e-ISSN: 2549-0281 Publisher: Masters Program in Public Health, Sebelas Maret University, Jl. Ir Sutami 36A, Surakarta 57126, Central Java, Indonesia Editor in Chief: Prof. Ari Natalia Probandari, dr., M.P.H., Ph.D Sebelas Maret University, Solo, Indonesia Aim and Scope The Journal of Health Policy and Management (JHPM) is a peer-reviewed, open-access international journal that publishes original research articles, systematic reviews, and meta-analyses on a four-monthly basis. Since its establishment on October 21, 2015, JHPM has served as a critical platform for disseminating high-quality, policy-relevant research that informs and influences health care systems and public health governance worldwide. JHPM provides a forum for researchers, policy-makers, health care managers, public health professionals, and academics to engage with evidence-based insights into the formulation, implementation, and evaluation of health policy and management practices. The journal embraces multidisciplinary and integrative approaches to better understand complex health challenges and generate innovative, actionable solutions. The scope of JHPM spans a wide array of topics, including but not limited to: Health policy development and analysis Health systems management and governance Health economics and financing Epidemiological research with policy implications Public and social policy in health Strategic health planning and administration Equity and access in health care delivery Ethical and philosophical dimensions of health policy Global health policy and comparative health systems JHPM welcomes rigorous research from scholars and practitioners across the globe, with a strong emphasis on contributions from low- and middle-income countries (LMICs). We especially encourage submissions that address urgent health system issues, propose innovative models of care, or evaluate health policy impacts in diverse settings. By promoting dialogue across disciplines and geographies, the Journal of Health Policy and Management aims to foster practical knowledge, inform policy decisions, and support the advancement of efficient, equitable, and sustainable health systems worldwide.
Masters Program in Public Health, Sebelas Maret University
Service Quality and Insurance Status as Determinants of Patient Satisfaction at Dr. Soehadi Prijonegoro Hospital, Sragen, Central Java, Indonesia
Background: Dr. Soehadi Prijonegoro Hospital, Sragen, Central Java, Indonesia, served 127,443 outpatient visits in 2019; however, visits declined sharply during 2020–2021 and began to increase again in 2022. A decline in service quality may reduce patient visits, which represent an important asset for hospitals. This study aimed to analyze the effects of service quality, patient education, patient status, and insurance status on patient satisfaction at RSUD dr. Soehadi Prijonegoro Sragen. Subjects and Method: This was a cross-sectional study conducted among 200 outpatients selected using purposive sampling based on inclusion and exclusion criteria. The study population comprised all outpatients at RSUD dr. Soehadi Prijonegoro Sragen. Data were collected using a Google Form questionnaire and analyzed using multiple linear regression and path analysis with Structural Equation Modeling (SEM). Results: Service quality had a direct, positive, and significant effect on patient satisfaction (b = 0.44; 95% CI = 0.24–0.63; p < 0.001). Empathy was the dominant factor, showing the strongest indirect effect (b = 0.77; 95% CI = 0.69–0.86; p < 0.001), followed by assurance (b= 0.69; 95% CI= 0.59–0.78; p < 0.001), tangibles (b= 0.55; 95% CI= 0.43–0.67; p < 0.001), responsiveness (b= 0.42; 95% CI = 0.29–0.55; p < 0.001), and reliability (b = 0.25; 95% CI = 0.11–0.39; p = 0.001). Patient trust had a significant indirect effect on service quality (b = 0.64; 95% CI= 0.54–0.74; p < 0.001), and insurance status also showed a significant indirect effect on service quality (b = 0.37; 95% CI = 0.24–0.50; p < 0.001). The direct effect of trust on patient satisfaction was positive but not statistically significant (b = 0.21; 95% CI = 0.04–0.37; p = 0.12). Conclusion: Service quality has a significant positive effect on patient satisfaction, with empathy as the most influential factor, followed by assurance, responsiveness, tangibles, and reliability. Patients with certain insurance coverage reported better perceptions of service quality. These findings suggest that strengthening empathy and assurance is crucial for improving patient satisfaction and loyalty in hospital settings.
