i

Reasons behind people are going abroad for medical treatments

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Topic name: Survey on reasons behind people are going abroad for medical treatments.

Submitted To:
Dr. Md. Abdul Momen
Assistant Professor
Department of Business Administration
East West University

Submitted By:
Name ID

Shah Imtiaz Noor 2014-3-10-248

Md. Shawon Khan 2015-1-10-039
Md. Habibul Hoque Sani 2015-1-10-112
Md. Nahid Hasan 2015-1-10-116
Md. Mahadi Hasan 2015-2-10-121
Faridul Hasan 2015-1-10-041
Md. Jubayer Ahsan 2015-1-10-246

Date of Submission: 9th April 2019

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Letter of Transmittal
9th April 2019
Dr. Md. Abdul Momen
Assistant Professor of Marketing
Department of Business Administration
East West University, Dhaka
Subject: Reasons behind Bangladeshi people are going to aboard for medical treatment

Dear Sir,
With great veneration and humble approach, we are submitting our research paper on the topic
titled ‘Reason behind Bangladeshi people are going to aboard for medical treatment’ which I have
prepared to fulfil the requirement of course Marketing Research (MKT414). It was undoubtedly
an interesting opportunity for us to work on this assigned topic to enhance my knowledge. We
would like to thank you for giving us the opportunity to do the study. we tried our best to go deep
into the topic and make full use of my capabilities in completing the report meaningful, though,
there might have some mistakes. This research paper will definitely give us experience, which we
can be used in our professional life. We will be always available for any further query and to
answer any questions on this research paper oblige and thereby.
We sincerely hope that you will appreciate our effort and we would be thankful once again if you
please give your judicious advice on the effort.
Sincerely yours,

Name ID Signature

Shah Imtiaz Noor 2014-3-10-248 ...................................

Md. Shawon Khan 2015-1-10-039 ...................................

Md. Habibul Hoque Sani 2015-1-10-112 ...................................

Md. Nahid Hasan 2015-1-10-116 ...................................

Md. Mahadi Hasan 2015-2-10-121 ...................................

Faridul Hasan 2015-1-10-041 ...................................

Md. Jubayer Ahsan 2015-1-10-246 ..............................................

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Acknowledgement

Firstly, we would like to thank all mighty Allah who provides us knowledge, energy & skills to
get opportunities & to increase our knowledge & experience by completing this assignment.

We would like to express our gratitude and indebtedness to our honorable course instructor, Dr.
Md. Abdul Momen, Assistant Professor, Department of Business Administration, East West
University, with his inexhaustible guidance, valuable advice, continuous inspiration, constructive
criticism and generosity he helped us to carry out this report carefully.

We would also like to express our gratitude to the respondents who helped us to gather all the
necessity information by answering the questionnaire.

Finally, we would like to thank to all the group members that directly or helped us to provide and
accumulate all the necessity information for all the accomplishment of this report.
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Executive Summary

This report is about the determinants of the reason behind Bangladeshi people are going to aboard
for medical treatment. A significant number of the people are going to aboard for medical
treatment. While people are going to aboard, they are spending huge amount of money in order to
have better treatment and facilities, which are not available in Bangladesh Meanwhile foreign
country, are learning lots of foreign currency from Bangladeshi people. Main reason behind this
situation is not to have proper medication and service from local hospital and doctors. There are
many more sub factors which are friendly behaviour, clean environment, nearly same expenses,
and easy to go to neighbour country for medical treatment and there are many more reasons which
help to stimuli them to go to aboard. That is why in this paper we tried to find out the factors,
which affects people to go to aboard for medical treatment. We prepared a theoretical framework
using secondary journal and a graphical model from it. The independent variables we found those
are- psychological factors, social and societal factors. The dependent variables were people’s
perception and word of mouth. We have also prepared research question to bring out real
information about our topic 1. Does money matter to the people while they are going to aboard for
medical treatment? 2. Are Bangladeshi people getting quality medical treatment in Bangladesh?
3. Does social perception affect general people’s perception regarding foreign medical treatment?
4. Does situational factors affect general people’s perception towards foreign medical treatment?
From the research questions, null and alternate hypothesis were prepared. A questionnaire was
prepared and data was collected from 185 respondents. Collected data was reliable after omitting
a single question. We did descriptive analysis, regression analysis. We did ANOVA test,
correlation analysis among different independent variables and paired t-test for analysing
hypothesis. We did crosstab analysis between the variable age and gender, and between education
and smoking habit. Finally, we proposed some recommendation for the medical organizations,
which are located in Bangladesh to increase their medical support and facilities so that it can make
people happy, and they can be able to retain our people to take medical treatment from our own
institutions.
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TABLE OF CONTENTS

Chapter 01: Background of the Study ............................................................................................ 1

1.1 Introduction .......................................................................................................................... 1

1.2 Problem statement ................................................................................................................ 2

1.3 Objective ............................................................................................................................... 2

1.3.1 General Objective .......................................................................................................... 2

1.3.2 Specific Objectives ........................................................................................................ 3

1.4 Significance of the study ...................................................................................................... 3

1.4.1 Significance to research................................................................................................. 3

1.4.2 Practical Implication ...................................................................................................... 4

1.4.3 Practical Implication ...................................................................................................... 4

1.5 Conclusion ............................................................................................................................ 4

Chapter 02: Literature Review ....................................................................................................... 6

2.1 Introduction .......................................................................................................................... 6

2.2 Overall Industry Situation ..................................................................................................... 6

2.3 Independent and Dependent variables .................................................................................. 7

2.4 Theory and details of Independent variables ........................................................................ 7

2.5 Hypothesis .......................................................................................................................... 10

2.6 Conclusion .......................................................................................................................... 10

Chapter 03: Methodology ............................................................................................................ 11

3.1 Introduction ........................................................................................................................ 11

3.2 Data collection .................................................................................................................... 11

3.2.1 Primary sources ........................................................................................................... 11
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3.2.2 Secondary sources ........................................................................................................ 11

3.3 Analytical Model of Research ............................................................................................ 12

3.3.1 Verbal Model ................................................................................................................... 12

3.3.2 Graphical Model .............................................................................................................. 12

3.4 Mathematical Model of Research ....................................................................................... 13

3.4 Data Analysis ...................................................................................................................... 13

3.5 Findings .............................................................................................................................. 13

3.5.1 Exploratory Research ................................................................................................... 14

3.5.2 Qualitative Research .................................................................................................... 14

3.5.3 Data Obtain .................................................................................................................. 14

