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The main purpose of this chapter is to analyze the relationship between service innovation and experience creation in the context of spas, wellness and medical tourism. The objectives include providing an overview of service innovation theory and models and applying them to the spa, wellness and medical tourism sectors.

Primary research was undertaken with the purpose of identifying the most important elements in the experiences of spa and wellness guests and tourists. An online questionnaire was collected from 17 different types of spa and wellness facilities from 56 countries including all kinds of spa, wellness hotels, and retreats. Information given was based on three major demand segments: local customers, domestic tourists, and international tourists. A case study is also given of Pärnu hospital in Estonia, where innovative practices are being implemented to enhance the patient experience.

Findings suggested that some aspects of innovation (e.g., design and technology) are not as important as expected, but evidence-based treatments, medical services, and natural and local resources are.

The research gives important insights into customer preferences and current and future trends; however, the research only focused on operator rather than consumer perspectives. This would require further research.

The research findings provide useful information to operators who are trying to create innovative, unique, and competitive customer services.

Existing service innovation models are applied to new sectors (spa, wellness and medical tourism) and new insights are given into how these sectors can increase innovation and enhance customer experiences.

This academic analysis explores the dynamic landscape of wellness tourism from 1998 to September 2021, emphasizing the surge in scholarly publications post-2010, primarily contributed by the United States. Key findings identify major authors, significant papers, and evolving trends while acknowledging research limitations and offering recommendations. Additionally, the 2022 study highlights 10 pivotal elements enriching holistic health resorts, coupled with strategic marketing and DMO influence. A comprehensive review utilizing the PRISMA methodology reveals two significant research clusters, focusing on tourist motivations and behavior, anticipating post-pandemic research and the need for diverse data sources. Wellness tourism embodies dynamism and diversity, driven by an ever-growing yearning for well-being, relaxation, and self-care. Travelers can choose from a broad spectrum of dimensions and destinations to personalize their wellness journeys according to their unique aspirations and goals, making it an exceptionally adaptable and customized form of travel. The industry's trajectory is set for continued expansion and transformation as more individuals acknowledge the paramount importance of nurturing their holistic well-being. However, a notable research gap is identified: the incorporation of cutting-edge technologies like wearable technology, virtual reality, and artificial intelligence in wellness tourism remains underexplored. This study addresses this void by investigating the utilization of technology to craft personalized and immersive wellness experiences, its impact on traveler preferences and behavior, and its role in destination management and marketing strategies. Recognizing technology's pivotal role in wellness tourism, this study seeks to bridge the gap between traditional wellness practices and contemporary technological advancements, fostering a holistic approach to well-being in the modern era.

The purpose of this theme issue is to explore the development of health tourism in challenging times, with a particular focus on the Visegrád countries. The issue investigates the ways in which health tourism enterprises and destinations can enhance resilience, adapt to post-pandemic conditions and navigate economic, social and political uncertainties. Additionally, it highlights the role of health tourism in improving individual and community well-being while aligning with the principles of sustainable development.

This theme issue employs a thematic approach, incorporating both theoretical and empirical perspectives on health tourism development. The research articles included in this issue utilize various qualitative and quantitative methodologies, such as case studies, survey-based research and Delphi studies. The focus is on examining the sustainability and resilience of health tourism enterprises and destinations in the Visegrád countries, drawing on data from key stakeholders, including industry professionals, policymakers and researchers.

The studies presented in this theme issue identify several critical aspects of health tourism development in the Visegrád region. Key findings include (1) the increasing significance of health tourism as a tool for regional economic development and social well-being; (2) the necessity of infrastructural improvements and service diversification to attract both domestic and international tourists; (3) the role of strategic collaboration between stakeholders, including policymakers, businesses and healthcare institutions, in ensuring the long-term viability of health tourism; (4) the importance of sustainable practices in health tourism management, particularly in light of climate change and resource conservation challenges and (5) the evolving consumer behaviour patterns in the post-pandemic era, which emphasize wellness, preventive healthcare and personalized experiences.

This theme issue contributes to the growing body of literature on health tourism by addressing gaps in research related to the Visegrád countries. It provides novel insights into the resilience and adaptability of health tourism enterprises and destinations in the face of global crises and economic fluctuations. By offering strategic recommendations for policymakers, industry practitioners and researchers, this issue fosters a deeper understanding of how health tourism can drive regional development and support sustainable growth in uncertain times.