Copyright (c) 2026 Journal of Health Policy and Management
Psychosocial Factors Affecting the Performance of Community Health Center Employees
Background: Community Health Centers (Puskesmas) serve as primary healthcare facilities whose effectiveness is strongly influenced by employee performance. Psychosocial factors such as motivation, leadership perception, delegation of authority, and social capital play an essential role in enhancing work effectiveness. However, unclear task distribution and suboptimal delegation practices remain common challenges that may weaken employee performance. This study aimed to examine psychosocial factors associated with employee performance in Puskesmas. Subjects and Method: This quantitative study employed a cross-sectional design and was conducted in 17 Community Health Centers across Surakarta, Central Java, Indonesia, from June to July 2025. A total of 224 employees were selected using proportional random sampling. Data were collected using structured questionnaires that had been tested for validity and reliability. Multivariate data analysis was performed using path analysis to assess both direct and indirect relationships among variables. Results: Employee performance was directly influenced by the delegation of authority and responsibility (b= 0.42; 95% CI = 0.32 to 0.53; p < 0.001) and motivation (b = 0.34; 95% CI = 0.23 to 0.45; p <0.001). Performance was indirectly influenced by social capital and leadership perception through motivation, as well as by motivation and leadership perception through the delegation of authority and responsibility. Length of employment, employment status, and gender showed direct but statistically non-significant effects on employee performance. Conclusion: Employee performance in community health centers can be enhanced through effective delegation of authority and responsibility, increased motivation, positive leadership perception, and strengthened social capital. In contrast, gender, employment status, and length of employment were not significant determinants of performance
Effects of Leadership Style and Work Environment on Job Satisfaction and Employee Performance in Community Health Centers
Background: As primary health care facilities, Community Health Centers (Puskesmas) require human resources with optimal performance and high levels of job satisfaction. Employee perform­ance is influenced by various factors, including leadership characteristics, work environment, salary, and length of service. This study aimed to examine the effects of leadership characteristics, work environment, salary, and length of service on job satisfaction and employee performance at Puskesmas. Subjects and Method: This quantitative study employed a cross-sectional design and involved 170 civil servant employees selected through proportional random sampling. Data were collected using a structured questionnaire and analyzed using path analysis. Results: The findings revealed significant indirect effects of leadership characteristics (b = 0.47; 95% CI = 0.36 to 0.59; p < 0.001), work environment (b = 0.49; 95% CI = 0.38 to 0.59; p < 0.001), and salary (b = 0.15; 95% CI = 0.04 to 0.25; p = 0.005) on employee performance through job satisfaction. Length of service had a significant indirect effect on job satisfaction and employee performance through salary (b = 0.36; 95% CI = 0.24 to 0.48; p < 0.001). In addition, job satisfaction had a direct and statistically significant effect on employee performance at Puskesmas (b = 0.37; 95% CI = 0.26 to 0.48; p < 0.001). Conclusion: Leadership characteristics, work environment, salary, and length of service play important roles in shaping job satisfaction and employee performance at Puskesmas. Leadership, work environment, and salary enhance employee performance indirectly through job satisfaction. Length of service does not have a direct effect on performance but influences it indirectly through salary. Furthermore, job satisfaction has a direct and significant impact on employee performance.
Evaluation of the Implementation of Clinical Accreditation Standards in Surakarta, Central Java, Indonesia
Background: Clinical accreditation is an effort to improve the quality of healthcare services, but its implementation in primary healthcare facilities still faces various challenges, particularly in ensuring quality sustainability. This study aims to evaluate the implementation of clinical accreditation standards and analyze their impact on service quality based on the 5M management approach. Subjects and Methods: This study used a qualitative evaluative approach, encompassing four levels: input, process, output, and outcome evaluation. Data were collected through in-depth inter-views with key informants, field observations, and document studies at four clinics in Surakarta, Central Java, Indonesia. The study was conducted from September to December 2025. Data validity was triangulated by creating a descriptive analysis. Results: Accreditation implementation has improved