Journal of Health Policy and Management (JHPM)
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Adapting to Transformations in Hospital Structure: A Case Study at Manguharjo Lung Specialist Hospital, Madiun
Full text linkBackground: Manguharjo Lung Specialist Hospital is a type C hospital in Madiun. Along with global health trends, health needs are increasing and varying. So the Management of Manguharjo Lung Hospital innovated to improve more diverse services by changing the form to a general hospital with a Man, Money, Method, Material, Market approach. The aim of this study was to examine the preparation of a non-pulmonary disease treatment program at the Manguharjo Lung Specialist Hospital, East Java, Indonesia.Subjects and Method: This qualitative study uses a case study approach, involving 4 hospital staff, 3 patients, 3 East Java Health Office officials, and 3 local community leaders. Data sources include interviews and a review of the hospital's strategic development plans and supporting documents.Results: Five themes emerged: (1) Opportunities for conversion, supported by strategic location, adequate resources, and community demand for non-pulmonary services; (2) Supporting factors, including skilled human resources and the potential for increased hospital income; (3) Public perception, where the hospital is still viewed primarily as a lung service facility, deterring broader usage; (4) Obstacles, particularly lack of approval from the East Java Health Office; (5) Efforts, such as opening non-lung services and preparing human resources and facilities.Conclusion: Manguharjo Lung Specialist Hospital has significant potential to transition into a general hospital due to strong supporting factors like skilled personnel. However, challenges like public perception and institutional approval must be addressed
Meta-Analysis: The Impact of Product, Price, Place, and Promotion on Patient Satisfaction
Full text linkBackground: A component of effective health care is measuring patient satisfaction. Satisfaction helps in the evaluation of health services from the patient's perspective. In order to compete globally, hospitals need to consider marketing strategies that emphasize understanding customer needs, wants and demands. One of the most common and widely applied marketing concepts in this context is the marketing mix, which includes four main elements, namely product, place, promotion and price. This research aims to estimate the magnitude of the influence of the marketing mix (4P) which includes product, price, place and promotion on patient satisfaction.
Subjects and Method: Meta-analysis studies with PICO research questions. Population = general patients. Intervention = high product quality, high promotion, long distance and high price. Comparison = low product quality, lack of promotion, close distance to facilities, and low price. Outcome= Patient satisfaction. Data obtained from Google Scholar, Pubmed, Scopus and ScienceDirect, with the keywords "Product for patient satisfaction" OR "Promotion for patient satisfaction" OR "Price for patient satisfaction" OR "Place for patient satisfaction" AND "Marketing patient satisfaction" OR "Marketing mix patient satisfaction” AND aOR. The effect size used was the Adjusted Odds Ratio (aOR) from multivariate analysis. Data analysis using the Review Manager 5.3 application.
Results: This meta-analysis was carried out on 20 primary studies with a cross-sectional design, originating from Turkey, Israel, Saudi Arabia, Ethiopia and Ghana. The sample size was 14,388 people. The meta-analysis results show that patient satisfaction increases with high product quality and is statistically significant (aOR= 2.23; CI 95%= 1.54 to 3.23; p<0.001) and good promotion, although not statistically significant (aOR= 1.42; CI 95 %= 0.75 to 2.71; p= 0.280). Patient satisfaction decreases with distance to a health facility (aOR= 0.55; 95% CI= 0.35 to 0.86; p= 0.009) and high price (aOR= 0.56; 95% CI= 0.38 to 0.81; p= 0.002).
