INTRODUCTION
Improving
health services in hospitals is a demand that must be met in order to provide
quality services for the community (Budo et al.,
2020).
However, the challenges faced in the development of health services in
hospitals are not only limited to internal factors, but also external factors
that can affect the performance and effectiveness of hospitals in providing
health services (Piyajeng
&; Wibowo, 2017).
Analysis
of external factors that affect the development of health services in hospitals
is important to do in order to understand the factors that can affect the
performance and effectiveness of hospitals in providing optimal health services
(Panggabean,
2020).
External factors that are the focus of this analysis include social, political,
economic, and technological factors that can affect the development of health
services in hospitals (Karmawan,
2018).
In
this journal, we will discuss the analysis of external factors that influence
the development of health services in hospitals with the aim of providing a
more comprehensive understanding of the factors that can affect the performance
and effectiveness of hospitals in providing optimal health services. There are
several previous studies that have been conducted to analyze external factors
that influence the development of health services in hospitals, including.
To
analyze external factors affecting the development of health services in
hospitals in Indonesia. This study uses the SWOT (Strengths, Weaknesses,
Opportunities, and Threats) analysis method to identify external factors that
affect the development of health services in hospitals (Nugraheni
&; Kirana, 2021).
Next
to analyze external factors that affect the performance of hospitals in
Indonesia. This study uses the method of analyzing external factors using the
PESTEL (Political, Economic, Social, Technological, Environmental, and Legal)
approach to identify external factors that affect the performance of hospitals
in Indonesia (Irawan &;
Ainy, 2018).
To
analyze external factors that affect the performance of hospitals in Indonesia.
This study uses the method of analyzing external factors using the PEST
approach to identify external factors that affect hospital performance in
Indonesia (Septiana,
2017).
From
the results of the study, it was found that external factors that affect the
development of health services in hospitals include social, political,
economic, and technological factors. These factors can affect the performance
and effectiveness of hospitals in providing optimal health services, so it
needs to be considered in the development of health services in hospitals.
Therefore, based on this background, this study aims to analyze external
factors in Health Service Development at Bungur Medika Hospital.
METHODS
In this study, the author uses qualitative analysis
(Creswell &; Creswell, 2017), namely analysis carried out on data, written
descriptions, and verbal descriptions then connected
with data, written descriptions, and other verbal descriptions to gain clarity
about the truth or vice versa so that new perspectives are obtained or
strengthen existing opinions (Basias &; Pollalis, 2018) . This
research is included in descriptive research because this study intends to
describe an event, namely human resource planning at Bungur Medika Hospital
with the development of hospital services as an effort to improve employee
performance. The approach in this study uses an interdisciplinary approach.
RESULTS AND DISCUSSION
1. External Factor Analysis Framework
Figure 1
External Factor
Analysis Framework
Porter's
found that there are five competitive forces that need to be analyzed in each
industry in developing strategies, namely Threat of New Entrants, Threat of
Substitute, Bargaining Power of Suppliers, Bargaining Power of Buyers and
Rivalry Among Existing Firms (Wijiharjono,
2021).
When conducting Porter's Five Forces analysis,
hospitals weighted and indexed all five competitive forces on the basis of
these pressures. Here are the quantitative weighting steps in Porter's Five
Forces
analysis:
1.
Determine the index value for each factor of each competing force.
Each factor in determining the index value is divided into index 1 = low /
insignificant level of influence, 2 = significant level of influence, 3 = very
significant.
2.
Determining the weight of each factor based on justification for
the value that most affects the competitive power, the sum of the weighting
results must be 1, where the value of 0 is the value that least affects the
competitive power. Justification of weighting based on the results of group
analysis.
3.
Multiplies the weight of each factor by the index, then sums and
infers the value based on a predetermined range. The data assessment ranges are
as follows:
Table
1 Data Assessment Range
|
Parameters
|
Value
|
|
Low
|
1.00 – 1.66
|
|
Keep
|
1.67 – 2.33
|
|
Tall
|
2.34 – 3.00
|
Source:(Porter's, 2008)
If the results of quantitative calculations
of Porter's Five Forces
analysis are in the range of 1.00 – 1.66, it can be categorized
as low where the company is in a competition that is not too competitive.