aspects of service structure and processes, including organizational governance, availability of SOPs, increased human resource understanding, and arrangement of service facilities and documentation. However, implementation is still dominated by administrative fulfillment and has not been fully integrated into a sustainable quality management system. Impacts on outcomes, such as patient satisfaction and quality culture, are beginning to be seen, but are not yet supported by data-based quality indicators and systematic evaluation. Key supporting factors include leadership commitment, availability of basic resources, and regulatory support, while inhibiting factors include limited human resources, workload, a suboptimal monitoring system, and the perception of accreditation as an administrative burden. Conclusion: Implementation of accreditation acts as an initial step in improving service quality, but is not enough to guarantee sustainability without strengthening the monitoring system, indicator-based evaluation, and internalization of a quality culture
Association Between Pharmacy Staff Communication Interaction Quality and Outpatient Satisfaction at ‘Aisyiyah Bojonegoro Hospital
Background: The quality of communication interaction between pharmacy staff and patients is a critical component of healthcare service delivery. Effective communication enhances patient understanding, comfort, and trust, which ultimately influence patient satisfaction. A preliminary assessment at ‘Aisyiyah Bojonegoro Hospital indicated varying levels of patient satisfaction with pharmaceutical services, suggesting potential gaps in communication quality and service performance. Subjects and Method: This study aimed to analyze the association between the quality of communication interaction among pharmacy staff and outpatient satisfaction at ‘Aisyiyah Bojonegoro Hospital. An analytical quantitative study with a cross-sectional design was conducted. A total of 377 outpatients were selected as the sample. Data were collected using structured questionnaires and analyzed using Spearman rho correlation and multiple logistic regression. Results: Bivariate analysis showed a significant relationship between communication interaction quality and patient satisfaction (p < 0.001; r = 0.514), indicating a moderate to strong positive correlation. Multivariate analysis demonstrated that communication quality remained a significant predictor of patient satisfaction (OR = 0.61; 95% CI = 0.39–0.96; p = 0.033), while other variables such as age, education level, gender, and marital status were not statistically significant. Conclusion: There is a significant association between the quality of communication interaction of pharmacy staff and outpatient satisfaction. Communication quality is a key determinant of patient satisfaction. Therefore, improving interpersonal communication skills through training and continuous evaluation is essential to enhance service quality.
Personal and Institutional Factors Affecting Physiotherapist Performance in Nusa Tenggara Barat, Indonesia
Background: Physiotherapist performance is an important indicator in determining the quality of medical rehabilitation services, influenced by the interaction of personal and institutional factors. This study aims to analyze the influence of personal factors (motivation, formal and non-formal education) and institutional factors (leadership and work environment) on physiotherapist performance. Subjects and Method: This study used a quantitative approach with a cross-sectional design. The subjects consisted of 183 physiotherapists in West Nusa Tenggara (NTB) Province. Data collection was conducted using a questionnaire that had been tested for validity and reliability. Independent variables included motivation, formal education, non-formal education, leadership, and work environment. The dependent variable was physiotherapist performance. Data analysis included bivariate analysis using Spearman's rho and multivariate analysis using path analysis with STATA. Results: Motivation (b = 0.44; 95% CI = 0.34 to 0.54; p < 0.001), work environment (b = 0.40; 95% CI = 0.29 to 0.51; p < 0.001), and formal education (b = 0.22; 95% CI = 0.13 to 0.32; p < 0.001) had a direct and significant influence on physiotherapist performance. Work environment (b = 0.40; 95% CI = 0.28 to 0.53; p < 0.001), leadership (b = 0.15; 95% CI = 0.03 to 0.28; p = 0.016), and non-formal education (b = 0.31; 95% CI = 0.19 to 0.44; p < 0.001) had an indirect effect on performance through motivation. Leadership also had an indirect effect on performance through work environment (b = 0.45; 95% CI = 0.34 to 0.56; p < 0.001). The model showed good fit (Chi-square = 9.92; p = 0.105; RMSEA = 0.066; CFI = 0.99; TLI = 0.97; SRMR = 0.024). Conclusion: Motivation, work environment, and formal education have a direct influence on physiotherapist performance, while leadership and non-formal education have an indirect influence through motivation and work environment as mediators.
