Toward Sustainable Healthcare: Examining ESG ‐Readiness in Austrian Regional State‐Owned Hospitals

ABSTRACT Reporting on environmental, social, and governance (ESG) issues is now an essential part of responsible corporate governance, including in the healthcare sector. This study investigates the ESG reporting practices of Austrian regional state‐owned hospitals (rSOHs), contributing to the growing sustainability literature. Thirteen interviews with representatives from 10 rSOHs, along with an analysis of reports and websites, reveal that most rSOHs are at an early stage of structured ESG reporting. Significant effort is needed to meet the standards of the Corporate Sustainability Reporting Directive (CSRD) and the European Sustainability Reporting Standards. While management commitment and employee engagement are key drivers, legal pressure and societal expectations further promote transparency. However, limited resources, administrative burdens, and the risk of superficial compliance hinder progress. Current efforts focus heavily on social issues, often neglecting governance and environmental issues. This study is among the first to assess ESG reporting in Austrian rSOHs under the CSRD, offering theoretical insights and proposing a practical ESG transformation framework for healthcare institutions.