Health Policy Commons^™

Building Health Resilience Against The Threat Of “Jakarta Sinking”: A Scoping Review, Risky Kusuma Hartono, Dewi Shinta

Journal of Indonesian Health Policy and Administration

In Jakarta, land subsidence amplifies flood risks—often described as the city “sinking”—which increases exposure to waterborne and vector-borne diseases, disrupts essential health services, and undermines health system resilience. This review examines how subsidence-induced flood amplification impacts health and its implications for system resilience. This study employs a literature review approach that combines narrative synthesis with scoping-oriented evidence mapping. Peer-reviewed articles in English or Indonesian (2015–2025) were searched across PubMed, Scopus, ScienceDirect, Google Scholar, and Portal Garuda using the following terms: flooding, Jakarta land subsidence, health impacts, and health system resilience. Data on hazards, populations, health outcomes, and resilience functions were …

Evaluation Of Disaster Mitigation Policy Implementation And Public Health Integration Through The “Sipatokkong” Program In Strengthening Tourism Village Resilience, Nurul Azisah Sahrani, Andi Alif Raihan Analta

Journal of Indonesian Health Policy and Administration

Disaster risks in tourism villages are increasing, generating multidimensional impacts on environmental, economic, institutional, and public health. In late 2024, Mattabulu Tourism Village experienced an 83% decline in tourist visits following a series of disasters, disrupting tourism activities and weakening local governance capacity. This study uses a qualitative case study design to evaluate disaster mitigation policy implementation through the “Sipatokkong” Program. Evaluation applied four Organisation for Economic Co-operation and Development–Development Assistance Committee (OECD-DAC) criteria: relevance, effectiveness, impact, and sustainability, operationalized through policy implementation, street-level bureaucracy, and collaborative governance frameworks. Data were obtained from five documents and non-participatory field observations conducted …

Perceived Susceptibility And Automatic Compliance In Indonesia's Triple Elimination Screening: A Mixed-Methods Study, Ratna Dewi Puspita Sari, Josef Maria Seno Adjie

Journal of Indonesian Health Policy and Administration

Despite global commitments to eliminating mother-to-child transmission of human immunodeficiency virus, syphilis, and hepatitis B, gaps remain in understanding the behavioral and systemic drivers of screening coverage in decentralized health systems such as Indonesia. This study aimed to analyze individual behavioral determinants and structural health system barriers affecting triple elimination screening coverage among pregnant women, focusing on perceived susceptibility and automatic compliance. A mixed-methods sequential explanatory study was conducted in Central Jakarta, Surabaya, and Karawang. The quantitative phase involved a cross-sectional survey of 1,224 pregnant women, with Health Belief Model variables analyzed using logistic regression. The qualitative phase comprised three …

Why Do Indonesians Travel Abroad For Medical Treatment? A Qualitative Phenomenological Study, Lucky Sarjono Buranda, Aries Wahyuningsih, Steven Busby

Journal of Indonesian Health Policy and Administration

More than one million Indonesian citizens travel abroad for medical treatment each year, generating financial transactions exceeding IDR 180 trillion (USD 11.5 billion). This study aimed to explore the reasons why Indonesians seek medical treatment overseas. A qualitative phenomenological approach was employed using in-depth interviews with Indonesian citizens who had received or were currently receiving medical treatment outside Indonesia. All interviews were recorded, transcribed, and analyzed through coding to identify themes, subthemes, and related properties. Interviews were conducted with 18 participants from three major Indonesian cities (Makassar, Surabaya, and Batam), as well as individuals receiving treatment in Singapore and Malaysia. …

Cost Analysis Of Rheumatoid Arthritis In Insured Patients And Its Determinant Factors: Data From A National Referral Hospital In Indonesia, Rudy Hidayat, Fara Fauzia, Mochammad Alfansyah Dhifanra, Aries Maulana

Kesmas

Rheumatoid arthritis (RA) leads to progressive functional impairment and considerable economic burden. This study estimated the annual (12-month) cost per patient among patients with RA and its determinant factors. A descriptive cross-sectional economic study of RA patients who had been treated for at least one year at the outpatient clinic of a national referral hospital in Jakarta, Indonesia, and met the 2010 ACR–EULAR criteria. Data collected from January 2023 to December 2024 were obtained from medical and billing records for demographic characteristics, direct medical costs, and DAS28-based disease activity, whereas non-medical and indirect costs were collected through structured patient interviews. …

