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Journal of Health Policy and Management
Published by Universitas Sebelas Maret
ISSN : -     EISSN : 25490281     DOI : -
Core Subject : Health,
Medicine & Pharmacology Public Health
Journal of Health Policy and Management (JHPM) is an electronic, open-access, double-blind and peer-reviewed international multidisciplinary and integrative journal, focusing on health policy, health system, and healthcare management. It began its publication on October 21, 2015. The journal is published twice yearly. It aims to improve the design and implementation of health policies, health systems, and healthcare management, primarily in low- and middle-income countries. JHPM analyzes policy initiatives and healthcare systems and provides evidence-based research to guide policymaking and management decision-making.
Arjuna Subject : -
Articles 253 Documents
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Evaluation of the Implementation of the Hospital Management Information System at Sentra Medika Hospital, Cikarang Anom Dwi Prakoso; Ice Marini; Niko Suwaryo; Hilda Septia; Shella Oktavitania; Althea Tugap Buambitun; Indah Azahra Fauliza
Journal of Health Policy and Management Vol. 11 No. 1 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpm.2026.11.01.08

Abstract

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.
Personal and Institutional Factors Affecting Physiotherapist Performance in Nusa Tenggara Barat, Indonesia Rizka Dwi Yulianti; Anik Lestari; Eti Poncorini Pamungkasari
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

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.
Association Between Pharmacy Staff Communication Interaction Quality and Outpatient Satisfaction at ‘Aisyiyah Bojonegoro Hospital Sudalhar; Andini Dwi Aningtyas; Afriza Umami; Pramono Apriawan Wijayanto; Septin Maisharah Karyono
Journal of Health Policy and Management Vol. 10 No. 3 (2025)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpm.2025.10.03.12

Abstract

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.
Evaluation of the Implementation of Clinical Accreditation Standards in Surakarta, Central Java, Indonesia Sari Tyaswikaning Aji; Tonang Dwi Ardyanto; Argyo Demartoto; Yeny Ristaning Belawati; Selfi Handayani
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

