Abstract
Background: Limited diffusion and utilization of health technology have greatly halted the improvement of resource integration and healthcare outcomes. However, the dynamic mechanism of health technology diffusion in the context of the integrated care system (ICS) remained largely unknown. The purpose of this study is to develop and validate the scale on Dynamics of Health Technology Diffusion in Integrated Care System (DHTDICS) for providing instruments to investigate the health technology diffusion in the ICS. Methods: The scale with 39 items was initially designed on the basis of the proposed model developed from previous research. And it was validated in a cross-sectional questionnaire survey including 246 participants. Exploratory factor analysis was used to assess domains in the questionnaire, and analyzed correlation, factorials, internal consistency and validity of the questionnaire. In addition, structural equation modeling was performed to determine the total effects of each domain on the health technology diffusion in the ICS.Results: Reliability analysis revealed excellent internal consistency, as the value of Cronbach’s alpha greater than 0.80 for all of the four DHTDICS domains in this study. An acceptable validity was confirmed through tests of construct validity, convergent validity and discriminant validity. With respect to the potential domains and dimensions that DHTDICS contributes, the results highlight the existence of 4 domains: personal beliefs, technical drivers, organizational readiness, and external environment. Among them, the impact on health technology diffusion is, in descending order, organizational readiness, personal beliefs, external environment, and technical drivers.Conclusions: The findings of this study support the validity of the DHTDICS, and will be a helpful reference for developing future intervention strategies to promote health technology diffusion in the ICS.
Dynamics of Health Technology Diffusion in the Integrated Care System (DHTDICS): A Development and Validation Study in China