Healthcare at the Crossroads: Impacts of Online Health Community on Off-line Healthcare Quality and Equity

Although hospital-affiliated online health communities (OHCs) provide enormous potential for health promotion, their application can create uncertainty and complexities for existing off-line healthcare systems in terms of quality and equity concerns. Understanding how and why physicians’ off-line care quality and equity may change after joining an OHC is a critical yet underexplored question, particularly for patients with low socioeconomic status (SES), who are more likely to be impacted by such changes. This study seeks to quantify these effects using operation-level inpatient data along with the correlated activities of physicians and patients in an OHC sourced from a prominent hospital. Our empirical results show that physicians’ OHC participation is associated with a 3.87% (4.63%) reduction (increase) in the relative risk (safety) of mortality (recovery) for patients who engage in the community. To understand the mechanisms of change, we find that the enhancement of patient care continuity is a key mechanism through which OHC participation may improve off-line service quality. Study results also provide evidence of partial mediation for management and relational continuity in the process chains of OHC outcomes. Additionally, the impact of OHC participation is found to be far more pronounced for patients with low SES, suggesting that OHCs can promote the equity of off-line care quality. This study further tests how community activities along with the ladder of OHC interactions between physicians and patients affect off-line healthcare outcomes. It adds to the literatures on OHC, healthcare operations management, and public health as well as offers practical implications for service operations of online health platforms.

History: Yong Tan, Senior Editor; Idris Adjerid, Associate Editor.

Funding: This research is partially supported by the National Natural Science Foundation of China [Grants 72322020, 72071218, 72071171, 72031001, 71932002], the Guangdong Basic and Applied Basic Research Foundation [Grant 2023B1515020073], the Seeding Funding for Strategic Interdisciplinary Research Scheme from the University of Hong Kong [Grant 102010198], and the Guangdong Provincial Key Laboratory of Future Networks of Intelligence [Grant 2022B1212010001].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/isre.2022.0250.