Assessing Determinants of Online Medical Services Adoption Willingness of General Hospital Physicians Using the Information-Motivation-Behavioral Skills Model: A Multi-Group Structural Equation Modeling Approach

Figures & data

Figure 1 Conceptual framework of physician’s OMS adoption willingness based on IMB model.

Notes: Pathway tests: “+” represents the positive relationships between IMB factors and OMS adoption willingness. Mediation tests: Test 1 (1—>3—>4) and Test 2 (2—>3—>4).

Abbreviation: OMS, online medical services.

Table 1 Basic Characteristics

Items		N/Mean	%/SD
Gender	Male	271	51
	Female	260	49
Age (years)^a		35.05	7.05
Education	Junior college or below	2	0.4
	Undergraduate	147	27.7
	Postgraduate	253	47.6
	Doctorate	121	22.8
	Post-doctorate	8	1.5
Working years	<5	183	34.5
	5–10	137	25.8
	10–15	83	15.6
	>15	128	24.1
Job title	Resident physician	159	29.9
	Attending physician	192	36.2
	Deputy chief physician	125	23.5
	Chief physician	55	10.4
Specialty	Surgery	151	28.4
	Internal medicine	192	36.2
	Gynecology and obstetrics	38	7.2
	Pediatrics	18	3.4
	Traditional Chinese medicine	12	2.3
	General practitioners	5	0.9
	Others	115	21.7
OMS use experience	Experienced	274	51.6
	Inexperienced	257	48.4
IMB constructs^a	Information	12.90	3.26
	Motivation	13.59	3.22
	Behavioral skills	12.98	3.53
	Adoption willingness	14.27	3.34

Note: ^aAge and IMB constructs were displayed in Mean and SD.

Abbreviation: OMS, online medical services.

Table 2 Bivariate Correlations Among IMB Constructs

IMB Constructs	1	2	3	4
1. Information	1.000	0.467**	0.546**	0.450**
2. Motivation		1.000	0.550**	0.693**
3. Behavioral skills			1.000	0.657**
4. Adoption willingness				1.000

Note: ** Refers to P < 0.01.

Table 3 Comparison of IMB Constructs on OMS Use Experience Groups

IMB Constructs	OMS Use Experience	Mean	SD	t
Information	Experienced	13.81	3.23	6.939***
	Inexperienced	11.93	3.00
Motivation	Experienced	14.12	3.24	3.951***
	Inexperienced	13.03	3.10
Behavioral skills	Experienced	14.11	3.26	8.098***
	Inexperienced	11.77	3.41
Adoption willingness	Experienced	15.04	3.12	5.703***
	Inexperienced	13.44	3.38

Note: *** Refers to P < 0.001.

Abbreviation: OMS, online medical services.

Table 4 Results of Structural Model for Full Sample and OMS Use Experience Subgroups

Model Paths	Full Sample				Experienced Subgroup				Inexperienced Subgroup
	β	b	S.E.	C.R.	β	b	S.E.	C.R.	β	b	S.E.	C.R.
BS<–In	0.431	0.466	0.061	7.621***	0.322	0.297	0.069	4.277***	0.457	0.651	0.129	5.063***
BS<–Mo	0.368	0.369	0.051	7.196***	0.419	0.387	0.07	5.553***	0.356	0.339	0.068	4.95***
AW<–In	−0.006	−0.01	0.052	−0.122	0.077	0.07	0.059	1.182	−0.06	−0.102	0.108	−0.944
AW<–Mo	0.495	0.508	0.049	10.352***	0.382	0.352	0.065	5.456***	0.588	0.631	0.071	8.873***
AW<–BS	0.424	0.434	0.052	8.303***	0.431	0.429	0.072	6.005***	0.388	0.437	0.082	5.328***

Note: ***Refers to P < 0.001.

Abbreviations: OMS, online medical services; In, information; Mo, motivation; BS, behavioral skills; AW, adoption willingness; β, standardized coefficient; b, unstandardized coefficient; S.E., standard error; CR, critical ratio.

Table 5 Direct and Indirect Effects and 95% Confidence Intervals (CI)

Model Pathways	Full Sample			Experienced Subgroup			Inexperienced Subgroup
	Estimate	95% CI		Estimate	95% CI		Estimate	95% CI
		Lower	Upper		Lower	Upper		Lower	Upper
Direct effect
In>AW	−0.006	−0.139	0.121	0.070	−0.095	0.243	−0.102	−0.335	0.115
Mo>AW	0.508	0.397	0.630	0.352	0.181	0.55	0.631	0.496	0.772
Indirect effect
In>BS>AW	0.202	0.122	0.314	0.128	0.040	0.258	0.285	0.148	0.516
Mo>BS>AW	0.160	0.092	0.248	0.166	0.067	0.314	0.148	0.077	0.256
Total effect
In total	0.196	0.081	0.312	0.198	0.050	0.340	0.183	−0.010	0.450
Mo total	0.668	0.551	0.785	0.518	0.360	0.697	0.779	0.617	0.946

Abbreviations: In, information; Mo, motivation; BS, behavioral skills; AW, adoption willingness.

Figure 2 Standardized structural model of OMS adoption willingness (full sample).

Note: ***Refers to P < 0.001.

Abbreviations: OMS, online medical services; ns, non-significant.

Figure 3 Standardized structural model of OMS adoption willingness (group comparison by OMS use experience).

Notes: Structural model with standardized estimates for experienced/inexperienced groups. The paths in bold yield significant differences between the two groups. ***Refers to P < 0.001.

Abbreviations: OMS, online medical services; ns, non-significant.