JMIR Publications

ABSTRACT

Background:

The Internet has caused the explosive growth of medical information and greatly improved the availability of medical knowledge, which makes the Internet as the main way for residents to obtain medical information and knowledge before seeking medical treatment. However, little is researched on how the Internet affects residents' decisions about medical institutions.

Objective:

To explore the associations between internet behavior of online browsing and healthcare provider choice in general Chinese adult population，and analyse other relevant factors influencing adults’ preferences for hospital types.

Methods:

With the adult resident (≥18 years old) in 12 regions including urban and rural areas taken as the research object, the medical institution choices for the population with various characteristics were analyzed, and the mixed-effects multinomial logit model was adopted to analyse the longitudinal data of the China Health Nutrition Survey (CHNS ) from 2006 to 2015.

Results:

The choices of the medical institution of people who browsed the Internet presented an obvious preference for self-care, followed by medical care from primary hospitals and municipal hospitals. Adult groups with different age, gender, education level, region, place of residence, the severity of illness and injury, years of suffering from hypertension, and history of chronic diseases showed diverse choices of medical institutions, and the differences were statistically significant(P<0.05). After controlling for confounding factors, the probabilities of residents participating in online browsing activities were 1.44 (e^0.363) times and 1.72 (e^0.545) times more likely to opt self-care and municipal medical treatment respectively than residents who did not participate in online browsing activities. However, the effect of online browsing on the selection probability of county-level hospitals was not significant compared with primary hospitals.

Conclusions:

The Internet has broken down the barriers to the knowledge of common diseases and thus produced a substitution effect of self-care on primary care. But with the uneliminated knowledge monopoly of difficult and complicated diseases and the increase in inconsistent and incomplete medical information has blurred the residents’ cognitive, which consequently exacerbates the rising tendency of visiting high-level medical institutions. Exploring the substantive impact of the Internet on medical decision-making is of great significance for further rational planning and use of the Internet to guide patients to the appropriate and correct medical institution based on their illness.