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<p>Knowledge payment systems have been introduced by some platforms to boost physicians’ knowledge contributions in online health communities (OHCs), which provide reliable health information to the public. This study examines the spillover effects of knowledge payment, exploring how it influences patients’ subsequent knowledge-seeking behaviors (i.e., online consultations) and how it affects physicians’ free knowledge contributions (in terms of both volume and effort). Grounded in mindsponge theory and signaling theory, we employed a quasi-experiment design combining difference-in-differences with propensity score matching to establish reliable causal inference. The analysis draws on longitudinal data from 2423 physicians over a 12-month period on a leading OHC in China. The results indicate that patients are more likely to seek online consultations from physicians who participate in paid knowledge activities compared to those who do not (<i>β</i> = 0.371; <i>p</i> &lt; 0.01). Furthermore, physicians involved in paid knowledge activities are more inclined to share free knowledge with greater effort (<i>β</i> = 0.878; <i>p</i> &lt; 0.01) and volume (<i>β</i> = 0.171; <i>p</i> &lt; 0.01). Additionally, the heterogeneity analysis shows that a physician’s accumulated free knowledge before the presence of the paid knowledge feature weakens these effects, while the number of paid knowledge posted strengthens them. The implementation of knowledge payment systems can enhance user interaction and professional engagement within OHCs. By incentivizing physicians and encouraging patient participation, such mechanisms offer a promising approach to strengthening digital health ecosystems and promoting equitable access to medical knowledge.</p>

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The effects of introducing knowledge payment to online health platforms: physicians’ free knowledge contribution and patients’ responses

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月18日

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  • Mingye Hu,
  • Yichan Wei,
  • Yan Li,
  • Xiaoxiao Liu

摘要

Knowledge payment systems have been introduced by some platforms to boost physicians’ knowledge contributions in online health communities (OHCs), which provide reliable health information to the public. This study examines the spillover effects of knowledge payment, exploring how it influences patients’ subsequent knowledge-seeking behaviors (i.e., online consultations) and how it affects physicians’ free knowledge contributions (in terms of both volume and effort). Grounded in mindsponge theory and signaling theory, we employed a quasi-experiment design combining difference-in-differences with propensity score matching to establish reliable causal inference. The analysis draws on longitudinal data from 2423 physicians over a 12-month period on a leading OHC in China. The results indicate that patients are more likely to seek online consultations from physicians who participate in paid knowledge activities compared to those who do not (β = 0.371; p < 0.01). Furthermore, physicians involved in paid knowledge activities are more inclined to share free knowledge with greater effort (β = 0.878; p < 0.01) and volume (β = 0.171; p < 0.01). Additionally, the heterogeneity analysis shows that a physician’s accumulated free knowledge before the presence of the paid knowledge feature weakens these effects, while the number of paid knowledge posted strengthens them. The implementation of knowledge payment systems can enhance user interaction and professional engagement within OHCs. By incentivizing physicians and encouraging patient participation, such mechanisms offer a promising approach to strengthening digital health ecosystems and promoting equitable access to medical knowledge.