Health Tourism in China: History
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Lina Zhong
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Rob Law
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Xiaonan Li
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Liyu Yang

Health tourism refers to domestic and international tourism for individuals to improve their health in order to achieve the purpose of treating individuals and protecting their well-being. The concept of health tourism evolved from medical tourism to health-care tourism, and to the concurrent health tourism.

  • health tourism
  • well-being
  • China

1. Introduction

Along with the outbreak of the novel coronavirus (COVID-19) pandemic, people have been paying more attention to health [1]. Consumers are more willing to pay attention to health risks, such as COVID-19-related health issues, and would like to participate more in health tourism. For example, a recent study [2] proved the moderating role of risk communication for health tourism to improve the physical and mental health of people affected by the COVID-19 pandemic. With the effective control of the pandemic in different countries and regions, the tourism industry may have more opportunities for health tourism development [3]. For instance, one recent study reflected the great needs of diversified provision of health tourism packages for different consumer groups [4]. As a result, it is expected that after the pandemic, tourists’ travel behavior may be changed [5], and the expected changes may require tourism destination organizations to be more responsible for the health concern of consumers [6]. Hence, a comprehensive overview of health tourism is conducive to explore current research gaps in order to identify future research directions and ultimately contribute to the development of the health tourism industry.
With the rapid development of health tourism, a number of studies have examined it [7]. Smith outlines some of the major lifestyle aspects affecting the health tourism sector (e.g., spas, health hotels, nursing homes, and medical facilities) in developed Western countries [8], and Smith and Puczkó conducted research on health tourism and balneology in Hungary [9]. India is considered a successful medical destination, where low-cost skilled labor, the latest medical technology, standards, and high-quality medical services exist simultaneously. Furthermore, India has an environment where English is widely used [10]. Specifically, India provides many different kinds of medical services, ranging from alternative treatments such as ayurvedic medicine and yoga to complicated procedures such as heart surgery, joint replacements, and hip resurfacing [11]. South Korea on the other hand enjoys a high reputation and competitiveness in providing minor treatments such as plastic surgery [12]. Using Bama longevity villages in China as a case study, Yan and He studied the co-evolution of therapeutic landscapes and health tourism through an actor-network perspective [13]. Kaoula and Bouchair adopted life cycle analysis to assess the environmental impact of different hotel buildings [14]. Nonetheless, with the intensification of aging and changes in people’s lifestyles, health tourism may face challenges in the future, although opportunities also exist simultaneously [15].

2. Health Tourism 

2.1. Types of Health Tourism

In terms of different types and characteristics of health tourism, rich classification systems were formed among academic researchers, such as tourists, products, and resources. From the perspective of tourists, health tourism can be divided into two types, the first type is active pursuit and the second one is passive realization, as with the current trend that an increasing number of people are paying more attention to their health and have actively pursued health tourism. Health products can be divided into two categories: one is medical-oriented (passive) and the other is health-oriented (active). Medical-oriented products mainly refer to medical tourism, whereas health-oriented products mainly include spiritual and religious tourism, yoga tourism, outdoor activities, sports and adventure, and volunteer tourism [16]. In terms of resource types, health tourism can be divided into health culture, religious experience, medical care, hot spring recuperation, forest recreation, and mountain fitness [17]. Different countries have different unique health tourism resources, such as spa tourism in Thailand, plastic surgery tourism in South Korea, and medicine tourism in China.
In addition, regarding function of health tourism, it can be divided into four types: medical maintenance such as medical tourism, leisure adjustment such as wellness tourism, physical enhancement such as sports tourism and self-realization such as adventure tourism [18]. Health tourism can be divided into three types: physical promotion, psychological promotion, and social adaptation [19]. From the perspective of satisfaction for health tourism, health tourism can be divided into three alternative types: restoring, continuing, and enriching health [20]. In summary, based on previous studies, different perspectives have been adopted to classify health tourism. Since the health tourism market has been continuing to grow, different types of health tourism may emerge. Thus, exploring the development of existing health tourism will be helpful to clarify its scope, products and types so as to predict the future development trends of health tourism.

