Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jun 27, 2025)
Date Submitted: Feb 24, 2025
Open Peer Review Period: Feb 25, 2025 - Apr 22, 2025
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The preference for online medical consultation services and the associated factors in China: a national cross-sectional study
ABSTRACT
Background:
As a new means of the delivery of health care services, online medical consultation has become an increasingly popular trend over the past few years. Little is known about the public’s preference for online medical consultation services in China. Understanding the factors associated with the willingness from a broader perspective is paramount to optimize resource allocation and enhance the preference.
Objective:
Our study aims to evaluate the public's preference for online medical consultation, and further explore the associated factors of the preference from the perspectives of demographic factors, physical status, mental health status and health promoting behaviors.
Methods:
This was a population-based cross-sectional study in 148 cities in China and conducted from June 20, 2023 to August 31, 2023. We collected demographic data and used visual analog scale (VAS) scores to assess the public’s preference for online medical consultation by a 100-point scale. we also collected the following information: a) sociodemographic characteristics; b) psychologic status: anxiety (assessed by Generalized Anxiety Disorder-7), depressive disorders (assessed by Patient Health Questionnaire-9) and self-efficacy (assessed by New General Self-Efficacy Scale); c) health-promoting behaviors; d) health literacy: electronic health literacy (assessed by e-Health Literacy Scale Short Form) and medication literacy (assessed by Medication Literacy Scale). A stepwise regression analysis was used to assess the factors associated with the preference. Subgroup analysis was performed by the presence of chronic disease or not.
Results:
This study included a total of 30,044 valid questionnaires. People have a moderate willingness to accept online medical consultation, with a mean score of 49.82 ± 28.59 out of 100. The results showed that residents in east China (β=-1.90, P<0.01), who lived with their parents (β=-0.86, P=0.03), with mild anxiety (β=-1.27, P=0.02), with mild depression (β=-1.41, P<0.001) was associated with a lower preference for online medical consultation. However, residents with medical-related occupations (β=5.25, P<0.001), with undergraduate or college degree or above (β=1.85, P<0.001), with monthly per capita household incomes ＞3,000 RMB (β=5.09, P<0.001), who currently used traditional Chinese medicine (β=1.72, P<0.01), who were vaccinated (β=3.29, P<0.001), with chronic diseases (β=1.64, P<0.001), with high medication literacy (β=2.64, P<0.001), with high ehealth literacy (β =11.45, P<0.001), with high self-efficacy (β =3.57, P<0.001) had a higher preference for online medical consultation. Subgroup analysis demonstrates inconsistent results among people with and without chronic diseases.
Conclusions:
This national, cross-sectional study revealed that people have a moderate willingness to accept online medical consultation services among Chinese residents. This study identified multiple factors associated with the preference, including demographic factors, physical status, mental health status and health promoting behaviors. Our study highlights the potential demand for online medical consultation services in China and underscores the need for tailored policies to address the diverse needs of different population. Clinical Trial: None.
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