Online healthcare question-and-answer (Q&A) services are essential in online healthcare. Physicians are the leading providers of online healthcare question-and-answer services; thus, their active participation is critical for the robust development of online healthcare platforms. Research on the behavior of stakeholders and their influencing factors will permit an in-depth analysis of the behavioral mechanism of patients and physicians in the online healthcare question-and-answer community. This thesis helps strengthen the role of platforms and policy-makers in developing online healthcare services, improving the quality of physicians' participation, and providing a high-quality online participation environment for physicians. Based on the background of online healthcare question-and-answer services, this thesis focuses on the spillover effects of physicians’ participation in free services, the incentive mechanisms for physicians’ involvement in paid services, and the potentially biased selection from patients in online healthcare services.

The main research questions are: (1) In the online healthcare community, will physicians' contributions to online free question-and-answer services have spillover effects?; (2) How does a change in the award strategy of an online healthcare platform affect the content volume and average content length of online paid services for physicians on the platform?; and (3) Are there any home preferences from patients in the online healthcare crowdsourcing paid question and answer market? If so, what are the underlying mechanisms?

The first study is empirical, analyzing the spillover effects of free knowledge contributions in online healthcare communities. Online healthcare communities (OHCs) have become increasingly popular and now impact the way physicians connect with patients. In OHCs, many physicians have become multitype service providers by offering both free and paid services. Considering those physician contributions both to online free services and to online paid services (to generate personal benefits) are essential, platforms need to encourage physicians’ online participation and improve their revenues. However, despite the increasing use of social media applications or functions in healthcare, little is known about the spillover effects of contributions to online free services on physicians’ benefits regarding paid services. Our study investigates the relationship between online free services (contributions to patient questions and answers) and the personal benefits of online paid services based on spillover effects and signaling theories. We analyze a panel dataset from 1,349 physicians participating in an OHC in China. Our results indicate that participation in online free services significantly increases the private benefits of family physicians up to a specific value. Moreover, we find that a physician’s ranking has a moderating effect on this relationship.

The second study is about the effects of changes to the award strategy in paid services on physicians' participation behavior. Online platforms have considered various incentives to increase physicians' online participation, including external awards to attract physicians. However, few studies discuss the effects of the award strategy of crowdsourced services in the online healthcare context. Based on this literature, we investigated the impact of changes in the award strategy on physicians' online participation in paid Q&A services in the context of a natural experiment where a platform suddenly changed the award strategy, which we call the focal platform. In combination with data from another healthcare platform, we compared the quantity and quality of physician responses before and after the change in the award strategy using an interrupted time-series approach. Our results show that a new equal-division strategy can increase the average effort of each answer both in the short and long run. This increase in effort comes at the expense of the number of responses on focus platforms in the long run. We also discuss the underlying mechanism of the effects in the future. These findings demonstrate that a platform's equal-division award is a double-edged sword. On the one hand, the new equal-division award strategy motivates physicians to engage on two platforms. On the other hand, the change in award strategy decreases the content volume provided by physicians.

The third study investigated possible home preferences in online healthcare services. Humans prefer a more self-related option over alternatives under uncertainty. Such a preference is particularly salient given geographic proximity, namely, home preference. Prior literature initially examines the impact of home preference in financial matters and generally attributes the bias to an economic rationale. We study healthcare crowdsourcing, a unique context wherein patients may demonstrate behavioral and rational considerations in their decision-making. We use a comprehensive dataset from a representative patient-physician crowdsourcing platform to identify salient home preferences and identify behavioral and rational drivers. Specifically, patients preferred local physicians’ answers over those of nonlocal physicians by 35.8%. We show that patients behaviorally degraded the signal from the platform-granted expert certificates by 26.1% when evaluating the answers posted by local physicians. We note that patients rationally favor local physicians’ answers by 53.6% if planning to have offline hospital visits. However, we do not find a significant interplay between the two drivers. In addition, we explore how home preferences may evolve along with dramatic environmental changes. We conduct a difference-in-difference-like analysis to capture the potential change in home preference before and after the COVID-19 pandemic. Patients became more rational after the outbreak of the coronavirus than they were before. They debiased themselves and evaluated local physicians’ answers with the consideration of expert certificates. Patients also avoided favoring the answers that recommended offline hospital visits. These findings provide several practical implications for healthcare platforms to help patients make precise decisions.

This thesis focuses on physicians who provide free and paid question-and-answer services. Based on the existing literature, this thesis employs the methods of model construction, empirical analysis, and text analysis. Finally, we proposed appropriate management and policy formulation strategies.