Scenario-Based Robust Decision-Making in Health Tourism Service Supply Chains

Document Type : Original Article

Authors

1 Department of Management and Accounting, College of Farabi, University of Tehran, Iran

2 Associate Professor, Department of Management and Accounting, College of Farabi, University of Tehran, Iran

3 Assistant Professor of Industrial Management, Shiraz University of Technology-Lamerd Higher Education Center, Fars, Iran

10.22091/jemsc.2026.14971.1334

Abstract

Health tourism is a dynamic sector of Iran’s economy with strong potential in the religious city of Qom. This study develops plausible future scenarios for the health tourism service supply chain and identifies suitable strategies using Robustness Analysis (RA). A mixed qualitative–quantitative design is employed. First, key influencing factors are identified through expert interviews and a literature review. Next, alternative scenarios are constructed and evaluated using a weighted decision-matrix that simultaneously accounts for system complexity and environmental uncertainty in a participatory decision-making setting. The analysis yields seven distinct scenarios derived from eight key factors, ranging from an ideal future characterized by sustainable development and attraction of religious markets to a pessimistic future marked by sanctions-driven stagnation and multiple crises. The RA results indicate that vertical integration and market development perform best under favorable conditions, whereas retrenchment and heterogeneous diversification are more effective under crisis conditions. The proposed weighted RA decision matrix provides a practical decision-support tool for policymakers and healthcare managers in Qom to select resilient strategies across diverse environmental futures.

