e-ISSN: 2549-0281 Publisher: Masters Program in Public Health, Sebelas Maret University, Jl. Ir Sutami 36A, Surakarta 57126, Central Java, Indonesia Editor in Chief: Prof. Ari Natalia Probandari, dr., M.P.H., Ph.D Sebelas Maret University, Solo, Indonesia Aim and Scope The Journal of Health Policy and Management (JHPM) is a peer-reviewed, open-access international journal that publishes original research articles, systematic reviews, and meta-analyses on a four-monthly basis. Since its establishment on October 21, 2015, JHPM has served as a critical platform for disseminating high-quality, policy-relevant research that informs and influences health care systems and public health governance worldwide. JHPM provides a forum for researchers, policy-makers, health care managers, public health professionals, and academics to engage with evidence-based insights into the formulation, implementation, and evaluation of health policy and management practices. The journal embraces multidisciplinary and integrative approaches to better understand complex health challenges and generate innovative, actionable solutions. The scope of JHPM spans a wide array of topics, including but not limited to: Health policy development and analysis Health systems management and governance Health economics and financing Epidemiological research with policy implications Public and social policy in health Strategic health planning and administration Equity and access in health care delivery Ethical and philosophical dimensions of health policy Global health policy and comparative health systems JHPM welcomes rigorous research from scholars and practitioners across the globe, with a strong emphasis on contributions from low- and middle-income countries (LMICs). We especially encourage submissions that address urgent health system issues, propose innovative models of care, or evaluate health policy impacts in diverse settings. By promoting dialogue across disciplines and geographies, the Journal of Health Policy and Management aims to foster practical knowledge, inform policy decisions, and support the advancement of efficient, equitable, and sustainable health systems worldwide.
Masters Program in Public Health, Sebelas Maret University
Determinants of Patient’s Satisfaction and Loyalty at Surakarta Central General Hospital, Central Java, Indonesia
Background: Hospitals are required to continuously improve service quality and ensure patient safety. Surakarta Central General Hospital, as the only type C vertical hospital owned by the Ministry of Health in Surakarta, faces competition from other type C hospitals operated by local governments and private sectors. This study aimed to identify factors influencing patient satisfaction and loyalty among users of healthcare services at Surakarta Central General Hospital. Subjects and Methods: This was a quantitative cross-sectional study conducted at the Surakarta Central General Hospital, Central Java, Indonesia, from April to May 2025. A total of 270 respondents, including both inpatients and outpatients, were selected using simple random sampling. The dependent variables were service quality, patient satisfaction, and patient loyalty. The independent variables included hospital image, type of health financing, type of disease, and type of care. Results: Patient loyalty was positively and significantly influenced by satisfaction (b = 0.33; 95% CI = 0.26–0.41; p < 0.001) and hospital image (b = 0.41; 95% CI = 0.29–0.53; p < 0.001). Patient satisfaction was positively and significantly affected by service quality (b = 0.19; 95% CI = 0.13–0.24; p < 0.001), hospital image (b = 0.25; 95% CI = 0.08–0.43; p = 0.005), and type of financing (b = 0.51; 95% CI = 0.11–0.92; p = 0.013). Service quality was positively and significantly influenced by hospital image (b = 1.13; 95% CI = 0.77–1.48; p < 0.001) and type of financing (b = 0.91; 95% CI = 0.05–1.78; p = 0.039). The path analysis model demonstrated good model fit, as indicated by the following indices: p = 0.702; RMSEA = 0.00; CFI = 1.00; TLI = 1.05; SRMR = 0.00; and CD = 0.33. Conclusion: Patient loyalty is directly and significantly influenced by satisfaction and hospital image. Patient satisfaction is directly and significantly influenced by service quality, hospital image, and type of financing. Service quality is directly and significantly influenced by hospital image and type of financing. Overall, the path analysis model demonstrated a good fit.
