Health tourism

from Wikipedia, the free encyclopedia

Health tourism is an umbrella term for travel that focuses on medical treatment and health services. The purpose of the tourist stay is the physical as well as mental maintenance, stabilization and restoration of health . The spectrum of health-related and medical measures ranges from wellness and fitness to cure , rehabilitation and disease prevention to surgical interventions .

Due to demographic change, health tourism is experiencing increasing social and economic importance worldwide . The increasing life expectancy of the population combined with a decline in the birth rate is placing a particular burden on the health systems in the western industrialized countries . This is due to the fact that the number of contributors is decreasing and personal provision is therefore becoming increasingly important. But the increase in lifestyle diseases such as cardiovascular diseases and allergies also makes it probable that there will be an increased deductible towards health costs.

The World Tourism Organization (UNWTO) sees health tourism as an independent sub-area of tourism . As an interdisciplinary field , it is located at the interface between ecology , economics , sociology , medicine , psychology and geography .

Health tourism has established itself at various German universities and colleges , mostly as a sub-discipline of economic-tourism courses . At vocational schools there is the qualification of the assistant for health tourism .

Conceptual classification

In the course of the 9th National Health Industry Conference 2013 in Rostock, the following definition was coined in an expert forum: Health tourism is that branch of the health and tourism industry that contributes to the maintenance and restoration and well-being, especially when using medically sound services. The term includes other terms, such as health-oriented vacation, recreational tourism , spa and rehabilitation tourism , healthcare tourism , wellness and fitness tourism and patient and medical tourism . The distinctions between the various terms are not always clear.

Health tourism is made up of the terms “ health ” and “ tourism ”. The World Health Organization (WHO) defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity " ( "Health is a state of complete physical, mental and social well-being and not Merely the absence of disease or infirmity " ). The term tourism is often used synonymously with the term "tourism". According to the World Tourism Organization (UNWTO), a tourist stay occurs when the travelers spend the night in a place outside of their usual surroundings and stay there for leisure, business or other reasons for no longer than a year. Day tourists are therefore not included in this definition.

In summary, so-called health tourism includes staying away from home with the primary goal of promoting, maintaining or restoring one's own health. The use of health-related and medical services can take place in wellness and spa hotels, thermal baths, spa centers, health centers , rehabilitation clinics and acute hospitals . In addition to the non-indication-specific health promotion through exercise , nutrition and relaxation , other travel motives also include preventive measures , especially in the curative context of clinics and rehabilitation centers.

Basic motives in health tourism

The willingness of potential guests to do something preventive for their own health and then pay for it themselves will grow in the future. There are three basic motives for health tourists.

Basic motives in health tourism
  • On the one hand, this includes wellness . "Wellness is primarily defined as a restoration of the balance in life (Horx) that has been lost due to the acceleration trend and the increase in complexity". Wellness has meanwhile become a kind of health-conscious attitude towards life in which a balance of the three elements body, mind and soul is sought.
  • Another fundamental motive is prevention . Prevention as early detection and treatment of threatening diseases is divided into three areas (primary, secondary and tertiary prevention).
  • Cure & rehabilitation is seen as the third fundamental motive . The aim of rehabilitation is to regain health and fitness for work to the highest possible degree after total or partial loss of employment due to accident or illness.

Forms of health tourism

The segments of health tourism have not yet been subdivided or delimited uniformly, because the market is very diverse and is constantly creating new branches. The health tourism market is essentially divided into the sub-markets “medical tourism”, “prevention / rehabilitation tourism” (health resort tourism), “medical wellness (tourism)”, “health-oriented vacation” and “wellness tourism”.

There is some overlap between these forms of health tourism; the boundaries are partly fluid. The offers of the German spas and health resorts can be found in all sub-markets, even if they are mainly assigned to prevention / rehabilitation and wellness tourism.

Types of health tourism

Medical tourism

Medical tourism”, also known as “patient tourism” or “clinic tourism”, describes those forms of health tourism in which medical treatment and surgical interventions are used, primarily abroad . Here again, quality and cost-oriented manifestations can be differentiated according to the primary travel motives. In quality-oriented medical tourism, people from countries with lower medical standards travel to countries with higher standards in order to receive medical treatment there. Cost-oriented medical tourism describes the opposite phenomenon: people from countries with a high medical standard undergo medical treatment in countries with lower medical standards. Travel-triggering motives are possible cost savings and shortened waiting times. In addition to cross-border medical tourism, reference should also be made to medical treatment in one's own country away from home. The patient usually pays for the costs himself.

