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Article

A Portrait of Socially Responsible Hospitals in Indonesia

by
Chrisanty Victoria Layman
,
Sasmoko
*,
Mohammad Hamsal
and
Lim Sanny
Business School Doctor of Research in Management, Bina Nusantara University, Jakarta 11480, Indonesia
*
Author to whom correspondence should be addressed.
Sustainability 2022, 14(6), 3437; https://doi.org/10.3390/su14063437
Submission received: 4 February 2022 / Revised: 8 March 2022 / Accepted: 10 March 2022 / Published: 15 March 2022
Versions Notes

Abstract

:
This study’s purpose is to measure social performance in hospitals in Indonesia, specifically focusing on the tendency for hospitals to act in the process of achieving various targets with a focus on social impacts on the community, stakeholders, and the environment. Although previous studies on hospital performance exist, few focus on the aspect of social responsibility. This study offers a way to measure the current social performance of hospitals using valued reference by hospital stakeholders. This study uses descriptive analysis and ANOVA for the indicators of social performance in the context of hospitals in Indonesia. Data used are from the Indonesian Commission on Accreditation of Hospital (ICAHO). This study uses data from 752 accredited hospitals in Indonesia. Results show that there were no significant differences in social performance between the different classes of hospitals. Social performance was found to be moderate on average for all classes: A, B, C, and D. However, across different accreditation levels of hospitals in Indonesia, social performance is scored as moderate with significant differences between the groups of accreditations. The implications of the results from this study provide a practical reference point measuring social performance for accredited hospitals in Indonesia.

1. Introduction

1.1. Social Performance in Healthcare

In recent years, several studies have emerged regarding corporate social responsibility (CSR) and corporate social performance (CSP) in the health sector, providing an overview of hospital CSR and the health industry. CSP is defined as a combination of social responsibility for business organizations, social response processes, policies, programs, and observable results related to the relationship between society and companies [1]. CSR has long been associated with performance in various industries and makes an important contribution to organizational success, as well as to building a reputation as a responsible business [2]. In the health sector, hospitals, closely related to human welfare, are expected to be responsible to society and sensitive to the interests of stakeholders [3]. This comprehensive definition assumes that the scope of CSP is broader than that of CSR.
Social responsibility awareness and social performance measurement in health care institutions are important contributing factors to health facilities’ ability to fulfill their responsibilities in light of the social impact accountability of their actions. Research on the topic of social performance highlights three main aspects: environmental, social, and governance [4]. Socially responsible behavior can be seen as part of strategic action in global markets, contributing to competitiveness. Such behavior represents an adaptive effort by many organizations to pay attention to their financial and social performance, leading to the promotion of social values that are receiving increased global recognition [5].
However, the approaches used for social performance measurement and quality improvement have not been rigorously evaluated, in large part because social service-based performance is not easy to measure. Furthermore, the expected strengths and concerns of social responsibility in social performance can vary over time, across cultural environments [6], between industries [7], and between stakeholder groups [8]. In previous hospital studies, research on the theme of hospital social performance has tended to be rare, especially in Indonesia.

