There is a great need for more scientific research in the field of medical tourism, based on the common knowledge of both disciplines tourism and medicine. First there is neither an internationally agreed definition nor a common methodology for data collection. So the real impact of touristic and medical services both for the source and for the receiving countries is un-known and imprecise. Second the internal processes of the health system have to be adapted to the needs of international patients, e. g., medical fee schedule, billing, language, inter-cultural qualifications of the staff. Moreover the whole service chain has to be taken into account, especially the pre- and post-processes, which mostly start or end abroad. Here quality standards as well as accreditations are current issues. Furthermore, several sociocultural impacts need to be analysed, such as making health care less affordable for local patients and/or moral and ethical concerns about certain treatment methods. Another area concerns the legal questions of risk, liability and malpractice.

International students enrolled in the long term are considered habitual residents. They act as hosts to their friends and relatives, generating word-of-mouth recommendations and revisiting the host country. In order to facilitate inbound tourism in post-COVID-19 tourism, it is necessary to understand their risk perception, place image, and loyalty and provide meaningful insights for tourism markets. This study explores how social and personal risk perception of COVID-19 and cognitive and affective place image explain place loyalty. International students for degree programs comprised the sample population for this study. Findings revealed that social risk perception negatively shapes cognitive and affective place image, while personal risk perception only explains affective place image. Both cognitive and affective place image significantly affects place loyalty and mediates between social risk perception and place loyalty. The research provides new evidence on the risk perception of COVID-19, showing that internal factors such as social and personal risk perception may cause somewhat different results contrary to previous studies. Although gender moderates the relationship between cognitive place image and loyalty, the influence of gender on the theoretical and empirical relationships between risk perception, place image, and loyalty is not significant for international students. Implications for theory and practice, limitations, and future studies are discussed.

The study examined the comparative assessment of destination image according to the perception of COVID-19 and travel risk among international students. The online survey was administered to 786 international students enrolled in universities in Korea. Cluster analysis was performed, and three distinct clusters were identified based on risk perception. Destination image attributes were generated into four underlying dimensions: social environment, tourist environment, destination environment, and imagery, using the exploratory factor analysis. A revised Importance-Performance Analysis (IPA) method was utilized to assess the destination image of Korea and used to compare the expected performance of the attributes on each cluster. In addition, a revised IPA grid of each cluster was presented to unveil the satisfaction attributes of the destination image and suggest communication strategies. This study provides practical insights to destination marketers and organizations to design marketing strategies for international students. Further practical and theoretical implications are discussed.