ISSN Electrónico: 2500-9338
Volumen 23 N°3
Año 2023
Págs. 103 – 120
SUSTAINABILITY REPORTS AS DRIVERS OF SOCIAL RESPONSIBILITY IN HEALTHCARE
COMPANIES
Aracelly Buitrago Mejía[1]
Enlace ORCID: https://orcid.org/0000-0002-6583-7827
Mario Samuel Rodríguez
Barrero[2]
Enlace ORCID: https://orcid.org/0000-0001-9356-6764
Patricia Izquierdo
Hernández[3]
Enlace ORCID: https://orcid.org/0000-0001-7377-9439
Fecha
de Recepción: 23 de mayo de 2023
Fecha
de Aprobación: 1 de septiembre de 2023
ABSTRACT:
Sustainability reports are public disclosures of the
economic, environmental, and social impacts of organizations in achieving the
Sustainable Development Goals (SDGs) and their social responsibility actions.
This knowledge is important to identify the actions that the healthcare sector
is undertaking to fulfill these objectives and to design strategies that foster
social responsibility processes aimed at strengthening organizations and
advancing their commitments in this area. The objective is to identify the
perception of healthcare companies have regarding the importance, relevance,
impact, and implementation of strategies to contribute to the achievement of
the SDGs. The study has a descriptive scope, a quantitative approach, and a
cross-sectional design. The research addresses the concept of sustainability
from the perspective of business people through the application of a structured
instrument with four variables: Perception of the relevance and feasibility of
implementing sustainability reports, Perception of the impact generated by the
company, Perception and management of environmental impact, and Perception and
influence of indicators. To collect information from the primary source, a
semi-structured interview with 21 questions was used, which was validated with
a Cronbach's Alpha of 0.758. The sample was defined with a confidence level of
95% for a total of 281 companies. The results show that 45% of business people
consider that their activities have a positive impact on the dimensions of
sustainable development, 64% are concerned about their contribution to the
achievement of the SDGs, and 30% believe that these contributions should be
mandatory and disclosed to society, therefore, it is recommended to move
towards the consolidation of sustainability reports as determiners of social
responsibility.
Keywords. Disclosed information; Health sector; Social balance;
Sustainability reports; Sustainable development goals.
MEMORIAS DE SOSTENIBILIDAD COMO
IMPULSORES DE LA RESPONSABILIDAD SOCIAL EN EMPRESAS DE SALUD
Resumen
Las memorias de sostenibilidad son informes públicos sobre los impactos
económicos, ambientales y sociales de las organizaciones en el logro de los ODS
y sus acciones de responsabilidad social. Este conocimiento es importante para
identificar las acciones que el sector salud está desarrollando para el
cumplimiento de estos objetivos, además permitirá diseñar estrategias que
permitan desarrollar procesos de responsabilidad social cuyo fin sea fortalecer
a las organizaciones y avanzar en el cumplimiento de sus compromisos en esta
materia. El objetivo es identificar la percepción de las empresas del sector
salud sobre la importancia, pertinencia, impacto e implementación de estrategias
para contribuir al logro de los ODS. El alcance del estudio es descriptivo, su
enfoque cuantitativo y su corte transversal. La investigación aborda el
concepto de sustentabilidad desde la perspectiva de los empresarios a través de
la aplicación de un instrumento estructurado con 4 variables: Percepción de la
pertinencia y factibilidad de implementar memorias de sustentabilidad,
Percepción del impacto generado por la empresa, Percepción y gestión del
impacto ambiental y Percepción e incidencia de los indicadores. Para recolectar
la información en fuente primaria se utilizó como técnica, una entrevista
semiestructurada de 21 preguntas la cual fue validada con el Alfa de Cronbach
de 0.758, la muestra se define con un grado de confianza del 95% para un total
de 281 empresas. Los resultados muestran que el 45% de los emprendedores
considera que sus actividades generan un impacto positivo en las dimensiones
del desarrollo sostenible, el 64% se preocupa por su contribución al logro de
los ODS y el 30% considera que estas contribuciones deberían ser obligatorias y
reveladas a la sociedad, por lo que se recomienda avanzar hacia la
consolidación de las memorias de sostenibilidad como dinamizadoras de la
responsabilidad social.
Palabras
Claves. Información revelada; Sector salud;
Balance social; Memorias de sostenibilidad; Objetivos de desarrollo sostenible.
RELATÓRIOS DE
SUSTENTABILIDADE COMO IMPULSIONADORES DA RESPONSABILIDADE SOCIAL EM EMPRESAS DE
SAÚDE
Resumo
As memórias de sustentabilidade são relatórios públicos sobre os impactos econômicos,
ambientais e sociais das organizações na realização dos Objetivos de Desenvolvimento
Sustentável (ODS) e suas ações de responsabilidade social.
