Going online or offline? Patients’ selection of healthcare service channels

IF 3.4 3区医学 Q1 HEALTH POLICY & SERVICES

Health Policy and Technology Pub Date : 2026-02-01 Epub Date: 2025-10-16 DOI:10.1016/j.hlpt.2025.101124

Tingting Zhang , Yuhan Wei , Xiangbin Yan , William Yu Chung Wang

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引用次数: 0

Abstract

Objectives

: The geographically uneven distribution of healthcare resources is a serious global problem. Online healthcare platforms serve as a viable means to redistribute healthcare resources across regions. This study aims to investigate the factors influencing patients’ healthcare channel choices in the context of online–offline healthcare service integration by employing cue utilization theory and cognitive dissonance theory.

Methods

: This study adopted a scenario-based survey method to collect data. The questionnaire was designed and distributed via an online survey platform. The proposed research model was empirically tested using the data collected and structural equation modeling methods.

Results

: The results showed that channel accessibility, flexibility, and physician communication negatively affected both cognitive and emotional dissonance. Physician competence was found to negatively affect cognitive dissonance, while physician empathy was found to negatively affect emotional dissonance. In addition, both cognitive and emotional dissonance positively influenced patients’ subsequent channel-selection behavior, with physicians’ suggestions playing a moderating role in the relationship between cognitive dissonance and patient behavior. Moreover, the influence of emotional dissonance on subsequent channel-selection and the moderating effect of a physician’s suggestion on this relationship differ fundamentally between online and offline contexts.

Conclusions

: These results enrich the literature on the integration of online and offline channels in the healthcare field and patients’ channel-selection behavior in this context. Furthermore, the study findings have practical implications for healthcare service facility management and policymakers in promoting the integration of online and offline healthcare services.

Public interest summary

The uneven distribution of healthcare resources is a significant global issue, and online platforms can help redistribute resources. This study explores the factors influencing patients’ healthcare channel choices in the context of online-offline healthcare service integration using cue utilization and cognitive dissonance theories. The research model was tested using data from a scenario-based survey and structural equation modeling methods. Results showed that channel accessibility, flexibility, and physician communication negatively affected cognitive and emotional dissonance. While physician competence was found to negatively affect cognitive dissonance, physician empathy was found to negatively affect emotional dissonance. Both cognitive and emotional dissonance positively influenced patients’ subsequent channel-selection behavior with physicians’ suggestions playing a moderating role, where the strength of the direct effect of emotional dissonance on subsequent channel selection behaviour and the moderating effect on this relationship differs significantly based on the initial channel context. These findings have practical implications for healthcare facility management and policymakers in promoting the integration of online and offline healthcare services.

查看原文本刊更多论文

上线还是下线？患者对医疗服务渠道的选择

医疗资源的地理分布不均是一个严重的全球性问题。在线医疗保健平台是跨地区重新分配医疗保健资源的可行手段。本研究旨在运用线索利用理论和认知失调理论，探讨线上线下医疗服务整合背景下患者医疗渠道选择的影响因素。方法：本研究采用场景调查法收集数据。问卷通过在线调查平台设计和发放。利用所收集的数据和结构方程建模方法对所提出的研究模型进行了实证检验。结果：渠道可及性、灵活性和医师沟通对认知失调和情绪失调均有负面影响。医师能力对认知失调有负向影响，医师共情对情绪失调有负向影响。此外，认知失调和情绪失调对患者后续的渠道选择行为均有正向影响，医生建议在认知失调与患者行为的关系中起调节作用。此外，情绪失调对后续渠道选择的影响以及医生建议对这种关系的调节作用在线上和线下情境中存在根本差异。结论：本研究结果丰富了医疗领域线上线下渠道整合及患者渠道选择行为的相关文献。此外，研究结果对医疗服务机构管理和政策制定者促进线上线下医疗服务整合具有实际意义。医疗资源分布不均是一个重大的全球性问题，网络平台可以帮助资源重新分配。本研究运用线索利用和认知失调理论，探讨线上线下医疗服务整合背景下患者医疗渠道选择的影响因素。利用基于场景的调查数据和结构方程建模方法对研究模型进行了测试。结果表明，渠道可及性、灵活性和医生沟通对认知和情绪失调有负面影响。医生能力对认知失调有负向影响，而医生共情对情绪失调有负向影响。认知失调和情绪失调对患者后续的渠道选择行为均有正向影响，其中医生建议起调节作用，其中情绪失调对后续渠道选择行为的直接影响强度以及对这种关系的调节作用因初始渠道情境而有显著差异。这些发现对医疗机构管理和政策制定者促进线上和线下医疗服务的整合具有实际意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy and Technology Medicine-Health Policy

CiteScore

9.20

自引率

3.30%

发文量

审稿时长

88 days

期刊介绍： Health Policy and Technology (HPT), is the official journal of the Fellowship of Postgraduate Medicine (FPM), a cross-disciplinary journal, which focuses on past, present and future health policy and the role of technology in clinical and non-clinical national and international health environments. HPT provides a further excellent way for the FPM to continue to make important national and international contributions to development of policy and practice within medicine and related disciplines. The aim of HPT is to publish relevant, timely and accessible articles and commentaries to support policy-makers, health professionals, health technology providers, patient groups and academia interested in health policy and technology. Topics covered by HPT will include: - Health technology, including drug discovery, diagnostics, medicines, devices, therapeutic delivery and eHealth systems - Cross-national comparisons on health policy using evidence-based approaches - National studies on health policy to determine the outcomes of technology-driven initiatives - Cross-border eHealth including health tourism - The digital divide in mobility, access and affordability of healthcare - Health technology assessment (HTA) methods and tools for evaluating the effectiveness of clinical and non-clinical health technologies - Health and eHealth indicators and benchmarks (measure/metrics) for understanding the adoption and diffusion of health technologies - Health and eHealth models and frameworks to support policy-makers and other stakeholders in decision-making - Stakeholder engagement with health technologies (clinical and patient/citizen buy-in) - Regulation and health economics