Would you really recommend it? Antecedents of word-of-mouth in medical tourism

Medical tourism (MT) is a valuable component of many national service economies. Understanding the marketing and recruitment of MT patients is therefore an important consideration for MT providers. Research shows that word of mouth (WoM) remains the most important acquisition channel in this sector. Yet, there is only a limited understanding of antecedent factors behind a patient referral. We develop a framework for WoM, finding support for tourism factors, service quality and perceived value as key antecedents on WoM referrals. We further extend the MT literature by integrating a novel perspective on value creation that surfaces the experiences of frontline service providers for the first time. This paper incorporates two complementary studies, one with a focus on value creation, the other on perceived value. By combing the two in a mixed-methods approach, we emphasise the role of service delivery on WoM. Several implications can be drawn from the study's findings.