Esse conhecimento é importante para identificar as ações
que o setor de saúde está desenvolvendo para cumprir esses objetivos e também
permitirá o desenvolvimento de estratégias
para promover processos de responsabilidade
social, com o objetivo de
fortalecer as organizações e avançar
no cumprimento de seus compromissos nessa área. O
objetivo é identificar a percepção
das empresas do setor de saúde
sobre a importância, relevância,
impacto e implementação de estratégias
para contribuir com o alcance dos ODS. O escopo do estudo é descritivo, com abordagem quantitativa e corte
transversal. A pesquisa aborda o conceito de sustentabilidade na perspectiva
dos empresários por meio da
aplicação de um instrumento
estruturado com 4 variáveis: percepção da relevância e viabilidade de
implementar memórias de sustentabilidade,
percepção do impacto gerado
pela empresa, percepção e gestão
do impacto ambiental e percepção e incidência dos indicadores. Para coletar
informações na fonte primária, foi utilizada uma técnica de
entrevista semiestruturada com
21 perguntas, validada com um coeficiente Alfa de Cronbach de 0,758. A amostra foi definida com um nível
de confiança de 95% para um
total de 281 empresas. Os resultados mostram que 45%
dos empresários consideram
que suas atividades geram um impacto positivo nas dimensões do desenvolvimento sustentável, 64%
se preocupam com sua contribuição para o alcance
dos ODS e 30% acreditam que essas
contribuições deveriam ser obrigatórias e divulgadas à sociedade.
Portanto, é recomendado avançar
na consolidação das memórias de sustentabilidade como
impulsionadoras da responsabilidade
social.
Palavras chave Informação divulgada; Setor de saúde; Balanço social; Memórias de
sustentabilidade; Objetivos de desenvolvimento sustentável.
1. INTRODUCTIÓN:
There are different
methodologies through which companies can announce their contributions to the
achievement of the SDGs, including periodic reports, social balance reports,
and sustainability reports. The last ones are based on the standards of the
Global Reporting Initiative (GRI), considered the best international practices
designed to inform the general public about the economic, environmental, and
social impacts generated by organizations, under the principles of stakeholder
inclusiveness, sustainability context, materiality, completeness, accuracy,
balance, clarity, comparability, reliability, and punctuality (GRI, 2018).
When considering the importance
of contributing to the achievement of the Sustainable Development Goals (SDGs),
which seek to mitigate, compensate, and change the way the global economic
landscape is currently managed to ensure the long-term sustainability of
humanity and the preservation of the environment and its different ecosystems, due
to the fact that the use and joy it´s not only a privilege of the human beings
but of the rest of the living beings whether animals or plants existing in the
planet, it is necessary for companies and regions to analyze and evaluate how
these global sustainable development goals are being embraced and developed by
companies, additionally, they should assess the potential impacts of those
policies on the growth and competitiveness of the companies in the market.
The research project has guided
its resources on studying the healthcare sector to identify their understanding
of the SDGs, as well as the various impacts these organizations may generate.
It aims to determine the current level of commitment to start, continue, or
improve the necessary sustainability processes to contribute to global
objectives. The present study identified the limited knowledge about how
healthcare companies recognize and adopt sustainability, and how these
processes can be useful in achieving their competitiveness as a problem.
The Kyoto Protocol (UN, 1997)
was the first international environmental initiative, and significant global
actions followed with the Global Compact (1999) and the Millennium Development
Goals Declaration (2000). Both aimed to involve the government, state, and
businesses extensively. The Global Compact emerged as an international proposal
by the United Nations at the World Economic Forum in Davos 1999 (Duke, 2010)
with the objective of promoting corporate citizenship by engaging businesses in
the major social and environmental challenges resulting from accelerated
globalization.
Since its beginnings, the
Global Compact has experienced quick growth and has become one of the most
internationally recognized global projects (Arevalo et al., 2013).
Participating companies must organize their operations based on ten universally
accepted principles in four thematic areas: human rights, labor standards, the
environment, and anti-corruption. It emphasizes that responsible business
practices build trust, social capital, and contribute to sustainable
development and markets.
The ten principles were
selected based on their relevance to the development of international
standards, their importance in advancing social and environmental issues, and
the level of intergovernmental support. They are derived from principles
established in the Universal Declaration of Human Rights, the ILO Declaration
on Fundamental Principles and Rights at Work, the Rio Declaration on
Environment and Development, and the United Nations Convention against
Corruption (Kell and Levin, 2003).
In 2015, the United Nations
organized the 'Global +15 Business as a Force for Good' initiative through the
Global Compact. This initiative was designed to highlight the private sector's
efforts and collaborations in advancing social priorities, with a specific
focus on the United Nations' global sustainable development agenda. It also
aimed to illustrate how the private sector is contributing to the goals of the
Post-2015 agenda, which gave rise to the Sustainable Development Goals (SDGs).
In this agenda, companies,
governments, and civil society organizations are considered equally responsible
for an advancing sustainable path (Scheyvens et al.,
2016). The transformation of companies from being drivers of inequality to
agents of development is based on the premise that (1) companies can leverage
resources and experiences more efficiently and effectively to achieve their
objectives, and (2) corporate profits and social goals can be complementary
(Van Westen et al., 2019). This latter assumption
garnered a significant attention in the 1990s and has generated substantial
evidence that businesses can indeed be socially responsible (Orlitzky et al., 2003). Based on those factors, the
question arises: How do sustainability reports drive the management of social
responsibility in the healthcare sector?
Firstly, the term 'development' gained relevance
starting from 1949 when U.S. President Harry Truman asserted the need to
promote investment in underdeveloped countries, making it a priority not only for
his nation but for other global powers and organizations as well. According to
the UN, sustainable development is a concept coined in the 1987 Brundtland
Report, which emerged from the United Nations World Commission on Environment
and Development established during the United Nations General Assembly in 1983.
Currently, there is a general consensus that "the sustainable development
that meets the needs of the present generation without compromising the ability
of future generations to meet their own needs" (World Commission on
Environment and Development WCED, 1987, p.1).