Conclusion: Patient satisfaction increases with high product quality and good promotions. Patient satisfaction decreases with distance to the facility and high prices
Determinants of Work Performance among Employee in Dr. Soediran Mangun Sumarso Hospital, Wonogiri, Central Java
Full text linkBackground: Good performance is the dream of every hospital which aims to achieve the predeter¬mined vision, mission and goals. Achieving the vision, mission and goals requires human resources who are capable of handling these matters. This study aimed to determine and analyze the deter¬mi¬nants of the performance of health and non-health workers.Subjects and Method: Cross-sectional study was conducted at Dr. Soediran Mangun Suwarso Hospital, Wonogiri, Central Java, from November to December. 200 hospital workers were selected using stratified random sampling. The dependent variable was work performance. The independent variables were work motivation, job satisfaction, job training, work environment, and job suitability. Data was collected using a questionnaire and analyzed using a path analysis model.Results: Performance of hospital employers was directly and positively influenced by job satisfaction (b= 0.15; 95% CI= 0.01 to 0.28; p = 0.033), work motivation (b= 0.17; 95% CI = 0.04 to 0.31; p= 0.009), and training (b= 0.16; 95% CI= 0.03 to 0.29; p= 0.017). Satisfaction increased motivation (b= 0.83; CI 95%= 0.54 to 1.12; p <0.001). Job satisfaction was influenced by the work environment (b= 0.13; CI 95%= 0.02 to 0.23; p= 0.016) and job suitability (b = 0.41; 95% CI= 0.30 to 0.51; p <0.001).Conclusion: Performance of hospital employers is directly and positively influenced by job satisfaction, work motivation, and training. Satisfaction increases motivation. Job satisfaction is influenced by the work environment and job suitability
Meta Analysis: Factors Affecting Health Care Service on Outpatient’s Satisfaction in Hospital
Full text linkBackground: Patient satisfaction with health services is very important to measure the level of health services offered to patients and the implementation of health services in hospitals. Patient expectations about service quality are also related to service perceptions and when patients have a good impression, patients' clinical experiences and outcomes are more likely to have positive responses. The aim of this study is to analyze the influence of health service factors on the level of satisfaction of outpatients in hospitals based on the results of several previous studies using meta-analysis.Subjects and Method: This research is a systematic review and meta-analysis based on data obtained through various databases including Google Scholar, PubMed, ResearchGate and Science Direct. This study used articles that were published from 2014 to 2022. The article search was carried out by considering the eligibility criteria defined using the PICO model. Population: outpatients. Intervention: comfortable waiting room, short waiting time, drug availability and payment status (free). Comparation: uncomfortable waiting room, long waiting time, no medicine available and payment status (Out of Pocket). Outcome: patient satisfaction. This article was collected within 1 month with the following keywords used: "Waiting Room" AND "Waiting Time" AND "Drug" AND "Payment Status" AND "Outpatient Health Services" OR "Satisfaction" AND "Cross Sectional Study". The articles included in this research are full text articles with a cross-sectional study design. This article was collected using a PRISMA flow diagram and analyzed using the Review Manager 5.3 application.Results: Meta-analysis of 16 articles using a cross-sectional research design from the countries of Ethiopia and Fiji. Total sample 15,453. Patient satisfaction increases with a comfortable waiting room (aOR= 2.54; 95% CI= 2.01 to 3.21; p < 0.001), short waiting time (aOR= 2.97; 95% CI= 1.62 to 5.47; p < 0.001), good availability of medicines. complete (aOR= 2.01; 95% CI= 1.55 to 2.60; p <0.001), and payment status (free) (aOR= 1.99; 95% CI= 1.34 to 2.95; p <0.001).Conclusion: Outpatient satisfaction in hospitals increases with the comfort of the waiting room, short waiting time, availability of medicines, and payment status (free)
Multilevel Analysis of Nurse’s Performance Predictors at Dr. Moewardi Hospital, Surakarta
Full text linkBackground: Nurse Performance plays a role as a determinant of patient satisfaction when providing nursing care. Nursing services in hospitals are one of the determining factors for good or bad service, quality and image of a hospital. Factors that influence nurse performance are gender, working time arrangements, education, work experience and job satisfaction. The aim of this study was to analyze the performance of inpatient and outpatient ward nurses at Dr. Moewardi Hospital.
Subject and Method: This research uses an observational analytic design with a cross-sectional approach. This research is intended to find the relationship between the independent variables, namely gender, working time arrangements, education, work experience and job satisfaction, with the dependent variable, namely the performance of nurses in the inpatient and outpatient wards at Dr. Moewardi. This research was conducted in October-November 2023. A sample of 200 posyandu cadres was selected using random sampling. Data collection was carried out using questionnaires/interviews and data was analyzed using a multiple linear regression analysis model with a multilevel approach.
Results: Gender has an influence and is significant between gender and nurse performance (b = -1.79; 95% CI = -3.13 to -0.45; p = 0.009). Working time arrangements have an influence on nurse performance, and this influence is statistically significant (b = 1.96: 95% CI = 0.39 to 3.54; p = 0.014). Job satisfaction has a positive and significant influence on nurse performance (b = 0.32 CI 95% = 0.10 to 0.4). The results of education and work experience did not show a statistically significant difference in nursing performance between nurses with DIII education and the nursing profession (b = 0.32; 95% CI = -0.86 to 1.51) and work experience of more than 12 years and less than 12 years (b = 0.71; 95% CI = -0.75 to 2.17). The results of this multilevel analysis also found that there was a contextual influence of the ward on nurse performance (ICC= 15.09%).
