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公众使用电子咨询的意愿的感知影响因素:基于网络调查数据的分析。

Perceived Factors Influencing the Public Intention to Use E-Consultation: Analysis of Web-Based Survey Data.

机构信息

School of Public Health, Capital Medical University, Beijing, China.

出版信息

J Med Internet Res. 2021 Jan 20;23(1):e21834. doi: 10.2196/21834.

Abstract

BACKGROUND

Unbalanced distribution of medical resources is becoming a major challenge, particularly in the selection of doctors. e-Consultation could provide patients with more choices of doctors and break the constraints of time and space. However, the acceptance of e-consultation is still poor and the mechanism of adoption is unclear.

OBJECTIVE

The aim of this study was to identify the factors influencing the public intention to use e-consultation and explore the effect path of the factors and behavior intention.

METHODS

The hypotheses of our research model were developed based on the technology acceptance model and perceived risk theory. A web-based survey was conducted by an electronic questionnaire collection platform; this survey that consisted of a 29-item questionnaire with 5-point Likert scales was completed by 934 respondents. Structural equation modeling was used to analyze the data. Item evaluation and reliability, validity, path loading, goodness of fit, and multiple group analysis were used to check the moderation effects.

RESULTS

The standardized factor loadings of the items were between 0.551 and 0.873. The composite reliability of 9 constructs ranged from 0.706 to 0.840. The average variance extracted ranged from 0.387 to 0.640. The fitness indices showed that the collected data fitted well with the research model. Perceived usefulness was the strongest positive factor effecting behavior intention (β=.399, P<.001). Perceived ease of use had a positive effect on behavior intention but it was not statistically significant (β=.117, P=.07) and it had a positive effect on perceived usefulness (β=.537, P<.001). Perceived risk could be well explained by financial risk (β=.972, P<.001), privacy risk (β=.774, P<.001), social risk (β=.871, P<.001), time risk (β=.894, P<0.001), and psychological risk (β=.774, P<.001). Perceived risk had negative effects on perceived usefulness (β=-.375, P<.001) and behavior intention (β=-.297, P<.001). Personal innovativeness had a positive influence on perceived ease of use (β=.241, P<.001) and a slight effect on behavior intention (β=.124, P=.001). Age (χ=133.5, P<.001) and usage experience (χ=82.5, P=.02) had a slight moderation effect on the paths.

CONCLUSIONS

Perceived usefulness and perceived risk have significant effects on public intention to use e-consultation. Therefore, platform and manufacturer must improve the function of e-consultation, which will promote the public intention to use e-consultation fundamentally. In order to control the perceived risk of public, government should play an important role in enforcing management of e-consultation markets and approving corresponding medical insurance policies. Besides, personal innovativeness had an effect on behavior intention. Moreover, the paths of factors had some heterogeneity among people with different characteristics. Therefore, it is necessary to adjust the strategies to fit more groups better.

摘要

背景

医疗资源分布不均正成为一个主要挑战,尤其是在医生选择方面。电子咨询可为患者提供更多医生选择,并打破时间和空间的限制。然而,电子咨询的接受程度仍然较低,其采用机制尚不清楚。

目的

本研究旨在确定影响公众使用电子咨询意愿的因素,并探讨这些因素和行为意愿的影响路径。

方法

本研究的假设基于技术接受模型和感知风险理论提出。通过电子问卷收集平台进行基于网络的调查,调查由包含 29 个项目的问卷和 5 点李克特量表组成,共由 934 名受访者完成。采用结构方程模型对数据进行分析。采用项目评估和信度、效度、路径加载、拟合优度和多组分析来检查调节效应。

结果

项目的标准化因子载荷在 0.551 到 0.873 之间。9 个构念的组合可靠性在 0.706 到 0.840 之间。平均方差提取在 0.387 到 0.640 之间。拟合指数表明,收集的数据与研究模型拟合良好。感知有用性是对行为意愿影响最大的积极因素(β=.399,P<.001)。感知易用性对行为意愿有积极影响,但不具有统计学意义(β=.117,P=.07),对感知有用性有积极影响(β=.537,P<.001)。感知风险可以很好地由财务风险(β=.972,P<.001)、隐私风险(β=.774,P<.001)、社会风险(β=.871,P<.001)、时间风险(β=.894,P<.001)和心理风险(β=.774,P<.001)来解释。感知风险对感知有用性(β=-.375,P<.001)和行为意愿(β=-.297,P<.001)有负面影响。个人创新性对感知易用性有积极影响(β=.241,P<.001),对行为意愿有轻微影响(β=.124,P=.001)。年龄(χ=133.5,P<.001)和使用经验(χ=82.5,P=.02)对路径有轻微的调节作用。

结论

感知有用性和感知风险对公众使用电子咨询的意愿有显著影响。因此,平台和制造商必须改进电子咨询的功能,从根本上促进公众使用电子咨询的意愿。为了控制公众的感知风险,政府应在执行电子咨询市场管理和批准相应医疗保险政策方面发挥重要作用。此外,个人创新性对行为意愿有影响。此外,不同特征人群的因素路径存在一定的异质性。因此,有必要调整策略以更好地适应更多群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ada/7857952/bd08fbcccc6f/jmir_v23i1e21834_fig1.jpg

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