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Managing Regional Public Service Agency (Badan Layanan Umum Daerah/BLUD) hospitals requires planning and budgeting processes that are accountable, measurable, and aligned with service performance. In practice, BLUD planning is still constrained by fragmented applications (hospital information system/SIMRS, finance, human resources, e-office, and procurement), duplicate data entry, approval delays, and limited monitoring of process compliance. This study aims to analyze requirements and design a web-based BLUD planning information system using an Enterprise Application Integration (EAI) approach through middleware to improve cross-system interoperability, data consistency, and the timeliness of executive reporting. The study adopts the Design Science Research (DSR) framework, comprising problem identification, definition of solution objectives, artifact design and development, demonstration, evaluation, and communication/report writing. The proposed system includes a unit-based budget proposal module and item management, a role-based approval workflow (RBAC) with SLA tracking, a budget ceiling (pagu) master to benchmark proposals, audit trails and report exports, and an executive dashboard integrating budget perspectives, service indicators (e.g., bed occupancy rate/BOR and patient visits), and process compliance. It also provides an integration design via middleware (ESB/message broker) supported by a canonical data model (CDM) and traceable logging (trace_id/correlation_id). Evaluation using black-box testing and API contract testing indicates that the main planning workflow operates as intended and the integration interfaces are consistently defined, providing a foundation for staged implementation and further performance evaluation.

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.

The work behavior of health workers is a key factor in determining the quality of service and patient safety in hospitals. In healthcare organizations with high work demands, feedback and rewards are important instruments of human resource management to form positive work behaviors. However, empirical evidence on the role of rewards as a mediating variable in the relationship between feedback and work behavior of health workers, particularly in Indonesian regional hospitals, is limited. This study aims to analyze the influence of feedback on work behavior through the role of reward mediation in health workers at Konawe Hospital, Southeast Sulawesi Province, Indonesia. This study used a quantitative approach with a cross-sectional design. Data was collected through a survey using a structured questionnaire based on the Likert scale of 170 health workers with ASN status at Konawe Hospital. The sampling technique used a combination of purposive and accidental sampling. Data analysis was carried out with Partial Least Squares–Structural Equation Modeling (PLS-SEM) using SmartPLS software version 4.0. The results showed that rewards had a positive and significant effect on work behavior (β = 0.579; t = 10.308; p = 0.000), and feedback had a positive and significant effect on rewards (β = 0.805; t = 25.851; p = 0.000). In addition, feedback also had a positive and significant effect on work behavior through rewards (β = 0.466; t = 8.362; p = 0.000), which confirms the mediating role of rewards. There is an influence of appraisal on work behavior and feedback on awards and awards has been shown to significantly mediate the influence of feedback on the work behavior of health workers. These findings emphasize the importance of effective feedback management and an integrated reward system as a managerial strategy to encourage positive work behavior and improve the quality of health services in regional hospitals.

The National Health Insurance Program (Jaminan Kesehatan Nasional or JKN) is a government initiative aimed at ensuring equitable, accessible, and affordable healthcare services for all Indonesian citizens. Since its implementation in 2014, the program has covered more than 90% of the population; however, several challenges remain, particularly concerning the quality of services at primary healthcare facilities such as community health centers (puskesmas). This study aims to analyze the quality of JKN services at the Cengkareng Public Health Center, West Jakarta, using the five dimensions of service quality proposed by Parasuraman: tangibles, reliability, responsiveness, assurance, and empathy. The research employed a descriptive qualitative method through in-depth interviews, direct observations, and document analysis involving healthcare workers and JKN patients. The findings indicate that the overall service quality at Puskesmas Cengkareng remains suboptimal. The tangibles and assurance dimensions are relatively good, while reliability, responsiveness, and empathy are still lacking. Major complaints include long waiting times, poor doctor–patient communication, and unfriendly staff attitudes. These findings highlight the need for improving human resource professionalism, strengthening service management systems, and conducting periodic evaluations to enhance the overall quality and patient satisfaction among JKN participants.  

