患者医疗数据共享意愿影响因素 ——结合改进计划行为理论（TPB）与技术接受模型（TAM）的分析*

Influencing Factors of Patients’ Willingness to Share Medical Data: Analysis Combining the improved Theory of Planned Behavior (TPB) and Technology Acceptance Model (TAM)

摘要:

国内外关于医疗数据共享意愿的研究中，涉及社会环境因素与医疗数据共享意愿关系的研究较少。为厘清患者医疗数据共享意愿的影响因素，进一步激活医疗健康数据价值释放，基于对医疗数据性质和有关文献分析，以计划行为理论（TPB）和技术接受模型（TAM）为理论基础，经过探索性研究后引入患者的感知成本和感知风险等因素，构建包含技术（T）、社会（S）、个人（I）3个维度的患者医疗数据共享意愿TSI模型，并通过问卷调查和结构方程模型对研究模型和假设进行实证检验。结果表明：感知行为控制是患者医疗数据共享意愿的直接影响因素，共享态度是患者医疗数据共享意愿的间接影响因素；主观规范和感知成本通过共享态度间接影响患者医疗数据共享意愿；感知风险和感知有用性不仅直接影响患者医疗数据共享意愿，还能通过共享态度间接影响患者医疗数据共享意愿。在此基础上，提出在组织层面提高医疗数据共享透明度、加强对患者隐私信息的立法保护，以及强化患者对数据共享感知有用性的认识，以促进医疗数据资源的深入整合。

Abstract:

In the domestic and international studies on the topic of willingness to share medical data, there are fewer studies involving the relationships between society-environmental factors and willingness to share medical data. In order to clarify the influencing factors of patients' willingness to share medical data and further activate the value release of medical and health data, based on the analysis of the nature of medical data and the relevant literature, considering the theory of planned behavior (TPB) and technology acceptance model (TAM) as theoretical basis, and introducing the factors of patients' perceived cost and perceived risk after an exploratory research, a TSI model of patients’ willingness to share medical data with three dimensions is constructed: technological (T), society (S), and individual (I). And the research model and hypotheses are empirically tested through questionnaires and structural equation modeling. The research results show that perceived behavioral control is a direct influencing factor of patients’ willingness to share medical data; sharing attitude is an indirect influencing factor of patients’ willingness to share medical data; subjective norms and perceived costs indirectly affect patients’ willingness to share medical data through sharing attitudes; perceived risk and perceived usefulness not only directly affect patients’ willingness to share medical data, but also indirectly affect patients’ willingness to share medical data through sharing attitudes. On this basis, in order to promote the deeper integration of resources of medical data, it is proposed to improve the transparency of medical data sharing at the organizational level, to strengthen the legislative protection of patients' private information, and to reinforce patients' awareness of the perceived usefulness of data sharing.