| 摘要: | 台灣南部地區某區域教學醫院開發一套遠距健康照護服務系統，供民眾免費加入健康生活會員，即可使用系統之服務，包含：就醫報告與記錄查詢、健康管理人員個案管理及提醒功能、遠距生理量測及傳輸等。「整合性科技接受使用理論」Unified Theory of Acceptance and Use of Technology, （UTAUT) 以「績效預期」、「易用預期」、「社會影響」、「幫助條件」構面，探討影響科技接受的行為意願及其因素。本研究應用該理論架構，探討南部地區民眾在遠距健康照護服務系統之使用與付費意願，並尋找影響使用及付費行為之相關因素，供醫療院所未來提供相關服務與收費之參考。
收案期間為2012年4月至2012年5月，有效半結構式問卷212份用以進行統計分析，包括已加入健康生活會員並開始使用遠距健康照護服務系統者152份，非會員亦未使用過該系統者60份。統計分析以SPSS 12.0統計套裝軟體進行。
使用意願平均分數結果顯示，會員顯著高於非會員族群、收入4-6萬元者顯著高於收入2-4萬元者。使用系統與相關服務之付費意願結果顯示，僅25% 受訪者同意或非常同意付費，86.8% 的民眾可以接受付費金額為每年500-1000元。費用來源與費用策略聯盟部份，39% 民眾認為應由健保局支付、43% 民眾認為可與保險公司策略聯盟。線性複迴歸分析結果部份，民眾之遠距健康照護服務系統使用意願在「績效預期」及「幫助條件」構面皆達統計顯著意義(p<0.001)，β值分別為0.25、0.50。迴歸線整體解釋力R2為0.59。
本研究發現，會員使用意願平均分數顯著高於非會員族群，但是否為會員身份與使用意願分數之因果關係難判定，仍建議增加誘因刺激民眾加入。此外，民眾可接受收費為每年500-1000元，費用來源建議亦可由全民健保、私人保險公司支付。政府即將實施之長期照護保險，可考慮將遠距健康照護相關服務納入給付方案。
A telehealthcare system had been developed and used at a regional teaching hospital in Southern Taiwan. People join and become the members can use services provided as followings: reports and query of their medical treatment, diagnosis, admission note, clinical laboratory, health management and reminder, transmission of physiological measurement value etc. The theory of Unified Theory of Acceptance and Use of Technology (UTAUT) explores four key aspects (Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions) to determine the factors which influence the intention and behavior of how people accept technology. The UTAUT theory is used to find out the intention and influential factors of the people on using telehealthcare system, and willingness to pay. We expect this study can provide some insights for the medical institutions in the future to manage the telehealthcare system.
Execution period was from April to May, 2012. 212 valid semi-structured questionnaires were collected and analyzed, including 152 joined members, and 60 non-members who never used the system. The SPSS 12.0 statistical software was used for the statistical analysis.
We found that the intention score of the group members is significantly higher than that of the non-member group. People with income NT$ 40,000-60,000 per month is also significantly higher than those with NT$ 20,000-40,000 per month. Only 25% people agree or very-agree to pay for this service. 86.8% people can accept the payment for NT$ 500-1,000 per year with charge. 39% people think the fees should be payable from The Bureau of National Health Insurance, 43% people think strategic alliance with insurance companies to pay the fee. The result of multiple liner regression shows that Performance Expectancy and Facilitating Conditions are significant factors which influence using intentions.
From results of this study, we recommend to provide more incentives to urge people becoming members and using this system, even if it is difficult to distinguish the causal relationship between membership and the using intention . We suggest that the payment can be covered by The Bureau of National Health Insurance or simply leverage private insurance companies. Another possibility is to include the telehealthcare payment in the compulsory long term care insurance which is enforced by the government in the future. |
