基于ELM的在线医疗患者定向就诊意向研究

管理评论 ›› 2021, Vol. 33 ›› Issue (7): 170-181,215.

基于ELM的在线医疗患者定向就诊意向研究

曹仙叶^1,2, 刘咏梅², 刘嘉琪³, 董薇², 朱张祥⁴

1. 湖南工商大学工商管理学院, 长沙 410205;
2. 中南大学商学院, 长沙 410083;
3. 中国社会科学院新闻与传播研究所, 北京 100021;
4. 湖南师范大学旅游学院, 长沙 410081

收稿日期:2018-06-20 出版日期:2021-07-28 发布日期:2021-08-02
通讯作者: 刘咏梅(通讯作者),中南大学商学院教授,博士生导师,博士
作者简介:曹仙叶,湖南工商大学工商管理学院讲师,中南大学商学院博士研究生;刘嘉琪,中国社会科学院新闻与传播研究所助理研究员;董薇,中南大学商学院博士研究生;朱张祥, 湖南师范大学旅游学院讲师,博士。
基金资助:
国家自然科学基金重点项目（71790615）；国家自然科学基金项目（71771219）；中国国家留学基金项目（201706370141）；教育部人文社会科学研究青年基金项目（18YJC630275）；湖南省自然科学基金项目（2017JJ2323；2018JJ3357）；中南大学中央高校基本科研业务费专项资金项目（2017zzts042）；中南大学"创新驱动计划"项目（2015CX010）。

Online Patients' Intentions of Office Visit: An Empirical Study Based on Elaboration Likelihood Perspective

Cao Xianye^1,2, Liu Yongmei², Liu Jiaqi³, Dong Wei², Zhu Zhangxiang⁴

1. School of Management, Hunan University of Technology and Business, Changsha 410205;
2. School of Business, Central South University, Changsha 410083;
3. Institute of Journalism and Communication, Chinese Academy of Social Sciences, Beijing 100021;
4. College of Tourism, Hunan Normal University, Changsha 410081

Received:2018-06-20 Online:2021-07-28 Published:2021-08-02

摘要/Abstract

摘要： 本文探究了在线医患咨询情境下，线上医生的回复信息和医生电子口碑对患者定向就诊意向的影响机制。基于精细加工可能模型（ELM），将医生回复的信息量和可读性对患者定向就诊意向的影响视为中心路径，同时视医生电子口碑对定向就诊意向的影响为边缘路径，患者卷入度作为两条路径的调节变量，构建在线患者定向就诊意向的Logit模型。通过采集好大夫在线（www.haodf.com）的15314位患者数据，进行实证检验。结果显示，信息量、可读性、医生电子口碑和卷入度对定向就诊意向有正向影响，卷入度增加了可读性和信息量对定向就诊意向的影响，同时削弱了医生电子口碑对定向就诊意向的正向影响。

关键词: 在线医疗, 信息质量, 卷入度, 定向就诊意向, 精细加工可能模型

Abstract: This paper explores the influence mechanism of reply information and electronic word of mouth (eWOM) of the online physician on online patient's intention of an office visit to the physician. Based on the Elaboration Likelihood Model, we build the theoretical model and the logit model of office visit intention. In the model, we set the influence of the amount of information and readability of physician's response contents on offline visit intention as the central route, and the influence of physician's eWOM on offline visit intention as the peripheral route, and patient involvement as the moderator variable of the two routes. We collect 15,314 patients' consulting data from good physician online (www.haodf.com) by web crawlers and test the hypotheses. The result shows that the amount of information and readability and eWOM have positive effects on the intention; Patient's involvement increases the importance of readability and amount of information on patient's offline visit intention. Furthermore, patient's involvement decreases the influence of eWOM on patient's offline visit intention.

Key words: online healthcare, information quality, involvement, intention of office visit, elaboration likelihood model

曹仙叶, 刘咏梅, 刘嘉琪, 董薇, 朱张祥. 基于ELM的在线医疗患者定向就诊意向研究[J]. 管理评论, 2021, 33(7): 170-181,215.

Cao Xianye, Liu Yongmei, Liu Jiaqi, Dong Wei, Zhu Zhangxiang. Online Patients' Intentions of Office Visit: An Empirical Study Based on Elaboration Likelihood Perspective[J]. Management Review, 2021, 33(7): 170-181,215.

