The Impact of Public Opinion on Local Policies on Internet Healthcare

During the Epidemic Period: Analysis Based on NPF Theory

Shuo Yuan

College of Philosophy, Law & Political Science, Shanghai Normal University, Shanghai, China

Keywords: Internet Medical Industry, Public Opinion, Social Policy.

Abstract: In the context of the decline in the number of Internet users in the Internet medical industry for the first time

in a year, and the deep crisis of public opinion and rectification, this study uses the binary logistic model to

consider public opinion as a separate variable to explore the relationship between public opinion, especially

the mainstream media, and local policies on the Internet medical industry during the new crown epidemic

period in China. In the field of Internet medical research, this study fills the gap in variable and theoretical

research. This study finds that during the COVID-19 period, the more mainstream media portray the Internet

healthcare industry as a hero in the narrative, the more likely it is to push local governments to introduce

relevant policies that are favorable to Internet healthcare. In the mainstream media's coverage and narrative

of Internet medicine, the role of Internet medicine has changed twice. At the same time, this study finds that

the two variables of "poverty alleviation" and "central policy" are also variable and observable during the new

crown pneumonia epidemic period, and also have high research value

1 INTRODUCTION

On May 17, 2024, the National Health Commission

issued the "Notice on Printing and Distributing the

Key Points of Work to Correct Unhealthy Practices in

the Field of Pharmaceutical Purchase and Sales and

Medical Services in 2024", which listed the issue of

violations of laws and regulations in the field of

Internet medicine as a key focus object. Then, in

October 2024, many mainstream media such as

People's Daily reported the news related to "chaos in

online diagnosis and treatment". For a time, the chaos

of online diagnosis and treatment and the improper

attitude of medical services in the Internet medical

industry have attracted the attention of many people.

In the past, the research in this field was mainly

for qualitative discussion and suggestions on the

problems arising from Internet medical policy, but in

recent years, there has been a wave of quantitative

research and analysis of the "Internet + Healthcare"

policy text under the guidance of theoretical models

such as PMC index model. From a horizontal point of

view, in the field of Internet medicine, the main

research can be divided into two categories,

qualitative research and quantitative research.

In qualitative research, it can be divided into the

following three aspects. One aspect is the exploratory

research on the regulatory model of Internet

medicinev(Chen & Wang, 2016; Ma & Yuan, 2019).

Another aspect is to conduct in-depth exploratory

research on the refinement of Internet medicine (Zhou

et al., 2016; Wei et al., 2020). The last aspect is to

conduct a comprehensive research on the current

situation and problems in the entire field of Internet

medicine. (Wang & Zhao, 2016; Xie, Gong, Luo,

2016; Luan & Tian, 2017; Zhou, 2021).

In quantitative research, it can be divided into two

categories: single-model quantitative research and

multi-model quantitative research. Single-model

quantitative research refers to the use of three types

of policy instrument models, Smith model, Horn-Mitt

model, policy network model, PMC model and other

models to study the field of Internet medicine (Sun et

al., 2020; Ge, Zhao, Han, 2021; Lu et al., 2022; Yang

et al., 2022; Wu et al., 2024). Multi-model

quantitative research uses a variety of models and

perspectives to explore the field of Internet healthcare

(Yao, 2022; Zhang& Liu, 2024).

In terms of theory, in countries other than China,

NPF theory is mainly applied to environmental

protection and other fields, and there are few studies

in the field of telemedicine. In China, the theoretical

application of NPF is rare, mainly focusing on the

nuclear energy policy in Taiwan (Tian, Lin, Wu,

2020), Shanghai's urban digital transformation

(Zhang, Qin, 2022), and fireworks policy (Ma& Chai,

Yuan, S.

The Impact of Public Opinion on Local Policies on Internet Healthcare During the Epidemic Period: Analysis based on NPF Theory.

DOI: 10.5220/0013982600004912

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 1st International Conference on Innovative Education and Social Development (IESD 2025), pages 277-281

ISBN: 978-989-758-779-5

277

2024), and the problems are discussed from the

mesoscopic and micro levels of NPF theory. Since the

research content of this study is the influence of

public opinion on local policies of Internet medicine,

the research object is public opinion and local

policies, and the mainstream media likes to use

storytelling to carry out policy narratives, which is in

line with the NPF theory, which is a policy process

theory centered on policy narrative. Therefore, this

study will apply NPF theory to the field of Internet

medicine and fill the gap in theoretical research.

NPF theory, also known as Narrative Policy

Framework, is a policy narrative-centered policy

process theory proposed by three scholars: Mark K.

McBeth, Michael D. Jones, and Elizabeth A.

