Corporate social responsibility and financial profile of Spanish private hospitals.

In the context of the recent economic crisis, the financial situation of the Spanish health sector has become a major concern for responsible actors from the public and private spheres, because of a decline in public spending and increased demand due to population growth and ageing. The public health system seeks collaborative synergies with the private health system to achieve better health care results, cut waiting lists and cope with financial pressure. The private health sector currently owns 452 hospitals in Spain (57% of the country's total). This paper analyses the financial statements of hospital companies in the Spanish private healthcare system, using compositional data (CoDa) methodology. It identifies a significant relationship between financial statement structure and corporate social responsibility (CSR). Relevant CSR indicators include a sustainability report according to the Global Reporting Initiative (GRI), accreditation by the Joint Commission International (JCI) and ISO 14001, 50001 and 26000 accreditations. These indicators reduce asset turnover and increase debt quality: the proportion of long-term debt within total liability. From a methodological perspective, the paper proposes the first application CoDa in statistical models to predict financial statements from non-financial variables, and the first use of CoDa in partial-least-squares structural equation models (PLS-SEM). Our methodological approach reduces the asymmetry, redundancy and outliers encountered in standard statistical models that predict financial ratios.