Determinants of patients' service choice in online health communities: an elaboration likelihood model perspective
| Date | 28 June 2023 |
| Pages | 1863-1879 |
| DOI | https://doi.org/10.1108/LHT-12-2022-0585 |
| Published date | 28 June 2023 |
| Subject Matter | Library & information science,Librarianship/library management,Library technology,Information behaviour & retrieval,Information user studies,Metadata,Information & knowledge management,Information & communications technology,Internet |
| Author | Yuangao Chen,Meng Liu,Mingjing Chen,Lu Wang,Le Sun,Gang Xuan |
Determinants of patients’service
choice in online health
communities: an elaboration
likelihood model perspective
Yuangao Chen, Meng Liu, Mingjing Chen, Lu Wang, Le Sun and
Gang Xuan
Zhejiang University of Finance and Economics, Hangzhou, China
Abstract
Purpose –The purpose of this research paper is to explore the determinants of patients’service choices
between telephone consultation and text consultation in online health communities (OHCs).
Design/methodology/approach –This study utilized an empirical model based on the elaboration
likelihood model and examined the effect of information, regarding service quality (the central route) and
service price (the peripheral route), using online health consultation data from one of the largest OHCs in China.
Findings –The logistic regression results indicated that both physician- and patient-generated information
can influence the patients’service choices; service price signals will lead patients to cheaper options. However,
individual motivations, disease risk and consulting experience change a patients’information processing
regarding central and peripheral cues.
Originality/value –Previous researchers have investigated the mechanism of patient behavior in OHCs;
however, the researchers have not focused on the patients’choices regarding the multiple health services
provided in OHCs. The findings of this study have theoretical and practical implications for future researchers,
OHC designers and physicians.
Keywords Online health communities, Elaboration likelihood model, Service choice, Service quality,
Disease risk
Paper type Research paper
1. Introduction
The medical industry has steadily stepped into online services in this decade, though it
should be treated differently because of its particularity. The Chinese government is
encouraging an Internet Plus health policy to optimize the uneven distribution of medical
resources and meet patients’needs (Yang et al., 2021). During the COVID-19 pandemic, people
have changed their traditional way of pursuing health information to seeking information
online (Zhu et al., 2022). Patients and physicians increasingly use social media to better search
for information and interact with each other, such as through online health communities
(OHCs). OHCs centralize health information for both patients and physicians. Patients receive
information as well as emotional and esteem support in OHCs (Zhao et al., 2020), while
physicians can obtain economic returns and achieve social responsibility. Hence, OHCs will
run successfully only when physicians can achieve sufficient returns.
Medical resources worldwide are currently deficient (Xu et al., 2018). In emerging OHCs,
patients can turn to physicians and find health-related information generated by others and
systems without location and time restrictions, alleviating the problem of limited and
irrationally distributed medical resources and changing traditional patient–physician
interactions (Chen et al., 2020b). However, balancing offline and online work is a challenge for
physicians; they must effectively use their time to communicate with patients online under
limited online service conditions and obtain worthwhile returns.
Patients’
service choice
in OHCs
1863
Thisresearch is supportedby the National Social ScienceFoundation of China underGrant No. 21BGL245.
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/0737-8831.htm
Received 28 December 2022
Revised 17 January 2023
11 May 2023
Accepted 29 May 2023
Library Hi Tech
Vol. 42 No. 6, 2024
pp. 1863-1879
© Emerald Publishing Limited
0737-8831
DOI 10.1108/LHT-12-2022-0585
In the offline medical scenario, patients need to decide which physician to visit, and the
subsequent service is mainly determined by visiting physicians. Meanwhile, in the online
scenario, OHCs provide different communication channels, and patients must decide their
service choice after selecting the physician. Good Doctors Online (https://www.haodf.com),
a typical Chinese OHC, provide consultations through online texts, telephone calls, and live
videos, among others. Physicians decide whether to open these services, and then patients
select one of the services based on their own needs. Online text consultations are valid for
24 h, while telephone and live video consultations are valid for 5–30 min. Telephone and video
consultations are usually more expensive, providing higher revenue for physicians.
Depending on the situation and personal preferences, patients may choose different
services. Online medical services provide various communication options according to the
patients’preferences, and benefit physicians and OHCs from differential service pricings.
Researchers have explored how patients choose physicians and purchase consultations
(Wu and Lu, 2018). However, to the best of our knowledge, little research has been conducted
on how patients make service choices. Most previous research has focused on factors
influencing patients’selection of physicians, while this study explores the determinants of
patients’online medical service choices. We advance patient behavioral studies from the
selection of physicians to service choice, thus, contributing to the literature on OHCs.
Hence, this study attempts to address the research gap in the effective factors for service
choice in the online medical context using the elaboration likelihood model (ELM) as a
theoretical framework. The ELM proposes that people process information and make
decisions through central and peripheral routes (Petty and Cacioppo, 1986a). Excluding text
and telephone consultation services, most physicians in Good Doctors Online rarely opened
other online services. This study focuses on the differences between these two types of
services considering the physician-patient communication process, using service quality and
the price difference between the two service channels as the central and peripheral routes,
respectively. Additionally, disease risk and patient consultation experience can moderate
these two routes. The research questions were as follows.
RQ1. How do differences in service quality and price between the central and peripheral
routes affect patient service choice?
RQ2. Do patients’disease risks and consulting experiences moderate their information
processing of service features when facing different service choices?
To address these questions, we collected data from Good Doctors Online to assess the
empirical model established based on existing studies and pioneered the regularity of
patients’service choices in OHCs. The remainder of this paper is organized as follows. Section
2reviews the relevant literature and theories. Section 3 proposes the research hypotheses and
presents the empirical model. Section 4 describes the research context, data, variables and
methods used. Section 5 presents the results and robustness tests. Finally, Section 6 discusses
the research findings and implications.
2. Theoretical foundation
2.1 Online health communities
OHCs provide communication media for both patients and physicians. Patients can choose
properphysicians after browsingthe physicians’introduction and feedbackfrom other patients
on theirhomepages without travelcosts and time limits. Researchhas examined the acceptance
of e-health, focusing on technology,user perception, personal preferences and switchingcosts
of abandoningtraditional consultations(Tao et al., 2020a,b). Somepatients participate in OHCs
only for information and others for further consultation (Ahadzadeh et al.,2018). After
accepting the new pattern and entering OHCs, users browse websites and obtain critical
LHT
42,6
1864
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