EXPRESS: Quality, Necessity, or Accessibility? Impact of Dockless Bike Sharing on Ineffective Use of Medical Resources

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In recent years, patients have increasing autonomy in medical decision-making. With great autonomy in selecting medical institutions, patients with low-risk diseases (LRD) may opt for treatment in prestigious hospitals, which limits the access of patients with high-risk diseases (HRD) to these hospitals. Moreover, due to limited medical knowledge and a fear of uncertainty regarding diseases, patients with greater medical autonomy may request various unnecessary medical tests to alleviate their health-related anxiety. This study takes a novel patients’ perspective to investigate how dockless bike sharing, which addresses the “last-mile problem” and improves geographical accessibility to medical institutions, affects two types of ineffective use of medical resources: disease-institution mismatch and overuse of medical tests. By introducing the concept of quality-accessibility trade-off in patients’ decision-making processes, we shed light on the psychological mechanism underlying the effect of dockless bike sharing on patients’ medical institution choices. We also introduce a new concept, perceived necessity of medical tests, to explain how dockless bike sharing reduces unnecessary medical tests. In Study 1, we designed a quasi-experiment and applied a difference-in-differences model based on real-world electronic health record data to show that dockless bike sharing increased the likelihood of patients choosing hospitals over clinics and decreased the number of unnecessary medical tests. In Studies 2a, 2b, 3a, and 3b, four randomized controlled experiments were employed to replicate the findings and reveal the underlying mechanisms. In sum, we found that dockless bike sharing acted as a “double-edged sword” in terms of its impact on exacerbating disease-institution mismatch and alleviating the overuse of medical tests. This study makes significant theoretical contributions to the Operations Management (OM), sharing economy, and medical resource management literature. It also offers important managerial insights for governments, shared mobility platforms, and healthcare providers.