Acceptance and Use of Teleconsultation as a Technological Strategy for Health Care: A Study with Users of the Brazilian Public and Private Health System (Preprint)

<sec> <title>BACKGROUND</title> Understanding the factors that influence the acceptance and use of teleconsultation technologies can increase population access to digital technologies in health. However, the implementation of teleconsultation faces technological barriers and challenges such as the digital divide, especially in economically emerging countries, where many people still experience digital exclusion. In this study, we analyzed teleconsultation as a technological strategy for healthcare. We used an expanded model of the Unified Theory of Acceptance and Use of Technologies 2 (UTAUT2), adapted for the technology. </sec> <sec> <title>OBJECTIVE</title> This study aims to analyze factors influencing the acceptance and use of teleconsultation by users of the Brazilian health system. Additionally, the study seeks to verify the moderating effects of the variables Gender, Age, and Experience in the constructs that influence the acceptance and use of teleconsultation, and to collect data about the characteristics of the research subjects that might assist in interpreting of the results. </sec> <sec> <title>METHODS</title> A survey with 403 valid responses was conducted to collect the data. The research instrument assessed Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, Price Value, Habit, Trust, and Digital Health Literacy about the Behavioral Intention to use and Use Behavior of teleconsultation. The proposed model was validated through Exploratory Factor Analysis and Confirmatory Factor Analysis, and the data analyzed through Structural Equation Modelling. </sec> <sec> <title>RESULTS</title> The results indicate the influence of most of the variables presented in the UTAUT2 model, as well as the variables used to expand it. The variables Performance Expectancy, Effort Expectancy, Social Influence, Habit, and Trust influenced the Behavioral Intention of teleconsultation. The variables Facilitating Conditions, Habit, Digital Health Literacy, and Behavioral Intention influenced the Use of teleconsultation. Additionally, the variables Gender and Experience had a moderating role among some of the relationships of the proposed model. </sec> <sec> <title>CONCLUSIONS</title> The original UTAUT2 Variables, with exception of Price Value, influence either the Behavioral Intention or Use Behavior of teleconsultation. Trust and Digital Health Literacy, used to expand the UTAUT2 model, showed the highest levels of influence on the variables Behavioral Intention and Use Behavior, respectively. These variables were followed by Facilitating Conditions that strongly influence the Use Behavior of teleconsultation. Habits also influence both Behavioral Intention and Technology Use Behavior. The study's results can help users, patients, health professionals and developers of technological solutions aimed at teleconsultation to understand the factors that influence its acceptance to overcome the barriers for its use by improving digital health solutions. </sec>