Global perspectives on health tourism: A comparative review of research trends and future prospects (2000–2024)

Abstract

This study systematically reviews global research trends in health tourism (2000–2024), comparing international and Chinese scholarly perspectives to identify key themes, differences, and future directions for the field. We employed a systematic literature analysis approach, examining studies on health tourism definitions, classifications, motivations, influencing factors, evaluation systems, and development strategies. Comparative insights were drawn between international and Chinese research priorities. Findings reveal distinct research emphases: International scholars focus on global perspectives, interdisciplinary integration, cross-border service delivery, and ethical concerns, while Chinese researchers prioritize localized frameworks, regional characteristics, and policy applications. Both groups, however, share an interest in industrial integration and growth drivers. The study recommends that China enhance standardized evaluation methods, deepen quantitative research, and cultivate distinctive health tourism brands. Globally, researchers should strengthen qualitative studies with holistic perspectives and develop transferable models. Future research should integrate four key dimensions—theoretical advancement, technological innovation, and industrial collaboration—to address evolving demands in global health governance and industry transformation.

Introduction

Since the early twenty-first century, global research on health tourism has grown significantly, offering valuable insights and practical impacts worldwide. However, most studies focus on individual countries rather than broader structures or global trends. This highlights a need for a more comprehensive and comparative understanding of health tourism. China, with its rich resources, large population, and cultural heritage, has developed substantial practical experience in health tourism that deserves more international academic attention. Similarly, Chinese researchers can learn from other countries’ findings and models to widen their global perspective. This study uses literature analysis to compare Chinese and international research on health tourism, identify transferable insights, and suggest ways to improve the quality and development of China’s health tourism industry.

Materials and Methods

The term “health tourism” is variably expressed in academic literature, often appearing as “health tourism,” “wellness tourism,” or “medical tourism.” To systematically review research in this field, this study searched relevant literature from 2000 to 2024 using Web of Science (WoS) for international publications and China National Knowledge Infrastructure (CNKI) for domestic sources.

For the international literature search, an advanced query was conducted using the formula AB (abstract) = (“health tourism” OR “wellness tourism” OR “medical tourism”), limited to English-language documents classified as “articles” or “reviews.” After excluding unrelated records, 532 valid documents were retrieved. For Chinese literature, an advanced search was conducted using the subject terms “health tourism,” “wellness tourism,” or “medical tourism.” From an initial pool of 2,651 documents, and after removing irrelevant materials such as reports, news articles, conference notices, and promotional content, a total of 1,632 valid documents were included.

Results

Literature shows global research focuses on health, wellness, and medical tourism. Key areas of focus include conceptual definitions, typologies, motivational drivers, influencing factors, evaluation systems, and development strategies. With this foundation, the present study conducts a systematic comparative analysis of Chinese and international research across these dimensions.

Research on the definition of health tourism

Health tourism typically refers to individuals or groups traveling beyond their place of permanent residence—whether internationally or regionally—with the primary motivation of active health management or passive medical intervention. It relies on the deep integration of medical and tourism resources at the destination to provide comprehensive travel experiences that address full life-cycle goals, such as disease treatment and health promotion. The conceptual framework of wellness tourism consists primarily of two core branches: wellness tourism and medical tourism.

In the international academic community, health tourism has been defined from various perspectives, which can be summarized into three main approaches: 1) From the perspective of tourism purpose, health tourism emphasizes achieving a multidimensional balance of body, mind, and spirit through non-therapeutic methods—such as hydrotherapy, meditation, and natural therapies—characterized by functional enhancement and cultural experiences.[1,2] 2) In terms of service content, health tourism typically involves low technical complexity, a strong experiential component, and a reliance on natural and cultural resources.[3] 3) From the supply and demand perspective, health tourism is viewed as an outbound consumer behavior that addresses global disparities in healthcare access. It aims to meet individuals’ diverse health-related needs—such as prevention, diagnosis, treatment, rehabilitation, and relaxation—in destinations outside their usual place of residence.[4,5]

