Antecedents and outcomes of health equity orientation in US hospitals: a publicness perspective

Purpose Recent commentary in public administration has called for a renewed focus on the equity aspect of publicness, which remains theoretical and qualitative, and calls for more empirical testing. Integrating these two related areas in the literature, this study seeks to identify mechanisms through which publicness dimensions (regulative, normative and cultural publicness) affect organizations' public value outcomes. Design/methodology/approach Using data from the 2022 and 2023 American Hospital Association (AHA) surveys, we use Moulton's (2009) realized publicness framework and investigate how all three dimensions are positively associated with hospitals' strategies to promote health equity. Furthermore, we examine the effect of a higher health equity orientation on realized public value outcomes in terms of cost, quality and access to care. Findings We found partial significance, with all three aspects of publicness associated with the equity orientation of the hospitals. Further, we found that hospitals' equity orientation was associated with the quality of care provided by the hospitals. Originality/value This is one of the few papers to explore both antecedents and consequences of health equity orientation in US hospitals.