Regarding the conceptualization of sustainable
development, it builds upon the multidisciplinary theoretical approaches
developed by the UN in the area of sustainability, which in turn originated
from studies conducted by the Club of Rome within the context of the First
World Earth Summit (Meadows, D. H., Meadows, D. L., Randers, J., & Behrens,
W., 1975). At that time, the thesis of the world as a system of finite
resources was presented, which could collapse if urgent action is not taken
regarding issues such as global overpopulation, industrial production,
availability of raw materials, and environmental pollution. As mentioned
earlier, this term is first introduced in the report "Our Common
Future" or the Brundtland Report of 1987.
As stated in the previous section, sustainable
development is that which satisfies the needs of the present generation without
compromising natural resources, thereby ensuring the sustainability of future
generations without degrading the environment (WCED, 1987). This concept is
complemented by the Triple Bottom Line theory proposed by John Elkington
(2004), who first suggested that for a company to be sustainable, it must
achieve a triple objective: economic viability, socially benefit, and being
environmentally responsible, as argued by Varón et
al. (2017).
The fundamental pillars of sustainable development are
economic, social, and environmental; its purpose is to achieve harmonization
between economic growth, quality of life, and proper resource management,
ensuring the conditions for life on the planet. This development model has
raised awareness among nations, sparking a global concern to adopt measures
that can mitigate the environmental degradation, the increasing inequality, and
other global issues (Justice Mensah, 2019).
Regarding the origins of sustainable development, it
can be stated that since Charles Keeling (1928-2005) conducted the first
measurements of carbon dioxide (CO2), it initiated a global movement in favor
of the planet, although it did not receive recognition at that time. According
to Siles (2015), these measurements were carried out
from 1958 at an astronomical observatory in Hawaii, since then, the scientific
community began to delve deeper and publish more on pollution and its
consequences, primarily climate change, which was later joined by other issues
such as poverty, inequality, health, and overall improvement in quality of life
and environmental stewardship.
As a result of CO2 measurements, there has been a
growing interest among academics, scientists, and world leaders on the subject,
leading to United Nations summits to create protective measures for the
environment and to promote sustainable development (Siles,
2015). This topic has taken top priority on the UN agenda in recent decades,
resulting in the creation of various organizations, mechanisms, agreements, and
strategies that have contributed to reducing the impact of human activity on
the planet.
The First United Nations Conference on the Human
Environment took place in Stockholm in 1972 and can be considered a major
achievement as it achieved consensus among world leaders to continue meeting
every 10 years on these issues. The 1979 The World Climate Conference was held in
Geneva recognizing pollution and climate change as a global threat, and since
then, different summits and events have marked milestones in the evolution of
sustainable development over the past 50 years.
There is next a description of the different events
that have had an impact on the current conception of development and the
decisions made by governments, companies, and various organizations to move
towards a more balanced society in terms of economic, social, and environmental
sustainability. While this list of events is not exhaustive due to the large
number of activities related to the subject, they are, in the author's opinion,
the most representative facts in terms of sustainable development over the past
50 years and serve as a guide for the following analysis.
1. The Club of Rome: This non-governmental
organization was founded in 1968, and its main contribution to sustainable
development is attributed to the report "The Limits to Growth" 1972,
written by Donella Meadows and 17 collaborators. The report analyzed the risk
of a global collapse if the current economic, social, and environmental model
of growth goes on. Based on this declaration, Meadows, D. H., Meadows, D. L.,
Randers, and Behrens (1975) emphasized the urgent need to change lifestyles and
reduce human impact on the planet. These declarations had a profound impact,
particularly in Europe, leading to movements such as Political Ecology and
Environmentalism. Almost 50 years after this manifesto, authors like Fernández
(2015) recognized that the hypotheses presented have been fulfilled based on
the analysis of its critical factors.
2. First United Nations Conference on the Environment:
This event, known as the "First Earth Summit," was held in Stockholm,
Sweden, and became a starting and turning point for the creation of the
international environmental policy and progress towards sustainable
development. According to Cabrera and Fierro (2013), this summit had
significant outcomes, such as the Stockholm Declaration on the Human
Environment, which enunciates a set of principles to raise awareness among
governments. The Action Plan for the Human Environment was created with 109
recommendations, those documents were adopted by the United Nations General
Assembly through the Resolution 2994 of 1972. In this regard, Buitrago, Serna,
and Rodríguez (2018) acknowledge that a transformation is required to ensure
the survival, security, and progress of humanity through the development of
alternatives that guarantee the foundation of natural resources.
3. World Conservation Strategy (1980): The
International Union for Conservation of Nature and Natural Resources (IUCN),
founded in 1948, published the World Conservation Strategy in 1980 with support
from the United Nations Environment Programme (UNEP),
the World Wildlife Fund (WWF), the Food and Agriculture Organization of the
United Nations (FAO), and the United Nations Educational, Scientific and
Cultural Organization (UNESCO).
4. The publication of the World Charter for Nature:
This declaration corresponds to United Nations General Assembly Resolution 37/7
of 1982 and contains five principles for human and ecosystem preservation,
which can be summarized as follows: a) Nature must be respected; b) The genetic
viability of the Earth must not be compromised; c) Every part of the Earth must
have conservation principles; d) Ecosystems, organisms, and resources must be
managed to maintain an optimal sustainable productivity; e) Nature must be
protected against degradation caused by wars and hostile activities. This publication
generated a pact among different countries that have been adjusting their
legislation to recognize the rights of nature, such as Ecuador, Bolivia, the
United States, New Zealand, and Colombia. This constitutes another step towards
sustainable development (Baracaldo, M., Castellanos, N., & Trejos, I., 2018).
