Sustainable Governance in Public Healthcare Infrastructure: An Integrated Technical–Financial Control Approach.

Public healthcare infrastructure projects require management approaches that ensure efficiency, transparency, and the sustainable use of public resources.While construction estimate preparation and cost control are traditionally considered administrative or technical procedures, their role in sustainable governance of infrastructure projects remains underexplored.This study analyzes how an integrated methodology for construction estimate preparation and control contributes to sustainable management practices in public hospital infrastructure.Adopting an applied qualitative case-study approach grounded in a socio-technical systems perspective, the research examines the implementation of technical-financial monitoring processes implemented within a real-world institutional context within hospital construction projects commissioned by the Mexican Social Security Institute (IMSS).The methodology integrates digital tools, standardized documentation, and field supervision activities to connect planning, execution, and financial monitoring stages.Results indicate that the integrated approach improves operational coordination, enhances digital traceability, and strengthens transparency in financial management.The systematic alignment between technical documentation and field verification reduced operational inconsistencies and supported evidence-based decision-making processes.Beyond efficiency improvements, the methodology served as a governance mechanism, reinforcing accountability and responsible resource allocation.The study contributes to the sustainable infrastructure management literature by reframing construction estimate control as a socio-technical instrument that supports institutional sustainability in public investment projects.Findings highlight that ope-rational management practices can generate social value by improving transparency and efficiency in the delivery of healthcare infrastructure.The proposed framework offers practical implications for public institutions seeking to strengthen sustainable governance mechanisms in construction management.