Evaluation of the Implementation of the Hospital Management Information System at Sentra Medika Hospital, Cikarang
Background: Sentra Medika Cikarang Hospital migrated from Avicenna to Teramedic in December 2024. Initial evaluations revealed infrastructure constraints, user literacy, and interface complexity that impacted system effectiveness. Objective: To measure the effectiveness of the implementation of Teramedic SIMRS through quantitative and qualitative analysis, and to formulate optimization recommendations. Subjects and Method: Convergent mixed methods design: cross-sectional survey (n = 111 respondents) for variables of wait time, data accuracy, interface, organizational support, satisfaction; and in-depth interviews with 15 key informants from IT, inpatient, medical records, pharmacy, and HR units. Quantitative data were analyzed using descriptive statistics, paired t-tests, and multiple linear regression. Qualitative data were analyzed thematically. Results: The survey showed an average reduction in clinical data wait time from 110 (SD= 15) to 86 (SD= 12) minutes (p < 0.001), an increase in medical record accuracy from 92% to 97% (p < 0.01), and an average user satisfaction score of 4.1/5. Regression analysis confirmed that digital literacy ( β = 0.45, p <0.001) and organizational support (β= 0.37, p < 0.001) significantly influenced satisfaction. Qualitative findings identified four main themes: infrastructure challenges (power outages, network), user adaptation and training, UX/UI design, and module integration. Conclusion: Teramedic SIMRS improves efficiency and data quality, but infrastructure and interface barriers need to be addressed through UPS upgrades, redundant networks, ongoing e-learning modules, and periodic UX/UI audits.
The Impact of Social Capital, Work Motivation, and Job Satisfaction on Health Workers’ Performance in Community Health Centers
Background: Social capital, which includes relationships between individuals, social networks, as well as trust in organizations, is believed to affect the effectiveness of collaboration and communication, which in turn impacts performance. Work motivation plays an important role in encouraging individuals to achieve organizational goals. In addition, job satisfaction, which is influenced by certain factors, contributes to the improvement of individual performance in the workplace. This study aims to analyze the influence of social capital, work motivation and job satisfaction on the performance of health workers in health centers. Subject and Method: This study is a cross-sectional study conducted on health workers at the Subang Regency health center in November-January 2025. The research sample of 203 health workers was selected using random sampling. The dependent variable is performance. Independent variables are social capital, work motivation and job satisfaction. Data collection using questionnaires. The data were analyzed using Multiple Linear Regression on Stata 13. Results: Social capital (b= 0.08; CI 95%= 0.02 to 0.14; p= 0.006), job satisfaction (b= 0.60; CI 95%= 0.36 to 0.84; p = 0.000), work motivation (b = 0.21; CI95%= 0.04 to 0.37; p= 0.013) has the influence to improve performance and is statistically significant. Age (b= 0.00; CI95%= -0.02 to 0.04; p= 0.613) there was an increase but statistically insignificant, of sex (b= -0.23; CI95%= -0.76 to 0.29; p= 0.385) followed by a statistically insignificant decrease. Length of work 11-19 (b= 0.01; CI95%= -0.57 to 0.61; p= 0.950) followed by an increase but statistically insignificant. Working time >20 years (b= -0.23; CI95%= -1.03 to 0.57; p= 0.572) followed by a statistically insignificant decrease, strata of puskesmas (b = 0.36; CI95%= -0.17 to 0.89; p= 0.184) there is an increase but statistically insignificant. Conclusion: The performance of health center health workers is influenced by social capital, work motivation and job satisfaction. Age, gender, length of work, strata of the health center are not factors that affect performance.
Factors Affecting Job Satisfaction and Performance of Health Workers at Community Health
Background: Motivation, leadership, career development, and rewards or incentives are important determinants of job satisfaction and performance among healthcare workers at Community Health Centers (CHCs). This study aimed to analyze and estimate the association between motivation, leadership, career development, rewards/incentives, job satisfaction, and the performance of healthcare workers. Subjects and Method: This was a cross-sectional study involving 200 healthcare workers from CHCs in Kerinci Regency, Jambi Province, conducted from October to November 2024. Samples were selected using accidental sampling. The dependent variable was health worker performance, the mediating variable was job satisfaction, and the independent variables were motivation, leadership, career development, and rewards/incentives. Data were collected using structured questionnaires and analyzed using path analysis. Results: Healthcare workers with high motivation were more likely to perform well than those with low motivation (b=0.31; CI 95%=0.18 to 0.45; p<0.001). Healthcare workers with high job satisfaction were more likely to perform well than those with low job satisfaction (b=0.43; CI 95%=0.30 to 0.46; p<0.001). Healthcare workers with high job satisfaction were more likely to be well motivated than those with low job satisfaction (b=0.21; CI 95%=0.13 to 0.29; p<0.001). Health workers who had a positive perception of leadership were more likely to be satisfied with their work than with a negative perception (b=0.74; CI 95%=0.68 to 0.80; p<0.001). Conclusion: The performance of healthcare workers in CHCs was directly affected by motivation and job satisfaction. Higher motivation and job satisfaction were associated with improved health worker performance.
