Green Accounting Implementation in the Healthcare Sector: A Tri Hita Karana Perspective

DOI

10.2991/978-94-6239-809-2_22How to use a DOI?

Keywords

Environmental Costs; Green Accounting; Medical Sector; Sustainability; Tri Hita Karana

Abstract

Sustainability issues in healthcare facilities have become increasingly urgent alongside growing attention to environmental, social, and governance (ESG) practices. Health clinics not only produce medical impacts but also generate environmental consequences through medical waste management, energy consumption, and disposable material usage, while the resulting environmental costs are frequently embedded in general operational expenses without adequate classification. This study aims to analyse the application of green accounting at Asta Medical Clinic using the Tri Hita Karana philosophy as an evaluation framework rooted in Balinese local wisdom. A descriptive qualitative approach with a case study method was employed through semi-structured interviews, direct observation, and documentation analysis. The analysis encompasses the identification, recognition, measurement, presentation, and disclosure of environmental costs, evaluated through three dimensions of Tri Hita Karana such as parahyangan (organizational ethics and spirituality), palemahan (environmental management), and pawongan (social responsibility). The findings reveal that the clinic has implemented green accounting, although environmental costs remain undifferentiated within general operational expenses without specific classification. The Tri Hita Karana values have been applied in the clinic operations, reflected in the parahyangan dimension through the organization’s moral and ethical commitment in healthcare services, the palemahan dimension through medical waste management practices and resource efficiency, and the pawongan dimension through social responsibility toward healthcare workers, patients, and the surrounding community. Key barriers identified include the absence of a structured environmental cost recording system and the lack of explicit internal policies that separately classify environmental costs.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Ni Kadek Cahya Dwi Utami
AU  - Made Andy Pradana Sukarta
AU  - Ida Bagus Gede Dananjaya
AU  - Ni Wayan Lady Andini
AU  - I Gede Nata Mintara
PY  - 2026
DA  - 2026/10/24
TI  - Green Accounting Implementation in the Healthcare Sector: A Tri Hita Karana Perspective
BT  - Proceedings of the International Conference on Sustainable Green Tourism Applied Science - Social Applied Science 2026 (ICoSTAS-SAS 2026)
PB  - Atlantis Press
SP  - 216
EP  - 226
SN  - 2352-5398
UR  - https://doi.org/10.2991/978-94-6239-809-2_22
DO  - 10.2991/978-94-6239-809-2_22
ID  - Utami2026
ER  -