Abstract
The healthcare sector faces a dual challenge: ensuring access to high-quality and innovation-driven care while reducing environmental and social externalities. Current approaches often rely on broad labels such as “green healthcare” without providing structured systems for measuring sustainability performance. This Thesis addresses this gap by developing and validating two multidimensional frameworks for environmental (Paper I) and social (Paper II) sustainability, through scoping reviews and formal consensus techniques. Then, two different empirical case studies further explore how healthcare manufacturers adopt circular economy principles in new product development (Paper III) and how hospitals integrate sustainability under institutional pressures and resource constraints (Paper IV). Findings emphasize the need for performance indicators and structured governance mechanism to enhance the long-term sustainability of the system.