Silver Tourism in Greece. Basic Elements of Marketing and Branding

Abstract

Major changes that have taken place around the world recently include the increase in world population, the expansion of life expectancy, the advancement of the health of people of all ages, and the greater flow of tourism between countries. For most countries, senior tourists constitute a distinctive part of the tourism industry. In order for Greece to emerge as an ideal tourism destination and to satisfy the demand and needs of senior tourists, it must improve and develop the necessary infrastructure and services through targeted strategies that will help its international image. This paper aims to record the opinions and preferences of senior tourists regarding the choice of a tourist destination in general, and especially in the current COVID-19 period, which factors influence their decision, which media they use when searching for information, and then the goal is to investigate their opinion on the recognition of Greece as a silver tourism destination, through the existing marketing and branding. The goal of the work is also to study the ability of Greece to emerge as a health tourism destination, specifically medical tourism for international elderly patients. Research has been contacted through online questionnaires on a random sample of elderly people living abroad during spring 2021.

1 Introduction

In modern times, the tourism sector is an important industry among others. It is an international activity that has contributed economic gains to countries around the world. However, it is not a concept that does not change, as it concerns an activity that is constantly evolving and trying to satisfy existing needs.

One of the categories of tourists that is directly affected by the changes that are taking place but also contributes to these changes are the elderly tourists. The expansion of the world's population, the expansion of life expectancy, the promotion of the health of people of all ages, and the greater flow of tourism between countries have led to the rapid development of “silver tourism”, which constitutes a characteristic part of the tourism industry.

The purpose of this paper is to examine the opinion, trends, and preferences of senior tourists regarding the choice of a tourist destination in general, and especially in the period of COVID-19, which factors are those that influence their decision positively or negatively, what means they use to gather information and then to investigate more specifically their opinion on the awareness of Greece as a tourist destination, through the existing marketing and branding. Finally, the goal of this paper is also to help define the necessary parameters in order for Greece to become a health and medical tourism destination for elderly tourists.

Creating a good image is particularly important for a tourist destination in order to attract tourism (Marshalls, 2014; Moustaka & Constantoglou, 2021). The brand and image of a tourist destination help create strong relationships between the destination and tourists (Constantoglou, 2020; Chatziliadou & Constantoglou, 2021). Therefore, destination management organizations should focus on investigating and understanding the purchasing behavior of senior tourists, and this is indeed the first question raised in this work, what are the preferences, motivations, and habits of senior tourists of age. Also given the COVID-19 pandemic, with the unpleasant consequences it has caused to tourism worldwide, a second question raised is to see if the preferences, motivations, and habits of senior tourists have been affected by the pandemic.

Nowadays, the tourism industry could not remain unaffected by the emergence of new technologies (Constantoglou & Trihas, 2020). With the presence of digitized technologies, the penetration of the Internet into the whole spectrum of human daily life and the variety of online possibilities we have now moved into the era of acceleration, availability and distribution of unlimited information, and the inclusion of all the aforementioned in the tourism industry. This is also the third research question of this paper. What are senior tourists’ main sources of information for travel advice, what is their view on the role of search engines, and how much are they influenced by social media?

As mentioned above, creating a good image is particularly important for a tourist destination in order to attract senior tourism. The fourth research question of this paper concerns Greece as a tourist destination and the opinion that senior tourists have about it.

The last research question of the paper has to do with the contribution of health tourism to sustainable development. To what extent health tourism can contribute to the sustainable development of a tourist destination and to what extent Greece is or could emerge as a medical tourism destination and a health tourism destination for senior tourists from all over the world.

2 Literature Review

Today 30% of the world's population belongs to the baby-boomers generation, which consists of those born after World War II, from 1946 to 1964. During this period, the birth rate of all countries in the world, especially those who actively participated in the war, had explosive growth, resulting in the birth of approximately 450 million people worldwide. Thanks to the emergence of new technologies, there have been several changes in the tourism industry. The new tourist, nowadays, is constantly informed (Balderas-Cejudo, 2019). People are aging, “that is, the upper age strata increase the proportion of the total population” (Balderas-Cejudo, 2019) and the market is changing.

Determining the age limit at which a person is considered as elderly is influenced by many factors. Many researchers have established that this age limit is at the age of 55 (Silva et al., 2020). Differences also appear in determining the age of the senior tourist (Senior Tourist). Many researchers, as well as the World Tourism Organization, define it at the age of 50 years and above (Fleischer & Pizam, 2002; Littrell et al., 2004; Utama, 2016; Wang, 2006), some define it from 55 years and above (Hossain et al., 2003; Hsu et al., 2007; Huang & Tsai, 2003), some at 60 years and above (Horneman et al., 2002; Reece, 2004; Shim et al., 2005), and finally, others are placing a age range from 65 to 74 years (Jang & Wu, 2006; Lee & Tideswell, 2005). Senior tourists constitute a distinct group of tourists with different and unique characteristics from the rest (Balderas-Cejudo, 2019; Silva et al., 2020; Vigolo, 2017).

