Background: Medical-tourism research has examined visit intention, satisfaction, and revisit behaviour, but rarely distinguishes treatment, destination, and provider decisions or how their influences vary over time. Purpose: This review synthesizes tourism research on how international patients decide to seek treatment abroad, select treatment, choose destinations, and trust providers. Methods: Following PRISMA 2020, Scopus, Web of Science, ScienceDirect, and PubMed/MEDLINE were searched for peer-reviewed empirical studies published from January 2020 to September 2026. Thirty-eight eligible studies published between 2020 and 2025 were included. Quality was appraised using MMAT, and findings were synthesized through iterative coding and best-fit framework synthesis. Findings: Evidence was predominantly quantitative and cross-sectional. Destination image, service quality, trust, and revisit intention dominated, while treatment choice was rarely primary. Domestic constraints, affordability, provider attributes, trust, and socially produced information shaped successive decisions. Originality: The review proposes a Medical Travel Decision Journey Framework linking decision objects, stages, and relational influences.
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Masa’Deh et al. (2026) studied this question.
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