Copyright (c) 2025 Journal of Health Policy and Management
Meta-Analysis: Exploring the Impact of Marital Status, Work Environment Conditions, Education, Gender, and Age on Job Satisfaction among Healthcare Professionals
Background: Health is a very complex field because it focuses on healthcare providers. The quality of healthcare can be determined through the job satisfaction of healthcare workers. Factors that can affect the job satisfaction of healthcare workers can be assessed based on marital status, working conditions, education, gender, and age. The purpose of this study was to estimate the effect of marital status, working conditions, education, gender, and age on job satisfaction among healthcare workers. Subjects and Method: A meta-analysis study was conducted in accordance with the PRISMA flow chart and PICO model. Population: healthcare workers. Intervention: female, >30 years old, bachelor's degree, single, and good working environment. Comparison: male, <30 years old, diploma, married, and poor working environment. Outcome: job satisfaction. Data were obtained from the Google Scholar, PubMed, BMC, ScienceDirect, Elsevier, and Springer Link databases. The keywords used were “gender” AND “age” AND ‘education’ AND “marital status” AND “work environment” AND “job satisfaction” AND “health workers” AND “cross-sectional” AND “aOR”. Data analysis was performed using Review Manager 5.3 software. Results: This meta-analysis included 12 cross-sectional studies from Myanmar and Ethiopia. The sample size was 3,962 health workers. Marital status (aOR= 1.43; 95% CI= 1.03 to 2.00; p= 0.003) and good working conditions (aOR= 1.55; 95%CI= 1.18 to 2.04; p= 0.002) significantly increased job satisfaction among health workers. Bachelor's degree (aOR= 1.51; 95% CI= 0.53 to 4.83; p= 0.400), female gender (aOR= 1.34; 95% CI= 0.87 to 2.05; p= 0.180), and age >30 years (aOR= 1.81; 95% CI= 0.81 to 4.09; p= 0.150) increased job satisfaction among healthcare workers but were not statistically significant. Conclusion: Marital status, work environment conditions, education level, gender, and age affect job satisfaction in health workers.
Indonesian Medical Students' Perceptions of Computer Based Test (CBT) Questions on Public Health Competency Test: An Evaluation Study
Background: The Indonesian Medical Competency Standards (SKDI) are the educational standards for doctors in Indonesia. To prove that students have met the competency requirements, a competency test is necessary. Research results show that CBT of Public Health questions fall into the moderate-difficult category. This means that institutions must have a specific strategy to guide students. Subjects and Method: This qualitative study conducted in-depth interviews with Indonesian medical students who had passed or failed the Indonesian Medical Competency Test. The interviews were conducted online using Zoom. Informants were selected from various regions in Indonesia. Results: The study identified five themes. The five themes are: 1) varying perceptions of the difficulty level of public health questions, 2) lack of focus, 3) question patterns and reference books, 4) sources and methods of learning for the public health question, and 5) examinees' expectations. Conclusion: Students' perceptions of the difficulty level vary. This is also related to the students' own preparedness. Students have specific expectations regarding certain questions, such as those related to Indonesian national health insurance (BPJS), epidemiology, and others
The Impact of Motivation, Stress, and Fatigue on the Performance of Primary Health Care Employees in Surakarta
Background: The performance of health personel is one of the biggest reasons for the good and bad health services. There are various factors that can affect employee performance such as motivation, stress, and work fatigue. This study aims to see if there is an effect of motivation, stress, and fatigue on the performance of Puskesmas employees. Subjects and Method: This study is a quantitative study using a cross-sectional design. This study was conducted on 17 health centers in the city of Surakarta, Central Java, Indonesia starting from August to September 2024. With a sample of 202 health center employees who were randomly selected or using a simple random sampling. The dependent variable in this study is the performance of health center employees. The independent variables in this study were motivation, stress, and fatigue. Data collection was carried out using a questionnaire and analyzed with path analysis. Results: Motivation has an influence on improving performance and is statistically significant. Motivation (b= 1.14; CI 95% = 1.06 to 1.06; p<0.001), stress (b= 0.83; CI 95% = 0.70 to 0.95; p<0.001), has a statistically significant effect on performance degradation, and fatigue (b=0.06; CI 95% = 0.02 to 0.12; p=0.041), had a degrading effect and was statistically significant. Conclusion: The performance of health center employees is influenced by motivation, stress, and fatigue.
