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Urinary tract infection (UTI) is a common bacterial infection that requires appropriate antibiotic management to prevent complications and antimicrobial resistance. Ceftriaxone and ciprofloxacin are commonly used antibiotics with different clinical indications in UTI treatment. This literature review aims to compare the role of ceftriaxone and ciprofloxacin in the management of urinary tract infections. A narrative literature review was conducted using articles published within the last ten years from PubMed, ScienceDirect, and Google Scholar databases. The review focuses on clinical effectiveness, resistance patterns, and therapeutic considerations. The findings indicate that ceftriaxone is primarily used in moderate to severe or complicated UTIs, particularly in hospitalized patients, whereas ciprofloxacin is more frequently used in uncomplicated UTIs in outpatient settings. However, increasing bacterial resistance and safety concerns limit the empirical use of ciprofloxacin. These findings emphasize the importance of rational antibiotic selection based on clinical conditions and local resistance patterns.  

Hypertension is one of the most common non-communicable diseases in Indonesia. Hypertensive patients must have high self-efficacy to comply with antihypertensive medication so that blood pressure can be controlled and complications prevented. Therefore, intervention is needed to improve therapy compliance. One intervention that can be given is the provision of pill cards. This study was a quasi-experimental design with a pre-intervention post-intervention control group design. Sampling was conducted using non-probability purposive sampling from July to September 2025. A total of 106 respondents were divided into two groups, with 53 respondents in the control group and 53 respondents in the intervention group. The control group was only given the MMAS-8 questionnaire, while the intervention group was given pill cards and the MMAS-8 questionnaire. In the intervention group, prior to intervention, 25 patients (47.2%) had low compliance, 21 patients (39.6%) had moderate compliance, and 7 patients (13.2%) had high compliance. After the intervention, there was a significant increase, with 21 patients (39.6%) showing high compliance, 26 patients (49.1%) showing moderate compliance, and 6 patients (11.3%) showing low compliance. Providing pill cards to outpatients with hypertension can improve patient medication adherence. Based on the results of the Wilcoxon Signed Ranks Test, a value of (p<0.001) was obtained, indicating that H0 was rejected and there was a significant effect.

Improving service quality is a primary priority in hospital management. Service quality can be improved by reducing the percentage of non-value added activities through the Lean Hospital approach. This study aims to identify activities and analyze the root causes of critical waste in the drug distribution and utilization processes at the Outpatient Pharmacy Installation of Karanganyar Regency Hospital. This study is a non-experimental research with a qualitative descriptive design. Critical waste was obtained through the distribution of a waste weighting questionnaire assessed by all personnel involved in the drug distribution and utilization processes. The results show that the Value Stream Mapping calculation for the drug distribution process obtained a lead time of 147.41 minutes and a VAR value of 36%, while in the drug utilization process, compounded prescription service obtained a lead time of 128.53 minutes and a VAR of 24%, and non-compounded prescription service obtained a lead time of 75.8 minutes and a VAR of 26%. The critical waste questionnaire calculation using the Borda method in the drug distribution process showed overproduction 60%, inventory 53.33%, and waiting 43.33%, while in the drug utilization process, waiting 43.75%, overproduction 42.85%, and defect 39.70%. The 5S method, a Lean method, was used to eliminate waste in the service process at the Outpatient Pharmacy Installation of Karanganyar Regency Hospital.

The JKN Mobile application is an electronic-based service innovation introduced by BPJS Health to facilitate JKN participants in accessing healthcare services and managing their membership information. This study aims to explore the experiences and perspectives of outpatient patients regarding the effectiveness of the JKN Mobile online registration system at Baubau City Regional General Hospital. A qualitative phenomenological approach was employed, with informants selected through purposive sampling. Data were collected to capture the meanings of patients’ experiences in using the application. The findings show that most patients are satisfied with the practicality, speed, and flexibility of the online registration system. However, technical problems, particularly unstable internet connectivity, remain a major challenge. Furthermore, the online registration system has contributed to improved service efficiency and patient satisfaction. These findings indicate the importance of continuous evaluation and improvement of the JKN Mobile online registration system to enhance service quality and health information system development at Baubau City Regional General Hospital.

Tuberculosis (TB) remains one of the leading infectious diseases causing morbidity and mortality in Indonesia. Limited public health literacy regarding TB symptoms, prevention, and treatment adherence contributes to delayed diagnosis and poor treatment outcomes. This community service program aimed to improve public understanding and awareness of TB through interactive educational activities conducted at the Outpatient Unit and TB Clinic of UPT Puskesmas DTP Saketi, Pandeglang Regency. The activities involved 30 participants, including TB patients and their families. Interactive counseling sessions, audiovisual media presentations, and group discussions were used to engage participants actively. Evaluation results showed a 35% increase in participants’ knowledge scores, greater awareness of the importance of completing treatment, and improved communication between patients and healthcare workers. The implementation of interactive education proved effective in enhancing TB health literacy and supporting national TB elimination efforts at the primary healthcare level.

