Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study
Abstract
:1. Introduction
2. Literature Review
2.1. The Elements of Digital Transformation on Public Services
2.2. The Experience and Service Design Path for the Elderly
2.3. The Operational Mechanism of Digital Transformation in Health Services
3. Materials and Methods
3.1. Participants
3.2. Research Method
3.3. Quantitative Research Process
3.3.1. Participant Selection
3.3.2. Data Collection Procedures
- Socio-demographic characteristics: including gender, age, living conditions, educational background, and health self-assessment of participants. Self-rated health ranged from 1 (very unhealthy) to 5 (very healthy).
- Perception of digital transformation: it included the perception of organizations, services, and technologies under digital transformation. The items were: Your perception of the transformation of digital services in the organization; Your perception of digital health service projects; Your perception of technology in digital health services.
- Identity of digital transformation: including the identity of the organizations, services, and technologies under digital transformation. The items were: Do you think digital transformation in the organization is effective; Do you think digital transformation in health services is effective; Do you think the application of digital technology is effective.
- Satisfaction with digital transformation: it included satisfaction with organizations, services, and technologies under digital transformation. The items were: You are satisfied with the transformation of digital services in the organization; You are satisfied with the health services in digital transformation; You are satisfied with the application of technology in digital transformation.
3.3.3. Statistical Analysis
3.4. Qualitative Research Process
3.4.1. Participant Selection
3.4.2. Data Collection Procedures
3.4.3. Data Analysis
- (1)
- Data organization
- (2)
- Data extraction
- (3)
- Data categorization
- (4)
- Grounded theory approach
4. Results
4.1. Participants
4.2. Differences in Perception, Identity, and Satisfaction under Digital Transformation
4.3. Correlation Analyses of Perception, Identity, and Satisfaction
4.4. Influencing Factors in Perception, Identity, and Satisfaction
4.5. Qualitative Time Series Analysis
4.6. Open Coding
4.7. Axial Coding
4.8. Selective Coding
4.9. Digital Transformation Model
5. Discussion
5.1. Digital Governance Transformation
5.2. Digital Service Transformation
5.3. Digital Technology Transformation
- Form an institutionalized decision-making process for management, consolidate the premise and foundation of digital transformation from the organization and security content, and realize governance transformation by relying on the establishment of working mechanisms and organizational capacity building.
- Focus on service redesign, recruit volunteers to help consolidate human resources, and realize the service transformation of aging-appropriate design on the process side.
- Assess the possible effects of the integration of digital technology on the elderly population and obtain feedback to achieve technological transformation through digital device use and family member support.
- Digital transformation should consider irreversible time changes, and it is necessary to track behavioral and effect feedback in the process to design more effective strategies.
5.4. Limitations and Future Research
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Item | 1 | 2 | 3 |
---|---|---|---|
Perception of organization | 0.706 | ||
Perception of service | 0.682 | ||
Perception of technology | 0.677 | ||
Identity of organization | 0.676 | ||
Identity of service | 0.663 | ||
Identity of technology | 0.641 | ||
Satisfaction of organization | 0.586 | ||
Satisfaction of service | 0.570 | ||