3.5.4 Sample area and sample size ....................................................................................... 14

3.6 Limitations of the Study ................................................................................................. 14

4.1 Demographic factor Analysis ............................................................................................. 15

4.2 Factor Analysis ................................................................................................................... 22

4.2.1 Correlation Matrix ....................................................................................................... 22

4.2.2 KMO &Barlett’s Test .................................................................................................. 23

4.2.3 Communalities............................................................................................................. 23

4.2.4 Total variance Explained ............................................................................................. 24

4.2.5 Component matrix ....................................................................................................... 26

4.2.7 Regression Analysis .................................................................................................... 29

4.2.12 Beta ................................................................................................................................ 32

Chapter 05: Recommendation ...................................................................................................... 33

References ..................................................................................................................................... 34

Appendix ....................................................................................................................................... 35
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Chapter 01: Background of the Study

1.1 Introduction:

Everyday people of Bangladesh are going to abroad for better medical treatment. They believe that
other countries medical service are much better than the Bangladesh. They are travelling to Indian,
Thailand, Singapore, USA and other countries for better medical treatment.

Bangladesh is faced with severe healthcare crisis and challenges due to its corrupt and expensive
healthcare system. Many Bangladeshi for the last two decades have been travelling overseas to
neighboring countries such as India, Thailand, and Singapore for medical treatment. The main
push factors for Bangladeshis to travel to India for medical treatment were non-availability of
specialized treatment, high cost, corruption, lack of medical expertise corruption and ethical
practice in Bangladesh. Further, the pull factors were experienced doctors and physicians, good
quality of nursing care (pre and post-surgery), low cost of surgery, and state of the art medical
technology, treatment and medical facilities in India, along with source of information from
relatives, which concurs with the emerging medical tourism literature.

A large number of Bangladeshi people are travelling abroad for better medical treatment and they
spend more than $2 billion annually on healthcare abroad. About 700,000 people go to abroad
every year for treatment spending US$ 3.5 billion due to lack of confidence on the local physicians
and poor diagnosis system. This also drainage hard-earned foreign currency at the same time
Bangladesh is becoming health tourism market for neighboring countries.

People suffering from various critical diseases mainly go to India, Singapore, Thailand and
Malaysia for treatment. Sources said India attracts the highest number of medical tourists from
Bangladesh while an estimated 425,000 patient travel to different south Asian countries for
treatment every year. (Daily Industry, 2018)

If our medical service are much higher or stable as foreigner country, hospital people will take
medical service from Bangladesh and economic growth will be high.
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1.2 Problem statement:

In this recent time, we have noticed that Bangladeshi people are extensively going to abroad for
medical treatment because people believe what they are expecting they are not getting that much
of medical treatment from Bangladeshi hospital. At the end, they bound to take the assistance from
the foreign country. Going abroad for medical treatment there are multiple reason behind it those
must have to find out. Moreover, Bangladeshi people have been earning more than before.
Bangladesh is going to be middle-income country whereas they are not having quality medical
treatment that moment they have started deciding to go to aboard for medical purpose. (Ahmed et
al., 2011)

The rate of going abroad for medical treatment increasing day by day. The study is based on the
independent and dependent factors which puss people to go abroad for medical treatment. This
approach examines the factors that influence people to go abroad for medical treatment. Much of
the investigation has been conducted on the medical condition in Bangladesh. If the causes of this
problem can be find out, Medical problem in Bangladesh can be minimized and retain patient in
Bangladesh. Therefore, from here we can understand that how much alarming news is that for
Bangladesh .This study will help in gaining insight into the factors influencing medical treatment
by learning practical knowledge and real life incidents, which are collected through our study to
make the research paper more informative. Moreover, this research paper is a great contribution
to enrich practical learning.

1.3 Objective:
1.3.1 General Objective:

The very first objective of the study is to prepare a research paper on the specified topic
implementing the knowledge that has been gathered over the semester at East West University-
Bangladesh from my honourable course supervisor Dr. Md. Abdul Momen. The primary object of
this project is to identify the reasons behind Bangladeshi peoples are going abroad for medical
treatment.
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1.3.2 Specific Objectives:

1. To identify the perspective of higher and lower income people about medical treatment.
2. To know how much people are reliable now on local medical services.
3. To know the challenges of taking medical service in Bangladesh.
4. Benefits or advantages oversees medical services.
5. To identify the positive and negative sides of local hospitals and services.
6. To know availability of medication in emergency time.
7. To know significant differences between Bangladeshi and oversees medical conditions.
8. Benefits they want in Bangladesh in medical services.

1.4 Significance of the study:

The study of factors influencing people to go abroad for their medical treatment. Nationals in
Bangladesh must try to describe the factors and analysis the factors because of improvement of
our medical sector. For standard of living with our economic growth, we must need to improve
quality of treatment.

1.4.1 Significance to research:

The rate of going abroad for medical treatment increasing day by day. The study is based on the
independent and dependent factors which puss people to go abroad for medical treatment. This
approach examines the factors that influence people to go abroad for medical treatment. Much of
the investigation has been conducted on the medical condition in Bangladesh. If the causes of this
problem can be find out, Medical problem in Bangladesh can be minimized and retain patient in
Bangladesh. Therefore, from here we can understand that how much alarming news is that for
Bangladesh .This study will help in gaining insight into the factors influencing medical treatment
by learning practical knowledge and real life incidents which are collected through our study to
make the research paper more informative. . Moreover, this research paper is a great contribution
to enrich practical learning.
 4

1.4.2 Practical Implication:

From our research future researcher who research something which is related with our study topic
they can use our study as secondary data. Students can use this research paper for academic
purposes. From our research decision maker can get knowledge about the practical situation of
Medical treatment. This research will help decision maker to learn the factors and consequences
that influencing to go abroad for medical treatment.