Meanwhile, if the quantitative results produce results in the range of 1.67 –
2.33, it is categorized as medium, the company is in a fairly intense
competition. Quantitative results that are in the range of 2.34 – 3.00 are
categorized as high parameters which means the company is in an industry that
has a high level of competition and is very competitive.
2.1 Threat of New Entrants
2.1.1 Capital Requirements (Weighting 0.3 and Index 1)
Capital requirements in the establishment of a
hospital require a large cost budget, this is because strategic land is needed
with an area that is not small, besides that the cost needs for the procurement
of medical equipment infrastructure, as well as human resource costs also
require a high budget, large capital is needed for the establishment of a
hospital. So because of this, the threat to newcomers gets a weight of 0.3 with
Index 1.
2.1.2 Product Deferentiation (Weight 0.3 and Index 3)
In product differentiation in the hospital
business, between one hospital and another hospital does not have a significant
difference. To distinguish it from other hospitals, our hospital prioritizes
services by utilizing the BPJS Health guarantee facility which is a government
program, with no cost, supported by the ease and speed of service utilizing the
digitization of the hospital management information system. In the product
differentiation section, hospitals with totality in BPJS Health services are
not much, because INA CBGs financing is low in paying for the services
provided, so in this case it gets a weighting of 0.3 with index 3.
2.1.3 Access to Distribution (Weighting 0.4 and Index 2)
The hospital is a business entity in the field
of health services needed by the community, so access to reach consumers in
this case patients is very open
(Prana, 2013). This hospital utilizes BPJS Health financing guarantees owned by
almost all communities, so that community reach to access health services
becomes easy (Widiastuti,
2017). In this section we give a weight of 0.4 with an index of 2.0
2.2
Industry rivalry
2.2.1 Diversity of Competitors (Weighting 0.3 and Index 3)
The availability of hospital services in the
Central Jakarta area with a variety of services and types of hospitals, gives
consumers many choices and increases competition in the health industry. From
various types of hospitals in the Central Jakarta area, all types of hospitals
are available from type A to type D. This increases competition in the
hospital industry. The community can choose a hospital according to their
financing ability. Thus, we conclude the weight for Diversity of
Competitors is 0.3 with index 3.
2.2.2 Concentration (Weight 0.3 and Index 1)
The concentration here is the number of
hospitals competing in a type of service and a similar industry. The number of
hospitals in the type C hospital industry in the Central Jakarta area is still
relatively small because there are only 4 type C hospitals and 3 special
hospitals in the Central Jakarta area with the population in the Central
Jakarta area based on the results of the population census in 2020 amounting to
1,056,896 people. Competitors of 4 type C hospitals and 3 special hospitals in
the Central Jakarta area: RS. General Mother, General Hospital Menteng Mitra
Afia, General Hospital Pertamina Jaya, General Hospital Budi Glory, Special
Hospital for Aesthetic Development Surgery, Pond Mother and Child Hospital and
Special Hospital for Salemba Satu Surgery. Thus the weight we give is 0.3 with
index 1.
2.2.3 Barrier to Exit (Weight 0.3 and Index 1)
In a business, it is very possible if a
company has low revenue so that it loses to its competitors but still chooses
to survive because it has a strategy (Ritonga,
2020). Because of this, there is an analysis to describe the hospital
strategy that will be made in the face of any obstacles and consequences if
exiting this business. Based on the analysis conducted, high capital in the
hospital business is one of the reasons for not easily exiting this business.
With high capital, especially for land, infrastructure, and human resources, so
we can conclude the weight given is 0.3 with Index 1.
2.3
Bargaining Power of Buyer
2.3.1 Price Sensitivity (Weighting 0.4 and Index 3)
Currently, with government policy in the
health sector by organizing the National Health Insurance, people can easily
access health services by using BPJS Kesehatan financing guarantees (Adiyanta,
2020). People without being able to seek treatment without being
charged, provided that they have a BPJS Health card that can be obtained
independently or through a contribution mechanism borne by the government.
