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Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study

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单位: [1]Beijing Inst Technol, Sch Management & Econ, Beijing, Peoples R China [2]Sustainable Dev Res Inst Econ & Soc Beijing, Beijing, Peoples R China [3]Wenzhou Med Univ, Sch Publ Hlth & Management, Wenzhou, Peoples R China [4]Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Med Insurance Management, Beijing, Peoples R China [5]Huazhong Univ Sci & Technol, TongJi Hosp, TongJi Med Coll, Wuhan, Peoples R China [6]Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing, Peoples R China [7]Beijing Inst Technol, Sch Management & Econ, 5 South Zhongguancun St, Beijing 100081, Peoples R China
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DOI: 10.2196/46621
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关键词: internet hospital conservation of resource theory medical practitioner Unified Theory of Acceptance and Use of Technology technostress resistance to change behavioral intention to use

摘要:
Background: The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners. Objective: This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework. Methods: A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model. Results: On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (beta=-.55; P<.001) and work overload (beta=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms. Conclusions: This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.

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出版当年[2022]版:
大类 | 2 区 医学
小类 | 2 区 卫生保健与服务 2 区 医学:信息
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 卫生保健与服务 2 区 医学:信息
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出版当年[2021]版:
Q1 HEALTH CARE SCIENCES & SERVICES Q1 MEDICAL INFORMATICS
最新[2023]版:
Q1 HEALTH CARE SCIENCES & SERVICES Q1 MEDICAL INFORMATICS

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者单位: [1]Beijing Inst Technol, Sch Management & Econ, Beijing, Peoples R China [2]Sustainable Dev Res Inst Econ & Soc Beijing, Beijing, Peoples R China
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通讯机构: [1]Beijing Inst Technol, Sch Management & Econ, Beijing, Peoples R China [2]Sustainable Dev Res Inst Econ & Soc Beijing, Beijing, Peoples R China [7]Beijing Inst Technol, Sch Management & Econ, 5 South Zhongguancun St, Beijing 100081, Peoples R China
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