Shanahan. NPF theory distinguishes between policy

content and form, and on the basis of this, NPF theory

overcomes and regulates the problem of narrative

relativity by subdividing the way policy content and

form are obtained (McBeth, Jones, Shanahan, 2014).

In NPF theory, role variables are a commonly used

concept, specifically, role variables refer to those

entities that act or are acted upon in the policy

narrative, the entity can be a person, an institution or

an organization, in terms of quantitative operations,

usually roles are divided into heroes, villains and

victims, heroes are social problem solvers, villains are

social problem makers, and victims are entities that

are hurt by villains (McBeth et al.,2018).

In summary, this study will focus on the

relationship between the relevant narratives of public

opinion and local policies on Internet healthcare

based on the NPF theory, using the fieldwork method

of online data collection and analysis, and using the

binary logistic regression model.

2 RESEARCH METHODS

2.1 Research Hypotheses and

Questions

Through the above literature review, this study

believes that in the field of Internet medicine,

qualitative research is mainly conducted, and

quantitative research is increasing year by year, but

some quantitative studies only focus on the text

analysis of policy content, discuss the content of

policy texts, and put forward specific problems of

Internet medicine on this basis. To explore the

statistically significant correlation between public

opinion and the implementation of Internet medical

policies.

In terms of the implementation of local policies on

Internet medicine, Lu Xinyue and other scholars have

used the Horn-Mitter model to study the influencing

factors in the implementation of Internet policies, but

they ignore the influence of public opinion media in

terms of system environment, and simply deduce

from objective factors such as the increase in elderly

patients, the long follow-up cycle of chronic diseases,

and the increase in the demand for family

rehabilitation cycles to the improvement of the

public's recognition of Internet medicine, and the

recognition of Internet medical services has been

continuously enhanced. Yang Ye and other scholars

(2022) have noticed the impact of public opinion on

the implementation of Internet medical policies, but

they only stay at the impact of the crisis of trust

generated by the interaction between public opinion

and service providers on the implementation of

Internet medical policies, and in essence, public

opinion is regarded as policy supervisors, rather than

as a separate variable that directly affects Internet

medical policies. Therefore, this study argues that

public opinion should be regarded as a separate

variable, and the impact of public opinion on local

policies on Internet medicine should be explored to

fill the gap in variable research.

Based on this, the following research hypotheses

are proposed. H0. In the context of the new crown

epidemic, the mainstream media will portray the

Internet medical industry as a hero, which will

promote local governments to introduce detailed

favorable policies in this field.

2.2 Variables and Binary Logistic

Regression Models

Taking Guangming Daily as an example, this study

searched for keywords such as "Internet medicine",

"telemedicine", "online medicine" and "Internet

diagnosis and treatment" in the academic and cultural

multimedia material database of Guangming Daily,

and selected reports that used the novel coronavirus

pneumonia as an introduction to lead to Internet

medical treatment and conformed to the NPF

theoretical narrative, and selected a total of 41 reports

from February 2, 2020 to December 27, 2022 as the

text analysis data of the variable "report score".

In terms of the variable "local policy", relevant

studies show that the higher the economic

development, the more perfect the Internet medical

policy system is, so the Internet medical policy in the

eastern developed region is perfect. The lower the

level of economic development, the more innovative

the Internet medical policy will be to encourage the

IESD 2025 - International Conference on Innovative Education and Social Development

278

development of Internet medicine, but the Internet

medical policy system is not perfect (Ju et al., 2021).

Therefore, this study refines the variable of "local

policy" to the spatial field of local policy in Shanghai,

which has a high level of economic development, and

searches for Internet medical care as keywords in the

open government affairs of the Shanghai Municipal

Health Commission to obtain text data.

Therefore, there are two variables in this study,

namely "reporting role" and "local policy", in which

the continuous variable "reporting score" with a value

range of -2 to 2 is the independent variable of this

study, and the dichotomous variable "local policy"

coded by 0,1 is the dependent variable of this study.

Specifically, among the variables of "media

reporting role", this study uses the concept of role as

a variable in NPF theory. In this variable, if Internet

healthcare is described as a "hero" in the narrative of

media coverage, it is coded as 0; If Internet medical

is described as a "villain" that creates social problems,

it is numbered 1. In the "local policy" variable,

determine whether the Shanghai Municipal Health

Commission has issued a reply or notice on the

Internet medical industry within 10 days after the

media report is released. If there is a notice that is

more inclusive than prudent in Internet medicine or

supports the development of Internet medicine, it will

be coded as "0" and regarded as a positive notice; If

there is no relevant policy, it will be numbered as "1"

and deemed not to be mentioned.

Since the dependent variables in this study were

binary categorical variables and the independent

variables were continuous variables, the method used

in this study was a binary logistic regression model.