Copyright (c) 2026 Journal of Health Policy and Management
The Impact of Waiting Time and Education Level on Outpatient Satisfaction: Meta-Analysis
Background: Patient satisfaction is a primary focus in the delivery of health care services. Assess­ment of patient satisfaction has been widely conducted worldwide and serves as an important tool for identifying service gaps and developing effective strategies to improve quality within the health care industry. Various factors influence patient satisfaction, including waiting time and educational level. This study aimed to analyze the effects of waiting time and educational level on outpatient satisfaction. Subjects and Method: This study employed a systematic review and meta-analysis using the PICO framework. The population consisted of outpatient clinic patients. The interventions were long waiting times and higher educational levels. The comparisons were short waiting time and lower educational level. The outcome was patient satisfaction. Data were obtained from Google Scholar, ScienceDirect, Elsevier, SpringerLink, Wiley, Scopus, and PubMed databases, covering publications from 2018 to 2023. The keywords used were “patient satisfaction” AND “waiting time” AND “short waiting time” AND “long waiting time” AND “educational level” AND “outpatient department”. A total of 13 articles met the inclusion criteria, which were full-text articles using a cross-sectional design, outpatient subjects, and reporting outcomes in the form of odds ratios. Article selection followed the PRISMA flowchart, and data analysis was performed using Review Manager version 5.4. Results: The 13 included studies involved a total of 25,017 participants from Ethiopia, Fiji, Pakistan, South Africa, and Serbia. The pooled analysis showed that patients experiencing long waiting times had 0.18 times lower satisfaction compared to those with short waiting times (aOR = 0.18; 95% CI= 0.06 to 0.49; p <0.001). In addition, patients with higher educational levels had 1.02 times higher satisfaction compared to those with lower educational levels, although this association was not statistically significant (aOR = 1.02; 95% CI= 0.34 to 3.02; p = 0.980). Conclusion: Shorter waiting times are associated with higher patient satisfaction in outpatient clinics. Higher educational level shows a positive but non-significant association with patient satisfaction.
Service Quality and Insurance Status as Determinants of Patient Satisfaction at Dr. Soehadi Prijonegoro Hospital, Sragen, Central Java, Indonesia
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.
Psychosocial Factors Affecting the Performance of Community Health Center Employees
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
Effects of Leadership Style and Work Environment on Job Satisfaction and Employee Performance in Community Health Centers
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.
Evaluation of the Implementation of Clinical Accreditation Standards in Surakarta, Central Java, Indonesia
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
Association Between Pharmacy Staff Communication Interaction Quality and Outpatient Satisfaction at ‘Aisyiyah Bojonegoro Hospital
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.
Personal and Institutional Factors Affecting Physiotherapist Performance in Nusa Tenggara Barat, Indonesia
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.
Evaluation of the Implementation of the Hospital Management Information System at Sentra Medika Hospital, Cikarang
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.
THE EFFECT OF WORK-LIFE BALANCE ON WORK STRESS, SLEEP DISORDERS AND EMPLOYEE PERFORMANCE
Background: Work-life balance is a crucial factor influencing employee psychological well-being and performance. An imbalance between work and personal life can increase job stress, trigger sleep disturbances, and decrease productivity. This study aims to analyze the effect of work-life balance on job stress, sleep disturbances, and employee performance. Subjects and Methods: This cross-sectional study was conducted at the Mineral and Coal Testing Center in Bandung from March to April 2025. A total of 207 patients were selected using exhaustive sampling. The dependent variable was work-life balance. The independent variables were work stress, sleep disturbance, and employee performance. Data were analyzed using path analysis. Results: The results of this study show that Work-life balance negatively affected job stress (b = -1.04; 95% CI = -1.18 to -0.91; p < 0.001) and sleep disturbance (b = -1.45; 95% CI = -1.65 to -1.23; p < 0.001), and positively affected performance (b = 0.42; 95% CI = 0.31 to 0.53; p < 0.001). Job stress positively affected sleep disturbance (b = 0.57; 95% CI = 0.49 to 0.65; p < 0.001). Conclusion: Work-life balance has a direct impact on performance and an indirect impact through reduced work-life stress and sleep disturbances. Interventions to improve work-life balance should be a company priority. to support employee productivity and well-being.