参考文献

[1] 王文娟,曹向阳. 增加医疗资源供给能否解决"看病贵"问题?——基于中国省际面板数据的分析[J]. 管理世界, 2016, (6):98-106
[2] Liu X., Guo X., Wu H., et al. The Impact of Individual and Organizational Reputation on Physicians' Appointments Online[J]. International Journal of Electronic Commerce, 2016,20(4):551-577
[3] Van De Belt T. H., Engelen L. J. L. P. G., Berben S. A., et al. Definition of Health 20 and Medicine 20:A Systematic Review[J]. Journal of Medical Internet Research, 2010,12(2):1-14
[4] Cao X., Liu Y., Zhu Z., et al. Online Selection of a Physician by Patients:Empirical Study from Elaboration Likelihood Perspective[J]. Computers in Human Behavior, 2017,73(8):403-412
[5] Yang H., Guo X., Wu T., et al. Exploring the Effects of Patient-Generated and System-Generated Information on Patients' Online Search, Evaluation and Decision[J]. Electronic Commerce Research & Applications, 2015,14(3):192-203
[6] Lu N., Wu H. Exploring the Impact of Word-of-Mouth About Physicians' Service Quality on Patient Choice Based on Online Health Communities[J]. BMC Medical Informatics & Decision Making, 2016,16(1):1-10
[7] Xu J. J., Yu Y. Q., Hu Q. H., et al. Treatment-Seeking Behaviour and Barriers to Service Access for Sexually Transmitted Diseases among Men Who Have Sex with Men in China:A Multicentre Cross-Sectional Survey[J]. Infectious Diseases of Poverty, 2017,6(1):1-10
[8] Alegana V. A., Wright J., Pezzulo C., et al. Treatment-Seeking Behaviour in Low- and Middle-Income Countries Estimated Using a Bayesian Model[J]. BMC Medical Research Methodology, 2017,17(1):1-12
[9] Petty R. E., Cacioppo J. T. Communication and Persuasion:Central and Peripheral Routes to Attitude Change[M]. New York:Springer-Verlag, 1986
[10] Petty R. E., Cacioppo J. T., Goldman R. Personal Involvement as a Determinant of Argument-Based Persuasion[J]. Journal of Personality & Social Psychology, 1981,41(5):847-855
[11] Petty R. E., Cacioppo J. T. The Effects of Involvement on Responses to Argument Quantity and Quality:Central and Peripheral Routes to Persuasion[J]. Journal of Personality and Social Psychology, 1984,46(1):69-81
[12] 吴江,李姗姗. 在线健康社区用户信息服务使用意愿研究[J]. 情报科学, 2017,35(4):119-125
[13] Goh J. M., Gao G. D., Agarwal R. The Creation of Social Value:Can an Online Health Community Reduce Rural-Urban Health Disparities?[J]. MIS Quarterly, 2016,40(1):247-263
[14] Ba S., Wang L. Digital Health Communities:The Effect of Their Motivation Mechanisms[J]. Decision Support Systems, 2013,55(4):941-947
[15] 杨化龙,鞠晓峰. 社会支持与个人目标对健康状况的影响[J]. 管理科学, 2017,30(1):53-61
[16] 张星,夏火松,陈星,等. 在线健康社区中信息可信性的影响因素研究[J]. 图书情报工作, 2015,59(22):88-96
[17] 张星,陈星,夏火松,等. 在线健康社区中用户忠诚度的影响因素研究:从信息系统成功与社会支持的角度[J]. 情报科学, 2016,34(3):133-138
[18] 张悦,张云秋. 基于认知风格的网络健康信息搜索行为研究[J]. 情报理论与实践, 2017,40(7):103-107
[19] Mano R. S. Social Media and Online Health Services:A Health Empowerment Perspective to Online Health Information[J]. Computers in Human Behavior, 2014,39(10):404-412
[20] Xiao N., Sharman R., Rao H. R., et al. Factors Influencing Online Health Information Search:An Empirical Analysis of a National Cancer-Related Survey[J]. Decision Support Systems, 2014,57(1):417-427
[21] 翟羽佳,张鑫,王芳. 在线健康社区中的用户参与行为——以"百度戒烟吧"为例[J]. 图书情报工作, 2017,61(7):75-82
[22] 范晓妞,艾时钟. 在线医疗社区参与双方行为对知识交换效果影响的实证研究[J]. 情报杂志, 2016,35(7):173-178
[23] Jin J., Yan X., Li Y., et al. How Users Adopt Healthcare Information:An Empirical Study of an Online Q&A Community[J]. International Journal of Medical Informatics, 2015,86:91-103
[24] 吴江,周露莎. 在线医疗社区中知识共享网络及知识互动行为研究[J]. 情报科学, 2017,35(3):144-151
[25] 吴江,施立. 基于社会网络分析的在线医疗社区用户交互行为研究[J]. 情报科学, 2017,35(7):120-125
