The research aims to describe the foundation of healthcare organizations’ past and present sustainability endeavors; describe the direction of a health-care organizations’ sustainable development; reveal and characterize what determines the foundation and direction in a public health-care sector; and provide some insights into social marketing for sustainability endeavors.,Based on a semi-inductive approach, judgmental sampling was applied to select relevant health-care organizations. Informants were identified according to their knowledge of their organizations’ sustainability initiatives.,Offer insights into the foundation of sustainability endeavors and the direction of sustainable development for upstream social marketing in the studied public sector. The social marketing perspective is a common factor of relevance for the studied public hospitals.,The foundations of sustainability endeavors undertaken across the studied health-care organizations have not so far been homogenous. The direction of sustainable development has also varied across the studied public healthcare organizations and there is a need to move beyond individuals and shift from a micro to a macro/structural environment of sustainable development, so as to observe the effectiveness of any social marketing intervention.,This study highlights the importance of applying an upstream social marketing approach and programs, as part of a social marketing strategy, to promote and stimulate sustainable change in health-care organizations.,Contrary to the common sense predominating in many societies nowadays regarding sustainability endeavors and sustainable development, we conclude that neither the foundation of such endeavors nor the direction of sustainable development has progressed adequately in the studied public healthcare sector. As social marketing is intended to benefit society and foster social change, the macro level of intervention of the upstream approach clearly reveals its usefulness in the public health area.,Reveals two axes based on a social marketing approach. One is of micro and macro determinants characterizing the direction of sustainable development in a public sector. Another is of homogeneous and heterogeneous foundations of sustainability endeavors.

中文翻译：

---

西班牙公立医院的可持续发展与可持续发展

该研究旨在描述医疗机构过去和现在的可持续发展努力的基础。描述卫生保健组织可持续发展的方向；揭示和描述决定公共卫生部门基础和方向的因素；并基于可持续发展的目的为社会营销提供一些见识。基于半归纳法，将判断性抽样应用于选择相关的医疗保健组织。根据对组织的可持续性举措的了解确定了信息提供者。为研究的公共部门提供了有关可持续性努力基础和可持续发展方向的见解，以进行上游社会营销。社会营销的观点是与所研究的公立医院相关的一个共同因素。迄今为止，跨所研究的医疗保健组织开展的可持续性努力的基础尚未统一。在所研究的公共卫生组织中，可持续发展的方向也各不相同，有必要超越个人，从微观到可持续发展的宏观/结构环境转变，以观察任何社会营销干预措施的有效性。 ，这项研究强调了应用上游社会营销方法和计划作为社会营销策略的一部分，对于促进和刺激医疗保健组织的可持续变革的重要性。与当今许多社会关于可持续性努力和可持续发展的常识相反，我们得出的结论是，在研究的公共医疗保健部门中，此类努力的基础和可持续发展的方向都没有得到充分的发展。由于社会营销旨在使社会受益并促进社会变革，因此上游方法的宏观干预水平清楚地揭示了其在公共卫生领域的有用性。揭示了基于社会营销方法的两个轴心。第一个是微观和宏观决定因素，这些因素决定了公共部门可持续发展的方向。另一个是可持续性努力的同质和异质基础。我们得出的结论是，在公共卫生研究领域，这种努力的基础和可持续发展的方向都没有得到充分的发展。由于社会营销旨在使社会受益并促进社会变革，因此上游方法的宏观干预水平清楚地揭示了其在公共卫生领域的有用性。揭示了基于社会营销方法的两个轴心。第一个是微观和宏观决定因素，这些因素决定了公共部门可持续发展的方向。另一个是可持续性努力的同质和异质基础。我们得出的结论是，在公共卫生研究领域，这种努力的基础和可持续发展的方向都没有得到充分的发展。由于社会营销旨在使社会受益并促进社会变革，因此上游方法的宏观干预水平清楚地揭示了其在公共卫生领域的有用性。揭示了基于社会营销方法的两个轴心。第一个是微观和宏观决定因素，这些因素决定了公共部门可持续发展的方向。另一个是可持续性努力的同质和异质基础。上游方法的宏观干预水平清楚地表明了其在公共卫生领域的有用性。，揭示了基于社会营销方法的两个方面。第一个是微观和宏观决定因素，这些因素决定了公共部门可持续发展的方向。另一个是可持续性努力的同质和异质基础。上游方法的宏观干预水平清楚地表明了其在公共卫生领域的有用性。，揭示了基于社会营销方法的两个方面。第一个是微观和宏观决定因素，这些因素决定了公共部门可持续发展的方向。另一个是可持续性努力的同质和异质基础。