Translated Titles

A Study of the Middle-aged and Elderly Patients Switching Intention Towards Cloud Healthcare





Key Words

雲端照護 ; PPM模型 ; 遠距照護 ; 轉換意圖 ; 人口老化 ; Cloud healthcare ; PPM model ; Telehealthcare ; Switching intention ; Ageing society



Volume or Term/Year and Month of Publication


Academic Degree Category




Content Language


Chinese Abstract

由於台灣人口老年化之趨勢,加上慢性病的危害,使得電子照護系統的需求提高。台灣遠距照護推動已經有一段時間,近年來雲端運算 (Cloud Computing)的興起,透過醫療雲結合原有的遠距照護,藉由行動裝置,幫助慢性病患者自我健康管理,並在熟悉的社區及居家環境中,就能獲得健康照護與預防保健服務。由於多數中老年人對於新科技的接受度較低,故本研究用以探討中老年病患對於雲端照護的轉換意圖。首先以Push Pull Mooring (PPM) 模型為架構,納入影響變數包含: 「不方便性」、「隱私及安全性」、「習慣性」、「不確定性」、「無所不在的照護」、「回應性」,並根據此六因素設計問卷。本研究針對有使用過遠距照護之病患為受訪對象,依據他們以往的使用經驗與雲端照護之認知,找出真正會影響他們意圖轉換使用雲端照護之推力、拉力及躊躇因子。透過分析結果顯示,三項因子及躊躇因子與推力效果間對中老年病患轉換使用雲端照護皆有顯著之影響。然而,躊躇因子與拉力效果間對中老年病患轉換意圖卻沒有顯著的影響關係。本研究以傳統醫療之推力、雲端醫療之拉力、病患躊躇因子三項觀點,探討中老年病患轉換使用雲端照護之意圖。雲端醫療可解決偏遠地區病患就醫之不便,對於慢性病患者,也可提供居家及社區型服務,如能廣泛受到病患接受,將能達到更好的醫療成效。預期研究成果可供醫療照護業者多方面的參考,並有助於設計出符合中老年病患需求之醫療模式。

English Abstract

Due to the formation of ageing society, the demand of electronic healthcare is rising. “Cloud healthcare” is a system which combines healthcare with cloud computing, it enables older people with chronic illnesses to live independently and have easy access to healthcare services. For middle-aged and elderly people, they are not familiar with most of new technologies because of their acceptance of new technology is low. To investigate their switching intention has assumed a new importance in recent year, this study uses push pull mooring (PPM) model to analyze middle-aged and elderly patients’ switching intention. This PPM model consists of 6 variables: “Inconvenience”, “Low privacy and security”, “Habit”, “Uncertainty”, “Ubiquitous care” and “Responsiveness”. According to these variables, the author develops questionnaires and the respondents are asked to have used telehealthcare. The results show that push effect, mooring effect and pull effect have a significant direct effect on patients’ switching intention. Also, the mooring effect has a significant direct effect on the relationship between push effect and switching intentions. On the other hand, the mooring effect does not have significant direct influence on the relationship between pull effect and switching intentions. It will be convenient for patients, especially in remote areas, to use cloud healthcare. Cloud healthcare can improve medical efficiency and quality, so that the author hopes to find the factors that affect these patients’ switching intention. These findings will serve as a reference for healthcare industry.

