Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 12, 2022
Date Accepted: Nov 17, 2023
Effect of "offline-to-online" trust transfer on the utilization of online medical consultation among Chinese rural residents
ABSTRACT
Background:
Online medical consultation may help rural residents access high-quality health care resources to overcome the geographic and economic disadvantages of rural areas. However, with limited experience with online communication, it is generally difficult for rural residents to trust and utilize online medical consultation services. A bounded rational decision-making model enlightening "offline-to-online" trust transfer may be a potentially effective way to encourage less technologically experienced rural residents to trust and utilize online medical consultation.
Objective:
To describe the "offline-to-online" trust transfer status of rural residents in the internet health care context and analyse the direct effect of "offline-to-online" trust transfer in facilitating rural residents to utilize online medical consultation. Meanwhile, we explore the spillover effect of "offline-to-online" trust transfer in facilitating the utilization of online medical consultation among rural family members and its distributional effect among different education levels of populations.
Methods:
A multistage stratified random sampling method was used to survey participants in rural areas in China from July to September 2021, with a total of 2597 rural residents from 960 rural households. We used logit regression to estimate the propensity score values and applied the propensity score matching method (K-nearest neighbour matching, radius matching, and kernel matching methods) to match treatment and control samples of rural residents; then, we calculated the average treatment effect scores to compare the differences between treatment and control rural samples in utilizing online medical consultation.
Results:
A total of 57.4% of rural residents experienced an "offline-to-online" trust transfer, and it was more likely to occur in the elderly population with a low-level education and high-level satisfaction with local health care services. Meanwhile, rural residents who experienced "offline-online" trust transfers were 37%-40% more likely to utilize online medical consultation than those who did not experience "offline-to-online" trust transfers, and family members of householders who experienced "offline-to-online" trust transfers were 25%-28% more likely to utilize online medical consultation than those householders who did not experience "offline-to-online" trust transfer. In addition, compared to those populations with high-level education, "offline-to-online" trust transfer had greater direct and spillover effects on the utilization of online medical consultation services among rural residents with low-level education.
Conclusions:
To promote rural residents’ "offline-to-online" trust transfer and its facilitation effect in their utilization of online medical consultation, we suggest that online health care providers should develop a "patient-oriented" service mode to enhance rural residents’ satisfaction with local health care services and fully utilize the trust expansion functions between physicians and patients and among family members.
Citation
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Copyright
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