Monika Rulle

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					Expectations of Health Tourists in Germany
          – Delusions and Reality


                 Monika Rulle

      Ernst-Moritz-Arndt-University Greifswald
        Institute of Geography and Geology
            Agenda

 Framework of Health
  Tourism
 Central Research Questions
 Methods
 Results
 Conclusion


                     Prof. Dr. Monika Rulle   Budapest, 2 Sep., 2010
  FRAMEWORK      QUESTIONS                  METHODS          RESULTS


                      Health

„Health is a state of complete physical, mental
and social well-being and not merely the
absence of disease or infirmity”
                                                         (Constitution of
                                              World Health Organization,
                                                           22 July,1946)




                   Prof. Dr. Monika Rulle                 Budapest, 2 Sep., 2010
  FRAMEWORK      QUESTIONS                     METHODS                 RESULTS


               Health Tourism

“Tourism associated with travel to health spas
or resort destinations where the primary
purpose is to improve the traveller’s physical
well-being through a regimen of physical
exercise and therapy, dietary control, and
medical services relevant to health maintenance”
                                            ((UN) WTO: Gee, Fayos-Sola 1997, p. 381)


                   Prof. Dr. Monika Rulle                          Budapest, 2 Sep., 2010
          FRAMEWORK                      QUESTIONS                   METHODS                      RESULTS

                      Segments of Health Tourism

                                                                                                Tourism for med.
                           Cure                 Wellness             Medical Wellness
                                                                                                   treatments

    Influence of
                           High                    Low                     Partial                  Very High
orthodox medicine

  Regulations /       Defined by state                                                          Medical expertise /
                                           Different certificates     Less certificates
   certificates       regulation (law)                                                             certificates

Who is approved?        Destination         Destination / staff             Offer                Hospital / doctor

                      Town (part of a                               Rehabilitation clinic /
Type of destination                                Hotel                                          Hospital / hotel
                       town): “Bad”                                        hotel

     Payment          Health insurance            Private                  Private                    Private


                                           Prof. Dr. Monika Rulle                             Budapest, 2 Sep., 2010
      FRAMEWORK          QUESTIONS                   METHODS       RESULTS

     Background:
    Medical Wellness
 Offers for the prevention of
  specific diseases or for the
  general health promotion
 Providers: hotels,
  rehabilitation clinics, spa
  centres, thermal baths

Prerequisites for Medical Wellness:
 High quality of the services, medically trained staff
 Direct involvement or presence of medical practitioner

                            Prof. Dr. Monika Rulle             Budapest, 2 Sep., 2010
      FRAMEWORK         QUESTIONS                   METHODS       RESULTS

              Central Research Questions
 What kind of expectations do Germans have about a health
  vacation?

 To what extend are health guests satisfied with the offers in
  health tourism destinations?

       Generate a reliable database about the expectations of
       guests towards health vacations

       Develop indicators for a systematic development of
       health offers concerning prevention in Mecklenburg-
       Western Pomerania (M-WP)


                           Prof. Dr. Monika Rulle             Budapest, 2 Sep., 2010
FRAMEWORK     QUESTIONS                  METHODS        RESULTS

            Telephone Survey
                                    Period of Research:
                                     21 May until 13 June 2008

                                    Population:
                                     All persons living in Germany
                                     aged ≥14 with a permanent
                                     landline telephone

                                    Sample:
                                     randomly drawn,
                                     6.325 calls, 1.063 interviews
                                     (response: 17%)


                Prof. Dr. Monika Rulle              Budapest, 2 Sep., 2010
       FRAMEWORK        QUESTIONS                   METHODS       RESULTS

                         Guest Survey
 Period of Research:
  30 June until 16 November 2008

 Population:
  Tourists, using health offers during
  their stay in hotels, rehabilitation
  clinics, medical spa treatment
  centres and thermal baths in M-WP

 Sample:
  Draw because of screening question.
  2.222 contacts, 904 interviews
  (response: 40%)