5. World Commission on Environment and Development:
This organization was created through United Nations General Assembly
Resolution 38/61 in 1983 to oversee the global environment. The Commission was
led by Harlem Brundtland, and its main purpose is to expand the ecological
basis of development, generating changes in attitudes, lifestyles, policies,
and forms of cooperation, strengthening the focus of governments and people
towards sustainable development. Strange and Bayley (2012, p.33) add that by
creating the Commission, the UN General Assembly explicitly emphasized two
important ideas: the well-being of the environment and the well-being of
economies and people are intricately linked, and sustainable development
implies cooperation on a global scale.
6. Vienna Convention: In response to the global
recognition of the problem caused by the hole in the ozone layer in 1987,
government representatives were summoned to this convention to create effective
mechanisms for ozone layer protection. This event concluded with the
establishment of the Convention and later the Montreal Protocol, which defined
controls on the use of substances that deplete the ozone layer and established
commitments to reduce the use of chlorofluorocarbons (CFCs) (Alaña, Capa, & Sotomayor,
2017).
7. Brundtland Report (1987): The publication of this
document, titled "Our Common Future," by the United Nations aimed to
promote sustainable development. It is considered a pivotal moment in the
evolution of this topic, as it sparked global interest among academics,
governments, and communities. Evidence of this is the presence of approximately
32,900 search results for academic documents with the term "Brundtland
Report" in both Spanish and English, and over 411,000 results in
non-academic search engines, demonstrating the increased interest on this
topic.
8. Montreal Protocol: This document was signed in 1987
as a result of the Vienna Convention (1985) with the aim of protecting the
ozone layer and achieving its complete recovery by 2050. Regarding this, Staehelin (2008) states that the results of over 50 years
of monitoring the ozone layer provided the information for the declarations,
negotiations, and modifications made to the Montreal Protocol, such as the one
in 2007. The significance of this event for understanding sustainable
development as a social phenomenon is that it constituted one of the major
commitments by governments to rethink and redirect their development by drastically
reducing the use of CFCs, halogens, and hydrochlorofluorocarbons.
9. Second Earth Summit: This event, also known as the
Rio Summit of 1992, is also crucial for understanding sustainable development
as a phenomenon of study. One of its outcomes was the publication of the
renowned report 'Beyond the Limits: Confronting Global Collapse, Envisioning a
Sustainable Future,' by Meadows, D. H., Meadows, D. L., and Randers (1992). The
report discusses how overshoot, exponential growth of population, industry, and
poverty are unsustainable in the medium-term. This document has had a tangible
impact on the political, social, economic, and academic areas, that is why it
is included in this conceptual journey. Based on the mentioned report,
Fernández (2015) states that there are two possibilities to restore global
equilibrium: the collapse or the gradual reduction of global consumption.
10. First Conference of Sustainable European Cities:
This meeting took place in the city of Aalborg in 1994, and its significance, according
to García (2004), lies in the signing of the Aalborg Charter. It was the first
commitment by municipalities to lead cities towards comprehensive sustainable
development, creating a network to share, study, and learn from the experiences
of other cities in the fulfillment of the Local Agenda 21, which is part of the
commitment made by participants in the Rio Summit (1992).
11. Second Conference of Sustainable European Cities:
This event took place in Lisbon (1996) and concluded with the signing of the
Lisbon Action Plan. The plan recognized that local authorities are the main
promoters and drivers of the Local Agenda 21 (García, 2011). The main
contribution of these conferences is that they started incorporating public
policies aligned with the sustainable development model, as well as, plans,
programs, and public projects involving the private partnership, that through a
diagnosis of the environmental, economic, and social sustainability carried out
interventions that were used as references for the implementation in other
cities, promoting the application of sustainable development principles.
12. Kyoto Protocol: This document emerged from the
Third Conference of the Parties (1997). It established a mechanism with
specific targets to reduce greenhouse gas emissions. One of the binding
commitments of the signing parties was to reduce gas emissions by 5% between
2008 and 2012 compared to 1990 levels and to achieve that Cooperation and
emissions trading strategies were created to stimulate the decrease of this
pollutant, reducing the environmental footprint (Álvarez, 2013). The Fourth
Conference was held in Buenos Aires (1998), the Fifth in Bonn (1999), and the
Sixth started on November 25, 2000, in The Hague. These conferences achieved
progress in protecting the atmosphere, a common and vulnerable resource (Anglés, 2010).
13. Publication of the Earth Charter and Declaration
of the Millennium Development Goals (MDGs): In 2000, these two events marked a
significant global advance toward sustainable development. The Earth Charter
outlines the foundations for building a more fair, sustainable, and peaceful
society based on respect and care for the community of life, social and
economic justice, democracy, and a culture of peace (Vilela
and Blaze, 2006). It represents another step towards education for sustainable
development, as documented by Hinojosa and Arenas (2012) in their presentation
of the impact of educational experiences based on the Earth Charter.
Once the deadline for the MDGs was reached in 2015, Samaniego
(2016) summarizes the results presented in Figure 2. On the other hand,
Castellanos, Ramírez, and Orozco (2016) group the 17 SDGs into aspects such as
dignity, people, prosperity, planet, justice, and partnership. The goals
encompass economic, social, and environmental dimensions. Among the most
important goals are ending poverty and hunger, reducing inequalities within and
among countries, building peaceful, fair, and inclusive societies, ensuring
sustainable and resilient protection of the planet and its natural resources
through sustainable and inclusive economic growth, a shared prosperity, and
decent work according to each nation's capacities and level of development.
