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Medical crowdfunding provides opportunities for individuals who lack financial resources to access the health services that they need. Despite the popularity of medical crowdfunding, the current understanding of the success of medical crowdfunding campaigns is fragmented and inadequate.
We aimed to comprehensively investigate which factors lead to the success of medical crowdfunding campaigns.
A search was conducted in PubMed, PsycINFO, Web of Science, ACM Digital Library, and ScienceDirect from 2010 to June 2020. Papers directly and indirectly related to the success of medical crowdfunding campaigns were included. Two reviewers independently extracted information on the success of medical crowdfunding campaigns.
Our search yielded 441 articles, of which 13 met the inclusion criteria. Medical crowdfunding is increasingly attracting academic attention, and most studies leverage text analysis as their research methods; however, there is a lack of consensus on the definition of medical crowdfunding among researchers. Four categories of factors that affect the success of medical crowdfunding were identified: platforms, raisers, donors, and campaigns.
Although some limitations exist in our systematic review, our study captured and mapped literatures of the success of medical crowdfunding campaigns systematically, which can be used as the basis for future research on this topic.
Crowdfunding has a massive impact on how people access health care services [
Generally, the success of a medical crowdfunding campaign could be defined as the degree to which the medical crowdfunding campaign achieves or exceeds the goals set by fundraisers. However, despite the convenience and popularity of medical crowdfunding websites, the success rates of medical crowdfunding campaigns on different platforms vary dramatically. For example, in China, campaigns have been reported to achieve just 18% of their goals [
Medical crowdfunding can not only make up for the deficiencies of health insurance systems but can also address problems such as limited financing channels and low private capital utilization rates [
We chose to conduct a systematic review, rather than choosing another method, for the following reasons: First, a systematic review could provide a comprehensive understanding concerning the success factors of medical crowdfunding campaigns. The comprehensive understanding could be a solid basis for further studies on this topic. Second, a systematic review could limit bias in identifying and rejecting bias by using explicit methods. Third, conclusions of the systematic review may be more reliable and accurate because it summarizes previous literature systematically. Fourth, the findings of systematic review could be used to reduce the delay between scientific discoveries and implementation. The generalizability of findings could be established by comparing studied success factors of medical crowdfunding campaigns [
We used PubMed, PsycINFO, Web of Science, ACM Digital Library, and ScienceDirect databases. These databases were chosen because they cover most disciplines that study medical crowdfunding, namely, medicine, information, psychology, global health, computer science, and business economics. Keywords and synonyms used in this search revolved around 2 concepts—crowdfunding, and health (
11 crowdfunding or crowd funding
22 health or disease or illness or medical or hospital or treatment
33 1 and 2
Papers that focused on the success of medical crowdfunding or other factors related to the success of crowdfunding (eg, narrative strategies and ethical factors of medical crowdfunding) published between 2010 and 2020 (because medical crowdfunding emerged after 2008) within conference proceedings or journals were included, and papers without research design details or results or not be written in English were excluded.
Papers were rated for quality using the McGill Mixed Methods Appraisal Tool version 2018 [
Metadata were extracted and listed in a spreadsheet (Excel, Microsoft Inc): author region, publication date, data sources, research questions, data collection settings, methods, results, discussions, conclusions, and bibliographies. To interpret our findings, all authors discussed how to present our findings systematically. Since the conception of medical crowdfunding is dynamic, we discuss the conception, then summarize bibliographic and study information. The success factors are based to the contextual structure of medical crowdfunding. Since there are 3 main actors in medical crowdfunding, and they interact with each other based on specific campaigns [
A total of 441 papers were identified from the 5 databases. After removing 46 duplicates, titles and abstracts were screened by 2 authors separately. When a difference in opinion arose, a third author was involved to mediate the discussion to reach agreement. Using inclusion and exclusion criteria, 27 papers were chosen for full-text review. After full-text review, 19 papers were assessed for quality, 13 papers were included (
Summary of literature search and study selection process.
Despite the acknowledgment of the benefit of medical crowdfunding in strengthening health care, there is still a lack of consensus on what constitutes crowdfunding campaigns in health care. However, to study the success factors of medical crowdfunding, we need to have a basic understanding of medical crowdfunding. Based on previous studies [
Of the 13 studies (
Study information.
