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MINISTRY OF EDUCATION AND TRAINING HANOI UNIVERSITY OF BUSINESS AND TECHNOLOGY LY THANH TIEN IMPROVING THE LINKAGE EFFICIENCY IN MEDICAL TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY SUMMARY OF PH.

MINISTRY OF EDUCATION AND TRAINING HANOI UNIVERSITY OF BUSINESS AND TECHNOLOGY  -LY THANH TIEN IMPROVING THE LINKAGE EFFICIENCY IN MEDICAL TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY SUMMARY OF PH.D THESIS MINISTRY OF EDUCATION AND TRAINING HANOI UNIVERSITY OF BUSINESS AND TECHNOLOGY  -LY THANH TIEN IMPROVING THE LINKAGE EFFICIENCY IN MEDICAL TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY Major : Business Administration Code : 9.340.101 SUMMARY OF PH.D THESIS Supervisors: 1.Dr Nguyen Quang Vinh Assoc.Prof Dr Kieu The Viet INTRODUCTION Rationale Nowadays, tourism is identified by most countries in the world as one of the important economic sectors, making significant and effective contributions to the cause of economic, political, cultural, social, diplomatic development, of the country In fact, tourism, including medical tourism, is an integrated economic sector that not only brings direct revenue from service fields such as hotel, tour, tourist attraction but also generates revenue, making an important contribution to promoting the development of related industries such as transport, catering, entertainment, commerce, healthcare and some auxiliary services of communication, banking, This type of medical tourism is not a new product, it has existed for many years Instead of coming for traveling purpose alone, tourists at present switch to the form of both traveling and medical treatment or health and beauty care For recent years, Asian countries, including Vietnam, have been stepping up investment, spread and promotion of medical tourism products and there is a fierce competition in becoming the leading tourism destination in terms of healthcare and medical treatment of the region Currently, national medical tourism services, in which Ho Chi Minh City plays an important role, can meet the needs of medical examination and treatment services of people as well as international tourists, especially the strengths of curing infertility by artificial insemination with high success rate; high-quality beauty care and dental cosmetic services at cheap prices; acupuncture technique; world-recognized traditional reflexology; rich source of natural medicinal herbs,… Ho Chi Minh City is a locality with great potential for medical services with professional quality on par with the region, many international-class intensive techniques but at a service price that is 70% cheaper than that of other countries in the world For the past years, medical tourism services have initially developed in Ho Chi Minh City In particular, the Department of Health and the Department of Tourism of Ho Chi Minh City signed a memorandum of understanding on the action program between two departments in deploying medical tourism products, established an interdisciplinary working group of health and tourism Accordingly, the city selected key products in medical tourism services in terms of health check and disease screening, health care with traditional medicine, reproductive health, cardiovascular health, skin care, dentistry, plastic surgery, otorhinolaryngology, Public and non-public hospitals registered to participate in providing medical tourism products, including: University Medical Center HCMC, HCMC Dental Hospital, Tu Du Hospital, City Children’s Hospital, Dermatology Hospital, Otolaryngology Hospital, Hoan My Hospital, Xuyen A Hospital, Traditional Medicine Institute, Ho Chi Minh City is a tourism market with high growth rate and is increasingly sought by domestic and international tourists Only high-quality medical examination and treatment combined with resort for customers in need and payment ability are an opportunity to create a great source of revenue for the City, on the other hand, also bring a new impetus for the tourism and health industries to rise up, towards a convenient, professional and effective integrated service system Therefore, the city needs to develop a medical tourism service supply chain To manage this service supply chain well, the tourism industry and the medical industry in general and medical tourism service providers in particular need to understand the factors affecting the supply chain, thereby offer solutions to improve the efficiency of the medical tourism service supply chain Because the basic feature of medical tourism services is intangible and cannot be stored, this supply chain is largely formed from the connection of information about demand and supply capacity The capacity of the service supply chain in general and the medical tourism service in particular is reflected in the ability to satisfy customer needs through the quality of the provided service Despite having many advantages in nature and climate, and many domestic and foreign customers coming for medical examination and treatment, the medical tourism service of Ho Chi Minh City has not really brought into full play its potential and not