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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).

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.

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.

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.

The purpose of this paper is to explore the influence of a physician’s prosocial behavior on a patient's choices in the online health community (OHC) context. Moreover, the authors explore how such effects differ across different online word-of-mouth (WOM) and professional titles.

Guided by the motivation, opportunity and ability (MOA) framework, this paper develops hypotheses and an econometric model. Then this paper used spline regression to test hypotheses on 6,204 physicians at The Good Doctor (www.Haodf.com), which is one of the largest Chinese OHCs. The authors conducted the propensity score matching and difference-in-difference method (PSM-DID) to address the concern about the bias caused by possible endogeneity concerns.

The authors’ results show that a physician’s prosocial behavior improves a patient's choice only when the strength of a physician’s prosocial behavior is below the tipping point. In addition, the influence of a physician’s prosocial behavior is heterogeneous for physicians with different online WOM and professional titles. For physicians with higher online WOM, the effect of a physician's prosocial behaviors on a patient's choice is positive, while for physicians with lower online WOM, a physician’s prosocial behavior has no impact on a patient’s choice. For physicians with higher professional titles, the quantity of a physician’s prosocial behavior has a positive impact on a patient’s choice, while for physicians with lower professional titles the quality of a physician’s prosocial behavior has a positive impact on a patient’s choice.

This study contributes new knowledge and provides new perspectives to study a patient's choice by addressing the importance of physician's prosocial behavior. With the effort of explicitly explaining the complex mechanisms, this study encourages physicians' engagement in a physician’s prosocial behavior and gives some implications on how to perform the behaviors strategically.

Consumer confusion is an emerging phenomenon of interest that significantly drives choice behaviour. Considering the dearth of scholarly focus on confusion faced by consumers in a healthcare setting, this paper aims to conceptualize and validate a patient confusion model consisting of its drivers and outcomes.

Drawing upon adaptive decision-making framework and consumer confusion literature, patient confusion model has been developed. Empirical data of 310 patients from three private sector hospitals in India was collected through pen and paper survey administration. The hypothesized patient confusion model was tested using partial least squares structural equation modelling (PLS-SEM) to derive confirmatory results.

The results confirm the role of decision-making variables such as information overload, information similarity, information ambiguity, information asymmetry, patient involvement and physician-patient communication in the occurrence of patient confusion. A significant impact of confusion on switching intention was also confirmed, providing insights for healthcare managers.

The effect of confusion on switching intention of consumers found through the present study holds significant implications from a healthcare management standpoint. Dissemination of credible information, improved communication between doctors and patients and creation of organized channels of health information provision also represent some of the notable implications for healthcare managers to mitigate patient confusion.

This study presents an empirically validated model of patient confusion creating a research agenda for theory development in this emerging area. Consumer confusion represents a core consumer behaviour problem that is of utmost significance in the healthcare sector. This paper is one of the first and early attempts to address this research problem.

In the digital age, the spread of online behavior and real-world information leads to social contagion. This study aims to investigate the contagion phenomenon of online physician choice and then discuss its potential influence on the sub-specialization process in the healthcare service industry. In specific, this study aims to propose the basic mechanism of infection and immunity as follows – exposure to antigen may lead to an immune response, and the success of the immune response may depend on the provision of appropriate immune signaling.

Data collected from haodf.com including 4 disease types and 247 physicians from 2008 to 2015 were used to test the proposed hypotheses. Panel vector autoregression method was utilized to analyze the panel data.

The obtained result shows that social contagion of physician choice over disease type is salient on e-consultation platforms, indicating that physicians associated with/on haodf.com are concentrating on an even narrower type of disease. Disclosing more simple signals (physician history orders) results in more disease concentration for that physician in the future. In contrast, disclosing more detailed signals (physician-contributed knowledge or physician reviews) leads to less disease concentration.

This finding implies that physician-contributed knowledge and physician reviews may act as immune signal which will tend to trigger a success immune response. This study not only suggests managers should be careful about the double-edged sword effect of online physician choice contagion but also provides the useful approaches to promote or restrain such a contagion in a flexible way.

This study examines how service feedback and physician popularity affect physician demand in the context of virtual healthcare environment. Based on the signaling theory, the critical factor of environment uncertainty (i.e. disease risk) and its impact on physician demand is also investigated. Further, the research on the endogeneity of online reviews in healthcare is also examined in the current study.