[26] Gray B. M., Vandergrift J. L., Gao G. G., et al. Website Ratings of Physicians and Their Quality of Care[J]. Jama Internal Medicine, 2015,175(2):291-293
[27] Gao G. G., Mccullough J. S., Agarwal R., et al. A Changing Landscape of Physician Quality Reporting:Analysis of Patients' Online Ratings of Their Physicians over a 5-Year Period[J]. Journal of Medical Internet Research, 2012,14(1):1-11
[28] Gao G. D., Greenwood B. N., Agarwal R., et al. Vocal Minority and Silent Majority:How do Online Ratings Reflect Population Perceptions of Quality[J]. MIS Quarterly, 2015,39(3):565-590
[29] Yang H. L., Guo X. T., Wu T. S. Exploring the Influence of the Online Physician Service Delivery Process on Patient Satisfaction[J]. Decision Support Systems, 2015,78(10):113-121
[30] 邓朝华,洪紫映. 在线医疗健康服务医患信任影响因素实证研究[J]. 管理科学, 2017,30(1):43-52
[31] Guo S., Guo X., Fang Y., et al. How Doctors Gain Social and Economic Returns in Online Health-Care Communities:A Professional Capital Perspective[J]. Journal of Management Information Systems, 2017,34(2):487-519
[32] Karyana M., Devine A., Kenangalem E., et al. Treatment-Seeking Behaviour and Associated Costs for Malaria in Papua, Indonesia[J]. Malaria Journal, 2016,15(1):1-12
[33] Mitiku I., Assefa A. Caregivers' Perception of Malaria and Treatment-Seeking Behaviour for under Five Children in Mandura District, West Ethiopia:A Cross-Sectional Study[J]. Malaria Journal, 2017,16(1):1-10
[34] 宁满秀,余平平. 农村中老年慢性病患者就诊行为与影响因素研究——基于charls数据的实证分析[J]. 中国卫生政策研究, 2016,9(5):35-41
[35] 孙梦洁,韩华为. 中国农村居民的就诊选择研究——来自甘肃、河南、广东三省农户调查的实证分析[J]. 经济评论, 2013,(2):40-50
[36] 张广科,邹文沈. 家庭结构与农村中老年人就诊行为——基于河北省邯郸市的调查[J]. 中国人口科学, 2014,(5):117-125
[37] Jowett M., Deolalikar A., Martinsson P. Health Insurance and Treatment Seeking Behaviour:Evidence from a Low-Income Country[J]. Health Economics, 2004,13(9):845-857
[38] Sahn D. E., Younger S. D., Genicot G. The Demand for Health Care Services in Rural Tanzania[J]. Oxford Bulletin of Economics and Statistics, 2003,65(2):241-260
[39] 辛艳,李滢滢,谢小妃,等. 社区医疗机构公众就诊行为意向影响因素研究[J]. 中国卫生事业管理, 2016,33(2):91-94
[40] Meservy T. O., Jensen M. L., Fadel K. J. Evaluation of Competing Candidate Solutions in Electronic Networks of Practice[J]. Information Systems Research, 2014,25(1):15-34
[41] Bi S., Liu Z., Usman K. The Influence of Online Information on Investing Decisions of Reward-Based Crowdfunding[J]. Journal of Business Research, 2017,71(2):10-18
[42] Salehan M., Kim D. J. Predicting the Performance of Online Consumer Reviews:A Sentiment Mining Approach to Big Data Analytics[J]. Decision Support Systems, 2016,81(1):30-40
[43] Malthouse E. C., Calder B. J., Kim S. J., et al. Evidence That User-Generated Content That Produces Engagement Increases Purchase Behaviours[J]. Journal of Marketing Management, 2016,32(5-6):427-444
[44] Kobsa A., Cho H., Knijnenburg B. P. The Effect of Personalization Provider Characteristics on Privacy Attitudes and Behaviors:An Elaboration Likelihood Model Approach[J]. Journal of the Association for Information Science and Technology, 2016,67(11):2587-2606
[45] Zhou T., Lu Y., Wang B. Examining Online Consumers' Initial Trust Building from an Elaboration Likelihood Model Perspective[J]. Information Systems Frontiers, 2016,18(2):265-275
[46] Peng L., Liao Q., Wang X., et al. Factors Affecting Female User Information Adoption:An Empirical Investigation on Fashion Shopping Guide Websites[J]. Electronic Commerce Research, 2016,16(2):145-169