Effect of Social Capital on Job Satisfaction and Performance of Healthcare Workers at Hermina Sukabumi General Hospital
Background: Social capital can serve as an important strategy for improving job satisfaction and performance. Satisfied employees will display a good personality in the work environment and improve performance positively in the health sector. This study aims to analyze the effect of social capital on job satisfaction and performance. Subject and Method: This study was conducted using a quantitative method with a cross-sectional approach and using a path analysis model. This study was conducted at Hermina General Hospital Sukabumi, West Java in December 2024. The sample of this study was 200 health workers. The exogenous variables were social capital, education, working period, age and gender. Endogenous variables were job satisfaction and performance. Results: Pathway analysis showed that the performance of health workers at Hermina Sukabumi Hospital was directly influenced by job satisfaction (b=0.33; 95% CI=0.22 to 0.45; p<0.001), age ≥ 29 years (b=0.17; 95% CI=0.03 to 0.31; p=0.016), education ≥bachelor’s degree (b=-0.14; 95% CI=-0.26 to -0.01; p=0.027), working period ≥4 years (b=-0.37; 95% CI=-0.50 to -0.24; p<0.001), gender (female) (b=-0.19; 95% CI=-0.32 to 0.06; p=0.003). Job satisfaction was indirectly influenced by 4 years of ≥ working period (b=0.08; 95% CI=-0.01 to 0.16; p=0.077), gender (female) (b=-0.08; 95% CI=-0.17 to 0.01; p=0.075) and social capital (b=0.81; 95% CI=0.77 to 0.85; p<0.001). Social capital had an indirect effect through job satisfaction with the total effect size (b=0.26). The effect of the total working period of ≥4 years on performance (b=-0.34). Total effect of gender (female) on performance (b=-0.21). Conclusion: Strong social capital can increase job satisfaction, and satisfied employees will have higher performance and increased productivity.
Determinants of Patient Safety Practice Behavior Among Nurses at Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia
Background: Patient safety is an event where the hospital builds patient care to be safer, including risk assessment, identifying, and managing matters related to patient risk, reporting and analyzing incidents, learning from incidents and their follow-up, as well as providing solutions to reduce the occurrence of risks and to avoid injuries caused by mistakes that occur due to doing an action or taking an action that should not have been taken. The purpose of this study is to identify the behavioral determinants of patient safety practices among nurses at Dr. Moewardi Hospital, Indonesia. Subjects and Method: This study was a cross-sectional study conducted at Dr. Moewardi Hospital in January 2025. The sample consisted of 200 inpatient nurses selected by a simple random sampling method. The independent variables in this study were work attitude, work stress, communication, teamwork, and work environment. The dependent variable was the patient safety practice behavior. Data collection was conducted using a questionnaire. Data analysis was conducted using path analysis. Results: The behavior of patient safety practice in inpatient nurses was directly influenced by positive work attitudes (b=0.22; 95% CI= 0.08 to 0.36; p= 0.002), low work stress (b= 0.16; 95% CI= 0.02 to 0.30; p= 0.022), and effective communication (b= 0.24; 95% CI= 0.11 to 0.36; p<0.001). The patient safety practice behavior among nurses through work attitudes was indirectly influenced by work stress and teamwork. The patient safety practice behavior among nurses through work stress is indirectly influenced by teamwork and the work environment. The patient safety practice behavior among nurses through communication was indirectly influenced by teamwork. Conclusion: The patient safety practice behavior among inpatient nurses is directly influenced by positive work attitudes, low work stress, and effective communication. The patient safety practice behavior among nurses through work attitudes is indirectly influenced by work stress and teamwork.
