Decoding perceived risks in online healthcare services: a safety-trust model based on grounded theory

Area of Science:

• Digital Health
• Health Services Research
• Patient Safety

Background:

• Online healthcare services (OHSs) are rapidly expanding in China, enhancing access but introducing quality, security, and trust concerns.
• Understanding user perceptions of risk is crucial for effective digital health governance and patient safety.

Purpose of the Study:

• To explore the multidimensional structure and temporal evolution of perceived risk in online healthcare services (OHSs).
• To provide empirical insights for developing trustworthy online medical platforms and digital health strategies.

Main Methods:

• Grounded theory approach applied to analyze 106,162 user-generated comments from four major online health forums.
• Identification and consolidation of perceived risk categories into four core domains.

Main Results:

• A perceived safety-trust model was developed, comprising professional-medical, institutional-transactional, technical-data, and relational-emotional domains.
• Risk salience evolved over time, shifting from professional to institutional/technical, and finally to relational-emotional concerns.
• User trust is influenced by professional competence, technological reliability, institutional transparency, and empathetic communication.

Conclusions:

• Perceived risk in OHSs is multidimensional and evolves, impacting user trust.
• Findings offer guidance for enhancing digital health governance, patient safety, and building trustworthy online health platforms.