Social Reporting in a Health Care Organization: A Case Study of a Regional Italian Hospital

Abstract

The Italian Health System (herein abbreviated as IHS) is principally financed by public funds ; the individual health units present difficulties in defining and measuring health care output and, at the same time, in the communication process to stakeholders about the clinical and ethical impacts of the use of economic resources. A reporting model based on a triple bottom line approach (social, environmental, and economic) could offer a system of multidimensional analysis, and it could increase external communication, thereby reducing information asymmetries between the health unit and its stakeholders. Despite the understanding that there are theoretical schemes proposed by previous literature and current guidelines, practitioners are still lacking appropriate models and tools to guide the social accountability process of the IHS entities. It is the absence of a single specific framework, applicable to social reporting for the particular reality of hospital health units, which has guided the research project illustrated in the present chapter. In order to understand how a health manager could adopt a suitable reporting format, starting from the current available standards, an Italian case study is discussed. The research is based on a constructive approach methodology. The design of the accountability model is centred on the basic levels of care (according to Italian regulations), and, for each of them, a wide range of performance indicators is presented so as to offer an idea of what is—or what could be—disclosed in the report. The project has required collaboration between an university and a regional public hospital. The chapter is composed of five main parts: a brief overview of the IHS regulations and the compulsory accountability system ; the need for social reporting by hospital units; the empirical accountability process, including stakeholder engagement activity which represents an example that an health care organization can follow; reflections on social reporting as a stakeholder engagement tool and a guide for the patient ; future research areas.