From the beginning of the twenty-first century until today, the rate of aging of the world population constitutes an unprecedented historical event, which will lead to significant changes in human daily life (World Population Prospects, 2017). In 2050, the number of elderly people will reach 500 million and the largest percentage will live in emerging countries, and also of particular interest is the prediction that the population of elderly people up to 79 years of age will remain stable after 2020 in developed countries. Following, population growth will be due to people over 80 years old (Gladwell & Bedini, 2004; World Population Prospects, 2017). Beyond developed countries, the percentage of people aged 80 and over will jump numerically after 2040 (Kazaminia et al., 2015; Prayag, 2012). This is why many scholars claim that we the world slowly and without choice is entering the era of the “silver economy” (World Population Prospects, 2017).

The rapid growth of the population together with the economic boom, the rapid development of global transportation means, and the technological changes brought by the wide use of Internet have led to the rapid growth of travel and tourism worldwide. The development of tourism and the aging of the population have, as a result, the rapid growth of senior tourism (Santos et al., 2016; Utama, 2016).

The impact of the elderly on tourism is evident from the following (Santos et al., 2016; Zsarnoczky et al., 2016):

• Increased revenue for the tourism industry as older people traveling year-round and staying longer in the destination.

• Limiting the seasonality of the destination, as older people travel year-round and in low demand periods to avoid the overcrowding of high demand periods.

• Improvement of the offered tourist products and services, as elderly people have higher demands and emphasize quality.

• Cooperation with other states and development of strategies for the promotion of each country-destination and the attraction of senior tourists.

• Support for winterization and strengthening of the local/national economy.

Senior tourists have different requirements and expectations during their stay in a tourist destination; therefore, their satisfaction assessment differs from that of a younger age group. Tourism marketing should therefore understand the need to segment the specific target group into smaller subgroups with common characteristics in order to understand their particular needs and attract them through the provision of distinct services (Alen et al., 2017). Primarily, age could be a criterion for segmenting senior tourists. However, according to researchers, the segmentation of senior tourists should be based on their perceived age and not their actual age, as perceived age is what determines their preferences (Alen et al., 2015). Another segmentation criterion could be income. Not all are characterized by the same economic level and situation, most elderly people are generally in a financially strong group (Alen et al., 2015). Another criterion that is at the center of tourism marketing interest is the education of the elderly. More and more elderly people are becoming educated, unlike before, an element that strongly influences their preferences during a trip (Losada et al., 2016; Santos et al., 2016).

The elderly place particular emphasis on many parameters when choosing a tourist destination, which, if they cannot be met, are becoming deterrent factors. These factors can be distinguished into factors related to the destination and factors related to the tourist himself (Sert, 2019).

The inhibitory factors related to destination are the unstable political and social environment in the destination, pandemics and public health issues, nonexistence or difficulty of movement with public transportation, insufficient public transport networks and road infrastructure, nonexistence of desirable tourist services, the distance from the country of residence, inability to serve people with special needs or people with chronic health problems, morals and customs of the destination country, extreme weather conditions, and finally accessibility of services (Lopes et al., 2020).

The inhibiting factors related to the tourist himself are the health profile of senior tourists, existence of work or family obligations, low income, limited free time, lack of desire to travel, insufficient information, absence of a tour guide, reduced skills that limit movement, and reduced mobility or physical difficulties (Huber et al., 2018).

The coronavirus pandemic (COVID-19) is one of the most important milestones of the twenty-first century. Within months, the global tourism industry moved from overtourism to no-tourism (Constantoglou & Klothaki, 2021).

A 2017 study by STOCHASIS estimates the turnover of the global medical tourism market between 45.5 billion and 72 billion dollars. About 14 million cross-border patients worldwide spend an average of $3,800–$6,000 per medical visit, including costs related to medical services, cross-border and local travel, hospital stay, and accommodation. In the European Union, the proportion of trips by older people was expected before the pandemic to increase from 15% in 2010 to 26% in 2030 and 32% in 2050.

Greece is one of the top holiday destinations for senior tourists as it has been observed that there is an increasing percentage of tourists between the ages of 55 and 64 choosing our place for their holidays; however, there is also a decrease in inbound tourists over the age of 65 years old (INSETE, 2016).

Senior tourism can become a decisive factor in extending the tourist season for Greece, since this segment of tourists allocates more time for entertainment, spends more and for a longer time, usually outside the tourist season (shoulder season). These tourists, they are not yet the largest percentage of those who travel to Greece, but they generate 40% of the total tourism income. This is a key motivation for the evolution of a destination. The development of senior tourism and the long-term stay of pensioners from other countries can contribute in many ways to the development of the Greek economy. The national strategy of the Greek Ministry of Tourism should aim to promote Greece as a leading, safe destination 365 days year-round, offering unique and integrated travel experiences in each destination, especially for the target population of older people (Dianoesis, 2021).