1.2. Hospital Accreditation in Indonesia

Hospitals as public health service institutions are influenced by developments in health science and technological advances. In addition, socioeconomic factors in the community must be capable of improving the quality of affordable health services. In Indonesia, hospitals constitute 63 percent of the entire health service system [9]. One of the efforts to monitor the quality of hospitals is the application of strict hospital accreditation standards. In light of the urgent need to obtain hospitals’ commitment to achieving better quality health services, it is necessary to have a hospital performance perspective that is efficient and has a positive and sustainable impact on the community. In addition, to ensure affordable quality healthcare, all JKN affiliated hospitals (hospitals with national health insurance programs) had to be accredited by June 2019 through the main hospital accreditation body, the Indonesian Commission on Accreditation of Hospitals (ICAHO) [10].
Hospital accreditation standards were implemented in an effort to improve the quality of health services in hospitals and carry out the mandate of Law of the Republic of Indonesia No. 44 of 2009 that requires hospitals to be accredited every three years. The ICAHO is a nonprofit national accreditation agency that guides and assists hospitals in improving service quality and patient safety through accreditation. ICAHO is recognized by the International Society for Quality in Health Care (ISQua) and is the official body that assesses and awards hospital accreditation in Indonesia [11].
Hospital accreditation is important for governments seeking to provide universal health care (UHC) by using independent professional surveys to ensure that financing for health services is only provided for facilities that meet high service standards [12]. Accreditation of health facilities can also provide external validation of the quality of health services where overall medical services are known to vary widely. Such evidence can impact consumer behavior, enabling the generation of new revenue streams or increased patients for accredited institutions. The ICAHO accreditation process itself involves a rigorous and exhaustive review process to determine whether a hospital meets standards of quality. These accreditation standards include measurements condensed to 16 chapters (for educational hospitals) and 15 chapters (for noneducational hospitals) amounting to more than 1300 items assessed through interviews, documents, observations [13], etc. However, no chapters specifically measure social performance.

1.3. Social Performance Framework

Concerns about social responsibility can be traced back to the 1930s and 1940s. Business social performance measurement began to be recognized from 1940 as an early reference to business social responsibility, and the 1950s marked the start of the modern era of CSR [14]. The practices of for-profit and nonprofit organizations can follow societal norms and values as measured by their social impact and interactions with various stakeholders. Stakeholders could also eventually withdraw their support from a prominent organization due to the organization’s negative image [15]. Therefore, the concept of performance has become a corporate priority and data collection, analysis, and reporting are used to explore challenges and future management directions (strategic behavior and decisions) [16].
CSP includes environmental assessment, stakeholder management, and various external actions of the organization and their social effects. Then, the process of social responsibility takes place, resulting in outputs that include performance and its impact on people, government, and environment [17]. As the concept of social performance developed, more forms of CSP measurement emerged such as FTSE4Good, Dow Jones sustainability index, Calvert, Fortune’s ranking of community/environmental responsibility, and the Kinder, Lydenberg, Domini Study and Analytics (KLD) [18]. In the KLD data, each company receives a score on seven different social aspects: community, corporate governance, diversity, employee relations, environment, human rights, and products [19]. However, studies of CSP have been criticized for an overemphasis on testing the effects on economic performance [20,21,22]. Most empirical studies that examine CSP results focus on an organization’s financial performance, reputation among stakeholders, and internal governance structure. Meanwhile, hospital performance is differentiated into several subgroups of patients (e.g., elderly, cancer, emergencies, etc.) that are associated with substantial variations in performance within hospitals [23].
The variations in hospital performance provided the initial inspiration for the hospital social performance variables that emerged from the concept of corporate social responsibility. Hospital social performance is then defined as the practice and process of hospitals in achieving various targets with a focus on social impacts (community, stakeholders, and the environment). Indicators are identified from the various responses and feedback from stakeholders [24]. Social performance feedback rests on the entity’s social identity, which is an important driver in the organization’s strategic decision-making process. Therefore, measurement reference points for social performance remain ambiguous, and a uniform consensus of benchmarks is lacking [25,26]. This study aggregates social performance measures that include social and environmental aspects deemed important by hospital stakeholders. The environmental aspects focus on the conservation and preservation of natural resources and thus address environmental problems such as climate change, pollution, green technology, water accessibility, and deforestation, among others. The social aspects focus on human resources and relationships and cover issues related to human rights, diversity, social justice, privacy, performance workers, and algorithmic bias, among others [27].