In contrast, there is no unified definition of health tourism in Chinese academia. Four theoretical frameworks have emerged: 1) The functional perspective focuses on the multiple objectives of health tourism—such as rehabilitation, health preservation, and mental adjustment—guided by the use of ecological resources.[6] 2) The technological perspective highlights the application of modern medical technologies, rehabilitation equipment, and smart health tools in service delivery, reflecting the theme of “technology empowerment.”[7] 3) The systems theory perspective views health tourism as a complex, integrated system involving multiple industries. It brings together service modules such as physical examinations, diagnosis and treatment, psychological support, and leisure activities to support holistic health management across the life course.[8] 4) The demand theory perspective is based on consumer behavior. It is primarily motivated by the need to prevent physical and psychological illnesses.[9]

Research on health tourism types

In the international academic community, scholars typically classify health tourism systematically based on factors such as functional attributes, ethical controversy, and travel duration [see Table 1 for details]. This classification approach helps clarify the connotations and heterogeneous nature of health tourism and provides a foundation for building theoretical frameworks and informing policy development.

Table 1.

Academic classification of health tourism types in international research

Classification Criteria		Type		Typical Products		Reference
Functional Attributes		Preventive & Wellness		Balneotherapy		[10]
				SPA Tourism		[11]
		Clinical Treatment		Cosmetic Surgery Tourism		[12]
				Dental Tourism		[13]
		Life Intervention		Stem Cell Therapy Tourism		[14]
				Gender Reassignment Tourism		[15]
Ethical Controversy		Low Controversy		Weight Loss Tourism		[14]
				Health Check-up Tourism		[13]
		Moderate Controversy		Cosmetic Surgery Tourism		[12]
				Commercial Surrogacy Tourism (Legal in Some Countries)		[15]
		High Controversy		Organ Trade Tourism		[15]
Travel Duration		Short-term		Treatment-focused Travel		[16]
		Long-term		Relocation Travel		[16]
				Treatment-phase Travel
				Rehabilitation-phase Travel

In contrast, the Chinese academic community has not yet established a unified standard for classifying health tourism types, but various exploratory approaches have emerged. One example is the “two-part method,” which centers on tourists’ level of initiative and divides health tourism into two categories: a) Active pursuit, involving proactive engagement in physical and mental well-being; and b) Passive pursuit, referring to the acceptance of services due to illness or specific needs.[17] Another approach is the “three-part method,” which classifies health tourism based on service content or treatment orientation. Commonly, this includes health tourism, medical tourism, and wellness tourism.[18] A “four-part method” classifies health tourism by service mode or travel motivation, breaking it down into demand motivation, service content, resource attributes, and functional objectives. This multifaceted system reflects not only the complexity of health tourism in both theory and practice but also the field’s adaptive response to increasingly diverse services and consumer preferences.

Research on health tourism motivation

According to international research, the motivations for health tourism can be systematically categorized into three levels based on the “push-pull theory” and the multidimensional driving model. Push factors reflect the internal motivations of tourists, such as the desire for health improvement, psychological adjustment, and social identity. Psychological needs also play a significant role in driving travel.[19] Additionally, health tourism may serve as a platform for social interaction or identity expression,[20] highlighting its symbolic social function. In contrast, pull factors emphasize the external appeal of the destination, including natural resources, technological capabilities, transportation convenience, and cultural richness. Lastly, structural drivers capture macro-level institutional influences and supply-demand dynamics. Origin countries may face medical resource shortages or inconsistent service quality, prompting outbound travel,[10] while destination countries capitalize on advantages such as strong branding, international promotion, and service innovation to attract global health tourists and drive the transnational flow of health tourism.[21]

On this basis, Chinese scholars have proposed a localized expansion model of health tourism motivation, shaped by the country’s unique social structure and cultural context. The model comprises four main dimensions: 1) The individual’s internal drive, focused on health improvement, psychological balance, and self-realization[17,22,23]; 2) The destination’s appeal, characterized by natural ecology, human resources, and medical services[24,25,26]; 3) The social and cultural mechanisms, rooted in the concepts of “relationship society” and “cultural identity,” which highlight the influence of social ties and identity on travel decisions[17,26,27]; 4) The institutional dimension, involving government policy guidance and coordinated industry development, reflecting the role of systemic and structural factors with distinct Chinese characteristics.[22]

Research on factors influencing health tourism

In the international academic community, research on the development of health tourism generally revolves around six key dimensions: economy, policy, culture, service, marketing, and accessibility. Economic factors, such as travel expenses and the ability to pay, directly influence tourists’ choices.[28] Policy factors emphasize institutional support, including mechanisms like medical visas and cross-border insurance.[28] Cultural considerations—such as religious beliefs, health perceptions, and cultural adaptability—also play an important role.[29] Service-related factors focus on improving the quality and standardization of medical care, along with certification systems.[30] Marketing factors involve brand-building and media outreach,[30] while accessibility encompasses transportation convenience,[31] geographic location,[30] and immigration policies.[28] Together, these factors shape the capacity and competitiveness of cross-border health tourism and its adaptability within the global market landscape.

