesh, H., Tabavar, A. A., Yagubi, N., & Derakhshan, A. (2020). The impact of green marketing on medical tourism with the mediating role of technology. Journal of Business Management Perspective, 19(74), 137-155. https://doi.org/10.52547/jbmp.19.41.137

Bazargan, A. (2018). An introduction to qualitative and mixed research methods. Didar Publications.

Béland, D., & Zarzeczny, A. (2018). Medical tourism and national health care systems: An institutionalist research agenda. Globalization and Health, 14(1), 1-7. https://doi.org/10.1186/s12992-018-0387-0

Bestam, H., Moadi Ghalibaf, M. M., & Ameli, A. (2016). The role of marketing in the development of health tourism in Iran. Journal of the Army School of Nursing, 16(30), 10-17. https://civilica.com/doc/898720

Da Costa Guerra, R. J., Gonçalves, E. C., & Figueiredo, V. (2021). Managing partnerships between tourism and hospitality stakeholders: The case of health and wellness products in Portugal. IGI Global. https://doi.org/10.4018/978-1-7998-5691-7.ch019

Dedeke, A. N. (2017). Creating sustainable tourism ventures in protected areas: An actor-network theory analysis. Tourism Management, 61, 161-172. https://doi.org/10.1016/j.tourman.2016.10.003

Engül, C., & Hakan, O. R. A. (2020). Healthcare tourism in second decade of 21st century: A review of Turkey as the new global center for international patients. Journal of Health Systems and Policies, 2(1), 56-86. https://dergipark.org.tr/en/pub/jhesp/issue/54021/683545

Farastkhah, M. (2016). Qualitative research method in social sciences with emphasis on grounded theory. Aghat Publications.

Gaines, J., & Lee, C. V. (2019). Medical tourism. Elsevier. https://doi.org/10.1016/B978-0-323-54696-6.00039-2

Ghasemi, M., Movahed, A., & Kodkhodaei, S. (2018). An analysis of theoretical models and presentation of a conceptual model for capacity development of medical tourism in Iran. 14th Congress of the Geographical Society of Iran,

Harandi, A., & Mirzaian Khamsa, P. (2017). Explaining the health tourist attraction model: Using a classical foundational data theory strategy. Urban Tourism Journal, 4(1), 87-98. https://doi.org/10.22059/JUT.2017.61997

Khazai, N., Amiri Bashli, M., Rasouli, S. H., & Gorgani, G. A. (2016). Analysis and Effects of Health Tourism Industry Development in Mazandaran Province. 2nd Annual Conference on Research in Civil Engineering, Architecture, Urbanism, and Sustainable Environment,

KhoshTaynet, B., & Sabahi, A. (2017). The relationship between strategic marketing and the sustainable development of health tourism in Iran. 5th National Conference on Applied Research in Management and Accounting,

Lee, T. J., Han, J. S., & Ko, T. G. (2020). Health-oriented tourists and sustainable domestic tourism. Sustainability, 12(12), 4988. https://doi.org/10.3390/su12124988

Lemon, K. N., & Verhoef, P. C. (2016). Understanding customer experience throughout the customer journey. Journal of Marketing, 80(6), 69-96. https://doi.org/10.1509/jm.15.0420

Malmir, M., Salehi, K., Moghadam Zadeh, A., & Dehghani, M. (2023). Meaning and concept of quality culture based on the view of stakeholders at Tehran University. Organizational Culture Management. https://doi.org/10.22059/jomc.2023.364285.1008585

Manna, R., Cavallone, M., Ciasullo, M. V., & Palumbo, R. (2020). Beyond the rhetoric of health tourism: Shedding light on the reality of health tourism in Italy. Current Issues in Tourism, 23(14), 1805-1819. https://doi.org/10.1080/13683500.2019.1650726

McNickel, D. (2019, May). Hands on brands. Marketing Magazine,

Mohammad Alipour Kanari, A., & Amirdehi, S. (2017). Factors affecting the development of health-medical tourism in the hospitals of Mazandaran province and its prioritization. 3rd National Conference on Organizational Transformation and Innovation, Mashhad.

Motegh, H. (2021). Evaluating the Social Impacts of Tourism from a Sociological Perspective. Sociological studies, 19(53), 91-109. https://journals.iau.ir/article_682476.html

Motouripour, R., Emadzadeh, M., & Mahmoudi Ghasare, S. (2018). Investigating factors affecting the loyalty of foreign tourists (case study: Isfahan). 2nd International Conference on Modern Researches in Management, Economics, Accounting and Banking, Georgia-Tbilisi.

