Hygiene Factors and Motivators of Primary Care Physicians' Continuous Usage Intention for B2B Telemedicine in China: SEM and fsQCA Finding

In China, the predominant mode of telemedicine service delivery is Business-to-Business (B2B), with primary care physicians (PCPs) as key users. However, the effective utilization of B2B telemedicine is relatively low. This study used a research model to analyze the “hygiene factors” and “motivators” affecting PCPs' continuous usage intention for B2B telemedicine, considering exogenous, technology, and endogenous dimensions. A valid sample of 421 PCPs from China was analyzed by using SEM and fsQCA. The SEM results revealed that within the individual layer (endogenous dimension), attitude, perceived behavioral control, and intrinsic motivation positively influence PCPs' continuous usage intention, while perceived risk has a negative impact. Additionally, in the technology dimension, assurance and reliability directly impact continuous usage intention, while tangibility indirectly influences continuous intention through the mediation of attitude. However, factors from the environment layer (exogenous dimension) do not significantly influence continuous usage intention. The fsQCA results offer insights into three configurations associated with high continuous usage intention and three configurations triggering low continuous usage intention. And base on these results, factors influencing PCPs' continuous usage intention are classified into “hygiene factors” and “motivators”. Our findings provide theoretical support for policymakers aiming to promote PCPs' engagement in B2B telemedicine adoption.