comparable to other countries in the region Most of the visitors who come for medical examination and treatment need to go sightseeing and relax However, many tourists said that planning a medical tourism tour took a long time because of little information, the number of medical and healthcare tours at travel agencies is still limited and travel agencies have not utilized segment of customers who are tourists – patients On the other hand, investment in resort services, medical examination and treatment is still quite fragmented and small, there is a shortage of long-term investments to attract tourists as well as full potential has not been utilized From the above fact, the author chooses the topic "Improving the linkage efficiency in medical tourism service supply chain in Ho Chi Minh City" as the topic of the Ph D thesis, majoring in Business Administration Objectives of the study 2.1 Research purpose Improve the linkage efficiency in medical tourism service supply chain in Ho Chi Minh City 2.2 Research mission (1) Systematize the theoretical basis of the supply chain and the efficiency of supply chain linkage in enterprises and organizations in general and in medical tourism service providers (2) Analyze and assess the actual situation of linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City in 2016-2020 period (3) Propose some solutions to improve the linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City Research subject and scope 3.1 Research subject - Actual situation of linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City - Factors affecting linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City - Experience in linkage efficiency in the medical tourism service supply chain in the world and in Vietnam 3.2 Research scope - Regarding space: Research the actual situation of linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City - Regarding time: Research in 2016 – 2020 period Research questions of the Thesis To solve the research objectives and missions of the Thesis, the main questions are raised, including: (1) What are the characteristics of supply chain interaction? Which characteristics will affect the compatibility of supply chain interaction? How can core features be interpreted in a comparative way to facilitate the application? (2) What is the supply chain model of medical tourism services? Why does efficiency in the medical tourism service supply chain need to be improved? (3) Which lessons does the experience in improving the efficiency of international and domestic medical tourism service supply chain bring to Ho Chi Minh City? (4) How factors inside and outside the supply chain affect the linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City? (5) How are the horizontal-vertical linkages, medical tourism service supply chain integration in Ho Chi Minh City today? (6) Which solutions will contribute to improving the linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City in the coming time? Expected scientific and practical significance 5.1 Scientific significance (1) Systematize the following issues: (i) general argument of supply chain; linkage efficiency in the supply chain (ii) factors affecting the supply chain; and (iii) experience in linkage efficiency in the supply chain at enterprises and organizations around the world and in Vietnam Therefore, the result of the study will make certain contributions to the completion of theoretical framework on the linkage efficiency in the supply chain at enterprises and organizations in general and in the field of medical tourism services in particular (2) Research result is a work from the combination of academic research and applied research Therefore, the research result reflects the reliability as well as complements and develops the methodology in evaluating the linkage efficiency in supply chain 5.2 Regarding practicality (1) The research result helps researchers and managers of medical tourism service providers identify the supply chain in terms of methodology and factors affecting the medical tourism supply chain, This will be a condition to conduct applied researches or have appropriate solutions to improve the efficiency of the medical tourism service supply chain (2) The research work can be a reference for those who are interested in linkage in international tourism service supply chain within provinces and cities nationwide The research result contributes to improving mechanisms and policies related to tourism development, health service and linkages in the health service supply chain (3) The thesis studies the current situation of linkages in the medical tourism service supply chain in Ho Chi Minh City; The given viewpoints and solutions can be applied to the practice of developing linkages of medical tourism service supply chain of the city in the coming time Research Methodology To conduct research on the Topic of the Thesis, the author uses the methodology of dialectics, logic, consistency and qualitative research and quantitative research methods, ., specifically: (1) Methodology: The study is based on the method of dialectical materialism and historical