Determinants of physicians' online medical services uptake: a cross-sectional study applying social ecosystem theory.
BMJ Open
; 11(9): e048851, 2021 09 16.
Article
in English
| MEDLINE | ID: covidwho-1416671
ABSTRACT
OBJECTIVE:
To investigate the determinants of willingness and practice of physicians' online medical services (OMS) uptake based on social ecosystem theory, so as to formulate OMS development strategies.DESIGN:
Cross-sectional survey.SETTING:
Research was conducted in two comprehensive hospitals and two community hospitals in Jiangsu, China, and the data were gathered from 1 June to 31 June 2020.PARTICIPANTS:
With multistage sampling, 707 physicians were enrolled in this study. OUTCOMEMEASURE:
Descriptive statistics were reported for the basic characteristics. χ2 test, Mann-Whitney U test and Spearman's correlation analysis were used to perform univariate analysis. Linear regression and logistic regression were employed to examine the determinants of physicians' OMS uptake willingness and actual uptake, respectively.RESULTS:
The mean score of the physicians' OMS uptake willingness was 17.33 (range 5-25), with an SD of 4.39, and 53.3% of them reported having conducted OMS. In the micro system, factors positively associated with willingness included holding administrative positions (b=1.03, p<0.05), OMS-related awareness (b=1.32, p<0.001) and OMS-related skills (b=4.88, p<0.001); the determinants of actual uptake included holding administrative positions (OR=2.89, 95% CI 1.59 to 5.28, p<0.01), OMS-related awareness (OR=1.90, 95% CI 1.22 to 2.96, p<0.01), OMS-related skills (OR=2.25, 95% CI 1.35 to 3.74, p<0.01) and working years (OR=2.44, 95% CI 1.66 to 3.59, p<0.001). In the meso system, the hospital's incentive mechanisms (b=0.78, p<0.05) were correlated with willingness; hospital advocated for OMS (OR=2.34, 95% CI 1.21 to 4.52, p<0.05), colleagues' experiences (OR=3.81, 95% CI 2.25 to 6.45, p<0.001) and patients' consultations (OR=2.93, 95% CI 2.02 to 4.25, p<0.001) were determinants of actual uptake. In the macro system, laws and policies were correlated with willingness (b=0.73, p<0.05) and actual uptake (OR=1.98, 95% CI 1.31 to 2.99, p<0.01); media orientation was also associated with willingness (b=0.74, p<0.05).CONCLUSION:
Multiple determinants influence physicians' OMS application. Comprehensive OMS promotion strategies should be put forward from multidimensional perspectives including the micro, meso and macro levels.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Physicians
/
Ecosystem
Type of study:
Observational study
/
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
BMJ Open
Year:
2021
Document Type:
Article
Affiliation country:
Bmjopen-2021-048851
Similar
MEDLINE
...
LILACS
LIS