1.4.3 Practical Implication:

A recent estimate of Bangladesh Investment Development Authority, which was prepared using
the data of Health Bulletin 2012, says Bangladeshis spend $2.04 billion annually on healthcare
abroad. The amount is 1.94% of the country’s total GDP. Indian High Commission in Dhaka says
it issued 130,000 medical visas until October this year, which is double the figure registered over
the same period last year. In fiscal year 2015-16, India saw 460,000 inbound patients at its different
hospitals, according to Export of Health Services survey conducted by Directorate-General of
Commercial Intelligence and Statistics of India. Of them, 165,000 were from Bangladesh.
Interestingly, only around 58,000 medical visas were issued to Bangladeshi nationals then, the
survey reveals. Bangladesh then covered over 35% of the foreign patients and more than 50% of
the total revenue from medical tourism, making it the largest contributor to medical and health
tourism of India. Ahoy Bangladesh Limited, a medical value travel company based in India,
informed that they receive 300 to 400 patients applying for Indian medical visas a month. (Dhaka
tribute, 2017)

1.5 Conclusion:

Bangladesh must improve its own medical services. On an average 1,000 Bangladeshis go to India
daily to take treatment, Malaysia gets on an average 10,000 medical tourists every year.
Bangladeshis to travel to abroad for medical treatment causes of low cost of surgery, qualified
experienced doctors, quality of nursing care, non-availability of treatment in Bangladesh, an state
of the art medical facilities and treatment in abroad which concurs with literature. Therefore, the
government and the companies will have to take care of this issue. In this study, we try to findings
and show that the type of treatment sought determined the choice of destination and medical
treatment for Bangladeshi patients is dependent on cost of treatment. Hence, in order to keep
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Bangladeshi patients within the country and to properly develop the local healthcare sector,
Bangladesh should focus on a comparable quality healthcare package.
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Chapter 02: Literature Review

2.1 Introduction:

A literature review is a type of review article, which is a scholarly paper, which includes the current
knowledge including substantive findings, as well as theoretical and methodological contributions
to a particular topic. Literature review is mainly a background or a theoretical framework, which
helps to know more insight of particular topics as it analyzed previously by some other researchers.
In this literature review part, we will try to come up with point of view and some thoughts about
the reason behind people going abroad for medical treatment.

2.2 Overall Industry Situation:

Medical Tourism Industry is the one sector whose present is bright and future seems even brighter.
Asia one of the first regions in the world to promote medical tourism and has created a brand name
for itself for having affordable and high quality healthcare. Asia medical tourist number of arrivals
is expected to cross the figure of 10 Million numbers by 2015. Asia medical tourism market is
expected to double by 2015 from its current market in 2011. Out of 7 countries 3 countries
Thailand, India and Singapore is expected to control more than 80% market share in 2015.Thailand
is the leader in medical tourist arrivals holding more than 40% share in Asia medical tourist arrivals
in 2011. Its medical tourism market is also expected to be more than double by2015 from its current
market in 2011 In Bangladesh, there are plenty of Hospital/Medicals. They are serving treatment
with a certain vision. People of Dhaka city rather people of Bangladesh try to get best possible
treatment from the doctors to secure their lifestyle and stay deceases free. The number of local
hospitals are well enough to give good treatment to the people. There is a situation a situational
problem arises that, local medicals are not treating people sufficiently so that people are going
abroad for better treatment. It later causes lack of faith to their own country treatment process.
(S.S.ROSE MARY, 2014)
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2.3 Independent and Dependent variables:

Independent Variable:
1. Low confidence on local doctors and flawed diagnosis
2. Service quality of abroad increases Bangladeshi people interest to go abroad for medical
treatment
3. Human resources difference between Bangladesh and High income countries
4. Lack of internal sector knowledge and perceived value of aboard influence people to go
abroad for medical treatment
Dependent Variable:
1. People are going abroad for better treatment instead local treatment.

2.4 Theory and details of Independent variables:

“Low confidence on local doctors and flawed diagnosis”

In other countries of the Southeast Asia region are profiting from medical tourism but only
Bangladesh is not only lag behind but also loses patients to other countries. Patients are willing to
go abroad for medical treatment because of the higher perceived quality of the treatment, despite
the fact that the same treatment can be achieved more cost effectively within the country.Because
of the increased medical expenditure abroad, financial resources of the country are being regularly
diverted out of the economy. (Miller & West 2007; Medhekar & Newby 2011)

States that travel abroad for medical treatment is growing fast in the twenty first century due to
long waiting list, high healthcare cost and health insurance in developed countries; Due to lack of
professionalism and service quality people are ignoring local treatments and going abroad just to
get better quality treatments. Bangladesh not only losing Medical tourism facility but also their
own country patients.

More health care facilities are being set up in Bangladesh and established facilities are increasing
their capacities. Despite this, the rate of patients depending on foreign health care is increasing.

Ironically, while Bangladeshi patients are seeking treatment in Apollo Hospitals in India and Sri
Lanka, the Apollo Hospital in Dhaka is being underutilized and the hospital has had to lay off staff.
Another reason for such failure could be faulty marketing. Marketing of the high quality of local
 8

hospitals is very weak, whereas foreign countries are establishing their reputation in this sector.
(M. Z. Mamun & Syed Saad Andaleeb, 2011).

“Service quality of abroad increases Bangladeshi people interest to go abroad for medical
treatment”

One of the huge problem is lack of information about the current services provided by the local
hospitals. People are not just aware of the competitively priced service packages available.

For example, procedures like coronary bypass surgeries have been very successful in a number of
facilities like the National Heart Foundation and the Ibrahim Cardiac Hospital & Research Center.
More complex procedures like liver transplant is also available within the country. However,
general ignorance due to lack of information dissemination has led to patients moving to another
country for treatments When dealing with the health care system, the question of quality arises
instinctively.Proper policy for evaluation of the quality of the doctor’s treatment and nursing in
Bangladesh is absent.

Physician registration rarely updated and the patients cannot know no about physicians past record.
Furthermore, the licenses of physicians are revoked for misconduct.

Bangladesh Medical Association (BMA) is not so much interested in these activities and lack of
interest of the Ministry of Health allows hospitals and private practitioners to take advantage of
patients, where ethical malpractices go unchecked. (M. Z. Mamun, & S.SAndaleeb, 2011).

“Human resources difference between Bangladesh and High income countries”

Human resources are in very short supply in medical sector in low and middle-income countries
compared with high-income countries or with the skill requirements of a minimum package of
health interventions. Equally, serious concern is exist about the quality and productivity of the
health workforce in low-income countries. Among available strategies to address the problems,
expansion of the numbers of doctors and nurses through training is highly constrained. This is a
difficult issue involving the interplay of multiple factors and forces. (Hongoro & McPake, 2004).
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Globally medical tourism is one of the fastest growing and niche global health-care service
segments of the tourism industry. That is why a country should focus on Medical Tourism sector
by recruiting more professional physicians, nurses and providing better treatments. “History shows
that people will always be willing to travel in order to relieve pain, save money and expand their
levels of comfort (Stanley, 2010).
Collaboration among the professional associations, appropriate academic groups, and health care
institutions, with leadership from the ministry of the country, is essential to create best learning
environment for dissemination of knowledge for professional development of physicians (Patnaik,
2010)
Lack of Medical potentiality knowledge students are not focused on medical tourism so that is why
Hospitals are not getting skilful and potential physicians and nurses in their hospitals. People have
a little bit confusion that “Local treatments are not good as Foreign treatments” This is local
hospitals losing their own patients and foreign customers as well. Human resource management
functions that have been heavily involved in transactional activities for a long time tend to lack
systems, processes, and skills for delivering state-of-the-art traditional activities are unable to
contribute in the transformational arena. (Noe et al, 2003).

