Seeking medical services through guanxi in China

Zhang, Shuai; Wu, Yuzhang; Ma, Wen; Cheng, Mei-Li; Li, Linzi

doi:10.1016/j.pec.2020.12.004

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…As Table 4 suggests, social connections have been further used in social networking apps, while medical platforms are more reflective of modern society’s norms of personal interactions. Guanxi is a prominent property of traditional societies, where interpersonal trust largely relies on well-established social connections [ 37 , 42 ]. With the help of WeChat, the traditional interaction pattern continues in doctor-patient communication.…”

Section: Discussionmentioning

confidence: 99%

Doctors’ Personal Preference and Adoption of Mobile Apps to Communicate with Patients in China: Qualitative Study

Chen,

Han,

Yang

et al. 2024

JMIR Mhealth Uhealth

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Background Different kinds of mobile apps are used to promote communications between patients and doctors. Studies have investigated patients’ mobile app adoption behavior; however, they offer limited insights into doctors’ personal preferences among a variety of choices of mobile apps. Objective This study aimed to investigate the nuanced adoption behaviors among doctors in China, which has a robust adoption of mobile apps in health care, and to explore the constraints influencing their selection of specific mobile apps. This paper addressed 3 research questions: (1) Which doctors opt to adopt mobile apps to communicate with patients? (2) What types of mobile apps do they choose? (3) To what degree do they exercise personal choice in adopting specific mobile apps? Methods We used thematic content analysis of qualitative data gathered from semistructured interviews with 11 doctors in Hangzhou, which has been recognized for its advanced adoption of mobile technology in social services, including health care services. The selection of participants was purposive, encompassing diverse departments and hospitals. Results In total, 5 themes emerged from the data analysis. First, the interviewees had a variety of options for communicating with patients via mobile apps, with the predominant ones being social networking apps (eg, WeChat) and medical platforms (eg, Haodf). Second, all interviewees used WeChat to facilitate communication with patients, although their willingness to share personal accounts varied (they are more likely to share with trusty intermediaries). Third, fewer than half of the doctors adopted medical platforms, and they were all from tertiary hospitals. Fourth, the preferences for in-person, WeChat, or medical platform communication reflected the interviewees’ perceptions of different patient cohorts. Lastly, the selection of a particular kind of mobile app was significantly influenced by the doctors’ affiliation with hospitals, driven by their professional obligations to fulfill multiple tasks assigned by the hospitals or the necessity of maintaining social connections with their colleagues. Conclusions Our findings contribute to a nuanced understanding of doctors’ adoption behavior regarding specific types of mobile apps for patient communication, instead of addressing such adoption behavior of a wide range of mobile apps as equal. Their choices of a particular kind of app were positioned within a social context where health care policies (eg, limited funding for public hospitals, dominance of public health care institutions, and absence of robust referral systems) and traditional culture (eg, trust based on social connections) largely shape their behavioral patterns.

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Section: Discussionmentioning

confidence: 99%

Doctors’ Personal Preference and Adoption of Mobile Apps to Communicate with Patients in China: Qualitative Study

Chen,

Han,

Yang

et al. 2024

JMIR Mhealth Uhealth

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show abstract

“…This study also employed thematic content analysis of qualitative data from semi-structured interviews with selected doctors in HZ and YC. Inductive content analyses are used widely to research doctor-patient communication ( 17 ). We chose 10 doctors from each city under study.…”

Section: Methodsmentioning

confidence: 99%

“…Researchers have used this perspective to explore the doctor-patient relationship in the offline service, finding that patients turn to social connections to seek more trustworthy medical services ( 16 , 17 ). We applied this perspective to explore the possible influence of guanxi on the doctor-patient communications in today’s China as mobile apps are gaining more popularity.…”

Section: Introductionmentioning

confidence: 99%

Two cities, two stages in transforming society—a mixed methods study comparing doctors’ adoption of mobile apps for communication with patients in Hangzhou and Yancheng, China

