title: Understanding patient e-loyalty toward online health care services.
abstract: BACKGROUND
  Public health institutions are making a great effort to develop patient-targeted online services in an attempt to enhance their effectiveness and reduce expenses. However, if patients do not use those services regularly, public health institutions will have wasted their limited resources. Hence, patients' electronic loyalty (e-loyalty) is essential for the success of online health care services.
  
  
  OBJECTIVE
  In this research, an extended Technology Acceptance Model was developed to test e-loyalty intent toward online health care services offered by public health institutions.
  
  
  METHODS
  Data from a survey of 256 users of online health care services provided by the public sanitary system of a region in Spain were analyzed. The research model was tested by using the structural equation modeling approach.
  
  
  RESULTS
  The results obtained suggest that the core constructs of the Technology Acceptance Model (perceived usefulness, ease of use, and attitude) significantly affected users' behavioral intentions (i.e., e-loyalty intent), with perceived usefulness being the most decisive antecedent of affective variables (i.e., attitude and satisfaction). This study also reveals a general support for patient satisfaction as a determinant of e-loyalty intent in online health care services.
  
  
  CONCLUSIONS
  Policy makers should focus on striving to get the highest positive attitude in users by enhancing easiness of use and, mainly, perceived usefulness. Because through satisfaction of patients, public hospitals will enlarge their patient e-loyalty intent, health care providers must always work at obtaining satisfied users and to encourage them to continue using the online services.
authors.affiliation: Business Management, School of Industrial Engineering, Universidad Politécnica de Cartagena, Spain. eva.martinez@upct.es
authors.forename: Eva
authors.initials: E
authors.lastname: Martínez-Caro
authors.forename: Juan Gabriel
authors.initials: JG
authors.lastname: Cegarra-Navarro
authors.forename: Marcelina
authors.initials: M
authors.lastname: Solano-Lorente
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001292:Attitude to Computers; D004059:Diffusion of Innovation; D017598:Efficiency, Organizational; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000379:methods; D008875:Middle Aged; D009862:Online Systems / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult