Many hospitals are competing for survival in their service areas. Because of intense competition within markets, hospitals are developing strategies to differentiate themselves. One way to do so is to create a physical infrastructure and service environment that generate a positive impact on patient perceptions. The purpose of this study is to review the literature on servicescape (i.e., a total impression of a service encounter developed through the use of human senses) and its effects on service quality and patient outcomes in healthcare settings. Servicescape studies have taken place in various healthcare settings (i.e., teaching hospitals, dental clinics, outpatient clinics) in 10 countries. Although servicescape in healthcare settings is a rarely researched topic at both the national and international levels, research indicates a significant positive association between servicescape and patient perceptions, patient satisfaction, and patient emotions. In light of the increasing emphasis in quality and value-based purchasing initiatives on patient experience and outcomes, more servicescape research in healthcare settings is needed. This systematic review underscores this need and enhances the knowledge base in this area.

Purpose The purpose of this paper is to determine the relationships between the health tourists’ perceptions on decisive factors (i.e. experience, technological infrastructure, flight distance, legal and moral restrictions, touristic attractions, religious similarity, waiting time and price of health tourism) and Turkey as their choice of healthcare tourism destination. Design/methodology/approach The data for this empirical study were collected from 288 patients in Turkey, all of whom being health tourists from various countries. Descriptive statistics and Kruskal–Wallis difference tests were utilized for analyses. Findings Statistically significant differences were found among health tourists in regards to the geographical regions of their residence. These finding suggest that differences among health tourists in regards to the geographical regions of their residence contributed to the healthcare tourists’ behaviors and health tourism market segmentations in Turkey. Research limitations/implications Among the constraints of the study are the time and funding limitations coupled with the limitations on the scale development attempts in the health tourism literature and limitation and biases related to primary data collection. Despite all these limitations, by being the first study exploring the health tourism market segmentations in Turkey, this study contributes to the literature about the perceptions of health tourists and their reasons in choosing Turkey as a health tourism destination. Practical implications Determining the Turkey’s health tourism market segmentations will generate the positive effect on the target market which is currently heterogeneous for health tourism operators and intermediary institutions. Moreover, this knowledge would allow the target market to be divided into homogeneous groups, with different marketing mixes for each group. Homogenized groups exhibit unified purchasing behaviors for their needs. Therefore, it is very important for health tourism operators and intermediary institutions to know how the preferences of health tourists from different geographical regions vary. Originality/value The paper fulfills a need for advancing the knowledge on the decisive factors in determining Turkey as the health tourism destination by revealing perceptions of health tourists from various geographical regions. This information is very valuable for the Turkey’s healthcare tourism marketing managers who desire to implement the strategies to achieve competitive advantage in the global health tourism market.