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中国在线医疗服务的咨询定价:分层线性回归方法。

Consultation Pricing of the Online Health Care Service in China: Hierarchical Linear Regression Approach.

机构信息

College of International Business, Zhejiang Yuexiu University, Zhejiang, China.

Shaoxing Key Laboratory of Intelligent Monitoring and Prevention of Smart City, Shaoxing, China.

出版信息

J Med Internet Res. 2021 Jul 14;23(7):e29170. doi: 10.2196/29170.

Abstract

BACKGROUND

Online health care services are a possible solution to alleviate the lack of medical resources in rural areas, and further understanding of the related medical service pricing system would contribute to improvement of the online health care community (OHC). Although many studies have investigated the OHC, the impact of physicians' reputations and wage levels on consulting prices in the OHC has rarely been discussed in the literature.

OBJECTIVE

This study was designed to explore the determinants of consulting prices in the OHC. We addressed the following questions: (1) Are the prices of online health consultation services affected by wage levels at the doctor's location? (2) How does a physician's online and offline reputation affect their consulting prices?

METHODS

Employing a large-scale sample of 16,008 doctors in China, we first used descriptive statistics to investigate the determinants of consulting prices in their entirety. Hierarchical linear modeling was then used to investigate the determinants of consulting prices in the OHC.

RESULTS

The empirical results led to the conclusion that if doctors have more elevated clinic titles, work in higher-level hospitals, have better online reputations, and/or have made more past sales, their consulting prices will be higher. Additionally, the wage level in the city in which the doctor is working determines their opportunity cost and therefore also affects consulting prices.

CONCLUSIONS

The findings indicate that the characteristics of the doctor, the doctor's online reputation, and past sales affect the consulting price. In particular, the wage level in the city affects the price of the consultation. These findings highlight that the OHC is important because it can indeed break through geographical restrictions and give rural residents the opportunity to obtain medical service from doctors in big cities. However, doctors from cities often charge higher fees because of their higher opportunity cost. The results reveal that one of the most important functions of the OHC is to reduce the medical disparity between urban and rural areas; however, planners appear to ignore the possibility that rural residents with lower incomes may not be able to afford such high medical consultation costs. Therefore, the government should consider providing incentives to encourage urban doctors to provide discounts to rural residents or directly offer appropriate subsidies.

摘要

背景

在线医疗服务可能是缓解农村地区医疗资源短缺的一种解决方案,进一步了解相关医疗服务定价系统将有助于改善在线医疗社区(OHC)。尽管许多研究都调查了 OHC,但医生的声誉和工资水平对 OHC 咨询价格的影响在文献中很少被讨论。

目的

本研究旨在探讨 OHC 咨询价格的决定因素。我们提出了以下问题:(1)在线健康咨询服务的价格是否受到医生所在地工资水平的影响?(2)医生的线上和线下声誉如何影响他们的咨询价格?

方法

我们使用中国 16008 名医生的大规模样本,首先使用描述性统计来全面调查咨询价格的决定因素。然后使用分层线性模型调查 OHC 中咨询价格的决定因素。

结果

实证结果表明,如果医生的职称较高、在较高等级的医院工作、线上声誉较好、/或过去销售业绩较好,他们的咨询价格将会较高。此外,医生工作所在城市的工资水平决定了他们的机会成本,因此也会影响咨询价格。

结论

研究结果表明,医生的特征、医生的线上声誉和过去的销售业绩会影响咨询价格。特别是,城市的工资水平会影响咨询的价格。这些发现表明,OHC 很重要,因为它确实可以突破地域限制,让农村居民有机会从大城市的医生那里获得医疗服务。然而,由于机会成本较高,城市医生往往收取更高的费用。研究结果表明,OHC 的一个最重要的功能之一是缩小城乡医疗差距;然而,规划者似乎忽略了这样一种可能性,即收入较低的农村居民可能无法承担如此高昂的医疗咨询费用。因此,政府应该考虑提供激励措施,鼓励城市医生向农村居民提供折扣,或直接提供适当的补贴。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5504/8319787/d64688336958/jmir_v23i7e29170_fig1.jpg

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