Roettl Johanna, Bidmon Sonja, Terlutter Ralf
Alpen-Adria Universitaet Klagenfurt, Department of Marketing and International Management, Klagenfurt, Austria.
J Med Internet Res. 2016 Feb 4;18(2):e32. doi: 10.2196/jmir.5244.
Substantial research has focused on patients' health information-seeking behavior on the Internet, but little is known about the variables that may predict patients' willingness to undergo online treatment and willingness to pay additionally for online treatment.
This study analyzed sociodemographic variables, psychosocial variables, and variables of Internet usage to predict willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the general practitioner (GP).
An online survey of 1006 randomly selected German patients was conducted. The sample was drawn from an e-panel maintained by GfK HealthCare. Missing values were imputed; 958 usable questionnaires were analyzed. Variables with multi-item measurement were factor analyzed. Willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the GP were predicted using 2 multiple regression models.
Exploratory factor analyses revealed that the disposition of patients' personality to engage in information-searching behavior on the Internet was unidimensional. Exploratory factor analysis with the variables measuring the motives for Internet usage led to 2 separate factors: perceived usefulness (PU) of the Internet for health-related information searching and social motives for information searching on the Internet. Sociodemographic variables did not serve as significant predictors for willingness to undergo online treatment offered by the GP, whereas PU (B=.092, P=.08), willingness to communicate with the GP more often in the future (B=.495, P<.001), health-related information-seeking personality (B=.369, P<.001), actual use of online communication with the GP (B=.198, P<.001), and social motive (B=.178, P=.002) were significant predictors. Age, gender, satisfaction with the GP, social motive, and trust in the GP had no significant impact on the willingness to pay additionally for online treatment, but it was predicted by health-related information-seeking personality (B=.127, P=.07), PU (B=-.098, P=.09), willingness to undergo online treatment (B=.391, P<.001), actual use of online communication with the GP (B=.192, P=.001), highest education level (B=.178, P<.001), monthly household net income (B=.115, P=.01), and willingness to communicate with the GP online more often in the future (B=.076, P=.03).
Age, gender, and trust in the GP were not significant predictors for either willingness to undergo online treatment or to pay additionally for online treatment. Willingness to undergo online treatment was partly determined by the actual use of online communication with the GP, willingness to communicate online with the GP, health information-seeking personality, and social motivation for such behavior. Willingness to pay extra for online treatment was influenced by the monthly household net income category and education level. The results of this study are useful for online health care providers and physicians who are considering offering online treatments as a viable number of patients would appreciate the possibility of undergoing an online treatment offered by their GP.
大量研究聚焦于患者在互联网上的健康信息搜索行为，但对于可能预测患者接受在线治疗意愿以及为在线治疗额外付费意愿的变量却知之甚少。
本研究分析社会人口统计学变量、心理社会变量以及互联网使用变量，以预测患者接受在线治疗的意愿以及为全科医生（GP）提供的在线治疗额外付费的意愿。
对1006名随机选取的德国患者进行了在线调查。样本取自GfK医疗保健公司维护的一个电子面板。对缺失值进行了插补；分析了958份可用问卷。对具有多项目测量的变量进行了因子分析。使用两个多元回归模型预测患者接受在线治疗的意愿以及为全科医生提供的在线治疗额外付费的意愿。
探索性因子分析表明，患者在互联网上进行信息搜索行为的个性倾向是单维的。对测量互联网使用动机的变量进行探索性因子分析得出了两个独立因子：互联网对健康相关信息搜索的感知有用性（PU）以及在互联网上进行信息搜索的社会动机。社会人口统计学变量并非预测患者接受全科医生提供的在线治疗意愿的显著因素，而PU（B = 0.092，P = 0.08）、未来更频繁与全科医生交流的意愿（B = 0.495，P < 0.001）、与健康相关的信息搜索个性（B = 0.369，P < 0.001）、与全科医生实际进行在线交流的情况（B = 0.198，P < 0.001）以及社会动机（B = 0.178，P = 0.002）是显著预测因素。年龄、性别、对全科医生的满意度、社会动机以及对全科医生的信任对为在线治疗额外付费的意愿没有显著影响，但它可由与健康相关的信息搜索个性（B = 0.127，P = 0.07）、PU（B = -0.098，P = 0.09）、接受在线治疗的意愿（B = 0.391，P < 0.001）、与全科医生实际进行在线交流的情况（B = 0.192，P = 0.001）、最高教育水平（B = 0.178，P < 0.001）、家庭月净收入（B = 0.115，P = 0.01）以及未来更频繁与全科医生进行在线交流的意愿（B = 0.076，P = 0.03）预测。
年龄、性别以及对全科医生的信任对于接受在线治疗的意愿或为在线治疗额外付费的意愿均不是显著预测因素。接受在线治疗的意愿部分由与全科医生实际进行在线交流的情况、与全科医生在线交流的意愿、健康信息搜索个性以及此类行为的社会动机所决定。为在线治疗额外付费的意愿受到家庭月净收入类别和教育水平的影响。本研究结果对于在线医疗服务提供者以及考虑将在线治疗作为一种可行方式的医生而言是有用的，因为相当数量的患者会欣赏接受全科医生提供的在线治疗的可能性。