Preventive and rehabilitation tourism

The "preventive and rehabilitation tourism " describes the classic " spa tourism ", which mainly includes the offers of the spas and health resorts . According to the definitions of the German Spas Association (DHV) and the German Tourism Association (DTV), the medical cure, far away from the familiar home environment, includes "a complex, medically guided exercise treatment for pre- and post-operative care ( prevention and rehabilitation ) and a curative treatment for suitable chronic illnesses and ailments during certain phases in a longer course of illness . ”Since January 1, 2000, the term cure is no longer used in German law . It was replaced primarily by terms such as “preventive services in recognized health resorts” or “outpatient or inpatient rehabilitation measures.” In general usage , the stay at a health resort has remained due to its long history. Preventive and rehabilitation tourism is mostly prescribed by a doctor, and the costs are at least partially covered by the health insurance or pension insurance .

Medical wellness (tourism)

Medical wellness is a combination of tourist and medical-therapeutic 'wellness' services. The medical services are provided as a basis or in addition to wellness offers on a reputable basis. As a result, services and products that only deal with wellness or tourism without a medical aspect are not taken into account.

Health-oriented vacation

With a smooth transition from the more clinical-medical forms of travel, the medical aspect is now falling significantly in the health-oriented vacation segment (vacation with health-oriented orientation). The intensity here lies in the ostensibly tourist sense of actively “doing something for your health”. Here, health aspects such as B. exercise, sensible nutrition, relaxation, but in contrast to medical wellness and higher, maintaining or improving personal health is not the primary or sole motive for travel. The self-determined use of private vacation days and the individual choice of destination predominate in this type of travel, so that the suitable destinations must actively attract guests using modern marketing methods.

The research group Urlaub und Reisen eV (FUR) differentiates in this context

  • the "health vacation in the narrow sense",
  • "Fitness vacation" and
  • the "cure on vacation - vacation with spa treatments" as well
  • Wellness vacation

The latter should, however, represent a separate and therefore following category.

Wellness tourism

" Wellness tourism " is self-initiated and self-financed health promotion , for which fitness , personal hygiene , healthy nutrition, relaxation, meditation , mental and social activity / bonding are constitutive. Travel motives are your own well-being and the search for relaxation . According to Lanz Kaufmann, wellness tourism is defined “as the totality of relationships and phenomena that result from the journey and stay of people with the main motive of maintaining or promoting their health”. It goes on to say "The stay takes place in a specialized hotel with appropriate professional competence and individual support, whereby a comprehensive service package consisting of the following elements is offered and requested: physical fitness, healthy nutrition, relaxation, mental activity". The term “wellness” is not legally protected, which means that there are no generally applicable, uniform criteria for its definition. As a result, various quality labels have emerged in the field of wellness tourism , both from interest groups and tourist actors.

Influencing factors of the health tourism market

Health tourism in Germany is currently in an increasingly dynamic development. The development of a “new health tourism” is being pushed by four market drivers.

These are:

  • Change in values - increasing health awareness,
  • Demographic change - new target groups,
  • Change in framework conditions - open market structure and
  • Change in providers - innovations and cooperation.

Changing values ​​- increasing health awareness

The increasing social importance of health tourism is reflected in the increasing appreciation of personal health. Many people have the desire to “do something for their health” (travel motive of the annual travel analysis (RA)). The patients are no longer passive users of health care providers, but rather become active designers. Health knowledge is now no longer only available to medical specialists, but also to interested laypeople.

Health is seen as a pillar of a conscious lifestyle in which issues such as healthy eating, fitness, healthy lifestyles and disease prevention play an increasingly important role in life.

Demographic change - new target groups

Future health tourism will be increasingly influenced by demographic change. The general conditions of a vacation spot are becoming more and more important. Due to the shift in age structures , both structural accessibility and basic medical and therapeutic security at the holiday destination are necessary.

Furthermore, there are changed demands and needs. Primary prevention with regard to age-related complaints and loss of attractiveness is increasingly in demand. Despite increasing age or illness, you don't want to miss out on vacation. Health tourism offers of secondary prevention / tertiary prevention are therefore increasing .

