Market Demand and Service Innovation as System-Level Constraints in Digital Elderly Care Services: A Qualitative Study from the Beijing–Tianjin–Hebei Region

This study examines how market demand and service innovation shape the transformation outcomes of digital elderly care services, from a service system and informatics perspective.Focusing on the Beijing-Tianjin-Hebei (BTH) region of China, the research investigates why large-scale investments in digital intelligence technologies have produced uneven transformation effects across elderly care service systems.Adopting a qualitative research design, the study draws on in-depth interviews and focus group discussions with 15 key stakeholders, including elderly users, family caregivers, service practitioners, and policymakers.Data were analyzed using reflexive thematic analysis to uncover system-level mechanisms through which digital applications are translated-successfully or unsuccessfully-into service value.The findings reveal three interrelated mechanisms.First, digital intelligence applications generate significant efficiency potential at the system level, yet frequently fail to improve service outcomes at the user level.Second, service innovation operates as a critical mediating process; when innovation is implemented through technology-driven, top-down service redesign, it constrains rather than enables transformation.Third, market demand functions as a socially embedded system constraint, shaped by trust networks, cultural norms, and user adaptability, which moderates the effectiveness of digital service systems.By reconceptualizing market demand and service innovation as structural conditions within digital service systems, this study contributes to service science and informatics research by explaining why digital transformation outcomes diverge from intended policy and operational objectives.The findings offer practical implications for the design, governance, and evaluation of digital elderly care service systems in aging societies.