3 Methodology

In this research, an attempt is made to examine the opinions and preferences of senior tourists regarding tourism and the recognition of Greece as a destination for them, as well as their opinions on health tourism in Greece; therefore, quantitative research is the most appropriate for its purposes. It was chosen to conduct a quantitative survey on a sample of foreign tourists of senior age (55 years and older) who have either visited the destination or not. Regarding the restrictions on the sample, the only one that was set was that the participants had to reside permanently in foreign countries. Finally, a questionnaire consisting of 38 questions of various types was used to collect the necessary data.

The main survey instrument in a quantitative survey is the structured questionnaire (Mills et al., 2017), which was used in this survey and will be presented in detail below. Due to the fact that the quantitative research method constitutes a process of researching a theory or an issue, which consists of a series of variables that are numerically measured and allow for statistical analysis, for this reason it was chosen to be used in the present research as well (Abawi, 2008). The snowball sampling method was used. As Atkinson and Flint (2001) point out “snowball sampling is a technique for finding research subjects”. Lately response rates to academic surveys are decreasing (Baruch & Holtom, 2008). Thus, the method of snowball sampling was considered to be relevant from the authors in order to increase the response rate of this research.

The participants filled out the questionnaire that was created in Google forms application. The distribution of the questionnaire was carried out using the social media of Facebook and LinkedIn, in which various groups/communities of users of these media with a common characteristic of tourism were identified, where the relevant link was published, which users could find the questionnaire and complete it, along with clear explanations of the purpose and limitations of the research. The questionnaire was published in four groups with open content and seven groups with closed content (requirement to register as a member of the specific ones) on Facebook, with the reason for the creation of the group being tourism for the elderly, and it was also republished and promoted by the personal profiles of some participants-members of the groups of them in order for their friends and acquaintances to participate, and finally, it was also published in five closed content groups on LinkedIn.

Research was conducted for 30 days, from May 2021 to June 2021. To ensure the reliability and validity of the questionnaire, a pilot test was conducted with ten persons of the specific age group to test efficacy and clarity. The questionnaires gathered from those persons are not part of the final sample. Little modifications were then made based on their recommendations. Then, the method of snowball sampling was used to send the questionnaires. It should also be mentioned that at the beginning of the questionnaire there was a note, which informed the participants about the purposes of the research, about the use of their answers and assured them about the protection of their personal data and their anonymity.

A total of 107 completed questionnaires were collected. The collected data were statistically analyzed using the Statistical Package for the Social Sciences (SPSS) version 24.0. Descriptive statistics were used to analyze the basic features of the data collected, and then cross-tabulations were applied to understand the correlation between the different variables.

4 Results

At this point, the results of the primary research conducted will be presented. One hundred and seven (107) completed questionnaires were collected from elderly tourists and permanent residents abroad.

Of the 107 participants in the survey, 48.6% (52 people) are men and 51.4% (55 people) are women (Graph 1).

Graph 1

Gender of participants

In Graph 2 which shows the distribution of the sample by age groups, the largest part of the participants belongs to the age groups 55–60 years (24 people) and 60–65 years (24 people), with a percentage of 22.4%, respectively, followed by 65–70-year-old group (23 people) with 21.5%, the 75–80-year-old group (17 people) with 15.9%, the 70–75-year-old group (16 people) with 15%, and finally, the 80 age group–85+ years old (three people) with a share of 2.8%.

Graph 2

Age of participants

Of the 107 participants, 38.3% (41 people) hold a master's degree, 32.7% (35 people) hold a bachelor's degree, 18.7% (20 people) are high school graduates, and finally 10.3% (11 people) hold a PhD (Graph 3).

Graph 3

Training of participants

Regarding marital status (Graph 4), the largest percentage declares married with 72% (77 people), followed by divorced with 14% (15 people), single with 5.6% (six people), a percentage who are widowed with 5.6% (6 people), and finally single-parent families with 2.8% (three people).

Graph 4

Marital status of participants

Of the 107 respondents, 10.3% (11 people) are from the United States of America, 6.54% from Italy (seven people), the same percentage of 6.54% from the United Kingdom (seven people) and from Germany (seven people), 5.61% from Spain (six participants), while France (six participants) recorded the same percentage. From China, Denmark, and Switzerland, four people responded to the questionnaire, with a percentage of 4.67% each country. From Australia, Russia, Turkey, the Netherlands, Finland, and Sweden, three people participated in the questionnaire, 3.74% of the participants from the aforementioned countries. From Belgium, Bulgaria, Ukraine, India, Israel, Cyprus, and Saudi Arabia, two people participated in the questionnaire, 1.87% of the participants from the aforementioned countries. Finally, from Morocco, Austria, Lithuania, Brazil, Poland, Albania, Jordan, Norway, Croatia, Algeria, Canada, Japan, Sudan, Portugal, Libya, Czech Republic, Egypt, Moldova, and Slovakia, one person participated in the questionnaire, from 0.93% of the participants for each country (Graph 5).

