Factors influencing the adoption of telemedicine services for middle-aged and elderly patients with chronic diseases in rural China: a multicenter cross-sectional study (Preprint)

Abstract

BACKGROUND Background Telemedicine services have greatly enhanced healthcare quality and increased access for residents in remote areas through innovative solutions. Despite this progress, low user awareness and limited acceptance of these services still pose significant challenges. To address this issue, this study aims to develop a model that identifies factors influencing the adoption of telemedicine services among middle-aged and elderly rural patients with chronic illnesses, drawing from the Health Information Technology Adoption Model (HITAM). OBJECTIVE This study examines the critical factors impacting the willingness of patients with chronic diseases to embrace telemedicine services using a structural equation model. METHODS Methods A multicenter cross-sectional study was conducted at five hospitals in western China, focusing on rural middle-aged and elderly patients with chronic diseases. An empirical test was performed on the hypothesis model using structural equation modeling to determine the significance of path coefficients. This approach aimed to gain insights into the factors influencing patients' willingness to adopt telemedicine services. RESULTS A total of 880 middle-aged and elderly patients with chronic diseases in rural areas were examined in this study, with an average adoption intention score for telemedicine services of 3.94 (standard deviation 1.02). CONCLUSIONS The findings highlight that patients' education level, monthly income, and need for care significantly impact their inclination towards adopting telemedicine services. Structural equation modeling revealed that social influence (SI), self-efficacy (SE), perceived reliability (PR), and perceived health threat (PHT) were peripheral variables, while perceived ease of use (PEU), perceived usefulness (PU), and attitude acted as core mediating variables that positively influenced patients' adoption of telemedicine services and subsequent usage behavior. Moreover, social influence (SI), perceived reliability (PR), perceived usefulness (PU), and attitude directly and positively influenced patients' willingness to adopt telemedicine services. CLINICALTRIAL none