1.4. Pollution Waste and Product Liability

The issues of pollution waste and product liability of hospitals apply to all classes, even more so in the COVID-19 pandemic era. There is growing urgency to ensure that the increased demand for health services is supported by proper disposal practices of COVID-waste and sustainable management of any environmental hazards, including the application of different disinfection techniques [28]. This is a huge issue faced by hospitals in Indonesia regarding the management of medical waste and health service facilities. During the COVID-19 pandemic, medical waste increased uncontrollably in several areas due to the failure of licensed transporters and third parties contracted by the hospitals to safely dispose of waste. Negligence of waste management resulted in the leakage of hazardous waste to surrounding areas [29,30].
The Ministry of Health issued Minister of Health Regulation No. 7 of 2019 concerning hospital environmental health, which regulates the technicalities of medical waste management. The handling of infectious waste or B3 medical specifically for COVID-19 is regulated in a Circular of the Minister of Environment and Forestry Number: SE.2/MENLHK/PSLB3/PLB.3/3/2020. Cases of deviations from proper medical waste management are a crime and could result in environmental damage [31].
Another important aspect of social performance that is a significant part of hospital obligations involves the potential legal liabilities of hospitals related to health care workers and their patients [32]. Hospital malpractice is seen as either intentional or unintentional mistakes or negligence by the hospital [33]. Product service liability is what ensures hospitals are responsible for the welfare of their patients and workers. Part of social performance, therefore, is managing responsibilities, risk, and potential liabilities [34]. Given the significant importance of this aspect and its impact on the environment and society, pollution waste and product liability are included in the measure of social performance in this study.
The study chose a reliable existing reference measure for hospitals, which is secondary data gathered by ICAHO during the hospital accreditation review processes. This study will be able to provide the scoring of current social performance within accredited hospitals. It then provides an overview of the level of achievement of social performance in Indonesian hospitals of differing classes, accreditation, and locations, specifically focusing on the tendency for hospitals to sometimes act in the process of achieving various targets with a focus on social impacts (community, stakeholders, and the environment).

2. Materials and Methods

2.1. Hospital Data

Most hospitals in Indonesia are divided into groups of class and accreditation [35]. The Indonesia hospital classification according to Minister of Health Regulation No. 30 of 2019 is based on the infrastructure, services, and human resources of the hospitals, which are divided into classes A to D (A being the highest class) [36]. Meanwhile, accreditation classes by ICAHO include the following classes: Paripurna (plenary, highest accreditation), Madya (intermediate), Utama (main), and Dasar (primary) [13]. To capture data and analyze hospital units in Indonesia, the study chose to use accreditation classes rather than infrastructure classes because not all classes of hospitals have accreditations. Furthermore, the study used data from ICAHO accredited hospitals online.
This accreditation assessment can thus be very representative of the hospital unit. In addition, the assessment is carried out by an ICAHO accreditation officer who is certified in all aspects of the ICAHO assessment. Data are also more accurately documented through the utilization of the SIKARS application, and evidence is observed based on various aspects of regulations, documents, observations, interviews, surveys, and simulation practices [37]. The data are also deemed more credible because the information is collected rigorously in the process the hospitals go through to obtain accreditation and pertains to a wide range of aspects regarding the hospitals.
The total population of ICAHO accredited hospitals was 2841 hospitals [35]. The sampling technique used in this study is the Krejcie Morgan sampling technique, which helps effectively determine the number of samples needed to represent a population [38]. With the number of 2841, the degree of accuracy is 0.05, under calculations based on the Krejcie Morgan formula and table [39]. The average number of samples to represent the population is 339. Based on the extracted ICAHO data provided, the study included a total of 752 hospitals of various accreditation levels and from different locations in Indonesia that had complete data for all the measurements needed for this study.

