| BackgroundWith the rapid development of the Internet,Internet technology has been gradually applied to the medical field.In the exploration and development of Internet medical treatment,Internet hospital,a new business form of the health industry,has emerged accordingly.Among them,public hospitals have become the main force in the construction of Internet hospitals,and public Internet hospitals have played a huge role.However,the sustainable development of public Internet hospitals still faces great challenges.Studies have shown that doctors are the key factor for the sustainable development of public Internet hospitals,which not only directly affects the transformation of medical service supply mode,but also plays a decisive role in patients’medical service utilization behavior.How do doctors perceive the construction of Internet hospitals dominated by public hospitals?What is the difference between their cognition and the current construction mode of public Internet hospitals?What are doctors’ willingness to use public Internet hospitals?What factors will affect their willingness to use public Internet hospitals?All these issues have a critical impact on the construction and sustainable development of public Internet hospitals,and can help the government and hospital administrators to make precise efforts and take corresponding measures to promote the sustainable development of public Internet hospitals.ObjectivesBased on the theory of planned behavior,technology acceptance model and perceived risk theory,this study analyzed doctors’ cognition and willingness to use public Internet hospitals,explored the factors that might affect doctors’ willingness to use public Internet hospitals,and provided suggestions for the sustainable development of public Internet hospitals.MethodsIn this study,a questionnaire survey was conducted among all clinicians in a tertiary public hospital in Jinan City,and 430 valid questionnaires were collected.The contents of the survey were mainly doctors’ cognition of public Internet hospitals,as well as doctors’ perceived usefulness,perceived ease of use,attitude,subjective norms,perceived behavioral control,perceived risk,and willingness to use public Internet hospitals.SPSS and AMOS were used for statistical analysis of the data,and descriptive analysis,univariate analysis and structural equation model were conducted to analyze the relationship between each dimension factor and the intention to use the data.Results(1)In terms of cognition of public Internet hospital system,only about 28%of doctors said they understood it.80.9%of doctors believed that different standards should be set for Internet consultation fees according to doctors’ professional titles.More than 90 percent of doctors said different standards should be set for Internet consultation fees according to the type and method of service provided.60.2%of doctors believed that the Internet consultation fees should be allocated in accordance with the distribution of offline outpatient consultation fees,but nearly 40%of doctors believed that the Internet consultation fees should be fully owned by doctors.More than half of the doctors expected to receive a single Internet visit fees of 30 yuan,and 25.8 percent expected to receive a single Internet visit fees of 50 yuan.37.4%of doctors prefered fixed schedule in hospitals that doctors can provide online services as well as offline diagnosis and treatment.34.0%of doctors prefered that hospitals do not arrange the schedule of Internet hospitals,and doctors can decide when to set up Internet hospitals independently.28.6%of doctors prefered fixed schedule in hospitals,and doctors can provide online services full-time.More than 70 percent of doctors said they need training on the system,procedures and norms of public Internet hospitals.(2)The score of doctors’ willingness to use public Internet hospitals was 3.91±0.73 points.The older doctors were and the longer their years of medical service were,the lower their willingness to use public Internet hospitals was.The higher the doctor’s education,the higher their willingness to use public Internet hospitals;The willingness of doctors in emergency department to use public Internet hospitals was lower than that of doctors in other departments;The willingness of associate chief physicians to use public Internet hospitals was lower than that of other doctors.(3)Doctors with different characteristics had significant differences in perceived usefulness,perceived ease of use,attitude,subjective norms,perceived behavioral control and perceived risk scores for public Internet hospitals(P<0.05):Doctors aged 50 and above had the lowest perceived ease of use and attitude scores for public Internet hospitals.The higher the doctor’s education,the higher the perceived usefulness and perceived ease of use,and the lower the perceived risk of public Internet hospitals.Emergency department doctors had the lowest perceived behavioral control score for public Internet hospitals.Doctors with medical experience of 21 years or more had the lowest perceived ease of use score for public Internet hospitals,and doctors with medical experience of 16-20 years had the lowest subjective norm score for public Internet hospitals.Deputy chief physicians had the lowest score of subjective norms for public Internet hospitals.Doctors with an annual income of less than 60,000 yuan had the lowest scores on perceived usefulness and perceived behavioral control of public Internet hospitals.The perceived ease of use,attitude and perceived behavior control scores of doctors who made visits on other Internet medical platforms were higher than those of doctors who did not make visits to public Internet hospitals,and the perceived risk scores of doctors who made visits to public Internet hospitals were lower than those of doctors who did not make visits.(4)Structural Equation Modeling results showed that the doctor’s attitude to public Internet hospital(β=0.167,P<0.001),subjective norms(β=0.152,P<0.001),perceived behavioral control(β=0.260,P<0.001),perceived usefulness(β=0.222,P<0.001)had positive influence on doctors’ willingness to use,perceived risk(β=-0.294,P<0.001)negatively affected the use of the doctor.Attitude partially mediates the effects of perceived usefulness and perceived risk on doctors’ willingness to use,and the mediating effect values were 0.038[95%CI=(0.012,0.077)]and-0.023[95%CI=(-0.051,-0.004)],respectively.Conclusions and suggestionsDoctors’ understanding of the system related to public Internet hospitals was insufficient.There were some differences between the current construction mode and supporting mechanism of public Internet hospitals and doctors’ cognition of them.Doctors’ willingness to use public Internet hospitals was relatively high.Doctors’ perceived behavioral control,perceived usefulness,attitude and subjective norms for public Internet hospitals all had a positive impact on doctors’ willingness to use them,while perceived risk had a negative impact on doctors’willingness to use them,with the greatest effect.Based on the above conclusions,in order to meet the interest demands of doctors and improve their willingness to use public Internet hospitals,this study puts forward the following suggestions:1.At the government level,various supporting policies and systems should be formulated and implemented to improve the policy environment2.From the hospital level,establish and improve the operation system of Internet hospitals(1)Strengthen the publicity and training,and innovate the salary incentive mechanism for doctors;(2)Attach importance to doctors’ value demands and enhance perceived usefulness;(3)Innovate service mode and rationally allocate and dispatch online and offline doctor resources;(4)Improve the construction of hospital information software and hardware facilities to improve the efficiency of diagnosis and treatment. |
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