3 FINDINGS

As shown in Table 1 of the results of the binary

logistic regression model, the reported role variables

are significant, and the Exp (B) value of the variable

is less than 1, so it can be concluded that the

mainstream media in the process of reporting on the

Internet medical industry, the Internet medical

industry is portrayed as a hero, and the more likely it

is to promote local governments to introduce relevant

policies that are favorable to Internet healthcare, so

the assumption H0 is valid.

Table 1. Binary logistic regression model result plot.

)

P-value

Reporting Character (Hero)

0.056* 0.011

intercept 2.556* 0.017

*Note: *P<0.05.

At the same time, in this process, this study found

that the role image of Internet medicine was divided

according to the two events of "new crown

vaccination" and "Omicron variant epidemic", and

there were two turning points in the narrative of

mainstream media reporting. Specifically, this study

found that in the early stage of the new crown

epidemic, the Internet medical industry was often

regarded by the mainstream media as a "hero" to

solve the problem of epidemic prevention and

control, optimize China's common health system,

reduce the burden of medical staff, and solve the

employment problem of college graduates. In the

period of normalization of epidemic prevention and

control, Internet medical care is often regarded by the

mainstream media as a ballast stone for economic

recovery and a booster for stimulating mass

consumption, and most reports discuss the benefits of

the Internet medical industry to epidemic prevention

and control, online consumption, public health and

other fields, and less discuss the problems and

disputes between service providers and consumers in

the Internet medical industry, and focus more on

issues such as institutional design that hinder the

further development of the Internet medical industry.

The first turning point came in the middle of the new

crown epidemic, when the landmark event was seen

as the start of mass production of China's new crown

vaccine and the launch of the new crown vaccination

program, and the public opinion of the mainstream

media began to change to a certain extent, and

relevant reports asserted that the spring of "online

medicine" has arrived, and it is still too early. The

second turning point occurred at the end of the new

crown epidemic, the landmark event was the

epidemic of the Omicron variant in China, due to the

reduced efficacy of the previous new crown vaccine,

the number of new crown pneumonia infections

showed a significant upward trend, the Internet

medical industry was once again valued, and in the

mainstream media reporting narrative, Internet

medical treatment was shaped as a "hero" to solve the

problem of medical resource run.

4 CONCLUSION

This study demonstrates the impact of public opinion,

especially the mainstream media, on local policies on

Internet healthcare during the new crown epidemic

period, treats public opinion as a separate variable,

and explores the impact of public opinion as a

separate variable on local policies, filling the gap in

variable research. At the same time, this study also

The Impact of Public Opinion on Local Policies on Internet Healthcare During the Epidemic Period: Analysis based on NPF Theory

279

applies the NPF theory to the field of Internet

medicine, which fills the gap of related theories.

In terms of the outlook for future research

directions, this study argues that a sustained focus

should be placed on the pandemic. The impact of

"poverty alleviation" and "central policies". This

study finds that during the period of COVID-19, the

Chinese government is also carrying out the "poverty

alleviation battle", so in the mainstream media's

narrative coverage of the poverty alleviation battle,

Internet medical care is also portrayed as a "hero" to

solve the problem of uneven distribution of medical

resources between regions. At the same time, when

exploring the impact of "reporting role" on "local

policies", this study finds that during the period of

new crown pneumonia, the central government has

issued many relevant policies that mention Internet

medicine, such as: the National Health Insurance

Administration and the National Health Commission

jointly issued the "Guiding Opinions on Promoting

the Development of "Internet +" Medical Insurance

Services during the Prevention and Control of the

New Coronary Pneumonia Epidemic (2020-03-03)",

"Opinions of the Central Committee of the

Communist Party of China and the State Council on

Deepening the Reform of the Medical Security

System (2020-03-05)", " Opinions on Supporting the

Healthy Development of New Business Formats and

New Models and Activating the Consumer Market to

Drive the Expansion of Employment (2020-07-14)",

"Notice on Further Promoting the "Internet + Medical

Health" and "Five Ones" Service Action (2020-12-

04), these relevant policies are conducive to the

development of Internet medicine, and there are also

those who believe that Internet medical supervision

should be strengthened, and those who have a neutral

attitude towards Internet medical care also have high

research value.

The limitations of this study focus on two main

aspects. In terms of the definition of variables, this

study defines public opinion as mainstream media

and ignores the role of self-media in today's world. In

terms of modeling, due to excessive workload and

other reasons, this study cannot perform 100% text

analysis and extraction of the content of mainstream

media reports, which will inevitably lead to the

problem of response bias, and there may be under-

representation or over-representation of the sample.

