## 6 Discussion  
This study utilizes a Structural Equation Model (SEM) to explore the factors influencing traffic attraction in general hospitals and specialized hospitals, contributing to the existing research on the mechanisms affecting hospital choice behavior. Unlike traditional studies, this research quantifies the critical role of medical level, emphasizing that enhancing hospital reputation, technical expertise, and service quality is more effective in attracting patients than merely expanding hospital size. These findings complement the existing literature on the impact of medical facilities on patient choice behavior and further validate the pivotal role of medical service quality in patient decision-making processes. Previous studies have extensively analyzed factors influencing patients' hospital choices, such as distance and service quality [40,41]. This study further investigates the specific factors that affect patients' decisions between general hospitals and specialized hospitals. The findings indicate that medical level is the most critical factor in patient decision-making, playing a central role. Specifically, patients are highly sensitive to evaluations of medical level focused on discipline development and clinical specialty expertise, placing greater emphasis on the reputation of relevant specialties when choosing a hospital. Additionally, this study incorporates online data (e.g., patient reviews and hospital ratings), revealing the significant impact of digital information on patient decision-making in the modern healthcare environment [42]. For general hospitals, this effect is particularly pronounced, especially when dealing with high-risk or complex disease groups, where online information becomes even more critical. These findings suggest that patient hospital selection is not entirely irrational. Given the strong correlation between hospital reputation and medical quality metrics, this study hypothesizes that empowering patients with greater freedom to choose healthcare providers may effectively foster quality competition among medical institutions. Moreover, this study also confirms significant differences in the influencing factors between general hospitals and specialized hospitals. First, hospital size has a significant impact on the traffic attraction of general hospitals, but its influence on specialized hospitals is relatively limited. General hospitals, due to their broad range of services and diverse patient populations, rely on their size to directly enhance their capacity and service coverage, thereby significantly increasing their traffic attraction. In contrast, the attractiveness of specialized hospitals is more dependent on specialized services and medical level rather than size-related factors. In the context of hospital scale variables, the number of medical departments serves as a key explanatory variable with theoretical support: As China's healthcare system reforms deepen, hospital departments are becoming more specialized and refined. This organizational optimization not only enhances the collaborative efficiency of healthcare services but also strengthens the hospital's regional radiating capacity through specialization development [43]. It is worth noting that the current competition among hospitals has shifted from overall scale competition to competition based on specialized characteristics. This shift has had a profound impact on the allocation of medical resources [44]. However, the influence of construction area and number of beds is relatively weaker, which diverges from traditional perspectives [45]. This phenomenon suggests that the relationship between a hospital's physical size and its actual attractiveness is not a simple linear one. Over-reliance on single indicators such as construction area and number of beds may fail to accurately capture the hospital's appeal and patients' actual choices.