materialism, which is the common basis for awareness in the research process (2) Synthesis, analysis and systematization of theory: The author inherited some theories from textbooks, survey results and some practical assessments of economists and economists at conferences, seminars, reports on scientific research topics and theses related to the linkage in medical tourism service supply chain to better clarify the conclusions drawn from the research process (3) Collection, statistics, synthesis and analysis of data: The author collects documents from different sources, categorizes and systemizes them into a coherent logical structure according to each scientific issue This method is used in all chapters of the Thesis, in order to make comments and assessment of medical tourism service supply chain (4) Desk research method: Collect secondary data sources by systematically using up information technology applications, Internet networks, communication networks; consult with analyses and opinions of experts and managers; use relevant legal documents, etc The author consulted a lot of useful information for the research process (5) Method of comparison, collation, inference: Based on collected, filtered, classified and processed secondary information sources, the author analyzes, compares and collates in order to assess the current situation of the research subject New contributions of the Thesis (1) The thesis systematizes the theoretical issues of supply chain and linkage in medical tourism service supply chain, including: Concept of supply chain; Vertical and horizontal supply chain model; Classification of manufacturing supply chain and service supply chain; Content of linkage in the medical tourism service supply chain; Factors affecting the linkage efficiency in the medical tourism service supply chain: Factor of mechanisms and policies of the State; Factor of demand and seasonality of medical tourists,… (2) The thesis collected, did statistics, synthesized data, calculated data, compared and analyzed the actual situation of the medical tourism service supply chain in Ho Chi Minh City Point out some shortcomings and causes of limitations in the medical tourism service supply chain in Ho Chi Minh City, such as: The linkage between state agencies at the central level has still not been very close in policy building and in administration; The coordination between departments, divisions and branches of the City in developing in the medical tourism service supply chain has still been limited; The linkage in the medical tourism service supply chain is not systematic, still fragmented and small (3) Propose the main directions and groups of solutions that can be applied to improve the efficiency of the medical tourism service supply chain in Ho Chi Minh City in the coming time , such as: Solution on mechanisms and policies to facilitate and promote tourism development and effectively link the medical tourism service supply chain of Vietnam and Ho Chi Minh City; Solution on construction and sustainable development of tourism in Ho Chi Minh City; Solution on training and retraining of high-quality human resources in the medical tourism service supply chain, Structure of the thesis In addition to the introduction, conclusion, table of contents, list of abbreviations, list of tables, figures and references, the Thesis is organized in the following chapters: Chapter 1: Theoretical basis of linkage efficiency in the medical tourism service supply chain Chapter 2: Actual situation of linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City Chapter 3: Solutions to improve linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City CHAPTER THEORETICAL BASIS OF LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN 1.1 SUPPLY CHAIN IN ENTERPRISES AND ORGANIZATIONS 1.1.1 Some definitions of supply chain For managers around the world, supply chain is a strategic asset According to Christopher M (2011) [1] “A supply chain is a network of organizations that are involved in linkages of upstream and downstream flows according to different processes and activities to create value in each product for customers” According to Lambert DM and Ellram LM (1998) [2] "Supply chain is the linkage between companies that are responsible for bringing products or services to the market" In short, the definition of supply chain is understood in many different ways, some are abstract, some are specific, some are general, according to the author " Supply chain is a collection of three or more enterprises that directly or indirectly connect by one or more flows of products, services, information and finance in the process of meeting customer requirements” 1.1.2 Supply chain model 1.1.2.1 Vertical supply chain model The vertical structure of the supply chain reflects the number of levels along the chain length The distance from the first supplier to the last customer is the vertical distance of the chain The functional level-based identification of chain members allows identification of focal member Some chains and customers identify focal member (enterprise, organization) through the brand of the original product first, whether