Hypertension substantially increases the risk of developing secondary conditions, including stroke, renal disease, coronary heart disease, and heart failure. Early management is therefore essential to prevent complications and adverse outcomes. Evidence indicates that untreated hypertension contributes to approximately 60% of stroke cases. Public knowledge regarding hypertension-related complications remains limited, and many individuals are unable to identify early signs of stroke the most common complication associated with hypertension. This study aimed to assess the knowledge of hypertensive patients regarding stroke risk and management at Santa Elisabeth Hospital Medan in 2024. A descriptive research design was employed. The sample consisted of 67 hypertensive patients attending the outpatient clinic, selected through purposive sampling. Data were presented using frequency distribution tables. The findings revealed that 52.2% of respondents demonstrated poor knowledge, 32.8% had moderate knowledge, and only 14.9% showed good knowledge regarding stroke risk and management. These results underscore the need for patients to adopt healthier lifestyles and for the hospital to strengthen educational efforts by providing more engaging and interactive learning materials for patients and their families.

Epilepsy is one of the most common chronic neurological disorders in children. Long-term use of antiepileptic drugs carries the risk of Drug Related Problems (DRPs) such as drug interactions, inappropriate dosing, and untreated indications. This study aimed to identify the types and incidence of DRPs in pediatric epilepsy outpatients at Embung Fatimah General Hospital, Batam. This was a descriptive, non-experimental study with a retrospective design. Data were collected from pediatric medical records (<18 years) between January–December 2024, with a total of 45 patients. DRPs were identified using the American Society of Hospital Pharmacist (ASHP) classification. Of 45 patients, the majority were aged 1–5 years (38%) and female (53%). The most frequently used antiepileptic drug was sodium valproate (56.36%). Identification DRPs included drug interactions (63.16%), untreated indications (5.26%), and inappropriate drug selection (5.26%). No cases of overdose or failure to receive medication were found. The most dominant DRP in pediatric epilepsy patients was drug interactions, particularly between valproic acid and folic acid.

Electronic Medical Record (EMR) is an essential component of hospital digital transformation aimed at improving administrative efficiency and service quality. This study aims to analyze the factors influencing the implementation of EMR in outpatient registration at a private hospital in North Jakarta. A mixed-methods design was employed, combining quantitative data collected from questionnaires completed by 30 registration staff with qualitative data obtained through structured interviews and direct observation. The logistic regression analysis revealed that Training and Staff Competence (X2) had a significant positive effect on outpatient registration (OR 30.663; p=0.040), while System Integration and Data Security (X4) also showed a significant effect (OR 15.121; p=0.047). In contrast, Technological Infrastructure Readiness (X1) was positive but not significant (p=0.112), and Organizational Culture and Managerial Support (X3) was negative and not significant (p=0.954). Simultaneously, the model explained 72.1% of the variation in registration effectiveness (Nagelkerke R²=0.721) with a classification accuracy of 93.3%. Qualitative findings supported the quantitative results, highlighting insufficient staff training, persistent technical issues in BPJS system bridging, and difficulties faced by elderly patients in adapting to digital registration. Elderly patients still required staff assistance and simple educational media such as tutorial videos displayed in hospital waiting areas. This study concludes that staff competence and system integration are the key determinants of successful EMR implementation in outpatient registration. It is recommended that hospitals strengthen continuous training programs, improve network and server stability, and expand patient education initiatives to ensure effective, efficient, and patient-friendly digital services.

Hospitals in DKI Jakarta continue to face service quality challenges, including long waiting times, fragmented information systems, and limited patient access to digital health technologies. Although digital transformation and digital literacy are expected to enhance service quality, the mediating role of patient experience remains insufficiently explored. This study investigates the effects of digital transformation and digital literacy on service quality, with patient experience as a mediating variable. A quantitative explanatory design was applied using data from 200 outpatients. Measurements were based on validated indicators of digital transformation, digital literacy, patient experience, and service quality. Structural Equation Modeling (SEM) with AMOS was employed for analysis. The findings show that digital transformation significantly improves patient experience and service quality. Digital literacy positively affects patient experience but does not directly influence service quality. Patient experience fully mediates the relationship between digital literacy and service quality and partially mediates the effect of digital transformation. These results highlight the critical role of patient experience in translating digital capabilities into perceived service improvements. Hospitals are encouraged to strengthen digital transformation initiatives, enhance digital literacy support—especially for older adults—and design user-friendly digital services that facilitate communication and access. This study integrates the Technology Acceptance Model and Customer Experience Theory to provide empirical evidence on how digital-based interventions can advance hospital service quality.