Satisfaction of technology | 0.522 |
Items | Perception | p | Identity | p | Satisfaction | p |
---|---|---|---|---|---|---|
Supply or demand side | <0.01 | <0.01 | <0.01 | |||
Supply side | 3.8 ± 0.4 | 3.7 ± 0.4 | 3.7 ± 0.4 | |||
Demand side | 3.1 ± 0.4 | 3.3 ± 0.5 | 3.4 ± 0.4 | |||
Gender | 0.58 | 0.26 | 0.64 | |||
Male | 3.5 ± 0.5 | 3.5 ± 0.6 | 3.5 ± 0.5 | |||
Female | 3.4 ± 0.5 | 3.5 ± 0.5 | 3.4 ± 0.5 | |||
Age | <0.01 | <0.01 | <0.01 | |||
<40 | 4.0 ± 0.2 | 3.8 ± 0.3 | 3.8 ± 0.3 | |||
40–59 | 3.7 ± 0.4 | 3.6 ± 0.4 | 3.5 ± 0.6 | |||
≥60 | 3.2 ± 0.4 | 3.3 ± 0.5 | 3.4 ± 0.5 | |||
Residence | 0.04 | 0.62 | 0.05 | |||
Living with partner | 3.4 ± 0.5 | 3.5 ± 0.4 | 3.5 ± 0.4 | |||
Living with children | 3.7 ± 0.5 | 3.6 ± 0.5 | 3.7 ± 0.4 | |||
Living alone | 3.2 ± 0.4 | 3.4 ± 0.5 | 3.2 ± 0.4 | |||
Education | <0.01 | 0.01 | 0.02 | |||
Primary and below | 3.3 ± 0.4 | 3.4 ± 0.5 | 3.3 ± 0.4 | |||
Junior | 3.2 ± 0.3 | 3.3 ± 0.4 | 3.4 ± 0.5 | |||
High | 3.3 ± 0.5 | 3.4 ± 0.6 | 3.4 ± 0.5 | |||
University and above | 3.8 ± 0.4 | 3.7 ± 0.4 | 3.7 ± 0.4 | |||
Self-rated health | 0.13 | <0.01 | 0.03 | |||
Healthy | 3.2 ± 0.5 | 3.3 ± 0.6 | 3.4 ± 0.4 | |||
Unhealthy | 3.5 ± 0.5 | 3.6 ± 0.5 | 3.5 ± 0.5 |
Supply Side | Demand Side | ||||||
---|---|---|---|---|---|---|---|
Perception | Identity | Satisfaction | Perception | Identity | Satisfaction | ||
Perception | 1 | Perception | 1 | ||||
Identity | 0.24 | 1 | Identity | 0.69 ** | 1 | ||
Satisfaction | 0.48 ** | 0.37 ** | 1 | Satisfaction | 0.64 ** | 0.56 ** | 1 |
Perception OR (95%CI) | p | Identity OR (95%CI) | p | Satisfaction OR (95%CI) | p | |
---|---|---|---|---|---|---|
Supply or demand side | ||||||
Supply side | 1 | 1 | 1 | |||
Demand side | 19.1 (8.7–45.1) | <0.01 | 5.4 (2.6–10.9) | <0.01 | 3.7 (1.8–7.2) | <0.01 |
Age | ||||||
≥60 | 1 | 1 | 1 | |||
40–59 | 10.4 (4.2–25.1) | <0.01 | 3.9 (1.7–8.9) | <0.01 | 1.9 (0.8–4.2) | 0.09 |
<40 | 116 (14.7–909.5) | <0.01 | 8.6 (3.0–24.7) | <0.01 | 11.2 (3.6–34.9) | <0.01 |
Residence | ||||||
Living alone | 1 | 1 | 1 | |||
Living with partner | 3.2 (0.3–30.2) | 0.08 | 1.6 (0.2–10.2) | 0.06 | 3.7 (0.4–34.1) | 0.24 |
Living with children | 8.8 (0.7–99.2) | 0.29 | 2.5 (0.3–19.5) | 0.38 | 12 (1.1–141.3) | 0.04 |
Education | ||||||
Primary and below | 1 | 1 | 1 | |||
Junior | 0.4 (0.1–1.5) | 0.85 | 0.6 (0.2–1.7) | 0.36 | 1.2 (0.4–3.7) | 0.66 |
High | 0.9 (0.3–2.5) | 0.19 | 0.8 (0.3–2.2) | 0.74 | 1.1 (0.4–2.9) | 0.88 |
University and above | 8.2 (2.9–22.8) | <0.01 | 3.1 (1.2–7.9) | 0.02 | 4.1 (1.5–10.6) | <0.01 |
Self-rated health | ||||||
Healthy | 1 | 1 | 1 | |||
Unhealthy | 3.9 (1.7–8.8) | <0.01 | 2.3 (1.1–4.7) | 0.02 | 0.6 (0.3–1.2) | 0.15 |
No. | Job | Gender | Age | Working Years |
---|---|---|---|---|
1 | Community manager | Female | 40 | 10 |
2 | Community manager | Female | 28 | 5 |
3 | Community manager | Female | 55 | 36 |
4 | Community manager | Female | 42 | 14 |
5 | Community manager | Male | 30 | 6 |
6 | Family doctor | Male | 45 | 18 |
7 | Family doctor | Female | 40 | 16 |
8 | Family doctor | Male | 36 | 8 |
9 | Family doctor | Female | 52 | 26 |
10 | Family doctor | Female | 47 | 23 |
11 | Service personnel | Male | 44 | 6 |
12 | Service personnel | Female | 32 | 2 |
13 | Service personnel | Female | 56 | 6 |
14 | Volunteer | Female | 56 | 6 |
15 | Volunteer | Female | 55 | 5 |
16 | Volunteer | Female | 50 | 2 |
17 | IT developer | Male | 27 | 5 |
18 | IT developer | Male | 34 | 8 |
19 | IT developer | Male | 30 | 6 |
20 | IT developer | Male | 30 | 5 |
No. | Gender | Age | Years of Residence | Utilization of Digital Health Services |
---|---|---|---|---|
1 | Male | 62 | 22 | Telehealth, Electronic health monitoring |
2 | Female | 63 | 14 | Online health consultation |
3 | Male | 82 | 34 | Wearable devices, Online health consultation |
4 | Female | 71 | 28 | Telehealth |
