Understanding a Nonlinear Causal Relationship Between Rewards and Physicians' Contributions in Online Health Care Communities: Longitudinal Study.
Understanding a Nonlinear Causal Relationship Between Rewards and Physicians' Contributions in Online Health Care Communities: Longitudinal Study.
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了解在线医疗社区中奖励与医生贡献之间的非线性因果关系：纵向研究
DOI：
10.2196/jmir.9082
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发表时间：
2017-12-21
影响因子：
7.4
通讯作者：
Hsu YT
中科院分区：
文献类型：
--
作者：
Wang JN;Chiu YL;Yu H;Hsu YT
在线医疗社区不仅仅是公众分享医生评论或医疗知识的地方，也是医患沟通的平台。发展中国家的医疗资源相对不足，在线医疗社区是缓解农村地区医院排长队和医疗资源缺乏现象的潜在解决方案。然而，在线医疗保健社区的成功取决于医生的在线贡献。本研究旨在探讨网路健康社群中，激励机制对医师线上贡献行为之影响。我们解决了以下问题：（1）来自哪个专业领域的医生更有可能参与在线医疗社群活动，（2）影响医生在线贡献的因素是什么，（3）激励机制，包括心理和物质奖励，导致医生在线贡献的差异？我们设计了一个纵向研究，涉及三个波的数据样本。所有数据均来自好医生网站，该网站是中国最大的在线医疗社区。我们首先使用描述性统计来调查医生在线贡献行为的整体。然后应用多元线性和二次回归模型验证奖励与医生在线贡献之间的因果关系。我们的样本包括来自3607家不同医院、10个不同专业领域和31个不同省市的40，300名医生。基于多元二次回归模型，我们发现控制变量的系数，过去的医生在线贡献，医生评论评级，诊所头衔，医院级别和城市级别分别为0.415，0.189，-0.099，-0.106和-0.143。心理（或物质）奖励主效应的标准化系数为0.261（或0.688），二次效应的标准化系数为-0.015（或-0.049）。所有估计值均具有统计学显著性（P<.001）。既往医师在线贡献多、评价评分高、来自基层诊所、非三级医院、非大城市的医师更愿意参与在线医疗社群活动。为促进医师网上贡献，需要建立适当的激励机制，包括心理和物质奖励。最后，我们的研究结果提出了两个指导方针，设计一个有用的激励机制，以促进医生在线贡献。首先，物质奖励比心理奖励更有用。第二，如奖励和医生在线贡献之间的凹下-增加的因果关系所示，虽然适当的奖励可以有效地鼓励医生为在线医疗保健社区做出贡献的意愿，但额外奖励的效果有限。
The online health care community is not just a place for the public to share physician reviews or medical knowledge, but also a physician-patient communication platform. The medical resources of developing countries are relatively inadequate, and the online health care community is a potential solution to alleviate the phenomenon of long hospital queues and the lack of medical resources in rural areas. However, the success of the online health care community depends on online contributions by physicians. The aim of this study is to examine the effect of incentive mechanisms on physician’s online contribution behavior in the online health community. We addressed the following questions: (1) from which specialty area are physicians more likely to participate in online health care community activities, (2) what are the factors affecting physician online contributions, and (3) do incentive mechanisms, including psychological and material rewards, result in differences of physician online contributions? We designed a longitudinal study involving a data sample in three waves. All data were collected from the Good Doctor website, which is the largest online health care community in China. We first used descriptive statistics to investigate the physician online contribution behavior in its entirety. Then multiple linear and quadratic regression models were applied to verify the causal relationship between rewards and physician online contribution. Our sample included 40,300 physicians from 3607 different hospitals, 10 different major specialty areas, and 31 different provinces or municipalities. Based on the multiple quadratic regression model, we found that the coefficients of the control variables, past physician online contributions, doctor review rating, clinic title, hospital level, and city level, were .415, .189, –.099, –.106, and –.143, respectively. For the psychological (or material) rewards, the standardized coefficient of the main effect was 0.261 (or 0.688) and the standardized coefficient of the quadratic effect was –0.015 (or –0.049). All estimates were statistically significant (P<.001). Physicians with more past physician online contribution, with higher review ratings, coming from lower level clinics, not coming from tertiary hospitals, and not coming from big cities were more willing to participate in online health care community activities. To promote physician online contribution, it is necessary to establish an appropriate incentive mechanism including psychological and material rewards. Finally, our findings suggest two guidelines for designing a useful incentive mechanism to facilitate physician online contribution. First, material reward is more useful than psychological reward. Second, as indicated by the concave-down-increasing causal relationship between rewards and physician online contribution, although an appropriate reward is effective in encouraging willingness on the part of physicians to contribute to the online health care community, the effect of additional rewards is limited.
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