Environmental Perspective For System Dynamics Modeling Of Stunting Mitigation To Achieve The Sustainable Development Goals In West Sumatra, Indonesia, Elsa Yuniarti, Nabila Azzahra, Yulhendri Yulhendri, Heldi Heldi, Mery Delvina, Saskia Putri Azeli

Kesmas

This study developed a system dynamics model to simulate stunting reduction in West Sumatra Province, Indonesia, by integrating infant and toddler health, maternal health, and environmental determinants. Secondary data from 2020–2024 on low birth weight, immunization, malnutrition, exclusive breastfeeding, maternal chronic energy deficiency, iron and folic acid supplement distribution, sanitation, and safe drinking water access were compiled from West Sumatra Provincial Health Office and Statistics Indonesia, and validated through consultation with five stakeholder institutions. Causal Loop Diagrams mapped feedback relationships among determinants and were translated into Stock Flow Diagrams using Powersim Studio 10. The model was validated through structural verification, …

Accessibility And Daily Cigarette Consumption Among Indonesian Adolescents: A Descriptive Study, Noviana Lathifah, Istiqomah Hanifah Rachman, Anisa Isnaini, Gloria Threesia Piliphinsa Simatupang

Journal of Indonesian Health Policy and Administration

Despite restrictive regulations, Indonesia faces a high prevalence of adolescent smoking, facilitated by easy access to tobacco products. This descriptive study aims to describe cigarette accessibility patterns and daily consumption trends among Indonesian adolescents. A cross-sectional study was conducted using secondary data from the 2019 Global Youth Tobacco Survey (GYTS) involving 9,208 respondents. Descriptive analysis was performed to examine the distribution of age at smoking initiation, daily cigarette consumption, and purchasing accessibility. The majority of respondents started smoking at ≥14 years of age. Daily cigarette consumption showed an increasing trend with age, with older adolescents more likely to consume more …

Deadline-Chasing In Digital Health: Forecasting Emr Adoption Dynamics And Regulatory Impact In Indonesian Primary Care, Suryo Satrio, Bukhori Muhammad Aqid

Journal of Indonesian Health Policy and Administration

Indonesia is accelerating digital health adoption under Minister of Health Regulation No. 24/2022, which mandates the use and integration of Electronic Medical Records (EMRs) with SATUSEHAT. However, evidence on how quickly primary health care facilities (Fasilitas Kesehatan Tingkat Pertama – FKTP) are adopting EMRs and what the adoption curve looks like remains limited. Survey findings also suggest key barriers and enablers, including security and data migration concerns, as well as human resource and infrastructure constraints. This observational study used provider-network data from a single EMR vendor. Key measures included cumulative registered facilities, monthly registrations, same-month activation (total_active/monthly inflow) as …

Factors Associated With The Performance Of Essential Public Health Efforts At Primary Health Centers In Jember Regency, Griselda Ardelia Hibatullah, Nuryadi Nuryadi, Yennike Tri Herawati

Journal of Indonesian Health Policy and Administration

Performance assessment of primary health centers is essential to ensure the quality of healthcare services, including the delivery of essential public health efforts. The performance target for essential public health efforts in Jember Regency is set at ≥82%. This study aimed to analyze factors associated with the performance of essential public health efforts. The study employed an analytical cross-sectional design conducted from April to May 2025, with a sample of 37 out of 50 units selected through simple random sampling. Primary data were collected using questionnaires, while secondary data were obtained from primary health center (Pusat Kesehatan Masyarakat – …

Optimizing Vitamin A Intervention: Strengthening Supplementation With Targeted Biscuit Fortification, Mayfa Yemima Simanjuntak, Nadia Amanda, Yuli Berliana Simanjuntak, Carissa Wityadarda, Lesta Livolina Simamora

Journal of Indonesian Health Policy and Administration

Vitamin A deficiency (VAD) remains a persistent public health challenge in Indonesia, particularly among children under five and breastfeeding mothers. This study aimed to analyze the distribution of vitamin A interventions and assess the potential of biscuit fortification as a complementary strategy. This study employs a literature review using the Health Policy Triangle (HPT) framework, examining policy context, content, key actors, and implementation processes related to vitamin A interventions. The analysis was conducted using secondary data from government reports, international agencies, and peer-reviewed literature published between 2018 and 2025, with comparative evidence from Vietnam, Bangladesh, and Ghana. The findings show …