Change in framework conditions - open market structure

Up to now, health tourism has primarily been determined by curative stays in rated health resorts and spas. Changes in the health system have also fundamentally changed the framework conditions for health tourism. Due to the withdrawal of the social security agencies, the previous market-defining, curse-focused providers across Germany are being encouraged to realign.

At the same time, there is the possibility that new providers will come onto the market. These not only participate in the previous health tourism market, but also shape it through innovative, target-group-specific offers and new sales channels. The market is therefore on the threshold of a "new health tourism". Some characteristics are already visible in some offers today. However, most of the development will probably only take place in the future.

Change in providers - innovations and cooperation

The range of offers in the health market is becoming ever larger and more specific. Cross-tourism provider cooperations open up new sales channels. In order to activate the innovation goal in health tourism, cooperation with medicine as well as medical and communication technology are important drivers. These drivers offer great innovation potential through topics such as hiking, cycling, and experiencing the landscape and nature.

Health tourism also has the task of optimally combining medicine and therapy with the existing tourist structures.

The "new health tourism" is in an early market phase. There is plenty of potential and niches for specializations for providers. It will depend on them whether the excellent opportunities can be converted into real demand and whether they can act competitively.

Historical classification and development of spas and health resorts

Life cycle of thermal spas

The discovery of thermal springs can now be traced back to the 14th century. From this discovery, health treatments gradually evolved. This led to the emergence of successful health destinations in the 18th and 19th centuries. The first German seaside resort Heiligendamm was founded in 1793 .

After the two world wars, thermal health resorts became increasingly insignificant. The infrastructure deteriorated towards the end of the 20th century. For a long time, thermal health resorts had a dusty image, which went hand in hand with the loss of attractiveness of many health resorts. However, revitalization measures at the beginning of the 21st century led to a renewed upswing.

Today's classification of spas and health resorts

The spas and health resorts can be divided into four categories:

  • Mineral and mud baths and places with medicinal spring spa operations,
  • Kneipp spas and Kneipp health resorts,
  • Climatic health resorts and climatic health resorts and
  • Maritime health spas and seaside resorts.

There are currently around 370 spas and health resorts in Germany. However, this is a constantly changing number.

The approx. 160 mineral and mud spas and places with medicinal spring spa operations form the largest section of spas and health resorts. You have local remedies of the soil such as healing waters , mineral and / or thermal springs, moors, peloids and healing gases. These are used as drinking cures , exercise baths, baths and spray baths, packs or inhalations.

With a number of around 70 Kneipp health baths and Kneipp health resorts , they form the second largest branch of health baths and health resorts in Germany. In contrast to the other pool sectors, there are no local remedies in the foreground. It is based on the holistic, spa therapeutic treatment concept ( Kneipp medicine ) according to Sebastian Kneipp . This consists of five elementary pillars: the medically recognized water healing methods, methods of living order, the effects of medicinal herbs as well as exercise and nutritional therapies.

There are 52 health resorts and climatic health resorts in Germany . These offer a constantly controlled, very high air quality. The climate, which serves as a natural remedy here, as well as the special air purity act through stimuli on the organism of the spa guest. At the same time, the forest acts as a natural filter. It ensures that the ozone content is kept low and that the heat load on the body is more balanced and less.

The smallest branch of the spas and health resorts in Germany are the 43 recognized sea spas and 50 seaside baths . They use the remedies of the sea, including the sea climate, sea water or sea silt. The spas are on the seashore or in the immediate vicinity. The climatic conditions are a very important factor. This climate is often referred to as the “maritime climate”.

Health tourism destinations and providers in health tourism

The health tourism destination offers a distinct bundle of services, which it presents as a clear core competence to the outside world, but is never solely dependent on a product or a target group.

The modern health destination is more than the sum of its individual businesses. It is a cluster of modern health and educational facilities, natural resources, sports facilities, cultural offerings, retail and gastronomy, accommodation and infrastructure.

The size of the destination can vary greatly in health tourism. In spa tourism, for example, an entire place or a larger part of the area forms a destination. The description of a limit is absolutely necessary for certification. Accordingly, the size of the destination is clearly defined here. A spa guest, on the other hand, does not necessarily define the health tourism destination according to the certification rules, but rather individually according to the experience.

"The boundaries of an experienced destination are usually not determined by the provider, but are defined by the perception of the guests."

