Health information plays a significant role in the health behavior of individuals. Word-of-mouth (WOM) is essential in this context. In recent years, new forms of online communication have greatly expanded the possibilities for seeking information and, in consequence, significantly changed communication behavior. Similarly, the doctor-patient relationship has gradually evolved and the traditional asymmetry of medical knowledge is increasingly being corrected as today’s health care consumers are becoming more well-informed. A key source of information is either in-person or online WOM. A research gap exists in terms of analyzing the current state of research of WOM in health care. Although various studies highlight the influence of WOM on health behavior, to the best of our knowledge there exists no systematic literature review that summarizes the current state of research on WOM in health care. Therefore, this paper presents a comprehensive systematic literature review on WOM in health care. The literature review investigates existing WOM studies in the health care sector based on a systematic search for articles in a twenty-year timeframe from January 2000 to December 2019. The resulting total of 34 articles constitutes the basis of this paper. These studies are analyzed using a model of WOM in health care and – based on the theory of cognitive dissonance, the theory of the strength of weak ties, and the theory of perceived risk – clustered into the creation, spread, and impact of WOM. The investigated studies emphasize the importance of the staff in the service process. Furthermore, negative reviews have a stronger impact than positive ones, with service quality representing the main reason for negative WOM. In addition, the importance of electronic word-of-mouth (eWOM) is underlined, as online reviews are gaining popularity for patient decision-making processes. Although some studies have addressed WOM in health care, research gaps remain. For example, there are few studies on eWOM and some medical disciplines in private practice are neglected in WOM research. By systematically presenting and analyzing the literature on WOM in health care, this paper represents an important starting point for future research and also provides insights into the role of WOM in health care practice.
Health information plays a significant role in the health behavior of individuals. Patients increasingly want to have an active say in the choice of their physician and the treatment methods they choose (Dobele & Lindgreen, 2011; Liang & Scammon, 2011). However, such co-determination is only possible on the basis of sufficient information. Because the actual medical service is difficult for patients to assess, there is a growing demand for simple medical information they can understand (Argan, 2012, 2016; Martin, 2017b). In addition, the doctor-patient relationship has gradually evolved. The traditional asymmetry of medical knowledge is increasingly being corrected as today’s health care consumers are becoming well-informed (Loane & D’Allesandro, 2014). New forms of online communication have greatly expanded information-seeking options in recent years, significantly changing communication behavior (Cao et al., 2017; Drevs & Hinz, 2014; Gheorghe & Liao, 2012; Hinz et al., 2012; Liang & Scammon, 2011; Lin & Lin, 2018).
Conclusion and further research
To the best of our knowledge, there exist no up-to-date literature reviews focusing on the state of WOM research in the health care sector. To provide an overview of the recent literature, the paper investigates the importance of WOM in the health care sector. Further, the importance of future research on this topic is outlined. Martin’s approach regarding the classification of the articles in terms of creation, spread, and impact dimensions is supported. With respect to the investigated articles and databases, this research is necessarily limited. The literature review identified 34 articles related to WOM and health care. Most of the studies concern the creation and impact of WOM, and only a few studies deal with the spread of WOM. Compared to the WOM content, the allocation between hospitals, physicians, health care providers, online communities, and others is rather balanced.
Nevertheless, several research gaps remain. For example, it is noteworthy that not a single study explicitly deals with prevention, despite the increasing importance of preventive health care. Because of this major research gap, WOM in preventive health care represents a future field of research. In addition, although a reasonable number of studies address WOM and eWOM, there are still fewer studies on eWOM, and no study has yet compared WOM and eWOM. The investigation of differences between WOM and eWOM communication is an important future research field and could be examined in future studies. Approximately half of the eWOM studies were conducted in Asia, while only few studies on this subject were carried out in North America and Europe, clearly indicating a need to catch up. Furthermore, only two studies involved a comparison between countries. Research into cultural differences could be more focused. Cultural components differ strongly, also in WOM. Therefore, additional WOM studies comparing countries would likely provide new scientific insights. Regarding medical disciplines, there exist few studies on general practitioners, gynecologists, and osteopaths, but no studies could be found on medical disciplines like dermatologists, ophthalmologists, otolaryngologists, and pediatricians, to mention only a few neglected fields.