Academic journal article Social Behavior and Personality: an international journal

The Relationship between Patient Donation and Satisfaction with Online Healthcare Service Quality

Academic journal article Social Behavior and Personality: an international journal

The Relationship between Patient Donation and Satisfaction with Online Healthcare Service Quality

Article excerpt

The worldwide online healthcare industry has experienced rapid expansion in recent years. As one of the biggest in the world, the Chinese online healthcare market has increased by more than 50% since 2016 and earnings exceeded 12 billion RMB (approximately US$1.7 billion) in 2017 (Electrical Design News, 2018). Using computer applications (apps) to obtain health information has become increasingly popular among Chinese smartphone users.

To encourage doctors to provide high-quality service online, the Chinese mobile healthcare platforms have adopted donation mechanisms similar to those used on the WeChat and Douyin social networking platforms. The mechanism allows patients to donate virtual gifts, for example, flowers and flags, to online physicians, and the revenue generated from donation is shared by the physician and the owners of the platform, providing financial reward for both. More important, patient donations could be a signal of excellent quality and, thus, could enhance the social reputation of both the physician and the platform.

Making donations has long been studied as a charitable behavior in research on psychology (Boenigk & Helmig, 2013), economics (Krishnamurthy & Tripathi, 2009), and nonprofit organizations (Bekkers & Wiepking, 2010). Sargeant, Ford, and West (2006) concluded that the motivation for donation is intrinsically associated with empathy and sympathy. Recently, researchers have begun to focus on the consumptive attribute of donation behavior in the context of social media platforms. Wan, Lu, Wang, and Zhao (2017) viewed donation as the donor's payment for the consumption of the knowledge or service. Wallace, Buil, and de Chernatony (2017) considered that donation on social media is a form of conspicuous consumption. Compared to donation to a charity and donation on social media, patient donation to an online healthcare service has some unique features. First, the patient as a donor is the person who needs the physician's help, whereas the charitable donor generally is the person who helps others (Ye, Teng, Yu, & Wang, 2015). Thus, patient donation should not be regarded as a charitable behavior. Second, most patients want to keep their illness situation private, so patient donation is unlikely to be a conspicuous consumption behavior. Therefore, we considered patient donation as a purely consumption behavior, that is, the payment for medical knowledge or suggestions online from a physician. Considering that the user's willingness to pay (WTP) increases incrementally as the degree of satisfaction increases (Homburg, Koschate, & Hoyer, 2005), the degree of patient satisfaction with an online healthcare service might be an important factor influencing the possibility that the patient will make a donation.

On the basis of the above arguments, in this study we explored the relationship between patient donation and patient satisfaction with the online healthcare service. We focused on two types of patient satisfaction: satisfaction with the process quality and satisfaction with the outcome quality, and investigated how these affect patient donation. Given that both free users and paying users can donate to physicians, we also investigated the difference in donation behavior between these two types of patient. Therefore, our research questions were as follows:

Research Question 1: How is patient donation behavior affected by satisfaction with the quality of process and of outcome of using of an online healthcare service?

Research Question 2: What is the difference in donation behavior between free and paying patients in use of an online healthcare service?

By answering these questions, we hoped to extend understanding of donation behavior from the context of traditional and social media settings to the setting of online healthcare.

Literature Review and Hypothesis Development

Donation Behavior and Satisfaction With Service Quality

For a long time, donation was studied as a charitable behavior (Bekkers & Wiepking, 2010; Sargeant et al. …

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