Exploring the factor explaining the continuity of hospital accreditation standard adoption in Indonesia

Authors

  • Viera Wardhani Post Graduate Program in Hospital Management, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
  • Sutoto National Hospital Accreditation Committee (KARS), Jakarta, Indonesia
  • Tjahjono Kuntjoro Master Program in Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
  • Adi Utarini Department of Health Policy and Management, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

DOI:

https://doi.org/10.35727/jha.v5i02.258

Keywords:

Hospital accreditation, External evaluation, Quality improvement, Determinant factors, Low middle-income countries

Abstract

Background: Hospital accreditation has been widely adopted to stimulate continuous quality improvement. Hence, understanding the factors that determine hospital capability to continuously maintain its accreditation status is critical..

Objective: This study aimed to explore the continuity of hospital accreditation status and its association with hospital characteristics and geographical disparities

Methods: A three-year cohort of accredited hospitals in the year 2012-2014 was used. Hospital accreditation status, reaccreditation status at three years post accreditation (2015-2017) and their timeliness and improvement of accreditation status were recorded from the hospital accreditation report managed by the Indonesian Commission on Accreditation of Hospitals. Cross-tabulation of the outcome variables with hospitals characteristics (classification, ownership, specialty) and geographical area was performed, followed by a multiple logistic regression analysis to investigate determinants of the reaccreditation

Results: Of the 461 hospitals accredited in the year 2012-2014, only 73% undertook the reaccreditation survey. At reaccreditation, 27% of the hospitals were reaccredited timely and  65% showed improved accreditation status. Higher hospital class, general hospitals, public

hospitals, and their location in Java-Bali islands tended to have higher proportion of timely accreditation and improved accreditation status at reaccreditation. The logistic regression analysis confirmed that hospital class and those located in Java-Bali were significant determinants for continuity of hospital accreditation status.

Conclusions: The low proportion of hospitals with continuous accreditation status within three years reaccreditation cycle is influenced by the hospital classification and provincial gap. This study suggested a step-wise quality regulation strategy focusing on developing a continuous quality improvement culture.

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Published

2023-07-30

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