| BackgroundRural residents faced additional obstacles in obtaining health services,such as farther distances and longer space,lack of medical resources,and unfamiliarity with medical procedures.Online health services have advantages in shortening the hospitalization distance,improving the accessibility of health services,simplifying medical procedures,etc.Its appearance is expected to achieve the goal of "information running instead of patients",and also provide another set of solutions to alleviate practical problems such as difficulties in queuing,seeking medical treatment,and diverting patients in large hospitals.However,the current online health service has fallen into the dilemma of a low utilization rate among rural residents.How to break the bottleneck and effectively improve the utilization rate has become an urgent problem in the industry.PurposeThrough the implementation of a cross-sectional survey,combing the rural residents’ attitudes and willingness to online health services,to reveal the problems in the development of the current stage of service from the demand side,and in-depth study of the results and findings,for the development of online service industry in rural residents to put forward the corresponding suggestions and countermeasures.Method(1)A semi-structured interview outline was prepared and interviews were conducted,and 23 interview samples were obtained.The interview results showed that it was feasible to carry out an online health service survey in Bengbu,and the obstacles in the process of rural residents’ using traditional offline health services,the promotion and obstacles in the use of online health services,and the thematic scenarios were obtained,which provided the material and basis for the preparation of quantitative research questionnaire.(2)Based on the Behavioral Model of Health Service Use and the Unified Theory of Acceptance and the Usage of Technology,combined with the development of online health services in Bengbu,using the crawler software to get the information on the two service platforms of the Good Doctor Online and the Network about Health Care Service We Chat official account of the Second Affiliated Hospital of Bengbu Medical College,a questionnaire for online health service willingness survey of rural residents was initially prepared.15 experts in relevant fields were selected for two rounds of expert consultation.Pre-survey was conducted to test the reliability and validity of the questionnaire.After revision,a formal questionnaire was finally formed.(3)A survey group was formed and trained to conduct the formal cross-sectional survey in Bengbu,Anhui Province,and 645 valid questionnaires were obtained.For the data related to willingness to use,rate and percentage were adopted to statistically describe.The chi-square test was used for univariate analysis and binary logistics regression was used for multivariate analysis.Then,use the rate and percentage described by statistics to analyze the data of three payment scenarios.Results(1)Rural residents’ willingness to use online health services is influenced by various factors in five dimensions: age(P=0.008),education level(P<0.001),per capita annual income(P=0.001),the function of online use(P=0.013),time spent online every day(P=0.002),drug purchases in pharmacies every year(P=0.014),transportation for medical treatment(P=0.010),years of illness(P=0.032),health concept and basic knowledge literacy(P<0.001),healthy lifestyle and behavior literacy(P=0.031),health skill literacy(P=0.001),hard work expectation(P<0.001),social influence(P=0.003),and promotion conditions(P=0.018).Specifically,people under 40 years old,junior high school or above educated level,annual income ≥10,000 yuan,use shopping or payment functions,have the habit of surfing the Internet during the day,purchasing drugs in pharmacies 5-9 times a year,high-level health concept and knowledge literacy,medium-level healthy lifestyle and behavior literacy,medium-level health skill literacy,thinking that online operation is easy,family/friends are very supportive and encouraging to use it,and trusting network security and privacy protection can promote the willingness to use online health services.However,the willingness to use online health services is hindered by people over 40 years old,walking to look for medical and being ill for a long time.(2)Rural residents have different willingness to use and to pay for different online health services.First of all,if online health services are provided free of charge/paid less,the willingness to use all services,especially health consultation services,is higher.Secondly,when online health services need to be paid for,rural residents are more willing to pay for the core business related to disease diagnosis,treatment,and rehabilitation,and online consultation services are limited by certain scenarios.Finally,for graphic inquiry/consultation,the service mode of free/less payment may be more suitable for rural residents.When the payment is high,it is more suitable to provide services by telephone/video.Therefore,when promoting core business to improve operational efficiency,the above factors need to be considered together.Conclusion(1)According to the different willingness to use online health services,rural residents can be divided into three groups: willingness group,potential willingness group,and no willingness group.In the face of different willing groups,we can formulate appropriate promotion countermeasures from different entry points to improve the overall utilization rate of online health services.(2)From the perspective of the service demand side,we find many problems hidden behind the low utilization rate of online health services,including a "wait-and-see" attitude of rural residents towards online health services,inadequate industry self-promotion,service simplification and homogenization,irregular trade rules and so on.These problems may be the pains in the development of the industry at the present stage,and we need to change the current situation to break the bottleneck that hinders development. |
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