Determinants of ESG Implementation and Social Sustainability Practices in Taiwanese Hospitals: A Mixed Methods Study

Background: Healthcare institutions increasingly face sustainability challenges associated with environmental governance, operational efficiency, digital transformation, and social responsibility in the post-pandemic era. However, limited studies have comprehensively examined the organizational factors influencing ESG implementation and healthcare social sustainability practices among hospitals. Objective: This study aimed to investigate the organizational determinants of ESG implementation and healthcare social sustainability practices among Taiwanese hospitals and to explore how healthcare professionals and hospital administrators perceive sustainability implementation within post-pandemic healthcare environments. Methods: A convergent mixed methods design integrating quantitative surveys and qualitative interviews was employed. Exploratory factor analysis (EFA), correlation analysis, and multiple regression analysis were performed, and qualitative data were analyzed using thematic analysis. Results: A total of 135 valid questionnaires were analyzed, and qualitative data were obtained from three semi-structured interviews. ESG sustainability support demonstrated the strongest positive influence on healthcare social sustainability practices (β = 0.481, p < 0.001), followed by operational sustainability (β = 0.276, p < 0.01) and sustainability management capability (β = 0.214, p < 0.05). Organizational resource pressure did not significantly influence healthcare social sustainability practices. The qualitative findings converged with and expanded upon the quantitative results by highlighting the importance of leadership support, digital healthcare transformation, operational coordination, and community health promotion in facilitating ESG implementation and long-term healthcare sustainability. Conclusions: The integrated findings suggest that healthcare ESG implementation increasingly functions as a comprehensive sustainability governance strategy involving operational sustainability, digital healthcare transformation, healthcare accessibility, and social responsibility practices within post-pandemic healthcare environments. Strengthening sustainability support systems, governance capability, and operational resilience may facilitate long-term healthcare social sustainability implementation.