On the feasibility of integrated reporting in healthcare. A context analysis starting from the 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, this paper discusses the process of production, construction, and consumption of the management commentary, which is a report combining financial and non-financial information about organizational performance, so that it can be considered as 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, and results in a heavy document steaming from preparers' silos-thinking approach, with scarce 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 players. This latter assertion, however, is not shared by the organization’s top management. Whether the implementation of IR framework is recommended by literature, even in the public sector context, it emerges the features of the organization can challenge its applicability.