REFERENCES

Chen, H.H., Wang, G.L. 2016. Assumptions of China's mo-

bile medical regulatory model under the background of

"Internet+". Chinese Journal of Hospital Management

(10): 30-33.

Chinese Government Net-work. 2024-05-17. Notice on

printing and distributing the key points of work to cor-

rect unhealthy practices in the field of pharmaceutical

purchase and sales and medical services in 2024.

https://www.gov.cn/zhengce/zhengceku/202405/con-

tent_6953851.htm.

Ge, P.N., Zhao, Y., Han, C.X. 2021. Implementation prob-

lems and countermeasures of Internet medical policy:

An analysis based on Smith Model. Journal of Health

Economics (01):17-21.

Jones, M.D. 2014. The science of stories: Applications of

the narrative policy framework in public policy analy-

sis. Springer.

Ju, W.S., Chen, X.Y., Yin, W.D., Yang, G.M., Lin, H., Wu,

J., & Fang, X.W. 2021. The evolution and development

of internet medical policy in China. China Digital Med-

icine (04): 1-8.

Luan, Y.B., Tian, Z.D. 2017. Problems and countermeas-

ures of "Internet + medical care" in China. Administra-

tive Reform (03): 59-63.

Lu, X.Y., Li, R.F., Zheng, Q.Y., Du, S.X., Wang, L., Tang,

Y., & Huang, Y.L. 2022. Analysis of influencing fac-

tors of Internet medical policy implementation based on

Horn-Mitt model. China Health Quality Management

(02): 71-76.

Ma, J.Z., Chai, X.M. 2024. Effect differences and govern-

ance strategies of public policy network communica-

tion: An analysis based on NPF Theory. Leadership

Science (03):155-160.

Ma, J., Ma, Y. 2019. Suggestions for the innovation of the

new model of "Internet+" regulatory system. Adminis-

trative Reform (03): 50-59.

Tian, H., Lin, G., Wu, W.X. 2020. Narrative behavior of

policy advocacy groups on Facebook: A study on nu-

clear energy policy issues in Taiwan based on narrative

policy framework. Taiwan Studies Journal (01): 90-100.

Shanahan, E.A., Jones, M.D., & McBeth, M.K. 2018. How

to conduct a Narrative Policy Framework study. The So-

cial Science Journal 55: 332-345.

Wang, L., Zhao, G.G. 2016. The dilemma and policy analysis

of "Internet + medical care". China Hospital (02):45-46.

Wei, M.Y., Cui, W.B., Wang, S., Yu, G.J. 2020. Risk analy-

sis and control strategy of internet hospital. China Health

Resources (02):99-101.

Wu, Y.X., Lang, Z.H., Niu, J.J., Zhou, L.F., Xu, N., Xu,

L.F., Yu, Q.Q. 2024. Text analysis of "Internet + nurs-

ing service" policy in the context of high-quality devel-

opment of public hospitals. Chinese Hospital Manage-

ment (10): 15-19.

Xie, W.Z., Gong, X.Q., & Luo, A.J. 2016. Development

status and challenges of Internet medicine in China.

Chinese Journal of Library and Information Science

and Information Science (09): 6-9.

Yang, Y., Zhang, J., Chen, H.Y., Mo, W.Q., Shi, Y.N., &

Zhang, X.P. 2022. The dilemma and optimization strat-

egy of China's Internet medical policy: Based on the

policy net-work theory. Journal of Health Economics

(08):14-17.

IESD 2025 - International Conference on Innovative Education and Social Development

280

Yao, C.H., Zhou, D., Wang, Y.F., Tian, D., Wu, Y., Zhou,

Y. 2022. Research on the development of Internet hos-

pitals in the post-epidemic era and their countermeas-

ures based on the SERVQUAL-ROST model. Chinese

Hospital Management (02): 31-34.

Zhang, Y., Qin, C.S. 2022. Policy Narrative, Public Atti-

tudes and Supportive Behavior Tendency: A Survey Ex-

periment Based on Shanghai's Urban Digital Transfor-

mation. Public Administration Review (03): 140-200.

Zhang, Y.Q., Liu, S.B. 2024. Quantitative research on Chi-

na's Internet medical policy text under the four-dimen-

sional framework of "Governance-Demand-Tool-

Theme". Library and Information Work (18):71-86.

Zhou, Z.L. 2021. The current situation, problems and de-

velopment path of "Internet + Healthcare". People's Fo-

rum (22): 88-91.

Zhou, Z., Mai, S.P., Cai, J.H., & Zong, W.H. 2016. A pre-

liminary study on China's "Internet + Healthcare" pol-

icy system. China Health Service Management (06):

404-457.

The Impact of Public Opinion on Local Policies on Internet Healthcare During the Epidemic Period: Analysis based on NPF Theory

281