Ageing well with tech: Exploring the determinants of e-healthcare services adoption in an emerging economy

The adoption of e-healthcare services is critical for improving healthcare accessibility and efficiency, particularly in regions with diverse populations, such as Malaysia. Although e-healthcare services offer numerous advantages, their adoption is considerably low and requires a thorough understanding of the key factors that influence their use. This study investigated the determinants and dynamics of e-healthcare adoption among adults over 40 years by extending the unified theory of acceptance and use of technology. We employed a quantitative research approach, specifically a cross-sectional design. Data were collected from 393 Malaysian respondents through a structured survey questionnaire, using convenience sampling. They were analyzed using partial least-squares-structural equation modeling. The findings revealed that performance expectancy, effort expectancy, social influence, and perceived product value significantly influenced individuals' intentions to use e-healthcare services. Meanwhile, perceived risk had an insignificant negative effect. Facilitating conditions significantly influenced individuals' intentions and actual usage of e-healthcare services. Furthermore, individuals' intentions to use e-healthcare services significantly affected their actual use of these services. Additionally, the intention to use e-healthcare services mediated the relationship between the factors and usage of e-healthcare services, except for perceived risk. Surprisingly, perceived service accuracy had no significant moderating effect on the relationship between individuals' intention to use and their actual use of e-healthcare services. This study offers valuable insights for educators, practitioners, and policymakers, enriching the scholarly discourse in this field. For education, integrating e-healthcare topics into curricula can enhance digital health literacy. In practice, healthcare providers should focus on improving user experience and addressing barriers to technology adoption. For policy making, developing supportive policies, and infrastructure to facilitate e-healthcare adoption is crucial to enhancing public health outcomes.