                           Prof. Dr. Monika Rulle             Budapest, 2 Sep., 2010
     FRAMEWORK     QUESTIONS                  METHODS      RESULTS

                         Topics

 Term Medical Wellness
 Preferred season for travelling
 Destinations in Germany
 Duration and expenditure in health tourism:
  preferences vs. reality
 Importance of different offers


                     Prof. Dr. Monika Rulle             Budapest, 2 Sep., 2010
   FRAMEWORK    QUESTIONS                    METHODS      RESULTS

       Knowledge of Medical Wellness


Only 21.8 % of all Germans knew the term
Medical Wellness:

Women: 24.4 %                           Men: 19.1 %




                    Prof. Dr. Monika Rulle             Budapest, 2 Sep., 2010
FRAMEWORK                QUESTIONS                    METHODS         RESULTS

 Associations with Medical Wellness
                No associations Other
                     5.9 %      0.9 %
                    Hotels                             Wellbeing
                    6.4 %                               16.9 %


    Own initiative
       7.9 %

(Rehabilitation-)
     clinic                                                    Health in focus
     8.1 %                                                         16.8 %



           Holiday
            8.4 %

                                                        Medical
                         Cure                         attendance
                        12.0 %                           16.6 %


                             Prof. Dr. Monika Rulle                Budapest, 2 Sep., 2010
 FRAMEWORK            QUESTIONS                    METHODS      RESULTS

         Preferred Season for Travelling
             Season not
              important
               10.3%

    Winter
     8.5%
                                                             Spring
                                                             35.7%


Summer
 18.9%




                                                    Fall
                                                    26.6%

                          Prof. Dr. Monika Rulle             Budapest, 2 Sep., 2010
Preferred
Destination for a
Health Vacation




                    Prof. Dr. Monika Rulle   Budapest, 2 Sep., 2010
                  FRAMEWORK              QUESTIONS                          METHODS                      RESULTS

                           Preferred Duration of Travel
            60%
                                                                  Duration of travel for stay lasting 2 nights
                                  48.4                            Duration of travel for one-week stay
            50%


            40%
Share (%)




                                                                 30.5                 30.6
            30%
                                                          23.9                                               24.3

            20%
                    12.8                 12.4
                                                                                9.3
            10%
                                                                                                       5.6
                           2.2
            0%
                    Below 1.5 h   1.5 up to 3 h          3 up to 4.5 h         4.5 up to 6 h         6 h and more

                                                  Duration of travel (h)



                                                Prof. Dr. Monika Rulle                               Budapest, 2 Sep., 2010
 FRAMEWORK                      QUESTIONS                                 METHODS                             RESULTS

Real Duration of Travel (Accord. to Number of Nights)
  29 nights and more (n=31)                25.8                    32.3                 12.9           19.4          9.7

      22 to 28 nights (n=48)        12.5          16.7           22.9            10.4     12.5                25.0

    15 to 21 nights (n=352)         14.2            21.3             19.9           13.9        11.1           19.6

      11 to 14 nights (n=81)          14.8           14.8               28.4             11.1             27.2

       8 to 10 nights (n=54)         14.8                24.1             20.4            14.8                24.1

       5 to 7 nights (n=175)          14.9                  34.3                  14.9          13.7           19.4

        3 to 4 nights (n=89)                 27.0                         37.1                   15.7          9.0    6.7

        1 to 2 nights (n=38)           23.7                               52.6                         10.5 5.3 5.3

                               0%                 20%           40%               60%              80%                100%

                        less than 1.5 h                    1.5 to less than 3 h            3 to less than 4.5 h
                        4.5 to less than 6 h               6 to less than 7.5 h            7.5 h and more



                                       Prof. Dr. Monika Rulle                                           Budapest, 2 Sep., 2010
                           FRAMEWORK                          QUESTIONS                    METHODS                  RESULTS

                          Preferred max. Expenditure per Day / Person
(incl. Accommodation, Meals, and Treatments / Health Classes)

                                                                                            39.4
                             up to 100
                                                                                                            49.8