Reference | Publication date (year, month) | Country | Study aim | Data sources | Method | Success factors |
Durand et al [ |
2018,6 | United States | To identify the factors influencing the success of crowdfunding campaigns | YouCaring | Text analysis, multiple linear analysis, logistic regression analysis | Campaign description length; goal amount; third-person description perspective; cognitive state |
Kim et al [ |
2018,4 | United States | To investigate how beneficiaries present their situations and how contributors view the information presented | GoFundMe, YouCaring, Fundly | Semistructured interviews | Authenticity |
van Duynhoven et al [ |
2019,6 | Canada | To explore the role of socioeconomic status in medical crowdfunding campaigns | Cancer-related activities published by Canadians; The 2016 Census Profile for aggregate dissemination area and area boundaries; forward sortation area boundaries | Exploratory spatial analysis | Socioeconomic status; demographic |
Xu and Wang [ |
2019,8 | China | Make clear the narrative strategy of medical crowdfunding article | Easy Fundraising | Thematic narrative analysis | Narrative strategies |
Kim et al [ |
2016,5 | United States | To assess the credibility of web-based medical crowdfunding campaigns | (1) Comment on Reddit related to the medical crowdfunding campaign, (2) 20 participants | Text analysis and semistructured interviews | Credibility; individual prestige |
Aleksina et al [ |
2019,7 | France | To investigate the determinants of successful crowdfunding campaigns in medical research | Consano, Experiment | Ordinary least square regression | Number of tweeters; goal amount; platform availability; total campaign number; total fundraising amount; total donor number |
Holmes et al [ |
2019,4 | United Kingdom | To determine whether crowdfunding of pharmacy-related products through popular web-based platforms | Kickstarter, Indiegogo | Text analysis | Media attention; platform audit; demographic information of donors |
Snyder et al [ |
2017,6 | Canada | To explore how Canadians can demonstrate to others that they should fund their health needs | FundRazr, Generosity, GoFundMe, YouCaring | Text analysis | Personal connections; depth of need; giving back; ethics |
Koole et al [ |
2018,12 | Netherlands | Identify key factors for the success of crowdfunding for grown-up congenital heart patients | A web-based donation platform | Text analysis | Professional organization support; stakeholder support; easy-to-understand message |
Barcelos and Budge [ |
2019,1 | United States | Investigated how transgender communities utilize crowdfunding expenses related to gender affirming medical care | GoFundMe | Hierarchical multiple regression analyses | Social media (Facebook) sharing; demographic information of raiser (age, location, race, identity) |
Berliner et al [ |
2017,8 | United States | Explore the usage, impacts, or consequences of the increasing reliance on crowdfunding for health | GoFundMe | Text analysis | Medical literacy; media literacy |
Bassani et al [ |
2019,8 | Italy | Examine the worldwide population of health care crowdfunding platforms and explore the relationship between health care crowdfunding success and national health systems | 76 crowdfunding platforms that host health care campaigns | Negative binomial regressions | Platform type; social return |
Kenworthy [ |
2019,11 | Norway | Map and document how medical crowdfunding is shaped by, and shapes, health disparities | An ethnography of US medical crowd-funding; a study of global health crowdfunding; a project of US medical crowdfunding campaigns | Exploratory conceptual and empirical analysis | Platform design (Search engine, lists, webpage, etc); Partnership with traditional media; Deservingness; Narratives |
For platforms, the factors influencing the success of medical crowdfunding campaigns can be divided into 2 aspects: technical and social (
The
Factors influencing the success of medical crowdfunding campaigns from the platforms.
