Patient complaints in online medical consultations: a latent Dirichlet allocation-based study_West China Medical Journal

Authors：

ZHANG Chenjing ¹ , TENG Yun ² , WAN Yan ² ,  XUAN Zhidong ¹

1. Institute of Social Medicine and Health Service Management, Henan University, Kaifeng, Henan 475000, P. R. China;
2. The First People’s Hospital of Lianyungang, Lianyungang, Jiangsu 222000, P. R. China;

Corresponding?author：

XUAN Zhidong, Email: shhzjzl2017@qq.com

Keywords：

Online medical consultation; patient complaints; latent Dirichlet allocation; service quality; medical platforms

DOI：

10.7507/1002-0179.202508269

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the content characteristics and main influencing factors of patient complaints in online medical consultation. Methods Online medical consultation data from 2020 to 2024 were collected from an internet hospital platform of a tertiary hospital in Jiangsu Province. Valid complaint texts were analyzed using latent Dirichlet allocation topic modeling. Results A total of 176 309 valid consultation records were included, including 5 872 valid complaint texts. The overall complaint rate for online consultations was 3.3%. Complaints were primarily concentrated on low responsiveness, complex service processes, and insufficient professional quality, with “no response” accounting for the highest proportion (40.4%). There were statistically significant differences in complaint rates among different genders, ages, consultation departments, consultation fees, and consultation years (P<0.05). Conclusions Patient complaints in online medical consultations show clear structural characteristics. Optimizing physician responsiveness, simplifying service processes, and enhancing professional communication skills are important strategies to reduce complaint risks.

Citation： ZHANG Chenjing, TENG Yun, WAN Yan, XUAN Zhidong. Patient complaints in online medical consultations: a latent Dirichlet allocation-based study. West China Medical Journal, 2025, 40(12): 1901-1904. doi: 10.7507/1002-0179.202508269 Copy

1.	王禹堯, 李禮安, 繆家清, 等. 某三甲醫院互聯網醫院在線問診運行現狀研究. 現代醫院, 2021, 21(11): 1770-1772.
2.	劉穎, 雷福明, 周娟. 對醫院開展線上問診服務滿意度現狀分析. 中國衛生標準管理, 2020, 11(12): 24-26.
3.	王丹丹, 戴瑞明, 盛韜, 等. 基于患者投訴數據的醫療機構服務質量評價方法. 中國衛生資源, 2023, 26(5): 509-514, 520.
4.	韓思柔, 徐民. 醫療投訴提高醫療服務質量的研究概述. 醫學與哲學, 2023, 44(2): 53-56.
5.	Tax S, Brown SW, Chandraschekaran M. Customer evaluations of service complaint experiences: implications for relationship marketing. J Mark, 1998, 62(2): 60-76.
6.	Blei DM, Ng AY, Jordan MI. Latent Dirichlet allocation. J Mach Learn Res, 2003, 3: 993-1022.
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10.	Ge F, Qian H, Lei J, et al. Experiences and challenges of emerging online health services combating COVID-19 in China: retrospective, cross-sectional study of internet hospitals. JMIR Med Inform, 2022, 10(6): e37042.
11.	王盼盼, 吳志艷, 羅繼鋒. 新增付費渠道對用戶問診決策的影響: 基于信號作用的解釋. 管理科學, 2021, 34(5): 53-64.
12.	Kahneman D, Tversky A. Prospect theory: an analysis of decision under risk. Econom, 1979, 47(2): 263-291.
13.	李論, 尹秋菊, 顏志軍. 醫生線上-線下服務評價對患者在線問診選擇的影響研究. 管理學報, 2022, 19(4): 565-574.
14.	趙可揚. 國內知名移動醫療 App 服務質量評價. 醫學信息學雜志, 2017, 38(2): 2-7.
15.	翟運開, 張倩, 趙棟祥. 疫情防控常態化下患者雙渠道就診滿意度影響因素研究. 圖書情報工作, 2022, 66(3): 118-129.
16.	王若佳, 張詩揚, 田曉晗, 等. 互聯網問診平臺中醫醫生服務評價研究. 中國衛生信息管理雜志, 2023, 20(2): 315-319, 326.
17.	Zhang T, Chen Q, Wang WYC, et al. Understanding physicians’ motivation to provide healthcare service online in the digital age. Int J Environ Res Public Health, 2022, 19(22): 15135.
18.	陳家和, 馬錦爐, 張育瑋. 互聯網醫療下患者持續線上咨詢和線下就診意愿影響因素研究. 中國全科醫學, 2020, 23(25): 3164-3169.
19.	Jiang X, Xie H, Tang R, et al. Characteristics of online healthcare service from China’s largest online medical entrance: cross-sectional survey. J Med Internet Res, 2021, 23(4): e25817.
20.	Hong Z, Deng Z, Zhang W. Examining factors affecting patients trust in online healthcare services in China: the moderating role of the purpose of use. Health Informatics J, 2019, 25(4): 1647-1660.
21.	林珂雯, 婁佳奡, 彭淑楨, 等. 臨床路徑的制訂與管理系列研究之二: 臨床路徑的信息化管理. 醫學新知, 2024, 34(3): 322-329.
22.	李美玲, 陳素雨, 張亞, 等. 數字化背景下呼吸病學課程思政探索與實踐. 數理醫藥學雜志, 2024, 37(8): 636-641.
23.	Oliver RL. A cognitive model of the antecedents and consequences of satisfaction decisions. J Mark Res, 1980, 17(4): 460-469.

