Disease risk and its moderating effect on the e-consultation market offline and online signals

Abstract

Purpose The purpose of this paper is to investigate the moderating effect of disease risk in terms of the major signals (i.e. status, reputation and self-representation) on the e-consultation platforms. Design/methodology/approach In this study, the proposed research hypotheses are tested using the transaction data collected from xywy.com (in Need of Therapy). In fact, xywy.com is one the leading e-consultation service websites in China that provides a platform for the interactions between the physicians and patients (Yu et al., 2016; Peng et al., 2015). Generally speaking, it has all the needed design elements and in other words, a standard e-consultation website should have such items/components as physician homepage, physician review, free consultation, paid consultation and recommendation systems. Findings The obtained results reveal that all attributes including status, reputation and self-representation have a positive impact on physician’s online order volume. Moreover, there is a positive moderating effect of disease risk onto the online reputation, indicating a higher effect exists for the diseases with high risk. However, the effect of offline status and online self-representation is not moderated by the disease risk, indicating market signals (online reputation) may have a stronger predictive power than seller signals (offline status and online self- representation), and therefore market signals are more effective when/if the disease risk is high. Originality/value E-consultation has gradually become a significant trend to provide the healthcare services, in the emerging economy such as China because of shortage of medical resources but having an adequate access in internet usage. The impacts of signals on the health care market have been validated by previous studies. However, the research focusing on the moderating effect of signaling environment in the health care industry is still lacking. As a result, the value of this research helps to bridge the aforementioned research gap.

The Impact of Signals Transmission on Patients’ Choice through E-Consultation Websites: An Econometric Analysis of Secondary Datasets

“…These e-consultation websites are also important in minimizing medical costs, enhancing clinical quality and efficacy, increasing the equity of medical services and meeting patient satisfaction. In order to make these e-consultation websites more effective for health consumers, it is necessary to adjust the contents of e-consultation websites to match the specific information needs according to the requirements of patients [ 16 ]. Due to the above reasons, e-consultation websites are the precious gold mines for patients regarding different aspects of healthcare during the COVID-19 pandemic [ 17 ].…”

“…The seller signal is the conventional signal clearly described in the previous signaling studies that the seller deliberately transmits to the buyer [ 23 ]. On the other hand, the market signal is the indicator or the information exchanged unconsciously or unknowingly between different players in the market [ 16 ]. The market signal as online word of mouth (WOM) is information regarding different products and services created by buyers based on the consumption experience.…”

“…Patients and physicians display different signals on e-consultation websites, affecting patients’ cognitive abilities to choose a good doctor [ 16 ]. People obtain information regarding the quality of healthcare services rendered by physicians through different signaling mechanism [ 25 ], such as the process that the signaler (i.e., the physician) sends measurable signals (i.e., offline reputation as physician title, education, experience and online effort) to the recipient (i.e., patients) to communicate details about the non-observable qualities (i.e., competency) in order to minimize information asymmetry [ 21 , 26 ].…”

“…Hong, et al [ 26 ] indicated that online reputation and knowledge contribution as market signals and seller signals significantly positively influence patients’ online choice to pay higher prices to physicians. In another study, the impact of seller signals (self-representation) and market signals (reputation) in e-consultation market is found significantly positive on physician volume of online bookings [ 16 ]. Zhang, et al [ 34 ] found that the higher a family doctor’s online reputation and knowledge contributions on virtual platforms, the greater that his/her private benefits.…”

“…However, only a few doctors and patients are adequately trained about how to use these digital services efficiently [ 44 ]. As a result, guidelines and recommendations are needed regarding the usage of different signals (i.e., online signals or offline signals) to educate both physicians and patients on how to transmit different signals on virtual platforms in order to improve the patients’ online consultation choice [ 16 , 23 , 36 ]. Therefore, this study aims to present a unique problem in the COVID-19 pandemic scenario, which incorporates different types of signals in the same research, that is, online signals and offline signals transmitted by marketers and sellers to investigate their impact on patients’ physician selection choice for e-consultation using the theoretical foundation of signaling theory.…”