Factors influencing behavior intentions to telehealth by Chinese elderly: An extended TAM model

Background and purpose: Telehealth bring significant benefits including improved quality of healthcare, efficiency and cost containment, especially for chronic patients and the elderly. China is the second largest country of investment in telemedicine systems, but the acceptance and behavioral intentions of the technology are still low in the elderly. The objective of this study is to explain the micro-mechanism that determines the behavioral intentions to use telemedicine systems from the perspective of elderly patients based on an extended Technology Acceptance Model. Methods: A sample consisting of 436 elderlies selected through multistage cluster sampling from four cities in mainland China. The empirical study was conducted to examine the proposed model by two aspects: measurement model and structural model. Results: The study determined that medical service satisfaction (t = 6.770, beta = 0.332), ease of use (t = 5.200, beta = 0.179), information quality (t = 12.540, beta = 0.639) had a significant impact on the elderly patients' acceptance to telehealth, and the acceptance had a significant impact (t = 14.356, beta = 0.697) on the elderly patients' behavior intentions of telehealth. The results also show that the variable of acceptance has significant mediating effects among the theoretical model. Conclusions: This study confirms the applicability of the extended Technology Acceptance Model in the behavioral intentions among elderly people in China using telehealth systems. The results indicate that relationship between telehealth systems and physical medical services are mutually reinforcing rather than alternative. The study will help technology developers better understand the behavioral characteristics of the elderly and encourage healthcare providers to better understand the true need of telehealth systems. These findings provide valuable information to telehealth system developers, governments, investors, and hospitals to promote the use of this technology by elderly patients.