The expectations derived from the SDGs correspond to
the articulation that was evident in the achievement of the MDGs, although not
fully attained, they provided a clear roadmap for global development goals and
the aspirations of the international community. Regarding implementation, in
most countries, the executive branch is responsible for implementing national
public policies, while the legislative branch oversees and controls budgetary
matters (Castellanos, Ramírez, and Orozco, 2016).
The important role of the private sector and each
individual citizen in achieving the SDGs is highlighted because they hold
significant capacity to make the transformations that the world requires to
become a better place to live in peace, prosperity, and harmony with the
environment. It is concluded in this section that the 2030 Agenda: Transforming
Our World, represents the current global vision about the meaning of
sustainable development and provides a roadmap for achieving it.
From a methodological perspective, the study corresponds to a
descriptive research with a quantitative and cross-sectional approach. It is
descriptive in a way that it builds a framework that articulates the applicable
concepts to the object of study, ordered according to the research topic, which
in this case is the Congruence Matrix presented in Table 3 (Mendoza and
Ramírez, 2020). It is quantitative because it employs a deductive, systematic,
measurable, and verifiable method (Suescúm J. M., 2019), and it is cross-sectional as this type
of study makes up a category of scholarly investigations that rely on
structured systematic observation, with a descriptive objective that refers to
a single temporal instance (Lozada et al., 2022).
The research addresses the concept of sustainability
from the perspective of business people through the application of a structured
instrument with 4 variables: Perception of the relevance and feasibility of
implementing sustainability reports, Perception of the impact generated by the
company, Perception and management of environmental impact, and Perception and
influence of indicators as presented in the Table 1.
Table 1.
Congruence Matrix
Target |
Variable |
Subvariable |
Operationalization |
|
Identify the perception of health sector
companies on the importance, relevance, impact and implementation of
strategies that allow them to contribute to the achievement of sustainable
development goals |
Perception of the relevance and
feasibility of implementing sustainability memories |
Degree
contribution |
Corporate
perception of the contribution to achieving the SDGs |
|
Voluntariness |
Contribution
to continuous improvement and sustainability |
|||
Accountability
for impact |
Extent
to which they should reduce impacts from economic activity |
|||
Opportunities
and threats |
Opportunities
or threats that may arise when implementing social balance or sustainability
memories in your company |
|||
Perception of the impact generated by
the company and its management |
Impact
recognition |
Level
of impact of economic activities on sustainable development dimensions |
||
Rating
the economic impact |
Rating
of economic impacts addressed by companies |
|||
Rating
the social impact |
Rating
of social impacts addressed by companies |
|||
Forms
of organisation |
Forms
of business organization to help mitigate the impact |
|||
Perception and management of environmental
impact |
Influence
of environmental impact |
Perception
of the influence of accountability on the environmental impact of the company
|
||
Risks
from an environmental perspective |
Risk
to companies in disclosing their contribution to sustainable development from
an environmental point of view |
|||
Environmental
impact assessment |
Rating
environmental impacts to be addressed by companies |
|||
Environmental
impact mitigation |
Mitigation
made to environmental impacts |
|||
Perception and
incidence of indicators |
Influence
on decision making |
The influence
of assessing the impacts of business activities on company decision-making |
||
Relevance
of indicators |
Need to
include an environmental, social and economic indicator in the company’s
social balance sheet |
|||
Number
of indicators |
Number of
indicators to include in the measurement of economic, environmental and
social impact |
|||
Willingness
to disclose the results |
Willingness
of health enterprises to disclose indicator results |
|||
Importance
of a measurement system |
Importance of
a system for measuring the contribution of health sector enterprises to the
environmental indicator of sustainable development |
|||
Source: own production
The study aims to identify the perception that
business people have regarding sustainability through a descriptive scope
study, so the results describe the behavior of each of the variables studied,
such as, the measurement of the healthcare sector's contribution to the SDGs,
the importance of aspects in managing compliance with basic safety standards,
the impact of healthcare sector activities on each dimension of sustainable
development, and the identification of opportunities or threats involved in
implementing social balance or sustainability reports in the surveyed companies.
To collect primary data, a semi-structured interview
with 21 questions was used as the technique, which was validated with a
Cronbach's Alpha of 0.758. The sample was defined with a confidence level of
95% for a total of 281 companies. The units of analysis were discretely
represented by 281 healthcare sector companies in the city of Ibagué. Once the surveys were conducted, the data was
analyzed and subsequently consolidated, and the results are presented in this
paper.
Table 2.
Sample selection
Type of undertakings classified by activity |
Population by subsector |
Representativeness in the sector |
Companies surveyed |
Activities of
hospitals and clinics, with hospitalization (surgical intervention centers). |
72 |
7% |
20 |
Activities of
medical practice, without admission |
307 |
30% |
83 |
Activities of
the dental practice |
219 |
21% |
59 |
Diagnostic
support activities |
168 |
16% |
46 |
Therapeutic
support activities |
118 |
11% |
32 |
Other human
health care activities |
149 |
14% |
41 |
Total companies Health sector - Ibagué |
1040 |
100% |
281 |
Sample |
281 |
Source: own production
Perception of the relevance and feasibility of
implementing sustainability reports
The results are
presented considering the 4 variables previously mentioned, related to the
perception of healthcare sector business people regarding sustainable
development and its scope within this sector. In this first section, the
relevance and feasibility of implementing sustainability reports are analyzed
from the perspective of business people based on 4 aspects: Degree of
contribution, Voluntariness, Business strategy, and Opportunities and threats
when implementing sustainability reports.