Topic Category 管理學院 > 科技管理研究所
社會科學 > 管理學
  1. Agrell H, Dahlberg S and Jerant AF, Patients’ perceptions regarding home telecare, Telemed J E-Health, Vol. 6, 2000, pp. 409-415.
  2. Anita L. Allen, Genetic Privacy: Emerging Concepts and Values, in Mark A. Rothstein (ed.), Genetic Secrets: Protecting Privacy and Confidentiality in the Genetic Era, (CT: Yale University Press, 1997), pp. 33.
  3. Alan Westin, Privacy and Freedom, Atheneum, New York, 1967, pp. 7.
  4. Aarts H and Dijksterhuis, Habits as knowledge structures: Automaticity in goal-directed behavior, Journal of Personality and Social Psychology, Vol. 78, 2000, pp. 53-63.
  5. Bansal, H.S., Taylor, S.F. and James, Y.S., Migrating to New Service Providers: Toward a Unifying Framework of Consuumers' Switching Behaviors, Journal of the Academy of Marketing Science, Vol. 33, 2005, pp. 96-115.
  6. Baldwin, L., Clarke, M., Eldabi, T. and Jones, R., Telemedicine and its role in improving communication in healthcare, Logistics Information Management Vol. 15, No. 4, 2002, pp. 309-319.
  7. Baron, R.M. and Kenny, D.A., The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations, Journal of Personality and Social Psychology, Vol. 51, No. 6, 1986, pp. 1173-1182.
  8. Bogue, D.J., Principles of Demography, New York: John Wiley, 1969.
  9. Cline, R.J.W. and Haynes, K.M., Consumer health information seeking on the Internet: The state of the art, Health Education Research Theory & Practice, Vol. 16, No. 6,2001, pp. 671-692.
  10. Chen Heng-Shuen, Su Mei-Ju, Tsai Tsung-Hsueh, Teng Shih-Shung, Zhang Han-Wei, Lai Jin-Shin, Lai Fei-Pei and Chen Ching-Yu, U-Care for the elderly: Implementation of a Comprehensive Living and Health Care Network, IEEE, June, 2007, pp.187-190.
  11. Chin, W.W., Marcolin, B.L. and Newsted, P.R., A partial least squares latent variable modeling approach for measuring interaction effects: results from a Monte Carlo simulation study and an electronic mail emotion/adoption study, Information Systems Research, Vol. 14, No.2, 2003, pp. 189-217.
  12. Chin, W.W., The partial least squares approach to structural equation modeling’, in G.A. Marcoulides (ed.), Modern Methods for Business Research, Mahwah, NJ: Lawrence Erlbaum Associates, 1998, pp. 295-336.
  13. Campbell, D.T. and Fiske, D.W., Convergent and discriminant validation by the multitrait-multimethod matrix, Psychological Bulletin, Vol. 56, 1959, pp. 81-105.
  14. Dhar, Ravi and Stephen M. Nowlis, The Effect of Time Pressure On Consumer Choice Deferral, Journal of Consumer Research, Vol. 25, March 1999, pp. 369-384.
  15. Dorigo,Guido and Waldo Tobler, Push-Pull Migration Laws, Annals of the Association of American Geographers, Vol. 73, No. 1, 1983,pp. 1-17.
  16. Erica Usher, The Millennium Development Goals and Migration, April, 2005.
  17. Fornell, Claes and David F. Larcker, Evaluating Structural Equation Models with Unobservable Variables and Measurement Error, Journal of Marketing Research, Vol. 18, February, 1981, pp. 39-50.
  18. Hou, C.Y. and Chen, C.C., "Cyberspace Migration"--Exploring Social Network Site Switching though Migration Theory: An Example of Plurk, Journal of Information Management, Vol. 19, No. 1, Jan 2012, pp. 105-132.
  19. Jung, M., Berthon, P., Fulfilling The Promise: A Model For Delivering Successful Online Healthcare, Journal of Medical Marketing, Vol. 9, No. 3, 2009, pp. 243-254.