2.2. Methods and Measures

The type of research approach used was descriptive research, which also aims to describe the characteristics of an object, individual, group, organization, or environment; analyze the relationship between variables; and develop information generalizations [40,41]. In addition, an analysis of the indicators in this study, which included testing outliers, identifying missing data, and testing the validity and reliability of the indicators, was carried out. Furthermore, an analysis of variance (ANOVA) was also conducted to determine the significant differences between groups of data [42]. These data were all analyzed using the software SPSS.
The data from ICAHO could be assessed as credible and reliable because of the detailed process and preparation of the hospital in providing evidence for each assessment, which involves the entire hospital unit community, including hospital directors, medical personnel, nonmedical personnel, and patients. Each element was scored with one of three values: 0, 5, or 10. A score of “0” signified a nonpassing grade, indicating the hospital could not provide sufficient evidence to pass the indicators for a given element. A score of “5” signified partial passing, where the hospital could provide some evidence of conduct in line with the indicators. Finally, a score of “10” indicated a full pass, meaning the hospital had fully provided evidence and accountability for the indicators of that element.
First, ICAHO item measures were filtered for keywords that were related to social performance, social impact, pollution and waste, and product service liability. Then, construct validity was measured by conducting congruent (construct) validity by ensuring the assessment element indicators taken from the data from the hospital accreditation results manifested into a set of dimensions or variables. Exploratory factor analysis was performed to identify and describe the underlying factors that explained the intercorrelation between a set of measured variables [43]. Principal component analysis (PCA) was one of the techniques used to reduce a set of measurable variables from a large set to a smaller set of variables or variable aggregate components [44,45]. In this study, PCA was used as an EFA extraction method for a data reduction strategy performed with SPSS software. Testing the construct specifications used 100 sample data that met the KMO and significance requirements.
The reduction was carried out in two analysis runs performed to see which items were “valid” or which items will “drop” with an eigenvalue > 0.4 (Table 1). From the results of this reduction, it is possible to map out the dimension reduction using the orthogonal approach with Varimax rotation. Furthermore, construct reliability was carried out to assess whether each variable item was a convergent and reliable measure for each construct by looking at the Cronbach alpha value requirements above the value of 0.5.
Confirmatory factor analysis and discriminant validity were also tested by looking at the correlation value to ensure that the two items convergent measured the construct, clustering in groups [46,47]. Convergent validity is achieved if each variable has a value of average variance extracted (AVE) > 0.5 and composite reliability (CR) > 0.7 [48]. The validity of a construct was considered to have been achieved (Table 2).
In the end, two main constructs were measured for hospital social performance: pollution and waste management (PW) and product liability (PL). PW comprises hospital-related activities to reduce or offset the impact of products, hospital outcomes, and operations on the environment. PL comprises activities related to operational site management, quality management, and service product safety, including data as well as assessment and strategy formulation to reduce the risk of infection to the community (Table 3).