Table 3.
Operationalization of the sector’s perception of
sustainability memories
Perception
of the relevance and feasibility of implementing sustainability memories |
Degree
contribution |
Corporate perception of the degree
of contribution to achieving the SDGs |
Voluntariness |
Contribution to continuous
improvement and sustainability |
|
Accountability
for impact |
Extent to which they should reduce
impacts from economic activity |
|
Opportunities
and threats |
Opportunities or threats that may
arise when implementing social balance or sustainability memories in your
company |
Source: own
production
Firstly, it was identified
that the general focus of environmental management in hospitals corresponds to
the management of hospital solid waste, energy and water consumption, food and
medication management, among others. When questioning healthcare sector
business people about the extent to which the sector should contribute to
achieving the United Nations Sustainable Development Goals (SDGs), 33% believe
that their contribution should be high, 31% believe it should be moderate, and
36% believe it should be low. Next, they were asked about the way they perceive
the contribution to continuous improvement and sustainability should be.
Figure 1.
Contribution to
continuous improvement and sustainability
Source: own
production
When asking business people
whether the contribution of healthcare sector companies to achieving the
Sustainable Development Goals (SDGs) should be voluntary or mandatory, 30%
believe it should be mandatory with penalties for non-compliance, 25% believe
it should be voluntary with incentives for contributing companies, 20% think it
should be voluntary without incentives because it is a contribution to the
environment, 10% believe it should be mandatory without penalties until
companies adapt to the issue, and 10% did not provide any information.
Regarding the question, To
what extent do you believe healthcare sector companies should reduce the
impacts derived from their economic activities?, 20% believe that both direct
and indirect impacts should be mitigated, 25% think that the direct impact
should be mitigated and the indirect impact should be assumed by the government
through taxes, another 25% responded that only a portion of the direct impacts
should be mitigated to remain competitive, and the rest should be assumed by
the government, 10% believe that no impacts should be assumed because taxes are
paid for that purpose, 15% consider that a different approach could be taken,
and the remaining 5% either do not know or did not respond, as shown in Figure
2.
Figure 2.
Extent to which they must reduce the impacts derived
from economic activity.
Source: own production
Regarding the opportunities
or threats that may arise when implementing social balance or sustainability
reports in their companies, assuming that when the condition is met, it is
classified as an opportunity, and when it is not met, it is classified as a
threat, 41% consider it as an opportunity, 39% see it as a threat, and the
remaining 20% either do not know or did not respond. This concludes the first
part of the results related to the perception of the relevance and feasibility
of implementing sustainability reports.
Perception of the impact generated by the company and
its management
In the second section, the perception of business
people in the healthcare sector regarding the impact generated by the company
is analyzed based on four aspects: Recognition of the impact, Rating of the
economic impact, Rating of the social impact, and Organizational forms, as
presented in Table 4.
Table
4.
Operationalization
of variable Perception of impact
Perception of the impact
generated by the company and its management |
Impact recognition |
Level of impact of
economic activities on sustainable development dimensions |
Rating the economic impact |
Rating of economic impacts
addressed by companies |
|
Rating the social impact |
Rating of social impacts
addressed by companies |
|
Forms of organization |
Forms of business
organization to help mitigate the impact |
Source: own production
As an initial question, the survey researched the
knowledge of the healthcare sector about sustainable development and
sustainability reports in the healthcare sector. The results indicate a
significant lack of knowledge in the healthcare sector regarding sustainable development
and sustainability reports. 15% of the respondents claimed to have no knowledge
of the topic, while 30% indicated minimal knowledge, as shown in Figure 3.
Figure 3.
Level of knowledge of the health sector regarding the
impact of its activities
Source: own production
It is very concerning that only 15% of the
respondents indicated some knowledge about sustainable development, as this
suggests a lack of commitment and action in implementing sustainable practices
in the sector. On the other hand, it is encouraging that 35% of the respondents
claimed to have extensive knowledge, which may indicate a growing interest in
sustainable development and greater adoption of sustainable practices in the
healthcare sector. However, there is still a need to continue working on
dissemination and awareness of these topics in the healthcare industry to
achieve significant change towards sustainability. Next, the survey asked about
the impact resulting from economic activities, as presented in Figure 4.
Figure
4.
Level
of impact derived from economic activities
Source: own
production
When evaluating the level of impact derived from
economic activities in the dimensions of sustainable development, the following
findings are observed: A high positive impact is perceived in the social
dimension by 30%, in the environmental dimension by 25%, and in the economic
dimension by 20%. A medium positive impact is generated in the social dimension
by 20%, in the environmental dimension by 10%, and in the economic dimension by
5%. Additionally, 25% of the business people express that no economic impact is
generated, while 15% consider the economic impact to be low. For 30% of the
business people, the environmental impact is considered negative medium, while
for 20% the economic impact and the impact on the social dimension are also
considered negative medium. A high negative impact is considered by 10% of the
business people in both the environmental and social dimensions, and by 5% in
the economic dimension.
Figure
5.
Rating
of the economic impacts tackled by the companies
Source: own production
Companies in the healthcare sector also recognize
the positive economic impacts derived from their economic activities. 40%
highlight a high impact on economic profitability, 35% highlight a high impact
on the gross domestic product (GDP), and 25% also highlight a high impact on
the sector's economic growth and the dynamism of the economy resulting from
payments to suppliers, distributors, banks, and employees.
