Digital trust in medical tourism portals: multiple pathways to consumer confidence

This study examines how consumer confidence is configurationally constructed in medical tourism portals using fuzzy-set Qualitative Comparative Analysis (fsQCA). Drawing on established theoretical perspectives, seven antecedent conditions are analyzed: Information Quality, Trust and Credibility Signals, Platform Quality and Usability, Security and Privacy Protection, Risk Perception Reduction, Communication and Responsiveness, and Governance and Ethical Transparency. Survey data from 163 portal users were analyzed across 128 possible configurations, applying a consistency threshold of 0.85 and a frequency cutoff of 3. The necessary condition analysis indicates that no single factor meets the 0.90 consistency threshold, suggesting the absence of a dominant driver of consumer confidence. Sufficiency analysis identifies four distinct equifinal pathways explaining 60% of high-confidence cases, with an overall solution consistency of 0.77. The findings highlight compensatory and asymmetric mechanisms in which combinations of informational, technological, and institutional factors jointly shape consumer confidence in digital healthcare platforms.