Graph 5

Country of permanent residence of participants

Regarding employment, in Graph 6, we see that 41.1% (44 people) have not yet retired, 30.8% (33 people) have retired but are still working, and finally 28% (30 people) are retired and not employed.

Graph 6

Professional occupation of participants

The question about the monthly income of the participants (Graph 7) highlighted as a larger group the participants who answered that they have a medium monthly income with a percentage of 49.5% (53 people), followed by those who answered that they have a high monthly income with 30.8% (33 people) and the analysis closes with the common people who have low incomes with a rate of 19.6% (21 people).

Graph 7

Monthly income of participants

In the second part of the questionnaire, participants were asked to answer about their travel preferences and habits. They were also asked to answer about their travel habits and preferences during the difficult period we are going through with the COVID-19 pandemic.

The majority of the sample (42.1%–45 people) stated that they travel 3–5 times a year, when 36.4% (39 people) travel 1–2 times, and 21.5% (23 people) travel more than 5 times each year (Graph 8).

Graph 8

Frequency of trips by elderly tourists

This question aimed to examine their preferences for where they choose to travel. Graph 9 shows the results from which it follows that 65.4% (70 people) choose foreign regions for their holidays, while 34.6% (37 people) are limited to their country of residence.

Graph 9

Results for where senior tourists choose to travel

In Graph 10, we can observe that 46.7% (50 people) of the sample mainly choose vacations lasting 4 to 7 days and 36.4% (9 people) choose vacations lasting 8 to 13 days. Also, 7.5% (8 people) usually go on vacation from 1 to 3 days, 6.5% (seven people) go on vacation from 2 to 3 weeks, and 2.8% (three people) go on vacation for more time.

Graph 10

Result for the trip duration of senior tourists

In Graph 11, the results on who senior tourists choose to travel with are presented. The results show that 35.5% (38 people) of the participants choose to travel with their partner/spouse, 29% (31 people) travel with their family, and 17.8% (19 people) travel group with people they know. Finally, 10.3% (11 people) stated that they travel alone and 7.5% (8 people) with a group of people they do not know.

Graph 11

Results with whom do senior tourists usually travel

Regarding the accommodation chosen by senior tourists for their stay, of the 107 participants, 31.8% (34 people) prefer budget hotels, while 15.9% (17 people) prefer to stay in luxury hotels. A corresponding percentage of 15.9% choose hostels for their stay. A percentage of 14% (15 people) book on Airbnb, while 9.3% (ten people) of the respondents answered that they prefer inns and the same number (9.3%) friends and relatives for their stay. Finally, a small percentage of 2.7% (three people) choose the cruises and a 0.9% (one person) the camping (Graph 12).

Graph 12

Accommodation preferences of senior tourists

From Graph 13, it follows that 46.7% (50 people) of senior citizens choose to organize their trip by themselves, while 31.8% (34 people) turn to tourist offices for help. Finally, 21.5% (23 people) belong to some group or group of elderly people who belong to the organization.

Graph 13

Results regarding travel booking method by senior tourists

Graph 14 shows in detail the results regarding the reasons that elderly people choose to travel. As can be seen, the majority of participants, 82.2% choose to travel for relaxation, 37.4% travel to visit friends, 36.4% travel for adventure, and 31.8% to visit relatives. Education and professional reasons follow in the choices with 22.4% and 18.7%, respectively, various sports and other events with 10.3%, health reasons with 7.5%, and finally, religious reasons with rate of 6.5%.

Graph 14

Main reasons that elderly people choose to travel

Of the 107 respondents, 69.2% (74 people) said that the COVID-19 pandemic has affected their mood and intention to travel, while 30.8% (33 people) say they are unaffected (Graph 15).

Graph 15

Impact of COVID-19 on mood and intention to travel

In Graph 16, the results are presented regarding who senior tourists would choose to travel with during the COVID-19 pandemic. The results show that 37.4% (40 people) of the participants would choose their partner/spouse, 27.1% (29 people) their family, and 15.9% (17 people) group with people where they know. Finally, 12.1% (13 people) said they would travel alone and 7.5% (8 people) with a group of people they do not know.

Graph 16

Results on who senior tourists would choose to travel with during the COVID-19 pandemic

Interest arises from the fact that while the majority of participants stated that their mood and intention to travel have been affected due to the pandemic, the answers regarding the company they would choose to travel with do not differ greatly from the choices they have in normal circumstances out of a pandemic.

Regarding the accommodation that senior tourists would choose for their stay in view of the COVID-19 pandemic, of the 107 participants, 70.1% (75 people) answered that in this case they would choose an individual residence, while the 26.2% (28 people) would choose luxury hotels for their stay. A small percentage of 2.7% (three people) also answered here that they would prefer a cruise ship and a 0.9% (one person) camping (Graph 17).

Graph 17

Accommodation preferences of senior tourists during the COVID-19 pandemic

From Graph 18, it appears that most of the participants 36.4% (39 people) would prefer to travel for their safety by plane during the pandemic, 31.8% (34 people) chose the car, 14% (15 people) the bus, 11.2% (12 people) the train, while 5.6% (6 people) would choose to travel by ferry and one person (0.9%) answered with none.