[47] Merkx A., Ausems M., De Vries R., et al. Come On! Using Intervention Mapping to Help Healthy Pregnant Women Achieve Healthy Weight Gain[J]. Public Health Nutrition, 2017,20(9):1666-1680
[48] Bhattacherjee A., Sanford C. Influence Processes for Information Technology Acceptance:An Elaboration Likelihood Model[J]. MIS Quarterly, 2006,30(4):805-825
[49] Sussman S. W., Siegal W. S. Informational Influence in Organizations:An Integrated Approach to Knowledge Adoption[J]. Information Systems Research, 2003,14(1):47-65
[50] 杨爽. 信息质量和社区地位对用户创造产品评论的感知有用性影响机制——基于Tobit模型回归[J]. 管理评论, 2013, 25(5):136-143
[51] Ho S. Y., Bodoff D. The Effects of Web Personalization on User Attitude and Behavior:An Integration of the Elaboration Likelihood Model and Consumer Search Theory[J]. MIS Quarterly, 2014,38(2):497-520
[52] Ghasemaghaei M., Hassanein K. A Macro Model of Online Information Quality Perceptions:A Review and Synthesis of the Literature[J]. Computers in Human Behavior, 2016,55(2):972-991
[53] Xiang Z., Du Q., Ma Y., et al. A Comparative Analysis of Major Online Review Platforms:Implications for Social Media Analytics in Hospitality and Tourism[J]. Tourism Management, 2017,58(1):51-65
[54] Valaei N., Baroto M. B. Modelling Continuance Intention of Citizens in Government Facebook Page:A Complementary PLS Approach[J]. Computers in Human Behavior, 2017,73(8):224-237
[55] Chua A. Y. K., Banerjee S. Helpfulness of User-Generated Reviews as a Function of Review Sentiment, Product Type and Information Quality[J]. Computers in Human Behavior, 2016,54(1):547-554
[56] Davis F. D. Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology[J]. MIS Quarterly, 1989,13(3):319-340
[57] Herr P. M., Kardes F. R., Kim J. Effects of Word-of-Mouth and Product-Attribute Information on Persuasion:An Accessibility Diagnosticity Perspective[J]. Journal of Consumer Research, 1991,17(4):454-462
[58] 孟园,王洪伟,王伟. 网络口碑对产品销量的影响:基于细粒度的情感分析方法[J]. 管理评论, 2017,29(1):144-154
[59] Barki H., Hartwick J. Measuring User Participation, User Involvement, and User Attitude[J]. MIS Quarterly, 1994,18(1):59-82
[60] Petty R. E., Cacioppo J. T. Involvement and Persuasion:Tradition versus Integration[J]. Psychological Bulletin, 1990,107(3):367-374
[61] Angst C. M., Agarwal R. Adoption of Electronic Health Records in the Presence of Privacy Concerns:The Elaboration Likelihood Model and Individual Persuasion[J]. MIS Quarterly, 2009,33(2):339-370
[62] 杜学美,丁璟妤,谢志鸿,等. 在线评论对消费者购买意愿的影响研究[J]. 管理评论, 2016,28(3):173-183
[63] Chun J. W., Lee M. J. Increasing Individuals' Involvement and WOM Intention on Social Networking Sites:Content Matters![J]. Computers in Human Behavior, 2016,60(7):223-232
[64] Cheung C. M. Y., Sia C. L., Kuan K. K. Y. Is This Review Believable? A Study of Factors Affecting the Credibility of Online Consumer Reviews from an Elm Perspective[J]. Journal of the Association for Information Systems, 2012,13(8):618-635
[65] Petty R. E., Cacioppo J. T., Schumann D. Central and Peripheral Routes to Advertising Effectiveness:The Moderating Role of Involvement[J]. Journal of Consumer Research, 1983,10(2):135-146
[66] Park D. H., Lee J., Han I. The Effect of On-Line Consumer Reviews on Consumer Purchasing Intention:The Moderating Role of Involvement[J]. International Journal of Electronic Commerce, 2007,11(4):125-148
[67] 朱丽叶,袁登华,张静宜. 在线用户评论质量与评论者等级对消费者购买意愿的影响——产品卷入度的调节作用[J]. 管理评论, 2017,29(2):87-96
[68] Zhang H. P., Yu H. K., Xiong D. Y., et al. HHMM-based Chinese Lexical Analyzer ICTCLAS[C]. Proceedings of the Second SIGHAN Workshop on Chinese Language Processing, 2003
[69] 胡蓉,陈慧芳,徐卫国. 移动医疗环境下患者感知价值形成机理研究[J]. 管理评论, 2017,29(3):261-270