Building Patient’s Loyalty: The Role of Trust, Expectations, and Satisfaction Among Outpatient Commitment
Background: Quality health services are the result of cooperation between patients and health service providers in a healthy environment. Hospitals as institutions engaged in service quality are a benchmark for assessing patient loyalty. One of the benchmarks is the quality of service received by patients from a hospital; therefore, it is the obligation of the hospital to maintain a good relationship with patients to create a maximum loyalty value. Based on Law Number 17 of 2023 concerning health, it is stated that local governments and communities are responsible for the implementation of health efforts. The implementation of health services is carried out responsibly, safely, quality, and equitably. The study aims to discover factors that affect the loyalty of outpatients at Klaten Islamic Hospital. Subjects and Method: It was a cross-sectional study conducted at Klaten Islamic Hospital from December 2024 to January 2025. The sample consisted of 200 outpatients selected using the simple random sampling method. The independent variables were hospital image, trust, expectation, past experience, and satisfaction. Meanwhile, the dependent variable was outpatient loyalty. Data collection was carried out using a questionnaire. Data analysis was conducted using path analysis. Results: The results of the path analysis that had been carried out in this study stated that the loyalty of outpatients at Klaten Islamic Hospital was directly influenced by trust (b=-0.02; 95% CI= -0.30 to 0.24; p= 0.831), satisfaction (b=0.44; 95% CI= 0.19 to 0.69; p<0.001), age (b= 0.13; 95% CI= 0.01 to 0.24; p= 0.024), hospital image (b= 0.20; 95% CI= 0.08 to 0.32; p=0.001), Education (b= -0.11; 95%CI= -0.22 to 0.00; p=0.054), gender (b= - 0.00; 95%CI= -0.11 to 0.11; p=0.958). Patient loyalty through patient trust was indirectly influenced by past experience, patient satisfaction, expectations, and polyclinic. Conclusion: The loyalty of outpatients at Klaten Islamic Hospital is directly influenced by trust, satisfaction, age, hospital image, education, and gender. Patient loyalty through patient trust is indirectly influenced by past experience, patient satisfaction, expectations, and polyclinic.
The Impact of Social Capital, Work Motivation, and Job Satisfaction on Health Workers’ Performance in Community Health Centers
Background: Social capital, which includes relationships between individuals, social networks, as well as trust in organizations, is believed to affect the effectiveness of collaboration and communication, which in turn impacts performance. Work motivation plays an important role in encouraging individuals to achieve organizational goals. In addition, job satisfaction, which is influenced by certain factors, contributes to the improvement of individual performance in the workplace. This study aims to analyze the influence of social capital, work motivation and job satisfaction on the performance of health workers in health centers. Subject and Method: This study is a cross-sectional study conducted on health workers at the Subang Regency health center in November-January 2025. The research sample of 203 health workers was selected using random sampling. The dependent variable is performance. Independent variables are social capital, work motivation and job satisfaction. Data collection using questionnaires. The data were analyzed using Multiple Linear Regression on Stata 13. Results: Social capital (b= 0.08; CI 95%= 0.02 to 0.14; p= 0.006), job satisfaction (b= 0.60; CI 95%= 0.36 to 0.84; p = 0.000), work motivation (b = 0.21; CI95%= 0.04 to 0.37; p= 0.013) has the influence to improve performance and is statistically significant. Age (b= 0.00; CI95%= -0.02 to 0.04; p= 0.613) there was an increase but statistically insignificant, of sex (b= -0.23; CI95%= -0.76 to 0.29; p= 0.385) followed by a statistically insignificant decrease. Length of work 11-19 (b= 0.01; CI95%= -0.57 to 0.61; p= 0.950) followed by an increase but statistically insignificant. Working time >20 years (b= -0.23; CI95%= -1.03 to 0.57; p= 0.572) followed by a statistically insignificant decrease, strata of puskesmas (b = 0.36; CI95%= -0.17 to 0.89; p= 0.184) there is an increase but statistically insignificant. Conclusion: The performance of health center health workers is influenced by social capital, work motivation and job satisfaction. Age, gender, length of work, strata of the health center are not factors that affect performance.
Factors Affecting Job Satisfaction and Performance of Health Workers at Community Health
Background: Motivation, leadership, career development, and rewards or incentives are important determinants of job satisfaction and performance among healthcare workers at Community Health Centers (CHCs). This study aimed to analyze and estimate the association between motivation, leadership, career development, rewards/incentives, job satisfaction, and the performance of healthcare workers. Subjects and Method: This was a cross-sectional study involving 200 healthcare workers from CHCs in Kerinci Regency, Jambi Province, conducted from October to November 2024. Samples were selected using accidental sampling. The dependent variable was health worker performance, the mediating variable was job satisfaction, and the independent variables were motivation, leadership, career development, and rewards/incentives. Data were collected using structured questionnaires and analyzed using path analysis. Results: Healthcare workers with high motivation were more likely to perform well than those with low motivation (b=0.31; CI 95%=0.18 to 0.45; p<0.001). Healthcare workers with high job satisfaction were more likely to perform well than those with low job satisfaction (b=0.43; CI 95%=0.30 to 0.46; p<0.001). Healthcare workers with high job satisfaction were more likely to be well motivated than those with low job satisfaction (b=0.21; CI 95%=0.13 to 0.29; p<0.001). Health workers who had a positive perception of leadership were more likely to be satisfied with their work than with a negative perception (b=0.74; CI 95%=0.68 to 0.80; p<0.001). Conclusion: The performance of healthcare workers in CHCs was directly affected by motivation and job satisfaction. Higher motivation and job satisfaction were associated with improved health worker performance.
