Combined effects of cues influencing patients’ purchasing behavior in online health-care communities: qualitative comparative analysis based on cue utilization theory

Background: The sudden outbreak of COVID-19 in early 2020 pushed the online health-care communities (OHCs) into the public eye in China. However, OHCs is an emerging service model, which still has many problems such as low patient trust and low patient utilization rate. Patients are the users and recipients of web-based medical services, as well as the core of medical services. Thus, based on cue utilization theory, this paper studies combination effect of influencing factors in patients’ purchase of web-based medical services through the qualitative comparative analysis method of fuzzy sets (fsQCA). Methods: This paper discards statistical methods based on variance theory-based relationships between explanatory and explained variables and uses a construct theory-based fuzzy set qualitative comparative analysis (fsQCA) approach to elucidate such complex relationships of patients' online purchasing behavior. We use a crawler to automatically download information from Haodf.com. This study crawled data in August 2020, involving 1210 physicians. Results: Service price, reputation and service quality are the key factors for patients’ purchasing behavior. Physician’s online reputation, online medical service price, number of published articles, mutual-help group, and appointment registration affect patients' purchasing behavior by means of weighted variation. Only when a high scope of internal attribute-related cue elements and a low scope of external attribute-related cue elements are combined with each other in a specific form, patients will generate purchase behavior. Conclusion: This paper clarifies the complex causes that promote to patients' purchasing behavior of web-based medical services, enriches and develops the relevant theories in the field of consumer purchasing behavior and online health-care communities market research, and has implications for governments, platforms, physicians and patients in the event of web-based medical service purchases.