“Lack of internal sector knowledge and perceived value of aboard influence people to go
abroad for medical treatment”
In health sector, reform the role and core functions of the public sector shift from a primary focus
on the direct provision of personal health services to a more clearly articulated normative role.
Which is a combination of health needs assessment and surveillance, policy making, regulatory,
financing functions with the assurance of the delivery of quality persona l health services and
population based services. This shift creates shifts in roles and functions for other organizations in
the sector. (Johnson, 2000).
Combination between sectors, institutions, communities, organized interest groups, and
individuals is required for better health practices. To work in together in harmony and cooperation
based on the mutually agreed principles and objective is another way to be succeed.
Health sector reform is also an important policy agenda of Bangladesh. In the developing
countries, the key elements of Health sector reforms are the promotion of the private sector and
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private sector changes in the internal structure and operation of the public sector and changes in
the financing of health care.
Health systems operates in an environment of scarce resources, effective programs still need to be
justified in terms of economic efficiency, which can be demonstrated by means of cost-
effectiveness, cost-benefit, and cost-utility analysis. These types of economic evaluations all relate
costs to consequences, but differ in how consequences are measured: as health effects, in monetary
units, or in quality-adjusted life years, respectively. (Young, 2005).
Travelling overseas for medical care has historical roots, previously limited to elites from
developing countries to developed, when health care was inadequate or unavailable at home. Now
however, the direction of medical travel is changing towards developing countries and
globalization and increasing acceptance of health services as a market commodity have led to a
new trend. Organized medical tourism for fee-paying patients, regardless of citizenship, who shop
for health services overseas using new information sources, new agents to connect them to
providers, and inexpensive air travel to reach destination medical. (Pocock and Phua, 2011)

2.5 Hypothesis:
1. H1: Low confidence on local doctors and flawed diagnosis.
2. H2: Service quality of abroad increases Bangladeshi people interest to go abroad for
medical treatment
3. H3: Image, trust, enjoyment, familiarity and perceived value of aboard influence people to
go abroad for medical treatment.
4. H4: Human resources difference between Bangladesh and High income countries.

2.6 Conclusion:

As we see that, in our country there are expert physicians available. Medicals should focus in
medical tourism to welfare for the people as well as country. It is true that Bangladesh has
sufficient number of available physicians and nurses available, but patients are somehow not very
satisfied and they seek foreign doctors to treat themselves. It may be good for the particular patients
but going abroad is threat for the local human resources and frequent practice of it can be a huge
lose and can causes big problem and can be a cause of demotivation for medical students.
Therefore, we tried to come-up with the factors, which is mainly influence people going abroad
instead local treatments.
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Chapter 03: Methodology

3.1 Introduction:
Research design is defined as a framework of methods and techniques chosen by a researcher to
combine various components of research in a reasonably logical manner so that the research
problem is efficiently handled.
In this research paper, we will use two types of research design,

1. Exploratory
2. Descriptive
In exploratory research design, the researcher’s ideas and thoughts are key, as it is primarily
dependent on their personal inclination about a particular topic. Explanation about unexplored
aspects of a subject is provided along with details about what, how and why related to the
research questions.
In a descriptive research design, a researcher is solely interested in describing the situation or case
under his/her research study. It is a theory-based research design, which is created by gather,
analyses and presents collected data. By implementing an in-depth research design such as this, a
researcher can provide insights into the why and how of research.

3.2 Data collection:

In the definition of methodology of research, it is the mechanism that how to collect information
from different sources. There are two ways to collect data, one is Primary source and another one
is secondary sources for preparing a report. Here we will use both qualitative and quantitative data
to generate the factor, which is influence the patient going abroad for medical treatment. Our study
is based on both Primary and Secondary sources.

3.2.1 Primary sources:

Primary data will be collected throughout a survey of questionnaire of 200 respondents. We will
design our survey questionnaire by measuring psychological, social, community and societal
factors, which influence the patient and the reason behind to going abroad for medical treatment
3.2.2 Secondary sources:
Most of the secondary sources such as overall ideas, terms, variables and sub variables will be
collected from the hospital, patients who already takes medical treatment from abroad,
international journals and articles.
 12

3.3 Analytical Model of Research:

Analytical research is a specific type of research that involves critical thinking skills and the
evaluation of facts and information relative to the research being conducted. Analytical research
is conducted in a variety of ways including literary research, public opinion, scientific trials and
Meta-analysis.

We use three analytical model in our research, verbal model, graphical model and mathematical
model. This model shows the relationship between these dependent and independent variables,
which relationship are important for our research. Therefore, these three analytical models are
given below.

3.3.1 Verbal Model:

A verbal model is a model that allows for linguistic
rather than numerical variables, and for causal
relationships between the variables to be formulated
verbally rather than mathematically. Our main purpose
is to find out the dependent and independent variables
and find out the relationship among them through verbal
mode. Our independent variables are low confidence on
local treatment, service quality of abroad medicals,
human resource difference, and affordable cost and
dependable variable is going abroad for better treatment
instead local treatment.

3.3.2 Graphical Model:

A graphical model or probabilistic graphical model or structured probabilistic model is a
probabilistic model for which a graph expresses the conditional dependence structure between
random variables. They are commonly used in probability theory, statistics particularly Bayesian
statistics and machine learning.
Graphical model provides analysis of casual relationships between the variables. Here, our
graphical model will show the causal relationship between Independent variables and Dependent
variables.
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3.4 Mathematical Model of Research:

Bangladeshi People are going to aboard for medical treatment (Y), and

3.4 Data Analysis:

The data about the patients who get medical treatment to abroad will be collected through
Exploratory research (survey, pilot survey and interview) then go for Descriptive research (have
set profile, where we will get the data or information, so our profile will be doctor and the
patients) method social media and analyzed with help of various tools and techniques.