Referral Patterns From Primary Care To Referral Care By Icd-10 Codes In Indonesia: Cross-Sectional Analysis Of National Claims Data (2017–2024), Della Dwi Ayu, Syarif Rahman Hasibuan, Putu Erma Pradnyani, Nisrina Widyasanti

Journal of Indonesian Health Policy and Administration

Primary health care (PHC) facilities serve as gatekeepers within Indonesia’s tiered health system. However, PHC referral patterns to hospitals still show substantial variation and remain insufficiently characterized by disease groupings based on the International Classification of Diseases, 10th Revision (ICD-10). This study aimed to identify the most frequently referred diagnoses from PHC to secondary or tertiary care facilities and to determine the participant characteristics associated with referrals. This observational study employed a cross-sectional design using secondary data from the National Health Insurance (Jaminan Kesehatan Nasional – JKN) claims database for the period 2017–2024. The unit of analysis was each …

Determinants Of Musculoskeletal Disorder In Formal And Informal Workers In Indonesia, Herlina J. El-Matury, Nabila Syahlan, Mohd Rafee B. Baharuddin

Kesmas

Musculoskeletal disorders (MSDs) are a leading cause of disability globally and are strongly influenced by occupational conditions. Evidence comparing MSD risk between formal and informal workers remains limited, particularly in developing countries. This study examined the association between individual and job-related factors with MSD symptoms among formal and informal workers in Indonesia. A cross-sectional study was conducted among 1,089 workers in North Sumatra Province, Indonesia, from August 2024 to December 2025. Participants were recruited using stratified convenience sampling from both the formal (office and health workers) and informal (drivers, traders, and farmers) sectors. MSD symptoms were assessed using the Nordic …

The Feasibility Of Long-Term Care Within Indonesia’S National Health Insurance Scheme: A Qualitative Study, Atikah Adyas, Wan Aisyiah Baros, Khaterina Kristina Manurung, Dedy Revelino, Dewi Susanna, Vetty Yulianty, Anita Pebrina Lubis, Arum Atmawikarta, Iis Sinsin Nuryasini, Ahmad Jet Alamin

Kesmas

The rising prevalence of chronic diseases and disabilities, along with the aging of the population, has reduced individual independence and increased the demand for long-term care (LTC). This study aimed to assess the feasibility of integrating home healthcare services into Indonesia’s National Health Insurance (NHI) scheme. A qualitative study using purposive sampling was conducted in Bandar Lampung, Yogyakarta, and Jakarta, Indonesia, selected based on disease burden, proportion of older adults, and regional development. Data was collected through in-depth interviews, focus group discussions, and observation between August and September 2024, involving 68 informants, including regulators, community members, and health facility staff. …

Resilience And Social Support On Depression Risk For Chronic Obstructive Pulmonary Disease Patients In South Tangerang, Indonesia, Adhityawarman Menaldi, Sali Rahadi Asih, Farah Ainul Mardhiyyah

Kesmas

Chronic obstructive pulmonary disease (COPD) is a major public health concern with psychosocial impacts, such as reduced resilience and depression. This study examined the moderating role of perceived social support on the relationship between resilience and depression among individuals diagnosed with COPD in South Tangerang, Indonesia. A quantitative cross-sectional study was conducted between January and February 2024 using self-administered questionnaires. Participants were adult patients with clinically diagnosed COPD, recruited from all public health centers (PHC) in South Tangerang. A total of 125 participants met the inclusion criteria and were included in the analysis. Participants had a mean age of 41.46±15.69 …

The Role Of Gynecologic Oncologists In Improving Survival Outcomes Of Epithelial Ovarian Cancer: A Retrospective Cohort Study, Widyorini Lh Hanafy, Bambang Dwipoyono, Asri C. Adisasmita, Yosephine E. Regina, Airine S. Lians, Oktaviani P. Rahayu, Jane G. Auwelia

