在线医疗健康服务医患信任影响因素实证研究

An Empirical Study of Patient-physician Trust Impact Factors in Online Healthcare Services

在线医疗健康服务作为线下医疗健康服务的补充对缓解医疗资源相对不足等问题有着重要的意义,而信任作为人际关系的基石对在线的医患关系有深刻影响,因此有必要研究在线医疗健康服务中的医患信任问题。有诸多因素影响医患信任,医患信任的提升对患者的行为意向也有积极影响。以在线医患信任为核心,重点从患者角度研究在线医疗健康网站中医患信任的影响因素,分析个人、网站、医院和医生4个方面的影响。同时,感知风险和感知收益从宏观上也会影响在线患者信任和患者行为意向,也将其纳入分析。基于此,以信任模型的概念框架以及感知风险和感知收益等理论为基础构建模型,提出9个假设。以有在线医疗健康网站中服务经验的用户为研究对象,使用问卷调查的方法进行调研,获得271份有效样本,利用结构方程模型的实证方法对研究假设进行检验。研究结果表明,除个人信任倾向外,医患信任影响因素中的网站、医院和医生的可信度均对在线患者信任有显著影响,其中网站因素的影响程度最高,在线患者信任也显著影响患者行为意向。感知收益和感知风险对在线患者信任也有显著影响,但对患者行为意向的影响不显著。将医患信任的研究从线下延伸至线上,探讨在线患者信任的影响因素。研究结果为研究在线医疗健康服务中的患者信任提供理论依据,同时为在线医疗健康服务的发展提供参考策略。

The service delivery model of online healtheare has received much more attention under the growing demand of health- care service and the development of Intcmet information technology. Online healtbcare servicc delivery serves as a supplementary deliver）, of the health service delivery oflline, and it can help alleviate the problems of relatively insufficient medical resources. As the cornerstone of interpersonal relationship, trust plays an important role in the relationship between patients and physicians, especially given the online environment. Therefore, the study of patient-physician trust in online healthcare service delivery is of great importance. Improving the trust between patients and physicians will led to an effective use of online healthcare services. Previous stud- ies have indicated that there are many factors affecting the trust between patients and physicians, however, the study in regard to online patient-physician trust is not sufficient. This study explores the factors affecting online patient-physician trust from the pa- tients perspective; and the influences from personal, website, hospital and physician are discussed. The perceived risks and per- ceived benefits are also included as they have an impact on the online patient-physician trust and the behavioral intention of the patients. The research model is built on the basis of online trust conceptual framework and the theory of perceived benefits and perceived risks. To verify the assumptions of this paper, questionnaires were carried out among the users who have used the on- line healthcare services, and statistics of 271 people were taken as the valid samples. The structural equation model was used to verify the assumptions. The results are as follows ： the propensity to trust has no significant impact on trust of online patients; the credibility of web- sites, credibility of hospitals and credibility of physicians are strong determinants of online patients＇ trust, and the credibility of websites has a stronger impact than that of other determinants＇ ; the trust of online patients has significant positive impact on the behavioral intention of patients ; perceived benefits and perceived risks have significant impacts on trust of online patients, howev- er, the behavioral intention of patients are not significantly affected by the perceived benefits and perceived risks. By extending the study of patient-physician trust from the offline to online environment, this research explores the factors of online patients＇ trust. The results provide a theoretical framework for the research of online patients＇ trust, and strategies are pro- posed to the providers of online healthcare services delivery. It may have practical significance on attracting more users and enhancing comprehensive competitiveness of online healthcare services delivery.