School of Business, East China University of Science and Technology, Shanghai, China.
Telemed J E Health. 2020 May;26(5):629-638. doi: 10.1089/tmj.2019.0021. Epub 2019 Oct 4.
We aim to investigate how a specialization differentiation strategy impacts a physician's online economic rewards and the market conditions under which a specialization differentiation strategy has stronger effects. The study was performed using data from the health care system of the People's Republic of China. We used physician-based secondary data (data that were collected by someone other than the researcher) in an econometric analysis of transactions obtained from an e-consultation website (haodf.com) for four clinical specialties (pediatrics, endocrinology, gynecology, and oncology) from 2008 to 2015. Patient economics are not considered in this study. A total of 1,153 physicians were included in the analysis. The specialization differentiation strategy has a significant positive impact on the physician's online income (β p β p β p β p Physicians whose expertise is different from that of the majority have higher online incomes and service prices, and this impact will be stronger when market competition is more intense. Our study indicates that e-consultations may accelerate the specialization trend observed in the health care industry because the online market favors more-specialized physicians, and competition in the online market is stronger than in the off-line market. The e-consultation impact may be positive for some complicated diseases but less positive or even negative for chronic diseases, and therefore, policy-makers should be cautious about unintended consequences.
我们旨在探讨专科分化策略如何影响医生的在线经济回报，以及专科分化策略在哪些市场条件下具有更强的效果。本研究使用了来自中华人民共和国医疗保健系统的数据，通过对来自电子咨询网站（haodf.com）的四个临床专科（儿科、内分泌科、妇产科和肿瘤科）2008 年至 2015 年的交易数据进行基于医生的二次数据分析（即由非研究人员收集的数据），采用计量经济学分析方法。本研究不考虑患者的经济学因素。共有 1153 名医生纳入分析。专科分化策略对医生的在线收入有显著的正向影响（β p β p β p β p 与大多数医生专业不同的医生具有更高的在线收入和服务价格，而当市场竞争更加激烈时，这种影响会更强。我们的研究表明，电子咨询可能会加速医疗行业观察到的专业化趋势，因为在线市场更有利于更专业化的医生，而且在线市场的竞争比离线市场更为激烈。电子咨询的影响对某些复杂疾病可能是积极的，但对慢性疾病则不太积极甚至可能是负面的，因此，政策制定者应该谨慎对待意料之外的后果。
