Healthcare Outcomes of Patients and Antecedents via Teleophthalmology in Eastern Taiwan during COVID-19
Abstract
:1. Introduction
1.1. Healthcare Accessibility
1.2. Communication Quality
1.3. Health Outcomes
2. Materials and Methods
2.1. Implementation of Teleophthalmology in Eastern Taiwan
2.2. Research Population and Design
2.3. Data Collection and the Establishment of the Scale
2.4. Statistical Analysis
3. Results
3.1. Measurement Model Assessment
3.2. Structural Model Assessment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Questionnaire Items
- Healthcare accessibility:
- I think that using teleophthalmology can save me time and money.
- I think the duration of teleophthalmology consultations to be reasonable.
- Communication quality:
- I think that using teleophthalmology allows for communication with remote physicians about my condition.
- I think the quality of physician-patient communication through teleophthalmology is good.
- Teleophthalmology adoption:
- I will continue using teleophthalmology services.
- I will recommend teleophthalmology services to my friends and family.
- Service quality:
- I think the remote consulting physician can explain and clarify the condition clearly.
- I think the teleophthalmology staff interact well with patients.
- I think the audio and video quality of teleophthalmology is good.
- Overall: I am satisfied with the quality of teleophthalmology services.
- Health outcomes:
- I think that using teleophthalmology can provide me with appropriate medical care.
- I think that using teleophthalmology is beneficial for my disease treatment and health promotion.
Appendix B. Difference Analysis of Demographic Variables
Construct | Category (n) | Mean | Standard Deviation | t Value | p Value |
---|---|---|---|---|---|
Healthcare accessibility | Male (62) | 4.55 | 0.61 | −0.899 | 0.370 |
Female (104) | 4.63 | 0.48 | |||
Communication quality | Male (62) | 4.16 | 0.77 | 0.458 | 0.648 |
Female (104) | 4.11 | 0.75 | |||
Teleophthalmology adoption | Male (62) | 4.25 | 0.84 | −2.822 | 0.006 ** |
Female (104) | 4.61 | 0.69 | |||
Service quality | Male (62) | 4.76 | 0.40 | −0.831 | 0.407 |
Female (104) | 4.81 | 0.28 | |||
Health outcomes | Male (62) | 4.21 | 0.72 | −1.809 | 0.072 |
Female (104) | 4.42 | 0.74 |
Construct | Category (n) | Mean | Standard Deviation | F Value | p Value |
---|---|---|---|---|---|
Healthcare accessibility | ≤20 (1) | 5.00 | 0.00 | 0.849 | 0.549 |
21–30 (2) | 5.00 | 0.00 | |||
31–40 (4) | 4.88 | 0.25 | |||
41–50 (7) | 4.64 | 0.38 | |||
51–60 (28) | 4.46 | 0.71 | |||
61–70 (47) | 4.55 | 0.57 | |||
71–80 (46) | 4.60 | 0.43 | |||
Above 80 (31) | 4.69 | 0.48 | |||
Communication quality | ≤20 (1) | 5.00 | 0.00 | 0.591 | 0.762 |
21–30 (2) | 4.00 | 0.00 | |||
31–40 (4) | 4.63 | 0.75 | |||
41–50 (7) | 4.14 | 0.75 | |||
51–60 (28) | 4.04 | 0.69 | |||
61–70 (47) | 4.07 | 0.80 | |||
71–80 (46) | 4.20 | 0.81 | |||
Above 80 (31) | 4.10 | 0.70 | |||
Teleophthalmology adoption | ≤20 (1) | 5.00 | 0.00 | 0.549 | 0.796 |
21–30 (2) | 5.00 | 0.00 | |||
31–40 (4) | 4.75 | 0.50 | |||
41–50 (7) | 4.57 | 0.53 | |||
51–60 (28) | 4.41 | 0.78 | |||
61–70 (47) | 4.46 | 0.72 | |||
71–80 (46) | 4.37 | 0.81 | |||
Above 80 (31) | 4.60 | 0.85 | |||
Service quality | ≤20 (1) | 5.00 | 0.00 | 1.014 | 0.424 |
21–30 (2) | 4.60 | 0.28 | |||
31–40 (4) | 4.90 | 0.20 | |||
41–50 (7) | 4.74 | 0.34 | |||
51–60 (28) | 4.84 | 0.16 | |||
61–70 (47) | 4.76 | 0.43 | |||
71–80 (46) | 4.73 | 0.39 | |||
Above 80 (31) | 4.89 | 0.14 | |||
Health outcomes | ≤20 (1) | 5.00 | 0.00 | 1.303 | 0.252 |
21–30 (2) | 5.00 | 0.00 | |||
31–40 (4) | 5.00 | 0.00 | |||
41–50 (7) | 4.43 | 0.79 | |||
51–60 (28) | 4.43 | 0.74 | |||
61–70 (47) | 4.21 | 0.80 | |||