1. We will use descriptive frequencies to find out the demographic variables.

2. We will also do Correlation to find out relationship between independent variable.
3. We will use the crosstabs to find out the relationship of the demographic variables with the
dependent variable.
4. We will use Paired T test to find out the accuracy of the hypothesis to put forward by us.
In addition, we will apply qualitative research methods to find out the reason behind patients
going to abroad for treatment. We also give focus on depth (one to one) and focus group
combine with few responders. Some patients may not have proper education knowledge so it
will be hard to get information and cannot talk with patients or their guardian will not give
time to talk them maybe in hurry.
3.5 Findings
Research design is a framework or blueprint for conducting the marketing research project. I
have conducted both exploratory and conclusive research for this study. Two types of research
design:

1. Exploratory Research
2. Qualitative Research
3. Data obtain
4. Sample area and sample size
 14

3.5.1 Exploratory Research

In order to find the factors that responsible for people going abroad for medical treatment is
limited between higher and lower income people. We have done exploratory research to find out
the current scenario. This exploratory research helped us to determine the design and survey of
our research paper.
3.5.2 Qualitative Research

From qualitative research we have identified some relevant factors that may have influence on
taking medical treatment in abroad. We have identified some demographic profiles of customers;
those are gender, educational qualification and age.
Given the exploratory nature of some aspects of the object, we have identified cost, reliability
and economic classes.
3.5.3 Data Obtain
We have obtained primary data trough survey by using a structured questionnaire. We made a
questionnaire form as a tool for gathering data. The questionnaire form was prepared with the
reference international journals. In the first part of questionnaire are questions about demographic
information. In the later part there are questions about their preference of going abroad for medical
treatment and the reasons of choosing other country instead of Bangladesh.
3.5.4 Sample area and sample size

The research has conducted in a single cross section design. That means there will be only one
sample of respondents and information will obtain from this sample only once. We have gone to
200 respondents with one sample and will collect information with that sample only once. We
will try to collect information from Dhaka city, Mirpur in a convenience sampling method. Those
respondents will be the part of the population that is close to hand. We think for interactive, or
statistical analysis SPSS will be helpful for us. For better understanding we have deployed
percentage analysis, mean. Those will show raw steams of data into represent able information.

3.6 Limitations of the Study:

Limitations is in everywhere. Our research will be based on survey (primary and secondary
sources) and information. We may face many problem or the barriers, those are,
1. Patients may not give right information,
2. Hospital may not give the proper knowledge and the specific information about their service,
3. We cannot go abroad to take information about their (foreign) hospital service, and Time
limitations.
 15

Chapter 4: Analysis and Findings:

4.1 Demographic factor Analysis:

Demographic factor refer personal characteristics that are used to collect and evaluate data from
the mass population. Before concluding the research, we determined some demographic factors
based on Bangladesh perspective that are gender, age, marital status, education level.

Statistics

Age Education Income Last time I have

Gender Group Marital Status Level Range visited abroad for
N Valid 200 200 200 200 200 200
Missing 0 0 0 0 0 0

The following frequency table analyzes all the demographic data.

 16

Frequency Table:

Gender: The following pie chart shows that in the survey of 100% respondent where 59% was
male and 41% was female.

Gender

Cumulative
Frequency Percent Valid Percent Percent
Valid male 118 59.0 59.0 59.0

female 82 41.0 41.0 100.0

Total 200 100.0 100.0

 17

Age:

Age Group
Cumulative
Frequency Percent Valid Percent Percent
Valid 20 years or below 8 4.0 4.0 4.0

21-30 years 95 47.5 47.5 51.5

31-40 years 45 22.5 22.5 74.0
41-50 years 33 16.5 16.5 90.5
Above 50 years 19 9.5 9.5 100.0
Total 200 100.0 100.0

The pie chart shows the age range of respondents. As it can be seen that people of 21-30 ages are
occupying the major portion of the chart. Here 47.5% belongs to 21-30 years age are 22.5%
belongs to 31-40 years age, 16.5% belongs to 41-50 years, 4% belongs to 20 years or below and
rest of the 9.5% belong to above 56 years.
 18

Marital Status:
In our survey 49.5% respondent were unmarried, 50.5% respondent were married

Marital Status

Cumulative
Frequency Percent Valid Percent Percent
Valid Single 99 49.0 49.0 49.5
Married 101 50.5 50.5 100

Total 200 100.0 100.0

 19

Education:
For our survey, it is very important to know the education level of the respondent. Therefore, we
collect that information also. In our survey Bachelor Degree, completed respondent was 46%.
Whereas 20.5% completed HSC, 15% completed Master’s Degree, 9% completed SSC and rest
of the 3.5% completed Professional degree.

Education Level
Cumulative
Frequency Percent Valid Percent Percent
Valid SSC 18 9.0 9.0 9.0
HSC 41 20.5 20.5 29.5
Diploma 12 6.0 6.0 35.5
Bachelor Degree 92 46.0 46.0 81.5
master Degree 30 15.0 15.0 96.5
Professional Degree 7 3.5 3.5 100.0
Total 200 100.0 100.0

3.5%
9%

15%

20.5%

92%

6%
 20

Income Range: Here we can see that 34.5% of people earn less than 30000. 34% of people
earn 31000-50000, 23.5% of people 51000-100000 and rest of 8% earn above 100000

Income Range

Frequenc Percen Valid Cumulative

y t Percent Percent

Less than 70 35.0 35.0 35.0

Valid 30000
31000-50000 68 34.0 34.0 69.0

51000-100000 48 24.0 24.0 93.0

Above 14 7.0 7.0 100.0

100000
Total 200 100.0 100.0
 21

Last time visited abroad:

Here we asked a very specific question that for which disease the respondent visited abroad last
time. We found that 20% people visited for heart disease, 25% people for eye, 25% of people for
stomach and rest 30% for other diseases.

Last time I have visited abroad for

Frequency Percent Valid Percent Cumulative
Percent
Valid 1 40 20.0 20.0 20.0
2 50 25.0 25.0 45.0
3 50 25.0 25.0 70.0
4 60 30.0 30.0 100.0
Total 200 100.0 100.0
 22

4.2 Factor Analysis:

4.2.1 Correlation Matrix:

Correlation Matrix are determined by the squared multiple correlation of the variable itself and
with the other variables. With the correlation Matrix, we want to show the interrelationship among
all the dependent and independent variables.