Background: Accurate coding of external cause in injury diagnoses is crucial to ensure the validity of medical records, support health policy decisions, and maintain the quality of morbidity reporting.  Objective: To determine the factors that influence the inaccuracy of external cause codes in injury diagnosis at Thalia Irham General Hospital, Panciro, Gowa Regency. Method: This study employed a descriptive qualitative approach using observation and in-depth interviews with outpatient coders handling injury cases. Result: The study found that only 36% of the medical record documents were coded accurately, 26% were inaccurately coded, and 36% lacked any external cause code. The main causes of inaccuracy included incomplete anamnesis, limited time, absence of specific standard operating procedures (SOPs), and the belief that external cause codes do not impact BPJS claims. Conclusion: The low level accuracy of external cause coding is caused by the lack of understanding of officers regarding the ICD-10 Chapter XX classification, the absence of a specific SOP for coding injuries, and the perception that external cause codes do not affect the claims system.

Introduction: Experiential marketing has become a growing trend in promotional activities by emphasizing personalization and active customer involvement. Preliminary observations indicate a decline in outpatient visits among patients with general insurance and non-JKN coverage in 2023, which may be influenced by a decrease in their intention to use outpatient services. This condition highlights the need for hospitals to implement experiential marketing strategies to enhance patient interest and experience. Objective: This study aims to empirically examine the influence of patient experience and service perception on the intention to use outpatient services, with Strategic Experiential Modules (SEMs) as an intervening variable. Methods: This quantitative research employs a causal design involving outpatient service users as the population. A non-probability sampling technique was used, yielding 249 respondents. Data were collected using a questionnaire and analyzed using Structural Equation Modeling (SEM) with AMOS software. Results: The findings reveal that patient experience and service perception simultaneously have a significant positive influence on the intention to use outpatient services through SEMs. Service perception directly shows a significant positive effect on both SEMs and intention to use outpatient services, while SEMs also significantly enhance usage intention. Service perception emerges as the dominant variable in increasing SEMs and usage intention, whereas patient experience has the weakest effect. Conclusion: Patient experience and service perception collectively influence the intention to use outpatient services with SEMs as an intervening variable. Strengthening Customer Relationship Management is essential by improving human resources and optimizing service asset.

The advancement of digital technology has transformed how people search for information and access health services. RSIA Clas C Cipondoh faces challenges related to its brand image, as indicated by low patient engagement with the hospital’s website and digital platforms, based on a preliminary survey. This study aims to analyze the simultaneous and partial effects of digital literacy, website quality, and ease of access on the brand image with digital marketing strategy as a moderating variable. A quantitative research method with a cross-sectional approach was employed. The study involved 152 outpatient respondents who had accessed the hospital website. Data were analyzed using index analysis with the Three Box Method and Moderated Regression Analysis (MRA) to test the moderating effect. Findings reveal that digital literacy, website quality, and ease of access simultaneously and significantly influence the hospital’s brand image. Partially, each of these variables also has a positive and significant effect on brand image. Moreover, the digital marketing strategy effectively moderates the relationships between digital literacy, website quality, and ease of access with brand image. The Three Box Method analysis indicates that although website quality falls into the high category, weaknesses remain in the interaction quality dimension. The study concludes that strengthening digital literacy, improving website quality, and ensuring ease of access supported by an effective digital marketing strategy can enhance the hospital’s brand image. Hospitals are advised to add interactive features such as chatboxes or live chat to improve patient engagement and online service experience.

Modern healthcare services are undergoing transformation toward a more humanistic and patient-centered approach, emphasizing hospitality based services in hospitals. However, many healthcare institutions, particularly in outpatient settings, have not fully adopted this concept. Patients often experience psychological distress, and when coupled with an unsupportive physical environment, their comfort and overall experience may be diminished. These conditions can negatively affect perceptions of service quality, patient satisfaction, and loyalty toward hospital services. This study aimed to analyze the influence of patients’ psychological conditions and the physical environment on hospitality-based services, with patient experience as an intervening variable, at the internal medicine outpatient clinic of BM Hospital. A quantitative research design using a cross-sectional approach was employed. The study involved 200 respondents selected through purposive sampling. Data were collected using structured questionnaires with Likert-scale items and analyzed with Structural Equation Modeling Partial Least Squares (SEM-PLS). The results showed that patients’ psychological conditions, the physical environment, and patient experience simultaneously and significantly influenced hospitality-based services. Hypothesis testing confirmed that both psychological conditions and the physical environment had a direct and significant impact on hospitality-based services. Furthermore, patient experience played a mediating role, strengthening the relationship between these factors and perceived service quality. The findings highlight the need for hospitals to integrate psychological support and a conducive physical environment into outpatient care delivery. Enhancing these dimensions can improve patient experience, foster greater satisfaction and comfort, and build stronger loyalty toward hospital services

