




































American Economic & Social Review 

 Vol. 8, No. 1; 2021 

ISSN 2576-1269   E-ISSN 2576-1277 

Published by CRIBFB, USA 

 

1 

EVALUATION OF PATIENTS’ SATISFACTION IN 

TELEMEDICINE SERVICE QUALITY: A CASE STUDY ON 

MAIZBHANDERI FOUNDATION, FATIKCHARI, BANGLADESH 
 

 
          Syed Irfanul Hoque 

          Managing Trustee 

                    Darul Irfan Research Institute (DIRI), Bangladesh 

                  Nayeb Sajjadah Nasheen 

                  Maizbhandar Darbar Sharif, Fatikchari, Chittagong, Bangladesh 

                   E-mail: tasauf.darulirfan@gmail.com 

 

                   Professor Dr. Asif Mahbub Karim, FCGIA 

              Dean, Binary Graduate School 

               Binary University of Management and Entrepreneurship, Malaysia 

               E-mail: drasifmkarim@gmail.com        

        

 Md. Rabiul Hossen 

       Lecturer 

                Department of English 

                 Nanupur Laila Kabir University College, Bangladesh 

               Associate Member 

                    Darul Irfan Research Institute (DIRI), Bangladesh 

                E-mail: tasauf.darulirfan@gmail.com 

 

          Dina Arjumand 

       Student 

            Department of “Urban & Regional Planning” 

           Chittagong University of Engineering & Technology 

         Associate Member 

           Darul Irfan Research Institute (DIRI), Bangladesh 

           E-mail: tasauf.darulirfan@gmail.com 

 

        

ABSTRACT 

Telemedicine provides healthcare services to the patients through the adaptation of a 

telecommunication system, as opposed to the face-to-face conventional way of visiting a hospital 

and doctor's chamber. In the new-normal situation during COVID 19, telemedicine is a new way 

forward in the absence of conventional appointments with doctors to ensure regular health services. 

It is important to evaluate patients' satisfaction with service qualities and their perception of 

telemedicine service. The study proposed a conceptual framework based on the e-SERVQUAL 

model and TAM model to evaluate the service qualities and customers' satisfaction. Data has been 

collected through a telephone questionnaire survey from the patients through the psychiatric 

department who have received healthcare services provided by Maizbhanderi Foundation. Data has 

been analyzed using IBM SPSS Statistics version 23 according to the patients’ responses on the 

mailto:tasauf.darulirfan@gmail.com
mailto:drasifmkarim@gmail.com
mailto:tasauf.darulirfan@gmail.com


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service qualities including responsiveness, reliability, information quality, empathy, ease of use, 

perceived usefulness, and their satisfaction with the telemedicine service. The study used Spearman 

Rank Co-relation to evaluate the co-relation of service qualities with customer satisfaction 

following the conceptual framework of the study. The result shows a positive co-relation of service 

qualities with customers’ satisfaction. The study will help to determine the customers' satisfaction 

with service qualities using technology.   

 

Keywords: e-SERVQUAL Model, TAM Model, Service Quality, Customer Satisfaction, 

Maizbhanderi Foundation.  

 

INTRODUCTION 

When longer life expectancy and costs have become a challenging issue to the present healthcare 

service system, telehealth service is providing a way to examine symptoms of patients by ensuring 

treatments, developed communication systems with quick responses. In developing countries, 

telemedicine services act as an adequate health care delivery system (Ayesha et al., 2020). Service 

Quality is very significant for the satisfaction of the customers, faith, and retention and so it has 

aroused huge controversy for decades (Baber, 2019). Customer satisfaction can be used as a thought 

in an overall assessment of the product, with value measurement obtained through experience and 

feelings that have been tested by the customers to the product (Tantarto et al., 2020) . It is very 

significant to have the acceptance of the patients for the successful implementations of telehealth 

services (Huang & Liu, 2015). It is important to evaluate the service qualities of telemedicine 

service according to the opinion of the customers.  

 

PROBLEM STATEMENT 

The COVID-19 disease has a quick expansion around the world and it was first reported in 

December 2019 in  China (Alam, 2020). Telemedicine is putting at the center stage of the digital 

health care solutions by the physician offices as the coronavirus pandemic has a swift shift in the 

health care delivery system (Chowdhury et al., 2021). According to this pandemic situation, 

Maizbhanderi Foundation has taken a step for providing healthcare services through virtual mode as 

telemedicine service. Customers’ satisfaction determination is very important for any service or 

business company. If the customers don’t have a good perception or satisfaction level, it is difficult 

for the company to run with the service. Evaluation of patients’ satisfaction in the service quality of 

telemedicine is also important. The paper focuses on determining patients' satisfaction with the 

service qualities of telemedicine service provided by the Maizbhanderi Foundation. The study 

proposed a framework based on the e-SERVQUAL model and TAM model to evaluate the service 

qualities. 