or not that enterprise has a manufacturing function The focal member holds a process management relationship for the first level of customer and supplier; Keep a supervisory relationship for the nd level onwards; The relationship is not in the form of process management for further levels; relationship is not among members in and out of the chain 1.1.2.2 Horizontal supply chain model The horizontal organizational structure reflects the number and type of members at each relationship level Studying the horizontal supply chain model will see the number of members and their relationship in the same function The members of this supply chain can be both competitors and potential customers of each other, they have contracted with each other to fulfill orders that will fail to be fulfilled if there is only one member 1.1.3 Basic components in the supply chain will include specific time and space factors along with distribution channels to bring the products to the market 1.1.5.2 Service supply chain (1) In the trend of globalization and knowledge economy, services play an increasingly important role in the economy, contributing to promoting manufacturing, circulation and distribution of goods and promoting the development of trade in goods in national and international scope When the economy develops at a high level, people have more demand for products and services such as cosmetic, medical examination and treatment, education, entertainment, etc., and the consumption trend marginal with services is much larger than the tangible product A service supply chain consists of many related enterprises that are jointly involved in the objective of providing a certain type of service to the market The objective of the service supply chain also focuses on satisfaction with the customer requirements and optimization of the costs of the chain The structure of a service supply chain can vary from a simple chain of connections to a vast multi-level network with participating member entities 1.2 LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN 1.2.1 Medical tourism service supply chain 1.2.1.1 Concept of medical tourism service Appearing thousands of years ago, Medical Tourism [5] was formed in the footsteps of Greek pilgrims from the Mediterranean to Epidauria where the god of healing was worshiped, founder of Asklepios Medical Industry Up to now, medical tourism has become popular and has become a service industry on a global scale, more expanded and diversified, including purposes of resort, beauty care, Medical tourism service is tours in which a person in need of medical treatment will go abroad, to a place where a hospital or medical center provides health or medical care at a relatively affordable rate Moreover, these patients often stay abroad after completing medical procedures and take advantage of the time to go sightseeing, participate in day-time trips or participate in any other traditional tourism activities 1.2.1.2 Types of medical tourism services The process of developing the medical tourism service industry of countries around the world can be classified into different types: (1) Inbound medical tourism service or domestic medical tourism service [6] is also called to be local medical tourism service, is when individuals travel from one province, city or state to another in their same native country to search for and use health care, medical examination and treatment services (2) International medical tourism or cross-border medical tourism service, this type is quite well known in the countries of the European Union, thereby workers, migrants and retirees will travel from one country to another for medical care (3) Medical tourism service “Diaspora” is the migration of a group of people, of the same ethnic origin, from the settlement land or ancestral land This is a special type of medical tourism for people who have a cultural identity connection or a family connection in the destination country for medical tourism 1.2.2 Supply chain of medical tourism products and services 1.2.3 Linkage efficiency in medical tourism service supply chain 1.2.3.1 Concept of linkage in medical tourism service supply chain (1) Each business service can be subdivided into a number of continuous stages, activities which can be handled and performed by service providers This allows multiple medical tourism providers to join the supply chain to increase chain specialization and efficiency (2) The basic resource of the medical tourism service supply chain is skilled labor in medicine The capacity of the medical tourism service supply chain is reflected in the ability to satisfy customer needs through the quality of the provided services 1.2.3.2 Performance of the health service supply chain The concept of linkage efficiency in a supply chain is very abstract Each one has a different definition and what is considered effective in a part of the supply chain can completely adversely affect another part of an enterprise, an organization When looking at the linkage efficiency in the supply chain, we assess it from many different angles and look at what happens within the medical tourism supply chain