Factor Analysis:
Correlation Matrix
TQ TQ3 TQ TQ SQ SQ SQ SQ5 CI1 CI2 CI5
2 4 5 2 3 4
Correlatio TQ 1.0 .415 .00 - .05 .10 .05 .209 - .03 .146
n 2 00 2 .02 4 7 6 .00 8
6 1
TQ .41 1.00 .06 .12 .05 .14 .02 .242 - - -.016
3 5 0 8 7 7 5 1 .04 .00
8 6
TQ .00 .068 1.0 .74 .46 .45 .31 .031 .24 .05 .070
4 2 00 6 7 9 4 3 1
TQ - .127 .74 1.0 .56 .46 .30 -.014 .26 .05 .156
5 .02 6 00 6 3 3 8 4
6
SQ .05 .057 .46 .56 1.0 .64 .35 -.063 .24 .06 .130
2 4 7 6 00 6 6 9 3
SQ .10 .145 .45 .46 .64 1.0 .38 -.031 .22 .05 .152
3 7 9 3 6 00 9 4 9
SQ .05 .021 .31 .30 .35 .38 1.0 .322 .23 .10 .286
4 6 4 3 6 9 00 0 7
SQ .20 .242 .03 - - - .32 1.00 - - .078
5 9 1 .01 .06 .03 2 0 .18 .20
4 3 1 8 7
CI - -.048 .24 .26 .24 .22 .23 -.188 1.0 .64 .390
1 .00 3 8 9 4 0 00 1
1
CI .03 -.006 .05 .05 .06 .05 .10 -.207 .64 1.0 .357
2 8 1 4 3 9 7 1 00
CI .14 -.016 .07 .15 .13 .15 .28 .078 .39 .35 1.00
5 6 0 6 0 2 6 0 7 0
 23

4.2.2 KMO &Barlett’s Test:

KMO &Barlett’s test plays an important role for accepting the sample adequacy. KMO describes
that the total no of respondent is adequate or not for the study. The range for KMO is 0 to 1. On
the other hand, Barlett’s test refers the respondent are significant or not. To find out the
significance level, a benchmark should be followed to get accurate result and it is done by
comparing with alpha value .05. If significance value less than .05 null hypotheses will be rejected
and if it is greater than .05 null hypothesis are accepted.

KMO and Bartlett's Test

Kaiser-Meyer-Olkin Measure of Sampling .679
Adequacy.
Bartlett's Test of Approx. Chi-Square 698.578
Sphericity Df 55
Sig. .000

Here the hypothesis is

H0: Total number of respondents is not significantly adequate for the study.

H1: Total number of respondents is significantly adequate for the study.

Since the value of significance level is, .000 is less than alpha value .05; therefore, the alternative
hypothesis is accepted which means that our respondent groups are significant and 67.9% adequate
for the research according to KMO measure of sampling Adequacy. We can continue our further
research with these respondent groups.

4.2.3 Communalities:

This is the proportion of each variable‘s variance that can be explained by the factors. The
Extraction value in the table represents which questions are not associated with the study. The
 24

highest range for extraction value is 1. It is better to have the greater value, which is very close to
1.

Communalities
Initial Extraction
TQ2 1.000 .698
TQ3 1.000 .728
TQ4 1.000 .669
TQ5 1.000 .724
SQ2 1.000 .662
SQ3 1.000 .614
SQ4 1.000 .732
SQ5 1.000 .781
CI1 1.000 .758
CI2 1.000 .769
CI5 1.000 .606
Extraction Method: Principal Component
Analysis.

Here we can see that, in the communalities table the extraction value of all components are less
than 1. In this phase we didn’t eliminated those components which are less than 0.5 rather we
primarily marked the components because there is a problem and kept for further analysis in a
broader extent.

4.2.4 Total variance Explained:

How many variables we really expect for our research is described by the total variance explained.
The total column of the total variance explained gives the eigenvalue, the % of variance column
 25

gives the ratio of the variance accounted for by each component in all of the Variables; the
cumulative % column gives the percentage of variance accounted for by the first 4 components to
the total variance.

Total Variance Explained

Initial Eigenvalues Extraction Sums of Rotation Sums of

Squared Loadings Squared Loadings
Component

Cumulativ

Cumulativ

Cumulativ
Variance

Variance

Variance
Total

Total

Total
% of

% of

% of
e%

e%

e%
1 3.2 29.432 29.432 3.238 29.432 29.432 2.866 26.050 26.050
38
2 1.8 16.540 45.972 1.819 16.540 45.972 2.017 18.334 44.384
19
3 1.5 14.259 60.231 1.568 14.259 60.231 1.475 13.411 57.796
68
4 1.1 10.139 70.370 1.115 10.139 70.370 1.383 12.575 70.370
15
5 .78 7.097 77.467
1
6 .64 5.823 83.291
1
7 .53 4.860 88.150
5
8 .41 3.745 91.896
2
9 .36 3.279 95.175
1
10 .32 2.920 98.095
1
11 .21 1.905 100.000
0
Extraction Method: Principal Component Analysis.
 26

In the total variance explained table, ideally, we should have 11 variables but initially we selected
4 variables which are greater than eigenvalue 1. Therefore, we considered these variables as the
factors of hiring employees that can explain 70.370 % of the total phenomenon.

4.2.5 Component matrix:

In case of component matrix, one component should be matched with only one variable. If it
does not happen then there must be some problem. The objective of component matrix is to
illustrate these problematic components to us so that we can eliminate them from our
questionnaire.

Component Matrix

Component

1 2 3 4
TQ2 .662
TQ3 .466 .496 .493
TQ4 .738
TQ5 .780
SQ2 .759
SQ3 .741
SQ4 .591 -.571
SQ5 .555 -.516
CI1 .551 -.638
CI2 -.717
CI5 .484
Extraction Method: Principal Component Analysis.

a. 4 components extracted.

Here, we have use the component matrix in order to find out the problematic variables of our
questionnaire and we have taken the suppress value absolute below 0.46. We can see that all the
components distributed in a scattered way. In many cases, one component is belonged in two
 27

variables. This situation is known as cross loading process. From the component matrix table still
we can‘t decide which components we should accept and which components we should eliminate
from our research questionnaire. To solve the problem again, we followed another statistical
procedure and that is Rotated Component matrix.

4.2.6 Rotated Component Matrix:

Rotated Component Matrix is used to eliminate problematic components from the questionnaire.
This process is done by Varimax method. By rotating the whole component matrix table
repeatedly, we conclude. The main purpose of this kind of rotation is to eliminate the most
problematic ones and keeping the most important ones, which can best describe the whole
phenomena. After using the rotation component matrix, we have found out some pairs of
variables to explain our Dependent variable.