Informed consent constitutes a fundamental legal and ethical requirement in healthcare services, ensuring that every medical action is performed with the patient’s full awareness and voluntary approval. In Indonesia, the obligation to obtain informed consent is firmly regulated under the Health Law No. 17 of 2023, the Minister of Health Regulation on Medical Consent, and provisions on medical records. This paper examines the essential role of informed consent as a protective instrument for both patients and healthcare providers within the clinical and legal framework. Informed consent guarantees patients’ rights to information, autonomy, and decision-making, while providing legal safeguards for medical practitioners by documenting the process of explanation, acceptance, or refusal of medical treatment. Proper documentation within medical records ensures accountability, continuity of care, and serves as crucial evidence when medical disputes arise. Medical disputes often stem from dissatisfaction, communication gaps, or misunderstandings about risks inherent in medical procedures. Therefore, informed consent functions not merely as an administrative requirement but as a mechanism for preventing conflict, clarifying responsibilities, and distinguishing unavoidable medical risks from professional negligence. By strengthening the implementation of informed consent, healthcare providers can enhance transparency, improve service quality, and reduce the likelihood of medical litigation.  

This study examines the implementation of digital health services via the Mobile JKN application at the Payung Sekaki Community Health Center in Pekanbaru City and explores factors affecting service effectiveness, especially complaints about long waiting times. Using a descriptive qualitative approach based on the Mobile Health Acceptance Model by Handayani et al. (2021), the study focuses on five constructs: ease of use, system availability, system responsiveness, health workers’ digital skills, and user trust. The results show that Mobile JKN has significantly simplified administrative processes, accelerated registration, and improved service efficiency at the health center. Effectiveness is supported by factors such as the application’s general ease of use, faster queue data processing, and adequate digital skills among staff. Users also show a high level of trust, though queue time estimation still needs improvement. Despite these benefits, complaints about long waits persist due to patients who register online but still queue manually and misunderstandings between Mobile JKN and e-Puskesmas queue numbers. Late patient arrivals also contribute to delays. Overall, Mobile JKN proves effective in enhancing digital health services, but further optimization is needed through better socialization of service procedures, accurate queue information, and improved system integration to maximize the advantages of digitalization.

This study analyses the challenges of digitalising registration services at Primary Healthcare Facilities (Fasilitas Kesehatan Tingkat Pertama, FKTP) in East Java, including limitations in human resources, technological infrastructure, and public digital literacy, all of which affect the satisfaction of National Health Insurance (Jaminan Kesehatan Nasional, JKN) patients. Utilising the Systematic Literature Review (SLR) methodology with the PRISMA approach, the study reviews literature from 2024–2025 sourced from databases such as Google Scholar, using keywords related to digitalisation, FKTP, and patient satisfaction. The analysis is based on the ADO (Antecedent, Decision, Outcome) framework. The findings identify three key factors: (1) Antecedents (human resource competence, infrastructure, digital literacy); (2) Decisions (human resource training, facility modernisation, public outreach); and (3) Outcomes (increased patient satisfaction through time efficiency and ease of access). The study emphasises the need to strengthen human resources, provide adequate infrastructure, and educate the public to ensure the sustainability of digital healthcare services at FKTPs in East Java.

The advancement of information technology has had a significant impact across various sectors, including healthcare. The digitalization of healthcare services has become a solution to improve efficiency, effectiveness, and accessibility for the public. Puskesmas Selindung still uses a manual patient registration system, which leads to several issues such as long queues, extended waiting times, and the risk of lost or damaged patient records. Based on visit data, the number of patients coming to Puskesmas Selindung has increased each year. Therefore, a digital queue system is needed to optimize the patient registration process. This research aims to analyze and design an Android-based patient registration queue application to improve service efficiency at Puskesmas Selindung. The research methods include system requirements analysis, user interface design, and the development of core features to support the online patient registration process. The implementation of this application is expected to reduce long queues, speed up administrative processes, and make it easier for patients to access healthcare services more effectively and accurately. With this Android-based system, the quality of healthcare services at Puskesmas Selindung is expected to improve significantly.