Mousaviyan, M., & Mousavi, S. A. (2017). Examining and presenting appropriate solutions to strengthen tourism in the development of cities and rural areas of the country. 1st Conference on Examining Challenges and Presenting New Urban Management Solutions, Tehran.

Pouya, A., Soltanpanah, H., & Irandoost, M. (2020). The Role of Experience-Based Marketing Strategies on Nature Tourists' Loyalty (Case Study: Ecotourism in Kurdistan Province). Consumer Behavior Studies, 7(1), 1-12. https://www.sid.ir/paper/964265/fa

Rasouli, S. H., Rahmani, S., Gholami Pouya, M. R., & Emamgholivand, F. (2025). Explaining Effective Indicators on Sustainable Tourism in Sari City. Scientific Journal of Spatial Economy Organization, 7, 85-106. https://sanad.iau.ir/Journal/jose/Article/1208574/FullText

Rasouli, S. H., Rajabi, A., & Motavali, S. a.-D. (2024a). Examining the Status of Sustainable Tourism in Sari City in the Context of Regional Development. Scientific Journal of Urban Planning and Development, 4(16). https://sanad.iau.ir/Journal/juep/Article/1122643

Rasouli, S. H., Rajabi, A., & Motavali, S. a.-D. (2024b). Explaining a Tourism Model Centered on Regional Development (Case Study: Sari City). Regional Geography Journal, 22(2), 139-168. https://jgrd.um.ac.ir/article_44705.html

Rasouli, S. H., Yazarlu, H., Pouriani, J., & Khamsai, S. (2024). Measuring Social Participation in the Development of the Tourism Industry and Its Application in Urban Planning Literature (Case Study: Sari City). Scientific Journal of Social Issues and Politics, 2(7), 1-21. https://sanad.iau.ir/Journal/jsp/Article/1127173

Rezvani, H., & Colleagues. (2021). Analyzing the Customer Experience Gap in Health Tourism in Iran. Journal of Service Management, 13(2), 85-102.

Sachmeforosh, L., Zanzerchi, S. M., & Zare Ahmadabadi, H. (2018). Designing a business model in health tourism using the business ecosystem model in Yazd province. 4th International Industrial Management Conference,

Sag, I., & Zengul, F. D. (2019). Why medical tourists choose Turkey as a medical tourism destination? Journal of Hospitality and Tourism Insights, 2(3), 296-306. https://doi.org/10.1108/JHTI-05-2018-0031

Sanavi Grossian, V., Mirabi, V. R., Kordloui, H. R., & Hasanpour Ghoroghchi, E. (2018). Identification and ranking of factors affecting the marketing of services in the field of health tourism in Mashhad using fuzzy TOPSIS technique. Tourism Management Studies Quarterly, 14(45), 249-269. https://doi.org/10.22054/tms.2019.30077.1870

Shafei, R. (2019). Studying the influence of market presence strategies on managerial attitudes and their relationship with the selection of marketing metrics in industrial manufacturing companies. Scientific Research Quarterly of Modern Marketing Research, 2(7), 81-104. https://sid.ir/paper/477038/fa

Sorkhossara, A., Nasrollahi, K., & Azerbaijan, K. (2018). Analyzing and Reviewing the Relationship Between Income and Expenditure in the Tourism Sector with Economic Growth. Scientific-Research Journal of Tourism and Development, 7(3), 1-24.

Ulusoy, H., & Tosun, N. (2020). Comparisons of health tourism within the EU countries. Springer International Publishing. https://doi.org/10.1007/978-3-030-36126-6_42

Zekavati, F., Andrevaj, L., & Zarin Joy, S. (2023). Designing a health tourism marketing model in health villages. Iran Journal of Health Education and Health Promotion, 11(1), 81-93. https://doi.org/10.52547/ijhehp.11.1.81

Downloads

Published

2026-06-01

Submitted

2025-07-01

Revised

2025-11-03

Accepted

2025-11-12

Issue

Section

Articles

How to Cite

Isazadeh Nesheli, S. ., Rostami, M. R., & Hosseini, S. H. . (2026). Developing an Indigenous Model of Customer Experience in Health Tourism in Mazandaran Province Using an Exploratory Mixed-Methods Approach. Journal of Resource Management and Decision Engineering, 1-20. https://journalrmde.com/index.php/jrmde/article/view/196

Similar Articles

1-10 of 147

You may also start an advanced similarity search for this article.