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Distance effects and home bias in patient choice on the Internet: Evidence from an online healthcare platform in China

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  • Chen, Qiulin
  • Xu, Duo
  • Fu, Hongqiao
  • Yip, Winnie

Abstract

Telemedicine and telehealth hold promise for reducing access barriers caused by travel distance. However, little is known about how the Internet affects patients' online provider choices and thus the spatial distribution of healthcare utilization. This study investigates the effect of distance on flows of online medical consultations using a unique dataset from one of the leading third-party online healthcare platforms in China: Haodf.com. We show that the geographic distance between doctors and patients is negatively associated with online service utilization, though this effect is almost 40% ~ 50% weaker for online medical services than it is for offline medical services. We also find a strong “home bias” in which patients and doctors tend to locate in the same prefecture and in the same province. Further analyses suggest that prior in-person visits before online consultations, the potential need for a follow-up physical visit after an online consultation, and information friction may contribute to the distance effect. These findings have policy implications for improving healthcare access in China and other nations.

Suggested Citation

  • Chen, Qiulin & Xu, Duo & Fu, Hongqiao & Yip, Winnie, 2022. "Distance effects and home bias in patient choice on the Internet: Evidence from an online healthcare platform in China," China Economic Review, Elsevier, vol. 72(C).
    • Handle: RePEc:eee:chieco:v:72:y:2022:i:c:s1043951x22000153
    DOI: 10.1016/j.chieco.2022.101757
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    as
    1. Daniele Fabbri & Silvana Robone, 2010. "The geography of hospital admission in a national health service with patient choice," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1029-1047, September.
    2. Acton, Jan Paul, 1975. "Nonmonetary Factors in the Demand for Medical Services: Some Empirical Evidence," Journal of Political Economy, University of Chicago Press, vol. 83(3), pages 595-614, June.
    3. Ali Hortaçsu & F. Asís Martínez-Jerez & Jason Douglas, 2009. "The Geography of Trade in Online Transactions: Evidence from eBay and MercadoLibre," American Economic Journal: Microeconomics, American Economic Association, vol. 1(1), pages 53-74, February.
    4. Nemet, Gregory F. & Bailey, Adrian J., 2000. "Distance and health care utilization among the rural elderly," Social Science & Medicine, Elsevier, vol. 50(9), pages 1197-1208, May.
    5. Joseph J. Doyle Jr. & John A. Graves & Jonathan Gruber & Samuel A. Kleiner, 2015. "Measuring Returns to Hospital Care: Evidence from Ambulance Referral Patterns," Journal of Political Economy, University of Chicago Press, vol. 123(1), pages 170-214.
    6. Rosella Levaggi & Roberto Zanola, 2004. "Patients' migration across regions: the case of Italy," Applied Economics, Taylor & Francis Journals, vol. 36(16), pages 1751-1757.
    7. Andreas Lendle & Marcelo Olarreaga & Simon Schropp & Pierre‐Louis Vézina, 2016. "There Goes Gravity: eBay and the Death of Distance," Economic Journal, Royal Economic Society, vol. 126(591), pages 406-441, March.
    8. Holger C. Wolf, 2000. "Intranational Home Bias In Trade," The Review of Economics and Statistics, MIT Press, vol. 82(4), pages 555-563, November.
    9. Fattore, Giovanni & Petrarca, Giuseppina & Torbica, Aleksandra, 2014. "Traveling for care: Inter-regional mobility for aortic valve substitution in Italy," Health Policy, Elsevier, vol. 117(1), pages 90-97.
    10. Fan, Jingting & Tang, Lixin & Zhu, Weiming & Zou, Ben, 2018. "The Alibaba effect: Spatial consumption inequality and the welfare gains from e-commerce," Journal of International Economics, Elsevier, vol. 114(C), pages 203-220.
    11. Maggie X. Chen & Min Wu, 2021. "The Value of Reputation in Trade: Evidence from Alibaba," The Review of Economics and Statistics, MIT Press, vol. 103(5), pages 857-873, December.
    12. repec:ecj:econjl:v:122:y:2012:i::p:400-417 is not listed on IDEAS
    13. Beckert, Walter, 2018. "Choice in the presence of experts: The role of general practitioners in patients’ hospital choice," Journal of Health Economics, Elsevier, vol. 60(C), pages 98-117.
    14. James E. Anderson, 2011. "The Gravity Model," Annual Review of Economics, Annual Reviews, vol. 3(1), pages 133-160, September.
    15. Avdic, Daniel & Moscelli, Giuseppe & Pilny, Adam & Sriubaite, Ieva, 2019. "Subjective and objective quality and choice of hospital: Evidence from maternal care services in Germany," Journal of Health Economics, Elsevier, vol. 68(C).
    16. Baker, Laurence C. & Bundorf, M. Kate & Kessler, Daniel P., 2016. "The effect of hospital/physician integration on hospital choice," Journal of Health Economics, Elsevier, vol. 50(C), pages 1-8.
    17. Jiang, Shan & Gu, Yuanyuan & Yang, Fan & Wu, Tao & Wang, Hui & Cutler, Henry & Zhang, Lufa, 2020. "Tertiary hospitals or community clinics? An enquiry into the factors affecting patients' choice for healthcare facilities in urban China," China Economic Review, Elsevier, vol. 63(C).
    18. Aoun, Nael & Matsuda, Hirotaka & Sekiyama, Makiko, 2015. "Geographical accessibility to healthcare and malnutrition in Rwanda," Social Science & Medicine, Elsevier, vol. 130(C), pages 135-145.
    19. Walter Beckert & Mette Christensen & Kate Collyer, 2012. "Choice of NHS‐funded Hospital Services in England," Economic Journal, Royal Economic Society, vol. 122(560), pages 400-417, May.
    20. Jeffrey H. Bergstrand & Peter Egger, 2013. "Gravity Equations and Economic Frictions in the World Economy," Palgrave Macmillan Books, in: Daniel Bernhofen & Rod Falvey & David Greenaway & Udo Kreickemeier (ed.), Palgrave Handbook of International Trade, chapter 17, pages 532-570, Palgrave Macmillan.
    21. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
    22. Anderson, James E, 1979. "A Theoretical Foundation for the Gravity Equation," American Economic Review, American Economic Association, vol. 69(1), pages 106-116, March.
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    Cited by:

