Exploring the Drivers of Patient Value Co-creation Behavior in Online Healthcare: A Mediated Model in the Lens of the Theory of Planned Behavior

Abstract

This study examines the factors influencing value co-creation behavior among patients utilizing online health services, grounded in the Theory of Planned Behavior (TPB). A structured questionnaire was distributed to 304 patients who had experienced online healthcare services and regularly used social media. Data analysis was conducted using Partial Least Squares Structural Equation Modeling (PLS-SEM). The findings show that all hypothesized relationships were statistically significant, with Attitude, Subjective Norms, and Perceived Behavioral Control collectively explaining 78.3% of the variance in Value Co-creation Behavior. This confirms the robustness of the extended TPB model in explaining how patients participate in online healthcare platforms. Additionally, the mediation analysis indicated that Attitude, Subjective Norms, and Perceived Behavioral Control fully mediate the influence of Trust, Health Consciousness, Self-Efficacy, EWOM, and Facilitating Conditions on Value Co-creation Behavior. These results imply that cognitive, social, and technological factors affect co-creation indirectly through core TPB components. The study advances theory by incorporating additional contextual and technological factors that better reflect the complexities of digital healthcare environments. Practically, it offers valuable insights for healthcare managers and digital marketers on how to build trust, foster social engagement, and enhance technological support to promote patient involvement and value co-creation. Finally, the study recognizes its cross-sectional design as a limitation and suggests that future longitudinal and cross-cultural research could strengthen the applicability of these findings.