Rotated Component Matrix

Component
1 2 3 4
TQ2 .820
TQ3 .841
TQ4 .815
TQ5 .847
SQ2 .807
SQ3 .762
SQ4 .715
SQ5 .814
CI1 .827
CI2 .863
CI5 .671
Extraction Method: Principal Component Analysis.
Rotation Method: Varimax with Kaiser
Normalization. A
a. Rotation converged in 5 iterations.
 28

From the rotated component matrix above, we found

TQ2,TQ3,TQ4,TQ5,SQ2,SQ3,SQ4,SQ5,CI1,CI2,CI5 items which belongs –
1. TQ2 Hospitals do not have enough specialized surgeons in Bangladesh.
2. TQ3: Hospitals do not have enough medical equipment such as dialysis machine and
others
3. TQ4: Pharmaceutical industries cannot maintain required medicine quality
4. TQ5: Required medicines are not always available in Bangladesh
5. SQ2: Ambulance services are not available (24/7)
6. SQ3: Nurses are not efficient in medical care.
7. SQ4: Hospitals environment is not neat and clean enough.
8. SQ5: Hospitals have lack of diagonal medical equipment such as ECG, X-RAY,ETT
9. CI1: Higher cost of medical treatment in private hospitals
10. CI2: Daily cost (Cabin charge, meal charge and others cost) is high in private hospitals
11. CI5: Repeated treatment for same diseases increase the cost of treatment

We have included these components in our research questionnaire and rest of the components has
been rejected in order to conduct an authentic research.

Component Transformation Matrix

Component 1 2 3 4

1 .879 .419 .087 .209

2 .245 -.785 .439 .362

3 -.386 .456 .678 .428

4 .133 -.001 .583 -.801

Extraction Method: Principal Component Analysis.

Rotation Method: Varimax with Kaiser Normalization.
 29

4.2.7 Regression Analysis:

Regression Analysis is a statistical process for estimating the relationships among variables.
Regression Analysis helps one understand how the typical value of the dependent variable changes
when any one of the independent variables is varied. It includes many techniques for modeling
and analyzing several variables. Here, we used Linear Regression to conduct the statistical study
for our research.

4.2.8 Linear Regression:

Linear Regression is the most basic type of regression and commonly used predictive
analysis.

Variables Entered/Removed

Variables Variables
Model Entered Removed Method
1 Factor_4, . Enter
Factor_3,
Factor_1,
Factor_2

a. Dependent Variable: Dependent Factor

b. All requested variables entered.

From the table above shows that our four independent variables remain exist that we
developed before conducting the survey.

4.2.9 Model Summary:

Model Summary table provides information about regression line’s ability to account for
the total variation in the dependent variable. It explains whether the independent
variables are able to judge the dependent variable or not. Model summary is comprised
with R, R Square, adjusted R Square and Std. Error of the Estimation. R square statistic
provides a measure of how well the model is fitting the actual data and variability in the
data that is explained by the model. It is a number between 0 to1. A number near 0
 30

represents a regression that doesn’t explain the variance in the dependent variable well
and a number close to 1 does explain the variance in the dependent variable that means
the observations are predicted exactly.

Model Summary

Adjusted R Std. Error of

Model R R Square Square the Estimate
1 .412a .170 .153 .42497
a. Predictors: (Constant), Factor_4, Factor_3, Factor_1,
Factor_2

4.2.10 ANOVA
Analysis of Variance (ANOVA) tests the hypothesis and is used to determine whether the
null hypothesis will be accepted or rejected.

ANOVAa

Sum of Mean
Model Squares df Square F Sig.
1 Regression 7.208 4 1.802 9.978 .000b
Residual 35.217 195 .181
Total 42.425 199
a. Dependent Variable: Dependent Factor
b. Predictors: (Constant), Factor_4, Factor_3, Factor_1, Factor_2

The F value of the test for the data is 9.978. The p-value associated with this F value is very small,
0.000 which is less than alpha value 0.05. The null hypothesis is rejected and our alternative
hypothesis that is independent variables have the exploratory power to explain the dependent
variable will be accepted. Here our hypothesis is,
H0: Independent variables don’t have the exploratory power to explain the dependent variable.
H1: Independent variables have the exploratory power to explain the dependent variable.
 31

So we reject the null hypothesis which indicate that independent variables do not have the
exploratory power to explain the dependent variable.

4.2.11 Coefficient:
Coefficient determines the specific relationship among the independent variables and dependent
variable. It exactly describes in which extent a specific factor can affect a dependent variable. In
this research we have three independent variables. Level of significance will determine the exact
variables for the study. The analysis of the result is described in the following:

Coefficients

Unstandardized Standardized
Coefficients Coefficients
Model B Std. Error Beta t Sig.
1 (Constant) 2.059 .348 5.920 .000
Factor_1 .124 .057 .145 2.180 .030
Factor_2 .070 .037 .131 1.870 .063
Factor_3 .067 .048 .094 1.376 .170
Factor_4 .270 .065 .285 4.171 .000
a. Dependent Variable: Dependent Factor

Hypothesis for all variables:

H0: Sponsored Ads, Native Ads, Crawling Ads and Wed Ads do not have any impact on
Consumers purchase intention.
H1: Sponsored Ads, Native Ads, Crawling Ads and Wed Ads have an impact on Consumers
purchase intention
 Factor 01: sig. value .030 > .05; H0 rejected
 Factor 02: sig. value .063 > .05; H0 accepted
 Factor 03: sig. value .000 < .05; H0 rejected
 Factor 04: sig. value .000 < .05; H0 rejected
 32

4.2.12 Beta:

Which variable quality issue or reliability issue that is the reason behind people are going abroad
for medical treatments instead local medicals will be determined by beta value. It explains the
probability of rejecting null hypothesis when the null is false the larger beta value insures the grater
impacts on dependent variable. Here, beta value of reliability factor .285 > Beta value .145 quality
factor. Since are reliability has larger beta value then quality factors there for it can be said that
“reliability upon local medical treatments” factors influence more on the reason why people are
going abroad for medical treatments instead local medicals.
 33

Chapter 05: Recommendation

So medical service in Bangladesh is day by day improving, but poor knowledge about Bangladesh
medical service is not getting success, but have to improve more in every way in medical service.
That is why we give some recommendation.

