Managing healthcare service ecosystems: Abstracting a sustainability-based view from hospitalization at home (HaH) practices

Sustainability seems to be a hot topic today upon which a paradigmatic transformation is going on; this affects many fields and sectors by revealing the significant implications for actors' participation, such as in healthcare. Today, healthcare calls for renewing and increasing its own main processes of hospitalization, as inspired by the current new light of sustainability; hospitalization at home (HaH) practices allow for new forms of hospitalizations, which are much more adherent to the real needs of patients and caregivers. Studies in service dominant logic (S-D logic) on service ecosystems help us in understanding which are the dynamics that are shaping actual conditions in healthcare. With the aim of contributing to the challenging debate about the role of "sustainability for healthcare", this manuscript proposes a conceptual framework for investigating healthcare domains through the interpretative lens provided by the service ecosystems view. Previous managerial contributions are analyzed in an attempt to emphasize the contact points between studies about service ecosystem and sustainability so as to outline the possible roadmaps for sustainability in the healthcare domain. The three dimensions of HaH-efficiency of healthcare service, effectiveness in resource usage, and patients' satisfaction-have been identified as possible levers on which promoting healthcare processes inspired by sustainability principles and their relations with the three pillars of sustainability science-the economy, society, and environment-have been analyzed. The reflections herein are finally discussed for proposing possible future directions for research interested in promoting a sustainability-based healthcare management.