 

OBJECTIVES 

 To evaluate the perception of the patients’ satisfaction about the service qualities of the 

telemedicine service. 

 To find out the relationship of service qualities with customer satisfaction. 

 

AN INTRODUCTION TO THE METHOD 

Telemedicine service is provided through video conferencing using the zoom platform or WhatsApp 

by Maizbhanderi Foundation. To understand the patients' perception of the telemedicine service, the 

study has conducted a telephone questionnaire survey. The researchers have developed a 

questionnaire based on the e-SERVQUAL model and TAM model including the service qualities; 

responsiveness, reliability, information quality, empathy, ease of use, perceived usefulness. Data 



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were collected from 50 participants who are psychiatric patients. They have shared their perception 

of the telemedicine service and satisfaction level with this service provided by the Maizbhanderi 

Foundation. They also have told their interest to use the service in future.  

 

RESEARCH QUESTIONS 

 How was the perception of the patients about the service qualities? 

 Are the patients overall satisfied with the service? 

 Is there any relation between service qualities with customer satisfaction?  

              

   LITERATURE REVIEW 

Telemedicine Service  

Telemedicine service has got a solid foundation as a possible, reliable, and efficient technology that 

is provided by information technologies and telecommunications which are being amplified rapidly 

(Sood et al., 2007). The activities of our life and business can be overhauled with help of 

Information and Communication Technology (ICT) (Economic & Review, 2020). Telemedicine 

service can ensure a decision under conditions of uncertainty and urgency which is considered as an 

emergency clinical activity (Haimi et al., 2018). Telemedicine service can ensure improved access 

to health care which enables patients to get care diagnosis and treatment from a remote area or at a 

distance (Kho et al., 2020) 

 

Service Quality in Telemedicine Service  

The measurement of service quality helps to evaluate the needs of consumers and also analyze the 

level of satisfaction of the customers with the provided services (Ghotbabadi et al., 2015). It is 

needed to understand how the company is running its business for several reasons (Akter, 2021). 

The significance of evaluating the perception of the patients is recognized by the healthcare 

providers and the satisfaction of the patient is used as an indicator of service quality (Gustke et al., 

2000) 

 

E-Service Quality  

e-SQ which means electronic service quality is very significant by which the satisfaction level of the 

customers with the services of any business can be easily determined (Baber, 2019). The customers 

can be easily involved in the product development process by e-service quality which can offer the 

competitive advantages of online commercial companies (Santos, 2003). The service Quality model 

is much known in the market research field, but it is not applicable in online-based services. As 

telemedicine service was provided using an e-platform, authors have used the e-SERVQUAL model. 

By reviewing papers of the e-SERVQUAL model, authors have selected four qualities such as 

responsiveness, reliability, information quality, empathy which will be suitable for evaluating 

telemedicine service quality perfectly.                                  

         

TAM Model  

In the TAM model, two terms named perceived usefulness and perceived ease of use indicate the 

attitude of the customers to accept the new technology which can impulse customers’ behavior, 

motive, and adoption of new technology (Mohtar et al., 2013). In the study of  (Davis, 1989), 

authors have defined Perceived usefulness as the degree to which a person believes that his or her 

job performance would be enhanced by using a particular system. So, the author used this factor 

"perceived usefulness" of the TAM model to evaluate as telemedicine has enhanced their 

performance or provide access to the health care system. In the study of (Davis, 1989), Perceived 

ease of use is defined as the degree to which a person has a belief that they can use the system 



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without any effort. In the study, the term “perceived ease of use” had been used to evaluate patients’ 

comfort and easiness while using the telemedicine service. 

 

METHODOLOGY 

Participants: The participants of the study were both female and male with a total number of 50. 

They are the participants of the telemedicine service program arranged by the Maizbhanderi 

Foundation. The program has been conducting since March 2020. The participants were Psychiatric 

patients.  

 

Table 1.  Participants according to Gender and Age 

 

Data Collection: Data has been collected from the patients of the psychiatric department who have 

experience of the telemedicine service provided by the Maizbhanderi Foundation. A telephone 

questionnaire survey was conducted using 5 points Likert scale data as 5-strongly agree to 1-

strongly disagree. The questionnaire was prepared according to some factors of the e-SERVQUAL 

and TAM model.  The sample size was 50.  

 

The Procedure of Data Analysis: Data has been analyzed using SPSS (Statistical Package for the 

Social Sciences) according to participants’ responses about the statements in the questionnaire. 

Patients' overall perception has been shown by using charts using Microsoft Excel 2019. Cronbach 

alpha has been done for checking the reliability among the statements in the questionnaire. 

