Implementation of Online Hospitals and Factors Influencing the Adoption of Mobile Medical Services in China: Cross-Sectional Survey Study

Abstract

Background Online hospitals are part of an innovative model that allows China to explore telemedicine services based on national conditions with large populations, uneven distribution of medical resources, and lack of quality medical resources, especially among residents needing to be protected from COVID-19 infection. Objective In this study, we built a hypothesis model based on the unified theory of acceptance and use of technology in order to analyze the factors that may influence patients’ willingness to use mobile medical services. This research was designed to assist in the development of mobile medical services. Residents who do not live in urban areas and cannot access medical assistance would greatly benefit from this research, as they could immediately go to the online hospital when needed. Methods A cross-sectional study based at the West China Hospital, Sichuan University, was conducted in July 2020. A total of 407 respondents, 18 to 59 years old, in Western China were recruited by convenience sampling. We also conducted an empirical test for the hypothesis model and applied structural equation modeling to estimate the significance of path coefficients so that we could better understand the influencing factors. Results Out of 407 respondents, 95 (23.3%) were aware of online hospitals, while 312 (76.7%) indicated that they have never heard of online hospitals before. Gender (P=.048) and education level (P=.04) affected people’s willingness to use online hospitals, and both of these factors promoted the use of online hospitals (odds ratio [OR] 2.844, 95% CI 1.010-8.003, and OR 2.187, 95% CI 1.031-4.636, respectively). According to structural equation modeling, the results of the path coefficient analysis indicated that performance expectancy, effort expectancy, and facilitating conditions have positive effects on patients’ willingness to use online hospitals. Conclusions The goal of our research was to determine the factors that influence patients’ awareness and willingness to use online hospitals. Currently, the public’s awareness and usage of online hospitals is low. In fact, effort expectancy was the most important factor that influenced the use of online hospitals; being female and having a high education also played positive roles toward the use of mobile medical services.

Factors Influencing the Acceptance of Pediatric Telemedicine Services in China: A Cross-Sectional Study

“…Telemedicine has the potential to benefit pediatric care by increasing access to pediatric specialists and remotely delivering high-quality health services, including radiology, mental health, dermatology, cardiology, pathology, patient education, chronic diseases, pediatric dentistry, and neonatal ophthalmology ( 29 , 30 ). In China, the current operational mode of telemedicine is limited in the business-to-business context and for common and chronic diseases ( 4 , 31 ); therefore, the functions of telemedicine services are not yet fully used. This study aimed to determine which factors influence the acceptance of telemedicine services in a Chinese pediatric specialized hospital.…”

“…However, insurers in the United States have expanded their coverage and reimbursement of various types of telemedicine services. Scholars believe that if the price of certain technological services is very low or free of charge, it probably will not have a strong influence on behavioral intention ( 4 , 36 ). Physicians and patients are more likely to take advantage of telemedicine if their perception of its value is higher, such as saving them money and time by avoiding an out-of-town trip to the hospital ( 11 ).…”

“…With the rapid development of ICT, telemedicine has been used widely around the world as a new mode of medical service ( 3 ). As the largest developing country with a large population, medical resources in China are distributed with imbalanced and uneven quality, especially in pediatric medical resources ( 4 ). Facing a serious situation of high demand for medical resources and shortage of pediatricians, telemedicine has been considered a crucial solution by Chinese health authorities to alleviate healthcare disparities and to improve the accessibility, affordability and quality of medical resources in urban and rural areas.…”

Impact of Service Quality on In-Patients’ Satisfaction, Perceived Value, and Customer Loyalty: A Mixed-Methods Study from a Developing Country

“…Positive recommendations from inpatients also improve in-patient revisit intentions, as supported by previous research on healthcare. [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] This result might suggest that in the case of financial resource constraints, managers should prioritize social influence to enhance CPV and customer satisfaction, attracting them to purchase private healthcare treatment in the first place. For instance, private hospitals should concentrate on loyalty programs, such as discounts for family members or social media marketing.…”

“…Social influence is derived from the Unified Theory of Acceptance and Use of Technology (UTUAT), a frequently used research on adoption behavior that has not been used to explore its' impact on CPV and customer satisfaction in the healthcare context. 46 Previous research has illustrated the positive impact of social influences on customer satisfaction, customer loyalty, and customer lifetime value in non-medical industries, such as retail banking and online life insurance. 47,48 Moreover, previous research has studied the direct implications of social influence on customer loyalty; however, their indirect influence on customer satisfaction is limited.…”