system Accordingly, a medical tourism service supply chain is considered effective when it can bring products at the lowest cost to users At the same time, consider the level of effective coordination of enterprises, hospitals, in the supply chain with partners to improve linkage efficiency 1.2.4 Content of linkage efficiency in the medical tourism service supply chain 1.2.4.1 Medical tourism service value chain The medical tourism service value chain, in the scope of a health service enterprise, includes the chain of activities from product design, service purchase, marketing, sales, operation, tour guide to bring products that are sublimated experiences for visitors and bring value and profits to enterprises 1.2.4.2 Relationships of linkage in the medical tourism service supply chain Through the supply chain of medical tourism products and service value chains, linkage relationships can be seen to form tourism products and value chains The relationships of linkage include: (i) International linkage, shown in the partnership in tourism activities in the legal documents related to tourism; (ii) Regional linkage is the linkage between localities within a country, creating a network of tourism and medical tourism linkages to promote the strengths of that locality; (iii) Vertical linkage is the linkage from central to local level, tourism enterprises and residential community at the tourist destination Travel agents and tourism management agencies maintain vertical linkages from central to local level to provide services to serve tourists, as well as direct and manage tourism development according to strategy and general orientation; (iv) Linkage according to business line of medical tourism service is the linkage between the fields of travel, hotel, catering, tourist transport, medical examination and treatment and plastic surgery; (v) Linkage between the tourism industry and other industries providing products and services for the tourism industry such as transportation, electricity and water supply, agriculture, industry, 1.2.4.3 Medical tourism service linkage integrator When the medical tourism supply chain operates, the components in the chain must be coordinated with each other to meet customer requirements in the best manner The role of supply chain coordination belongs to the service integrator, which is considered the core component of a medical tourism service supply chain In medical tourism supply chains, customer needs are often highly customized, each of their individual service requests will be transferred to the service integrator 1.2.4.4 Development of science and technology in medical tourism services In modern society, the role of science and technology is becoming more and more important The dramatic advances of science and technology for the past two decades, especially in the fields of information technology, biotechnology, nanotechnology, automation, have fundamentally changed the mindset of people and strategies of many countries For the past years, Medicine has made rapid and remarkable progress, thanks to the significant role of research and application of science and technology in preventive medicine, medical examination and treatment, manufacturing of drugs, medical supplies and equipment 1.2.5 Criteria to evaluate the linkage efficiency in the medical tourism service supply chain In order to evaluate the linkage efficiency in the medical tourism service supply chain, in addition to the contents, influencing factors, etc., it is necessary to have a number of qualitative and quantitative criteria 1.2.5.1 Qualitative criteria (1) Assessment of risks in the medical tourism service supply chain (2) Price and quality of medical services 1.2.5.2 Quantitative criteria 1.3 FACTORS AFFECTING THE LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN 1.3.1 Factor of mechanism and policies of the State State mechanisms and policies have a great impact on the activities of linking the medical tourism service supply chain of a country Favorable conditions in terms of regulations and policies on encouraging foreign direct investment, reducing costs and time in business establishment registration related to the medical field, import of modern medical equipment are all positive impacts for local and national medical tourism service supply chain activities 1.3.2 Economic, political and social factors 1.3.2.1 Environmental factor The environment is increasingly becoming an important factor to determine the attractiveness of a tourism and medical tourism destination A locality attracts tourists and medical tourists thanks to its natural beauty or historical and cultural values, satisfactory medical conditions but if its quality of the environment is not secured and degraded, such factors attracting the tourists will also gradually wear out and all efforts to attract tourists will lose their efficiency 1.3.2.2 Security-political factor Security is always one of the concerns of tourists when deciding to go to a place to travel and get medical treatment A locality that wants to attract many tourists and medical tourists must first ensure the safety of tourists during the process