A secondary data econometric analysis using 3-wave data sets of 823 physicians obtained from two PRWs (Healthgrades and Vitals) was conducted. The analysis was run using the difference-in-difference method to consider physician and website-specific effects.

The study's findings indicate that physician popularity has a stronger positive effect on physician demand compared with service feedback. Improving popularity leads to a relative increase in the number of appointments, which in turn enhance physician demand. Further, the impact of physician popularity on physician demand is positively mitigated by the disease risk.

The authors' research contributes to a better understanding of the signaling transmission mechanism in the online healthcare environment. Further, the findings provide practical implications for key stakeholders into how an efficient feedback and popularity mechanism can be built to enhance physician service outcomes in order to maximize the financial efficiency of physicians.

This study aims to examine the performance implications of an information governance (IG) framework for managing, controlling access to and securing information, focusing on (1) the performance benefits of an organization's IG orientation and (2) how the configuration of IG orientation and supply chain (SC) strategy type relate to performance outcomes.

This study leverages multiple secondary sources for US hospitals, serving as the context for the study. It also employs cluster analysis to develop an SC strategy taxonomy, namely sophisticated and delivery-focused SC strategies. The proposed research model is tested using a robust regression to mitigate the influence of outliers and produce more accurate estimates.

IG orientation is positively associated with financial performance and patient experience, and IG-oriented hospitals with a sophisticated SC strategy realize more financial benefits and achieve better patient care experiences compared to other configurations. Regardless of SC strategy type, IG-oriented hospitals offer better care experiences than non-IG-oriented hospitals.

This paper offers empirical evidence that a hospital's IG orientation and SC strategy jointly affect financial outcomes and patient experience. For hospitals, an organization-wide framework for governing information streamlines both intra- and inter-organizational information flows and improves care delivery throughout a patient's care experience.

This is one of a few studies that empirically examine the performance implications of governance of information in the domain of supply chain management (SCM). This study also develops an SC strategy taxonomy for the healthcare context and offers a springboard for research in service SC strategy.

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

This paper aims to examine the health technology use in health information seeking, communication and personal health information management, as well as in the effects they may have on his relationship with the physician and on the consumption of medical resources.

An online survey was conducted. The questionnaires were distributed via online health discussion forums using Google's survey software with a summary presentation of the study’s objective. The final selection of 362 individuals was made using social media, direct email and collaboration with community groups. The empirical validation of the causal model was conducted using the partial least square approach.

The results show that the use of e-health strengthens the quality of the patient–physician relationship and patient empowerment while increasing the consumption of medical resources.

The results of this research indicate that the internet has transformed the relationship of patients to health, to their doctors and to the health-care system. In this new context, a reconsideration of the status of the patient must be considered by health service providers.

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

Given the popularity of online health communities (OHCs) and medical question-and-answer (Q&A) services, it is increasingly important to understand what constitutes useful answers and user-adopted standards in healthcare domain. However, few studies provide insights into how health information characteristics, provider characteristics and recipient characteristics jointly influence user information adoption decisions. To fill this research gap, this study examines the combined effects of physicians' certainty tone as information characteristics, seniority as provider characteristics and disease severity as recipient characteristics on patients' health information adoption.

Drawing on dual-process theory and information adoption model, an extended information adoption model is established in this study to examine the effect of attitude certainty on patients' health information adoption, and the moderating effects of online seniority and offline seniority, as well as patient motivation level—disease severity. Utilizing logit regression models, the authors empirically tested the hypotheses based on 4,224 Q&A records from a popular Chinese OHC.

The results show that (1) attitude certainty has a significant positive impact on patients' health information adoption, (2) the relationship between attitude certainty and information adoption is negatively moderated by physicians' online seniority, but is positively moderated by offline seniority; (3) there is a negative three-way interaction effect of attitude certainty, online seniority and disease severity on patients' health information adoption.

This study extends the information adoption model to examine the two-way interaction between argument quality and source reliability, as well as the three-way interaction with user motivation level, especially for health information adoption in the healthcare field. These findings also provide direct practical applications for knowledge contributors and OHCs.