On the feasibility of integrated reporting in healthcare: a context analysis starting from a management commentary

The paper aims at investigating mechanisms that affect the possible development of integrated reporting (IR) practices in the healthcare sector. Through a performative case study in a university hospital, this paper discusses the process of production, construction, and consumption of a management commentary, which is a report combining financial and non-financial information about organizational performance; a management commentary can be considered the natural setting to develop IR. Findings from interviews with both the report’s preparers and institutional users show that the management commentary mainly addresses normative requirements, which results in a heavy document stemming from the preparers’ silo mentality, with very limited usefulness for its users. Interviews with users provided insights about the material non-financial information that would have added value to their decision making if addressed within the hospital’s reporting practices. Users reported that the management commentary could be meaningful if it arose from a shared planning process emphasizing the connectivity of the university hospital’s activities with the local stakeholders’ activities. This latter assertion, however, is not shared by the organization’s top management. Although the implementation of an IR framework is recommended in the literature, even in the context of the public sector, it emerges that the features of an organization can challenge its applicability.