  20. Jones, A., M., Mothersbaugh, D.L., and Beatty, S.E., Switching Barriers and Repurchase Intentions in Service, Journal of Retailing, Vol. 72, 2000, pp. 259-274.
  21. Kerwin ,K.E., The role of the Internet in improving healthcare quality, Journal of Healthcare Management, Vol. 47, No. 4, 2002, pp. 225-236.
  22. Limayem, M., Hirt, S.G. and Cheung, C.M.K., How Habit Limits the Predictive Power of Intention: The Case of Information Systems Continuance, MIS Quarterly, Vol. 31, No. 4, 2007, pp. 705-737.
  23. Lai, J.Y., Debbarma, S., Ulhas, K.R., An Empirical Study of Consumer Switching Behavior Towards Mobile Shopping: A Push-Pull-Mooring Model., International Journal of Mobile Communications, Schedule to print in Vol. 10, No. 4, Aug 2012.
  24. Longino, C.F. and Serow, W.J., Regional differences in the characteristics of elderly return migrants, Journal of Gerontology: Social Science, Vol. 47, No.1, 1992, pp. 38-43.
  25. L.F. Pitt, R.T. Watson and C.B. Kavan, Service Quality: A Measure of Information Systems Effectiveness, MIS Quarterly, Vol.19, No.2, June, 1995, pp. 173-187.
  26. Lee, Everett S., A Theory of Migration, 1966, pp. 47-57.
  27. Moon, B., Paradigms in Migration Research: Exploring 'Moorings' as a Schema, Progress in Human Geography, Vol. 19, No. 4, 1995, pp. 504-524.
  28. Nunnally, J.C., Psychometric Theory (2nd ed.), NY: McGraw-Hill, New York, 1978.
  29. Pirouz, D.M., An overview of partial least squares, Retrieved February 19, 2008, from http://www.merage.uci.edu/~dpirouz04/research/pls/PLS.pdf, 2006.
  30. Shih, F.J., Exploring the Relationship between Virtual Team, Telemedicine and Medical Treatment Performance--Resource-Based View, Journal of Chang Gung Institute of Technology, Vol. 3, 2007, pp. 1-8.
  31. Tan, H.F., Wu, M.R. and Tseng H.F, The Future Telemedicine System in Taiwan: A Lesson from Past 9-year Experience, Sun Yat-Sen Management Review, Vol. 12, No. S1, Dec 2004, pp. 65-91.
  32. Unni, R. and Harmon, R., Perceived effectiveness of push vs. pull mobile location-based advertising, Journal of Interactive Marketing, Vol. 7, 2007.
  33. Xu, H., Oh, L.B. and Teo, H.H., Perceived effectiveness of text vs. multimedia Location-Based Advertising messaging, International Journal of Mobile Communications, Vol. 7, No. 2, 2009, pp. 154-177.
  34. Conference Papers
  35. Cheng, Z., Yang, Y., and John, L., Cyber migration: An empirical investigation on factors that affect users' switching intentions in social networking sites, the 42nd Hawaii International Conference on System Science, IEEE Computer Society, 2009.
  36. National Institute of Standards and Technology (NIST), The Cloud Definition Framework , Retrieved May 2012, from http://www.nist.gov/itl/cloud/, Nov 2010
  37. Armbrust M, Armando Fox, Rean Griffith, Anthony D. Joseph, Randy Katz, Andy Konwinski, Gunho Lee, David Patterson, Ariel Rabkin, Ion Stoica, and Matei Zaharia, Above the clouds: A Berkeley view of Cloud Computing, UC Berkeley EECS, 2009.
  38. Boyle, P.J. and Halfacree, K, Migration and gender in the developed world, Routledge Publication, New York, 1999.
  39. Bargh, J.A., Auto-motives: Preconscious determinants of social interaction, in E.T. Higgins & R.M. Sorrentino (eds.), Handbook of motivation and cognition, Vol. 2, New York: Guilford Press, 1990, pp. 93-130.
  40. Chu, C.C., Is EasyCard really convenient?, Unpublished master’s thesis, Institute of Information Management, National Central University, Taiwan, 2011.
