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The Impact of the Internet on Health Consultation Market Concentration: An Econometric Analysis of Secondary Data.

The Impact of the Internet on Health Consultation Market Concentration: An Econometric Analysis of Secondary Data.
Author Information (click to view)

Li J, Zhang Y, Ma L, Liu X,


Li J, Zhang Y, Ma L, Liu X, (click to view)

Li J, Zhang Y, Ma L, Liu X,

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Journal of medical Internet research 2016 Oct 2818(10) e276
Abstract
BACKGROUND
Many markets have traditionally been dominated by a few best-selling products, and this is also the case for the health care industry. However, we do not know whether the market will be more or less concentrated when health care services are delivered online (known as E-consultation), nor do we know how to reduce the concentration of the E-consultation market.

OBJECTIVE
The aim of this study was to investigate the concentration of the E-consultation market and how to reduce its concentration through information disclosure mechanisms (online reputation and self-representation).

METHODS
We employed a secondary data econometric analysis using transaction data obtained from an E-consultation Website (haodf.com) for three diseases (infantile pneumonia, diabetes, and pancreatic cancer) from 2008 to 2015. We included 2439 doctors in the analysis.

RESULTS
The E-consultation market largely follows the 20/80 principle, namely that approximately 80% of orders are fulfilled by nearly 20% of doctors. This is much higher than the offline health care market. Meanwhile, the market served by doctors with strong online reputations (beta=0.207, P<.001) or strong online self-representation (beta=0.386, P<.001) is less concentrated. CONCLUSIONS
When health care services are delivered online, the market will be more concentrated (known as the "Superstar" effect), indicating poor service efficiency for society as a whole. To reduce market concentration, E-consultation websites should provide important design elements such as ratings of doctors (user feedback), articles contributed by doctors, and free consultation services (online representation). A possible and important way to reduce the market concentration of the E-consultation market is to accumulate enough highly rated or highly self-represented doctors.

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