45% acknowledge a medium impact derived from tax
payments, 40% a medium impact on social profitability, and 30% a medium impact
derived from the purchasing power of workers' payments. As for low impact, 40%
recognize a low impact on sectoral economic growth, 35% on contribution to GDP,
25% on economic profitability, and the increase in workers' purchasing power.
However, 35% of the business people believe that there are no impacts generated
in terms of tax contributions and the increase in workers' purchasing power. 30%
think that there is no impact generated in social profitability and the
dynamism of the economy through payments made by companies to their internal
and external stakeholders. 20% believe that there is no impact economic growth
in the sector and contribution to GDP. 15% believe that there is no impact on
economic profitability.
Figure
6.
Rating
of the social impacts addressed by the companies
Source: own production
Apropos the social impacts derived from economic
activity, 50% of business people consider that there is a high impact on labor
formality, 45% believe that there is a high impact on social investment, labor
inclusion, and occupational diseases. 40% believe that there is a high impact
on the protection of users of products or services, workplace accidents. 35%
consider a high impact on salaries of low-level employees, labor informality,
and employment growth, and 30% consider a high impact on labor stability.
About medium impact, 35% consider it in relation to
salaries of low-level employees, 30% consider it in occupational diseases, and
25% consider it in labor inclusion and labor stability. The low impact is
identified by business people as 35% in workplace accidents, informality, and
labor formality, 25% in labor inclusion, employment growth, and compliance with
human rights, and 20% in the protection of users of the product or service.
Regarding quality management and the question of
how the healthcare sector should be organized to contribute to the fulfillment
of internal quality policies, 35% believe that each company contributes
independently, 15% of business people believe that a strategic plan should be
designed for the sector led by the Chamber of Commerce or Economic Guild,
another 15% think that a strategic plan led by the public sector (city hall or
state hall) should be designed, another 15% believe that strategic allies
should be involved to contribute to the fulfillment of the quality policy, 10%
consider other ways, and another 10% do not report information.
Perception
and Management of Environmental Impact
In this third section of results, the perception of
business people regarding risk management and environmental impact is analyzed
through 4 questions related to the influence of environmental impact, risks
from an environmental perspective, environmental impact assessment, and
mitigation of environmental impact, as presented in Table 5.
Table
5.
Management
perception operationalization
Perception and management
of environmental impact |
Influence of environmental impact |
Perception of
the influence of accountability on the environmental impact of the company |
Risks from an
environmental perspective |
Risk to
companies in disclosing their contribution to sustainable development from an
environmental point of view |
|
Environmental impact assessment |
Rating
environmental impacts to be addressed by companies |
|
Environmental impact mitigation |
Mitigation
made to environmental impacts |
Source: own production
Regarding the question about the perception of the
influence of accountability on the environmental impact of the company, 25% of
business people believe it has a high positive impact, 20% consider it has a
low positive impact, another 20% believe it has no significant impact, 15%
think it has a high negative impact, 10% consider it has a low negative impact,
and another 10% provide other kinds of responses, as shown in Figure 7.
Figure
7.
Perception
of accountability for environmental impact
Source: own production
Regarding the question of what could be the greatest
risk that revealing their contribution to sustainable development from an
environmental point of view would pose to companies, 20% believe the impact
would be unfavorable. In the economic sphere, 5% state that the impact results
would be unfavorable, and in the social sphere, 30% responded that the result
would be unfavorable, as observed in Figure 8.
Figure
8.
Risk
to reveal the contribution of sustainable development, environmental
perspective
Source: own production
Furthermore, it is observed that 15% of respondents
consider revealing sustainability information as administrative burden, 10%
responded that they do not have an appropriate method to do so, 5% believe the
company could be harmed, 10% responded that they see no benefits in it, and 5%
stated other issues. Subsequently, the assessment of environmental impacts was
asked as presented below.
Figure
9.
Classification
of environmental impacts to be addressed by companies
Source: own production
When analyzing the responses of business people
have regarding the environmental impacts that companies must address, a high
impact is observed in most of the variables queried, especially in water
consumption at 50%, generation of debris and industrial waste at 45%,
generation of odors at 40%, water pollution at 35%, generation of solid waste
at 30%, and liquid discharge at another 30%. Medium impact is identified in air
pollution at 55%, generation of noise, generation of odors, generation of solid
waste, and energy consumption, each at 35%. Low impact is identified in water
pollution at 50%, liquid discharge at 45%, generation of noise, water
consumption, and energy consumption, each at 40%. Finally, questions were asked
about the mitigation of these impacts.
The results allow to demonstrate the interest and
commitment of healthcare sector companies have to mitigate the environmental
impacts derived from their economic activity, especially in the three analyzed
variables. Regarding high impact, 45% of companies have mitigated impacts through
the use of environmentally friendly materials, 30% have achieved a medium
impact, and 25% have achieved a low impact. 35% of companies have achieved a
high impact through environmental impact mitigation activities, 15% have
achieved a medium impact, and 50% still generate a low impact. As for the reuse
of materials and solid waste, 30% have a high impact, 40% have a medium impact,
and 30% have a low impact.
Perception
and Impact of Sustainability Indicators
In this final section, the impact of sustainability
indicators from the perspective of healthcare sector companies is analyzed.
Questions were asked about their influence on decision-making, the relevance of
implementing indicators, the number of indicators, willingness to disclose
results, and the importance of a measurement system.
Table
6.
