JMIR Publications

ABSTRACT

Background:

Obesity is a unique chronic disease, with China having the largest number of overweight and obese people in the world. Online medical consultation (OMC) provides advantages in obesity treatment, but there has been little research from the perspective of obese patients’ demand for obesity OMC. The existing research also neglects the different demand scenarios of OMC obese patients.

Objective:

The objective is to assess the different demands for obesity OMC by For-Drug and For-Advice patients, and to compare For-Drug and For-Advice patients’ preferences for obesity OMC.

Methods:

We conducted discrete choice experiments (DCE) comprising 800 qualified participants, with 400 participants assigned to the For-Drug scenario and 400 to the For-Advice scenario. The two scenarios shared the same DCE design comprising 16 choice sets with 6 representative attributes, but had different demand scenario descriptions. We used a mixed logit model to analyze the data and estimated the willingness to pay (WTP) and relative importance scores (RIS).

Results:

Participants in the two scenarios both preferred higher-level doctors and doctors from higher-level hospitals, but the preference coefficients and WTP in the scenario For-Advice were higher than that in the scenario of For-Drugs, implying obese For-Advice patients had more requirements and expectations of doctors when asking for professional advice. Less waiting time and lower OMC fees were preferred in both demand scenarios and the RIS for OMC cost was over 48% in both scenarios. For-Advice patients had a significant preference for telephone consultation and were willing to pay more for telephone consultations than text consultations. For-Drug participants preferred longer consultation time (β=0.029) while For-Advice participants preferred shorter consultation time (β=-0.030). The difference could be explained by the different consultation needs in the two scenarios where longer patient consultations was preferred by For-Drug patients who sought detailed advice on drug side-effects, while quick and direct responses were preferred by For-Advice participants. For-Drug participants rated consultation duration time higher than waiting time, while For-Advice participants rated the waiting time as more important than consultation duration time. RIS showed that urgent and direct consultation was preferred by For-Advice patients.

Conclusions:

We identified two typical For-Drugs and For-Advice demand scenarios when obese adults chose OMC and used DCE to compare their preferences in the two scenarios. Our results revealed similar OMC preferences by the two groups that inform OMC competitors on differential pricing, using high-level doctors and hiring doctors from higher-level hospitals, especially tertiary hospitals. The For-Drugs and For-Advice differences in consultation duration, consultation form, speed of replies and wait time offer OMC platforms and online doctors an opportunity to segment the market by offering different services to different types of users.