Yani Wang

Background: Internet hospitals are playing a significant role in medical care with their potential to provide widely accessible outpatient service delivery via information technologies. Current research on patients’ satisfaction with internet hospitals mainly focus on physician-patient relationship and patient demand, and less is considered about the whole process of online consultation. Objective: This study aims to identity the factors influencing patient satisfaction considering the entire process of online consultation to help physicians deliver better online medical services and to help physical hospitals operate internet hospitals more effectively. Methods: Based on the service quality (SERVQUAL) theoretical model, questionnaire items were designed for the 5 dimensions of reliability, assurance, responsiveness, empathy, and tangibility. The research samples for data collection were 355 patients on the internet hospital platform operated by a tertiary general hospital in Beijing. Confirmatory factor analysis was performed for dimensions of the measurement model, and path analysis was performed for the structural model. Results: The current consultation process of internet hospitals, as perceived by patients, did not yet meet their expectations, and the overall satisfaction rate of patients was only 7.15. The 5 dimensions of reliability, responsiveness, empathy, tangibility, and assurance had different positive predictive effects on patient satisfaction in internet hospitals to a certain extent. Among them, tangibility exerted the greatest impact on patient satisfaction in internet hospitals (β=0.25) but obtained the lowest score among the sampled participants (mean=6.78). Conclusions: Internet hospitals and physicians should focus on the factors of the above dimensions, especially the tangibility of medical services in the multistage online consultation, thus better serving patients and promoting the sustainable development of internet health care.

BACKGROUND Internet hospitals are playing a significant role in medical care with their potential to provide widely accessible outpatient service delivery via information technologies. Current research on patients’ satisfaction with internet hospitals mainly focus on physician-patient relationship and patient demand, and less is considered about the whole process of online consultation. OBJECTIVE This study aims to identity the factors influencing patient satisfaction considering the entire process of online consultation to help physicians deliver better online medical services and to help physical hospitals operate internet hospitals more effectively. METHODS Based on the service quality (SERVQUAL) theoretical model, questionnaire items were designed for the 5 dimensions of reliability, assurance, responsiveness, empathy, and tangibility. The research samples for data collection were 355 patients on the internet hospital platform operated by a tertiary general hospital in Beijing. Confirmatory factor analysis was performed for dimensions of the measurement model, and path analysis was performed for the structural model. RESULTS The current consultation process of internet hospitals, as perceived by patients, did not yet meet their expectations, and the overall satisfaction rate of patients was only 7.15. The 5 dimensions of reliability, responsiveness, empathy, tangibility, and assurance had different positive predictive effects on patient satisfaction in internet hospitals to a certain extent. Among them, tangibility exerted the greatest impact on patient satisfaction in internet hospitals (β=0.25) but obtained the lowest score among the sampled participants (mean=6.78). CONCLUSIONS Internet hospitals and physicians should focus on the factors of the above dimensions, especially the tangibility of medical services in the multistage online consultation, thus better serving patients and promoting the sustainable development of internet health care.

Taking the perspective of innovative knowledge management, this study aimed to investigate the stimulation mechanism of continuous innovative knowledge contribution (CIKC). Through a quantitative study conducted in an open innovation community, we modeled a stimulus–organism–response framework to conduct a path analysis from the external environment to internal cognition, and then to knowledge contribution, and filled in the gaps in the mediating and moderating mechanisms. We focused on the stimuli of knowledge contribution, in view of both quantity and quality. Panel data from six periods in one year was collected for dynamic analysis, and we used the fixed effect model to test our hypotheses of mediation effect, moderation effect, and mediated-moderation effect. There were some interesting findings, showing that user’s self-efficacy plays a partial mediating role in the quantity, rather than the quality, of CIKC; meanwhile, the users’ knowledge level plays a moderating role, and there is a negative moderating mechanism of knowledge level in the process from participation value to the quality of CIKC.

This study focuses on patient engagement in online health communities (OHCs) and investigates the mechanism related to the impact of social support provided by patients on their personal engagement. Based on social support theory, we put forward a research model and conduct empirical analysis using datasets of 4797 patients with 160,484 posts and 1,647,569 replies from an online health community in China. The mediation of peer involvement and moderation of community status are also examined. The results indicate that the subdimensions of social support positively influence patient engagement with informational support exerting the greatest impact. Peer patient involvement imposes significant partial and positive mediating effects on the relationships, especially on informational support. Community status negatively moderates the impacts of social interactions and informational support on patient engagement in that the influence of social interactions and informational support are more profound for patients with low community status. The findings can bring an understanding of patient engagement in OCHs, and provide theoretical and practical implications to facilitate the development of an online healthcare service.