Exploring patient satisfaction and its influencing factors in Chinese internet hospitals: An analysis using two-factor theory and Kano model based on user-generated contents.

Abstract

Objective: There is currently a lack of in-depth understanding of patient satisfaction and usage of internet hospitals in real-world scenarios. This study aims to comprehensively collect internet hospital Applications (APPs) in China, investigate their patient satisfaction, identify influencing factors, and understand the differences in the factor attributes.

Methods: This study was a cross-sectional observational study. We collected China's internet hospital APPs and their patient reviews from eight Chinese APP stores in October 2024. First, data preprocessing was conducted through deduplication, identification of bot accounts, sentiment analysis, and manual inspection. Second, based on the Two-Factor Theory, the Latent Dirichlet Allocation topic model and Tobit model were employed to identify influencing factors. Third, the Wald test was used to examine the effect differences of these factors. Finally, the factor attributes were identified using the Kano model.

Results: A total of 148 internet hospital APPs in China and their 121,458 patient reviews were included. The number of these APPs and users showed an initial increase followed by a decrease, peaking in 2020. For influencing factors, 12 factors significantly affected patient satisfaction and dissatisfaction. The Wald test results indicated that there is a significant difference in the influencing effect between patient satisfaction and dissatisfaction. Twelve factors were further categorized into ten charm factors and two essential factors.

Conclusion: In recent years, patient satisfaction and real-world usage effectiveness of internet hospital APPs have been suboptimal. Research has shown that influencing factors exhibit asymmetry and can be further classified into charm factors and essential factors. On the one hand, reliability and customer service are basic needs of patients. On the other hand, online diagnosis and treatment functions, doctor's professional level, easy to use, and compatibility can effectively improve patient compliance.