Abstract :
Keywords Healthcare 4.0; Contingency factors; Digital technologies; Barriers; Survey Highlights * Influence of contingencies on the healthcare 4.0 (H4.0) adoption and barriers. * 159 managers from 16 hospitals located in Brazil, India, Mexico and Argentina. * Contingencies' effect is more prominent on H4.0 technologies adoption than barriers. * Hospitals' managers can anticipate issues inherent to emerging economies. Abstract Studies on the influence of contingency factors on the introduction of novel digital technologies into high-complexity systems, such as hospitals, are still incipient. As the introduction of Healthcare 4.0 (H4.0) usually implies in high capital expenditures and requires a more skilled labor force, such understanding gains relevance when considering hospitals in emerging economies, more likely to be resource-constrained. This study examines the effect of five contingency factors on the adoption of H4.0 technologies and associated barriers to H4.0 adoption in emerging economies; they are: hospital's ownership and age, number of employees, number of inpatient beds, and functionality (teaching hospital or not). The analysis is based on a transnational survey with 159 middle and senior managers from 16 hospitals, located in Brazil, India, Mexico and Argentina. Results indicate that contingencies do affect both H4.0 technologies adoption and associated barriers although not homogeneously in terms of effect, being more prominent on technologies' adoption than on barriers to H4.0 implementation. Our study sheds light on these relationships, providing hospitals' managers a means to anticipate potential issues and handle eventual difficulties inherent to the context in which they are inserted. Author Affiliation: (a) Universidade Federal de Santa Catarina, Capitao Americo 96, Nivaldo Dias 102, 88037-060 Florianópolis Brazil (b) Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (c) Universidade de São Paulo, São Carlos, Brazil (d) Pontificia Universidad Catolica, Santiago, Chile (e) Universidad Austral, Buenos Aires, Argentina (f) Universidad Autónoma de Baja California, Ensenada, México (g) University of Liverpool, Liverpool, United Kingdom * Corresponding author. Article History: Received 1 December 2019; Revised 29 February 2020; Accepted 31 March 2020 Byline: Guilherme Luz Tortorella [gtortorella@bol.com.br] (a,*), Flávio Sanson Fogliatto [ffogliatto@producao.ufrgs.br] (b), Kleber Francisco Espôsto [kleberesposto@usp.br] (c), Alejandro Mac Cawley Vergara [amac@ing.puc.cl] (d), Roberto Vassolo [RVassolo@iae.edu.ar] (e), Diego Tlapa Mendoza [diegotlapa@uabc.edu.mx] (f), Gopalakrishnan Narayanamurthy [g.narayanamurthy@liverpool.ac.uk] (g)