Socio-Technical Integration in Digital Healthcare Distribution: An Ontological Framework of Contextually-Mediated Channel Efficacy

Purpose: This research advances an integrative framework for optimizing healthcare service distribution through digital channels by synthesizing service quality dimensions with contextually-mediated technology acceptance constructs. The study interrogates the differential efficacy of distribution channels across demographic and geographical contexts, with particular emphasis on the socio-technical determinants of sustainable channel adoption. Research design, data and methodology: The investigation employs methodological triangulation through a sequential mixed-methods design. Initial qualitative exploration with seven domain experts informed the development of context-sensitive measurement instruments, subsequently validated through quantitative analysis of 295 users across diverse distribution regions of Vietnam. The study operationalizes a Socio-Technical Adaptive Channel Integration (STACI) framework through structural equation modeling with multi-group analysis capabilities, enabling dimensional comparison of distribution effectiveness across demographic and geographical boundaries. Results: The empirical trajectory reveals pronounced asymmetries in channel effectiveness determinants, with service quality (β = 0.534, p < 0.001) and security protocols (β = 0.278, p < 0.001) emerging as dominant predictors of channel attitudes, substantially outweighing traditional usability factors. Multi-group analysis uncovers significant contextual variations in distribution effectiveness, with path coefficient differentials between urban and rural implementation contexts (∆β = 0.237, p < 0.05). The structural model demonstrates robust explanatory power, accounting for 51.3% of variance in channel attitudes and 63.4% in distribution system adoption intentions. Conclusions: This research contributes to distribution theory by establishing the Socio-Technical Adaptive Channel Integration framework, which reconceptualizes distribution systems as context-dependent socio-technical networks rather than uniform service delivery mechanisms. The epistemic insights generate strategic implications for developing adaptive, segment-specific digital distribution architectures in healthcare service delivery, with particular relevance for addressing inequities in channel accessibility across diverse implementation contexts.