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与杜西模式原型地区远程医疗服务接受度相关的因素。

Factors associated with the acceptance of telemedicine services in Dusit model prototype area.

作者信息

Benjakul Nontawat, Wongsin Utoomporn, Siri Sukhontha, Prutipinyo Chardsumon

机构信息

M.Sc. (Public Health Administration), Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand.

Department of Anatomical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, 10300, Thailand.

出版信息

Sci Rep. 2025 Jul 13;15(1):25311. doi: 10.1038/s41598-025-11193-6.

DOI:10.1038/s41598-025-11193-6
PMID:40653511
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12256603/
Abstract

The Dusit Model, a prototype area in Bangkok, Thailand, integrates telemedicine into primary and tertiary care to reduce overcrowding and promote equitable access. This study aimed to identify factors influencing telemedicine acceptance using an extended Technology Acceptance Model (TAM). A cross-sectional study was conducted among 389 participants using Vajira@Home. Variables included demographics, the extended Technology Acceptance Model (TAM), and telemedicine acceptance. Descriptive statistics, chi-square tests, and multivariate binary logistic regression were employed. Telemedicine acceptance was significantly correlated with generation, perceived ease of use (adjusted OR = 3.95, p = 0.047), and facilitating conditions (adjusted OR = 5.78, p = 0.013). Compared to Generation Z, Baby Boomers and Generation X had lower odds of acceptance (OR = 0.01 and 0.22, respectively). Model fit was confirmed (AUC = 0.79; Hosmer-Lemeshow p > 0.05). Generation, usability perceptions, and infrastructure support critically influence telemedicine acceptance. Policy should prioritize digital literacy for older adults, improve user experience, and invest in infrastructure to enhance equitable adoption.

摘要

泰国曼谷的一个样板地区——杜西模型,将远程医疗整合到初级和三级医疗中,以减少过度拥挤并促进公平就医。本研究旨在使用扩展技术接受模型(TAM)确定影响远程医疗接受度的因素。对389名使用Vajira@Home的参与者进行了一项横断面研究。变量包括人口统计学、扩展技术接受模型(TAM)和远程医疗接受度。采用描述性统计、卡方检验和多变量二元逻辑回归分析。远程医疗接受度与代际、感知易用性(调整后的OR = 3.95,p = 0.047)和促进条件(调整后的OR = 5.78,p = 0.013)显著相关。与Z世代相比,婴儿潮一代和X世代接受远程医疗的几率较低(OR分别为0.01和0.22)。模型拟合得到确认(AUC = 0.79;Hosmer-Lemeshow p > 0.05)。代际、可用性认知和基础设施支持对远程医疗接受度有至关重要的影响。政策应优先考虑提高老年人的数字素养,改善用户体验,并投资于基础设施建设,以促进公平采用。

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本文引用的文献

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A Retrospective Secondary Data Analysis of Telemedicine Service Utilization (2020-2023) Among Patients Covered By The Universal Coverage Scheme in Thailand.泰国全民医保计划覆盖患者的远程医疗服务利用情况(2020 - 2023年)回顾性二次数据分析
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Telemedicine Utilization in Tertiary, Specialized, and Secondary Hospitals in Thailand.泰国三级、专科医院及二级医院的远程医疗应用情况
Telemed Rep. 2024 Aug 5;5(1):237-246. doi: 10.1089/tmr.2024.0027. eCollection 2024.
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[Potential of a Telemedical, Inpatient-Outpatient Care Concept to Improve the Quality of Healthcare from the User's Perspective - An Acceptance Analysis of the TELnet@NRW Study].[从用户角度看远程医疗、住院-门诊护理概念改善医疗质量的潜力——TELnet@NRW研究的接受度分析]
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Perception and Acceptance of Telemedicine Use in Health Care Among the General Public in China: Web-Based Cross-Sectional Survey.公众对中国医疗保健中远程医疗使用的认知和接受程度:基于网络的横断面调查。
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Barriers and facilitators to technology acceptance of socially assistive robots in older adults - A qualitative study based on the capability, opportunity, and motivation behavior model (COM-B) and stakeholder perspectives.老年人对社交辅助机器人技术接受的障碍和促进因素 - 基于能力、机会和动机行为模型(COM-B)和利益相关者观点的定性研究。
Geriatr Nurs. 2024 Jul-Aug;58:162-170. doi: 10.1016/j.gerinurse.2024.05.025. Epub 2024 May 29.
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Digit Health. 2024 May 26;10:20552076241256752. doi: 10.1177/20552076241256752. eCollection 2024 Jan-Dec.
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Inquiry. 2024 Jan-Dec;61:469580241246466. doi: 10.1177/00469580241246466.
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