In contrast, Chinese academic research tends to prioritize national development strategies and regional resource planning. Scholars in China highlight three key dimensions influencing health tourism: macro-environment, market demand, and supply guarantee. Macro-environmental factors include policy support,[32] socio-economic development,[33] and rising public health awareness.[34] Market demand reflects growing trends such as health consumption upgrades,[27] population aging,[34] and changing lifestyles.[35] Supply-side guarantees emphasize the construction of service systems, encompassing the allocation of ecological resources,[36] the development of health-related products,[37] and technological and talent support.[35] This approach embodies a strategic framework centered on the “policy–market–supply” model, reflecting China’s emphasis on aligning health tourism development with national priorities and localized implementation.

Research on health tourism evaluation

The evaluation of health tourism in the international academic community primarily focuses on three key areas: evaluation models, evaluation methods, and evaluation dimensions. Jeong proposed evaluating health tourism quality based on four elements: effectiveness, value, professionalism, and sustainability.[38] Regarding evaluation methods, Ghasemi employed a combined fuzzy SWARA-PROMETHEE method to rank eight health tourism destinations by priority.[39] Lopes used a multi-criteria decision-making (MCDM) approach, integrating the PROMETHEE method and GAIA (Geometrical Analysis for Interactive Aid), to construct a comprehensive evaluation system for hot spring spa destinations.[2] In addition, Park analyzed the relationship between health-related dimensions and tourists’ willingness to revisit using multivariate regression analysis.[40] For evaluation dimensions, Voigt proposed six aspects: self-transcendence, physical health and appearance improvement, escape and rest, enhancement of social relationships and novel experiences, self-esteem building, and physical and mental indulgence.[41]

In contrast, Chinese scholars focus more on quantitative evaluation. Researchers commonly employ methods such as policy text quantitative analysis, CiteSpace-based visualization analysis, and SWOT analysis. Health tourism is highly policy-sensitive, making it a common focus in Chinese academic research to study policy impacts on this sector. A comparison of the two is shown in Table 2.

Table 2.

Comparative analysis of health tourism evaluation: International vs. Chinese academic focus

Evaluation Content		International Research Focus		Chinese Research Focus
Evaluation Models		Quality evaluation based on four elements: effectiveness, value, professionalism, and sustainability.[38]		Quantitative evaluation criteria, including health tourism policy effectiveness, health tourism policy objectives, and health tourism policy measures.[42]
Evaluation Methods		Combined fuzzy SWARA-PROMETHEE method for destination ranking.[39] MCDM with PROMETHEE-GAIA approach.[2] Multivariate regression analysis.[40]		Policy Text Quantitative Analysis.[43] Visualization Analysis via CiteSpace.[44] SWOT quantitative analysis.[45]
Evaluation Dimensions		Six aspects: self-transcendence, physical health & appearance improvement, escape & rest, enhanced social relationships & novel experiences, self-esteem building, physical & mental indulgence.[41]		Resource evaluation, industry performance, policy effectiveness, brand value.[46,47,48]

Research on health tourism-related countermeasures

In the international academic community, scholars have proposed a range of multi-dimensional strategies aimed at promoting the sustainable development of health tourism, forming a comprehensive strategic framework. One key approach is the resource-driven strategy, which focuses on leveraging natural and ecological assets to enhance the added value of health tourism products.[49] The cultural empowerment strategy emphasizes improving cross-cultural service capabilities among practitioners and fostering trust among international tourists.[50] Branding and marketing strategies aim to establish global influence through localized promotion, personalized services, and the application of 4Ps marketing theory.[51] The differentiation and synergy strategy seeks to develop competitive advantages at both macro and micro levels—spanning services, talent cultivation, and international collaboration.[52,53] In addition, industrial cluster development and standardization policies highlight the importance of integrated resources and standardized systems to enhance service consistency.[54,55] The competitiveness enhancement strategy utilizes digital intelligence to improve service precision,[56] while the flexible coordination strategy advocates breaking away from rigid development models by dynamically tailoring services to resource conditions and individual needs, injecting adaptability and inclusiveness into the health tourism sector.[57]