Determinants of Inpatient Satisfaction at Dr. M. Yunus Regional General Hospital, Bengkulu, Indonesia
Background: A hospital is a healthcare facility that provides medical services and care to patients that serve for the treatment and treatment of various diseases or health conditions supported by the services provided in the hospital. This study aims to analyze the factors that affect inpatient satisfaction so that it is known which factors are most influential and health service improvements can be more measurable. Subjects and Method: This study uses a cross-sectional study conducted at the dr M. Yunus Bengkulu Regional General Hospital, Indonesia, from January to February 2024. The sample consisted of 165 inpatient respondents who were selected by stratified random sampling technique. The independent variables in this study were age, gender, education level, ward type, class of care, financing method, tangibles, assurance, responsiveness, realibility and empathy. The dependent variable is inpatient satisfaction. Data collection was carried out by questionnaire. The data will be tested for validation and reliability so that Cronbach's alpha score is obtained in Stata 13.0 Software. The average SERVQUAL score will be assessed as the difference between the expected score and the actual score. Results: The patient satisfaction score obtained based on the gap in the SERVQUAL score between expectations and reality were reliability factors (-2.81), assurance (-4.72), tangibles (-4.68), empathy (-4.76), and responsiveness (-4.53). The results of the analysis of the influence of patient satisfaction on patient loyalty obtained a percentage value of 80.6% with the number of loyal patients as many as 133 out of 165 patients. Conclusion: The services provided by the Regional General Hospital dr M Yunus Bengkulu have not been able to meet the expectations of patients. Empathy is the least satisfying thing for the patient among others. Meanwhile, reliability is the thing that can satisfy patients the most.
The Relationship Between Motivation, Length of Service, Work Environment, Job Satisfaction, and the Performance of Healthcare Workers at National Hospital of Diponegoro, Semarang, Indonesia
Background: Performance is the result of work achieved by a person in carrying out his duties which is based on skills, experience, seriousness, and time aimed at the progress of an organization or company. This study aims to analyze the relationship between motivation, length of work, work environment, job satisfaction, and the performance of health workers at Semarang Hospital. Subjects and Method: This study uses an observational analytical design with a cross-sectional approach conducted at the Semarang Hospital from June to July 2024. The sample consisted of 200 health workers who were selected by a simple random sampling method. The independent variables in this study were motivation, length of work, work environment, and job satisfaction. The dependent variable is the performance of the health workers of Semarang Hospital. Data collection was carried out by questionnaire. The data was analyzed using the structural equation model (SEM) analysis model. Results: The performance of health workers increased with a good work environment (b=0.38; 95% CI=0.19 to 0.56), but decreased with longer working A good work environment was influenced by strong work motivation (b=0.13; 95% CI=0.01 to 0.23), and high job satisfaction (b=0.45; 95% CI=0.30 to 0.59). Work motivation was positively influenced by job satisfaction (b=0.37; 95% CI=0.17 to 0.53). Length of work was positively influenced by job satisfaction (b=0.48; 95% CI=0.30 to 0.59). This Path Analysis shows good goodness of fit: Chi Square p= 0.268 ( >0.050), RMSEA= 0.04 (<0.08), CFI= 0.99 (>0.90), TLI= 0.096 (>0.90), and SRMR= 0.03 (<0.05). Conclusion: Performance is directly affected by the work environment, and the length of work, and is indirectly affected by job satisfaction and work motivation.
