The More Complex the More Inefficient: Evidence from Online Health Knowledge Sharing Platform Incentive Mechanism (Preprint)

Abstract

BACKGROUND Online health knowledge-sharing platforms (OHKSPs) play an increasingly important role in enriching residents’ health knowledge, thus improving their health behaviors. The participation of physicians determines whether the platforms can provide high-quality health knowledge to the public. However, little research has focused on motivating physicians to share more professional health knowledge on the platforms. Understanding physicians’ behavioral intention for professional health knowledge sharing (PHKS) is essential to support the development of OHKSPs and improve public health. OBJECTIVE We examine the relationship between incentives and PHKS in OHKSPs. Specifically, we explore the effects of incentives with different complexities in an OHKSP on the quantity and quality of PHKS. We explore how such effects differ across varying levels of professional titles. METHODS We conducted four field experiments with different incentive strategies in one of China's largest OHKSPs. Monthly panel data of 10,584 physicians were collected from January 2018 to December 2019. An empirical study with a fixed-effect analysis was conducted to test our hypotheses. The time fixed effect and the individual fixed effect were considered to identify incentives' effects on physicians’ PHKS. Additionally, a cross-sectional analysis was performed for a robustness check. RESULTS The results show that the incentive has a significant positive effect on the quantity of physicians’ PHKS (β=0.50012, 0.35167, 0.28337, 0.22899; p<0.01). However, the incentive has a significant negative effect on the quality of physicians’ PHKS (β=-0.12911, -0.12039, -0.10948, -0.07933; p<0.01). We found that the positive effect of incentives with high complexity on the quantity of physicians’ PHKS is significantly smaller than incentives with low complexity (0.22899<0.50012, p<0.01). The absolute value of the negative effect of incentives with high complexity on the quality of physicians’ PHKS is also significantly smaller than incentives with low complexity (-0.12911<-0.07933, p<0.01). Moreover, we found that high professional title positively impacts the effect of incentives with low complexity on both the quantity and the quality of physicians’ PHKS (coefficients are in the same valence). CONCLUSIONS Incentives have a bilateral effect on PHKS, i.e., a positive effect on the quantity of physicians’ contribution and a negative effect on the quality of physicians’ PHKS. Such bilateral switches of PHKS require a balanced state in conjunction with practical implications. Furthermore, the more complex the incentives are, the more inefficient the effects on physicians’ PHKS are. This research also identifies a moderate effect of professional titles on incentives and physicians’ PHKS.