The willingness to pay for online medical consultation services and the associated factors in China: A national cross-sectional study

Background Online medical consultation is growing in China, yet public willingness to pay and influencing factors are not fully understood. Objective To evaluate the public willingness to pay for online medical consultation, and explore associated sociodemographic, health, and behavioral factors. Methods This was a population-based cross-sectional study in China. We used a 100-point Visual Analogue Scale (VAS) to assess willingness to pay for online medical consultation. Informed by Andersen’s Behavioral Model, we assessed: a) predisposing factors: gender, age, place of residence, education level, region, monthly per capita household income, occupation status, occupation type, marital status, presence of children, living with parents, living alone, depressive disorders, anxiety, and self-efficacy; b) enabling factors: current use of traditional Chinese medicine, vaccination status, medication literacy, and eHealth literacy; and c) need factors: the presence of chronic disease. Stepwise regression identified factors associated with willingness to pay, with subgroup analysis by chronic disease status. Results Public willingness to pay for online medical consultation was moderate, with a mean score of 49.82±28.59. Adults in east China ( B = -1.90, P < 0.001), who lived with their parents ( B = -0.86, P = 0.03), with mild anxiety ( B = -1.27, P = 0.002), or with mild depression ( B = -1.41, P < 0.001) were associated with a lower willingness to pay for such services. However, adults with medical-related occupations ( B = 5.25, P < 0.001), with undergraduate or college degree or above ( B = 1.85, P < 0.001), with monthly per capita household income > 3,000 RMB ( B = 5.09, P < 0.001), who currently used traditional Chinese medicine ( B = 1.72, P < 0.001), who were vaccinated ( B = 3.29, P < 0.001), with chronic diseases ( B = 1.64, P < 0.001), with high medication literacy ( B = 2.64, P < 0.001), with high eHealth literacy ( B = 11.45, P < 0.001), with high self-efficacy ( B = 3.57, P < 0.001) had a higher willingness to pay for such services. Subgroup analysis revealed variations by chronic disease status. Conclusions Chinese adults show moderate willingness to pay for online medical consultation, influenced by diverse factors. Tailored policies should address subgroup disparities and accessibility.