Telehealth is the remote delivery of health care using various telecommunication methods, such as telephones, cellphones, and mobile wireless devices, with or without a video connection (Dorsey & Topol, 2016). The Health Resources and Services Administration defines telehealth as the use of communication technologies to offer quality treatment, information, and education (Balestra, 2018; Rutledge et al., 2017). It is a component of e-health. From the perspective of patients, the fundamental aim of telehealth is to increase access to care, and as such, it has historically increased access to health care for conditions and populations for which care was otherwise not available (Rayman, 1992). Rural and remote patients were the original target audience for the development of telehealth (Gajarawala & Pelkowski, 2021). Researchers found that telehealth could drastically reduce American healthcare costs by reducing issues like prescription usage, needless hospital visits, and extended hospital stays (Rutledge et al., 2017).
Furthermore, according to Rutledge et al. (2017), telehealth minimizes patient transportation and longer waits, enhances productivity without increasing net costs, gives patients in remote locations and places with such a provider scarcity access to services and care, and enables equivalent or higher-quality care. This is how it can help to lessen the numerous difficulties the healthcare system in Bangladesh encounters (Uddin Quadery et al., 2021). Given that people can affect how telehealth services are provided (van Gemert-Pijnen et al., 2011), it is vital to comprehend their goals and, more significantly, to compare the knowledge of this service among users and non-users to maintain the correct and effective usage of telehealth (Orlando et al., 2019).
Bangladesh has made significant improvements in public health, meeting the MDG 4 objective of reducing under-five child death by two-thirds from 1990 to 2015 and raising other important metrics including maternal death, prevention programs, and improved survival from diseases like malaria, TB, and diarrhea (WHO Regional Office for the Western Pacific, 2015). Increases in the availability of birthing services, children's vaccination percentages, the use of oral rehydration solutions to manage diarrhea, and tuberculosis treatment success rates have all contributed to these results (WHO Regional Office for the Western Pacific, 2015). Nevertheless, there are still difficulties, such as the fact that Bangladesh is still far from providing universal health care for those in disadvantaged categories, such as those with poor income status and those living in remote areas (Ghaddar et al., 2020). Inequitable access to health services between urban and rural areas, incoordination between elementary healthcare services in rural and urban areas, a severe shortage of educated health professionals with the right skill in public organizations, and a substantial increase in uncontrolled unofficial suppliers in the private sector, a persistently low annual contribution to health in the national budget, and transportation issues are obstacles to the realization of universal health coverage (Udechukwu et al., 2021). According to Ghaddar et al. (2020), telehealth, which utilizes modern technological breakthroughs to benefit patients, can get beyond many of the limitations of the healthcare system.
However, the assessment of telehealth knowledge among adults who utilized and unutilized the service has not been well documented; instead, the literature primarily focuses on how influencing factors are perceived and how people behave toward adopting new technologies. A few existing studies compared users and non-users, but most focused on the expertise and opinions of experts, such as doctors, and not on the nonprofessionals. To investigate the variables that impact users' and non-users decisions to start engaging with an integrated telehealth service, Cook et al. (2016) conducted a qualitative study in the United Kingdom in 2016. However, they did not evaluate the degree of knowledge or make any comparisons between users and non-users. Likewise, Saprikis et al. (2022) analyze the factors that affect adopters and non-adopters to identify their differences and commonalities. In addition, Hofstede et al. (2014) and Lee & Rho (2013) investigated perceptions of contributing factors to the adoption of mobile health monitoring/telehealth services across both groups (users and non-users) in the Netherlands and South Korea, respectively. None of the research investigated how knowledgeable the average person is.
However, two trends in telehealth studies have been observed in Bangladesh. One group either examined the significance of using this service (S. R. Chowdhury et al., 2020; Kadir, 2020) or assessed how people's perceptions of telehealth use differ from one another (Rahman et al., 2020; Zobair et al., 2020). The effectiveness of telehealth services in improving knowledge and behaviors in particular illnesses/specific conditions, such as maternal and newborn healthcare (M. E. Chowdhury et al., 2019), hypertension (Jahan et al., 2020), diarrhea (Masud et al., 2020), and diabetes (Morrison et al., 2021) was discussed by the second group of researchers. To our knowledge, however, no previous study has been discussed about comparing knowledge between utilized and unutilized adult individuals. As a result, this study explored the assessment of telehealth knowledge among adults who used and did not use telehealth services as well as examined the association between study variables and telehealth knowledge. As a result, we believe this study will help us better understand what it means to use telehealth services in Bangladesh.