Towards an improved understanding of the antecedents of digital health service loyalty during a pandemic: An fsQCA approach

Abstract

Loyalty towards digital health services has received unprecedented attention and acceptance during the Covid-19 pandemic period. However, whether this popularity will be retained into the future and the factors that can influence such loyalty is undetermined. This paper provides insight into this issue through a cross-cultural examination of the influence of digital service quality (e-quality) on consumer satisfaction and loyalty (e-loyalty) in the digital health service sector during a pandemic. A fuzzy-set qualitative comparative analysis (fsQCA) is applied using a sample of 50 customers drawn from different professions across different countries who actively showed loyalty towards digital health during the pandemic. Research constructs evaluation for reliability and internal consistency was subsequently performed using Cronbach's alpha and Correlation analysis. The results reveal a significant positive relationship between service quality and the twin outcomes of consumer satisfaction and loyalty, while the findings established satisfaction as a prominent mediator for digital health. Findings from the fsQCA analysis identified four core factors that underpin loyalty in digital health platforms. Alternative paths have been identified based on gender, current education status, and other professions. In addition, two topologies are introduced taking digital health services from different platforms during the pandemic. Because of the primary nature of the data, this is first-hand experience gathered from the people who are directly or indirectly involved in receiving help from digital health services in a pandemic context. The application of the fsQCA technique for examining loyalty towards digital health services is applied in the e-health or digital health literature for the first time. The study findings will assist digital health service providers seeking insight into the factors that influence loyalty of e-health service consumers, enabling them to focus more accurately on the service quality dimensions that are effective in influencing consumer satisfaction and retention. The findings of this study contain a number of contributions, illustrating different topologies towards digital health that provide educators and policymakers with valuable insights.