• Adrian Lubowiecki-Vikuk Kazimierz Wielki University in Bydgoszcz
  • Justyna Kurkowiak Medical University of Warsaw,
Keywords: Central and Eastern Europe, medical tourism, healthcare, medical tourism potential, Ward’s method


Medical tourism potential of CEE is currently not clearly identified due to the lack of data concerning the number of medical tourists in respective countries. The aim of the present study is to shed light on potential research topics in the field of medical tourism. A detailed analysis of scientific and consulting literature was used to identify the elements of medical tourism potential. The agglomerative clustering algorithm forms distinct groups of countries that are similar with regard to that potential. Creating the statistical synthetic measures allows one to construct the ranking of countries with respect to their potential regarding medical tourism. Four distinct groups of countries emerge from the cluster analysis. It was found that the countries from the European Union (EU), which are characterized by higher economic indicators, create similar clusters and take the highest positions in the ranking. Surprisingly, the price level is not the top criterion determining the position within the classification. The obtained results fill the gap in the field of medical tourism in CEE and have implications for further research related to medical tourism. This classification could be a useful tool for the various stakeholders interested in the development potential of medical tourism in this part of Europe


Global Peace Index: Measuring peace, its causes and its economics value. (2015). Report 34. Institute for Economics and Peace. Retrieved from

Beladi, H., Chao, Ch.-Ch., Ee, M. S., & Hollas, D. (2015). Medical tourism and health worker migration in developing countries. Economic Modelling, 46, 391–396. doi:10.1016/j.econmod.2014.12.045

Björnberg, A. (2016). Euro Health Consumer Index 2015. Report. Health Consumer Powerhouse Ltd., Täby. Retrieved from

Brazdil, P.B., & Soares, C. (2000). A comparison of ranking methods for classification algorithm selection. In: de Mántaras, R. & Plaza, E. (Eds.), Machine Learning: Proceedings of the 11th European Conference on Machine Learning ECML 2000. Springer, Berlin, pp. 63–74.

Connell, J. (2013). Contemporary medical tourism: Conceptualisation, culture and commodification. Tourism Management, 34, 1–13. doi:10.1016/j.tourman.2012.05.009

Crooks, V.A., Turner, L., Snyder, J., Johnston, R., & Kingsbury, P. (2011). Promoting medical tourism to India: Messages, images, and the marketing of international patient travel. Social Science & Medicine,72, 726–732. doi:10.1016/j.socscimed.2010.12.022

Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare. Official Journal of the European Union, 50(88), 45.

Eurostat. Statistics Explained (2015). Retrieved from,_2001,_2006_and_2011_(per_100_000_inhabitants)_YB15_bis.png

Fetscherin,M., & Stephano, R. M. (2016). The medical tourism index: Scale development and validation. Tourism Management, 52, 539–556. doi:10.1016/j.tourman.2015.08.010

Hellwig, Z. (1968). On the optimal choice of predictors. Study VI. In: Gostkowski, Z. (Ed.), Toward a system of quantitative indicators of components of human resources development. UNESCO, Paris, pp. 1–23.

Iordache, C., Ciochină, I., & Popa, R. (2013). Medical tourism – between the content and socio-economic development goals. Development strategies. Romanian Journal of Marketing, 1, 31–42.

Karmowska, G., & Marciniak, M. (2015). Spatial diversification of living standards in the former communist countries of Central and Eastern Europe and the Balkans. Comparative Economic Research,18(4), 123–138. doi:10.1515/cer-2015-0032

Kesar, O., & Rimac, K. (2011). Medical tourism development in Croatia. Zagreb International Review of Economics & Business,14(2), 107–134.

Kiss, K. (2015). The challenges of developing health tourism in the Balkans. Tourism, 63, 97–110.

Kukuła, K., & Bogocz, D. (2014). Zero unitarization method and its application in ranking research in agriculture. Economic and Regional Studies, 7(3), 5–13.

Langvinienė, N. (2014). Changing patterns in the health tourism services sector in Lithuania. Procedia - Social and Behavioral Sciences,156, 310–316. doi:10.1016/j.sbspro.2014.11.194

Lubowiecki-Vikuk, A., & Rab-Przybyłowicz, J. (2015). Wybrane aspekty funkcjonowania rynku turystyki medycznej w Polsce. Folia Turistica, 34, 85–107.

Lunt, N., Smith, R.D., Mannion, R., Green, S.T., Exworthy, M., Hanefeld, J., & et al. (2014). Implications for the NHS of inward and outward medical tourism: A policy and economic analysis using literature review and mixed-methods approaches. Health Services and Delivery Research, 2(2), 1–234. doi:10.3310/hsdr02020

Marinau, C., Csosz, I., Martin, S. C., & Ciolac, R. (2009). European experience in the field of health tourism, overview of the countries of Western Europe, Central and Eastern Europe. Management Agricol, 11(4), 279–288.

Rab-Przybyłowicz, J. (2016). Medical tourism: Theoretical considerations. Studia Periegetica, 2, 13–31.

Romaniuk P., & Szromek, A.R. (2016). The evolution of the health system outcomes in Central and Eastern Europe and their association with social, economic and political factors: An analysis of 25 years of transition. BMC Health Services Research, 16, 95. doi:10.1186/s12913-016-1344-3

Smith, M., & Puczkó, L. (2014).Health, tourism and hospitality: Wellness, spas and medical travel. 2nd ed. Routledge, London.

Smith, M., Puczkó, L., Michalkó, G., Kiss, K., & Sziva, I. (2016). Balkan wellbeing and health tourism study. Final Report. MetropolitanUniversity, Budapest. Retrieved from

Travel & Tourism Competitiveness Report. (2015). World Economic Forum, New York. Retrieved from

Treatment Abroad. (2015). Compare the cost of treatment abroad. Retrieved from

UNGEGN. (2016).East Central and South-East Europe Division. Retrieved from

Ward, J. H. (1963). Hierarchical Grouping to Optimize an Objective Function. Journal of the American Statistical Association, 58(301), 236–244.

WHO. (2015). Regional office for Europe. Retrieved from