Asset sharing in the healthcare sector: part one—impact on perceptions of service quality and intention to use the service again

Abstract

Background/Aims The sharing economy comprises three main actors: sharing platforms, asset providers and end users (consumers). These actors arguably possess decision-making autonomy and make sharing-related decisions on their own behalf, but the growing prevalence of asset sharing in the healthcare sector implies the possibility of heteronomous, provider-driven decisions. This article reports the findings of the first part of a two-part study providing insights into the unintended effects of sharing healthcare assets when the sharing decision is made by the healthcare service provider, not the service user. Methods Building on reactance theory, this study used an experimental scenario-based design. A total of 398 participants (all members of the general public) were randomly assigned to three groups and given a scenario involving a consultation with a physician. In one scenario, participants were told they would undergo an operation in a theatre used solely by the physician's practice, while in the other two scenarios the theatre was shared with either five or 10 other practices. Participants were asked about their perceptions of the physician and whether they would use their services again, ranking agreement to items on a 7-point Likert scale. Regression analyses were performed to assess the relationships between asset sharing conditions, participants’ perception of the quality of the service and the intention to use the service again. Results Healthcare asset sharing was significantly and negatively associated with perceived service quality (b=−0.54; P=0.000). While perceived service quality had a significant positive effect on intention to use the service again (b=0.91; P<0.001), none of the sharing or non-sharing conditions had a significant direct effect on intention to use the service again. This indicates that perceived service quality had a full mediating effect on the relationship between asset sharing and intention to use the service again. Conclusions Sharing healthcare assets could negatively affect patients’ intention to use the service again by reducing the perceived quality of the service. Healthcare organisations should work to reduce the impact of asset sharing on perceived quality in order to prevent a negative effect on patient-related outcomes, such as satisfaction and intention to use the service again.