Involving stakeholders in university hospital performance reporting: The state of the art in Italy

University hospitals (UHs) need to pay attention to diverse stakeholders’ interests when reporting their performance information, to meet different knowledge expectations concerning the activities they have performed and the outcomes they have achieved. In the existing literature, the level of consideration of UH performance reports reserve for a broad variety of stakeholders interested in UH outcomes, each with different information needs, has not been analyzed. To contribute to fill this gap, this study offers an empirical examination of the Italian experience by investigating whether and to what extent all the thirty-two public university hospital authorities (UHAs) involve stakeholders in their annual performance reports (APRs). First, sixteen key stakeholder groups with an interest in the performance reporting of UHAs were mapped, and the related accountability relationships were described. Subsequently, the APRs for 2017 were examined by employing the content analysis method and common descriptive statistics. Findings reveal that only one UHA involved all sixteen stakeholder groups in its performance report; sixteen UHAs involved at least ten stakeholder groups; and the remainder showed a weak, scarce or even absent involvement for stakeholders. Moreover, it emerged that three stakeholder groups were singled out for greater attention in UHA performance reports (patients, managers and regional government) over others. Involving stakeholders in performance reports needs to be encouraged, as it is an essential prerequisite for developing suitable integrated performance reporting systems.