1. Have to establish more specialized hospital,

2. Appoint more specialized doctor,
3. Hire more skilled manpower (nurse and other medical stuff),
4. Improve medical infrastructure,
5. Use high medical equipment,
6. Establish more high quality diagnosis hospital,
7. Improve HRM policy in medical sector,
8. Establish more specialized hospital in every town and provide best medical service.
 34

References:
1. Daily Industry. )2018, October 8(. 700,000 Bangladeshis go abroad for health services
every year. Retrieved from http://www.dailyindustry.news/700000-bangladeshis-go-
abroad-health-services-every-year/

2. Ahmed, C., mustafiz, R., rahim, M., Torok, M., Buetow, S., Brothers, S., Jorgensen, P.
)2011(. World Medical Journal, 123)1327(. Retrieved from
http://www.nzma.org.nz/journal/123-1327/4469/ Mary, S., )2014(. Medical Tourism in
Asia, Volume. II

3. Anita M., & Newby L., )2011(. Information Search to Travel Abroad for Medical
Treatment,Volume 19

4. Mamun, M., Andaleeb, S., )2013(. International Journal of Health

5. Cornor M., )2012(. Outbound Medical Tourism: The Case of Bangladesh,Muhammad

Mahboob Ali, World Review of Business Research, Pp. 50 –
 35

Appendix:

“Survey on reasons behind people are going abroad for medical treatments”

Dear Valued Respondent,

You are invited to participate in this survey on reasons behind people are going abroad for medical
treatments. The purpose of this survey is to solicit views on quality performance of the
Bangladeshi hospitals and its relationship with customer satisfaction.
Please be assured that your identity will remain anonymous and your responses to the survey will
be hold in strictly confidence and used for academic purposes only. We do appreciate if you could
take a few minutes of your valuable time in completing this questionnaire. Your feedback is
important and will contribute towards enriching the knowledge and understanding of the survey
that identify the reasons behind people are going abroad for medical treatments. Thank you very
much for your time and cooperation.
Contact no:
+8801621516780
+8801727494530
Email: mahadi.04@yahoo.com
Section A: Respondent’s Demography

Please tick () in the appropriate space below.

1. Gender

[1] Male [2] Female

2. Age Group

[1] 20 years or below [2] 21 – 30 years

[3] 31 – 40 years [4] 41 – 50 years

[5] Above 50 years

3. Marital Status

[1] Single [2] Married

 36

4. Highest Educational Level

[1] SSC [2] HSC

[3] Diploma [4] Bachelor Degree

[5] Master Degree [6] Professional Degree

[7] Others, please specify………………………………....

5. Income Range – (Monthly)

[1] Less than 30000 [2] 31000 - 50000

[3] 51000 – 100000 [4] Above 1000000

6. Last time I have visited abroad for disease.

Section B: Treatment Quality

Please read carefully the statements below and show the extent to which you agree or
disagree with each statement. Using the scale below, please choose and circle the relative
items toindicate your answer, ranging from, 1= Strongly Disagree to 5= Strongly Agree.
Disagree

Disagree

Strongly
Strongly

Neutral

Agree

Agree
No. Description

1 Doctors are not giving enough time to patients for prescribing 1 2 3 4 5

medicines

2 Hospitals do not have enough specialized surgeons in 1 2 3 4 5

Bangladesh
3 Hospitals do not have enough medical equipment such as 1 2 3 4 5
dialysis machine and others

4 Pharmaceutical industries cannot maintain required medicine 1 2 3 4 5

quality

5 Required medicines are not always available in Bangladesh 1 2 3 4 5

 37

Section C: Service Quality:

Please read carefully the statements below and show the extent to which you agree or
disagree with each statement. Using the scale below, please choose and circle the relative
items toindicate your answer, ranging from, 1= Strongly Disagree to 5= Strongly Agree.

Disagree

Disagree
Strongly

Strongly
Neutral

Agree

Agree
No. Descriptio
n
1 Emergency services are not available (24/7) 1 2 3 4 5
2 Ambulance service is not always available
1 2 3 4 5
3 Nurses are not efficient in medical care
1 2 3 4 5
4 Hospitals environment is not neat and clean enough 1 2 3 4 5
5 Hospitals have lack of diagonal medical equipment such as
1 2 3 4 5
ECG, X-RAY, ETT

Section D: Cost Issue

Please read carefully the statements below and show the extent to which you agree or
disagree with each statement. Using the scale below, please choose and circle the relative
items toindicate your answer, ranging from, 1= Strongly Disagree to 5= Strongly Agree.
Disagree

Disagree
Strongly

Strongly
Neutral

Agree

Agree
No. Description

Higher cost of medical treatment in private hospitals

1 1 2 3 4 5
Daily cost (cabin charge, meal charge, and others cost)
2 1 2 3 4 5
is high in private hospitals.
Medicine cost is less in abroad than Bangladesh
3 1 2 3 4 5
4 Diagnosis cost is higher in Bangladesh 1 2 3 4 5
Repeated treatment for same diseases increase the cost of
5 1 2 3 4 5
treatment in Bangladesh
 38

Section E: Reliability Issue

Please read carefully the statements below and show the extent to which you agree or
disagree with each statement. Using the scale below, please choose and circle the relative
items to indicate your answer, ranging from 1= Strongly Disagree to 5= Strongly Agree.

Disagree

Disagree
Strongly

Strongly
Neutral

Agree

Agree
No. Description

1 Treatment in Bangladesh are not reliable to be cured. 1 2 3 4 5

2 Unavailability of emergency services. 1 2 3 4 5

3 Uncertainty in treatment of Intensive Care Unit (ICU) 1 2 3 4 5

4 Unreliability in doctor’s qualification 1 2 3 4 5

5 Addition of irrelevant medical cost 1 2 3 4 5

Section F: Main Factors

Please read carefully the statements below and show the extent to which you agree or
disagree with each statement. Using the scale below, please choose and circle the relative
items to indicate your answer, ranging from 1= Strongly Disagree to 5= Strongly Agree.

Disagree

Strongly
Neutral
Disagree
Strongly

Agree

Agree
NO. Description

Low quality equipment and infrastructures are responsible

1. 1 2 3 4 5
for taking medical treatment in abroad.
Higher cost of treatments in Bangladesh is responsible for
2. 1 2 3 4 5
taking medical treatment in abroad.
Low treatment quality in Bangladesh is responsible for
3. 1 2 3 4 5
taking medical treatment in abroad.
4. Poor service quality is responsible for taking medical
1 2 3 4 5
treatment in abroad.
Unreliability of treatment is responsible for taking medical
5. treatment in abroad. 1 2 3 4 5

“Thank you”