Effects of contingencies on healthcare 4.0 technologies adoption and barriers in emerging economies

•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. 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.