Graph 18

Preference of means of transport by senior tourists during the COVID-19 pandemic

Of the 107 respondents, 82.2% (88 people) stated that they emphasize the observance of basic protection measures regarding the COVID-19 virus, while 17.8% (19 people) answered negatively (Graph 19).

Graph 19

Compliance with the observance of basic protection measures against the COVID-19 virus

Graph 20 shows in detail the results regarding the measures emphasized by senior tourists to avoid transmission of the COVID-19 virus and to protect themselves. As it can be seen, almost all participants (103 people–96.3%) keep safe distances from others and 93.5% (100 people) answered that they regularly wash their hands. High percentages of 89.7%, 88.8%, and 85% gathered as measures the avoidance of handshakes and hugs, the use of masks and gloves, and the avoidance of moving outside the house in case of unwellness with notification of the doctor, respectively. This is followed by the use of antiseptic with a percentage of 73.8%, the avoidance of gatherings with 62.6%, and finally, the avoidance of unnecessary travel outside the home with a percentage of 57.9%. Also, one person (0.9%) answered that they do not observe any of the aforementioned protection measures.

Graph 20

Results regarding the measures followed to protect and avoid the transmission of the COVID-19 virus

The following graph (Graph 21) shows in detail the results regarding the reasons that elderly people would choose to travel during the pandemic. As can be seen, the majority of participants, 78.5% (84 people) would choose to travel during the pandemic for reasons of relaxation and recreation as well as during non-pandemic periods.

Graph 21

Main reasons for travel for the elderly during COVID-19

38.3% chose visiting friends, 33.6% to visit relatives, and 33.6% for adventure. Professional and educational reasons follow in the choices with 22.4% and 20.6%, respectively, various sports and other events with a percentage of 10.3%, health reasons with a percentage of 8.4%, and finally, religious reasons with a rate of 5.6%.

The reasons that would motivate the surveyed senior tourists to choose to visit one country over another are shown in Graph 24, and the most common response among the others was the uniqueness and uniqueness of the destination (59.81%), followed by value for money to follow (48.6%), the offer of discount offers from the destination's agencies (44.86%), the tourist image of the destination (28.97%), and finally, the publicity of the destination in the mass media (15.89%) (Graph 22).

Graph 22

Reasons for activating senior tourists for choosing a destination

In Graph 23, respondents were asked to choose the three main parameters they take into account when choosing to visit a country. They chose environment (61.68%), entertainment (54.94%), and quality of service (48.59%), followed by local population, cost, food, and weather. As the first choice, the environment received the most answers (42.99%), followed by service quality with 21.49% and then entertainment with 14.95%. However, entertainment was chosen by the largest percentage (28.97%) as the second choice.

Graph 23

Factors influencing senior tourists to choose a destination

Graph 24

Reasons influencing senior tourists to prevent choosing a destination

In Graph 24, regarding the reasons for preventing a visit to a destination, the majority 97.2% answered terrorism, 52 answers (48.6%) had natural disasters and pandemics, and 46 answers (43%) related to a government travel ban/directive by their country's government. Then the options for the unstable political situation of the region are heard with a percentage of 28% (30 responses) and finally the low quality of services with 15.9% (17 responses).

|In the third section, respondents were asked to answer regarding the sources of information they use for travel advice, their opinion on the role of search engines in the promotion, and advertising of tourist destinations as well as their degree of influence on Greece from social media.

In Graph 25, respondents were asked to indicate the media they use most for their information about a trip. Most of the answers were collected on the Internet, where 87.18% of the participants answered that it is important or very important, and immediately after came information from relatives and friends (word-of-mouth) with 86.91%, travel agents with 80.37%, social media with 62.62%, travel reports with 42.05%, and last choices were print media with 28.03% and television with 19.63%. The least responses were collected by television with 40.19%, travel reports with 28.10%, and print media with 28.03%.

Graph 25

Sources of information for obtaining tourist information from the elderly

Following participants were asked to indicate the degree of agreement or disagreement they had with three statements related to the role of search engines, and the results are shown in Graph 26. The majority (85.93%) responded that they agreed (agree and strongly agree) with the proposition that search engines are a fast and authoritative way of retrieving travel-related information. 57.94% responded that they agree with the statement that you get the right results and 41.12% responded that they agree that assisted search helps with destination brand campaigns.

Graph 26

Role of search engines in the promotion and advertising of tourist destinations

In the next question, the participants were invited to answer whether they are influenced by the comments they read about Greece on social networks (Graph 27). Most respondents (45.8%–49 people) answered neutrally. Immediately after 26.2% (28 people) answered a lot, while 13.1% (14 people) answered a little, 10.3% (11 people) answered a lot, and 4.7% (5 people) answered not at all. We observe here that comments through social media do not make a significant difference in the decision of senior tourists.