3. Results

As noted earlier, the 752 hospitals profiled included classes A (highest) to D. The hospitals included 27 A class hospitals, the highest class for hospitals; 143 B class hospitals; 396 C class hospitals; 176 D class hospitals; and 10 nonclass hospitals (Be). Data also included hospitals accredited by ICAHO, mostly Paripurna accredited hospitals (329), Utama hospitals (155), Madya hospitals (176), and Dasar accredited hospitals (92). Most of the hospitals in this research were in West Indonesia (80%), with a majority located on Java Island. The others were in Central Indonesia (15.4%) and East Indonesia (2.3%). Descriptive statistics are used to present quantitative descriptions in an organized form and help summarize large amounts of data. Inferential statistics are used to make judgments about the probability that observed differences between groups are reliable or may have occurred by chance in this study. Moreover, inferential statistics were used to make inferences from our data to more general conditions, while descriptive statistics were used to describe the data for this study (Table 4 and Table 5).
Based on the social performance (SP) value, the mean SP value from the hospital data was 8.14, which places it in the moderate category (6.50–8.49). Thus, it can be concluded that the social performance conditions of hospitals in Indonesia sometimes run an enabling process to achieve targets and results that focus on the impact on society, stakeholders, and the environment. The results of the sample data also show that the upper and lower bound conditions are in the moderate category. The five categories of this scale are (1) very low, (2) low, (3) moderate, (4) high, and (5) very high. The range was calculated by the maximum data value minus the minimum value. In this calculation, it is known that k = 5, and n = 752. Based on the data, a range of categories were created to describe the social performance range (Table 6).
The results of the trend value of social performance in class A, B, C, D, and Be hospitals in Indonesia is moderate (Table 7). These hospitals often engage in the process of achieving various targets with a focus on significant social impacts (community, stakeholders, and environment) at α < 0.05. Hospitals in class A (μ = 8.00), B (μ = 7.79), C (μ = 7.82), and D (μ = 7.72) are all found to all be moderate. Furthermore, based on the ANOVA results, social performance differences between the groups of hospitals in classes A, B, C, and D were found to be not significant (α = 0.732).
Similarly, accredited hospitals in Indonesia also tend to be moderate: accredited plenary (μ = 8.00), intermediate (μ = 7.98), primary (μ = 7.85), and basic (μ = 7.44; Table 8). As such, they take on the process of achieving various targets with a focus on significant social impacts (α < 0.05). However, the results show a significant difference between the groups of accreditations in terms of social performance (α = 0.000). Hospitals with paripurna and utama accreditation had the highest social performance score (mean 7.98). Meanwhile, hospitals with Madya accreditation (mean 7.70) and Dasar accreditation had lower social performance scores (mean 7.44).
In terms of location, hospitals in western, central, and eastern Indonesia take moderate steps (Table 9) in the process of achieving various targets with a focus on social impacts. On the other hand, based on the trend of SP values from hospitals located in the provinces of Bali (μ = 8.04), Java (μ = 7.90), Sumatra (μ = 7.79), Sulawesi (μ = 8.11), Kalimantan (μ = 7.79), Maluku (μ = 7.85), Nusa Tenggara (μ = 7.26), and Papua (μ = 8.00), also scored at moderate (Table 9).
There was no significant difference in social performance between hospitals based either on location zones (α = 0.603) or province where the hospitals were located (α = 0.145).

4. Discussion

Our study results show that there were no significant differences in social performance between the different classes of hospitals. Social performance was found to be moderate on average for all classes: A, B, C, and D. Previous studies have shown that providing adequate facilities (medical, support, and staff) will have a positive influence on overall hospital performance, patient service levels, and operational effectiveness [49], yet there was still inconsistent evidence between hospital accreditation and organizational performance [50]. This study, however, found significant differences in social performance between different levels of hospital accreditation. This suggests the success of ICAHO in measuring quality across different accreditation levels of hospitals in Indonesia. Furthermore, the many components within ICAHO can measure the distinct differences of social performance in hospitals not previously measured.
Compared to unaccredited hospitals, accredited hospitals are mostly government-owned and act mostly as referral hospitals [50]. This is also supported by the study’s analysis showing that the indicators that most influence social performance are related to hospital work policies involving decision making and freedom of supervision, recruitment, retention, development, and continuing education of all staff by involving hospital leaders. This indicates that hospital community orientation is positively associated with higher total margins, and nonprofit hospitals engaged in community orientation experience lower mean operating margins relative to for-profit hospitals [51]. Social performance is also predicted to be achieved in hospitals that have quality indicators to measure the quality of work units, as well as in hospitals that organize a hospital management information system (SIM RS) for the relevant laws and regulations to achieve good social performance. Community orientation is comparable to CSR because it also requires responsiveness to social welfare in the form of meeting the health needs of the hospital community [52].
The study contributes to understanding the implication of accreditation in measuring social performance in Indonesia that previously met with inconsistent results. The different organizational design factors, size, and ownership types were significantly associated with different accreditation statuses; the number of specialists and market concentration had no effect [53]. However, in practice, it should be noted that, while in this study the the trend value of certain variables is moderate to high, this does not necessarily indicate the level of awareness a given hospital has about its social responsibility. Hospital activities have generally been directed by the government toward community goals; thus, it is possible that social performance aspects cannot be distinguished from aspects of the hospital strategy. This social responsibility initiative must also be balanced with common interests where the activities carried out have an important priority for the hospital by their respective expertise. There is a need not only for an assessment of results and monitored deviations but also explorations of the unique strength contributing to hospital performance. In the assessment process for the hospital accreditation level by ICAHO, for example, the assessor can observe and provide an assessment of the hospital’s strengths outside of the formal assessment elements of accreditation.