There are a large number of providers in health tourism. These can be divided into different groups. Providers include spas and health resorts, sanatoriums, rehabilitation clinics and hospitals, but also medical wellness centers as well as (wellness) hotels and tour operators. Decisive for the choice of the provider is the concern of the health tourist.

Development trends in health tourism

Due to growing health awareness and as a result of demographic change, the possibility seems created that the demand in health tourism will increase in the next few years. In addition, it is not just about the fact that people are taking on more and more responsibility for their own health, but also that more and more companies are investing in the health of their employees. As a result, health is becoming increasingly important on vacation.

The “New Health Tourism” is still in its early stages, as tourism and the health industry are only just beginning to create synergies and use them systematically.

Overall, not all potentials and niches have been fully exploited so far. In order for this to succeed, many challenges still have to be mastered, such as B. the increasing competitive pressure or the question of sustainability in health tourism. But it should definitely be mentioned that health tourism will play an increasingly important role in everyone's life in the future.

literature

  • Reno Barth, Christian Werner: The wellness factor: modern quality management in health tourism. Relax-Verlag, Vienna 2005.
  • Waldemar Berg: Health tourism and wellness tourism. Oldenbourg Verlag, Munich 2008.
  • A. Brittner-Widmann: Structures and spatial distribution of wellness tourism in Germany. in Reuber / Schnell (Ed.): Postmodern leisure styles and spaces. Berlin 2006, pp. 291-301.
  • Matthias Buchholz: Health Tourism: Eastern Europe in System Change. From a traditional health resort to a modern health destination. In: Eastern Europe Economy. 54th year, 1–2 / 2009, p. 73.
  • Kerstin Böhm: Service quality in health tourism. Success factor for the German spas and health resorts. VDM Verlag, Saarbrücken 2007.
  • Manfred Cassens: Health Tourism and Tourist Destination Development. A textbook. Oldenbourg Verlag, Munich 2013.
  • DTV - Deutscher Tourismusverband eV: Wellness practice guide. Issue 27, Bonn 2002, p. 3.
  • W. Freyer, M. Naumann: Wellness from a tourism industry perspective. In: Postmodern Leisure Styles and Leisure Spaces. New offers in tourism. Volume 5, Berlin 2006, pp. 303-316.
  • Chuck Y. Gee, Eduardo Fayos-Solá: International Tourism: A Global Perspective. World Tourism Organization Education Network, Manoa et al. 1997.
  • Kirsten Hermes: Medical Wellness as an example of the adaptation of wellness concepts from the USA in Germany. Grin Verlag, Munich 2008, ISBN 978-3-640-18863-5 .
  • Hans Hopfinger: The geography of leisure and tourism: attempt to determine the location. In: Christoph Becker, Hans Hopfinger, Albrecht Steinecke: Geography of leisure and tourism: Balance and outlook. Oldenbourg Verlag, Munich 2003, p. 1ff.
  • Claude Kaspar: Health tourism is the trend. In: Claude Kaspar: Yearbook of the Swiss Tourism Industry. Institute for Tourism and Transport Economics, St. Gallen 1996, pp. 53–61.
  • Competence Center Health Tourism Schleswig-Holstein: Prevention-oriented health tourism in Schleswig-Holstein. Quality manual. Kiel (no year), p. 8.
  • Ramona Körber: Wellness as a new form of health tourism in traditional spas and health resorts. Volume 15, Tier 2002.
  • Eveline Lanz Kaufmann: Wellness Tourism. Decision-making bases for investments and quality improvements. FIF, Bern 2002.
  • Monika Rulle: Health Tourism in Europe: Development Trends and Diversification Strategies. Profil-Verlag, Munich 2008.
  • Monika Rulle, Wolfgang Hoffmann, Karin Kraft: Success strategies in health tourism: Analysis of the expectations and satisfaction of guests. Erich Schmidt, Berlin 2010.
  • Meike Sonnenschein: Medical Wellness & Co. Preventive health tourism in Germany. Changing supply and demand. Pro Business, Berlin 2009.
  • Melanie Smith, Laszlo Puczko: Health and Wellness Tourism. Amsterdam 2009.
  • Katrin Tams: Wellness ABC - information about wellness. Vista-Point-Verlag, Cologne 2012.