In the Chinese context, the development of health tourism is driven by a holistic approach combining policy direction and systematic infrastructure planning. Foundational to this model is the strengthening of infrastructure, including comprehensive improvements in transportation, healthcare facilities, and digital service platforms.[58] The resource and industrial integration strategy promotes the combined value of natural landscapes, cultural assets, and modern medicine, supporting the creation of sanatorium hubs and signature tourism products to foster diversified industry clusters.[59] Product innovation is also central, with a focus on full life-cycle service offerings tailored to diverse demographic groups—ranging from leisure-based wellness and ecological healing to cultural health experiences.[60] Parallel efforts are made in talent development and standard system construction, enhancing the training of professionals and improving service quality.[61] At the market level, precision marketing and international cooperation are both prioritized to broaden service coverage and global presence. Finally, strong policy support and institutional mechanisms—including fiscal and land policy coordination, interdepartmental collaboration, and the development of a tourism destination rating system—lay the groundwork for building a sustainable and robust health tourism ecosystem.[62]

Discussion

This study shows that health tourism has emerged as a prominent topic of academic interest, both now and in the foreseeable future, drawing significant attention from scholars in China and abroad. Internationally, the academic community has developed a relatively mature theoretical framework and research tradition in this field, marked by increasing interdisciplinary integration. In China, researchers have accelerated their efforts, driven by supportive policies and strong cultural foundations, and have gradually established a theoretical system with distinct Chinese characteristics. While notable differences exist in research perspectives and methodologies between Chinese and international scholars, a shared understanding has been formed on several key issues (see Table 3 for details).

Table 3.

Comparative analysis between Chinese and International academic research

Chinese Academic Research		Research Similarities		International Research
1. Research Paradigm Emphasis on phenomenon description, experience summarization, policy analysis, local resource development. 2. Research Focus Emphasis on service integration, resource-oriented classification criteria, and policy guidance. 3. Research Depth and Progression Commenced in the Early 21st Century, and till now is exploration. Undergoing the Construction of Localized. Focusing on the industry. Convergence of “tourism+” and “+ tourism.”		1. Academic Viewpoints Recognizes the characteristics of industry convergence, acknowledges medical tourism as a subcategory of health tourism, and endorses the central role of service quality and resource endowment in health tourism. Development Drivers Differences in costs and premium for health service. Service transformation and technological innovation.		1. Research Paradigm Emphasize theoretical transplantation and innovative application. Utilizes quantitative and mixed-methods research, with a focus on developing measurement tools. Engages in cross-national comparisons and global value chain analysis, with attention to ethics and sustainable development. 2. Research Focus Emphasizes cross-border elements and systematized. Based on service attributes, highlights cultural adaptation and ethical risks. Infrastructure, service quality, and demand conditions. 3. Research Depth and Progression Commenced in the 1970s. A standardized evaluation system has been established. Theoretical systems have been formed in relevant academic disciplines.

Consensus and differences in research content

Chinese and international scholars generally focus on key themes in health tourism research, including the definition of its scope, classification of types, driving forces, influencing factors, and policy recommendations. A strong consensus has emerged on core issues such as the importance of industrial integration, resource endowments, and service quality. Medical tourism is widely regarded as a central component of health tourism.

International research, having developed earlier and on a more solid theoretical foundation, has led to the establishment of standardized analytical frameworks and evaluation systems. In contrast, Chinese scholars tend to be influenced by traditional medical concepts, emphasizing a holistic philosophy of “harmony between man and nature.” Their research is often more humanistic and philosophical, but it lacks a comprehensive standardized evaluation system, which still needs further development and refinement.

Regional differences in research focus

Research priorities differ across regions. International scholars often focus on individual-centered issues, such as tourist satisfaction, risk management, and ethical concerns—including cross-border reproductive tourism and transgender-related services. In contrast, Chinese research emphasizes localized development strategies, policy support, the utilization of local resources, and cultural heritage.

Similarities and differences in research methods

Methodologically, international scholars prioritize empirical, data-driven research. They frequently apply quantitative techniques such as behavioral scales, structural equation modeling, and cluster analysis to segment the health tourism market and validate theoretical models, thereby ensuring rigor and reproducibility. However, international research tends to be weaker in qualitative depth, often relying on surface-level case studies or descriptive analysis without probing deeper into underlying social and cultural dimensions.