Diabetes mellitus (DM) is one of the global health challenges that continues to rise, including in Indonesia. However, the lack of education and counseling from pharmacists regarding the use of natural ingredients medicines has the potential to affect the effectiveness of treatment and the management of DM. This study aims to measure the level of knowledge, attitudes, and behaviour of DM patients, related to the use of natural ingredient drugs in DM management. This study uses a cross-sectional method design, starting with the collection of quantitative data. Sampling was conducted using purposive sampling technique over a period of four months. The research involved 101 DM patients from 15 pharmacies in Kendal Regency. The level of knowledge (44.6%), attitude (66.3%), and behaviour (39.6%) of patients in the moderate category. However, the limited knowledge of pharmacists remains a barrier to optimizing pharmaceutical services related to educating patients about natural ingredient medications.

This study aims to analyze the spatial patterns of ambulance transport demand in Semarang City based on patients’ origin subdistricts, origin villages, and destination healthcare facilities. The analysis employed the K-Means Clustering algorithm as a data mining method to group areas according to similarities in the volume of ambulance requests. The dataset consisted of ambulance transport service records from January 2024 to September 2025, obtained from the Semarang City Health Office. The analytical procedures included data cleaning, normalization, determination of the optimal number of clusters using the Elbow Method, and cluster formation using K-Means. The results show two main clusters for subdistricts and destination healthcare facilities. High-demand subdistricts were generally densely populated areas such as Banyumanik and Pedurungan, with an average of 1,256 requests, while RSUP Dr. Kariadi emerged as the dominant referral facility with 3,893 requests. Meanwhile, village-level origins formed three clusters, with average demands of 549 (high), 190 (medium), and 36 (low). These findings are expected to support strategic planning for equitable ambulance fleet distribution and improved efficiency of patient transportation services in Semarang City.

Response time refers to the speed of nurses in providing initial responses to patients, measured from the moment patients arrive at the hospital entrance until they receive medical attention from emergency room staff. Patient satisfaction is an important indicator of healthcare quality, reflecting the comparison between patient expectations and the services received. This study passed the ethical review process with approval number 66/EC-LPPM/UWHS/IV-2025 and used a quantitative correlational design with a cross-sectional approach. The sampling technique applied purposive sampling involving 197 respondents. Data were collected using a nurse response time observation sheet and a patient satisfaction questionnaire that had undergone validity and reliability testing. The validity test using the Pearson Product Moment method showed that the calculated r value was greater than the r table value of 0.361, indicating that all questionnaire items were valid. The reliability test using Cronbach’s alpha produced a coefficient value of 0.855, confirming that the instrument was reliable. Data analysis used univariate and bivariate analysis with the Spearman’s rho test. The results showed that nurse response time was categorized as fast (≤ 5 minutes) for 177 respondents (89.8%). Patient satisfaction levels showed that 177 respondents (89.8%) were very satisfied, 10 respondents (5.1%) were satisfied, and 10 respondents (5.1%) were moderately satisfied. The Spearman Rank test produced a p-value of 0.000 (<0.05) with a correlation coefficient of 0.893, indicating a strong and positive relationship between nurse response time and patient satisfaction in the Emergency Room of Charlie Hospital Kendal.

This study investigates the clinical handover process as a critical component of patient safety and healthcare service quality in hospital settings. Inconsistent communication, incomplete documentation, and the absence of standardized procedures were identified as major problems contributing to communication failures and potential adverse events. The objective of this research was to develop and test a structured and effective handover model that could improve communication accuracy and documentation reliability among healthcare professionals. A mixed methods design was employed, consisting of a qualitative phase (in-depth interviews, observations, and document analysis) to explore real-world handover practices, followed by a quantitative phase using a pretest–posttest design to evaluate the effectiveness of the proposed model. The study proposes an integrated handover model based on SBAR-IM (Situation, Background, Assessment, Recommendation, Intervention, Monitoring) strengthened by Quality Control (QC) and Mutual Confirmation (MC) mechanisms. The findings demonstrate a significant improvement in handover quality after implementation, with communication scores increasing from 74 to 84.5 and documentation scores improving from 48.3 to 63.0 (p < 0.05). Qualitative results further revealed reduced communication errors, improved clarity of clinical information, and enhanced interprofessional collaboration. This study concludes that the proposed SBAR-IM–based QC–MC model is effective, practical, and suitable for improving patient safety and healthcare service quality in hospital environments.