  41. Chang, T.H., Yeh, M.C., Lou, M.L., Liu, L.F., and Hung L.C., Comparison Perception Regarding Telehome Care between Home Care-Giver and Home Nurse Nurse, Cheng Vhing Medical Journal, Vol. 3, No. 1, Jan 2007, pp. 27-35.
  42. Goldstein, D.E., e-Healthcare: Harness the Power of Internet e-Commerce & e-Care, Md.: Aspen Publishers, Gaithersburg, 2000.
  43. Hsu, C.H. and Tang, Y.J., Current Status and Future Perspective of Telehomecare, Taiwan Geriatrics & Gerontology, Vol. 3, No. 4, 2008, pp. 272-285.
  44. James, W., The principles of psychology, London: Macmillan and Co., Ltd., 1890.
  45. Longino, C.F. Jr., The forest and the trees: micro-level considerations in the study of geographic mobility in old Age, in elderly migration and population redistribution, London: Belhaven, 1992, pp. 23-34.
  46. Michel Tenenhaus, Vincenzo Esposito Vinzi, Yves-Marie Chatelin and Carlo Lauro, PLS path modeling, Computational Statistics and Data Analysis, Vol. 48, No. 1, 2005, pp. 159-205.
  47. Parasuraman, A., Zeithaml, V.A., Berry, L.L., SERVQUAL: A Multiple-Item Scale For Measuring Consumer Perception of Service Quality, Journal of Retailing, Vol. 64, No. 1, 1988, pp. 12-40.
  48. Patricia I. Carter, Health Information Privacy: Can Congress Protect Confidential Medical Information in the “Information Age”?, 25 Wm. Mitchell L. Rev. 223, 1999, pp. 230.
  49. Peter A. Winn, Confidentiality in Cyberspace: The HIPAA Privacy Rules and the Common Law, 33 RUTGERS L.J. 617, 2002.
  50. Ravenstein, E.G., The Laws of Migration, Journal of the Royal Statistical Society, Vol. 48, 1885, pp. 167-235.
  51. Westelius, A. and Edenius, M., Gaps between intended and actual use, International Journal of Public Information Systems 2, 2006.
  52. Wu, C.C., Medical Contracts, Unpublished master’s thesis, Soochow University School of Law, 2005.
  53. Burke, L. and Weill, B., Information Technology for the Health Professions, 2nd edn. Upper Saddle River, NJ: PEARSON Prentice Hall, 2005.
  54. Lee, C.N. and Cheng, C.C., The construction of homecare service platform at the mobile medicine, the 10th Medical Informatics Symposium in Taiwan, 2007.
  55. Zhang, K.Z.K., Cheung, C.M.K., Lee, M.K.O., and Chen, H., Understanding the blog service switching in Hong Kong: An empirical investigation, the 41st Hawaii International Conference on System Sciences, IEEE Computer Society, 2008.
  56. Internet
  57. Department of Statistics, Ministry of the Interior, Taiwan, Population Distribution by Age, Retrieved May 2012, from http://sowf.moi.gov.tw/stat/year/y02-01.xls, 2012.
  58. Department of Statistics, Ministry of the Interior, Taiwan, Taiwan Life expectancy at birth in 2011, Retrieved May 2012, from http://sowf.moi.gov.tw/stat, Feb 2012.
  59. Department of Health, Executive of Yuan, Taiwan, The Top Ten Causes of Death of 2010 in Taiwan, Retrieved May, 2012, from http://www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=81294&s=1, 2011.
  60. Department of Health, Executive of Yuan, Taiwan, Taiwan Pilot Telecare Project, Retrieved May 2012, from http://doh.telecare.com.tw/Aboutus.aspx, 2007.
  61. National Cheng Kung University Information Systems and Application Laboratory (NCKU ISA Lab), Cloud computing system, Retrieved May 2012, from http://isa.imis.ncku.edu.tw/cht/index.php?cmd=researchdescriptions_eng, 2011
  62. Ringle, C.M., Wende, S. and Will, A., SmartPLS-Version 2.0, Germany: University at Hamburg, Retrieved February 20, 2008, from http://www.smartpls.de, 2005.