title: When elders choose: Which factors could influence the decision-making among elderly in the selection of health tourism services?
abstract: BACKGROUND
  Elderly beneficiaries (age 65+) exhibit specific characteristics that influence the distribution of health tourism market. High incidence of multiple morbidities and functional disability are hallmarks in this age group. For these reasons, elderly population requires different elements and diverse spectrum of services within health tourism, in comparison to younger beneficiaries. Thus, differences would occur within heterogeneous elderly population itself. A preliminary study that we conducted showed that the level of functional independence was one of the significant factors that guided decision-making among elderly beneficiaries when it came to their health tourism-related choices. Results suggested that beneficiaries recognized and appreciated the effect of the natural remedies and attractions available at the given destination.
  
  
  OBJECTIVE
  Maritime and continental health tourism are two different entities commonly selected by elderly beneficiaries for therapeutic purposes. We propose that the climate conditions, geographical location and availability of regional natural remedies are the key factors to why different services were elected by different groups of elderly. The model of Croatia, an established country in the field of health tourism was utilized for this purpose. Differences in the diagnostic categories of beneficiaries are expected due to effects of marine (sea, Mediterranean climate) and continental (thermal water, healing mud) health tourism. In addition, multitudes of mutually intertwined factors affect decision-making process among elderly regarding their health tourism choices. Such factors include the scale of preferences (with special emphasis on well-being and health), leisure opportunities, marketing influences, cost (price) and the availability/diversity of health tourism services within the particular region. Moreover, individual psychosocial and physical characteristics, disabilities and other debilitating conditions, examined in our preliminary study, significantly contributed to the decision-making scheme. We shouldn't disregard sociodemographic and cultural preferences among elderly as potential factors.
  
  
  CONCLUSIONS
  Confirmation of our hypothesis could change the usual approach towards the group of elderly beneficiaries (65+) in the health tourism domain. This approach is often largely based on chronological age criteria exclusively. The contents of this manuscript could serve as a blueprint for the development of comprehensive and sustainable health tourism strategies worldwide.
authors.affiliation: Dr. Andrija Stampar Teaching Institute of Public Health, Reference Center of the Ministry of Health of the Republic of Croatia for Health Care of the Elderly, Mirogojska cesta 16, 10 000 Zagreb, Croatia. Electronic address: nada.tomasovic@du.t-com.hr.
authors.forename: N
authors.initials: N
authors.lastname: Tomasović Mrčela
authors.affiliation: University of Split, School of Medicine (MEFST), Šoltanska 2, 21 000 Split, Croatia. Electronic address: jborovac@mefst.hr.
authors.forename: J A
authors.initials: JA
authors.lastname: Borovac
authors.affiliation: University of Split, School of Medicine (MEFST), Department of Family Medicine, Šoltanska 2, 21 000 Split, Croatia. Electronic address: davorka.vrdoljak@mefst.hr.
authors.forename: D
authors.initials: D
authors.lastname: Vrdoljak
authors.affiliation: Clinic for Rheumatology, Physical Medicine and Rehabilitation, Clinical Hospital Center "Sisters of Mercy", Vinogradska cesta 29, 10 000 Zagreb, Croatia. Electronic address: simeon.grazio@zg.t-com.hr.
authors.forename: S
authors.initials: S
authors.lastname: Grazio
authors.affiliation: School of Health Science, DIU Libertas International University, Svetog Dominika 4, 20 000 Dubrovnik, Croatia. Electronic address: ana_tikvica@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Tikvica Luetić
authors.affiliation: Dr. Andrija Stampar Teaching Institute of Public Health, Reference Center of the Ministry of Health of the Republic of Croatia for Health Care of the Elderly, Mirogojska cesta 16, 10 000 Zagreb, Croatia. Electronic address: spomenka.tomek-roksandic@stampar.hr.
authors.forename: S
authors.initials: S
authors.lastname: Tomek-Roksandić
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001688:Biological Products / Q000627:therapeutic use; D002755:Choice Behavior; D015897:Comorbidity; D003657:Decision Making; D005260:Female; D005853:Geriatrics / Q000379:methods*; D006801:Humans; D008297:Male; D057193:Medical Tourism
chemical_list: D001688:Biological Products