Graph 27

Destination impact score from social media comments

Following participants were asked to determine how much they are influenced by the reviews they see about Greece on social networks and various other media (e.g., Trip Advisor, Booking.com, etc.), with the neutral answers to achieve 33.6% (36 people) and a maximum of 32.7% (35 people). 14% of the sample answered a lot, while others (14%–15 people) answered a little and 5.6% (6 people) answered not at all (Graph 28).

Graph 28

Degree of influence for destination from social media reviews

In this fourth part, the respondents answered a series of questions regarding Greece as a tourist destination, if they have visited it, what would motivate them to visit it, how they would characterize it as a tourist destination, and if they would recommend it as a destination for friends and relatives.

Of the 107 respondents, 58.9% (63 people) have visited Greece, while 41.1% (44 people) answered negatively (Graph 29).

Graph 29

Visits to Greece by senior tourists

Respondents answered regarding the reasons that would motivate them to visit Greece (Graph 30). The most important reason was the good climate of Greece and the scenic beauty with 93.46% of the respondents answering very and very much and immediately after, the culture and heritage of Greece with 85.04%, the value-price relationship with 82.24%, and adventure with 74.76%. The calm state of the city emerged as less important reasons with 58.87% and religion with 23.36% which was the only reason that had a negative balance (11.21%).

Graph 30

Motivating reasons of senior tourists for choosing Greece as a tourist destination

Following respondents were asked how they would characterize Greece as a tourist destination based on some statements (Graph 31). Of the 107 respondents, 18.69% answered that they agree that Greece is a popular destination and 51.40% answered that they quite agree. 25.23% have a neutral opinion and 4.67% disagree. Greece is an attractive destination and 41.12% of the participants fully agree with this statement, while 50.47% quite agree and 8.41% are neutral. With the statement that Greece is a safe destination, 15.89% completely agree, and 44.86% quite agree, while 37.38% are neutral and 1.87% disagree. Of the 107 participants, 66.35% fully agree that Greece has many monuments, while 29.91% agree and 2.8% are neutral. Accordingly, 64.48% fully agree that Greece has many natural attractions, 33.64% agree, and 1.87% are neutral. Finally, 39.25% fully agree with the statement that Greece has a very good climate, 49.53% somewhat agree, and 11.21% are neutral.

Graph 31

Opinions of senior tourists on Greece as a tourist destination

In the following question, the respondents were asked to answer whether they would recommend Greece as a tourist destination to someone of their own. 37.4% of the sample answered that it is neither likely nor unlikely, 28% probably suggested it, and 24.3% much more likely to suggest it, while 9.3% probably would not suggest it and 0.93% (one person) would not recommend it at all (Graph 32).

Graph 32

Future recommendation of tourist destination Greece

Of the 107 participants, 50.5% (54 people) have not visited a country outside their country of permanent residence for medical reasons and/or for reasons of health and well-being, while 49.5% (53 people) answered positively (Graph 33).

Graph 33

Percentage of respondents who have or have not traveled to another country for medical and/or health and wellness reasons

Of the 107 participants, 56.1% (60 people) would consider traveling to Greece for medical reasons and/or for reasons of health and well-being, while 43.9% (47 people) answered negatively (Graph 34).

Graph 34

Percentage of respondents who would consider traveling or not traveling to Greece for medical and/or health and well-being reasons

Of the 107 participants, 66.4% (71 people) view the treatment of COVID-19 by the Greek government positively, while 33.6% (36 people) have not been positively affected (Graph 35).

Graph 35

Percentage of respondents who have been positively affected by the Greek Government's handling of COVID-19 and would consider traveling for medical and health and wellness reasons

When asked if they would travel to Greece for medical and/or wellness reason, 72 people (67.3%) would travel to Greece for medical purposes or for health and wellness tourism if family or friends suggested it, and 68 people (63.6%) said they would travel if recommended by a qualified or the family doctor. Impressively, 33.6% (36 people) said they would travel if it was suggested by Internet ads. This percentage is probably due to health and wellness reasons more. Also, 35 people (32.7%) would travel if their insurance company suggested it. Advertisements from hotels (32 people–29.9%), advertisements in medical journals (27 people–25.2%), in magazines and publications of tourist interest (three people–2.8%), and hospital advertisements (two persons–1.9%) follow (Graph 36).

Graph 36

Who can affect a trip for medical and/or health and wellness reasons

Following respondents were asked how important are the following factors to choose Greece for a medical procedure? Their views are (Graph 37).

Graph 37

Factors influencing destination choice for medical and/or health and wellness reasons

• Cost of medical procedures. 57% of participants (61 respondents) stated that it is important, 30.84% (33 respondents) very important, 5.61% (6 respondents) are neutral, 4.67% (5 respondents), and 1.87% (2 respondents) stated that it is not particularly important or not at all important, respectively.

• Travel expenses. 55.14% of the participants (59 respondents) stated that it is important, 28.97% (31 respondents) very important, 10.28% (11 respondents) are neutral, 3.74% (four respondents), and 1.87% (two respondents) stated that it is not particularly important or not at all important, respectively.

