Perceived quality of e‐health services: A conceptual scale development of e‐health service quality based on the C‐OAR‐SE approach

Hadwich, Karsten, Georgi, Dominik, Tuzovic, Sven, Büttner, Julia, & Bruhn, Manfred (2010) Perceived quality of e‐health services: A conceptual scale development of e‐health service quality based on the C‐OAR‐SE approach. International Journal of Pharmaceutical and Healthcare Marketing, 4(2), pp. 112-136.

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  • Health service quality is an important determinant for health service satisfaction and behavioral intentions. The purpose of this paper is to investigate requirements of e‐health services and to develop a measurement model to analyze the construct of “perceived e‐health service quality.”


  • The paper adapts the C‐OAR‐SE procedure for scale development by Rossiter. The focal aspect is the “physician‐patient relationship” which forms the core dyad in the healthcare service provision. Several in‐depth interviews were conducted in Switzerland; first with six patients (as raters), followed by two experts of the healthcare system (as judges). Based on the results and an extensive literature research, the classification of object and attributes is developed for this model.


  • The construct e‐health service quality can be described as an abstract formative object and is operationalized with 13 items: accessibility, competence, information, usability/user friendliness, security, system integration, trust, individualization, empathy, ethical conduct, degree of performance, reliability, and ability to respond.

Research limitations/implications

  • Limitations include the number of interviews with patients and experts as well as critical issues associated with C‐OAR‐SE. More empirical research is needed to confirm the quality indicators of e‐health services.

Practical implications

  • Health care providers can utilize the results for the evaluation of their service quality. Practitioners can use the hierarchical structure to measure service quality at different levels. The model provides a diagnostic tool to identify poor and/or excellent performance with regard to the e‐service delivery.


  • The paper contributes to knowledge with regard to the measurement of e‐health quality and improves the understanding of how customers evaluate the quality of e‐health services.

Impact and interest:

17 citations in Scopus
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35 since deposited on 06 Aug 2015
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ID Code: 86431
Item Type: Journal Article
Refereed: Yes
Keywords: Health Services, Quality, Switzerland, Internet
DOI: 10.1108/17506121011059740
ISSN: 1750-6123
Subjects: Australian and New Zealand Standard Research Classification > COMMERCE MANAGEMENT TOURISM AND SERVICES (150000) > MARKETING (150500) > Consumer-Oriented Product or Service Development (150501)
Divisions: Current > QUT Faculties and Divisions > QUT Business School
Current > Schools > School of Advertising, Marketing & Public Relations
Deposited On: 06 Aug 2015 01:12
Last Modified: 05 Aug 2016 02:06

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