JMIR Publications

ABSTRACT

Background:

To promote sustained contributions by doctors to online healthcare communities, these platforms have introduced a content payment model that offers economic incentives for doctors' online knowledge activities. However, the impact of these paid features on unpaid knowledge activities remains unexplored.

Objective:

This study investigates how the introduction of economic incentives in online medical communities affects doctors’ unpaid knowledge activities in the community.

Methods:

The data for this study were obtained from the Haodf online platform in China, which has implemented paid scenarios for its science popularization function, providing economic benefits to doctors. The dataset, which is panel data, includes 7,453 doctors who participated in both paid and unpaid knowledge contributions on the website. This study examines the impact of paid knowledge activities on doctors' free knowledge contributions, focusing on dimensions including knowledge quantity, quality, and diversity. To address the timing discrepancies in doctors' participation in paid activities, we employed a combined approach of propensity score matching and multi-period difference-in-differences (PSM-DID) method.

Results:

In the balance test results of the propensity score matching, the absolute values of the standard deviations of all matching variables are basically less than 5% after matching, ensuring the accuracy of the results obtained from the Difference-in-Differences (DID) method. This study found that participation in paid knowledge activities has a positive spillover effect on doctors' free knowledge contributions, which is manifested in the increase of post quantity (473.1%, P<.001), article length (108%, P=.009), function word frequency(0.6%, P=.001), causal word frequency(0.2%, P<.001), and content information entropy(6.6%, P=.006). The paid function leads to a decrease in the consistency of title content (-115.5%, P<.001).

Conclusions:

The findings of this study contribute to the existing literature on the impact of economic incentives in the medical context. For the platform, providing economic incentives to doctors can have positive significance in promoting the development of the platform's knowledge ecosystem and can effectively encourage doctors to contribute to both paid and free knowledge activities. This study provides a valuable reference for the platform to introduce a paid knowledge model, which is beneficial to the sustainable development of the platform.