Research On The Use And Impact Mechanism Of Mobile Health Services For Patients Based On The Whole Process Of Visits

[Purpose]Mobile health(m Health)provides effective support in optimizing the allocation of medical resources,improving patient experience and meeting the diversified needs of patients,and is expected to alleviate the problem of "difficulty in accessing healthcare".In the current context of insufficient and uneven distribution of total medical resources,it is key to promote the healthy and sustainable development of m Health to deeply explore the mechanism of mobile health service usage and impact.This paper focuses on the use of m Health services and the influence mechanism of offline and online,and explores the influencing factors of m Health service use by patients before consultation,the influence mechanism of m Health service use on service accessibility and patient experience during consultation,based on theories of resource scarcity,channel complementarity,attribution,uncertainty,information transparency,information integration and service quality from the perspective of the whole process of consultation.We also explore the influence of offline visiting experience on the quality and efficiency of online services after consultation.The results of this study provide theoretical support and practical guidance for promoting the development of the "Internet + medical services",optimizing online and offline medical processes and improving patient experience,and also have positive practical significance for implementing the supply-side reform of medical services and helping health care services to be fair and inclusive.[Methods]This paper takes the whole process of patient consultation as the main research line,takes the use of mobile health services by patients in a medical institution as the research context,collects data on patients' offline consultation and online doctor-patient interaction,and uses various research methods such as literature review,econometric analysis,interview,panel data analysis,DID,HLM and mediating effect analysis to explore the use of mobile health services and the influence mechanism of online and offline in the three stages of preconsultation,consultation and post-consultation.First,a logistic regression model is constructed to analyze the influencing factors of patients' m Health service usage at the appointment registration stage(pre-consultation);second,regression analysis and interviews are used to analyze the influence mechanism of patients' m Health service usage on offline service accessibility,and unbalanced panel,DID and HLM model are constructed to analyze the influence mechanism of m Health service on offline waiting time;finally.linear model,nonlinear model and mediating effect model are constructed to study the influence of patients' offline visit experience on online service quality and service efficiency.[Results](1)Study of factors influencing the use of m Health services by patients at the preconsultation stage.The results showed that resource scarcity positively influenced the use of m Health services(?= 0.435,p<0.05),and the use of m Health services was higher when the value of healthcare resources was higher.Resource accessibility negatively influenced m Health service use(?=-0.134,p<0.05),with higher m Health service use among patients with lower accessibility.Experience had a negative moderating effect on the relationship between resource scarcity and m Health service use(?=-0.129,p<0.05)and a positive moderating effect on the relationship between resource accessibility and m Health service use(?= 0.138,p<0.05).(2)Study of the mechanism of the impact of m Health service use on service accessibility and patient experience at the consultation stage.The results showed that in terms of the impact of m Health service use on healthcare accessibility,distance positively influenced patients' use of m Health to access offline healthcare services(?= 0.273,p<0.05),patients with rural households were more likely to use m Health to access offline healthcare services than patients with urban households(?=-0.031,p<0.10),and disease severity had an inverted U-shaped effect on patients' use of m Health to access offline healthcare services.In terms of the impact of m Health service use on patient experience,improving the information transparency significantly reduced patient waiting time by approximately 4.90%(?=-0.049,p< 0.001),or approximately 6.43 minutes(?=-6.430,p< 0.001).Physician popularity positively influenced patient waiting time(?= 0.394,p< 0.01),and patient-level uncertainty(travel process: ?= 0.100,p< 0.001;service process: ?= 0.021,p< 0.001;outcome: ?=-0.040,p< 0.001)significantly influenced patient waiting time.Information transparency had a negative moderating effect on the relationship between physician-level uncertainty(reputation: ?=-0.056,p< 0.001;popularity: ?=-0.056,p< 0.001),patient-level uncertainty(service process: ?=-0.020,p< 0.01;outcome: ?=-0.011,p < 0.001)and waiting time.(3)Study of the mechanism of offline experience on the quality and efficiency of online services.The results showed that patients' offline consultation experience negatively influenced the richness of patients' online condition descriptions(text information provision:?=-0.085,p<0.01;picture information provision: ?=-0.047,p<0.05),while positively influencing the exhaustiveness of online demand expressions(?=0.034,p< 0.01).The richness of patient online condition description(text information provision: ?= 0.099,p<0.01;picture information provision: ?= 0.444,p<0.01)positively influenced the quality of physician online services,while negatively influencing the efficiency of physician online services(text information provision: ?=-0.718,p<0.01;picture information provision: ?=-0.605,p<0.01).The exhaustiveness of patient need expression positively influenced the quality of online doctor-patient interaction(?= 0.210,p<0.01)and information quality(?=0.058,p<0.01),while negatively influencing service efficiency(?=-0.501,p<0.01).In addition,each dimension of patient online information provision exerted a significant mediating effect between offline experience and online service quality.[Conclusions]m Health services play a positive role in optimizing the allocation of medical resources,improving patient experience and meeting the diverse needs,and in the process of promoting "Internet + medical health",we should focus on the use of m Health services by patients and its impact.Actively adopting m Health services to optimize the allocation of healthcare resources and improve patient experience,and encouraging patients to use and participate in online services is a feasible way to further alleviate the problem of "difficulty in accessing healthcare" and enhance the public's sense of access to healthcare.This paper enriches the research related to m Health,online and offline influence mechanisms,healthcare operations management,and service quality of online health services,while complementing the application of uncertainty and information transparency theories in the healthcare field.Based on the empirical results,this paper proposes optimization strategies and policy recommendations for the development of m Health services based on the whole process.[Innovation and Deficiency]Innovations:(1)Exploring the influence mechanism of online and offline from the perspective of the whole process of consultation.This paper focuses on the use and influence mechanism of patients' mobile health care in the environment of online and offline service integration,explores the interaction and influence mechanism of online and offline channels from the perspective of the whole process of consultation,and constructs a model of the influence of offline service accessibility and patient experience as well as online service quality.(2)Exploring the influence mechanism of m Health service usage from the perspective of resource competition.Based on channel complementarity theory and attribution theory,this paper constructs a model of the impact of resource scarcity and accessibility on the use of m Health services from the perspective of resource competition.(3)Study on the impact mechanism of m Health to enhance patient experience.Based on uncertainty theory and information transparency theory,this paper identifies three types of uncertainties that affect patients' waiting time during the consultation process and finds that information transparency has a moderating effect on the relationship between uncertainty and waiting time.(4)Study on the mechanism of the influence of offline consultation experience on online service quality.Based on information integration theory and service quality theory,this paper explores the mechanism and impact of cross-channel transfer of users in the environment of integration of online and offline services from the perspective of the whole process of consultation,and clarifies the impact of patients' offline consultation experience on patients' online participation and the mechanism of online participation behavior on healthcare service quality.Deficiencies:(1)The empirical data in this paper come from a single medical institution,and the generalization of the research findings still requires caution.(2)Although this paper uses a combination of interviews,propensity score matching,and robustness tests to increase the reliability of the findings and weaken the possible endogeneity of the model,there are still potential unobserved variables.(3)There is still room for improvement in the measurement methods of patients' online engagement behaviors and service quality,and the textual topic and emotional information are not deeply explored.