The willingness to pay for online medical consultation services and the associated factors in China: A national cross-sectional study

Background: Online medical consultation is growing in China, yet public willingness to pay and influencing factors are not fully understood. Objective: To evaluate the public willingness to pay for online medical consultation, and explore associated sociodemographic, health, and behavioral factors. Methods: This was a population-based cross-sectional study in China. We used a 100-point Visual Analogue Scale (VAS) to assess willingness to pay for online medical consultation. Informed by Andersen’s Behavioral Model, we assessed: a) predisposing factors: gender, age, place of residence, education level, region, monthly per capita household income, occupation status, occupation type, marital status, presence of children, living with parents, living alone, depressive disorders, anxiety, and self-efficacy; b) enabling factors: current use of traditional Chinese medicine, vaccination status, medication literacy, and eHealth literacy; and c) need factors: the presence of chronic disease. Stepwise regression identified factors associated with willingness to pay, with subgroup analysis by chronic disease status. Results: Public willingness to pay for online medical consultation was moderate, with a mean score of 49.82±28.59. Adults in east China (B= -1.90, P< 0.001), who lived with their parents (B= -0.86, P= 0.03), with mild anxiety (B= -1.27, P= 0.002), or with mild depression (B= -1.41, P< 0.001) were associated with a lower willingness to pay for such services. However, adults with medical-related occupations (B= 5.25, P< 0.001), with undergraduate or college degree or above (B= 1.85, P< 0.001), with monthly per capita household income > 3,000 RMB (B= 5.09, P< 0.001), who currently used traditional Chinese medicine (B= 1.72, P< 0.001), who were vaccinated (B= 3.29, P< 0.001), with chronic diseases (B= 1.64, P< 0.001), with high medication literacy (B= 2.64, P< 0.001), with high eHealth literacy (B= 11.45, P< 0.001), with high self-efficacy (B= 3.57, P< 0.001) had a higher willingness to pay for such services. Subgroup analysis revealed variations by chronic disease status. Conclusions: Chinese adults show moderate willingness to pay for online medical consultation, influenced by diverse factors. Tailored policies should address subgroup disparities and accessibility.

© The Author(s) 2026.