影响中国老年人远程医疗行为意向的因素：扩展的 TAM 模型。
Factors influencing behavior intentions to telehealth by Chinese elderly: An extended TAM model.
机构信息
College of Business Administration, Hunan University of Commerce, Changsha, China; School of Economics and Management, Southeast University, Nanjing, China; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, USA.
School of Economics and Management, Southeast University, Nanjing, China.
出版信息
Int J Med Inform. 2019 Jun;126:118-127. doi: 10.1016/j.ijmedinf.2019.04.001. Epub 2019 Apr 3.
BACKGROUND AND PURPOSE
Telehealth bring significant benefits including improved quality of healthcare, efficiency and cost containment, especially for chronic patients and the elderly. China is the second largest country of investment in telemedicine systems, but the acceptance and behavioral intentions of the technology are still low in the elderly. The objective of this study is to explain the micro-mechanism that determines the behavioral intentions to use telemedicine systems from the perspective of elderly patients based on an extended Technology Acceptance Model.
METHODS
A sample consisting of 436 elderlies selected through multistage cluster sampling from four cities in mainland China. The empirical study was conducted to examine the proposed model by two aspects: measurement model and structural model.
RESULTS
The study determined that medical service satisfaction (t = 6.770, β = 0.332), ease of use (t = 5.200, β = 0.179), information quality (t = 12.540, β = 0.639) had a significant impact on the elderly patients' acceptance to telehealth, and the acceptance had a significant impact (t = 14.356, β = 0.697) on the elderly patients' behavior intentions of telehealth. The results also show that the variable of acceptance has significant mediating effects among the theoretical model.
CONCLUSIONS
This study confirms the applicability of the extended Technology Acceptance Model in the behavioral intentions among elderly people in China using telehealth systems. The results indicate that relationship between telehealth systems and physical medical services are mutually reinforcing rather than alternative. The study will help technology developers better understand the behavioral characteristics of the elderly and encourage healthcare providers to better understand the true need of telehealth systems. These findings provide valuable information to telehealth system developers, governments, investors, and hospitals to promote the use of this technology by elderly patients.
背景与目的
远程医疗带来了显著的效益，包括提高医疗质量、提高效率和控制成本，特别是对慢性病患者和老年人而言。中国是投资远程医疗系统的第二大国家，但该技术在老年人中的接受度和行为意图仍然较低。本研究的目的是从老年人患者的角度出发，基于扩展的技术接受模型，解释决定使用远程医疗系统的行为意图的微观机制。
方法
通过多阶段聚类抽样，从中国四个城市中选取了 436 名老年人组成样本。通过两个方面进行实证研究来检验所提出的模型：测量模型和结构模型。
结果
研究确定医疗服务满意度（t=6.770，β=0.332）、易用性（t=5.200，β=0.179）、信息质量（t=12.540，β=0.639）对老年人对远程医疗的接受度有显著影响，而接受度对老年人对远程医疗的行为意图有显著影响（t=14.356，β=0.697）。研究结果还表明，在理论模型中，接受度变量具有显著的中介效应。
结论
本研究通过在中国使用远程医疗系统的老年人中验证了扩展的技术接受模型的适用性。研究结果表明，远程医疗系统与实体医疗服务之间是相互增强的关系，而不是替代关系。本研究将有助于技术开发者更好地了解老年人的行为特征，并鼓励医疗服务提供者更好地了解远程医疗系统的真正需求。这些发现为远程医疗系统开发者、政府、投资者和医院提供了有价值的信息，以促进老年人对该技术的使用。
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