From awareness to adoption: a panoramic perspective on the utilization of Internet Medical Services among Chinese patients with chronic disease

作者：Rui Qiu, Rui Song, Xiaoyi Wu, Jiahui Feng, Yingyue Yang, Yixin Pan, Xiaoying Lin · 发表于：BMC Health Services Research · 年份：2025 · DOI：10.1186/s12913-025-13601-z · 被引用次数：5 · 研究领域：Mobile Health and mHealth Applications、Telemedicine and Telehealth Implementation、Technology Adoption and User Behaviour

BACKGROUND: Chronic diseases pose substantial healthcare burdens globally, notably in aging nations like China. Internet Medical Services (IMS) demonstrate significant potential to mitigate healthcare challenges in chronic disease management through optimized resource allocation and enhanced remote care capabilities. However, persistent adoption disparities and the "high demand-low penetration" paradox highlight persistent barriers stemming from the digital divide. This study aims to investigate factors influencing IMS utilization among chronic disease patients, examining their effects across specific IMS domains and acceptance pathways, thereby offering new insights for optimizing chronic disease management. METHODS: This study extended the Technology Acceptance Model (TAM) by integrating eHealth literacy and Technology anxiety to evaluate the utilization of IMS among 520 patients with chronic diseases in Jinan, China. IMS was categorized by functional domains (Information Access, Convenience Services, Online Health) and utilization stages (Awareness, Want, Adoption). The dual-method analysis: Awareness-Want-Adoption Gap (AWAG) matrix for service-specific disparity mapping and Structural Equation Modeling (SEM) to quantify perceptual drivers, providing a panoramic perspective to deconstruct the complex utilization. RESULTS: Information Access IMS showed the highest acceptance, while Online Health exhibited severe Want-to-Adoption collapse (71.43% gap). Affluent patients demo...