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数字健康时代中国住院医师对远程医疗服务的偏好:混合方法研究

Resident Preferences for Telemedicine Services in China in the Digital Health Era: Mixed Methods Study.

作者信息

Jiang Maomin, Zhao Jian, Zhao Ranran, Feng Jialiang, Gu Manli, Yang Meifang, Ma Zengming

机构信息

School of Nursing, Soochow University, Suzhou, China.

Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

出版信息

J Med Internet Res. 2025 Sep 3;27:e67390. doi: 10.2196/67390.

Abstract

BACKGROUND

In the digital health era, telemedicine has become a key driver of health care reform and innovation globally. Understanding the factors influencing residents' choices of telemedicine services is crucial for optimizing service design, enhancing user experience, and developing effective policy measures.

OBJECTIVE

This study aims to explore the key factors influencing Chinese residents' choices of telemedicine services, including consultation fee, physician qualifications, appointment waiting time, scope of services, privacy protection, and service hours. The study also analyzes preference heterogeneity among residents with different demographic characteristics to provide scientific evidence for optimizing telemedicine services in the digital health era.

METHODS

This study used a mixed methods design combining qualitative interviews and a discrete choice experiment. Interviews identified key telemedicine attributes, informing the discrete choice experiment scenarios. Preferences and willingness to pay were analyzed using mixed logit and latent class models.

RESULTS

Residents' preferences for telemedicine services were primarily shaped by the scope of services, appointment waiting time, and privacy protection, with substantial willingness to pay for more comprehensive, secure, and timely services. The optimal telemedicine services configuration-offering consultation plus prescription, high privacy, immediate access, 24-hour availability, and expert physicians-yielded a maximum willingness to pay of RMB 661.6 (a currency exchange rate of US $1=RMB 7.1803 is applicable). Latent class analysis revealed pronounced heterogeneity: while privacy and service scope remained universally prioritized, older, male, rural, and less-educated residents favored broader coverage, easier platforms, and lower costs; younger, female, and highly educated groups preferred faster, higher-quality, and more privacy-sensitive services.

CONCLUSIONS

This study reveals key drivers and significant demographic heterogeneity in Chinese residents' preferences for telemedicine services. Residents demonstrated a high willingness to pay for comprehensive services (eg, "consultation + prescription"), enhanced privacy protection, and shorter appointment waiting times. Additionally, the study innovatively identified 3 distinct resident profiles: "Diverse-Service-Oriented," "Utility-Oriented," and "Value-Oriented," and proposed differentiated optimization strategies to effectively address diverse resident needs, thereby promoting equitable access and efficient adoption of telemedicine services.

摘要

背景

在数字健康时代,远程医疗已成为全球医疗保健改革与创新的关键驱动力。了解影响居民选择远程医疗服务的因素对于优化服务设计、提升用户体验以及制定有效的政策措施至关重要。

目的

本研究旨在探讨影响中国居民选择远程医疗服务的关键因素,包括诊疗费用、医生资质、预约等待时间、服务范围、隐私保护和服务时间。该研究还分析了不同人口特征居民之间的偏好异质性,为数字健康时代优化远程医疗服务提供科学依据。

方法

本研究采用定性访谈和离散选择实验相结合的混合方法设计。访谈确定了远程医疗的关键属性,为离散选择实验场景提供信息。使用混合逻辑模型和潜在类别模型分析偏好和支付意愿。

结果

居民对远程医疗服务的偏好主要受服务范围、预约等待时间和隐私保护的影响,他们非常愿意为更全面、安全和及时的服务付费。最优的远程医疗服务配置——提供诊疗加处方、高度隐私保护、即时接入、24小时可用以及专家医生服务——产生的最高支付意愿为661.6元人民币(适用汇率为1美元=7.1803元人民币)。潜在类别分析显示出明显的异质性:虽然隐私和服务范围仍然普遍被优先考虑,但年龄较大、男性、农村和受教育程度较低的居民更喜欢覆盖范围更广、平台更便捷和成本更低的服务;年轻、女性和高学历群体则更喜欢更快、更高质量和对隐私更敏感的服务。

结论

本研究揭示了中国居民对远程医疗服务偏好的关键驱动因素和显著的人口异质性。居民对综合服务(如“诊疗+处方”)、加强隐私保护和缩短预约等待时间表现出很高的支付意愿。此外,该研究创新性地识别出三种不同的居民类型:“服务多样化导向型”、“实用导向型”和“价值导向型”,并提出了差异化的优化策略,以有效满足不同居民的需求,从而促进远程医疗服务的公平可及和高效采用。

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