5. Conclusions

This study emphasizes the importance of social performance measures for hospitals in Indonesia. Given that there are no direct universal measures, the study uses existing reference points in measuring the accreditation of hospitals to measure hospital social performance in Indonesia. In this case, this study suggests social performance be measured in terms of how the hospitals manage waste and pollution, as well as their product service liabilities.
However, this study has several limitations. First, the data entered in this study are only applicable to represent accredited hospitals in Indonesia. There was no comparable exploration of social performance outcomes at hospitals not assigned to one of the classes examined herein. There are also some missing data from the incomplete ICAHO database, such that not all hospitals can be fully represented in this study. Moreover, the study was conducted during the COVID-19 pandemic. During the pandemic, the hospital accreditation process was temporarily postponed, and there was also a distance limitation such that the study could not be supported by updated data, primary data, or direct observation at the hospital location.
Future research may want to consider extensive and longitudinal studies regarding this aspect of social performance over time, possibly before and after being accredited by ICAHO. Finally, the implementation of social responsibility in hospitals may not be directly measured within the element boundaries of ICAHO. Therefore, the secondary data analysis should also investigate direct observations over time. Researchers might also want to include further discussion of telemedicine and dissemination of social performance accountability to stakeholders.

Author Contributions

C.V.L. and S. conceptualized the idea of the research study; C.V.L. organized the planning and data collecting for the article; L.S. monitored the methodology data validation; M.H. supervised the formal analysis and article writing; C.V.L. compiled the interpretation and writing of the original draft; L.S. and M.H. monitored the review and editing; C.V.L. finalized the draft and visualization; and S. was responsible for the funding acquisition. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the Ministry of Education, Culture, Research, and Technology of the Republic of Indonesia [grant numbers 064/SP2H/LT/DRPM/2021T, 2021].

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Data of Indonesia’s hospital accreditation by ICAHO/KARS, related to this study can be found publicly here: http://akreditasi.kars.or.id/application/report/report_accredited.php (accessed on 1 February 2022).

