Shi Jingjin, Yan Xueming, Wang Miao, Lei Ping, Yu Guangjun
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Pediatr. 2021 Oct 18;9:745687. doi: 10.3389/fped.2021.745687. eCollection 2021.
Pediatrician workforce shortages have aroused great attention from health authorities in China. Telemedicine services have been known to enhance the management of children's health, yet the rate of adoption and usage in Chinese hospitals still at a quite low level, and the factors influencing the acceptance of telemedicine services remains unclear. The purpose of this empirical study was to evaluate the reliability and validity of a technology acceptance measurement instrument applied in healthcare, to investigate the perception of telemedicine services on the provider-side and demand-side, and to determine the factors that may drive individuals to adopt telemedicine services. A cross-sectional survey study based at Shanghai Children's Hospital, Shanghai Jiao Tong University, was conducted in March 2020. A total of 456 valid responses were obtained by convenience sampling. The internal consistency of items was assessed by Cronbach's alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both the reliability and validity of the questionnaire. Structural equation modeling analysis was used to test and verify the interrelationships among relevant variables. Price value is the strongest predictor (β = 0.30, = 0.02), facilitating conditions (β = 0.28, = 0.01) and hedonic motivation (β = 0.13, = 0.04) also have significantly positive direct effects on telemedicine acceptance. The results showed the perception of child patients' families were significantly more acceptable to telemedicine services than pediatricians ( = -2.99, < 0.01). Participants with no prior experience and lower education may be more willing to adopt telemedicine. Telemedicine will likely continue to have an integral role in pediatric health care delivery, and the findings can assist policy makers and hospital administrators in determining the more valued characteristics of telemedicine services from a behavioral perspective. Future attention will be paid to the pricing, training and service quality of telemedicine in China.
儿科医生劳动力短缺已引起中国卫生部门的高度关注。远程医疗服务已知可加强儿童健康管理，但中国医院的采用率和使用率仍处于相当低的水平，且影响远程医疗服务接受度的因素仍不明确。本实证研究的目的是评估一种应用于医疗保健领域的技术接受度测量工具的可靠性和有效性，调查医疗服务提供方和需求方对远程医疗服务的看法，并确定可能促使个人采用远程医疗服务的因素。2020年3月，在上海交通大学附属上海儿童医学中心开展了一项横断面调查研究。通过便利抽样共获得456份有效回复。通过克朗巴哈系数（α）、组合信度（CR）和提取的平均方差（AVE）评估各项目的内部一致性，以评估问卷的可靠性和有效性。采用结构方程模型分析来检验和验证相关变量之间的相互关系。价格价值是最强的预测因素（β = 0.30，p = 0.02），便利条件（β = 0.28，p = 0.01）和享乐动机（β = 0.13，p = 0.04）对远程医疗接受度也有显著的正向直接影响。结果显示，儿童患者家庭对远程医疗服务的接受度明显高于儿科医生（t = -2.99，p < 0.01）。没有 prior experience且教育程度较低的参与者可能更愿意采用远程医疗。远程医疗可能会继续在儿科医疗服务中发挥不可或缺的作用，这些发现可帮助政策制定者和医院管理人员从行为角度确定远程医疗服务更有价值的特征。未来将关注中国远程医疗的定价、培训和服务质量。 （注：原文中“prior experience”表述有误，可能是“previous experience”，这里按“先前经验”翻译）