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
Health Insurance Ownership and Factors Related to the Utilization of Health Services in Blitar, Central Java, Indonesia Afrizal Ikhsanul Fathoni; Yeny Ristaning Belawati; Hafi Nurinasari; Selfi Handayani; Arsita Eka Prasetyawati
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: Blitar City, Indonesia, aims to achieve 99.74% universal health coverage (UHC) by 2024. However, public health services are only accessible to 34.6% of the population. Utilization of services for non-communicable diseases such as hypertension remains below 20%. The aim of this research was to analyze the relationship between health insurance ownership, predisposing factors, and supporting factors on the utilization of health services. Subjects and Method: This was a cross-sectional study design and involved 405 respondents in Blitar City, Central Java, Indonesia. Data collection was conducted using a structured questionnaire instrument measuring demographic characteristics, socioeconomic status, health status, health insurance ownership, and psychological behavioral aspects (self-efficacy, attitude, and intention) rated on a Likert scale. Data were analyzed using a structural equation modeling (SEM) approach for path analysis. Results: Path analysis revealed five main factors that significantly influenced healthcare utilization. Directly, gender (b=0.15; CI 95%=0.05 to 0.26; p=0.005), marital status (b=0.13; CI 95%=0.02 to 0.24; p=0.017), and behavioral intention (b=0.07; CI 95%=0.03 to 0.12; p=0.003) had a significant positive effect. Indirectly, self-efficacy was the most dominant positive predictor of behavioral intention (b= 0.54; CI 95%=0.49 to 0.59; p<0.001), followed by behavioral attitude (b=0.09; CI 95%= 0.02 to 0.15; p=0.009). Conclusion: Self-efficacy, gender, marital status, attitudes, and intentions are dominant factors. The government needs to simplify digital systems, optimize men's health programs, and transform service quality to keep pace with the high pace of UHC achievement.
Transformational Leadership and Tuberculosis Control Performance: Mediating Roles of Well-Being and Motivation Dedi Ari Saputro; Setyo Sri Rahardjo; Revi Gama Hatta Novika; Anik Lestari; Eti Poncorini Pamungkasari
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: Tuberculosis control requires optimal performance from healthcare workers. Psychosocial factors such as transformational leadership, subjective well-being, and work motivation are believed to play a role in enhancing this performance. This study aims to analyze the effects of transformational leadership and subjective well-being on the performance of healthcare workers in TB control, as well as to examine the role of work motivation as a mediating variable. Subjects and Method: This study employed a cross-sectional design with a sample of 265 health workers at nine community health centers in Sragen Regency, selected using purposive sampling. The independent variables included transformational leadership and subjective well-being; the dependent variable was health worker performance; and work motivation served as the mediating variable. The data were analyzed using path analysis. Results: The results of the study indicate that work motivation has a positive and significant effect on the performance of healthcare workers (b = 1.04; 95% CI 0.63 to 1.45; p<0.001). Transformational leadership also has a positive and significant effect on performance (b=0.36; 95% CI 0.14 to 0.57; p=0.001), while subjective well-being has a positive but not significant effect (b=0.21; 95% CI -0.02 to 0.43; p=0.075). Transformational leadership (b=0.18; 95% CI 0.11 to 0.24; p<0.001) and subjective well-being (b= .38; 95% CI 0.33 to 0.42; p<0.001) have a significant effect on work motivation. Furthermore, work motivation significantly mediated the effects of transformational leadership (b=0.19; 95% CI 0.10 to 0.27; p<0.001) and subjective well-being (b=0.39; 95% CI 0.23 to 0.56; p<0.001) on healthcare workers’ performance. Conclusion: Work motivation and transformational leadership significantly influence healthcare workers’ performance in tuberculosis control, with work motivation serving as the primary mediator linking transformational leadership and subjective well-being to performance.
Exploring Readiness for Change among Community Health Cadres in Indonesia’s Minimum Service Standards Program: A Path Analysis Ani Afifah; Revi Gama Hatta Novika; Setyo Sri Rahardjo; Eti Poncorini Pamungkasari; Anik Lestari
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: The increasing workload of integrated health service post cadres in implementing the six minimum service standards has not been fully accompanied by adequate cadre readiness. This condition may affect the optimization of the community-based integrated health service post service quality. This study aimed to analyze the effects of perceived program feasibility, perceived benefits, perceived management support, and self-efficacy on cadre readiness in implementing the six minimum service standards. Subjects and Method: This analytic observational study used a cross-sectional design conducted in Sragen Regency, Central Java, Indonesia, from February to March 2026. A total of 217 active Integrated Health Service Post cadres were selected using purposive sampling from 25 primary healthcare centers. The dependent variable was cadre readiness, while the independent variables included perceived program feasibility, perceived benefits, perceived management support, and self-efficacy. Data were collected using a structured and validated questionnaire developed from the Organizational Readiness for Change framework. Data were analyzed using descriptive statistics, bivariate linear regression, and multivariate path analysis with STATA. Results: Self-efficacy had a direct and significant effect on cadre readiness (b=0.45; 95% CI=0.34 to 0.53; p<0.001). Perceived benefits also had a direct and significant effect on cadre readiness (b=0.34; 95% CI=0.26 to 0.42; p<0.001). Regarding indirect effects through self-efficacy, perceived program feasibility had a significant indirect effect on cadre readiness (b=0.37; 95% CI=0.15 to 0.59; p=0.001). Perceived benefits also showed a significant indirect effect (b=0.29; 95% CI=0.12 to 0.46; p=0.001), as did perceived management support (b=0.16; 95% CI=0.04 to 0.28; p=0.009). Conclusion: Cadre readiness to implement the six MSS is influenced by perceived program feasibility, perceived benefits, management support, and self-efficacy. Strengthening organizational support and cadre capacity is essential for successful implementation.
Effects of Leadership Style and Work Environment  on Job Satisfaction and Employee Performance in Community Health Centers Khuzaimah Triverta; Setyo Sri Rahardjo; Bhisma Murti; Okid Parama Astirin; Erindra Budi Cahyanto
Journal of Health Policy and Management Vol. 11 No. 1 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

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.
Psychosocial Factors Affecting the Performance of Community Health Center Employees Nadia Fitriana Fariati; Setyo Sri Rahardjo; Bhisma Murti; Ratih Puspita Febrinasari; Anik Lestari
Journal of Health Policy and Management Vol. 11 No. 1 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

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
Service Quality and Insurance Status as Determinants of Patient Satisfaction at Dr. Soehadi Prijonegoro Hospital, Sragen, Central Java, Indonesia Alifia Ayu Romadhona; Bhisma Murti; Revi Gama Hatta Novika; Setyo Sri Rahardjo; Sumardiyono
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

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.

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