**3. Method**

Research carried out in the field of a business model and its applicability in spa enterprises requires a step-by-step procedure. In the first stage of empirical research, qualitative research was carried out based on in-depth interviews conducted among managers of the largest spa enterprises in Poland. The research carried out at this stage made it possible to identify the scope of applicability of business models in spa enterprises.

The second stage of research concerns the task of getting to know and analyzing the preferences and expectations of tourists visiting Polish spas, as well as potential tourists in order to formulate the value proposition for the client. This stage of empirical research is aimed at getting to know the necessary activities aimed at identifying a potential additional segment of Polish spa clients and extending the scope of existing activities in the light of observed cultural and demographic changes.

In the research stage of spa enterprises, the study was attended to by managers of 17 entities which together provide 33% of all health resort treatment services in Poland, operating in 95 facilities (sanatoriums and spa hospitals), which constitute 36% of all facilities in Poland. The research was carried out in 2018.

The companies analyzed were selected from the list of spa treatment establishments developed and made available by the Ministry of Health of the Republic of Poland. The choice was made based on the potential of the services provided—these were the largest spa enterprises in Poland in terms of annual visitor count and accommodation capacity. Some of those enterprises are spread across multiple health resorts in various towns. Such a choice of research subjects provided a good insight into the discussed industry and allowed to draw conclusions of enough significance to picture the current state of spas in Poland. The research questionnaire consisted of two parts. The first one included 18 questions characterizing the structure of the business model, enabling a description of each of the model's components. In the second part of the questionnaire, the subject of general information on the conducted activity and sources of its financing was taken (eight questions). Some of the questions concerned not only the indication of selected variants of the answer, but also their weighing. The responses helped to formulate a universal model of a spa enterprise business.

The methodological objective was also possible through empirical research and its subsequent use in the conceptual phase. The basis for the research and analysis was the most popular business model scheme CANVAS by A. Osterwalder and Y. Pigneur [49] because of its dual prominence; it is a tool, but also a concept that describes what a business model is, by breaking it down into nine key elements. Among them, we can distinguish: (1) customers' segment, being the axis of each business model; (2) proposals of values for selected customers' segments; (3) communication channels between the defined elements; (4) relations with customers; (5) revenue streams; (6) key resources, (7) key activities; (8) key partners; and (9) cost structure, meaning all the costs related to the execution of the defined business model. Nine of the mentioned elements are defined as the business model template. They compare the tool to a canvas which can be used to paint a picture of the existing or new business model. The utilitarian character of CANVAS makes it also a suited research tool, thanks to this clear division of a business model into elementary pieces. By studying each of them separately, it is possible to gather data that describes the whole picture of the business model in full detail, focusing on all nine aspects, oftentimes using different sources for fully understanding each of them. While asking the managers directly to describe their business model, the outcomes might be incomparable if even provided, given the low rate of familiarity with the business model concept among spa managers, and considering the vast selection of definitions describing business models.

According to the adopted research methodology, the implementation of the objectives of this work assumed the application of a step-by-step approach, in which the current state of the situation is first identified, concerning both the activities of spa enterprises, the scope of application of business models in health resort enterprises, and the characteristics of individual components (elements) of the business model. Due to the diversity of factors influencing health resort operations, it was also necessary to learn about the nature of organizational and social changes that affect the situation of the spa enterprises (Figure 1).

**Figure 1.** Research areas discussed in empirical and theoretical research. Source: Own study.

In terms of tasks, the first stage of the research consisted of in-depth interviews on the applicability of business models of selected spa enterprises, considering their forms, as well as the characterization of particular elements of the applied business strategy (in the absence of business models). In the second stage, the preferences of patients concerning the spa treatment services and the needs of potential patients were analyzed, which constituted the basis for a conclusion concerning the proposal of value for the spa customer, for it is a key element of each business model that shapes all its other elements.

In the research of tourist expectations, a research survey was made available to determine their expectations regarding the offer of Polish health resorts, and at the same time, to develop a proposal of value for visitors. The study mainly concerned people who had already completed a spa treatment, but potential clients were excluded, and the research required reaching those people in their everyday life environment. The questionnaire contained 34 questions and was divided into three major parts. The first and last one included questions for all participants, while the second one contained two sets of questions—one for spa visitors and one for potential visitors. Answers that where given by the respondents in the first part decided what set of questions they should receive in the second part. This way, the conducted research allowed us to gather opinions of spa visitors, as well as get to know the expectations of potential clients. Clients who visited a spa in the last 10 years where asked about their experiences and needs, while the potential clients explained why they have not visited a spa so far and what their expectations are. The questionnaire was made available and disseminated on the Internet on social networks related to health resorts, and people interested in the subject were made available in the Internet community. Eight-hundred-and-ten people participated in the study. After the selection of the collected questionnaires for further research, 753 respondents were qualified, of which 63.5% (478 people) were patients of Polish health resorts (TS), i.e., people who had been in one of the Polish spas in the last 10 years. The second group of respondents (275 respondents) are people who have never been to Polish health resorts, and who at the same time express such a desire, having specific expectations (PT).

In the tourist group, 478 responses were obtained, which exceeded the minimum sample size estimated at 474 surveys (for the accepted level of maximum statistical error of the sample of ±4.5% and the confidence level *p* = 0.95). In the case of potential patients, the maximum statistical error of the sample is ±6%, with the assumed significance level of α = 0.05 (then the minimum size of the research sample is 267 respondents).

Statistical analysis of the collected data required the use of descriptive methods (arithmetic average supplemented by standard deviation) and intergroup comparisons (attribute significance index based on the structure index). In the case of normal distribution variables, the Student's *t*-test was used to compare two mean values in the independent groups tested, first determining the uniformity of variance (Fisher-Snedecor test) [50,51]. For a comparison of the two groups with non-normal distribution, the U (Mann-Whitney) test was used [52]. As a result, this stage of research allowed us to learn about the needs of both spa patients and potential patients, which at the same time made it possible to focus on developing a proposal of value consistent with the needs of the market. Then, it was also possible to integrate the structure of the obtained spa product into the business model.

In accordance with the adopted approach to research, the preliminary identification of the research problem led to a conclusion on the classification of the undertaken research. Therefore, it should be stressed that they were applied research in both descriptive and practical terms. However, using the physical criterion, the undertaken research was primarily of a qualitative nature, although quantitative research was also carried out in the dimension of creating a value proposition for the patient.

### **4. Results**

The presented results are divided into two parts that correspond to the two different groups of research subjects. In the first subsection, findings from the literature review regarding business models are presented. Those are supplemented by the findings from in-depth interviews of spas' managers, giving an overall insight into all key elements of a business model used in a current spa enterprise. Because value proposition is the key component of every business model, and because it can be perceived from two perspectives, the company's and the customers point of view, the second subsection is dedicated to the standpoint of spa visitors. It contains findings obtained through the previously described questionnaire, regarding expectations and value for spa customers and potential customers. The results of both findings are used in the discussion section in order to get a comprehensive model of

a spa enterprise business that meets both the issues of running a spa business from the enterprises stand point, as well as meeting the needs of clients in the form of expectations towards value proposition.