• Insurance coverage. 50.47% of participants (54 respondents) stated that it is important, 40.19% (43 respondents) very important, 7.48% (eight respondents) are neutral, and 1.87% (two respondents) stated not it is highly important and not at all important.

• Innovative interventions. 41.12% of the participants (44 respondents) declared that they are neutral, 26.17% (28 respondents) consider it important, 22.43% (24 respondents) very important, and 10.28% (11 respondents) said not is particularly important.

• High success rates. 76.64% of the participants (82 respondents) stated that it is very important, 22.43% (24 respondents) important, while 0.93% (one respondent) is neutral.

• High-quality hospitals and medical staff. 79.44% of the participants (85 respondents) stated that it is very important, 18.69% (20 respondents) important and 1.87% (two respondents) are neutral.

• Distance from the country of permanent residence. 43.93% of participants (47 respondents) stated that it is important, 28.97% (31 respondents) are neutral, 13.08% (14 respondents) stated that it is not particularly important, 11.21% (12 respondents) very important, and 2.8% (three respondents) not important at all.

• Greece is a member of the European Union. 37.38% of the participants (40 respondents) are neutral, 31.78% (34 respondents) stated that it is not particularly important, 14.95% (16 respondents) important, 14.02% (15 respondents) not at all important,, and 1.87% (two respondents) very important.

• High-quality hosting services. 49.53% of the participants (53 respondents) stated that it is important, 44.86% (48 respondents) very important and 6.54% (seven respondents) are neutral.

• Recovery in a tourist destination. 51.4% of participants (55 respondents) stated that it is important, 28.97% (31 respondents) are neutral, 14.95% (16 respondents) very important, and 5.61% (six respondents) said not is particularly important.

Following participants asked which will be the activities that would affect positively their opinion to travel to Greece. Eighty-six people (80.4% of the participants) answered they would visit Greece to see the museums and archeological sites, 42 participants (39.3%) to visit the thermal springs, 32 participants (29.9%) for spa activities, 23 participants (21.5%) for holistic treatments, 12 participants (11.2%) for yoga activities, and seven people (6.5%) for meditation (Graph 38).

Graph 38

Health and wellness tourism activities

5 Conclusion

In order to better understand the findings of this research, the results will be presented by part, answering the research questions of this paper and reaching overall conclusions.

The demographics section revealed an almost equal participation of men and women, mostly holders of a bachelor's or master's degree, and people from all age groups surveyed, with most being aged 55–70, which shows the dissemination and promotion of research in social networks and participation in online research. The present study elicited responses from all educational levels. Professional activists are more involved because they have more convenience to travel abroad for vacation, even though low or middle economic income represents the largest proportion of participants. The origin of the sample was varied, from many different countries in Europe and outside Europe, and the majority stated that they were married.

The first part of the research carried out concerns the senior tourism market and the preferences and habits of senior tourists, their preferences and habits were also investigated during the difficult period we are going through with the COVID-19 pandemic, giving answers to the first two research questions of this paper: What are the preferences, motivations, and habits of senior tourists and to what extent have they been affected by the COVID-19 pandemic? The findings showed that most of the sample travels between 3 and 5 times a year, while there are several who travel 1–2 times a year and those who travel more than 5 times. Furthermore, it is observed for the duration of the trip that the majority is divided into 4–7 nights and 8–13 nights. This highlights a great opportunity to promote Greece as a short-term vacation destination. In relation to destination preferences, it is observed that the majority choose holidays abroad more than holidays within their country of residence. We would expect that senior tourists would choose their country of permanent residence in order to avoid the hassle of a long journey; however, the findings are positive and create opportunities for senior tourism in Greece.

Regarding the preferences and habits of senior tourists before and during the coronavirus, most participants stated that they generally prefer to travel with their partner/spouse and family, and they maintain the same choices during of the pandemic. The answers for accommodation preference seem to be evenly distributed in all the options asked in the questionnaire with that of budget hotels dominating, while in the same question asked about accommodation preferences during the pandemic, the majority preferred individual residences and almost the rest of the luxury hotels. The findings here are not surprising, as these are seniors who would presumably mostly make these travel companion choices and would be particularly careful about their accommodation during the pandemic.

The main reasons seniors choose to travel are mainly for relaxation and recreation, to visit friends and family, and for adventure. These are the same reasons that seniors would choose to travel during the coronavirus. The majority of participants in our survey, as expected, stated that their mood and intention to travel have been affected by the pandemic, as well as that they place a lot of emphasis on following the basic protection measures to avoid and transmit the COVID-19. As a means of transportation for making a trip during the pandemic, the plane and the car were the two options with the highest concentration of responses.

Regarding the method of booking the trip, it should be emphasized that the majority—almost half of the participants—of the senior tourists choose to organize the trip themselves, while the rest of the sample addresses a travel agency or some other association/group elderly people. Although the percentage is not large, the individual's organizational autonomy is significant in the sense that we would expect it to be related to in-person and online bookings of transport tickets and hotels, so it is concluded that the elderly tourist participants of this research have some understanding of new technology.