5 | Female | 72 | 22 | Telehealth, Wearable devices |
6 | Female | 73 | 28 | Online health consultation |
7 | Female | 62 | 6 | Online health consultation |
8 | Male | 82 | 32 | Telehealth |
9 | Male | 77 | 24 | Medication reminder, Online health education |
10 | Female | 72 | 25 | Online health consultation |
11 | Female | 78 | 15 | Wearable devices, Electronic health monitoring |
12 | Female | 67 | 26 | Online health education |
13 | Male | 81 | 13 | Telehealth |
14 | Male | 80 | 17 | Online health consultation |
15 | Male | 67 | 22 | Wearable devices, Online health education |
16 | Female | 63 | 10 | Online psychological consultation |
17 | Female | 65 | 9 | Telehealth |
18 | Male | 63 | 20 | Online health consultation, Medication reminder |
19 | Male | 75 | 12 | Online health education |
20 | Female | 81 | 32 | Online health education |
21 | Male | 81 | 27 | Online health consultation |
22 | Female | 65 | 11 | Telehealth, Wearable devices |
23 | Female | 76 | 25 | Online health consultation |
24 | Female | 72 | 22 | Online health consultation |
Categories | Concepts |
---|---|
Establish working mechanism | Establish digital teams, clarify project division, establish an information reporting system, regular meetings, establish project teams, select young managers, establish an analysis system, determine work procedures. |
Collaboration with grassroots departments | Multi-community collaboration, community meeting room sharing, building management cooperation, service experience sharing, unified security management, service group notification, vaccination records. |
Multi-agency coordination | Two-way referral service, appointment registration, nurse communication, the elderly health service coordination, family doctor team, welfare supplies on behalf of others, drug distribution, the elderly housekeeping services. |
Supervision and feedback | Set up feedback mailbox, work progress report, confirm partner authority, information release review, service effect evaluation, service content feedback, leadership reception day. |
Organizational capacity building | Digital discussion meeting, organizational communication meeting, digital thinking, brainstorming, project discussion, Dingding App daily report, WeChat App operation, expert consultation. |
Digital resource sharing | Data sharing, data backup, data traceability, community information registration, SMS reminder, service record synchronization, information covering the whole community. |
The elderly service design | Enlarge fonts, slow down processes, amplify notification sounds, health and wellness knowledge, free health lectures, traditional Chinese medicine services, regular telephone calls. |
Seek external human resources | Volunteer participation, college students caring for the elderly, provision of sphygmomanometer, public welfare promotion, business preferential services. |
Digital service process | Use mobile phones throughout the process, paperless, telemedicine, Dingding video, QR code service, electronic health code, electronic medical insurance card, smart registration, electronic health record. |
Service staff support | Guidance for appointment registration, medical reminder, department guidance, electronic signboard, electronic questionnaire, electronic equipment guidance. |
Digital transformation training | Digital training, development of new digital functions, daily Dingding report, entry of electronic information records, mobile phone training for the elderly. |
Digital security | Risk control, personal information privacy, information collection protocol, electronic police, infrared smoke sensor, focus on key groups, prevention of telecommunication fraud. |
Use of digital devices | Use of registration APP, use of self-service registration machines, wearing of smart wristbands, electronic test list printer, electronic triage, electronic hospital guidance. |