of travel in its locality That safety is not only reflected in the stable and peaceful political situation but also through the measures taken by local authorities at all levels for theft, crime, traffic accidents, etc Security factor is reflected in the WEF's annual report on national tourism competitiveness through expert assessment of damages caused by terrorism and crime 1.3.2.3 Hygiene and health factor Tourism and medical tourist services are one of the activities that contain many risks for people, because when they travel to another place, they are temporarily away from their usual residence environment At that time, differences in living conditions, weather, climate, etc can cause impacts on human health Therefore, similar to security and political issues, hygiene and health in destinations are also one of the top concerns for patients and tourists 1.3.2.6 Types of medical services Medical tourism services can offer a wide range of therapies, from medical to traditional and alternative therapies These therapies will vary depending on each country and some certain technologies as well as laws of host countries Currently, in our country, there are the following types of basic medical services: (1) Outpatient examination (2) Inpatient treatment (3) Medical emergency and on-duty emergency service (4) Occupational medical service (5) Periodic follow-up treatment service 1.3.3 Factors of demand and seasonality of medical tourists 1.3.3.1 Factor of medical tourism demand Global economic growth of countries around the world in the health sector, especially demand of patients, medical experts as well as medical technology, funding sources and regimes shifted cross-border among countries, has increased the consumption and manufacturing models of health services for recent decades 1.3.3.2 Seasonality in medical tourism services The seasonality of medical tourism activities affects the fluctuation of tourism demand during the year The main factor that determines the seasonality here is the weather at destinations or at the tourist source market Tourism in general and the linkage of medical tourism service supply chain in particular will suffer from overcrowding of tourists in the peak season and very few visitors in the low season 1.3.3.3 Tourists are an integral part of the tourism service supply chain In the market mechanism and medical tourism business, tourists are part of medical tourism products and services This is applied not only to hotels, restaurants and tourist attractions but also to all medical services and goods at the tourist destinations The tourists are an important subject in tourism relations, targeted by all tourism business and management activities By consuming and paying for the consumption of tourism products, the tourists are the creators of tourism income 1.3.4 Factor of international integration The process of international integration has been increasingly intensive and comprehensive in bilateral and multilateral relations in the fields of economy, culture, society, environment and common issues towards the Millennium Development Goals have the impact of promoting development, while also creating opportunities and challenges for the tourism and medical tourism economy and medical tourism, specifically: 1.3.4.1 International integration creates opportunities to develop medical tourism (1) Opportunities to expand the tourist market and promote the image of the country and region: International integration’s removal of the boundaries between countries and regions is undeniable International integration promotes the common prosperity of countries, thereby creating favorable conditions for the development of trade liberalization, easing of visa policy and boom of lowcost airlines, thereby increasing travel between countries, etc (2) Opportunity to exchange, learn experiences and apply advanced science and technology; (3) Opportunity to renew thinking on tourism and medical tourism economic development; (4) Opportunity to link and expand tourist routes and new types of tourism; (5) Opportunity to have an effective support policy system 1.3.4.2 International integration creates challenges for the development of medical tourism (1) International integration increases the competitive pressure for medical tourism of countries; (2) International integration increases the dependence of tourists of the countries on foreign markets; (3) International integration creates challenges in preserving the cultural values of the nation 1.4 INTERNATIONAL AND DOMESTIC EXPERIENCE IN LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN IN AND LESSONS FOR HO CHI MINH CITY 1.4.1 International experience in linkage efficiency in the medical tourism service supply chain 1.4.1.1 According to the World Health Organization 1.4.1.2 India 1.4.1.3 Singapore 1.4.1.4 Korea 1.4.1.5 Malaysia 1.4.2 Experience in efficieny of linkages in domestic tourism and medical tourism supply chain 1.4.2.1 Experience of Hanoi City 1.4.2.2 Experience of Da Nang city 1.4.3 Learned lessons for Ho Chi Minh City CHAPTER ACTUAL SITUATION OF LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY 2.1 OVERVIEW OF