Conclusion: Nurse performance is directly influenced by gender, working time arrangements and job satisfaction. Variations at level 2 wards have a contextual influence on nurse performance
Analysis of Managerial Leadership on Improving the Quality of Hospital Services Through Patient Safety Culture at dr. Darsono Hospital, Pacitan, East Java
Full text linkBackground: Patient safety is an important issue because of the large number of medical error cases that occur in various parts of the world. Patient safety culture is the first step in developing safety because it contains values, attitudes, competencies, and behavioral patterns that determine patient safety programs. The aim of this research is to analyze the influence of managerial leadership on improving the quality of hospital services through a patient safety culture.Subjects and Method: This was a quantitative study with an explanatory approach. The population used was health workers at Dr. Darsono Hospital, as many as 240 people. Based on the proportionate stratified sampling technique, a sample of 148 people was obtained. This research consists of independent variables and dependent variables. Independent variable is managerial leadership and the dependent variables are patient safety culture and hospital service quality. The data was then analyzed using SEM PLS.Results: The results of the analysis show that managerial leadership has a significant effect on patient safety culture and improving service quality (p<0.001), patient safety culture has a significant effect on improving service quality (p<0.001), and patient safety culture can mediate the relationship between managerial leadership and service quality (p<0.001). The values of the patient safety culture determination coefficient of 64.9% and the service quality variable of 80.9% showed both variables influenced this study; the remaining 35.1% and 19.1% were explained by other variables outside the study model.Conclusion: Patient safety culture at Dr. Darsono Hospital is in the sufficient category; a managerial leadership role is needed to improve the implementation of patient safety culture so that the quality of hospital services can increase optimally
Multilevel Analysis: Factors Related to Work Performance in Health Workers at Community Health Centers
Full text linkBackground: Patient satisfaction is a very valuable asset because if patients are satisfied they will continue to use the services of their choice. The level of patient satisfaction arises as a result of the performance of health services obtained after the patient compares it with the quality of health services. The aim of this research is to analyze the performance of health workers at community health centers.
Subjects and Method: Cross-sectional research was conducted at community health centers in Karanganyar, Central Java, from November to December 2023. A total of 210 health workers were selected using stratified random sampling. The dependent variable was work performance. The independent variables were age, length of work, employment status, income and work environment. Data were collected using questionnaires and analyzed using multiple multilevel linear regression.
Results: Age decreased the performance but was not statistically significant (b= -0.33; CI 95%= -1.63 to 0.97; p = 0.623). Length of work (b= -1.19; CI 95%= -2.30 to -0.08; p= 0.035) and income (b= -1.43; CI 95%= -2.78 to -0.07; p = 0.039) significantly degraded the performance. Employment status decreased performance but it was statistically close to significant (b= -1.44; CI 95%= -3.04 to 0.16; p = 0.078). A comfortable work environment significantly increased performance (b= 0.16; 95% CI= 0.02 to 0.30; p = 0.029). There was a contextual influence of community health center factors on work performance (ICC= 9.62%).
Conclusion: Age decreases performance but is not statistically significant. Length of work and income significantly decrease performance. Employment status decreases performance but is statistically close to significant. A comfortable work environment significantly improves performance. There is a contextual effect of community health center factors on work performance
Meta-Analysis: Effects of Gender, Waiting Time, Visits, and Insurance on Outpatient Satisfaction with Health Services
Full text linkBackground: Patient satisfaction is the result of the service process felt by the patient, overall satisfaction arises from the patient's evaluation of the experience or as an interaction, including the availability of health services provided by officers (health workers), so that patient satisfaction can be used to assess the quality of services received by the patient. This study aims to estimate the magnitude of the influence of gender, waiting time, visits, and insurance on health service satisfaction.
Subjects and Method: Systematic review and meta-analysis using PRISMA flow charts and PICO models. Population: outpatients. Intervention: Female, long waiting time, already visited, using insurance. Comparison: Male, short waiting time, first time visit, and not using insurance. Outcome: Outpatient satisfaction with health services. The online databases used were Google Scholar, Biomedcentral, Taylor & Francis and Plos with the keywords gender, waiting time, visits, insurance, outpatient satisfaction, cross-sectional and aOR. Inclusion criteria were full text articles with cross-sectional use of multivariate analysis that included aOR and were published from 2014-2024. Data analysis using the RevMan 5.3 application.
