ArticleBMC health services research2026
From facilitating conditions to intention to use internet hospitals among doctors: multiple mediators of perceived risk and performance expectancy.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInternet hospital is an online medical platform where doctors can provide patients with convenient medical services. Facilitating conditions, perceived risk, and performance expectancy have been identified as factors associated with the intention to use new technologies. However, limited studies explore the effects of these three factors on doctors' intention to use internet hospitals. This study aims to investigate the relationship between facilitating conditions, perceived risk, performance expectancy, and behavioral intention of doctors in public hospitals to use internet hospitals. Furthermore, it seeks to comprehend the multiple mediation effects of perceived risk and performance expectancy on the relationship between facilitating conditions and behavioral intention.
methodsA multicenter cross-sectional web-based survey was conducted from November to December 2022, using a sample of 233 doctors from 8 public hospitals in Shanghai. Structural equation modeling (SEM) and multi-group analysis were applied to test the proposed model and examine differences across professional title subgroups.
resultsThe findings revealed significant correlations between facilitating conditions, perceived risk, performance expectancy, and behavioral intention (β = 0.337, p < 0.001; β=-0.213, p < 0.001; β = 0.460, p < 0.001, respectively). Facilitating conditions was indirectly associated with intention to use internet hospitals through perceived risk (β = 0.044, p = 0.02) and performance expectancy (β = 0.210, p = 0.001), and these two variables formulated a sequential mediating pathway (β = 0.021, p = 0.02). The mediation effect accounted for 44.8% of the total effect of facilitating conditions. Among doctors with lower titles, the path coefficient from facilitating conditions to behavioral intention was significantly higher compared to doctors with higher titles (CR=-2.923, p = 0.003); the path coefficient from perceived risk to behavioral intention was significantly lower than doctors with higher titles (CR=-3.258, p = 0.001).
conclusionsThe findings suggest policymakers augment the doctors' intention to utilize internet hospitals by optimizing the circumstances surrounding internet hospitals, establishing comprehensive support systems, enhancing the performance benefits, and alleviating the perception of risk.
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