Formation mechanism of residents' intention to purchase commercial health insurance: the moderating effect of environmental pollution perception

AIM: With the development of the social economy, commercial health insurance in China has gradually been recognized by residents, but it is still in the initial stage of the market. To identify influencing factors of residents' intention to purchase commercial health insurance and to explore the influencing mechanism and heterogeneity of intention, this study aimed to reveal the formation mechanism of intention to purchase commercial health insurance. METHODS: This study introduced water and air pollution perceptions as moderating variables and, constructed a theoretical framework combining the stimulus–organism–response model and the theory of reasoned action models. The structural equation model was developed, and multigroup analysis and moderating effect analysis were carried out. RESULTS: The results show that advertising marketing and the behavior of relatives and friends positively influence cognition. Cognition, as well as advertising marketing and behavior of relatives and friends, has a positive impact on attitude. Furthermore, purchase intention is positively affected by cognition and attitude. Both gender and residence play a significant moderating role in influencing purchase intention. Air pollution perceptions positively moderate the path from attitude to purchase intention. CONCLUSION: The validity of the constructed model was verified and could be used to predict the willingness of residents to purchase commercial health insurance. Furthermore, policy recommendations to promote the further development of commercial health insurance were proposed. This study provides a valuable reference for insurance companies to expand the market and for the government to improve commercial insurance policies.