Cost is no longer an obstacle for people to obtain health services. So we give
a weight of 0.4 with index 3.
2.3.2 Buyers Information (Weighting 0.2 and Index 3)
The ease of obtaining information in today's
digital era makes it easier for people to obtain information on health services
of a hospital very easily
(Putra, 2019). The registration process and queue can be trimmed to make it
easier for the community. The hospital built will prioritize a digitalization
system to support the community to obtain facilities in hospitalization. For
this reason, a weight of 0.2 with index 3 is given.
2.3.3 Switching Cost (Weight 0.2 and index 2)
The cost of transfer by patients who switch to
other hospitals, especially those who do not use BPJS Health guarantees, will
result in a considerable increase in costs for patients. Patients will try to
be able to seek treatment by using BPJS Health insurance as long as the quality
of service at the hospital can be maintained. Then the weight given is 0.2
with index 2.
2.4
Bargaining Power of Supplier
2.4.1 Number of Suppliers (Weight 0.4 and Index 2)
Suppliers to hospitals determine the
availability of materials used to provide health services for patients. In
this case, the need for consumables, pharmaceutical supplies, and supplies of
medical devices determine the continuity of the service process. In Indonesia,
the availability of suppliers of the three things mentioned above is very
sufficient, many vendors of consumables, pharmaceutical supplies, and medical
devices. This makes it easier for hospitals to obtain materials that are the
basic material for health services. Then the weight given is 0.4 with index 2.
2.4.2 Supplier Pricing (0.4 Weighting and Index 2)
The pricing of pharmaceutical drugs and
consumables needed by hospitals in providing services is regulated by the
government through the e-catalog process and the highest retail price
mechanism, so that prices can be controlled properly and not based on market
prices (Indayanti,
2021). Different things are found in the prices of medical devices
which are relatively higher than the prices of medical devices in other
countries. The availability and prices that have been set by the government
provide good opportunities for the hospital industry, especially for hospitals
that prioritize the use of generic products, especially those that accept BPJS
Health patients.
2.4.3 Supplier Information (Weight 0.2 and Index 2)
To get profile information from suppliers
related to health products needed by the hospitals they produce and the prices
offered, companies can obtain this information through online media or also get
it through information in the form of direct offers from suppliers in Jakarta.
In this case, the hospital easily gets information related to suppliers, then
the weight given is 0.2 with an index of 2.
2.5
Subtitute Competition
2.5.1 Buyers Propensity to Substitute
(Weight 0.4 and Index 2)
Hospital services are currently facing
challenges through health services that can be accessed through online media.
Currently, the era of technology makes it easier for people to conduct health
consultations, health consultation applications such as Halodoc, Alodokter,
Klikdokter, Good Doctor and SehatQ have become a trend in people's lifestyles
to get ease of service
(Ayu et al., 2022). Technological advances have caused the
tendency to choose substitute services to be high. Although it cannot replace
the function of the hospital as a whole, the availability of this service can
be a competitor in outpatient services for a hospital. Replacement services
are a threat to hospitals emerging from services based on digital technology.
Online health services,
online
consultations,
online drug delivery, pose a threat to hospitals although
not completely. On the one hand, hospitals can also develop similar services.
So we give a weight of 0.4 with index 2.
2.5.2 Relative Price (Weighting 0.2 and Index 2)
Hospital services that focus on the community
of BPJS Health guarantee users will make hospitals the main choice in getting
health services. The community is facilitated in meeting the needs in the
health sector. So that many hospitals will switch to serving BPJS Health
patients. Then it is given a weight of 0.2 with index 2.
2.5.3 Performance of Substitute (Weight 0.3 and Index 3)
In the early stages due to newly built and
growing hospitals, performance needs to catch up with hospitals that have
already been running. That way it is given a weight of 0.3 with an index of 3.
