Examination of Sustainability through the Time in the Public Healthcare Service Network: An Abstract

Abstract

The service network notion indicates that actors are interconnected (Hedaa and Törnroos 2008), that real competition exists (Büyüközkan et al. 2011), and that relationships among the actors are long-lasting (Håkansson and Snehota 1995). In addition, since the growing demand for healthcare in developed countries generates a context of scarce resources, Spohrer et al. (2007, p. 75) conclude that sustainability is an: “…extremely relevant target…”. Therefore, focusing attention on the sustainability approach of health service seems pertinent for research. The research purpose is double: (i) to frame the base of healthcare organizations’ sustainability endeavours and the direction of sustainable development through the time; and (ii) to reveal the influence of the network on the public healthcare sector. Following Yin (1994 p. 1) a case study methodology has been used. The framework proposed by Orlikowski and Yates (2002) was selected to structure and give sense to the information collected. These authors pointed out that the time structuration process require flow and periods to have meaning. The inductive approach proposed by Thomas (2006) has been used to gather data. This study was carried out by the research team divided into three stages in the studied public hospitals. First, the research team contacted by phone the general manager at 15 public hospitals in different regions, only seven of them considered sustainability as part of their core activity for the future. Second, a series of in-depth interviews were carried out during a two-year period with the key informants of each hospital. Third, the research team also interviewed three additional general managers at other hospitals not included in the initial sample. The empirical findings and the previous discussion of findings indicate that the foundation of sustainability efforts undertaken across the studied healthcare organizations has not been homogenous. On the contrary, it has been distinctly heterogeneous across the studied regional autonomies. The direction of sustainable development has also varied across the studied public healthcare organizations and their related regional autonomies. Organizationally sustainable development by the studied public healthcare organizations appears to be affected by both micro- and macro-related determinants in the regional autonomies. The findings have also revealed that the direction of sustainable development in the studied public healthcare organizations across regional autonomies was either positive, negative or none at all.