Proposing and Empirically Investigating a Mobile-Based Outpatient Healthcare Service Delivery Framework Using Stimulus–Organism–Response Theory

Abstract

The emergency departments (EDs) of tertiary hospitals (THs) are significantly overcrowded, while primary healthcare centers (PHCCs) are underutilized. Therefore, the Chinese government is attempting to reduce outpatient flow from THs and establish a referral system between the EDs of THs and PHCCs. First, in this article, we propose a mobile-based outpatient healthcare service delivery framework (MOHSDF), which can help divert the flow of outpatients toward the PHCCs before they visit the EDs of THs. Second, this article examines that the MOHSDF-specific characteristics, including performance attributes (e.g., effort expectancy and performance expectancy), communicative power (e.g., interactivity), and perceived government support, are the stimuli that can help build an organism (e.g., initial trust and internal satisfaction). This organism will result in the behavioral intent to prescribe treatment using the MOHSDF. The data are collected from 292 TH physicians in Hefei, China, and analyze using Smart-PLS. All the proposed hypotheses are accepted, excluding two direct and one mediating relationship. These insignificant direct relationships are between performance attributes and internal satisfaction. Moreover, internal satisfaction does not mediate the relationship between effort expectancy and behavioral intent to prescribe treatment using the MOHSDF. This article has significant implications for researchers, government healthcare authorities, policymakers, and m-health service providers.