71–80 (46) | 4.24 | 0.70 | |||
Above 80 (31) | 4.45 | 0.72 |
Construct | Category (n) | Mean | Standard Deviation | F Value | p Value |
---|---|---|---|---|---|
Healthcare accessibility | Illiteracy (34) | 4.60 | 0.53 | 0.480 | 0.750 |
Elementary school (66) | 4.59 | 0.39 | |||
Junior high school (17) | 4.62 | 0.55 | |||
High school (32) | 4.52 | 0.79 | |||
University level and above (17) | 4.74 | 0.40 | |||
Communication quality | Illiteracy (34) | 3.97 | 0.72 | 0.721 | 0.579 |
Elementary school (66) | 4.23 | 0.80 | |||
Junior high school (17) | 4.18 | 0.64 | |||
High school (32) | 4.09 | 0.73 | |||
University level and above (17) | 4.06 | 0.81 | |||
Teleophthalmology adoption | Illiteracy (34) | 4.47 | 0.90 | 0.644 | 0.632 |
Elementary school (66) | 4.49 | 0.73 | |||
Junior high school (17) | 4.21 | 0.81 | |||
High school (32) | 4.52 | 0.64 | |||
University level and above (17) | 4.59 | 0.81 | |||
Service quality | Illiteracy (34) | 4.79 | 0.33 | 1.236 | 0.298 |
Elementary school (66) | 4.83 | 0.27 | |||
Junior high school (17) | 4.71 | 0.32 | |||
High school (32) | 4.82 | 0.27 | |||
University level and above (17) | 4.66 | 0.58 | |||
Health outcomes | Illiteracy (34) | 4.47 | 0.75 | 0.839 | 0.502 |
Elementary school (66) | 4.29 | 0.71 | |||
Junior high school (17) | 4.18 | 0.73 | |||
High school (32) | 4.31 | 0.78 | |||
University level and above (17) | 4.53 | 0.78 |
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Township | Average Monthly Cases in 2020 | Average Monthly Cases in 2021 | Average Monthly Cases in 2022 |
---|---|---|---|
Chishang | 11 | 10.75 | 8.17 |
Luye | 6.75 | 7.17 | 7.83 |
Guanshan | 3 | 6.17 | 9.67 |
Haiduan | 4.625 | 7.67 | 5.17 |
Yanping | 0 | 0 | 1.5 |
Total | 25.375 | 31.76 | 32.34 |
Construct | Cronbach’s α | CR | AVE |
---|---|---|---|
Healthcare accessibility | 0.68 | 0.70 | 0.54 |
Communication quality | 0.96 | 0.96 | 0.93 |
Teleophthalmology adoption | 0.87 | 0.88 | 0.78 |
Service quality | 0.68 | 0.71 | 0.40 |
Health outcomes | 0.99 | 0.99 | 0.98 |
Construct | 1 | 2 | 3 | 4 | 5 |
---|---|---|---|---|---|
1. Healthcare accessibility | (0.735) | ||||
2. Communication quality | 0.094 | (0.964) | |||
3. Teleophthalmology adoption | 0.182 * | 0.179 * | (0.883) | ||
4. Service quality | 0.143 | 0.333 *** | 0.396 *** | (0.632) | |
5. Health outcomes | 0.197 * | 0.161 * | 0.268 *** | 0.288 * | (0.990) |
Goodness of Fit Index | Value | Acceptable Threshold Value | Result |
---|---|---|---|
χ2/df | 1.922 | <3 | Good |
GFI | 0.920 | >0.90 | Good |
NFI | 0.932 | >0.90 | Good |
IFI | 0.966 | >0.90 | Good |
RMR | 0.034 | <0.050 | Good |
RMSEA | 0.075 | <0.080 | Good |
Construct | Direct Effect | Indirect Effect | Total Effect |
---|---|---|---|
Healthcare accessibility | - | 0.108 | 0.108 |
Communication quality | - | 0.150 | 0.150 |
Telemedicine adoption | 0.219 | - | 0.219 |
Service quality | 0.287 | - | 0.287 |
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Chen, H.-C.; Chang, C.-Y.; Tsai, C.-H.; Hsu, W.-L.; Sung, W.-F.; Wu, Y.-X. Healthcare Outcomes of Patients and Antecedents via Teleophthalmology in Eastern Taiwan during COVID-19. Healthcare 2024, 12, 1672. https://doi.org/10.3390/healthcare12161672
Chen H-C, Chang C-Y, Tsai C-H, Hsu W-L, Sung W-F, Wu Y-X. Healthcare Outcomes of Patients and Antecedents via Teleophthalmology in Eastern Taiwan during COVID-19. Healthcare. 2024; 12(16):1672. https://doi.org/10.3390/healthcare12161672
Chicago/Turabian StyleChen, Hsing-Chu, Ching-Yu Chang, Chung-Hung Tsai, Wei-Lin Hsu, Wen-Fang Sung, and Yu-Xuan Wu. 2024. "Healthcare Outcomes of Patients and Antecedents via Teleophthalmology in Eastern Taiwan during COVID-19" Healthcare 12, no. 16: 1672. https://doi.org/10.3390/healthcare12161672