Collins, AyşeMedhekar, A.Wong, H. Y.Çobanoğlu, C.2020-02-062020-02-0620191660-5373http://hdl.handle.net/11693/53143The purpose of this paper is to explore how Americans choose a country and medical facility to travel abroad for medical treatment based on the following factors country environment, tourism destination, medical tourismcosts andmedical facilities and services. Design/methodology/approach – Online survey with the help of Amazon Mechanical Turk website was used for data collection, and 541 valid cases were used of American residents who had travelled abroad formedical tourism. Exploratory and confirmatory factor analyses were undertaken to validate the scales. Findings – Findings indicated fourmajor factors that can influence American medical tourists’ choices of medical tourism destinations. These factors are overseas’ country factors, attractiveness of tourism destination, medical tourism costs and facilities and services. Both the convergent and discriminant validities for the constructs were established. The results of the measurement-model-fit based on various measures were within the suggested cut-off values. Research limitations/implications – Out of the 541 responses of post-travel experienced medical tourists, it is hard to tell how similar/dissimilar the participants are in terms of ranking the four factors. To be competitive to attract global medical tourists, research suggests that the five popular countries of treatment, India, China, Thailand, Mexico and Turkey, identified in this study should provide high quality of medical and tourismfacilities to patients. Originality/value – This study contributes to the understanding of the underlying factors, which influence American medical tourists’ choice of destinations, with validated scales. For this exploratory research, 25 new items together with 34 items from other studies were adapted.EnglishDestinationUSACostOutboundMedical-tourismHealthcare-qualityArticle10.1108/TR-06-2018-0083