Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 10, 2021
Open Peer Review Period: Nov 10, 2021 - Jan 5, 2022
Date Accepted: May 30, 2022
(closed for review but you can still tweet)
Perception of physicians as predictors of the future use of the National Death Information System (SINADEF) in Peru: a cross-sectional study
ABSTRACT
Background:
A computer application called the National Death Information System (SINADEF) was implemented so that physicians can prepare death certificates in electronic format and the information is available online. In 2018, only half of the estimated deaths were certified using SINADEF. When a death is certified in paper format, the probability of entering the mortality database decreases. It is important to know, from the user's perspective, the factors that can influence the successful implementation of SINADEF. Whether physicians believe SINADEF is useful and easy to operate, this could support its successful
Objective:
To identify the perceptions of physicians and other factors as predictors of their behavioral intention to use the SINADEF to certify a death.
Methods:
Observational, cross-sectional study. A survey was applied to physicians working in Peru, who used SINADEF to certify a death, for a period of 12 months, starting in November 2019. A questionnaire was adapted, based on the Technology Acceptance Model, TAM2. The questions measured the dimensions of Subjective Norm, Image, Job Relevance, Output Quality, Demonstrability of Results, Perceived Usefulness, Perceived Ease of Use, and Behavioral Intention to Use. Chi-square and logistic regression tests were used in the analysis, and a confidence level of 95% was chosen to support a significant association.
Results:
Two hundred seventy-two physicians responded to the survey, 183 (67.3%) men, the average age was 45.3 ± 10.1 years. The age range was 24 to 73 years. In the bivariate analysis, the intention to use SINADEF was found to be associated with Perceived Usefulness, expressed as "Using SINADEF avoids falsifying a death certificate" (p < 0,001), "Using SINADEF reduces the risk of errors" (p < 0,001), "Using SINADEF allows to carry out a certificate in less time" (p < 0,001); and the perceived Ease of use expressed as "I think SINADEF is easy to use" (p < 0,001). In the logistic regression Perceived Usefulness, (OR 8,5; 95% CI 2,2-32,3; p = 0,002); the Perceived Ease of Use (OR 10,1; 95% CI 2,4 -41,8; p = 0,001); and training in filling out death certificates (OR 8,3; 95% CI 1,6-42,8; p = 0,011) were found to be predictors of the Behavioral Intention to Use SINADEF.
Conclusions:
The behavioral intention to use the SINADEF is related to the perception that it is an easy-to-use system, with the belief that it improves the performance of physicians to carry out this task, and with training in filling out death certificates
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