DIGITAL HEALTH GOVERNANCE AND SERVICE DELIVERY QUALITY IN PUBLIC HOSPITALS: THE MEDIATING ROLE OF ORGANIZATIONAL EFFICIENCY

Abstract

Digital Health Governance (DHG) has become an important tool in enhancing service quality in public health systems, especially in developing countries like Pakistan, where resources are limited. The aim of this study was to investigate the effect of DHG on Service Delivery Quality (SDQ) in public hospitals of Pakistan with Organizational Efficiency (OE) as a mediator and Administrative Leadership Competence (ALC) as a moderator. A structured questionnaire was used to collect the data from healthcare professionals in all three provinces of Punjab, Sindh, and Khyber Pakhtunkhwa, and was analyzed by using the Partial Least Squares Structural Equation Modeling (PLS-SEM 4.0) with bootstrapping of 5,000 resamples. Results show that DHG has a significant and positive effect on SDQ (beta = 0.31, p < 0.001), and that DHG has a substantial effect on OE (R2 = 0.42), and that the relationship between DHG and SDQ is partially mediated by OE. This pathway is greatly enhanced by Administrative Leadership Competence. The study brings together governance, efficiency, and leadership in a single explanatory framework and provides useful policy and management advice for those who wish to institutionalize digital health reforms and enhance service outcomes in resource-constrained public hospital environments.