                                                                                                    45.8
                         100 up to 200
                                                                                             39.7
    Expenditure (Euro)




                                                           11.2
                         200 up to 300
                                                     8.7


                                               2.3
                         300 up to 400
                                             0.9


                                             1.3
                         400 and more
                                             0.9                                                    Male        Female


                                         0           10             20           30         40             50            60
                                                                               Share (%)



                                                                  Prof. Dr. Monika Rulle                         Budapest, 2 Sep., 2010
          FRAMEWORK                                      QUESTIONS                                          METHODS                               RESULTS

                       Real Expenditure per Day / Person
(incl. Accommodation, Meals, and Treatments / Health Classes)

   Rehabilitation clinic                                                  77,7                                                  6,2    7,0           5,9




                  Hotel         4,8          22,5                                  37,7                                  17,5         7,7            4,5




        Spa treatment
                                7,3              25,5                            23,6                             25,5                9,1          9,1
           centre




         Thermal bath                                45,9                                     16,2                   21,6             5,4         10,8



                           0%         10%         20%          30%         40%          50%           60%          70%          80%         90%          100%

      < 25 Euro                       25 until under 50 Euro         50 until under 100 Euro         100 until under 150 Euro     150 until under 200 Euro

      200 until under 250 Euro        250 until under 300 Euro       300 until under 350 Euro        ≥ 350 Euro                   Missing




                                                                 Prof. Dr. Monika Rulle                                                     Budapest, 2 Sep., 2010
              FRAMEWORK                                 QUESTIONS                     METHODS        RESULTS

                       Importance of Different Services
                              Kompetence of staff


                              Medical supervision


                   Accom. / offers under one roof


                       Attractive leisure time activ.

                                                                                                           very important
        Price reductions by the health insurance
                                                                                                           rather imp.
                                                                                                           medium imp.
          Medical surpervision after return home
                                                                                                           rather n. imp.
                                                                                                           not important
          Packages (accom., meals, treatments)


Leisure time activities for accompanying persons


 Further contact with the destination after the trip


 Information about destination after return home


                                                        0%         20%        40%     60%   80%     100%



                                                             Prof. Dr. Monika Rulle               Budapest, 2 Sep., 2010
                                                                    0.0   0.5      1.0       1.5         2.0

                                                       Massage
Willingness to pay for                   Schwimm. / Aquasports

health offers                                           Dancing
                                             Relaxation Methods
                                                     Gymnastics
0 = „No, would not like to pay for it“          Personal Trainer
1 = „Yes, would pay in part myself“               Med. check-up

2 = „Yes, would pay completely myself“            Thermal baths
                                                           Yoga
                                             Dietary Programme
                                                  Nordic Walking
                                                Cornary Training
                                                    Akupunkture
                                                      Mud packs
                                           Hot-Stone-treatments
                                                   Indiv. therapy…
                                                       Ayurveda
                                               Thalasso therapy
                                                     Kneipp cure
                                                 Algea treatment
                                                    Fasting cure
                                                  Rulle
                                 Prof. Dr. Monika Chalk treatment               Budapest, 2 Sep., 2010
                Three relevant target groups:
             Tourists interested in health tourism…
                    … younger                   … married               … generation
                          men                         women                   65plus
Preferred           4-star-hotel                4-star-hotel            (reha-) clinics
accommodation       (23.1 %)                    (23.3 %)                (22.8 %)


Expenditure per     100 until below             below 100 EUR           below 100 EUR
day                 200 ER (45.5 %)             (49.3 %)                (54.7 %)

                        Competent personell, accommodation and offers under one roof,
Importat criteria
                                       certified offers, package offers

Imortant criteria
                                                Reductions because
in comparison to
                    Leisure time acitivities    of credit points from   Medical supervision
other tartget
                                                the health insurance
groups


                                       Prof. Dr. Monika Rulle                 Budapest, 2 Sep., 2010
     FRAMEWORK      QUESTIONS                  METHODS      RESULTS

