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德国患者对处方和全额报销的移动健康应用程序的接受度:基于 UTAUT2 的在线调查研究。

Patient Acceptance of Prescribed and Fully Reimbursed mHealth Apps in Germany: An UTAUT2-based Online Survey Study.

机构信息

Faculty of Health, School of Medicine, Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, 58448, Witten, Germany.

Health Care Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, Witten, 58448, Germany.

出版信息

J Med Syst. 2023 Jan 27;47(1):14. doi: 10.1007/s10916-023-01910-x.


DOI:10.1007/s10916-023-01910-x
PMID:36705853
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9880914/
Abstract

The study aims to (1) investigate current levels of patient acceptance of mHealth in Germany; (2) determine the influencing factors of patients' intention to use, and (3) test the influence of prescription and reimbursement status on patient acceptance. Online survey with 1349 participants, of which 1051 were complete and included for statistical analysis, from a broad cross-section of the German population, addressing both users of mobile health (mHealth) applications and people without prior experience. SEM modeling based on a combination of two theoretical frameworks: the extended Unified Theory of Acceptance and Use of Technology and Health Protective Behavior Theories were used to assess acceptance. Users of mHealth in Germany are mostly patients between the ages of 30 - 50 with mental health or endocrine conditions. General willingness to use mHealth apps / DiGAs (mHealth apps fully reimbursed by social health insurance) is high at 76%, especially if they are governmentally certified, however only 27% of respondents were willing to pay out of pocket. With the exception of a spike in performance expectancy and data security, DiGAs lack a clear differentiation from mHealth apps. Perceived self-efficacy and performance expectancy are significant predictors of willingness to use digital health interventions; with age, attitude, and e-literacy being key demographic predictors. A key takeaway for regulators, providers of mHealth apps/ DiGAs, and other stakeholders involved in mHealth adoption is the importance of addressing negative beliefs early on, targeted communication around effortless usage of mHealth services across age groups and demographics, and focus on highlighting expected benefits of mHealth app/ DiGA usage.

摘要

该研究旨在:(1) 调查德国患者对移动医疗 (mHealth) 的接受程度;(2) 确定影响患者使用意愿的因素;(3) 检验处方和报销状况对患者接受度的影响。采用在线调查方式,对德国具有广泛代表性的人群进行调查,包括移动医疗应用程序的使用者和无相关经验的人群,共 1349 名参与者参与,其中 1051 名参与者完整且符合统计分析要求。研究采用了基于扩展的接受和使用技术统一理论和健康保护行为理论的 SEM 模型来评估接受度。德国 mHealth 的使用者主要是 30-50 岁的精神或内分泌疾病患者。普遍愿意使用 mHealth 应用程序/数字化治疗应用程序(由社会医疗保险全额报销的 mHealth 应用程序),使用率高达 76%,特别是如果这些应用程序得到政府认证,但是只有 27%的受访者愿意自费使用。除了使用性能预期和数据安全的显著提高,数字化治疗应用程序与 mHealth 应用程序相比没有明显的差异化。感知自我效能和使用性能预期是数字健康干预措施使用意愿的重要预测指标;年龄、态度和电子素养是关键的人口统计学预测指标。对于监管机构、mHealth 应用程序/数字化治疗应用程序的提供者以及其他参与 mHealth 采用的利益相关者来说,一个重要的启示是,需要尽早解决负面观念,针对不同年龄组和人群,围绕轻松使用 mHealth 服务进行有针对性的沟通,并重点强调 mHealth 应用程序/数字化治疗应用程序使用的预期收益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/90f740074199/10916_2023_1910_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/8b5fde4164e1/10916_2023_1910_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/c3271ee0f8fe/10916_2023_1910_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/077de7378063/10916_2023_1910_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/00e5b8b6b676/10916_2023_1910_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/09befceb3b43/10916_2023_1910_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/90f740074199/10916_2023_1910_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/8b5fde4164e1/10916_2023_1910_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/c3271ee0f8fe/10916_2023_1910_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/077de7378063/10916_2023_1910_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/00e5b8b6b676/10916_2023_1910_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/09befceb3b43/10916_2023_1910_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecee/9883350/90f740074199/10916_2023_1910_Fig6_HTML.jpg

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[3]
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[4]
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JMIR Aging. 2025-5-26

[5]
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BMC Health Serv Res. 2025-4-18

[6]
Insights Into How mHealth Applications Could Be Introduced Into Standard Hypertension Care in Germany: Qualitative Study With German Cardiologists and General Practitioners.

JMIR Mhealth Uhealth. 2025-3-28

[7]
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[8]
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本文引用的文献

[1]
There's an app for that, but nobody's using it: Insights on improving patient access and adherence to digital therapeutics in Germany.

Digit Health. 2022-7-3

[2]
Attitudes Toward Mobile Apps for Pandemic Research Among Smartphone Users in Germany: National Survey.

JMIR Mhealth Uhealth. 2022-1-24

[3]
Applying an Extended UTAUT2 Model to Explain User Acceptance of Lifestyle and Therapy Mobile Health Apps: Survey Study.

JMIR Mhealth Uhealth. 2022-1-18

[4]
Physicians' Attitudes Toward Prescribable mHealth Apps and Implications for Adoption in Germany: Mixed Methods Study.

JMIR Mhealth Uhealth. 2021-11-23

[5]
Relationship Between Perceived Risks of Using mHealth Applications and the Intention to Use Them Among Older Adults in the Netherlands: Cross-sectional Study.

JMIR Mhealth Uhealth. 2021-8-30

[6]
Factors influencing mHealth adoption and its impact on mental well-being during COVID-19 pandemic: A SEM-ANN approach.

J Biomed Inform. 2021-4

[7]
Drivers of Mobile Health Acceptance and Use From the Patient Perspective: Survey Study and Quantitative Model Development.

JMIR Mhealth Uhealth. 2020-7-9

[8]
Health System Stakeholders' Perspective on the Role of Mobile Health and Its Adoption in the Swiss Health System: Qualitative Study.

JMIR Mhealth Uhealth. 2020-5-11

[9]
Acceptance of Mobile Health Applications: Examining Key Determinants and Moderators.

Front Psychol. 2019-12-10

[10]
Development of the mHealth App Trustworthiness checklist.

Digit Health. 2019-11-21

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