Developing key ESG performance indicators for sustainable healthcare institutions: a modified Delphi study in South Korea

Purpose Healthcare institutions are increasingly focusing on environmental, social, and governance (ESG) management, yet systematic performance indicators remain underdeveloped. This study develops and validates ESG performance indicators tailored to healthcare institutions in South Korea using a systematic expert consensus methodology. Design/methodology/approach The process involved two phases. First, 45 preliminary ESG indicators applicable to healthcare institutions were identified through a review of ESG frameworks, healthcare sustainability reports, prior studies, and expert interviews. Second, a two-round modified Delphi survey with healthcare practitioners and academic experts was conducted to assess indicator suitability. Findings A total of 44 ESG performance indicators were established, covering environmental (15 indicators), social (16 indicators), and governance (13 indicators) domains. These indicators reflect the public-interest, non-profit, and patient-centered characteristics of healthcare institutions, thereby addressing the limitations of corporate-centric ESG frameworks. Originality/value This study is among the first to develop and validate ESG performance indicators tailored to healthcare institutions in South Korea. By adapting corporate-centric ESG frameworks to the public-interest, non-profit, and patient-centered characteristics of healthcare, it contributes to ESG performance measurement research and offers practical guidance for healthcare ESG management.