Tuberculosis (TB) is an infectious disease that remains a global and national health problem, with Indonesia among the top three countries with the highest TB burden in the world. Long TB treatment often impacts the physical, social, emotional, functional, and spiritual aspects of patients, so measuring the quality of health is important in assessing the success of therapy comprehensively. This study aims to determine the description of the quality of health of Tuberculosis patients at Wava Husada Hospital Malang using the Functional Assessment of Chronic Illness Therapy Tuberculosis (FACIT-TB) instrument. This study is a descriptive study with a cross-sectional approach conducted on outpatient TB patients at Wava Husada Hospital Malang during June–August 2025. A total of 113 respondents who met the inclusion criteria were included. Data were obtained through the FACIT-TB questionnaire, which comprises five main variables: Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, Functional Well-Being, and Spiritual Well-Being. The results showed that the majority of patients (53.1%) experienced moderate physical impairment, 73.5% had good social engagement, and 70.8% were emotionally stable. Fifty-four percent of respondents still had moderate functional impairment, while 45.1% were in the moderate spiritual impairment category. These findings indicate that although most patients demonstrated good emotional and social adaptation, physical, functional, and spiritual challenges remain that require further attention in healthcare. In conclusion, the overall quality of health of TB patients at Wava Husada Hospital in Malang is in the moderate category. These results underscore the importance of a multidimensional approach to TB patient management, emphasizing not only medical aspects but also psychosocial and spiritual support to improve therapy success and patient quality of life.

Patient satisfaction is a feeling that arises from the performance of health services that have been obtained after the patient compares it with what was expected. Rather than the reality that occurs there are still complaints about outpatient registration services based on electronic medical records, Frequent obstacles are if the network is disrupted, then access to the EMR can be hampered or cannot be accessed at all and the limited capacity of the waiting room is also an obstacle, especially with the large number of patients during peak hours so that many patients wait outside the waiting room. This study aims to determine the level of patient satisfaction in outpatient registration based on EMR. This study uses a quantitative method with a population of 13,750 and a sample of 99 outpatients. Based on the results of the study in 2025, it can be concluded that patient satisfaction with RME-based outpatient registration in the aspect of tangibles can be categorized as "Less Satisfied" especially regarding facilities such as AC/Television, from the aspect of reliability it can be categorized as "Satisfied" even though there are a few respondents who answered "Less Satisfied", from the aspect of responsiveness it can be categorized as "Satisfied" even though there are some patients who feel "Less Satisfied", from the aspect of assurance in RME-based outpatient registration it can be categorized as "Satisfied" but there are a small number of patients who answered "Less Satisfied" and from the aspect of empathy it can be categorized as "Satisfied" even though there are some patients who answered "Less Satisfied". So the researcher's suggestion is that the Hospital improves the quality of the waiting room, especially AC, television, increases the number of chairs and provides adequate seating for all patients, so that patients are more comfortable and avoid overcrowding

Long outpatient waiting time is an indicator of suboptimal hospital administrative systems. The Hospital Management Information System (SIMRS) is designed to improve administrative efficiency; however, in practice, complaints about long patient waiting time still persist. This study aims to examine the relationship between the registration administrative system using SIMRS and the waiting time for outpatient services at RS Patria IKKT in 2025. A quantitative approach with a cross-sectional analytical design was employed. The sample consisted of 100 outpatient respondents selected using purposive sampling. Data were collected through questionnaires and analyzed using the Chi-Square test and Spearman correlation to determine the relationship between variables. The results show that the system quality, information quality, and service quality of SIMRS at RS Patria IKKT are categorized as good. Spearman correlation analysis reveals no significant relationship between system quality (p=0.281) and information quality (p=0.910) to waiting time. However, the Chi-Square test indicats a significant relationship between service quality (p=0.001) and outpatient waiting time. The implementation of SIMRS at RS Patria IKKT contributes to accelerating administrative processes and reducing outpatient waiting time. Nevertheless, improvements in service quality are necessary to achieve more optimal results.