Kesmas

Epithelial ovarian cancer (EOC) is a leading cause of gynecological cancer mortality and is often diagnosed at an advanced stage, resulting in poor survival outcomes. Access to specialized gynecological oncology services has been associated with improved prognosis; however, data on its impact in Indonesia remain limited. This study aimed to evaluate the association between gynecologic oncologist (GO) services and disease-free survival (DFS) in patients with EOC. This retrospective cohort study included 76 patients with EOC who were treated at a national cancer hospital in Jakarta between 2015 and 2018. Patient data were obtained from medical records and followed for three …

Patterns Of Tobacco Marketing And User Engagement On Social Media In Indonesia: Challenges For Digital Public Health, Resti Yulianti Sutrisno, Nopryan Ekadinata, Sutantri Sutantri, Dinasti Pudang Binoriang, Enrico Aditjondro, Rachfiansyah Rachfiansyah, Yosef Rabindanata, Silvia Dini, Rebecca Perl, Riska Rachmawati, Bertha Tesma Wulandari, Dianita Sugiyo

Kesmas

Large-scale tobacco marketing on social media has resulted in widespread population-level exposure, particularly in Indonesia, which faces growing challenges in digital public health. This study aimed to assess the associations between platform type and marketing tactics and identify correlations of user engagement. An analytical cross-sectional study was conducted using secondary data from the Tobacco Enforcement and Reporting Movement (TERM), collected from January 2022 to August 2023. A total of 21,255 tobacco marketing posts from social media were analyzed. Platform–tactic associations were examined using Chi-square tests, and multivariable Poisson regression was used to identify factors associated with user engagement. The findings …

Low-Dose Prophylaxis Versus On-Demand Treatment For Children With Severe Hemophilia A In Indonesia: A Conceptual Model, Levina Chandra Khoe, Nur Atika, Dhia Ticha Pertiwi, Septiara Putri

Kesmas

Hemophilia A is a rare bleeding disorder caused by a deficiency of clotting factor VIII, leading to recurrent bleeds, joint damage, and disability. Low-dose prophylaxis has been shown to achieve better clinical outcomes than on-demand treatment in reducing bleeding frequency. However, in Indonesia, access and affordability remain key challenges. This study aimed to develop a conceptual model for conducting a health economic evaluation of low-dose prophylaxis treatment for children with severe hemophilia A in Indonesia. This study followed the ISPOR-SMDM Modeling guidelines, outlining two-stage processes: conceptualization of the clinical problem and model development. A systematic literature review was conducted to …

Analysis Of Coverage Of Tuberculosis Prevention Therapy (Tpt): Literature Review, Septia Rahmalina, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Tuberculosis Preventive Therapy (TPT) is a crucial intervention for tuberculosis (TB) control, particularly among high-risk groups such as household contacts of TB patients and people living with Human Immunodeficiency Virus (HIV). Despite being recommended by the World Health Organization (WHO), TPT implementation still faces challenges at the primary care level. This study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to review 11 articles published between 2021 and 2025 that were relevant to TPT implementation in various high-TB burden countries, including Indonesia. The main barriers identified were input (logistics, training), process (tracing, education, monitoring), and output …

The Relationship Between Accessibility Factors And Post-Inpatient Control Visits Among Non-Jkn Participants At Hospital X, Putri Candaika, Desy Kartika Ningsih, Risky Kusuma Hartono

Journal of Indonesian Health Policy and Administration

The rate of post-inpatient control visits remains relatively low due to various factors, including accessibility. At Hospital X, 220 of non-Jaminan Kesehatan Nasional (JKN) participants scheduled for post-inpatient control visits between January and March 2025, 71.82% attended, and 28.18% did not. Patients who did not attend control visits were twice as likely to be readmitted. This study aimed to determine the relationship between accessibility and post-inpatient control visits for non-JKN participants at Hospital X. This quantitative study employed an analytical cross-sectional design, with a population of 220 patients and a sample of 142 patients selected using probability sampling. Bivariate …

Private Sector Healthcare Investment In Indonesia: Leveraging Australia-Indonesia Partnerships For Health System Transformation, Susan Josephine Neuhaus

Journal of Indonesian Health Policy and Administration

Australia and Indonesia are strategic partners with expanding bilateral trade valued at AUD 26.7 billion (2022-23). Health care partnerships between the two countries offer significant opportunities for private sector engagement. Indonesia’s large population, rapidly growing middle class, and implementation of Universal Health Coverage (UHC) through the Jaminan Kesehatan Nasional (JKN) present partnership opportunities to strengthen health system capacity, address infrastructure gaps and workforce shortages, and contribute to shared economic and prosperity goals. This study explores how Australian private healthcare investment can complement government initiatives in supporting Indonesia’s UHC while advancing Australia’s regional engagement. A descriptive qualitative analysis was conducted using …

