Analytical Investigation of Telemedicine Service Quality and Patient Satisfaction in Federal Medical Centres in North Central Nigeria: A Gap-Filling Study

Telemedicine implementation in Nigerian federal medical centres in the North Central zone is expanding, yet the relationship between telemedicine service quality dimensions and patient satisfaction has not been analytically examined in this specific context, creating a gap that limits service quality improvement efforts. This study analytically investigates telemedicine service quality and its determinants of patient satisfaction at federal medical centres in Abuja, Lokoja, and Lafia. A cross-sectional analytical survey was applied to 320 patients who had completed at least two telemedicine consultations, selected through purposive sampling at the three facilities. The SERVQUAL instrument adapted for telemedicine (TELE-SERVQUAL) was used to measure five service quality dimensions: reliability, assurance, tangibles, empathy, and responsiveness, alongside overall patient satisfaction. Structural equation modelling in AMOS tested hypothesised relationships between service quality dimensions and satisfaction. Available telemedicine quality literature from North Central Nigerian contexts identifies consultation audio-visual clarity and physician responsiveness as the dimensions most strongly determining patient satisfaction. The Information Systems Service Quality Model and the Patient Satisfaction Framework by Sitzia and Wood provide the analytical basis. Findings confirm that reliability and empathy are the strongest TELE-SERVQUAL predictors of satisfaction, with reliability mediated by connection quality. This study fills the gap in telemedicine quality-satisfaction research specific to Nigerian federal medical centre settings. Recommendations address telemedicine bandwidth provisioning standards and physician empathetic communication training for remote consultation. Keywords: telemedicine, service quality, patient satisfaction, North Central Nigeria, federal medical centres.