Chen,

Su,

2024

Front. Public Health

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ObjectivesMobile apps have become commonplace in doctor-patient communication over the last 20 years. Doctors mainly use two kinds of app, social networking apps (i.e., WeChat) and medical platform apps (i.e., Haodf). The purpose of this study was to investigate whether the attributes of social interaction in local society impact doctors’ choice of mobile apps to communicate with patients. This article addresses two research questions: (a) To what degree do doctors’ adoption patterns in different societies differ? (b) Why do doctors choose certain mobile apps to communicate with patients?MethodsThis study employed a mixed methods research design to analyze doctor’s adoption behavior patterns in two cities, Hangzhou (HZ) and Yancheng (YC), which represent two stages in transforming society. Various patterns, measured as the percentage of doctors who utilize the medical platform app of Haodf among all doctors and the average service counts per doctor, were compared in three groups of tertiary hospitals: the top ones in HZ, the average ones in HZ, and the average ones in YC. We also conducted thematic content analysis of qualitative data from semi-structured interviews with 20 purposely selected doctors in the two cities.ResultsThe percentages of doctors who have adopted the app of Haodf from the three groups of tertiary hospitals were 49.97%, 41.00%, and 32.03%, with an average service counts per doctor of 261, 182 and 39, respectively. According to the interviewees, doctors from YC are more likely to use social networking apps to communicate with patients than their HZ counterparts to maintain social connections with their relatives, friends, colleagues, and others.ConclusionThis study demonstrates that doctors’ choices of mobile apps are dependent upon social context. In traditional society, where people have close ties, the logic of using social networking apps lies in doctors’ need to maximize the utility of their knowledge by maintaining social connections with others. In modern society, where the close ties between people have gradually weakened, the logic of using medical platform apps lies in doctors’ needs for reputation marketing, either for themselves or for institutions, their affiliated departments or hospitals.

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“…As a result, labour resources in remote rural areas are more scarce. However, when encountering difficulties in harvesting crops, building houses, getting medical treatment, employment or even personal finance, residents of these areas rely heavily on the help of neighbors and relatives in the same village (Bulte et al, 2018;Judd, 1997;Weng & Xu, 2018;Zhang et al, 2021;Zhou et al, 2022). To ask for help, in the case of scarce labour sources, giving relatively extravagant gifts better highlights the importance of the recipient to the giver (Ellingsen & Johannesson, 2011) and can also demonstrate the status and strength of the giver in the group (Andreoni & Bernheim, 2009;Brown et al, 2011;Zhu et al, 2021).…”

Section: Literature Reviewmentioning

confidence: 99%

Adding insult to injury: Living in a remote location increases the burden of gift expenses among the rural poor in China

Luo,

Ding,

et al. 2024

J of Intl Development

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Based on data from the China Labor‐force Dynamics Survey (CLDS), our study examines how geographical remoteness impacts farmers' gift expense burden. Farmers' gift expense burden increases significantly as the distance from the village to the county‐level city increases. Two key mechanisms for more remote rural areas exacerbate farmers' gift expense burden: stronger reliance on neighbours and relatives for assistance and more concentrated authority among local officials. Our research offers new perspectives on disparities in gift expense burden among farmers in developing countries and suggests viable avenues to alleviate their financial strain.

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Seeking medical services through guanxi in China

Cited by 7 publications

References 6 publications

Doctors’ Personal Preference and Adoption of Mobile Apps to Communicate with Patients in China: Qualitative Study

Doctors’ Personal Preference and Adoption of Mobile Apps to Communicate with Patients in China: Qualitative Study

Two cities, two stages in transforming society—a mixed methods study comparing doctors’ adoption of mobile apps for communication with patients in Hangzhou and Yancheng, China

Adding insult to injury: Living in a remote location increases the burden of gift expenses among the rural poor in China

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