Web links

Individual evidence

  1. ^ Claude Kaspar: Health tourism in trend. In: Claude Kaspar: Yearbook of the Swiss Tourism Industry. Institute for Tourism and Transport Economics, St. Gallen, 1996, p. 55.
  2. ^ Manfred Cassens: Health Tourism and Tourist Destination Development. Oldenbourg Verlag, Munich 2013, p. 2.
  3. Monika Rulle, Wolfgang Hoffmann, Karin Kraft: Success strategies in health tourism: Analysis of the expectations and satisfaction of guests. Erich Schmidt, Berlin 2010, p. 1f.
  4. Kerstin Böhm: Service Quality in Health Tourism: Success Factor for German Spas. VDM Verlag, Saarbrücken 2007, p. 15.
  5. ^ Chuck Y. Gee, Eduardo Fayos-Solá: International Tourism: A Global Perspective. World Tourism Organization Education Network, Manoa et al., 1997, p. 381.
  6. Study of Health and Tourism Management BA Website of the Nürtingen-Geislingen University of Economics and Environment. Retrieved November 4, 2013.
  7. Conference report "9th National Industry Conference on the Health Industry 2013", p. 23 (link: http://www.bioconvalley.org/fileadmin/user_upload/Downloads/Branchenkonferenz/Konferenzbericht_web2013.pdf )
  8. Monika Rulle, Wolfgang Hoffmann, Karin Kraft: Success strategies in health tourism: Analysis of the expectations and satisfaction of guests. Erich Schmidt, Berlin 2010, p. 5.
  9. WHO Definition of Health ( Memento of the original from July 7, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . World Health Organization website. Retrieved November 4, 2013.  @1@ 2Template: Webachiv / IABot / www.who.int
  10. Hans Hopfinger: The geography of leisure and tourism: attempt to determine the location. In: Christoph Becker, Hans Hopfinger, Albrecht Steinecke: Geography of leisure and tourism: Balance and outlook. Oldenbourg Verlag, Munich 2003, p. 1.
  11. ^ Understanding Tourism: Basic Glossary . UNWTO website. Retrieved November 4, 2013.
  12. Kerstin Böhm: Service Quality in Health Tourism: Success Factor for German Spas. VDM Verlag, Saarbrücken 2007, Annex 1, p. 1.
  13. ^ Manfred Cassens: Health Tourism and Tourist Destination Development. Oldenbourg Verlag, Munich 2013, p. 128.
  14. ^ Meike Sonnenschein: Medical Wellness & Co .: the preventive health tourism in Germany. Pro Business, Berlin 2009, p. 17.
  15. Monika Rulle: The health tourism in Europe. 2nd Edition. Eichstätt 2004, p. 208.
  16. ^ Deutscher Tourismusverband eV (DTV): Practical Guide to Wellness. Issue 27, Bonn 2002, p. 3.
  17. See Walter Freyer, Michaela Naumann: Wellness from a tourism industry perspective. In: Paul Reuber, Peter Schnell (Ed.): Postmodern leisure styles and leisure spaces. New offers in tourism. Volume 5, Berlin 2006, pp. 303-316.
  18. M. Rulle, W. Hoffmann, K. Kraft: Success strategies in health tourism. Berlin 2010, p. 5f.
  19. Kerstin Böhm: Service Quality in Health Tourism: Success Factor for German Spas. VDM Verlag, Saarbrücken 2007, Annex 1, p. 4.
  20. Reno Barth, Christian Werner: The wellness factor: modern quality management in health tourism. Relax-Verlag, Vienna 2005, pp. 55–57.
  21. based on Melanie Smith, Laszlo Puczko: Health and Wellness Tourism. Amsterdam 2009.
  22. Monika Rulle, Wolfgang Hoffmann, Karin Kraft: Success strategies in health tourism: Analysis of the expectations and satisfaction of guests. Erich Schmidt, Berlin 2010, p. 6.
  23. Reno Barth, Christian Werner: The wellness factor: modern quality management in health tourism. Relax-Verlag, Vienna 2005, p. 45ff.
  24. ^ Manfred Cassens: Health Tourism and Tourist Destination Development. Oldenbourg Verlag, Munich 2013, p. 56.
  25. ^ Manfred Cassens: Health Tourism and Tourist Destination Development. Oldenbourg Verlag, Munich 2013, p. 56.
  26. Kerstin Böhm: Service Quality in Health Tourism: Success Factor for German Spas. VDM Verlag, Saarbrücken 2007, p. 5.