Human Immunodeficiency Virus (HIV) infection leading to Acquired Immune Deficiency Syndrome (AIDS) remains a global public health issue, with 39 million people living with HIV worldwide in 2022. Although X Hospital in Malang City provides a comprehensive care program, internal data shows a significant level of non-adherence to antiretroviral (ARV) therapy, often in the form of irregular consumption or discontinuation of medication without medical recommendation. This observational study with a cross-sectional approach aims to identify the determinants of ARV non-adherence, involving 81 non-adherent AIDS patients at Hospital X through total sampling techniques. The characteristics of the respondents were dominated by males, highly educated, and working in the non-government sector, with the majority using the ARV regimen TLD, COTRIMOXAZOLE. The results of statistical analysis indicate that all eight determining variables tested show a highly significant positive correlation (p < 0.001) with non-compliance, meaning that the more severe the problems with these factors, the lower the patient compliance. Furthermore, the top five factors showed a very strong positive correlation (r > 0.80) with non-adherence, namely motivation/depression, social support, communication with service providers, treatment costs, and age or routine. These findings underscore that these five key determinants must be a crucial focus in designing and implementing targeted intervention strategies to effectively improve patient adherence to ARV therapy.

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.

Doctors play a crucial role in determining the quality of healthcare services and in upholding the right to health as guaranteed by the constitution and international human rights frameworks. Despite this essential role, medical practice continues to encounter significant challenges, including disparities in medical education quality, inadequate competency assessment mechanisms, and limited integration of professional ethics, discipline, and scientific standards within the health legal system. These issues create risks to patient safety and undermine public trust in medical services. This research analyzes the urgency of health law reform to ensure physician competence and proposes an integration model that unites ethics, discipline, and scientific foundations as the core pillars for equitable and welfare-oriented medical professional governance. Using a normative legal research method, this study adopts legislative, conceptual, and comparative approaches. Primary and secondary legal materials are examined qualitatively through doctrinal studies, normative analysis, and comparisons with governance practices of the medical profession in other countries. The study finds that health law reform should prioritize strengthening regulations on competency standards, transparent certification and periodic recertification systems, as well as integrated professional oversight that aligns ethics, discipline, and legal accountability. The proposed integration model serves as a framework to ensure that every physician maintains measurable competence, adheres to professional ethics, and upholds clear legal responsibilities in clinical practice. Reforming health law through such integration is a strategic step to enhance medical service quality, reinforce patient protection, and advance global justice and welfare.

This study aims to analyze the effect of the use of Health Information Media in the form of leaflets on the level of patient knowledge about influenza in pharmacies Ngudi Waluyo, Ungaran. Leaflet Media is used as an educational tool to improve patient understanding related to influenza, including aspects of causes, symptoms, complications, and management and treatment. The type of research used is quasi experiment with pre-test and post-test design, involving 94 respondents who meet the inclusion criteria. Data analysis was conducted using the Wilcoxon statistical test to determine the difference in the level of knowledge of patients before and after education. The results showed a significant increase in the level of knowledge of patients after obtaining education using leaflets. Before being given education, respondents with a good knowledge level category were 56.7%, and increased to 96.8% after providing education, with a value of p = 0.001 (p < 0.05) which showed a significant difference between the two measurements. Thus, the Health Information media in the form of leaflets proved effective in increasing patient knowledge about influenza and can be used as an alternative educational media that is simple, practical, and efficient in supporting pharmaceutical services in pharmaceutical service facilities.

