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Description of the Project

This project focuses on spa development in the V4 region (Czech Republic, Hungary, Poland and Slovakia) and analyses the extent to which traditional medical spas are being adapted to attract and accommodate commercial (non-state-funded) guests and international tourists. This includes the development of infrastructure, the upgrading and regeneration of facilities, the improvement of service quality and the enhancement of visitor experiences. The potential for wellness services and health tourism are a major focus of the research.

Background to the Study

During the Socialist period (1945-1989) the emphasis in spa development was mainly on providing health-enhancing facilities for residents and domestic tourists. Balneotherapy (the use of medical waters in spa treatments) typically consisted of a range of therapeutic treatments administered over three or four weeks. Although some intra-regional tourism existed at that time, especially to spa towns, the emphasis was much more on the domestic markets. 

After 1989, the situation started to change and tourism development accelerated once the V4 countries joined the EU in 2004. Their expectations of spas were sometimes different from those of the previous domestic and inter-regional tourists and it implied the need to upgrade and invest in spa development to improve quality and services. However, funding was often lacking despite some ongoing government support for balneotherapy. EU fund helped with renovations from 2004 onwards. 

The V4 countries show some similarities to other countries in the region. For example, research on wellbeing and health tourism was undertaken in eleven Balkan countries (several of which are post-socialist including Albania, Bosnia and Hercegovina, Bulgaria, Croatia, Romania, Serbia and Slovenia (Smith and Kiss, 2015). A lack of funding for renovations and the much-needed upgrading of infrastructure was highlighted in this study, as well as the need for better quality and friendlier service. Although many staff are medically educated, they are not trained enough in customer service. More effective marketing would also be required. 

The research in the V4 project used a Delphi Study where 28 spa experts were questioned about the following themes:

  • Main challenges for thermal baths and medical spas in the post-Socialist era (1990 onwards)
  • Share of government support (health insurance) compared to self-funding and how this has changed over time
  • The changing nature of local resident and domestic tourists’ use of spas.
  • The impacts of international tourism development on spa development in the region
  • The meaning of wellness and the types of services that are being offered in spas
  • Existing conflicts between user groups (e.g. medical and wellness guests; older and younger generations; men and women; international tourists and local residents; different nationality guests)
  • Use of customer satisfaction evaluation systems and monitoring of quality
  • Collaborations and networks of spas and their main roles and benefits
  • Future challenges, opportunities and development options for V4 spas
  • How did the COVID-19 situation affect spas in the V4 region and how is the situation being handled?

The project is a collaboration between researchers from four Universities:

  • Czech Republic: Lucie Sobotkova, University of Pardubice, email:
  • Hungary: Melanie Kay Smith, Budapest Metropolitan University, email:
  • Poland: Diana Dryglas, AGH University of Science and Technology, email:
  • Slovakia: Jan Derco, Technical University of Kosice, email:

As part of the project, we have undertaken the following:

  • The establishment of a network of spa experts from the V4 countries and wider region
  • The publication of a special issue of the International Journal of Spa and Wellness entitled: From Medical to Wellness: Challenges and Opportunities for Spas, including the following articles:
  • A Delphi Study consisting of two rounds of interviews with 28 spa experts
  • A report in English comparing research data from the four countries
  • Four reports in the national languages of the V4 countries with detailed research about spa development in Czech Republic, Hungary, Poland and Slovakia

Summary of Findings

The data from the V4 countries contains many similarities:

  • This includes the problems of meeting quality standards for paying and international guests, but not being able to fund this through state or health insurance funds 
  • Low salaries and lack of education for employees and the difficulties of recruiting a qualified workforce
  • Addressing special needs of different segments of guests. There was a consensus that the main priorities should be infrastructural improvements followed by creating quality services for new, often self-paying or international guests
  • In all countries, state funding has been reduced since 1990 and the number of self-paying guests is slowly rising. EU funds have mainly helped with renovation and infrastructural developments
  • Wellness treatments are growing in popularity especially among younger and foreign guests, but emphasis is still placed firstly on physical health restoration
  • Medical wellness, preventative care and healthy lifestyle advice is growing but is not yet well established
  • The main future challenges are connected to further infrastructure, service and quality improvements, for which constant monitoring is required, better segmentation as well as increasing digitalisation

Project logo:


Project partners:

Technical University of Košice –
AGH University of Science and Technology –
University of Pardubice, Faculty of Economics and Administration –

The project is co-financed by the Governments of Czechia, Hungary, Poland and Slovakia through Visegrad Grants from International Visegrad Fund. The mission of the fund is to advance ideas for sustainable regional cooperation in Central Europe.

Coordinator of the project: Melanie Smith PhD
Coordinator's e-mail address: :
Coordinator's phone: +36-20-462-4443