Introduction The digital economy has become a important driver for the high-quality development of industry. Exploring its impact on and pathways for enhancing the smart health and aging care industry holds significant practical importance. Methods Leveraging the theoretical underpinnings of TOE framework and configuration analysis, this research utilizes dynamic Qualitative Comparative Analysis (QCA) to examine provincial-level panel data from China between 2012–2022, investigating how the digital economy’s configuration effects evolve over time. Results The digital economy drives the high-quality development of the smart health and aging care industry through five pathways, which can be divided into three classes: digitally technology-driven, dual-core “digital technology–digital environment” driven, and digitally environment-led. Low-quality development patterns follow three pathways, which can be summarized into two types: “digital technology–digital environment” constrained and “digital technology–digital organization–digital environment” multi-dimensional constrained. Multi-period comparative analysis reveals multiple trajectory evolution phenomena in the digital economy’s drive toward high-quality development of the smart health and aging industry. Among these, the digital technology-driven and dual-core “digital technology-digital environment” models represent dominant trajectories, while the digital environment-led model constitutes a turning-point trajectory. Discussion The digital economy drives the high-quality development of the smart health and aging care industry through multiple pathways and evolutionary trajectories, with the three elements—digital technology, digital environment, and digital organization, functioning synergistically. This research provides theoretical references and practical insights for understanding how the digital economy era propels the high-quality development of the smart health and aging care industry.
Tan et al. (Mon,) studied this question.