The findings highlight that today's senior tourists are influenced by economic factors (offers, value for money) and experiential factors (destination uniqueness and distinctiveness) when choosing a destination, rather than reputation and image has in the viewing media. In fact, this is also confirmed by the parameters that determine their decisions, as the environment of the tourist destination, the entertainment, and the quality of the services offered emerged as the most prevalent. Concluding with the participants’ habits and preferences regarding the choice of tourist destination, the participants stated that they would avoid visiting destinations with terrorism threatening their safety or due to weather conditions and pandemic and due to government travel ban/directive of their country.

In the next section of the questionnaire, the third research question is answered, which are the main sources of information of senior tourists, what is their opinion on the role of search engines, and how much they are influenced by social media. The results showed that a large percentage of respondents consult the Internet first and social networks secondarily, but without overriding the information they get from acquaintances and relatives or from travel agencies. For the most part, all participants recognized the importance of the Internet for obtaining and disseminating travel advice and information. However, fewer agreed that you get the right results from search engines and that assisted search helps target brand campaigns. The results showed a use of online media by the respondents–senior tourists to search for information about the place they wish to visit, which is of great interest considering that the research is aimed at senior tourists. It is therefore concluded that the Internet has penetrated into the lives of senior tourists and more and more are acquiring the necessary technological knowledge to use it.

In the next section of the survey which was about Greece as a tourist destination for senior tourists and what is their opinion about this tourist destination, which corresponded to the fourth research question, more than half of the participants answered that they have visited Greece at some point, as they also stated that it is likely to very likely that they have recommended it as a destination to friends and family. Greece as a country has scenic beauty and very good climatic conditions, which emerged as the main reason for senior tourists to visit it, with the strong stock of cultural heritage following immediately after the price–quality ratio and the adventure. Finally, the majority of the sample agreed that Greece is a quite attractive destination with many cultural and natural attractions, with a good climate and quite a popular destination.

In the last section of the research, Greece is examined as a medical destination for the elderly. The fifth and last research question asked was whether health tourism is able to contribute to the sustainable development of the tourist destination and whether Greece can develop into a medical tourism and health tourism destination for senior tourists from all over the world. It is a general admission by all researchers that Greece has the potential to start in the leading medical tourism destinations and gain a large market share but lacks a comprehensive national strategy. Combined with its excellent climatic conditions, cultural heritage, Mediterranean diet, and natural resources, Greece can become a suitable medical tourism destination for international patients. Despite this, there is a limited number of tourist–patients of all ages worldwide who travel for medical purposes and intense competition from neighboring countries.

The results of the primary research brought several issues to the fore. In the question of whether they have ever traveled to another country to receive medical tourism or wellness tourism services, an equal distribution of the sample was noted and in fact in the case of Greece the majority thinks positively of traveling for these reasons. As the main tourism and wellness activities that would motivate them to visit Greece, visits to museums and archeological sites, visits to thermal springs, spa activities, and holistic treatments emerged.

Greece's handling of the pandemic affects a large percentage of respondents (66.4%) positively on a potential trip for medical or wellness reasons. Most of the survey participants stated that they would visit Greece for medical and/or wellness reasons following the suggestion of their family doctor or their friends and relatives. This is where the need for planning promotions and advertisements comes into play. According to the responses of the respondents, advertisements in medical journals, tourism magazines and publications, hospital advertisements, hotel advertisements, and the Internet are used as sources of information and can become means for choosing a medical and health and wellness tourism destination. But it still needs a lot of work for them to stand out further.

Regarding the factors that make Greece a choice for senior tourists for a medical procedure, the most important criteria for choosing a medical tourism destination are the high quality of hospitals and medical staff, high success rates, and the cost of medical procedures and travel expenses. Next comes recovery in a tourist destination, insurance coverage, and high-quality hospitality services. From the answers, we can draw the conclusion that even if the tourist character of a medical tourism destination is largely linked, in the specific product it is not the dominant selection criterion.

Overall, we conclude that Greece is a very attractive destination, which is faced with the challenges of the current state of tourism and tries to cope with the needs of tourists. The aim is to attract capital, investment, and tourists and thus form an attractive image for further economic and political gains.

In this context, the organizations involved have taken several measures as the majority of the sample was positive when asked if they would recommend Greece for vacations to relatives and friends. However, there are still many areas that need to be improved, which are not only related to the quality of tourism products, but also to the ways of promoting tourism products. The relevant authority must understand the needs of the tourists and adjust the products offered accordingly. They must seek and inspire good cooperation between private and public agencies in order to create the best partnership and thus create better conditions. The tourism industry is now very demanding, and competition is fierce. Consumers can obtain information directly. Therefore, those who are fully prepared to cope with the ever-changing market will manage to survive and thrive. This needs continuous study and search for information on consumer needs in order to understand the preferences of senior tourists.