Brand equity turns into a decisive element that affects patient choices. Patients are more likely to select hospitals with strong brand awareness, brand association, perceived quality, and brand loyalty, according. However, there is currently little research on the direct connection to the patient's decision-making process, particularly when it comes to hospitals.This study aims to determine the relationship between brand equity and patient decisions to choose Hospital X in Depok. This study uses a quantitative approach with a cross sectional design. The sample consisted of 131 outpatients selected using consevutive sampling technique and calculated with Gpower software. The independent variables include four brand equity indicators, namely brand awareness, brand association, perceived quality, and brand loyalty, while the dependent variable is the patient's decision. Data were collected through questionnaires and analyzed using the chi- square test. The results show that only brand loyalty is significantly related to patient decisions (p=0.009), while brand awareness, brand association, and perceived quality are not related but need to be improved through more effective marketing strategies. This study contributes to the management of RS X in developing branding strategies to increase patient attraction, especially by strengthening brand loyalty and improving aspects that are not yet optimal.

The quality of outpatient services is an essential indicator of hospital performance and patient satisfaction. At Mega Buana Hospital Palopo, patient complaints remain regarding waiting times, limited facilities, and staff communication, highlighting the need for evaluation based on the Ministry of Health Regulation No. 129/Menkes/SK/II/2008. This study aimed to analyze the relationship between human resources, medical staff interactions, service processes, and patient satisfaction with outpatient service quality. This research employed a quantitative design with a cross-sectional approach. A total of 116 patients were selected through accidental sampling. Data were collected using a validated and reliable questionnaire and analyzed using the chi-square test. The results revealed significant associations between human resources (p=0.001), medical staff interactions (p=0.003), and patient satisfaction (p=0.002) with outpatient service quality. The service process, particularly waiting time and queue management, proved to be important factors influencing patients’ perceptions of service quality. Overall, the service quality was categorized as good but not yet fully aligned with the national standards, especially in administrative speed, queue system, and facility comfort. In conclusion, outpatient service quality at Mega Buana Hospital Palopo is influenced by human resources, medical staff interactions, service processes, and patient satisfaction. The findings emphasize the importance of strengthening human resource management, improving the quality of medical staff communication, enhancing queue management, and providing adequate supporting facilities to meet national service standards.

In the healthcare sector, patient revisit intention serves as an important measure of hospital success, influencing financial stability, operational effectiveness, and long-term patient retention. With increasing competition, hospitals must strengthen trust, improve service quality, and maintain a positive institutional image to retain patients. This study focuses on the declining number of non-BPJS (non-insured) patients at Cinta Kasih Tzu Chi Hospital, Cengkareng, which impacts revenue sustainability. The research aims to assess how trust and customer perceived value affect revisit intention, and whether hospital image moderates these relationships. A quantitative approach was applied using a structured questionnaire distributed to 95 non-BPJS outpatients who had previously sought treatment more than once. Data were analyzed through Structural Equation Modeling (SEM) using the Partial Least Squares (PLS) method via SmartPLS software. The findings reveal that both trust and perceived value significantly and positively influence revisit intention, implying that patients with strong trust and satisfaction tend to return. Although hospital image directly influences revisit intention, it does not significantly moderate the link between perceived value and revisit intention. Therefore, hospitals are advised to enhance patient trust and perceived value while sustaining a credible institutional image to strengthen loyalty among non-BPJS patients

Malaria is an infectious disease caused by various species of Plasmodium, such as Plasmodium vivax, Plasmodium falciparum, Plasmodium malariae, and Plasmodium ovale, which are transmitted through the bite of Anopheles mosquitoes. The spread of this disease is highly influenced by the presence of mosquito breeding sites as vectors of transmission. This study aims to analyze the relationship between the knowledge and attitudes of outpatients toward malaria prevention behaviors at the ASA Enterop Clinic in Jayapura. The study design used a descriptive analytical method with a cross-sectional approach. The research instrument was a questionnaire, and data analysis involved both univariate and bivariate analysis, as well as Chi-square statistical testing. The results showed that 57 respondents (54.0%) had good knowledge with good prevention behavior, and 5 respondents (8.0%) had moderate knowledge with good prevention behavior. Meanwhile, 1 respondent (4.4%) had good knowledge but poor prevention behavior, and 5 respondents (5.0%) had moderate knowledge with poor prevention behavior. The conclusion of this study indicates a significant relationship between knowledge and attitudes with malaria prevention behavior in the research area. These findings highlight the importance of improving public knowledge and attitudes in preventing malaria and suggest that strengthening health education and awareness is crucial for disease prevention.