From Casinos to Sustainability: Unveiling the Health Tourism Potential of Gaming City

This study examined the potential for Macao to develop as a health tourism destination by incorporating perspectives from both tourists and industry stakeholders. A mixed-methods approach was employed, combining quantitative survey data collected from tourists with qualitative data derived from 16 in-depth interviews with representatives from the health care, tourism, hospitality, and food sectors. The study investigated how tourist motivation, contextual perceptions, and behavioral intention influenced the perceived potential of Macao as a health-oriented destination. The quantitative findings indicated that increased health consciousness, high service quality, and cultural proximity significantly enhanced tourist motivation, while perceptions of public safety did not exert a sustained influence. Tourist motivation was positively associated with behavioral intention, which partially mediated the relationship between motivation and the perceived potential of the destination. The qualitative findings revealed several structural constraints, including limited training opportunities, specialist shortages, regulatory rigidity, and weak cross-sector collaboration. Stakeholders emphasized the need for more flexible government policy, strategic coordination, and greater integration of traditional Chinese medicine and wellness offerings. This study contributed to the tourism literature by applying a contextual behavior model to the domain of health tourism and offered practical insights for diversifying Macao’s economy in the post-pandemic era.