Purpose This study aims to understand the factors affecting the continuance usage intention (CUI) of mHealth among the rural elderly. Design/methodology/approach An integrated model was proposed with the constructs derived from multiple models such as the unified theory of acceptance and use of technology, information system success model and expectation confirmation model. Data were collected from 400 participants who had prior experiences with mHealth services in Bangladesh. The research model was tested using the partial least squares method based upon structural equation modelling. Findings The findings indicated that system quality, performance expectancy, facilitating conditions and social influence were significant to the degree of confirmation and ultimately affect satisfaction and CUI. Surprisingly, service quality and information quality were insignificant. Research limitations/implications This study has added in the field of knowledge by contributing some new thoughts and interpretations of continuance usage modelling for mHealth services. The findings may become beneficial for the government agencies, policymakers, mHealth systems developers and service providers. Originality/value As limited research was found on CUI of mHealth in the integrated view of rural elderly’s value, this research contributes to the extant literature by categorizing key factors that might support to proliferate the continuance usage of this service. Moreover, the contextualization of the related variables and integration of the existing model is theoretically original. Furthermore, because of a generic approach, the findings could be easily modified to assist other developing countries in the planning and up-take of mHealth.

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Purpose The purpose of this paper was to explore the comparative influential factors affecting the behavioral intention and actual usage of mHealth services in two distinct national environments, i.e. China and Bangladesh, in relation to the international expansion of mHealth services. Design/methodology/approach In this study, widely accepted Unified Theory of Acceptance and Use of Technology (UTAUT) with two additional variables, i.e. Perceived Reliability and Price Value have been selected as a theoretical framework. Primary data were collected from existing mHealth users among generation Y in both China and Bangladesh. A total of 296 and 250 questionnaires were deemed as usable for data analysis for Bangladesh and China, respectively. Findings Performance expectancy and social influence had significant impact on the adoption intention of mHealth services for both countries. Effort expectancy and price value were insignificant factors for Bangladesh, whereas facilitating condition and perceived reliability were insignificant for China. Practical implications The insights from this study could benefit mHealth services providers and those policymakers who seek to enter the Chinese and the Bangladeshi healthcare market. The dimensions identified in the study are based on a full assessment of mHealth usages experiences. Global service providers can use the dimensions identified by the paper to better assess their service performance on an international level. Originality/value The paper is unique in that it is one of the first cross-country examinations of influential factors affecting the adoption of mHealth services in two different countries. This study confirms the applicability of extended UTAUT model in the context of mHealth services among the generation Y in developing countries such as China and Bangladesh.