Innovation in health tourism: a service innovation perspective and research agenda

Health tourism (HT) is an umbrella domain encompassing medical tourism and wellness tourism. While these subdomains have developed substantial research, service models increasingly connect hospitals, clinics, hotels, resorts, and wellness providers, creating overlaps between healthcare, hospitality, and travel. This study uses innovation to connect these subdomains and explain the development of HT and identify future directions. We analysed 365 English-language Scopus and Web of Science documents published between 2003 and 2025. Bibliometric analysis mapped the keyword co-occurrence and thematic evolution, while targeted full-text reading of selected studies strengthened the identified clusters and trajectories. Drawing on service innovation perspectives, the findings show that innovation in HT occurs through service recombination, experience design, organisational coordination, capability development, market positioning, digital infrastructure, and governance. Five clusters structure the field: clinical risk, ethics, and digital trust governance; wellness destinations, sustainability, and service innovation; ecosystem collaboration and innovation capability; cross-border health policy and data infrastructure; and digital experience design. The field evolved from risk, ethics, and uncertain cross-border treatments towards destination medical and wellness services, destination development, digital coordination, and stronger policy and data-governance infrastructures. This review develops a research agenda around trust, service design, digital coordination, governance, and evidence-based wellbeing outcomes.