Dimensions and factors | Definitions | Functions | Reference | ||||
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Platform audit | Review of campaigns on crowdfunding platforms | Reviews of campaigns by crowdfunding platforms affect donor decisions. | Holmes et al [ |
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Platform availability | The degree to which the platform is available to users | The availability of the platform affects donor incentives, and thus, campaign funding results. | Aleksina et al [ |
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Platform types | Whether the platform is specialized or general | Platforms with more extensive publicity are more popular than specialized smaller platforms. | Bassani et al [ |
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Platform design | Design elements of the platform including search engine, lists, webpage, etc | Platform design determines donors’ experiences, and consequently, their donation behavior. | Kenworthy [ |
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Total campaign number | Total number of campaigns initiated in the platform | With more categories and projects, more potential donors visit the platform. | Aleksina et al [ |
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Total fundraising amount | Total money raised in the platform | Higher total amounts raised on the platform represent higher recognition and acceptance of the platform. | Aleksina et al [ |
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Total donor number | Total number of donors appears in the platform | With more donors in the platform, there is a better possibility of getting funding. | Aleksina et al [ |
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Partnership with traditional media | Platform collaboration with traditional media to disseminate the information of its campaigns | Traditional media can help medical crowdfunding campaigns get more donors. | Kenworthy [ |
The
The influencing factors from raisers (ie, the beneficiaries) can be analyzed in terms of 3 aspects: demographic, individual characteristics, and social (
The demographic characteristics of the raisers include age, nationality, and geographic locations. Younger individuals were more likely to succeed in health crowdfunding [
Successful crowdfunding campaigners had better media literacy and medical literacy [
Social factors included personal connections, stakeholder support, professional organization support, and individual prestige. Raisers’ personal connections establish social networks and can share links, which allows more potential donors to see the information of the campaigns, thus obtaining more funds. Gaining the support of stakeholders and professional organizations makes it easier to successfully raise funds for medical crowdfunding campaigns [
Factors influencing the success of medical crowdfunding campaigns from the raisers.
Dimensions and factors | Definitions | Functions | Sources | ||||
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Age | Age | Younger people are more likely to succeed in health crowdfunding. | Aleksina et al [ |
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Education level | Level of education | Raisers with higher levels of education are more likely to attract the attention of donors (higher donation possibility). | van Duynhoven et al [ |
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Income | Income | Raisers with higher income are more likely to attract the attention of donors (higher donation possibility). | van Duynhoven et al [ |
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Geographical location | Where raisers reside | Raisers are more likely to get help from people in or near their districts, especially in wealthier places. | Barcelos and Budge [ |
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Media literacy | Raisers’ ability to make use of different media | The raisers of successful crowdfunding campaigns have good media literacy. | Berliner and Kenworthy [ |
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Medical literacy | Raisers’ ability of leverage different medical knowledge | A certain level of medical literacy (of raisers) facilitates the proper description of the disease and relevant understanding of the health care system. | Berliner et al [ |
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Deservingness | The degree to which raisers are thought to be deserving of receiving donations | Once raisers are perceived to be deserving, their campaigns attract many donors, and they succeed in raising funds. | Kenworthy [ |
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Personal connections | Raisers’ personal connections with others including their families, friends, and colleagues | The scale of raisers’ personal connections has a positive effect on the success rate of fundraising. | Snyder et al [ |
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Stakeholder and professional organization support | Raisers get support from different stakeholders and professional organizations | The support from stakeholders and professional organizations makes fundraising easier. | Koole et al [ |
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Individual |
Raisers’ personal respect and admiration from others inside and outside the platform | The prestige of raisers can serve as the signal of the credibility and success of their campaigns. | Kim et al [ |
The determinants of intention to donate in donors can be mainly divided into demographic and individual characteristics (
Donor gender [
Individual characteristics included cognitive state and social returns.
Factors influencing the success of medical crowdfunding campaigns from donors.
Dimensions and factors | Definitions | Functions | Sources | ||||
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Age | Age | Younger donors have higher willingness to donate. | Holmes et al [ |
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Education level | Level of education | Donors with higher levels of education have higher willingness to donate. | Holmes et al [ |
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Income | Income | Donors with higher income have higher willingness to donate. | Holmes et al [ |
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Geographical location | Where raisers reside | Donors are more willing to contribute to crowdfunding campaigns in or near their own regions. | Aleksina et al [ |
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Cognitive state | The cognitive state of the donor when they read the campaign | Donors may feel threatened by negative campaign descriptions and social pressure to donate. The positive cognitive state invoked by the campaign description would promote donors’ donation behavior. | Durand et al [ |
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Social returns | The intrinsic motivation of donors to give back to society | The more returns to the society from the donation, the more possibility donors would donate. | Bassani et al [ |
Success factors for campaigns can be divided into 2 aspects: the format and the content (
Format-related factors include goal amount, campaign description length, third-person description, and social media sharing. When a campaign is close to its fundraising goal, it encourages donation behavior and increases the likelihood of project success [
Content-related factors included the narrative strategy, authenticity, credibility, being easy to understand, giving back, and depth of need.
