OBJECTIVES: Online Health Communities (OHCs) contributes to patient access to health information and doctor-patient communication. However, how patient engagement types influence doctor service provision in OHCs remains unclear. METHODS: With the PACE system, this study employs content analysis and clustering methods to examine the relationship between patient engagement types and doctor service provision. A qualitative study utilizing discourse analysis of online doctor-patient communication was conducted. A total of 300 consultation records from the Chinese OHC, Ding Xiang Doctor (DXY), were collected between August 1 and October 31, 2023. RESULTS: The study identifies four patient engagement types, including emotional disclosure, decision-making engagement, consumption-oriented, and doctor-driven types. Discourse analysis reveals that doctors adjust their communication strategies according to patient engagement types, prioritizing service provision and communication tasks differently. Specifically, doctors turn to 1) respond with more empathy to emotional disclosure patients, providing more comforting words
2) discuss more with decision-making engagement patients on treatment plan and provide more medical explanations
3) focus more on information provision by answering patient inquiries with less interaction with consumption-oriented patients
and 4) demonstrate more authority with higher frequency of use of closed questions, outlining possible conditions and providing concise diagnostic advice with doctor-driven patients. CONCLUSIONS: This study explores the impact of patient engagement in OHCs on doctor service provision. It reveals that doctors adapt their communication approaches based on the patient engagement types. PRACTICE IMPLICATIONS: The results indicate that doctors adjust their service provision based on patient engagement online, emphasizing the importance role of patients in self-report health conditions and concerns. Patients are encouraged to adopt proactive engagement to facilitate the effective online doctor- patient communication, and ultimately improve the quality of online health consultations. In addition, the doctors are expected to be more patient in OHCs compared to offline, and help patients to align their online engagement types accordingly.