Perceived Trust and Continuous Usage Intention of AI-Based Chatbot Service in the Healthcare Industry: Focused on Chinese Users

The purpose of this study is to explore the mechanism by which medical chatbots meet patients' expectation, increase satisfaction, and influence their intention for continuous use, by applying the<br/>Expectation Confirmation Model (ECM) and conducting an empirical study with 313 Chinese users who have over 1 year usage experience. The research findings demonstrate that the perceived usefulness of AI-based chatbot service has a significantly positive direct impact and a significantly positive indirect impact (through satisfaction) on the intention to continuously use such services. Perceived trust has a significant positive impact on continuous use intention through the mediating effect of satisfaction, although its direct impact is not significant. The level of users’ expectation confirmation significantly influences both perceived usefulness and perceived trust, and it exerts a relatively strong indirect impact on continuous use intention through satisfaction. The research findings not only help in understanding users' psychological and behavioral patterns but also provide recommendations for improvement to relevant technology developers. Additionally, they offer theoretical support and empirical evidence for the application of more smart healthcare systems in the future, contributing to the widespread adoption of smart healthcare.