How does online interactional unfairness matter for patient–doctor relationship quality in online health consultation? The contingencies of professional seniority and disease severity
How does online interactional unfairness matter for patient–doctor relationship quality in online health consultation? The contingencies of professional seniority and disease severity
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DOI：
10.1080/0960085x.2018.1547354
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发表时间：
2018-11
影响因子：
9.5
通讯作者：
Xiaofei Zhang;Xitong Guo;K. Lai;Yi Wu
中科院分区：
文献类型：
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作者：
Xiaofei Zhang;Xitong Guo;K. Lai;Yi Wu
近年来，在线健康咨询平台的发展引起了对在线医患关系发展的重大研究关注，特别是在每个患者的卫生保健资源有限的发展中国家。然而，在信息和通信技术(ICT)的背景下，医患关系发展中的在线互动不公平在很大程度上被忽视了。本研究提出并测试了一个模型，该模型考察了在线互动不公平(即人际不公平和信息不公平)如何影响在线医患关系质量，以及医生的专业资历和患者的疾病严重程度的或有作用。本研究利用中国某领先的在线健康咨询平台的83,553个观察点的档案数据，采用罕见事件Logistic回归对模型进行检验。研究结果表明，在中国医疗保健背景下，网络人际不公平和网络信息不公平分别对关系质量激励有正向和负向影响，医生的职业年限和患者的疾病严重程度加强了不公平感与关系质量激励之间的联系。本研究提升了中国对资讯科技医疗服务中的线上医患关系发展的认识，并为线上医疗服务利益相关者管理医疗服务不公平提供实际的见解。
ABSTRACT In recent years, the development of online health-consultation platforms has drawn significant research attention to online patient–doctor relationship development, particularly in developing countries, where there are limited health care resources for each patient. However, online interactional unfairness in patient–doctor relationship development has been largely overlooked in the context of information and communication technology (ICT). This study proposes and tests a model that examines how online interactional unfairness (ie, interpersonal unfairness and informational unfairness) influences online patient–doctor relationship quality and the contingent roles of a doctor’s professional seniority and a patient’s disease severity. Using archival data with 83,553 observations from a leading online health-consultation platform in China, this study employed rare-event logistic regression to test the model. The results show that online interpersonal unfairness and online informational unfairness have negative and positive effects on relationship-quality incentive, respectively, in the Chinese health care context and that a doctor’s professional seniority and a patient’s disease severity strengthen the link between unfairness perceptions and relationship-quality incentive. This study advances the knowledge of online patient–doctor relationship development in ICT-based health care in China and provides practical insights for online health care stakeholders for managing unfairness in the health care context.