HO CHI MINH CITY 2.1.1 Characteristics of natural and socio-economic conditions of Ho Chi Minh City 2.1.2 Overview of the medical tourism service supply chain in Ho Chi Minh City 2.1.2.1 Medical tourism service supply chain for foreign tourists 2.1.2.2 Medical tourism service supply chain for domestic tourists 2.1.3 Linkages in the medical tourism service supply chain in Ho Chi Minh City Ho Chi Minh City has boosted the improvement of the quality of factors of the industry and field serving essential tourism needs, including medical tourism, in addtion, promoted the improvement and linkage of factors in the tourism supply chain and at the same time enhanced innovative products from the factors of the industry and field involved in the main part of the tourism product 2.2 ACTUAL SITUATION OF EFFICIENY OF LINKAGES IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY 2.2.1 Supply chain of medical products and services in Ho Chi Minh City 2.2.1.1 Medical, healthcare facilities in Ho Chi Minh City For the past time, healthcare facilities in Ho Chi Minh City have continuously developed in both quantity and quality The City Department of Health organizes a quality inspection and assessment team for all affiliated hospitals based on Vietnam Hospital Quality Criteria version 2.0 issued by the Ministry of Health There are 110 hospitals in Ho Chi Minh City subject to quality evaluation, including: 32 city hospitals; 23 district hospitals; 53 private hospitals and ministerial and branch hospitals (Ho Chi Minh City Orthopedics and Rehabilitation Hospital, Post Office General Hospital) 2.2.1.2 Human resources in the medical tourism service supply chain 2.2.1.3 Medical tourism products and services 2.2.1.4 Tourism development in Ho Chi Minh City 2.2.2 Linkage efficiency in the medical tourism service supply chain 2.2.2.1 Promotion and spread of medical tourism 2.2.2.2 Medical tourists 2.2.2.3 Administrative procedures, accommodation facilities, means of transportation 2.2.3 Relationship of linkage in medical tourism service supply chain 2.2.3.1 Relationship of linkage between the tourism-medical-transport sectors 2.2.3.2 Relationship of international linkage 2.2.3.3 Relationship of linkage among localities 2.2.4 Medical tourism service integrator in Ho Chi Minh City 2.2.4.1 Tour organizations 2.2.4.2 Digital integration in the medical tourism service supply chain 2.2.5 Development of science and technology in medical tourism services 2.3 ANALYSIS OF LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN BY SWOT MODEL 2.3.1 Strengths The cost of medical tourism service is lower than that in many countries in the world; With rich tourism and medical tourism resources; Medical tourism products for domestic and foreign tourists are increasingly diverse and meet the needs of tourists 2.3.2 Weaknesses Linkages in the medical tourism service supply chain in Ho Chi Minh City in particular and in Vietnam in general develop behind other countries in the region and the world; Awareness of the potential as well as the benefits of linkages in the medical tourism service supply chain is not high 2.3.3 Opportunities The demand for tourism combined with medical examination and treatment, beauty care, of domestic and foreign tourists is increasing; The development of investment, resources and technology of linkages in the medical tourism service supply chain is increasing 2.3.4 Threats The fierce competition of the domestic and international medical tourism service market; The rapid development of the medical tourism service supply chain also creates many risks 2.4 ASSESSMENT OF ACTUAL SITUATION OF LINKAGE EFFICIENCY IN THE HEALTH TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY 2.4.1 Achieved results achieved in the linkage efficiency in the medical tourism service supply chain 2.4.1.1 Expansion of linkages in the medical tourism service supply chain to contribute to the socio-economic development of the City 2.4.1.2 Propaganda and promotion of the image of the medical tourism chain 2.4.1.3 Improvement of medical examination and treatment capacity to promptly meet the development needs of domestic and foreign medical tourism 2.4.2 Shortcomings and limitations: The thesis proposes eight shortcomings and limitations in the actual situation of linkage efficiency in the medical tourism service supply chain 2.4.3 Causes of the shortcomings and limitations 2.4.3.1 Objective causes 2.4.3.2 Subjective causes CHAPTER SOLUTIONS TO IMPROVE THE LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY 3.1 PERSPECTIVE AND OBJECTIVES OF IMPROVING THE LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY BY 2025, WITH A VISION TO 2030 3.1.1 Perspective on socio-economic, tourism and medical tourism development of Ho Chi Minh City 3.1.1.1 Vietnam tourism development strategy by 2025, with a vision to 2030 3.1.1.2 Development orientation of Vietnam medical tourism 3.1.2 Objectives of developing linkages in the medical tourism service supply chain in Ho Chi Minh City by 2025, with a vision to 2030 3.1.2.1 Socio-economic development objective of Ho Chi Minh City 3.1.2.2 Direction of tourism and medical tourism service