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This study aims to examine the problems of the concession system that Macao has long-term adopted to regulate its gaming industry and discuss alternatives.

Theoretical reflection was used to provide qualitatively different insights about governmental supervision of the gaming industry.

Two options for reform are proposed: (1) replace the concession system with a licensing system that does not restrict the number of concessionaires or the period of concession or (2) adopt a modified form of the concession system that changes the number of concessionaires, period of concessions and methods for selecting concessionaires.

This study’s results have implications for the Macao government and other gaming jurisdictions in Asia.

This study provides a comprehensive examination of the concession system for governmental supervision of the gaming industry.

Effectively engaging patients is critical for the sustainable development of online health communities (OHCs). Although physicians’ general knowledge-sharing, which is free to the public, represents essential resources of OHCs that have been shown to promote patient engagement, little is known about whether such knowledge-sharing can backfire when superfluous knowledge-sharing is perceived as overwhelming and anxiety-provoking. Thus, this study aims to gain a comprehensive understanding of the role of general knowledge-sharing in OHCs by exploring the spillover effects of the depth and breadth of general knowledge-sharing on patient engagement.

The research model is established based on a knowledge-based view and the literature on knowledge-sharing in OHCs. Then the authors test the research model and associated hypotheses with objective data from a leading OHC.

Although counterintuitive, the findings revealed an inverted U-shape relationship between general knowledge-sharing (depth and breadth of knowledge-sharing) and patient engagement that is positively associated with physicians’ number of patients. Specifically, the positive effects of depth and breadth of general knowledge-sharing increase and then decrease as the quantity of general knowledge-sharing grows. In addition, physicians’ offline and online professional status negatively moderated these curvilinear relationships.

This study further enriches the literature on knowledge-sharing and the operations of OHCs from a novel perspective while also offering significant specific implications for OHCs practitioners.

Online health question-and-answer (Q&A) forums have developed a new business model whereby listeners (peer patients) can pay to read health information derived from consultations between askers (focal patients) and answerers (physicians). However, research exploring the mechanism behind peer patients' purchase decisions and the specific nature of the information driving these decisions has remained limited. This study aims to develop a theoretical model for understanding how peer patients make such decisions based on limited information, i.e. the first question displayed in each focal patient-physician interaction record, considering argument quality (interrogative form and information details) and source credibility (patient experience of focal patients), including the contingent role of urgency.

The model was tested by text mining 1,960 consultation records from a popular Chinese online health Q&A forum on the Yilu App. These records involved interactions between focal patients and physicians and were purchased by 447,718 peer patients seeking health-related information until this research.

Patient experience embedded in focal patients' questions plays a significant role in inducing peer patients to purchase previous consultation records featuring exchanges between focal patients and physicians; in particular, increasingly detailed information is associated with a reduced probability of making a purchase. When focal patients demonstrate a high level of urgency, the effect of information details is weakened, while the interrogative form is strengthened.

The originality of this study lies in its exploration of the monetization mechanism forming the trilateral relationship between askers (focal patients), answerers (physicians) and listeners (peer patients) in the business model “paying to view others' answers” in the online health Q&A forum and the moderating role of urgency in explaining the mechanism of how first questions influence peer patients' purchasing behavior.