    1. Fu, Hongqiao & Cheng, Terence C. & Zhan, Jiajia & Xu, Duo & Yip, Winnie, 2024. "Dynamic effects of the COVID-19 pandemic on the demand for telemedicine services: Evidence from China," Journal of Economic Behavior & Organization, Elsevier, vol. 220(C), pages 531-557.
    2. Chen, Yutong, 2024. "Does the gig economy discriminate against women? Evidence from physicians in China," Journal of Development Economics, Elsevier, vol. 169(C).
    3. Shen, Chi & Lai, Sha & Deng, Qiwei & Cao, Dan & Zhao, Dantong & Zhao, Yaxin & Zhou, Zhongliang & Dong, Wanyue & Chen, Xi, 2023. "Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China," GLO Discussion Paper Series 1309, Global Labor Organization (GLO).
    4. Meng Tian & Lei Yuan & Renzhong Guo & Yongsheng Wu & Xiaojian Liu, 2022. "Evaluations of Spatial Accessibility and Equity of Multi-Tiered Medical System: A Case Study of Shenzhen, China," IJERPH, MDPI, vol. 19(5), pages 1-18, March.
    5. Cui, Chengsen & Zhang, Yue & Ding, Ruoxi & He, Ping, 2024. "Impact of the Essential Public Health Service program on financial protection and health outcomes among hypertensive patients: A quasi-experimental study in China," Social Science & Medicine, Elsevier, vol. 345(C).

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    More about this item

    Keywords

    Distance; Home bias; Patient choice; Gravity model; Online medical consultations;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L86 - Industrial Organization - - Industry Studies: Services - - - Information and Internet Services; Computer Software
    • R12 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - General Regional Economics - - - Size and Spatial Distributions of Regional Economic Activity; Interregional Trade (economic geography)

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