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All Journal Journal Medical Informatics Technology Journal of Innovative and Creativity
Hely Hely
Universitas Bunda Thamrin
Computer Science & IT Dentistry Education Engineering Languange, Linguistic, Communication & Media Mathematics Medicine & Pharmacology Public Health Social Sciences Other

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An Integrated Approach to Strengthening Public Health System Resilience Against Environmental and Disaster-Related Threats: A Literature Review Hely Hely; Murni Noviani; Balqis Nurmauli Damanik
Journal of Innovative and Creativity Vol. 5 No. 3 (2025)
Publisher : Fakultas Ilmu Pendidikan Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/joecy.v5i3.6084

Abstract

The purpose of this study is to develop an integrated framework for strengthening public health system resilience in the face of increasing environmental and disaster-related threats. While research on environmental health risks, administrative health governance, and disaster preparedness has progressed independently, public health systems continue to suffer from fragmented strategies. This fragmentation weakens coordinated responses during crises such as climate-driven disasters, pandemics, or infrastructure failures. Therefore, this review aims to synthesize current approaches and propose a unified model for adaptive and sustainable health system resilience. Materials and methods. A structured literature review was conducted using the PRISMA methodology. A total of 36 peer-reviewed articles published between 2018 and 2025 were analyzed. Selected studies were categorized into four thematic areas: environmental health, health governance, disaster preparedness, and integrated resilience models. Quantitative frameworks such as Delphi–AHP and system dynamics were reviewed alongside qualitative governance and policy analyses. Results.The findings reveal significant gaps in current public health resilience strategies. Although predictive modeling and hospital safety protocols are widely discussed, their implementation is often localized and not mainstreamed into national health policies. Governance issues such as fragmented leadership, limited budgets, and lack of inter-agency coordination were consistently cited. Only a few studies presented cross-sectoral resilience models. Conclusions.A unified resilience framework is essential for modern health systems. It must combine environmental forecasting, flexible governance, community engagement, and disaster preparedness. The proposed model provides a foundation for future research and policy innovation aimed at achieving resilient, equitable, and proactive health systems.
Determinants of Hospital Length of Stay Among Pulmonary Tuberculosis Inpatients at A Secondary General Hospital in Indonesia: A Comparative Analysis Balqis Nurmauli Damanik; Hely Hely
Journal Medical Informatics Technology Volume 4 No. 2, June 2026
Publisher : SAFE-Network

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37034/medinftech.v4i2.150

Abstract

Tuberculosis (TB) remains a major public health challenge in Indonesia, which has the second-highest TB burden globally. Hospital length of stay (LOS) is an important indicator of inpatient care efficiency and influences reimbursement under the Indonesia Case-Based Groups (INA-CBGs) payment system. However, evidence regarding determinants of LOS in Indonesian secondary hospitals is still limited. This retrospective comparative study analyzed secondary medical-record data from a secondary general hospital in Medan, North Sumatra, collected between January and August 2025. Among 238 identified records, 215 patients with a primary diagnosis of pulmonary TB (ICD-10: A15.0–A16.9) met the inclusion criteria. LOS was calculated from admission and discharge dates. As LOS was not normally distributed (Shapiro–Wilk, p < 0.001), the Kruskal–Wallis and Mann–Whitney U tests with Dunn post-hoc correction were applied (α = 0.05). The median LOS was 3 days (IQR 2–4; range 0–13). Most patients were younger than 65 years (75.3%), while 51.2% had no documented comorbidity. Comorbidity burden was the only factor significantly associated with LOS (H = 18.74, p < 0.001; η² = 0.082). Patients with two or more comorbidities had significantly longer hospitalization than those without comorbidities (mean 4.18 vs. 2.82 days; p < 0.001) and those with one comorbidity (p = 0.013). No significant differences were found according to age group or insurance status. These findings indicate that comorbidity burden contributes to prolonged hospitalization among pulmonary TB inpatients and support integrating multimorbidity management into TB care. Larger multicenter prospective studies are needed to validate these findings.
Co-Authors Balqis Nurmauli Damanik Murni Noviani