Easy-to-understand information in the campaign description gives potential donors a clear picture of the campaign [
Factors influencing the success of medical crowdfunding campaigns from campaigns.
Dimensions and factors | Definitions | Functions | Sources | |
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Goal amount | The objective amount of money the campaign plan to raise. | Goal amount has a positive impact on campaign success. | Durand et al [ |
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Campaign description length | The length of the medical crowdfunding campaign description. | Campaign description length has a positive impact on campaign success. | Durand et al [ |
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Third-person description perspective | The narrative perspective of the campaign is the third person. | The third-person perspective makes the story more objective and realistic, which makes it more convincing. | Durand et al [ |
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Social media sharing | The number of shares and likes of campaigns in social media which connect to the platform. | The more shares and likes potential donors see, the more likely they are to donate. | Barcelos and Budge [ |
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Narrative strategy | The way that raisers describe their illness and ask for donations. | Narrative strategies such as more positive emotions, more information, and appropriate arousal level have impacts on crowdfunding success. | Durand et al [ |
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Authenticity | The content of medical crowdfunding campaigns is authentic. | Potential donors payed attention on their impression of raisers’ authentic medical conditions and make their decisions based on it. | Kim et al [ |
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Credibility | Credibility of medical crowdfunding campaigns. | Credibility of campaigns which could be formed based collective endorsement have impacts on the success of medical crowdfunding campaigns. | van Duynhoven et al [ |
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Easy-to understand message | The degree to which the message is easily understood. | Easy-to-understand information helps potential donors get a sense of the raisers’ intention, which in turn helps donors make decisions. | Koole et al [ |
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Giving back | Portraying the raisers as someone who selflessly gives back to society. | The past efforts of the raisers on behalf of others were used as a rationale for the potential donors to contribute to the crowdfunding campaign. | Snyder et al [ |
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Deep of need | Campaign content reflects the urgent need of funds to solve health problems. | The urgency of need for help would determine the success of raising money. | Snyder et al [ |
By investigating 13 studies, the key factors of successful medical crowdfunding campaigns were extracted. On this basis, we conducted a more in-depth review and provide a comprehensive understanding of the factors that influence successful campaigns. We find the success factors of medical crowdfunding campaigns could be divided into 4 categories: platforms, raisers, donors, and campaigns. The success factors involve the main actors in the whole medical crowdfunding campaigns, but campaign factors were more frequently studied than other factors. Platform factors, however, played an important role in medical crowdfunding [
The 4 categories of successful factors that are actors in medical crowdfunding interact with each other [
Theory for understanding the success factors of medical crowdfunding can be developed from our findings. None of articles included in this review take strong theoretical perspective to help analyze, explain, and predict the success factors of medical crowdfunding and convey few theoretical implications. Therefore, it is necessary to apply more theories to better understand this topic. Second, more methods or mixed methods could be employed to investigate this topic. Although text analysis was used most often, more insights could be explored using other methods that possess different advantages. We found that data were collected from single sources, which may result inherent biases; collecting data from multiple sources could allow validation to proposed research models and used methods in different studies.
Our study has some limitations. First, no new factors and relationships about medical crowdfunding could be explored through systematic review. This was the most significant inherent limitation of our study since we relied on previously published literature. Second, additional literature could have been included in our systematic review. Literature written in other languages from other databases may also have discussed the success factors of medical crowdfunding. Third, bias may still exist in the process of selection and evaluation of literature. Although we attempted to minimize bias from differences between reviewers, such as solving conflicts in judgment by discussion among reviewers, bias cannot be excluded. Fourth, heterogeneity exists in the literature included in the review; therefore, the quality of our review results may be impacted. Other categories of success factors, such as health systems or national economic status, could be also be considered.
By examining platform, raiser, donor, and campaign–related success factors, we provide information that can be used as the basis for future research and future medical crowdfunding campaigns.
Preferred Reporting Items for Systematic Reviews and Meta-analyses
This work was partially supported by grants from the National Natural Science Foundation of China (grants 71801100, 72004072, and 72004071), the Humanities and Social Science Foundation of Ministry of Education of China (grants 20YJC870016), and the Fundamental Research Funds for the Central Universities (grant 2019kfyXJJS172).
None declared.