The Sustainable Market Adaptation in Medical Tourism and Hospitality: A Comparative Case Study of Pre-Accession Countries of Albania and North Macedonia

Abstract

This master thesis is an analysis of the market structure, sustainability, challenges, and opportunities in the tourism and hospitality market, focusing on medical tourism in EU pre-accession countries Albania and North Macedonia. Tourism and medical tourism are important parts of economic development, although both countries are dealing with several serious barriers to EU compliance at the structural, regulatory, and environmen tal levels. This research aims to assess the development, competitiveness, and opportunities of these sectors using the EU integration trajectory. Using an integrative research review methodology that combines academic literature, national and international policies, macroeconomic indicators, EU progress reports and surveys with stakeholders, we assess the relative economic contribution of tourism and medical tourism to GDP, employment and investment, as well as the level of market competitiveness, using concentration ratios and the Herfindahl-Hirschman index. The results suggest that while in both nations, tourism does add value, including medical tourism, the countries are faced with common sustainability challenges: lack of capacity building, underlying regulatory issues, and low awareness of sustainable tourism practices. After examining the results of the interview, it is clear that there is still a need to raise awareness for sustainability and how to implement it in medical tourism. The results suggest that only half of the participants are aware of the regulations and are taking responsibility in performing sustainable actions even though they can distinguish some of the most important actions to be taken. We argue that sustainable tourism iii and medical tourism contribute not just to the economy, but also to the larger EU accession process. It proposes aligning the national frameworks with the European Union Green Deal, building the institutions and capabilities, investing in green and digital infrastructure, increasing transparency, and developing regional cooperation to ensure future competitiveness while meeting EU legislation.