Obstructive ileus is a digestive system disorder characterized by a blockage caused by abnormalities in the intestinal lumen, intestinal wall, or foreign objects outside the intestine. Blockages in this intestinal area can cause accumulation or buildup at the site of the blockage. Patients with obstructive ileus generally experience complaints such as nausea, vomiting, abdominal distension, bowel disorders, flatus (gas) disorders, and the most common symptom is abdominal pain. The goal of this community service is to enable families to understand the definition, causes, and management of obstructive ileus and to practice applying warm compresses to minimize pain in the affected area. The methods used in this activity were counseling, interactive discussions, and practice of applying warm compresses. The media used were leaflets and flipcharts. The results obtained from this health education activity can improve patient (family) knowledge and practice in applying warm compresses to relieve pain. It is hoped that after this activity, patients (families) can apply knowledge of how to manage pain independently as an initial preventative measure to reduce pain

Health care facilities are places used for promotive, preventive, curative, and rehabilitative health services carried out by the government and the community. Calculating the germ count on door handles of healthcare facilities is very important, because patients are not aware that the door handles contain and transmit germs that cause infections. This study aims to determine the percentage of germ contamination on door handles of healthcare facilities at X Hospital and X Community Health Center. The type of research conducted is descriptive quantitative with an observational case report approach. This study is a frequency distribution in tabular form using a percentage formula. The number of samples used by the researchers was 8 samples, using 4 sampling points at the Hospital and 4 sampling points at the Community Health Center (Puskesmas): the Emergency Room, Main Door, Pharmacy Room, and Laboratory Room. Data collection by conducting laboratory tests on door handle swab samples was then examined using the ALT method. The results showed that the percentage of door handles that did not meet ALT standards was 3 samples (75%) at X Hospital. Meanwhile, on door handles at health facilities Puskesmas. The percentage of door handles at Puskesmas was obtained 4 samples (100%) at X  Puskesmas. Door handles at health facilities do not meet the standards of the Republic of Indonesia's Minister of Health Decree No. 1204 / MENKES / SK / X / 2004, the decision Ho was accepted H1 was rejected.

Nutrition services are an essential component in hospital healthcare systems, directly supporting patient recovery through timely and clinically appropriate nutrition. This study aimed to analyze the timeliness of meal distribution, diet appropriateness, diet types, patient satisfaction, and factors supporting efficient nutrition service at Hospital X. A descriptive quantitative observational design was employed, involving 35 inpatients, observing meal delivery, menu accuracy, and staff performance. Results showed that the majority of diet-receiving patients were male (60%), aged 20–45 years (34.3%), with most staying 2 days (60%). Meal distribution was timely: 94.3% for breakfast, 97.1% for lunch, and 100% for afternoon snacks and dinner. The most common diets were TKTP (High Calorie High Protein, 22.9%) and DMRG (Low Salt Diet, 17.1%), and all patients received diets according to medical indications (100%). Patient satisfaction regarding meal timeliness, diet appropriateness, taste, food temperature, and staff performance was mostly satisfied to very satisfied, with minor dissatisfaction (5.7%) only during breakfast due to distribution delays. Despite limited personnel, service efficiency was achieved through clear task division, effective communication, work discipline, supporting systems, and active supervision. In conclusion, nutrition services at Hospital X are effective, efficient, timely, diet-appropriate, support patient recovery, and comply with hospital service standards. The alternative hypothesis (H1) is accepted, and the null hypothesis (H0) is rejected

Type 2 Diabetes Mellitus is a chronic disease that not only causes physical disorders, but also has an impact on the patient's psychological condition, especially increased stress levels. Unmanaged stress can worsen medical conditions, decrease adherence to treatment, and negatively impact the patient's quality of life. Social support is known to have an important role as a protective factor in helping patients cope with psychological burden. This study aimed to analyze the relationship between social support and stress levels in patients with Type 2 Diabetes Mellitus. The research design used was descriptive correlation with a cross-sectional approach, involving [number of respondents] patients selected with the [mention sampling technique]. The research instrument used a validated social support questionnaire and stress scale. The data were analyzed by the Pearson/Spearman correlation test according to the data distribution. The results showed that there was a significant relationship between social support and stress levels in patients with Type 2 Diabetes Mellitus (p < 0.05), with a negative correlation direction, which means that the higher the social support received by the patient, the lower the level of stress experienced. These findings confirm the importance of the role of family, health workers, and the social environment in supporting patients to manage stress and improve quality of life. This study recommends the need for social support-based interventions in diabetes management programs in health services.