supply chain development of Ho Chi Minh City 3.1.2.3 Principled perspective when proposing solutions to develop the medical tourism service supply chain in Ho Chi Minh City 3.2 SOME SOLUTIONS TO IMPROVE THE LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICE SUPPLY CHAIN IN HO CHI MINH CITY BY 2025, WITH A VISION TO 2030 3.2.1 Solutions on mechanisms and policies to facilitate and promote the development of tourism and linkage efficiency in the medical tourism service supply chain 3.2.1.1 Solutions for sustainable development of Vietnam tourism after Covid-19 pandemic 3.2.1.2 Night-time economic development 3.2.1.3 State management agencies must renew their awareness and thinking about the development of medical tourism services 3.2.2 Solutions to build and develop tourism sustainably in Ho Chi Minh City 3.2.3 Solutions to train and retrain high-quality human resources in the medical tourism service supply chain 3.2.4 Solutions to strengthen integrators and promoters of domestic and international medical tourism service supply chain 3.2.5 Solutions to minimize risks in the medical tourism service supply chain 3.2.6 Solutions for infrastructure construction and technology development in the medical tourism service supply chain in a way to meet domestic and international standards 3.2.7 Solutions for outstanding branding to promote strengths and high technology in medical tourism services 3.3 SOME RECOMMENDATIONS TO CONTRIBUTE TO IMPLEMENTATION OF SOLUTIONS TO IMPROVE THE LINKAGE EFFICIENCY IN THE MEDICAL TOURISM SERVICES SUPPLIER CHAIN IN HO CHI MINH CITY 3.3.1 Recommendations to ministries and branches It is needed to have an overall coordination among ministries: Health, Culture - Sports and Tourism, Justice, Public Security, Planning and Investment, Foreign Affairs, Natural Resources and Environment, etc to issue relevant mechanisms and policies; facilitate and reform administrative procedures for the activities of linking the medical tourism service supply chain In fact, the coordination and linkage between the State agencies at the central level is still not very close in policy building and in administration The inter-sectoral, central and local coordination is still not synchronous and irregular in both awareness and action 3.3.2 Recommendations to departments and branches of Ho Chi Minh City The role of local government has a great impact on tourist attraction and medical tourism In order to effectively and sustainably develop linkages in the medical tourism service supply chain, the city's departments and branches should review, amend, supplement and immediately complete mechanisms, policies and laws to facilitate the operation of the medical tourism service supply chain; Promulgate preferential policies on land, tax and credit to mobilize investment resources in medical tourism clusters, dynamic areas for medical tourism development and areas with medical tourism potential; Thoroughly implement reform of administrative procedures related to the chain of medical tourism service linkages to welcome domestic and foreign tourists; Resolutely apply punishment measures to corrupt practices that cause troubles for medical tourism service linkage chains CONCLUSION For the Thesis with the topic "Improving the linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City", the author has researched and supplemented the general theory of linkages in the medical tourism service supply chain, thoroughly assessed actual situation of linkages in the medical tourism service supply chain, thereby drawing out some of the shortcomings, limitations and objective and subjective causes of the limitations on linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City On that basis, groups of solutions are proposed to contribute to improving the linkage efficiency in the medical tourism service supply chain in Ho Chi Minh City in the coming period The content of the research has basically answered the research questions and gaps about medical tourism and the medical tourism service supply chain in Ho Chi Minh City The research result of the thesis can be considered and applied to the tourism and health sectors of Ho Chi Minh City from the stage of strategy building, organization of implementation to improve the linkage efficiency in the medical tourism service supply chain, thereby enhancing the position and promoting the strengths of the tourism and medical tourism industry of Ho Chi Minh City in the domestic and international markets ... plastic surgery; (v) Linkage between the tourism industry and other industries providing products and services for the tourism industry such as transportation, electricity and water supply, agriculture,... including: University Medical Center HCMC, HCMC Dental Hospital, Tu Du Hospital, City Children’s Hospital, Dermatology Hospital, Otolaryngology Hospital, Hoan My Hospital, Xuyen A Hospital, Traditional... integrated service system Therefore, the city needs to develop a medical tourism service supply chain To manage this service supply chain well, the tourism industry and the medical industry in general

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