Behavioural Economics and Digital Healthcare Marketing in Patient Choice: Understanding Trust, Nudges, and Digital Engagement in Hospital Selection and Healthcare Utilisation

Digital information environments are now shaping patients' selection of healthcare providers, allowing them to research hospitals and consultants, and to consider cost, convenience, access, and reputation indicators before accessing care. Patients rarely act rationally in choice models; they usually face uncertainty due to information asymmetry and time pressure. This means that by the time a patient is ready to assess a provider's clinical quality, they may have already built a relationship. This means patients do not have much time to assess a healthcare provider's clinical quality before they've developed a relationship with that provider. To reduce both uncertainty and perceived risk in their healthcare decision-making, patients use trust signals, online review sites, social proof, and other methods. Digital presence, including search engine results, hospital-consultant websites, consultant profiles, appointment platform websites, and social media pages, is essential and pivotal to the overall perception of credibility and preference for healthcare services.
Objectives: The aim of this narrative review was to investigate the role of behaviour economics in the healthcare decision-making process, hospital selection, and patients' utilisation of healthcare services, and to identify possible barriers, facilitators, and practical steps for healthcare organisations.
Method: The research used a narrative literature review, drawing on PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, Emerald, and Google Scholar. The published peer-reviewed papers spanning 2015–26 were included in the review, and seminal research papers were also included to provide the theoretical basis for the research. The emphasis was mainly on literature in health services research, medical informatics, public health, and health care service management, including studies on trust, online reputation, digital engagement, appointment systems, behaviours, and decision-making processes.
Results: The literature shows that patients make decisions based on trust, the reputation of the hospital/providers, reviews, the hospital's digital accessibility, convenience (place, time, or ease of use), wait time, and social proof. The four key behavioural mechanisms are loss aversion, framing effects, availability bias, and social norms. Digital influences encompass the quality of web pages, online scheduling systems, reputation signals, and multichannel engagement, which together result in care-seeking behaviour and a sense of credibility.
Conclusion: Behavioural economics is a valid tool for understanding patient behaviour in the online healthcare service purchasing process and for identifying how digital marketing can build trust and reduce consumer friction. Digital marketing strategies and tactics that effectively boost patients' utilisation of health services are even more powerful when applied ethically and with a view to promoting patient-centred care. These digital marketing strategies can be most effective when healthcare providers (like hospitals) partner closely with their marketing expert(s) on reputation management and share their expertise, give patients accurate information about their health, and make services accessible to patients in an easy-to-use way so they can make informed choices about their health

Behavioural economics; hospital choice; digital health marketing; patient decision-making; online reputation; nudging; healthcare branding; trust; choice architecture

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