Spearman rank correlation has been conducted using IBM SPSS version 23 for checking the 

correlation of service qualities according to patients’ perception with their satisfaction level. 

 

The Scale of The Questionnaire: The questionnaire was designed by following a 5-point Likert 

scale to know the opinion about their perception of service qualities of the telemedicine service and 

their satisfaction level with the service including future preference.  

 

Proposed Research Framework: The research framework has been prepared based on the e-

SERVQUAL model and TAM model. The service qualities such as Information Quality, 

Responsiveness, Empathy, and Reliability are from the e-SERVQUAL model, and Ease of use and 

Perceived usefulness from the TAM model which are being used as independent variables, and 

customers' satisfaction as the dependent variable. 

 

 

 

 

 

 

   Gender Age in year Total Participants 

10-20 21-30 31-40 41-50 51-60 F % 

Male 1 8 5 7 1 22 44 

Female 4 2 9 7 6 28 56 

Total 5 10 14 14 7 50 100 

1 2 3 4 5 

Strongly Disagree Disagree Moderately Agree Agree Strongly Agree 



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Figure 1. Proposed Research Framework 

 

       RESULTS 

Reliability Test: Cronbach alpha method has been used for checking the reliability among the 

statements in the questionnaire which is a measure of internal consistency. The co-efficient value of 

Cronbach alpha has been found 0.87 which is considered very strong reliability among the 

statements in the questionnaire. 

 

Patients' Perception of the Service Qualities of Telemedicine: For evaluating patients’ perception 

of telemedicine service qualities, the responses of the participants are analyzed by determining some 

service qualities like Responsiveness, Reliability, Information Quality, Empathy, Ease of use, and 

Perceived usefulness. 

 

Table 2. Perception of patients about Telemedicine service 

       

       Factors 

 

Statements 

Responses (%) 

1 2 3 4 5 

 

Responsiveness 

Employees of the telemedicine service provide me perfect 

schedule. 

4 2 20 12 62 

Employees/doctors in the institution give me prompt 

service.  

8 4 18 10 60 

 

 

Reliability 

When this institution promises to do something by a 

certain time, it does so. 

4 4 14 28 50 

When I face a problem, consultants/doctors/assistants 

show a sincere interest to solve the problem. 

4 8 12 24 52 

 

Information 

Quality 

The information (such as on-screen messages, and other 

documentation) provided was clear and easy to 

understand.  

4 2 14 18 62 

It was easy to find the information I needed. 0 2 22 16 60 

     Empathy I have got individual care from this telemedicine service. 2 4 20 28 46 

Information Quality  

Responsiveness  

Empathy 

Reliability  

Ease of use   

Perceived usefulness  

Customers’ Satisfaction  



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0% 20% 40% 60% 80% 100%

Responsiveness

     Reliability

Information Quality

Empathy

   Ease of use

Perceived Usefulness

Patients' perception about service quality 

Strongly agree Agree Moderately Agree Disagree Strongly Disagree

 

In the light of the patients' perception and responses, it has been found that most of the 

patients have agreed with the above statements under the service qualities of telemedicine service. 

Few have disagreed with the statements. The maximum number of patients have agreed that they 

have found the employees are responsive, reliable, have good information quality, Ease of use, and 

perceived usefulness.  

 

 

 

 

 

 

 

 

 

 

 

 
              

 

 

                   

              Figure 2. Patients’ perception of service qualities 

 

This value shows the mean value for the statements according to the service qualities such as 

perceived usefulness, Ease of use, Empathy, Information Quality, Reliability, Responsiveness. 

About 83% of Patients’ said that this Telemedicine service is very useful. About 76% of the total 

patients agreed that it was easy to use the system. 76 % of the patients agreed that the employees 

and doctors showed empathy while providing telehealth service. Around 78 % of the patients agreed 

that the information provided by the employees are clear and understandable. 77% of the patients 

said that the telemedicine service is reliable for them. And 73 % of the patients agreed that the 

employees are very responsive and sincere to them.  

 

 

 

 

 

 

The employees of service understand my specific needs. 2 4 16 28 50 

 

 

Ease of use 

It was simple & easy to use this system. 2 4 20 22 52 

I believe the service will be beneficial for me.  4 0 16 32 48 

I felt comfortable using this system. 0 2 24 30 44 

 

Perceived 

Usefulness 

This Telemedicine service improves my access to 

healthcare services. 

4 2 16 26 52 

This service saves me time traveling to a hospital or 

Doctors’ chamber. 

0 2 10 28 60 



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56%

20%

16%

4%

4% Customers' Satisfaction 

Strongly Agree

Agree

Moderately Agree

Disagree

Strongly Disagree

Customers’ Satisfaction 
Lastly, patients’ overall satisfaction was evaluated according to their responses. This factor was 

evaluated under the statements including overall satisfaction, the interest in using telemedicine in 

the future. 