Based on the description above, the following
is the conclusion of Porter's Five Forces Analysis:
Table
2. Total Weight of Threat Value of New Entrants
|
Threat of New Entrants
|
Weight
|
Table of Contents
|
Value
|
|
Capital Requirement
|
0,3
|
1
|
0,3
|
|
Product Differentiation
|
0,3
|
3
|
0,9
|
|
Access to Distribution
|
0,4
|
2
|
0,8
|
|
Total Value
|
2,0
|
Table
3 Total Weight of Industry Rivalry Value
|
Industry Rivalry
|
Weight
|
Table of Contents
|
Value
|
|
Diversity of Competitors
|
0,3
|
3
|
0,9
|
|
Concentration
|
0,3
|
1
|
0,3
|
|
Barrier to exit
|
0,3
|
1
|
0,3
|
|
Total Value
|
1,5
|
Table
4 Total Weighted Value of Bargaining Power of Buyers
|
Bargaining Power of Buyers
|
Weight
|
Table of Contents
|
Value
|
|
Price Sensitivity
|
0,4
|
3
|
1,2
|
|
Buyers Information
|
0,2
|
3
|
0,6
|
|
Switching Cost
|
0,2
|
2
|
0,4
|
|
Total Value
|
2,2
|
Table
5 Total Weight of Bargaining Value of Supplier
|
Bargaining Power of Supplier
|
Weight
|
Table of Contents
|
Value
|
|
Number of Suppliers
|
0,4
|
2
|
0,8
|
|
Supplier Pricing
|
0,4
|
2
|
0,8
|
|
Supplier Information
|
0,2
|
2
|
0,4
|
|
Total Value
|
2,0
|
Table 6 Total Weights of Substitute
Competition
Values
|
Substitute Competition
|
Weight
|
Table of Contents
|
Value
|
|
Buyers Propensity to Substitute
|
0,4
|
2
|
0,8
|
|
Relative Price and Performance
of Substitute
|
0,2
|
2
|
0,4
|
|
Performance of Substitute
|
0,3
|
3
|
0,9
|
|
Total Value
|
2,1
|
Table
7 Total Weights Analysis of Porter's Five Forces
|
Factor
|
Weight
|
|
Threat of New Entrants
|
2,0
|
|
Industry Rivalry
|
1,5
|
|
Bargaining Power of Buyers
|
2,2
|
|
Bargaining Power of Supplier
|
2,0
|
|
Substitute Competition
|
2,1
|
|
Average
|
1,96
|
(Source: Results of processed data
and author's discussion)
Below is a spider diagram of the value of
Porter's Five Forces Private General Hospital Type C provider BPJS
Figure 2 Spider
Diagram of Porter's Five Forces RS Bungur Medika
Based on the results of the discussion of the
five competing forces listed above, it can be seen that the average weighting
of the five competing forces is 1.96. From Porter's Five Forces analysis above,
quantitative results in the range of 1.67 – 2.33, based on these weightings, it
can be concluded that the competitive strength of this industry is moderate. So
it takes great competitive power to be able to enter this business or in other
words the competition is quite intense.
External analysis uses PEST analysis which
analyzes external factors, namely: political, economic, social and
technological. Analysis of these factors greatly helps the company in testing
the external environment and determining the right strategy for the company
which is an opportunity and threat to the company.
2.3.1
Political analysis
Political conditions affect the plan to
establish and operate the hospital through established government policies.
These policies bring opportunities and threats to Bungur Medika Hospital.
2.3.1.1 Political Opportunity Analysis
1.
National Medium-Term Development Plan Policy 2020-2024. The
2020-2024 RPJMN policy in realizing health indicators has a policy direction,
namely increasing access and quality of health services towards universal
health coverage with an emphasis on strengthening basic health services
(Primary Health Care) and increasing promotive and preventive efforts
supported by innovation and utilization of technology. Strategies to be
implemented in the 2020-2024 RPJMN include: improving maternal, child, and
reproductive health; acceleration of improving community nutrition, improving
disease control, strengthening the Healthy Living Community Movement (GERMAS)
and improving health services and drug and food supervision. The 2020-2024
RPJMN policy provides opportunities for health facilities to continue to
progress and develop, including providing opportunities for Bungur Medika
Hospital.
2.
Indonesia's commitment to achieving Universal Health Coverage
is an opportunity for Bungur Medika Hospital with the support of the government
as a regulator to make policies that support easy access to comprehensive and
quality health services without financial barriers. The government focuses
policy targets on the ease of public access to health services. Health
development programs with the aim of improving health status through health
efforts and community empowerment supported by equitable distribution of health
services.