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Anvari, A., Kordnaiej, A., & Amiri, A. (2017). Combining robustness analysis and fuzzy screening to develop a robust strategic planning model for service logistics network; (Case study: Shiraz Electric Distribution Company). New Research in Decision Making, 2(1), 1–28. https://journal.saim.ir/article_25139.html
Ba, M., Pérez, F. M. D., Cejas, M. B., & González, C. G. G. (2023). The development of health tourism in Senegal’s coastal region. African Journal of Hospitality, Tourism and Leisure, 12(1). 1-11. https://www.ajhtl.com/uploads/7/1/6/3/7163688/article_18_12_1_273-291.pdf
Butler, R. W., & Szromek, A. R. (2019). Incorporating the value proposition for society with business models of health tourism enterprises. Sustainability (Switzerland), 11(23). 1-11. https://doi.org/10.3390/su11236711
Büyüközkan, G., Mukul, E., & Kongar, E. (2021). Health tourism strategy selection via SWOT analysis and integrated hesitant fuzzy linguistic AHP-MABAC approach. Socio-Economic Planning Sciences, 74. 1-11. https://doi.org/10.1016/j.seps.2020.100929
Ding, L. (2024). Tourist choice of sustainable hot springs tourism under post-COVID-19 pandemic period: A case in Colorado. International Journal of Tourism Research, 26(1). 1-11. https://doi.org/10.1002/jtr.2619
Driouchi, T., Leseure, M., & Bennett, D. (2009). A robustness framework for monitoring real options under uncertainty. Omega, 37(3). 1-11. https://doi.org/10.1016/j.omega.2007.09.004
Dunets, A. N., Yankovskaya, V. V., Plisova, A. B., Mikhailova, M. V., Vakhrushev, I. B., & Aleshko, R. A. (2020). Health tourism in low mountains: A case study. Entrepreneurship and Sustainability Issues, 7(3). https://doi.org/10.9770/jesi.2020.7.3(50). 1-11
Farber, R., & Taylor, A. (2023). Global health diplomacy and commodified health care: Health tourism in Malaysia and Thailand. Studies in Comparative International Development, 58(3). 1-11. https://doi.org/10.1007/s12116-023-09406-y
Fathi, M. R., Azar, A., Jandaghi, G. R., & ranjebar totoei, S. (2024). Forecasting the production and consumption of energy carriers in the supply chain and choosing a strategy with a robustness analysis approach (Case study: National Iranian Copper Industries Company). Logistics Thought23(90), 135-155. https://doi.org/10.22034/lot.2022.1268988.1208
Fathi, M. R., Pahlevanzadeh, M., Saffarinia, A., & Raesi Nafchi, S. (2025). Design of a green dental tourism supply chain network: A case study of Qom Province. Green Development Management Studies, 4(Special Issue), 15–28. https://doi.org/10.22077/jgdms.2025.7600.1130
Fathi, M. R., Sabalani, S., & Razi Moheb Seraj, S. (2022). Investigating the effect of strategic orientation on agility and resilience of tourism supply chain. Tourism and Leisure Time, 7(13), 203–220. https://doi.org/10.22133/tlj.2023.374380.1065
Grimm, V., & Berger, U. (2016). Robustness analysis: Deconstructing computational models for ecological theory and applications. Ecological Modelling, 326. https://doi.org/10.1016/j.ecolmodel.2015.07.018
Ibrahim, F. A., Pahuja, E., Dinakaran, D., Manjunatha, N., Kumar, C. N., & Math, S. B. (2020). The future of telepsychiatry in India. Indian Journal of Psychological Medicine, 42(5_suppl). 1-11. https://doi.org/10.1177/0253717620959255
Kiss, K. (2015). The challenges of developing health tourism in the Balkans. Tourism, 63(1). https://hrcak.srce.hr/137486
Lee, J., & Kim, H. bumm. (2015). Success factors of health tourism: Cases of Asian tourism cities. International Journal of Tourism Cities, 1(3). 1-11. https://doi.org/10.1108/IJTC-08-2014-0014
Malhotra, N., & Dave, K. (2024). Dimensions and drivers of medical tourism industry: a systematic review of qualitative evidence. International Journal of Business and Globalisation, 36(1). 1-11. https://doi.org/10.1504/IJBG.2024.135998
Namen, A. A., Bornstein, C. T., & Rosenhead, J. (2009). Robustness analysis for sustainable community development. Journal of the Operational Research Society, 60(5), 587–597. https://doi.org/10.1057/palgrave.jors.2602585
Namen, A. A., Bornstein, C. T., & Rosenhead, J. (2010). The use of robustness analysis for planning actions in a poor Brazilian community. Pesquisa Operacional, 30(2). https://doi.org/10.1590/S0101-74382010000200002
Nilashi, M., Samad, S., Manaf, A. A., Ahmadi, H., Rashid, T. A., Munshi, A., Almukadi, W., Ibrahim, O., & Hassan Ahmed, O. (2019). Factors influencing medical tourism adoption in Malaysia: A DEMATEL-Fuzzy TOPSIS approach. Computers and Industrial Engineering, 137. 1-11. https://doi.org/10.1016/j.cie.2019.106005
Oltean, F. D., Gabor, M. R., Stăncioiu, A. F., Kardos, M., Marta, K., & Marinescu, R. C. (2020). Aspects of marketing in dental tourism-Factor of sustainable development in Romania. Sustainability (Switzerland), 12(10). 1-11. https://doi.org/10.3390/su12104320
Pinos Navarrete, A., & Shaw, G. (2021). Spa tourism opportunities as strategic sector in aiding recovery from Covid-19: The Spanish model. Tourism and Hospitality Research, 21(2). https://doi.org/10.1177/1467358420970626
Schupbach, J. N. (2018). Robustness analysis as explanatory reasoning. British Journal for the Philosophy of Science, 69(1). 1-11. https://doi.org/10.1093/bjps/axw008
Sorourkhah, A. (2024). A scenario-based alternative to conventional tools for choosing the strategy in turbulent environments. International Journal of Research in Industrial Engineering, 13(2), 224–236. https://doi.org/10.22105/riej.2024.448579.1428
Sorourkhah, A., Adel, A., Kafaki, B., & Abadi, S. N. (2017). The use of weighted robustness analysis in strategy selection (Case study: Saipa Automotive Industries Research and Innovation Center). Industrial Management, 9(4), 665–690. https://doi.org/10.22059/imj.2018.247856.1007361
Sorourkhah, A., & Edalatpanah, S. A. (2022). Using a combination of matrix approach to robustness analysis (MARA) and Fuzzy DEMATEL-Based ANP (FDANP) to choose the best decision. International Journal of Mathematical, Engineering and Management Sciences, 7(1). https://doi.org/10.33889/IJMEMS.2022.7.1.005
Tsekouropoulos, G., Vasileiou, A., Hoxha, G., Dimitriadis, A., & Zervas, I. (2024). Sustainable approaches to medical tourism: Strategies for Central Macedonia/Greece. Sustainability (Switzerland), 16(1). 1-11. https://doi.org/10.3390/su16010121
Wang, H.-H., Grant, W. E., Koralewski, T. E., Brewer, M. J., & Elliott, N. C. (2021). Simulating migration of wind-borne pests:“Deconstructing” representation of the emigration process. Ecological Modelling, 460, 109742. https://doi.org/10.1016/j.ecolmodel.2021.109742
Wang, H., Feng, Y., Xu, S., Xu, X., Jiang, K., Nie, X., & Zhou, N. (2023). Analysis of spatial-temporal pattern, dynamic evolution and influencing factors of health tourism development in China. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-42462-x
Wong, B. K. M., & Sa’aid Hazley, S. A. (2020). The future of health tourism in the industrial revolution 4.0 era. Journal of Tourism Futures, 7(2). 1-11. https://doi.org/10.1108/JTF-01-2020-0006
Yazdi, M. R. T., & Barazandeh, H. (2016). Identifying and ranking health tourism development barriers in Iran using fuzzy VIKOR method. Asian Social Science, 12(5). 1-11. https://doi.org/10.5539/ass.v12n5p54
Yıldız, M., Aydin, M. A., Gökçay, G., Kizilarslan, V., & Yaman, U. (2023). The effect of intercultural sensitivity and ethnocentrism on health tourism awareness level in nurses: Analysis with machine learning approach. Archives of Psychiatric Nursing, 46. 1-11. https://doi.org/10.1016/j.apnu.2023.07.002
Zhong, L., Deng, B., Morrison, A. M., Coca-Stefaniak, J. A., & Yang, L. (2021). Medical, health and wellness tourism research a review of the literature (1970–2020) and research agenda. International Journal of Environmental Research and Public Health, 18(20). 1-11. https://doi.org/10.3390/ijerph182010875
 
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