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Does high-speed rail development impact online healthcare demand? Evidence from a large medical platform in China

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  • Tang, Jiali
  • Xu, Duo
  • Fu, Hongqiao

Abstract

While the “death of distance” hypothesis predicts diminishing geographic frictions, offline connectivity continues to shape online transactions, as seen in e-commerce and online healthcare. This study exploits China's High-Speed Rail (HSR) introduction as a natural experiment to identify how improved physical accessibility affects the demand for online medical consultations. Using approximately 18 million consultation records from a major Chinese online healthcare platform and a difference-in-differences (DID) design, we find that the HSR introduction increases online consultation volume by 12.09 %. The effect is driven predominantly by cross-city consultations directed to online doctors based in provincial capitals and top medical hubs (e.g., Beijing, Shanghai, and Guangzhou). The impact is particularly pronounced among younger patients, residents in the western region, and medical departments who are more likely to require subsequent in-person hospital visits. Our mechanism analysis shows that the HSR introduction stimulates offline appointment bookings via the platform, especially cross-city appointments and those following online medical consultations. This pattern is consistent with online-offline complementarity, whereby lower expected travel costs for in-person follow-ups encourage patients to initiate online medical consultations. These findings suggest that an integrated online-offline healthcare approach may be more effective than internet-centered solutions in addressing healthcare accessibility and inequality issues.

Suggested Citation

  • Tang, Jiali & Xu, Duo & Fu, Hongqiao, 2026. "Does high-speed rail development impact online healthcare demand? Evidence from a large medical platform in China," China Economic Review, Elsevier, vol. 95(C).
    • Handle: RePEc:eee:chieco:v:95:y:2026:i:c:s1043951x25003025
    DOI: 10.1016/j.chieco.2025.102644
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