Chinese researchers, faced with a less developed disciplinary foundation, have largely relied on descriptive qualitative approaches and policy document analysis in the early stages. While this helps illuminate macro-level policy trends and development strategies, it lacks the empirical rigor and data support needed to strengthen the credibility and applicability of the findings.

Suggestions for future research

To meet the growing demands of global health governance, industry transformation, and sustainable development, future studies need to focus on exploring the following directions:

First, theoretical deepening through interdisciplinary collaboration and localized theory building. Future research should aim to construct a health tourism theoretical framework that aligns with national realities. This involves integrating insights from ecology, ethics, and tourism geography to form a co-evolutionary model of “nature–society–health.” Such a model can help elucidate the dynamic relationship between resource development and ecological carrying capacity. Furthermore, combining this framework with tools from behavioral economics, neuroscience, and psychology will enable deeper exploration of the emotional drivers behind tourist decision-making, offering theoretical support for personalized service design and precision marketing.

Second, technological empowerment through digital transformation and research paradigm shifts. The rapid adoption of emerging technologies—such as artificial intelligence, the Internet of Things, and blockchain—is reshaping the field of health tourism. These tools support the creation of intelligent platforms for resource monitoring, dynamic demand forecasting, and health risk early warning systems. Meanwhile, immersive technologies like virtual reality enable innovative “cloud healing” experiences and cross-temporal, cross-regional service models.

Third, industrial collaboration to enhance governance and product innovation. To address the challenges in integrating medical care, wellness, and cultural tourism, research should focus on analyzing the collaborative dynamics among governments, businesses, communities, and tourists. A co-construction and co-governance model is needed to build an inclusive, multi-stakeholder governance system. In parallel, the development of integrated product offerings such as “Traditional Chinese Medicine +” and “Climate Therapy +” should be promoted. Personalized services powered by big data and health profiling can better meet diverse consumer needs. Establishing international certification systems and service quality standards will help align China’s health tourism sector with global practices and encourage cross-border cooperation in medical services.

Conclusion

In summary, health tourism has emerged as a globally prominent academic focus, with substantial theoretical insights and practical innovations laying a solid foundation for industry development. However, amid evolving health demands, demographic shifts, and the restructuring of global governance systems, the field must address three core challenges: fragmented research paradigms, the gap between theory and practice, and insufficient cross-cultural collaboration. To this end, we propose the following actionable steps: 1) Establish a Transnational Health Tourism Research Alliance. Create a global research consortium with leading institutions to regularly release joint studies and policy white papers. Develop an open-data platform for sharing policy evaluations, tourist behavior data, and industry innovation cases across nations. 2) Promote Translational Research Demonstration Projects. Collaboratively promote the selection of international health tourism demonstration zones to translate theoretical models into practical solutions. 3) Develop an Interdisciplinary Methodological Toolkit. Integrate digital technologies with traditional research methods. Create a Health Tourism Sustainability Index incorporating quantifiable metrics such as ecological carrying capacity and cultural inclusivity. We urge the global academic community to break down disciplinary barriers by fostering deeper integration of public health, tourism management, and data science. Adopt research accountability principles requiring all studies to include concrete translational plans beyond theoretical discussions. Establish a Global Health Tourism Observatory to monitor real-time impacts of climate change, pandemic trends, and other factors on the industry

Only through shared values, methodological innovation, and collaborative action can we transform health tourism research into an effective tool for advancing global health governance and promoting human well-being—this transcends industry development and underscores our collective commitment to building a healthy community with a shared future for mankind.

Informed consent statement

Informed consent was obtained from all subjects involved in the study.

Author’s contributions

LYR: Writing-original draft, Validation, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. ZHB: Writing-review and editing, Supervision, Resources, Project administration, Funding acquisition, Conceptualization. WHB: Writing-review and editing, Formal analysis, Conceptualization. YLN: Writing-review and editing, Conceptualization.

Data availability

The analyzed data are available from the authors upon reasonable request.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

This study was supported by the 2023 General Project of Jiangxi Province Think Tank Research, “Research on the Integrated Development of Traditional Chinese Medicine Culture and Ecotourism in Jiangxi” (23ZK31)