 

 

 

 

 

 

 

 

 

 

 

 
              Figure 3. Patients’ overall satisfaction  

 
In the light of the above chart, a total of 76 % are agreed that they are overall satisfied with 

the telemedicine service and they have preferred the service for the future also. Only 8 % of the total 

patients are dissatisfied with the service.  

 

Spearman Rank Correlation 

Spearman rank correlation has been done for justifying the co-relation of the perception of the 

patients about the service qualities of telemedicine service with their satisfaction level.  

 

Table 3. Correlation of service qualities with Patients’ Satisfaction 

Spearman Rank Correlation Responsive 

ness 

Reliability Information 

Quality 

Empa

thy 

Ease  

of 

use 

Perceived 

Usefulness 

      Customer 

Satisfaction 

 

 

Responsiveness 

Correlation 

Coefficient 

1.000 .735** .517** .632** .568** .525** .643** 

Sig. (2-

tailed) 

. .000 .000 .000 .000 .000 .000 

N 50 50 50 50 50 50 50 

 

 

Reliability 

Correlation 

Coefficient 

.735** 1.000 .559** .711** .670** .631** .793** 

Sig. (2-

tailed) 

.000 . .000 .000 .000 .000 .000 

N 50 50 50 50 50 50 50 

 

 

Information 

Quality 

Correlation 

Coefficient 

.517** .559** 1.000 .526** .341* .376** .544** 

Sig. (2-

tailed) 

.000 .000 . .000 .015 .007 .000 

N 50 50 50 50 50 50 50 



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From Table 3, it has been found that all the service qualities are positively correlated with 

customers’ satisfaction. The correlation between customers' satisfaction and responsiveness has a 

strong and positive correlation with the value of r is 0.643. Reliability has a positive and strong 

correlation with customers’ satisfaction with the r-value 0.793. The information quality is 

moderately co-related with customers’ satisfaction having the value of r, 0.544. In light of the 

analysis, we can find the perception of the service qualities of telemedicine service has a strong and 

positive correlation with customers’ satisfaction.   

 

DISCUSSION 

Due to the pandemic situation, the whole world is in turmoil (Asgor, 2021). Overall, in the new 

normal situation, the Telemedicine service is an alternative healthcare service for the patients. 

Information and Communication Technology (ICT) has been accepted as one of the main driving 

forces behind organizational competitiveness in the present-day business environment (Okon, 

2018). It has enabled to provide telemedicine through e-platform. The service qualities of 

telemedicine were evaluated according to the perception and satisfaction of the patients. In the 

pandemic situation, telemedicine is an alternative and the best way for providing health care 

services to patients. In the light of the study, most of the patients are satisfied with the service 

provided by the Maizbhanderi foundation. And also they have preferred the telemedicine service for 

the future. According to patients' responses and preferences, we can decide to run the service in the 

future. This study will be helpful to determine customers' satisfaction with the service qualities 

according to the proposed framework based on the e-SERVQUAL model and TAM model. Few 

limitations have been found while conducting the survey. As it was a telephone questionnaire 

survey, many of the participants did not pick up the phone and also some of them switched off their 

phones. That's why we conducted the participants which were more than our sample size for getting 

responses according to our exact sample size. Few patients were dissatisfied with the telemedicine 

service. In the rural areas of Bangladesh, many people are not aware of the usage of ICT and also 

 

 

Empathy 

Correlation 

Coefficient 

.632** .711** .526** 1.000 .478** .443** .677** 

Sig. (2-

tailed) 

.000 .000 .000 . .000 .001 .000 

N 50 50 50 50 50 50 50 

 

       

Ease of 

use 

Correlation 

Coefficient 

.568** .670** .341* .478** 1.000 .706** .784** 

Sig. (2-

tailed) 

.000 .000 .015 .000 . .000 .000 

N 50 50 50 50 50 50 50 

 

Perceived 

Usefulness 

Correlation 

Coefficient 

.525** .631** .376** .443** .706** 1.000 .651** 

Sig. (2-

tailed) 

.000 .000 .007 .001 .000 . .000 

N 50 50 50 50 50 50 50 

 

Customers’ 

Satisfaction 

Correlation 

Coefficient 

.643** .793** .544** .677** .784** .651** 1.000 

Sig. (2-

tailed) 

.000 .000 .000 .000 .000 .000 . 

N 50 50 50 50 50 50 50 

**. Correlation is significant at the 0.01 level (2-tailed). 

*. Correlation is significant at the 0.05 level (2-tailed). 



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Telemedicine services. So, the study will be taking an approach to increase awareness about the 

telemedicine service. The persons who have the weakness to use the telemedicine service will be 

trained to use the service properly. According to the patients' perception, this service can be 

improved to make the patients satisfied.  

 

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