ArticleFrontiers in public health2026
The impact of E-health literacy on patient loyalty in county-level public hospitals: the mediating role of value co-creation and the moderating role of perceived social support.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: This study explores the mechanisms by which E-health literacy among inpatients in county-level public hospitals influences patient loyalty. It further examines the mediating role of value co-creation and the moderating effect of perceived social support, seeking to provide empirical evidence for the digital transformation of county hospitals and patient relationship management. Methods: A stratified random sampling method was employed to survey 784 inpatients in county-level public hospitals in Shandong Province. E-health literacy, value co-creation, perceived social support, and patient loyalty were assessed using a structured questionnaire. Correlation analysis, regression analysis, and moderated mediation models were applied to examine both the direct and indirect effects of E-health literacy on patient loyalty. Results: E-health literacy was positively associated with patient loyalty, and value co-creation mediated this relationship. Furthermore, perceived social support was found to moderate the relationship between E-health literacy and patient loyalty, suggesting that elevated perceived social support weakened the positive association between E-health literacy and patient loyalty. Conclusion: E-health literacy appears to be an important factor associated with inpatient loyalty in county-level public hospitals. Value co-creation and perceived social support play important mediating and moderating roles, respectively, within this process. By enhancing patients' E-health literacy, promoting value co-creation behaviors, and leveraging social support resources, it is possible to foster sustained improvements in patient loyalty and advance the quality of smart healthcare services in county-level public hospitals.
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