                     Conclusion
 Medical Wellness is overestimated in its
  importance
 Health tourism is possible all year around,
  however, less interest in winter
 1 day should not exceed the cost of 100 € (130 $)
  pro person / per day
 Medical advice is important
 Offers should be well evaluated: traditional offers
  are most interesting for guests
                      Prof. Dr. Monika Rulle             Budapest, 2 Sep., 2010
Thank You For Your Interest!
Contact

Prof. Dr. Monika Rulle

Institute of Geography and Geology
Ernst-Moritz-Arndt-University Greifswald
Germany
E-Mail: rulle@uni-greifswald.de




                              Prof. Dr. Monika Rulle   Budapest, 2 Sep., 2010
    RAHMEN                 ZIELE             METHODIK                    ERGEBNISSE


Präferenz der Unterkunft für Gesundheitsurlaub
                    8,2%           8,6%
            3,6%
                                                               5-Sterne-Hotel

                                                               4-Sterne-Hotel
                                                       20,3%
                                                               3-Sterne-Hotel
    19,0%
                                                               Pension

                                                               Ferienwohnung

                                                               Klinik (insbesondere
                                                               Rehaklinik)
                                                   9,0%        Andere

                                                               Beherbergungsform nicht
            20,7%                                              wichtig
                                       10,6%




                              Prof. Dr. Monika Rulle                      Budapest, 2 Sep., 2010
                       RAHMEN                          ZIELE                      METHODIK                                      ERGEBNISSE
                      Anwendungen oder Übernachtungen in
                              Rehabilitationsklinik
                       ≥75                  42,1                                15,8               10,5                           31,6



                    65 - 74              35,4                           15,2                14,6                               34,8



                    55 - 64                        49,3                                   14,0               9,6                      27,2
Alter (in Jahren)




                    45 - 54                 41,5                                   20,5                 7,3                       30,7



                    35 - 44                     45,7                                        25,0                     8,2                   21,2



                    25 - 34                        49,0                                     17,0               6,8                    27,2



                       ≤24                      46,5                                 13,5              8,4                        31,6


                              0%   10%     20%            30%       40%         50%              60%           70%          80%            90%         100%
ja, sowohl Anwendungen / Kurse als auch Übernachtungen           ja, aber nur Anwendungen bzw. Kurse         ja, aber nur Übernachtungen      nein, weder noch




                                                                Prof. Dr. Monika Rulle                                              Budapest, 2 Sep., 2010
              RAHMEN                            ZIELE                       METHODIK                            ERGEBNISSE

             Zufriedenheit mit Gesundheitsangeboten
                     Schwimmen / Aquasport                         35,6                                  27,4               3,5
                                  Massage(n)                         40,3                              14,0     3,0
                          Ärztliche Betreuung             20,6                 20,4              4,5
Erstellung e. indiv. Anwendungsprogramms             12,5               21,8             5,9
                         Gesundheits-Check             15,0               20,9            4,3
                                    Gymnastik            19,9                18,3          2,2
                     Entspannungsverfahren           13,5           11,0 1,7
             Moor- und Fangoanwendungen              12,4          11,2
    Nordic Walking od. Wandern unter Anl.           10,5       7,1
                       Herz-Kreislauftraining      7,5      7,5 2,3
                         Ernährungsberatung      4,9 7,5
                       Kneipp-Anwendungen        4,6 5,4
            Persönlicher Gesundheitstrainer     3,2 3,2
                           Thermalsolebäder     2,8 3,3
                    Heilkreide-Anwendungen      3,3
                        Algen-Anwendungen        4,4
                                     Thalasso   3,4
                                     Ayurveda   2,8
                                  Fastenkurse   2,1
                                        Yoga
                                   Akupunktur
                                      Tanzen
                    Hot-Stone-Anwendungen

                                                0%        10%         20%     30%          40%           50%          60%         70%   80%
                                                     Sehr zufrieden                Zufrieden                     Mittelmäßig
                                                     Eher nicht zufrieden          Überhaupt nicht zufrieden

                                                          Prof. Dr. Monika Rulle                                  Budapest, 2 Sep., 2010

				
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