Prophylactic Antibiotic Analysis In Obs-Gyn, Orthopedics, Gastrointestinal Surgery At A South Tangerang Hospital, January-March 2024, Evelina Endang Nurjaman, Helen Andriani

Journal of Indonesian Health Policy and Administration

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality …

Harmonization And Ambiguity In Regulations For Physicians With Family Medicine Competence Post-Law No. 17 Of 2023, Danar Wahyu Giwang Katon, Dumilah Ayuningtyas, Purnawan Junadi, Wahyu Sulistiadi, Roberth J. Pattiselanno, Fitria Fitria, Ika Fitri Alfiani

Journal of Indonesian Health Policy and Administration

Strengthening primary care services in Indonesia requires that community health centers, namely Pusat Kesehatan Masyarakat (Puskesmas), involve medical personnel with family medicine competence. However, the fulfillment of physicians with this competence, especially Primary Care Family Medicine Specialists or Spesialis Kedokteran Keluarga Layanan Primer (Sp.KKLP), still face significant obstacles. This qualitative research uses the integrated Easton's System Model and Buse's Policy Framework to analyze the dynamics of this policy. The findings reveal a gap between the strong legal foundation and weak implementation mechanisms on the ground. First, there is ambiguity in terminology and lack of harmonization among regulations, especially concerning the …

Moving Toward Healthy Ageing: The Role Of Physical Activity In Cognitive Function And Self-Esteem Among Older Adults In Türkiye, Canan Birimoglu Okuyan, Müjde Kerkez

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: A cross-sectional study was conducted with 251 older adults. Data were collected using the International Physical Activity Questionnaire, the Standardized Mini-Mental State Examination, and the Rosenberg Self-Esteem Scale. Spearman’s correlation and chi-square tests were employed for statistical analysis.

Results: Physical activity levels were positively correlated with both cognitive function (r = 0.546, p < 0.001) and self-esteem (r = 0.168, p < 0.05). No significant association was observed between cognitive function and self-esteem. Physical inactivity, cognitive decline, and low self-esteem were more prevalent among women, participants with lower educational attainment, those with chronic diseases, and individuals engaged in polypharmacy.

Conclusions: The findings emphasize the importance of integrating physical activity promotion into national healthy ageing policies, particularly in Mediterranean contexts such …

Workplace Policy And Associated Factors Of Minimum Acceptable Diet Practices: An Online Survey Among Working Mothers In Indonesia, Fadhila Iswi Deandra, Judhiastuty Februhartanty, Muchtaruddin Mansyur

Kesmas

Working mothers in Indonesia may influence complementary feeding practices, particularly their ability to ensure that their infants properly meet the minimum acceptable diet (MAD). In this cross-sectional study, an online survey was distributed through various online platforms where participants were recruited using convenience sampling. The questionnaire covered sociodemographic factors, workplace policies, and infant and young child feeding (IYCF) practices. Descriptive and logistic regression analyses were conducted. A total of 394 working mothers participated, of which over 90% of the respondents reported meeting minimum dietary diversity, minimum milk frequency, minimum milk feeding frequency, and MAD indicators as assessed with a standardized …

Post-Release Health Insurance Utilization Among Ex-Prisoners: A Scoping Review, Icha Khaerunnisa, Megah Andriany, Luky Dwiantoro

Kesmas

The lack of health insurance coverage after prison release significantly reduces access to essential healthcare services, hindering the continuity of care during community reintegration. The evidence on studies of health insurance use following prison release is limited. This scoping review aimed to summarize research on health insurance utilization after release from prison. Literature searches were conducted across databases including ScienceDirect, PubMed, and Scopus. Relevant articles were selected through a two-stage screening process. Data were extracted from the included studies and presented in tabular and descriptive formats. The keywords used were "health insurance AND post-release" and "inmates OR prisoners." This scoping …

General Practitioners' Perspectives On Identifying Early Symptoms For Breast Cancer Detection In The Primary Care Facilities: A Case Study, Bob Andinata