1. 王禹堯, 李禮安, 繆家清, 等. 某三甲醫院互聯網醫院在線問診運行現狀研究. 現代醫院, 2021, 21(11): 1770-1772.
2. 劉穎, 雷福明, 周娟. 對醫院開展線上問診服務滿意度現狀分析. 中國衛生標準管理, 2020, 11(12): 24-26.
3. 王丹丹, 戴瑞明, 盛韜, 等. 基于患者投訴數據的醫療機構服務質量評價方法. 中國衛生資源, 2023, 26(5): 509-514, 520.
4. 韓思柔, 徐民. 醫療投訴提高醫療服務質量的研究概述. 醫學與哲學, 2023, 44(2): 53-56.
5. Tax S, Brown SW, Chandraschekaran M. Customer evaluations of service complaint experiences: implications for relationship marketing. J Mark, 1998, 62(2): 60-76.
6. Blei DM, Ng AY, Jordan MI. Latent Dirichlet allocation. J Mach Learn Res, 2003, 3: 993-1022.
7. Skrypczak AM, Tressel WA, Ghayour S, et al. Negative online reviews of orthodontists: content analysis of complaints posted by dissatisfied patients. Am J Orthod Dentofacial Orthop, 2020, 158(2): 237-246. e4.
8. 倪維斌, 姜垚松, 羅瑋, 等. 基于 hLDA 層次主題模型的患者投訴分類框架研究. 中華醫學圖書情報雜志, 2018, 27(10): 28-32.
9. Jonkisz A, Karniej P, Krasowska D. The servqual method as an assessment tool of the quality of medical services in selected Asian countries. Int J Environ Res Public Health, 2022, 19(13): 7831.
10. Ge F, Qian H, Lei J, et al. Experiences and challenges of emerging online health services combating COVID-19 in China: retrospective, cross-sectional study of internet hospitals. JMIR Med Inform, 2022, 10(6): e37042.
11. 王盼盼, 吳志艷, 羅繼鋒. 新增付費渠道對用戶問診決策的影響: 基于信號作用的解釋. 管理科學, 2021, 34(5): 53-64.
12. Kahneman D, Tversky A. Prospect theory: an analysis of decision under risk. Econom, 1979, 47(2): 263-291.
13. 李論, 尹秋菊, 顏志軍. 醫生線上-線下服務評價對患者在線問診選擇的影響研究. 管理學報, 2022, 19(4): 565-574.
14. 趙可揚. 國內知名移動醫療 App 服務質量評價. 醫學信息學雜志, 2017, 38(2): 2-7.
15. 翟運開, 張倩, 趙棟祥. 疫情防控常態化下患者雙渠道就診滿意度影響因素研究. 圖書情報工作, 2022, 66(3): 118-129.
16. 王若佳, 張詩揚, 田曉晗, 等. 互聯網問診平臺中醫醫生服務評價研究. 中國衛生信息管理雜志, 2023, 20(2): 315-319, 326.
17. Zhang T, Chen Q, Wang WYC, et al. Understanding physicians’ motivation to provide healthcare service online in the digital age. Int J Environ Res Public Health, 2022, 19(22): 15135.
18. 陳家和, 馬錦爐, 張育瑋. 互聯網醫療下患者持續線上咨詢和線下就診意愿影響因素研究. 中國全科醫學, 2020, 23(25): 3164-3169.
19. Jiang X, Xie H, Tang R, et al. Characteristics of online healthcare service from China’s largest online medical entrance: cross-sectional survey. J Med Internet Res, 2021, 23(4): e25817.
20. Hong Z, Deng Z, Zhang W. Examining factors affecting patients trust in online healthcare services in China: the moderating role of the purpose of use. Health Informatics J, 2019, 25(4): 1647-1660.
21. 林珂雯, 婁佳奡, 彭淑楨, 等. 臨床路徑的制訂與管理系列研究之二: 臨床路徑的信息化管理. 醫學新知, 2024, 34(3): 322-329.
22. 李美玲, 陳素雨, 張亞, 等. 數字化背景下呼吸病學課程思政探索與實踐. 數理醫藥學雜志, 2024, 37(8): 636-641.
23. Oliver RL. A cognitive model of the antecedents and consequences of satisfaction decisions. J Mark Res, 1980, 17(4): 460-469.

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