Acknowledgments

The authors of this study would like to express their deepest thank you to the Indonesian Commission on Accreditation of Hospital (ICAHO) of Indonesia who provided the data used in this study. The authors would also express deepest thank you to Indonesia’s Ministry of Research and Technology/National Agency for Research and Technology that funded this research. Finally, our deepest thank you goes to Bina Nusantara University’s Business School Doctor of Research in Management Program supported and made this study possible.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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Table
Table 1. Individual Construct Reliability.
Table 1. Individual Construct Reliability.
ConstructItemsRun 1Run 2Reliability Statistics
DropValidDropValidCronbach’s Alphan of Items
Pollution and Waste (PW)918080.6328
Product Liability
(PL)		4123181530.8103
Table
Table 2. The Construct validity and reliability of the second-order CFA.
Table 2. The Construct validity and reliability of the second-order CFA.
ConstructSFL > 0.5AVE > 0.5CR > 0.7Convergent Validity
Social Performance (SP)0.600.75established
Pollution and Waste (8 PW)0.73 good validity
Product Liability (3 PL)0.81 good validity
Table
Table 3. Social performance measures.
Table 3. Social performance measures.
Pollution and Waste Management (PW)
PW1The hospital has a proper storage and treatment system for liquid and solid hazardous and toxic waste materials by statutory regulations.
PW2The hospital has regulations for handling hazardous waste in accordance with the WHO category and statutory regulations.
PW3The hospital reduces the risk of infection through the proper management of linen/laundry by statutory regulations.
PW4Linen/laundry management is carried out by infection prevention and control principles.
PW5The hospital reduces the risk of infection through proper management of infectious waste.
PW6The hospital determines the management of the morgue by laws and regulations.
PW7The hospital establishes the safe management of sharps and needles waste.
PW8The hospital conducts regular inspections of clean water and wastewater by laws and regulations.
Product Liability (PL)
PL1The hospital plans and implements programs for inspecting, testing, and maintaining omedical equipment, ensuring all quality utility systems (support systems) function safely, efficiently, and effectively.
PL2The hospital establishes standard diagnostic codes and procedure/action codes, including adequate information to identify patients, support diagnoses, justify treatments, maintain examination documents and treatment results, and maintain patient data confidentiality.
PL3The hospital proactively conducts infection risk assessments; implements infection prevention and control programs and strategies; and ensures overall occupational health related to health services for patients and clinical and nonclinical staff.
Table
Table 4. Descriptive Variable Statistics.
Table 4. Descriptive Variable Statistics.
nMinMaxMeanStd. Deviation
SP7524.0010.008.141.00762
Table
Table 5. Inferential Statistics Data Trend μ.
Table 5. Inferential Statistics Data Trend μ.
SP
MAX10.00
MIN4.00
Range6.00
lower bound8.07
upper bound8.22
Mean8.14
μ (level category)moderate
Table
Table 6. Social performance range.
Table 6. Social performance range.
LevelCategoryRange SP
Very lowThe hospital fully neglects to take any steps in the process of achieving the various targets with a focus on social impacts (community, stakeholders, and the environment).2.50–4.49
LowThe hospital takes minimal steps in the process of achieving the various targets with a focus on social impacts (community, stakeholders, and the environment).4.50–6.49
ModerateThe hospital occasionally takes steps in the process of achieving various targets with a focus on social impacts (community, stakeholders, and the environment).6.50–8.49
HighThe hospital takes several steps in the process of achieving various targets with a focus on social impacts (community, stakeholders, and the environment).8.50–10.49
Very HighThe hospital fully engages in the process of achieving various targets with a focus on social impacts (community, stakeholders, and environment).10.50–12.49
Table
Table 7. Social Performance Scores based on Hospital Class.
Table 7. Social Performance Scores based on Hospital Class.
Hospital ClassABCDBe
n2614039318211
Std. Error0.1920.0830.0500.0810.332
Mean8.007.967.887.827.72
95% Confidence Lower bound7.607.797.787.66.98
Upper bound8.398.137.987.988.46
5% Trimmed Mean8.058.047.967.917.80
Table
Table 8. Social performance based on hospital accreditation.
Table 8. Social performance based on hospital accreditation.
ParipurnaMadyaUtamaDasar
n33017715788
Std. Error0.5540.0750.0670.135
Mean7.977.857.987.44
95% Confidence Lower bound7.867.707.847.17
Upper bound8.088.008.117.71
Table
Table 9. Social performance based on location zone.
Table 9. Social performance based on location zone.
West IndonesiaCentral IndonesiaEast Indonesia
n61729104
Std. Error0.0410.1760.090
Mean7.887.757.96
95% Confidence Lower bound7.807.397.78
Upper bound7.968.128.14
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Layman, C.V.; Sasmoko; Hamsal, M.; Sanny, L. A Portrait of Socially Responsible Hospitals in Indonesia. Sustainability 2022, 14, 3437. https://doi.org/10.3390/su14063437

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Layman CV, Sasmoko, Hamsal M, Sanny L. A Portrait of Socially Responsible Hospitals in Indonesia. Sustainability. 2022; 14(6):3437. https://doi.org/10.3390/su14063437

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Layman, Chrisanty Victoria, Sasmoko, Mohammad Hamsal, and Lim Sanny. 2022. "A Portrait of Socially Responsible Hospitals in Indonesia" Sustainability 14, no. 6: 3437. https://doi.org/10.3390/su14063437

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