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. 2024 Apr 23;24(1):514.
doi: 10.1186/s12885-024-12281-y.

Differences in influencing mechanism of clinicians' adoption behavior for liver cancer screening technology between the leading and subordinate hospitals within medical consortiums

Shiyin Wu  1 , Yuhang Zheng  1 , Lingjie Wang  1 , Wenbin Liu  2
Affiliations

Differences in influencing mechanism of clinicians' adoption behavior for liver cancer screening technology between the leading and subordinate hospitals within medical consortiums

Shiyin Wu et al. BMC Cancer. .

Abstract

Background: Medical consortiums have been extensively established to facilitate the integration of health resources and bridge the technical gap among member institutions. However, some commonly appropriate technologies remain stagnant in subordinate hospitals, although they have been routinely applied in leading hospitals. Besides, the mechanism underlying differences in clinicians' adoption behavior at different levels of institutions was unknown. Therefore, this study aimed to investigate the differences in influencing mechanisms of clinicians' hepatic contrast-enhanced ultrasound technology (CEUS) utilization behavior between leading and subordinate hospitals within medical consortiums, thus providing clues for expanding effective and appropriate technologies within integrated care systems.

Methods: A self-designed scale was developed based on the theory of planned behavior (TPB). A multistage sampling method was applied to investigate clinicians who were aware of CEUS and worked in liver disease-related departments within the sampled medical institutions. The final sample size was 289. AMOS 24.0 software was used to construct multi-group structural equation modeling (SEM) to validate the hypotheses and determine the mechanism of hepatic CEUS utilization.

Results: It revealed that behavioral intention significantly influenced adoption behavior, regardless of whether it was in leading hospitals or subordinate hospitals (β = 0.283, p < 0.001). Furthermore, behavioral attitude (β = 0.361, p < 0.001) and perceived behavioral control (β = 0.582, p < 0.001) exerted significant effects on adoption behavior through behavioral intention. However, in leading hospitals, subjective norm had a significant positive effect on behavioral intention (β = 0.183, p < 0.01), while it had a significant negative impact on behavioral intention in the subordinate hospitals (β = -0.348, p < 0.01).

Conclusion: To effectively translate the adoption intention into actual behavior, it is recommended to elucidate the demand and facilitators involved in the process of health technology adoption across leading and subordinate hospitals. Additionally, bolstering technical support and knowledge dissemination within subordinate hospitals while harnessing the influential role of key individuals can further enhance this transformative process.

Keywords: Clinicians; Liver cancer screening; Medical consortium; Technology adoption; Theory of planned behavior.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A framework for a theoretical model of planned behavior
Fig. 2
Fig. 2
Model of utilization behavior of CEUS among 289 clinicians (*P < 0.001)
Fig. 3
Fig. 3
Model of utilization behavior of CEUS among clinicians in leading hospitals. (*P < 0.01, **P < 0.001)
Fig. 4
Fig. 4
Model of utilization behavior of CEUS among clinicians in subordinate hospitals. (*P < 0.01, **P < 0.001)
See this image and copyright information in PMC

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