The The Relationships between Reliability, Tangible Evidence, Responsiveness, Empathy, and Gender with Outpatient Satisfaction at Mitra Delima General Hospital, Malang, East Java, Indonesia
Background: Patient satisfaction is a patient's feeling received from the health service performance felt by patients in their services and compared with what is expected. This study aims to analyze the variables that influence patient satisfaction. Subjects and Method: This study is an observational analytical study with a cross-sectional design. This study was conducted at Mitra Delima General Hospital, Malang, in August-September 2024. A sample of 200 patients was selected using simple random sampling. The dependent variable in this study was patient satisfaction. The independent variables in the study were reliability, assurance, tangible evidence, responsiveness, empathy, and gender. Data collection was carried out using a questionnaire and analyzed using path analysis. Results: Patient satisfaction in hospitals is influenced by reliability (b= 0.60; 95% CI= 0.47 to 0.73; p<0.001), tangible evidence (b= 0.43; 95% CI= 0.29 to 0.58; p<0.001), responsiveness (b= 0.33; 95% CI= 0.15 to 0.52; p<0.001), empathy (b= 0.72; 95% CI= 0.56 to 0.88; p<0.001), and gender (b = 0.14; 95% CI= 0.01 to 0.27; p =0.025). Conclusion: Patient satisfaction is positively influenced by reliability, tangibles, responsiveness, empathy, and gender.
Evaluation of Anesthesia Management Care in the Central Surgical Installation
Background: Effective anesthesia management is essential to ensure patient safety, minimize perioperative complications, and promote optimal recovery. Comprehensive planning across the pre-, intra-, and postoperative phases allows anesthesiologists to deliver systematic and high-quality care. Evaluating each component of anesthesia services context, input, process, product, and outcome is crucial for maintaining professional standards and improving patient satisfaction. Therefore, this study aimed to evaluate anesthesia care arrangements (pre-, intra-, and postoperative) at the Central Surgical Installation of dr. Soepraoen Kesdam V/Brawijaya Malang Hospital using the CIPP evaluation model. Subjects and Method: This qualitative evaluative study was conducted from June 1 to July 1, 2024, employing the Context, Input, Process, and Product (CIPP) framework. Five anesthesiologists were selected through probability sampling. Data were collected through in-depth interviews, direct observations, document reviews, and Focus Group Discussions, and analyzed through data reduction, classifica­tion, and interpretation. Results: Evaluation of the context and input components showed that anesthesia services complied with professional standards and ASKAN guidelines, supported by adequate human resources, infrastructure, and standard operating procedures. The process component including assessment, diagnosis, intervention, implementation, evaluation, and documentation was implemented adequately but not fully aligned with the ASKAN guidelines. Product evaluation indicated satisfactory documentation quality with partial conformity to the 2023 ASKAN edition. The outcome showed stable patient hemodynamics and high satisfaction levels. Conclusion: Context and input components were well-implemented, while process and product evaluations were adequate but require improved documentation to align with the latest ASKAN standards.
The Influence of Servqual Indicators in Measuring Health Service Quality and Patient Satisfaction
Background: Health services are organized efforts by individuals or institutions to prevent and treat diseases, restore health, and improve community well-being. Both government and private healthcare institutions play a crucial role in ensuring accessible and high-quality services. The quality of health services is a key determinant of patient satisfaction. This study aimed to assess the SERVQUAL indicators in measuring the quality of health services and patient satisfaction at Diponegoro National Hospital. Subjects and Method: A cross-sectional study was conducted at Diponegoro National Hospital, Semarang, in July 2024. A total of 200 patients were recruited using accidental sampling. The dependent variables were service quality and patient satisfaction, while the independent variables included age, education, gender, and financing method. Data were collected using structured questionnaires and analyzed through path analysis. Results: The concept of service quality was represented by SERVQUAL indicators: reliability (b= 0.61; 95% CI= 0.46–0.76; p<0.001), assurance (b= 0.50; 95% CI= 0.35–0.64; p<0.001), tangibles (b= 0.67; 95% CI= 0.56–0.78; p<0.001), and responsiveness (b= 0.66; 95% CI= 0.46–0.76; p<0.001). Patient satisfaction showed a positive structural relationship with service quality (b= 0.31; 95% CI= 0.07–0.55; p= 0.012). The financing method also affected satisfaction, with insured (BPJS) patients reporting higher satisfaction than general patients (b= 0.15; 95% CI= 0.02–0.27; p= 0.015). Conclusion: Health service quality is defined by multiple SERVQUAL indicators, including reliability, assurance, tangibles, empathy, and responsiveness. Patient satisfaction is positively associated with service quality and influenced by the financing method, indicating the importance of equitable and high-quality healthcare delivery
