JMIR Publications

ABSTRACT

Background:

The doctor–patient relationship is a typical principal–agent relationship. Information asymmetry and patient uncertainty generally exist in the doctor–patient interaction, which hinders patient rehabilitation as well as harmony in the doctor–patient relationship. With the development of the online health industry, patients can easily access online information related to health care and thus mitigate this principal–agent problem to some extent. However, how patients’ online health behaviors affect their trust in doctors has not been fully studied.

Objective:

The purpose of this article was to explore the impact of illness-related online information quality and doctor-related online word-of-mouth information on patient trust from the perspective of reducing uncertainty based on principal–agent theory.

Methods:

A Web-based survey consisting of 337 participants was used. The research constructed a structural equation model and used SmartPLS 3.2.8 software to test the reliability and validity of the measurement model and the path coefficient of the structural model.

Results:

This research revealed that online health information quality and online word-of-mouth doctor ratings act as uncertainty mitigators and negatively affect patient information asymmetry and patients’ worries about doctor opportunism. Patient information asymmetry and patients’ worries about doctor opportunism as uncertainty antecedents positively affect patient uncertainty. Patient uncertainty negatively affects patient trust. In addition, by classifying patient uncertainty into that concerning the illness and that concerning the doctor, this paper identified the different roles of the two types of patient uncertainty.

Conclusions:

This study affirms the role of online health information quality and online word-of-mouth doctor ratings in reducing patient uncertainty and explains the positive influence mechanism of patients’ online health behaviors on patient trust. And the two types of online health information (illness-related online information quality and doctor-related online word-of-mouth information) as uncertainty mitigators have different effects on patient trust. Therefore, patient trust can be improved by strengthening the management of online health information. This research generates new insights into an understanding of the impact of digital health on patient trust in doctors.