Business Administration College, Zhejiang Gongshang University, Zhejiang Province, China.
J Med Internet Res. 2020 Sep 28;22(9):e18737. doi: 10.2196/18737.
The internet has become a major source of health care information for patients and has enabled them to obtain continuous diagnosis and treatment services. However, the quality of web-based health care information is mixed, which raises concerns about the credibility of physician advice obtained on the internet and markedly affects patients' choices and decision-making behavior with regard to web-based diagnosis and treatment. Therefore, it is important to identify the influencing factors of continuous use of web-based diagnosis and treatment from the perspective of trust.
The objective of our study was to investigate the influencing factors of patients' continuous use of web-based diagnosis and treatment based on the elaboration likelihood model and on trust theory in the face of a decline in physiological conditions and the lack of convenient long-term professional guidance.
Data on patients with diabetes in China who used an online health community twice or more from January 2018 to June 2019 were collected by developing a web crawler. A total of 2437 valid data records were obtained and then analyzed using correlation factor analysis and regression analysis to validate our research model and hypotheses.
The timely response rate (under the central route), the reference group (under the peripheral route), and the number of thank-you letters and patients' ratings that measure physicians' electronic word of mouth are all positively related with the continuous use of web-based diagnosis and treatment by patients with diabetes. Moreover, the physician's professional title and hospital's ranking level had weak effects on the continuous use of web-based diagnosis and treatment by patients with diabetes, and the effect size of the physician's professional title was greater than that of the hospital's ranking level.
From the patient's perspective, among all indicators that measure physicians' service quality, the effect size of a timely response rate is much greater than those of effect satisfaction and attitude satisfaction; thus, the former plays an essential role in influencing the patients' behavior of continuous use of web-based diagnosis and treatment services. In addition, the effect size of electronic word of mouth was greater than that of the physician's offline reputation. Physicians who provide web-based services should seek clues to patients' needs and preferences for receiving health information during web-based physician-patient interactions and make full use of their professionalism and service reliability to communicate effectively with patients. Furthermore, the platform should improve its electronic word of mouth mechanism to realize its full potential in trust transmission and motivation, ultimately promoting the patient's information-sharing behavior and continuous use of web-based diagnosis and treatment.
互联网已成为患者获取医疗保健信息的主要来源，使他们能够获得持续的诊断和治疗服务。然而，网络医疗保健信息的质量参差不齐，这引发了人们对互联网上获取的医生建议的可信度的担忧，并显著影响了患者对网络诊断和治疗的选择和决策行为。因此，从信任的角度来确定影响患者持续使用网络诊断和治疗的因素非常重要。
本研究旨在探讨在生理状况下降和缺乏便捷的长期专业指导的情况下，基于详尽可能性模型和信任理论，从患者角度出发，确定影响患者持续使用网络诊断和治疗的因素。
通过开发网络爬虫，收集了 2018 年 1 月至 2019 年 6 月期间中国使用在线健康社区两次或两次以上的糖尿病患者的数据。共获得 2437 条有效数据记录，然后使用相关因素分析和回归分析对我们的研究模型和假设进行验证。
及时回复率（中心路径下）、参照群体（边缘路径下）、以及衡量医生电子口碑的感谢信和患者评分都与糖尿病患者持续使用网络诊断和治疗呈正相关。此外，医生的职称和医院的排名级别对糖尿病患者持续使用网络诊断和治疗的影响较弱，医生职称的影响大于医院排名级别。
从患者的角度来看，在衡量医生服务质量的所有指标中，及时回复率的影响远大于效果满意度和态度满意度；因此，前者在影响患者持续使用网络诊断和治疗服务的行为方面起着至关重要的作用。此外，电子口碑的影响大于医生的线下声誉。提供网络服务的医生应该在网络医患互动中寻找患者接收健康信息的需求和偏好的线索，并充分利用他们的专业性和服务可靠性，与患者进行有效沟通。此外，平台应完善其电子口碑机制，充分发挥其在信任传递和激励方面的潜力，最终促进患者的信息共享行为和持续使用网络诊断和治疗。