  27. Definition of terms - Quality standards for the rating of health resorts, recreation areas and healing fountains (PDF; 912 kB). Website of the German Spa Association. Retrieved November 4, 2013, p. 20.
  28. ^ Meike Sonnenschein: Medical Wellness & Co .: the preventive health tourism in Germany. Pro Business, Berlin, 2009, p. 31.
  29. Monika Rulle, Wolfgang Hoffmann, Karin Kraft: Success strategies in health tourism: Analysis of the expectations and satisfaction of guests. Erich Schmidt, Berlin 2010, p. 8.
  30. ^ DHV: Annual report of the German Spa Association e. V., 10/2007 to 10/2008, Bonn 2008, p. 18 ff., Link: http://www.deutscher-heilbaederverband.de/jahresbericht-des-DHV-2008-PDF-671925.pdf
  31. ^ J. Kagelmann, W. Kiefl: Health trips and health tourism - basics and lexicon . Munich 2016.
  32. M. Lohmann, D. Schmücker: Demand for health-oriented forms of vacation . In: Journal of Tourism Science . No. 7/2 , 2015, p. 5-18 .
  33. ^ J. Kagelmann, W. Kiefl: Health trips and health tourism - basics and lexicon . Munich 2016, p. 107 .
  34. M. Lohmann, D. Schmücker: Demand for health-oriented forms of vacation . In: Journal of Tourism Science . No. 7/2 , 2015, p. 11 .
  35. ^ Eveline Lanz Kaufmann: Wellness Tourism. Decision-making bases for investments and quality improvements. FIF, Bern, 2002, p. 2.
  36. Lanz Kaufmann (1999) quoted. according to Körber (2002), p. 25.
  37. ^ Katrin Tams: Wellness. Wellness ABC - information about wellness. Vista-Point-Verlag, Cologne 2012, p. 10.
  38. German wellness certificate with quality seal. (PDF; 475 kB). Website of the German Wellness Association. Retrieved November 4, 2013.
  39. IchZeit host. ( Memento of the original from August 19, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Rhineland-Palatinate Tourism website. Retrieved August 18, 2014.  @1@ 2Template: Webachiv / IABot / www.gastlandschaften.de
  40. Federal Ministry of Economics and Technology (ed.): Industry report: Innovative health tourism in Germany, Berlin 2011, p. 9.
  41. Competence Center Health Tourism Schleswig Holstein: Quality Handbook "Prevention-Oriented Health Tourism in Schleswig-Holstein, Kiel (no year), p. 8.
  42. Federal Ministry of Economics and Technology (ed.): Industry report: Innovative health tourism in Germany, Berlin 2011, p. 10.
  43. Federal Ministry of Economics and Technology (ed.): Industry report: Innovative health tourism in Germany, Berlin 2011, p. 9ff.
  44. Federal Ministry of Economics, Technology (ed.): Industry report: Innovative health tourism in Germany. Berlin 2011, p. 12.
  45. Federal Ministry of Economics, Technology (ed.): Industry report: Innovative health tourism in Germany. Berlin 2011, p. 12ff.
  46. Federal Ministry of Economics, Technology (ed.): Industry report: Innovative health tourism in Germany. Berlin 2011, p. 12.
  47. Federal Ministry of Economics, Technology (ed.): Industry report: Innovative health tourism in Germany. Berlin 2011, p. 13.
  48. M. Rulle, K. Vos: Revitalization of traditional destinations: cultural heritage as the basis for modernization efforts in European health resorts. Lecture on the occasion of the DGT annual conference, Trier 2008, p. 3. (link: http://www.aguweb.de/fileadmin/docs/announcements/jahrestagung08/4-3_Rulle_Vos_Revitalisierung.pdf )
  49. ^ A. Brittner-Widmann: Structures and spatial distribution of wellness tourism in Germany. In: Reuber / Schnell (Ed.): Postmodern leisure styles and spaces. Berlin 2006, p. 293.
  50. ^ Matthias Buchholz: Health Tourism: Eastern Europe in System Change. From traditional health resort to modern health destination. In: Eastern European Economy. 54th year, 1–2 / 2009, p. 73.
  51. Monika Rulle: The health tourism in Europe. 2nd Edition. Eichstätt 2004, p. 43.
  52. Federal Ministry of Economics, Technology (ed.): Industry report: Innovative health tourism in Germany. Berlin 2011, p. 43.