Kesmas

In primary care settings, general practitioners (GPs) frequently face challenges in identifying the early symptoms of breast cancer. This study aimed to explore, in depth, the perspectives of GPs regarding the identification and interpretation of early-stage breast cancer symptoms during the early detection process in primary care facilities. This study used a qualitative approach based on a case study. Data were collected through in-depth interviews with GPs at primary health care and private clinics in Depok City, Indonesia, complemented by observations and documentation. The data was analyzed using the Miles and Huberman method. The questionnaire assessment and focus group discussion …

African Swine Fever In Indonesia: Insights From Southeast Asia’S Policy Response Through The One Health Approach, Niken Salindri, Wachyu Sulistiadi

Journal of Indonesian Health Policy and Administration

African Swine Fever (ASF) seriously threatens pig production systems, food security, and rural livelihoods across Southeast Asia. This study employs an analysis of secondary national data from Indonesia using a quantitative descriptive analysis approach, complemented by regional policy responses to ASF from 2019 to 2024. To contextualize regional findings, this study also integrates official statistics from Statistics Indonesia (BPS) covering provincial pork production trends (2021–2023), the number of ASF-affected pigs per province (2020–2024), and per capita pork consumption by district. Quantitative data show that ASF outbreaks have been disproportionately concentrated in specific provinces such as East Nusa Tenggara and North …

The Effects Of Input And Characteristic Factors On Contact Rate Achievement Among Puskesmas In Indonesia, Iqbal Andri Makarim, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The contact rate is the lowest-performing indicator in the Performance-Based Capitation Payment system initiated by BPJS Kesehatan. Analysis of the 2019 National Health Facility Research (Rifaskes) data showed that less than half of Puskesmas in Indonesia achieved the target. This cross-sectional study analyzed 5,384 Puskesmas from the 2019 Rifaskes to examine the effect of input and characteristic factors on achieving the contact rate. Independent variables included health worker ratios (doctors, nurses, midwives per 5,000 participants), completeness of essential medical equipment, communication facilities, P-Care application use, and Puskesmas characteristics. Multivariate logistic regression identified four significant factors: doctor ratio (OR=1.06; p<0.0001), midwife ratio (OR=1.01; p=0.033), completeness of essential medical equipment (OR=1.16; p=0.029), and BLUD-based financial management (OR=1.13; p=0.029). These factors explained only 2.6% of the variance (Nagelkerke R²=0.026), suggesting other unmeasured influences. Policy implications include equitable distribution of health personnel, targeted procurement of essential equipment, strengthening financial autonomy through BLUD, and optimizing P-Care data utilization to improve service accessibility and performance.

Overview Of A Hospital Management Information System Using The Hot-Fit Method In Medan Hospitals In 2025, Grace Putri Laia, Hotmarina Lumban Gaol, Jev Boris

Journal of Indonesian Health Policy and Administration

Hospital Management Information System (SIMRS/HMIS) is crucial in ensuring efficiency and quality in hospital services by integrating clinical and administrative functions. This study aims to evaluate the implementation of HMIS at Medan Adventist Hospital in 2025 using the Human-Organization-Technology Fit (HOT-Fit) framework. A descriptive design with total sampling was employed, involving 70 respondents comprising medical records staff, inpatient and outpatient registration staff, and ward officers. Data were collected through a structured questionnaire adapted from a validated instrument (validity 0.690–0.900; reliability 0.841–0.911) and analyzed using descriptive statistics. The results showed a high level of implementation in all HOT-Fit domains: system use …

Has Regional Hospital Autonomy Achieved Its Goals? Lessons Learned From Indonesia: A Systematic Review, Masyitoh Basabih, Indriaswari Widhakuswara

Kesmas

This study examined the impact of hospital autonomy implementation on the performance of regional public hospitals in Indonesia, particularly in terms of efficiency, effectiveness, and governance. A systematic review of 32 peer-reviewed studies published between June 12 and September 6, 2023, was conducted using Garba Rujukan Digital and Google Scholar, following PRISMA guidelines. Studies addressing financial performance, service outcomes, and challenges related to implementing autonomy were included. The findings indicated that while autonomy led to improvements in infrastructure, service types, visit volumes, and hospital revenues, it had only a marginal impact on improving key health performance outcomes, such as service …