2.2. Hotpots of Health Tourism in China

Table 1 summarizes the themes and hotpots of health tourism in China at different stages. During 1981–2005, there were few studies on health tourism, and no hot topic was identified, but various scattered topics started to gain attention from academic researchers. From 2006 to 2010, there were many studies relating to tourists. In this period, medical industry, ecotourism, forest tourism and rural tourism started to gain attention from academic researchers. From 2011 to 2015, academic researchers began to pay attention to the tourism environment. Topics such as international medical tourism, forest park, industry convergence became popular. From 2016 to 2021, policy-related research has become a hot topic, such as pilot zone, health care industry, and health town.
Table 1. Themes and hotpots.
Themes and Hotpots 1981–2005 2006–2010 2011–2015 2016–2021
Hotpots No Medical tourism, wellness tourism, health care, ecotourism, and tourists Travel, scenic areas, medical service and resources, tourism environment Chinese medicine, medical service, pilot zone, forest tourism, health and wellness tourism, and health care industry
Themes Medical tourism Medical tourism Chinese medical industry International medical tourism, Chinese medical tourism Chinese medicine, pilot zone
Wellness tourism Leisure health Ecotourism, Wellness tourism product Tourism resources Wellness culture
Health tourism Health tourism, tourism industry Health care Health management Health town
Forest tourism Forest bath Forest tourism Forest Park Forest tourism
Health and wellness tourism Health and wellness tourism Rural tourism Scenic areas, tourism environment Health and tourism industry
All-for-one tourism No Developed strategy Industry convergence Industrial development
Specifically, after the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003, health tourism has been continuously an object of attention. For example, Beijing proposed the “Happy Life and Healthy Tour”, Ningbo established a health tourism area, and Hangzhou launched health tourism from the perspective of humanistic care [21]. With the government’s vigorous advocacy of health tourism, an increasing number of academic papers started to carry out research related to health tourism. 2004 was the year that academic researchers regarded health tourism as the core research object [18]. The key word in the academic circles from 2014 to 2016 was “health service industry”. In 2016, the state council issued the “Outline of the ‘Healthy China 2030’ Plan” [22], which proposed the initiatives to improve the health service system [23]. In summary, after SARS, the Chinese government took leadership in proposing the development of health tourism, academic researchers following the pace then. With the deepening of health tourism-related research, currently, academics have devoted effort to proposing the concept of health service industry, supporting the government in formulating and introducing health service policies.
For health and wellness tourism research, the government first proposed the goal of developing health and wellness tourism. Since then, academic researchers have started to carry out relevant research. For example, in 2012, Panzhihua City first proposed the goal of building a “China Sunshine Health and Wellness Tourism City” [24], which officially opened the prelude to the development of the health and wellness tourism industry led by the Chinese government. In January 2016, the former China National Tourism Administration issued the “National Health and Wellness Tourism Demonstration Base” standard, proposing that health and wellness tourism should pay attention to the harmony of nature [23]. After that, the academic research hotspots turned to “health and wellness tourism industry” and “forest health”. Since then, academic research results have gradually supported the government in publishing the standards of health and wellness tourism demonstration bases and the definition of health and wellness tourism. The issuance also helps to standardize the academic research on health and wellness tourism, thereby urging the research on health and wellness tourism to develop a deeper level with more dimensions.
In terms of Chinese medicine tourism, in 2015, the state council issued “Several Opinions on Further Promoting Tourism Investment and Consumption”, with the purpose of preparing the launch of a batch of Chinese medicine health tourism demonstration products [25]. In 2016, the China National Tourism Administration and the State Administration of Traditional Chinese Medicine jointly issued the “Notice on the Establishment of National TCM Health Tourism Demonstration Zones (Bases and Projects)”, requesting to explore new concepts and new models for the development of traditional Chinese medicine health tourism [25]. Since then, “Chinese medicine” and “Chinese medicine health tourism” have become academic research hotspots in 2016.
In summary, the research process and the development of health tourism in China is shown in Figure 1. As shown in Figure 1, the first publication of health tourism in China is in 1981. At the beginning of the 21st century, health tourism entered a stage of rapid development. Under the guidance of policies, various types of health tourism have emerged, such as medical tourism, health tourism, forest tourism, and rural tourism. The development during this period paid more attention to the quantity. Starting from 2010, the government began to issue various health tourism standards to regulate the health tourism market, and academic researchers began to focus more on the quality of health tourism (e.g., service quality). In recent years, health tourism is in the stable stage. That is, with the government’s construction of a high-level international health tourism center, the academic field has begun to explore innovative models and paths for the development of health tourism.
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Figure 1. Research process of China’s health tourism.

This entry is adapted from the peer-reviewed paper 10.3390/su141610435

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