Perception
and incidence of indicators
Influence on decision making |
The influence of assessing the impacts of business activities on
company decision-making |
|
Relevance of implementing indicators |
Need to include an environmental, social and economic indicator in the
company’s social balance sheet |
|
Number of indicators |
Number of indicators to include in the measurement of economic,
environmental and social impact |
|
Willingness to disclose the results |
Willingness of health enterprises to disclose indicator results |
|
Importance of a measurement system |
Emphasis on the implementation of a system to measure the contribution
of health sector enterprises to the environmental indicator of sustainable
development |
Source: own production
Regarding the question of whether evaluating the
impacts of business activities influences the company's decision-making, 35%
consider it has a high influence, 10% state it has a moderate influence, 5%
believe it has a low influence, 30% consider it has no influence, 15% responded
with "don't know/no answer," and 5% did not respond according to the
question. In relation to the question of whether it is necessary to include
environmental, social, and economic indicators when conducting a social
balance, 25% consider it is very necessary, 10% consider it is partially
necessary, 30% consider it somewhat necessary, 10% consider it is unnecessary,
and 15% believe it is not necessary to conduct a social balance.
Figure
10.
Need
to include indicators in the social balance
Source:
own production
Regarding the question of how many indicators
should be incorporated into a system for measuring social, economic, and
environmental impact, 40% of business people believe that there should be fewer
than 10 indicators, 30% believe it should be between 11 and 20 indicators, 25%
believe it should be between 21 and 30 indicators, and 5% responded with
"don't know/no answer." Regarding the question of how willing
healthcare sector companies are to disclose the results of their environmental,
social, and economic indicators, 20% state they are completely willing, 30%
believe they are partially willing, 25% responded that they are somehow
willing, 20% do not believe they are willing, and 5% responded with "don't
know/no answer."
Regarding the question of how important the
implementation of a system to measure the contribution of healthcare sector
companies to the environmental indicator is, 30% consider it is very important,
10% believe it is important, 20% responded that it is somehow important, 30%
consider it is not important, and 10% responded with "don't know/no
answer," as shown in following figure.
Figure
11.
Importance
of implementing a measurement system
Source:
own production
The results show that a significant portion of
respondents consider the implementation of a measurement system for the
environmental contribution of healthcare sector companies to be important or
very important. However, a significant percentage of respondents consider it is
not important or somewhat important. This lack of importance may be due to a
lack of understanding about the relationship between business practices and
environmental impact. It is necessary to emphasize in education and awareness
about the importance of measuring the environmental contribution of companies
and how this can help to improve the sustainability of the healthcare sector.
5. DISCUSSION
AND CONCLUSIONS
Healthcare
companies, especially hospitals and health centers, are complex facilities that
consume a significant amount of energy resources for their operation and
generate different types of waste based on patient care, which has various
effects on the environment. These entities could be generators of positive
environmental impact if they strategically manage environmental risks, evaluate
ecological risks, and assess the real impacts caused by point or diffuse
sources of pollutants.
It
is significant that a percentage of companies not only recognize the impacts
derived from their economic activities but also take steps to mitigate some of
the generated impacts. However, some business people in the sector are not
aware yet of the importance of contributing to the achievement of sustainable
development goals through their corporate social responsibility. Around 45% of
business people consider that their activities have a positive impact on the
dimensions of sustainable
development,
40% believe the impact is negative, and 15% consider that they have no impact.
About
50% of business people believe that a project for the management of solid waste
should be included in the company's strategic plan. 64% of business people are
concerned about the contribution they should make to the achievement of
sustainable development goals. Regarding the obligation to contribute to
improving environmental processes, 30% recognize this obligation with penalties
for non-compliance, 25% see it as voluntary but expect incentives, and 20% see
it as voluntary without incentives as they consider it a contribution to the
environment. In terms of organizing for greater contributions to sustainable
development, 35% believe each company should do it independently, 15% think it
should be done with allies, another 15% with the support of government
entities, and another 15% with the support of private entities such as economic
associations.
Analyzing
the risks that may arise from the activities of healthcare companies and
implementing a management system consistent with the contribution to achieving
the SDGs, especially in the environmental aspect by focusing on minimizing,
controlling, and mitigating all environmental impacts in their surroundings,
making it binding to their strategic and quality management plans in service
provision would be a good starting point for creating a culture of
sustainability and adopting daily conscious actions that improve the
organization's reputation, this can lead to other benefits in various areas,
including environmental, economic, and social aspects, while achieving desired
standards of quality and competitiveness. However, this requires a significant
effort in training processes to foster a culture of disclosing sustainability
information through sustainability reports and promoting a culture of
sustainability in the sector. This not only benefits the population health but
also the well-being of employees (Hernández et al., 2022).
It
is very interesting to see that while there is still a need to deepen and
expand the coverage of companies willing to engage in sustainability processes,
there is also a significant number of them already working on mitigating some
impacts and are willing to walk on the path of producing sustainability reports
and sharing them with their stakeholders. This will be beneficial for the
companies themselves, as well as their internal and external stakeholders,
society as a whole, and the conservation of the planet and its ecosystems. It
is crucial in the face of constant threats such as climate change and other
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[1] Doctor en Ciencias Económicas y Administrativas,
(Universidad para la Cooperación Internacional UCI), México, Universidad
del Tolima, (Colombia), abuitragom@ut.edu.co
[2] Doctor en Administración Gerencial, Universidad Benito
Juárez García (México), Universidad Cooperativa de
Colombia, Colombia, mario.rodriguezb@campusucc.edu.co
[3] Doctor en
Ciencias Económicas y Administrativas, (Universidad para la Cooperación
Internacional UCI), México, Universidad Cooperativa de Colombia, Colombia, patricia.izquierdo@ucc.edu.co