Result: Twelve primary studies were used to analyze gender and patient satisfaction with health services. Women had satisfaction with health services 1.19 times compared to men (aOR= 1.19; 95% CI=1.11 to 1.28; p<0.001). Ten primary studies were used to analyze insurance and patient satisfaction with health services. Patients who have insurance are 1.23 times more satisfied with health services than those who do not have insurance (aOR= 1.23; 95% CI=1.09 to 1.40; p<0.001). Seven primary studies were used to analyze waiting times and patient satisfaction with health services. Patients who experienced short waiting times were 0.30 times more satisfied with health services compared to those with long waiting times (aOR=0.30; 95% CI=0.21 to 0.44; p<0.001). Seven primary studies were used to analyze visit frequency and patient satisfaction with health services. Patients who have visited are 2.96 times more satisfied with health services than patients who are visiting for the first time (aOR=2.96; 95% CI=2.60 to 3.37; p<0.001).
Conclusion: Female gender, short waiting times, repeat visits and insurance in increasing outpatient satisfaction with health services
The Relationship between The Use of Mobile JKN Application and Health Services at Majene Regency Hospital
Full text linkBackground: This study is motivated by the digital transformation of BPJS Kesehatan services through the Mobile JKN application to improve the accessibility and efficiency of health services. The purpose of this study is to determine the relationship between the use of the Mobile JKN application and health services at the Majene Regency Hospital.
Subjects and Method: This study is a cross sectional study design using a quantitative approach and data collection through a questionnaire conducted at the Majene Regency Hospital, in August-September 2024. The total sample is 100 respondents with a sampling technique, namely purposive sampling. The study subjects were patients who used the JKN mobile application. The independent variable is health services. The intermediate variable is the Mobile JKN application. The dependent variable is satisfaction. The data was analyzed using the Wilcoxon test to see the difference in the level of satisfaction and service quality before and after the use of the Mobile JKN application.
Results: The results of the study showed that 91.6% of respondents used the Mobile JKN application, with a significant increase in satisfaction with health services, from an average score of 3,010 to 3,972 after using the application. The use of applications also has an impact on time efficiency and ease of access to health services. The average score of health services (Queue) was higher after the use of the Mobile JKN Application (Mean=4,209; SD=0.645) compared to before (Mean=3.484; SD=0.688), and this result is statistically significant (p=0.000). The health service satisfaction score was higher after using the JKN mobile application (Mean=3,972; SD=0.524) compared to before (Mean=3.010 ; SD=0.522), and this result was statistically significant (p=0.000).
Conclusion: There is a positive relationship between the use of the Mobile JKN application and the improvement of the quality and satisfaction of health services at the Majene Regency Hospital
Effects of Age, Safety Environment, and Fair Salary on Work Satisfaction
Full text linkABSTRACT
Background: Job satisfaction generally describes how satisfied a person is in carrying out their work. Job satisfaction can also be influenced by various factors such as competitive salaries, adequate staff numbers, a pleasant work environment, opportunities for growth and professionalism, reasonable workload, recognition by superiors, positive relationships with colleagues, autonomy at work, security. work, career advancement and fair rewards. This study aims to estimate the effect of age, a safe work environment and fair payment on the job satisfaction of health workers.
Subjects and Method: A systematic review and meta-analysis was conducted using PRISMA guidelines and the PICO model. The articles used range from 2014 to 2023. Population = Health workers. Intervention=age range >30 years, safe work environment, fair pay. Comparison= age range <30 years, unsafe work environment, fair pay. Outcome = job satisfaction. Articles were collected from databases such as Google Scholar, PubMed, and Science Direct. The literature search used the keywords "Safety Environment or Conducive Environment" AND "Fair Salary" AND "Health Provider" AND "Job Satisfaction" AND "Cross Sectional". A total of 9 articles met the inclusion criteria for meta-analysis, and were further assessed using RevMan 5.3.
Results: Meta-analysis with a cross-sectional study design of 9 primary study articles from Ethiopia and Myanmar showed that age over 30 years did not affect job satisfaction among health workers (aOR=1.00; 95% CI= 0.94 to 1.07; p= 0.940). A safe work environment (aOR= 1.23; 95% CI= 0.92 to 1.65; p= 0.160) can increase health workers' job satisfaction, but this increase is not statistically significant. Fair pay (aOR= 2.38; 95% CI= 1.78 to 3.19; p<0.001); can increase job satisfaction of health workers and these results are statistically significant.
Conclusion: Age over 30 years does not affect job satisfaction among health workers. A safe work environment can increase health workers' job satisfaction, but this increase is not statistically significant. Fair pay can increase health workers' job satisfaction and this result is statistically significant.
Keywords: safety environment, fair salary, health provider, job satisfactio