Effect of Negative Online Reviews and Physician Responses on Health Consumers' Choice: Experimental Study

BACKGROUND

The COVID-19 pandemic has highlighted the importance of online medical services. Although some researchers have investigated how numerical ratings affect consumer choice, limited studies have focused on the effect of negative reviews that most concern physicians.

OBJECTIVE

This study aimed to investigate how negative review features, including proportion (low/high), claim type (evaluative/factual), and physician response (absence/presence), influence consumers' physician evaluation process under conditions in which a physician's overall rating is high.

METHODS

Using a 2×2×2 between-subject decision-controlled experiment, this study examined participants' judgment on physicians with different textual reviews. Collected data were analyzed using the t test and partial least squares-structural equation modeling.

RESULTS

Negative reviews decreased consumers' physician selection intention. The negative review proportion (β=-0.371, P<.001) and claim type (β=-0.343, P<.001) had a greater effect on consumers' physician selection intention compared to the physician response (β=0.194, P<.001). A high negative review proportion, factual negative reviews, and the absence of a physician response significantly reduced consumers' physician selection intention compared to their counterparts. Consumers' locus attributions on the negative reviews affected their evaluation process. Physician attribution mediated the effects of review proportion (β=-0.150, P<.001), review claim type (β=-0.068, P=.01), and physician response (β=0.167, P<.001) on consumer choice. Reviewer attribution also mediated the effects of review proportion (β=-0.071, P<.001), review claim type (β=-0.025, P=.01), and physician response (β=0.096, P<.001) on consumer choice. The moderating effects of the physician response on the relationship between review proportion and physician attribution (β=-0.185, P<.001), review proportion and reviewer attribution (β=-0.110, P<.001), claim type and physician attribution (β=-0.123, P=.003), and claim type and reviewer attribution (β=-0.074, P=.04) were all significant.

CONCLUSIONS

Negative review features and the physician response significantly influence consumer choice through the causal attribution to physicians and reviewers. Physician attribution has a greater effect on consumers' physician selection intention than reviewer attribution does. The presence of a physician response decreases the influence of negative reviews through direct and moderating effects. We propose some practical implications for physicians, health care providers, and online medical service platforms.

Expectation and Complaint: Online Consumer Complaint Behavior in COVID-19 Isolation

Purpose

This study aims to articulate the nature of consumer complaining behavior (CCB) by analyzing the mechanism and characteristics of online CCB in COVID-19 isolated environment.

Patients and Methods

For the purpose, this study collected data via a web-based questionnaire survey from 408 consumers in Shanghai, China during COVID-19 isolation. Through building and analyzing a structural equation model that consists of six latent variables such as perceived service quality, perceived product quality, customer satisfaction, negative emotion, customer complaint; the study analyzed the basic characteristics of CCB, and focused on the moderation test of consumer expectation to validate its important role in consumer decision-making behavior.

Results

First, compared to perceived service quality, perceived product quality has a stronger influence on customer satisfaction and has a weaker influence on negative emotions in the COVID-19 isolated environment. Second, the total influence of perceived product quality on customer complaints is stronger than that of perceived service quality. Third, the direct impact of negative emotions on customer complaints was much stronger than the effect of customer satisfaction on customer complaints. Meanwhile, it can also act as a mediating variable to make customer satisfaction have an additional indirect effect on complaints. Finally, the study also found that consumer expectation can reinforce the influences of customer satisfaction on negative emotions and customer complaints, while it weakens the effect of negative emotions on customer complaints.

Conclusion

This study suggests that the classic CCB factors still exert a stable influence on customer complaints through cognitive and emotional response pathways, but the influence difference is obvious in the COVID-19 isolated environment. And the influence processes are significantly moderated by consumer expectation level. Enterprises should conduct more targeted marketing interactions, according to these CCB characteristics.