Cluster Comput
DOI 10.1007/s10586-014-0356-1
Factors influencing the acceptance of telemedicine for diabetes
management
Mi Jung Rho · Hun Sung Kim · Kyungyong Chung ·
In Young Choi
Received: 19 November 2013 / Revised: 29 January 2014 / Accepted: 10 February 2014
© Springer Science+Business Media New York 2014
Abstract Telemedicine service is effective intervention in
blood glucose management and reducing the progression
of diabetic complications. While telemedicine service for
the enhanced management of diabetes has been known for
its usefulness, there is little understanding regarding which
factors should be considered when diabetic patients accept
telemedicine. Thus, this study aimed to examine the fac-
tors that influence the acceptance of telemedicine service
for the enhanced management of diabetes mellitus based
on the Unified Theory of Acceptance and Use of Tech-
nolog (UTAUT) model. Data were collected from a paper-
based survey of 116 diabetic patients who were outpatients
in six different university hospitals. This study used partial
least squares regression to determine the causal relationship
between the five variables. Demographic variables, such as
age and gender, as moderating variables for behavioral inten-
tion to use were analyzed. The results indicate that facilitat-
ing factors have effects on the behavioral intention to use
telemedicine service through the performance expectancy
( p < 0.05). In addition, facilitating factors have effects on
the behavioral intention to use telemedicine service through
M. J. Rho · I. Y. Choi (B )
Department of Medical Informatics, Catholic University of Korea
College of Medicine, Catholic University of Korea Songeui
Campus, 222, Banpo-daero, Seocho-gu, Seoul 137-701, Korea
e-mail: iychoi@catholic.ac.kr
H. S. Kim
Department of Endocrinology, Seoul St. Mary’s Hospital, Catholic
University of Korea College of Medicine, 222, Banpo-daero,
Seocho-gu, Seoul 137-701, Korea
K. Chung
School of Computer Information Engineering, Sangji University,
83 Sangjidae-gil, Gangwon-do, Wonju-si 220-702, Korea
the effort expectancy ( p < 0.05). This study also found that
performance expectancy, effort expectancy and social influ-
ence have positive effects on behavioral intentions to use
telemedicine service, as predicted using the UTAUT model
( p < 0.05). Finally, gender and age were found to be mod-
erators between PE and behavioral intention to use telemedi-
cine service as predicted using the UTAUT model. Our results
showed that telemedicine service for diabetes mellitus man-
agement should facilitate infrastructure methods such as con-
tinuous assistance service and service guideline education.
Therefore, the capacity of telemedicine service providers is
more important for telemedicine success than the compe-
tence of the individuals receiving telemedicine service care.
In addition, performance expectancy, effort expectancy and
social influence are influencing factors for the acceptance
of telemedicine service for diabetes management. Accord-
ingly, in order to raise service usage, telemedicine service
providers’ variety support is important.
Keywords Telemedicine · Diabetes mellitus · Facilitating
conditions · UTAUT model · Behavioral intention to use
1 Introduction
In 2008, the Korean Health and Society Research Center
reported that chronic patients were suffering from an aver-
age of 2.21 illnesses [24]. Of these Korean patients with
chronic illnesses, the death from diabetes rates was higher
compared with other member nations of the Organization
for Economic Cooperation and Development (OECD). Dia-
betes is also gradually becoming a prevalent disease in South
Korea [23]. Diabetic patients require periodic medical care
from healthcare providers over long periods of time. In addi-
tion, continuous lifestyle management such as regular diet,
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