Copyright (c) 2025 Journal of Health Policy and Management
Meta-Analysis: Exploring the Impact of Marital Status, Work Environment Conditions, Education, Gender, and Age on Job Satisfaction among Healthcare Professionals
Background: Health is a very complex field because it focuses on healthcare providers. The quality of healthcare can be determined through the job satisfaction of healthcare workers. Factors that can affect the job satisfaction of healthcare workers can be assessed based on marital status, working conditions, education, gender, and age. The purpose of this study was to estimate the effect of marital status, working conditions, education, gender, and age on job satisfaction among healthcare workers. Subjects and Method: A meta-analysis study was conducted in accordance with the PRISMA flow chart and PICO model. Population: healthcare workers. Intervention: female, >30 years old, bachelor's degree, single, and good working environment. Comparison: male, <30 years old, diploma, married, and poor working environment. Outcome: job satisfaction. Data were obtained from the Google Scholar, PubMed, BMC, ScienceDirect, Elsevier, and Springer Link databases. The keywords used were “gender” AND “age” AND ‘education’ AND “marital status” AND “work environment” AND “job satisfaction” AND “health workers” AND “cross-sectional” AND “aOR”. Data analysis was performed using Review Manager 5.3 software. Results: This meta-analysis included 12 cross-sectional studies from Myanmar and Ethiopia. The sample size was 3,962 health workers. Marital status (aOR= 1.43; 95% CI= 1.03 to 2.00; p= 0.003) and good working conditions (aOR= 1.55; 95%CI= 1.18 to 2.04; p= 0.002) significantly increased job satisfaction among health workers. Bachelor's degree (aOR= 1.51; 95% CI= 0.53 to 4.83; p= 0.400), female gender (aOR= 1.34; 95% CI= 0.87 to 2.05; p= 0.180), and age >30 years (aOR= 1.81; 95% CI= 0.81 to 4.09; p= 0.150) increased job satisfaction among healthcare workers but were not statistically significant. Conclusion: Marital status, work environment conditions, education level, gender, and age affect job satisfaction in health workers.
Indonesian Medical Students' Perceptions of Computer Based Test (CBT) Questions on Public Health Competency Test: An Evaluation Study
Background: The Indonesian Medical Competency Standards (SKDI) are the educational standards for doctors in Indonesia. To prove that students have met the competency requirements, a competency test is necessary. Research results show that CBT of Public Health questions fall into the moderate-difficult category. This means that institutions must have a specific strategy to guide students. Subjects and Method: This qualitative study conducted in-depth interviews with Indonesian medical students who had passed or failed the Indonesian Medical Competency Test. The interviews were conducted online using Zoom. Informants were selected from various regions in Indonesia. Results: The study identified five themes. The five themes are: 1) varying perceptions of the difficulty level of public health questions, 2) lack of focus, 3) question patterns and reference books, 4) sources and methods of learning for the public health question, and 5) examinees' expectations. Conclusion: Students' perceptions of the difficulty level vary. This is also related to the students' own preparedness. Students have specific expectations regarding certain questions, such as those related to Indonesian national health insurance (BPJS), epidemiology, and others
The Impact of Motivation, Stress, and Fatigue on the Performance of Primary Health Care Employees in Surakarta
Background: The performance of health personel is one of the biggest reasons for the good and bad health services. There are various factors that can affect employee performance such as motivation, stress, and work fatigue. This study aims to see if there is an effect of motivation, stress, and fatigue on the performance of Puskesmas employees. Subjects and Method: This study is a quantitative study using a cross-sectional design. This study was conducted on 17 health centers in the city of Surakarta, Central Java, Indonesia starting from August to September 2024. With a sample of 202 health center employees who were randomly selected or using a simple random sampling. The dependent variable in this study is the performance of health center employees. The independent variables in this study were motivation, stress, and fatigue. Data collection was carried out using a questionnaire and analyzed with path analysis. Results: Motivation has an influence on improving performance and is statistically significant. Motivation (b= 1.14; CI 95% = 1.06 to 1.06; p<0.001), stress (b= 0.83; CI 95% = 0.70 to 0.95; p<0.001), has a statistically significant effect on performance degradation, and fatigue (b=0.06; CI 95% = 0.02 to 0.12; p=0.041), had a degrading effect and was statistically significant. Conclusion: The performance of health center employees is influenced by motivation, stress, and fatigue.