Digital effect evaluation | Decreased medical satisfaction, decreased medical time, increased risk, difficulty with electronic use, insufficient health reminders. |
Digital perception | Willing to go to a community health service center, unwilling to go to a general hospital, weak experience, not suitable for the elderly, complex digital operations. |
Digital popularization | Door-to-door support from social workers, distribution of mobile phones for the elderly, telephone notification for the elderly, registration to receive gifts. |
Family member support | Electronic family network, family member early warning notice, family member teaching, family member accompanying medical treatment. |
Community health | Chronic diseases, traditional Chinese medicine, vaccination, epidemic prevention and control, first aid measures, AED first aid. |
Main Categories | Subcategories | Concept Explanation |
---|---|---|
A. Institutionalization of digital health service transformation | A1 Establish working mechanism | Establishing a working mechanism is the guarantee of digital transformation |
A2 Collaboration with grassroots departments | Collaboration between grassroots departments is the internal consensus of digital transformation | |
A3 Multi-agency coordination | Multi-agency coordination is the premise to meet the diverse health needs of the elderly | |
A4 Supervision and feedback | Monitoring and feedback ensure that the organization’s risks can be controlled | |
A5 Organizational capacity building | Organizational capacity building is the internal driving force for digital transformation | |
A6 Digital resource sharing | Digital resource sharing is the data foundation for digital transformation | |
B. Digital health service transformation service redesign | B1 The elderly service design | Age-friendly service design is the goal of digital transformation |
B2 Seek external human resources | External resources can expand digital transformation resources | |
B3 Digital service process | Digital service process is a direct manifestation of digital transformation | |
B4 Service staff support | Service personnel promote humanistic care under digital transformation | |
B5 Digital transformation training | Digital transformation training enhances digital capabilities at different stages | |
B6 Digital security | Digital security is the premise of digital transformation | |
C. Digital health service transformation experience evaluation | C1 Use of digital devices | Digital device usage is an enabling tool for digital transformation |
C2 Digital effect evaluation | Digital effect evaluation reflects the recognition of the elderly | |
C3 Digital perception | Digital perception experience is the source of service optimization | |
C4 Digital popularization | Digital popularization can expand the value of digital transformation | |
C5 Family member support | Family member support is a family requirement for the elderly to embrace digital | |
C6 Community health | Community health is final result of digital transformation |
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Zhou, S.; Ni, Z.; Ogihara, A.; Wang, X. Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study. Int. J. Environ. Res. Public Health 2022, 19, 8221. https://doi.org/10.3390/ijerph19138221
Zhou S, Ni Z, Ogihara A, Wang X. Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study. International Journal of Environmental Research and Public Health. 2022; 19(13):8221. https://doi.org/10.3390/ijerph19138221
Chicago/Turabian StyleZhou, Siyu, Ziling Ni, Atsushi Ogihara, and Xiaohe Wang. 2022. "Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study" International Journal of Environmental Research and Public Health 19, no. 13: 8221. https://doi.org/10.3390/ijerph19138221