Key Factors Affecting Job Satisfaction of Inpatient Nurses at Sukoharjo Regional Hospital
Background: Quality health services are the result of cooperation between patients and health care providers in a supportive environment. Nurses as professionals are responsible for providing high-quality nursing care for better patient outcomes. The Human Resources (HR) department plays a crucial role in managing the workforce and ensuring that hospitals have qualified and competent staff of healthcare professionals. The purpose of this study is to find out the factors that affect nurses' job satisfaction. Subjects and Method: The cross-sectional study was conducted at the Sukoharjo Regency Hospital from June to July 2024. A total sample of 200 inpatient nurses was selected by simple random sampling. The dependent variable is job satisfaction. The independent variables were salary perception, work environment, autonomy, supervision, relationships between colleagues, work rewards, and work attitudes. Data collection was carried out by questionnaire. Data were analyzed using path analysis. Results: The results of the pathway analysis that has been carried out in this study stated that the job satisfaction of inpatient nurses at Sukoharjo Hospital was directly influenced by supervision (b=0.14; CI 95%= 0.01 to 0.26; p= 0.040), salary perception (b= 0.23; CI 95%= 0.10 to 0.36; p <0.001), autonomy (b = 0.18; CI 95%= 0.06 to 0.31; p= 0.005), work environment (b= 0.18; CI 95%= 0.05 to 0.31; p= 0.006). Job satisfaction through salary perception is indirectly influenced by income and work rewards in the work environment. Conclusion: The job satisfaction of inpatient nurses at Sukoharjo Hospital is directly influenced by supervision, salary perception, autonomy, and work environment. Job satisfaction through salary perception is indirectly influenced by income, work rewards in the work environment.
Impact of Safety Climate on Workers' Safety Practices in the Textile Industry
Background: The textile industry has high risks related to occupational safety and health (OSH), so work accidents often occur. The number of accidents in Indonesia is increasing from year to year. One of the methods to overcome this problem is the implementation of the Occupational Safety and Health Management System. In addition, the safety climate and safety behavior are important indicators in reducing work accidents. This study aims to analyze the influence of the safety climate on safety behavior in the textile industry. Subjects and Method: This was a cross-sectional study conducted in 2 textile companies located in Surakarta and Semarang, in June-August 2024. A sample of 200 workers was selected using simple random sampling. The dependent variable was safety behavior. The independent variables were safety climate, working period and education level. Data collection was carried out using questionnaires and data was analyzed using path analysis. Results: Safety behavior was positively influenced by condusive climate (OR= 5.04; 95% CI= 1.68 to 15.13; p= 0.004), implementing occupational health and safety management system (OR= 55.48; 95% CI= 18.26 to 168.53; p < 0.001), high education (OR= 2.18; 95% CI= 0.99 to 4.81; p= 0.052), and long tenure (OR= 2.78; 95% CI= 0.97 to 7.97; p= 0.056). Conclusion: Safety behavior is positively influenced by condusive climate, implementing occupational health and safety management system, high education, and long tenure.
Effect of Marketing Mix (Product, Place, Promotion, and Price) on Outpatient Patient Satisfaction at Nur Hidayah Hospital, Bantul
Background: Patient satisfaction is an indicator of how well a patient is treated in medical practice, from the point of view of service quality and from how happy the patient is with the services provided. One of the marketing strategies that can be used is the 4P marketing mix that includes a combination of variables or core activities in the marketing system, such as products, distribution, promotions, and prices. This study aimed to analyze the effect of 4P marketing mix strategy on patient satisfaction. Subjects and Method: A cross-sectional study was conducted at Nur Hidayah Hospital, Bantul, Yogyakarta, Indonesia. A sample of 203 patients selected using a simple random sampling. The dependent variable was patient satisfaction. The independent variables were product, place, promotion, and price. Data collection was carried out using a questionnaire and analyzed by path analysis using the STATA 13 application. Results: Marketing mix strategy directly increased patient satisfaction (b= 0.92; 95% CI= 0.87 to 0.98; p<0.001). Product (b= 0.63; 95% CI= 0.54 to 0.72; p <0.001), place (b = 0.52; 95% CI = 0.41 to 0.63; p<0.001), promotion (b = 0.65; 95% CI = 0.55 to 0.74; p<0.001), and price (b= 0.76; 95% CI= 0.68 to 0.83; p<0.001) showed positive and significant loadings, indicating that all four components are strong constructs representing the marketing mix strategy. Conclusion: Marketing mix strategy directly increases patient satisfaction.