Beyond the Average User: Unobserved Heterogeneity in Teleconsultation Continuance Intention in Chile

Background: Telemedicine can expand healthcare access, yet average-user models may obscure differences in beliefs and perceptions underlying teleconsultation continuance. Objectives: This study integrates the Unified Theory of Acceptance and Use of Technology (UTAUT) and Technology Readiness (TR) to examine continuance intention and unobserved user heterogeneity in Chile. Methods: Study 1 used face-to-face survey data from teleconsultation users (n = 388), Partial Least Squares Structural Equation Modelling (PLS-SEM), and PATHMOX segmentation to identify groups. Study 2 evaluated these segments in an independent sample (n = 1536) using measurement invariance assessment, PLS multigroup analysis, and importance–performance map analysis (IPMA). Both studies used non-probability quota sampling and included only adults with prior medical teleconsultation experience from three metropolitan areas. Results: Three segments were identified: adults 61 years and older, users under 61 with high health consciousness, and users under 61 with low health consciousness. Performance expectancy was the strongest predictor of continuance intention. However, relationships differed across segments: facilitating conditions were significant only among older adults, with greater reliance on social influence. TR more strongly influenced effort expectancy and facilitating conditions among low-health-consciousness users under 61. Older adults showed the lowest performance in TR and facilitating conditions. Conclusions: Even though these findings cannot be generalised to rural populations or individuals who have never used teleconsultation, they show that, among experienced urban users of medical teleconsultation, aggregate models may conceal segment-specific mechanisms underlying continuance intention. This supports the development of tailored strategies, such as providing technical support for older adults and emphasising benefits in communications targeting younger users with lower health consciousness.