How does online interactional unfairness matter for patient-doctor relationship quality in online health consultation? The contingencies of professional seniority and disease severity

In recent years, the development of online health-consultation platforms has drawn significant research attention to online patient-doctor relationship development, particularly in developing countries, where there are limited health care resources for each patient. However, online interactional unfairness in patient-doctor relationship development has been largely overlooked in the context of information and communication technology (ICT). This study proposes and tests a model that examines how online interactional unfairness (ie, interpersonal unfairness and informational unfairness) influences online patient-doctor relationship quality and the contingent roles of a doctor's professional seniority and a patient's disease severity. Using archival data with 83,553 observations from a leading online health-consultation platform in China, this study employed rare-event logistic regression to test the model. The results show that online interpersonal unfairness and online informational unfairness have negative and positive effects on relationship-quality incentive, respectively, in the Chinese health care context and that a doctor's professional seniority and a patient's disease severity strengthen the link between unfairness perceptions and relationship-quality incentive. This study advances the knowledge of online patient-doctor relationship development in ICT-based health care in China and provides practical insights for online health care stakeholders for managing unfairness in the health care context.