Determinants of Inpatient Satisfaction at Dr. M. Yunus Regional General Hospital, Bengkulu, Indonesia
Background: A hospital is a healthcare facility that provides medical services and care to patients that serve for the treatment and treatment of various diseases or health conditions supported by the services provided in the hospital. This study aims to analyze the factors that affect inpatient satisfaction so that it is known which factors are most influential and health service improvements can be more measurable. Subjects and Method: This study uses a cross-sectional study conducted at the dr M. Yunus Bengkulu Regional General Hospital, Indonesia, from January to February 2024. The sample consisted of 165 inpatient respondents who were selected by stratified random sampling technique. The independent variables in this study were age, gender, education level, ward type, class of care, financing method, tangibles, assurance, responsiveness, realibility and empathy. The dependent variable is inpatient satisfaction. Data collection was carried out by questionnaire. The data will be tested for validation and reliability so that Cronbach's alpha score is obtained in Stata 13.0 Software. The average SERVQUAL score will be assessed as the difference between the expected score and the actual score. Results: The patient satisfaction score obtained based on the gap in the SERVQUAL score between expectations and reality were reliability factors (-2.81), assurance (-4.72), tangibles (-4.68), empathy (-4.76), and responsiveness (-4.53). The results of the analysis of the influence of patient satisfaction on patient loyalty obtained a percentage value of 80.6% with the number of loyal patients as many as 133 out of 165 patients. Conclusion: The services provided by the Regional General Hospital dr M Yunus Bengkulu have not been able to meet the expectations of patients. Empathy is the least satisfying thing for the patient among others. Meanwhile, reliability is the thing that can satisfy patients the most.
The Relationship Between Motivation, Length of Service, Work Environment, Job Satisfaction, and the Performance of Healthcare Workers at National Hospital of Diponegoro, Semarang, Indonesia
Background: Performance is the result of work achieved by a person in carrying out his duties which is based on skills, experience, seriousness, and time aimed at the progress of an organization or company. This study aims to analyze the relationship between motivation, length of work, work environment, job satisfaction, and the performance of health workers at Semarang Hospital. Subjects and Method: This study uses an observational analytical design with a cross-sectional approach conducted at the Semarang Hospital from June to July 2024. The sample consisted of 200 health workers who were selected by a simple random sampling method. The independent variables in this study were motivation, length of work, work environment, and job satisfaction. The dependent variable is the performance of the health workers of Semarang Hospital. Data collection was carried out by questionnaire. The data was analyzed using the structural equation model (SEM) analysis model. Results: The performance of health workers increased with a good work environment (b=0.38; 95% CI=0.19 to 0.56), but decreased with longer working A good work environment was influenced by strong work motivation (b=0.13; 95% CI=0.01 to 0.23), and high job satisfaction (b=0.45; 95% CI=0.30 to 0.59). Work motivation was positively influenced by job satisfaction (b=0.37; 95% CI=0.17 to 0.53). Length of work was positively influenced by job satisfaction (b=0.48; 95% CI=0.30 to 0.59). This Path Analysis shows good goodness of fit: Chi Square p= 0.268 ( >0.050), RMSEA= 0.04 (<0.08), CFI= 0.99 (>0.90), TLI= 0.096 (>0.90), and SRMR= 0.03 (<0.05). Conclusion: Performance is directly affected by the work environment, and the length of work, and is indirectly affected by job satisfaction and work motivation.