3.
Law No. 40 of 2004 concerning the National Social Security System
which is the legal basis of all regulations related to the National Social
Security System. This opens up opportunities for Bungur Medika Hospital to
build a business with commercial purposes. Presidential Decree No. 64 of 2020
mentions the increase in BPJS contributions. This is an opportunity for Bungur
Medika Hospital, it is hoped that this fee increase can be a solution to
overcome the BPJS deficit so that there are no more arrears in paying fees to
the hospital.
In addition to the above regulations, there
are still many policies that affect the hospital's business, including:
1.
Law No. 24 of 2011 concerning the Health Social Security
Organizing Agency.
2.
Law No. 44 of 2009 concerning Hospitals.
3.
Law No. 29 of 2004 concerning the Practice of Medicine.
2.3.1.2 Political Threat Analysis
1.
Law No. 42 of 2009 states that the medical device tax is
designated as a luxury tax. The implementation of the medical device policy as
a luxury item has increased the burden of operational and investment costs for
Bungur Medika Hospital. This is a threat to the sustainability of the hospital.
2.
Presidential Decree No. 4 of 2020 concerning the Second Amendment
to Presidential Regulation No. 82 of 2018 concerning Health Insurance. In this
Presidential Regulation, it is regulated regarding the Standard Inpatient Class
(KRIS). This poses a threat to the business to be run, namely Bungur Medika
Hospital.
3.
The government only provides tax incentives for educational
hospitals and public hospitals, while private hospitals are not given tax
incentives. This is a threat to Bungur Medika Hospital because it has to manage
operational costs, maintenance costs and development costs and recalculate unit
costs to be able to meet these needs.
Table 8
Political opportunities and threats
|
Political Opportunities
|
RPJMN Policy 2020-2024 in the health sector
|
|
National Social Security System Policy
|
|
Political Threats
|
Luxury Tax Policy for medical devices
|
|
Tariff Policy that has not changed since
2016
|
2.3.2
Economic Forces
Economic growth and inflation rates have an
impact on people's economic conditions, this provides opportunities and threats
for Bungur Medika Hospital.
2.3.2.1 Economic Opportunity Analysis
Economic opportunity analysis, including:
1.
Gross Regional Domestic Product
Gross Regional Domestic Product Based on
Constant Prices 2010 by Business Field in Central Jakarta City (billion
rupiah), 2016–2020
Picture
3 GRDP of Central Jakarta City
The increase in GDP of Central Jakarta City
from year to year shows the economic ability of its people is getting better.
This affects the purchasing power and access to basic human life facilities,
including the health sector. This is a good opportunity for Bungur Medika
Hospital to continue to grow by utilizing the potential of a good economic
sector.
2.
Economic growth of DKI Jakarta
Figure
4 Comparison of DKI Jakarta and National economic growth
Figure
5 Economic growth of DKI Jakarta
DKI Jakarta's economic growth continues to
increase, declining conditions occurred in 2020 during the Covid 19 Pandemic,
in accordance with the decline in national and world economic growth. This is a
good opportunity for the investment climate including business in the health
sector, including for the development of Bungur Medika Hospital.
3.
Supply Chain Financing (SCF) Program
This SCF scheme is an opportunity for
hospitals. Bungur Medika can maintain liquidity so that cash flow management is
not disturbed and RS. Bungur Medika is able to provide the best service.
2.3.2.2 Analysis of Economic Challenges
1.
The cost system of BPJS that uses the package system (INA CBG's)
is a threat to hospitals, this is because INA CBG's tariff standards are still
low. Rates based on the class or category of RS and not based on the severity
of the disease are considered less relevant. In this case, the change from BPJS
rates differ between Class A/B/C/D Hospitals.
2.
Inflation Rate
Inflation is a threat to Bungur Medika Hospital, inflation occurs
due to price increases indicated by the increase in most expenditure group
indexes. The increase in production costs for drug manufacturing and education
costs, operational costs and hospital maintenance will have an impact on health
service services and the number of facilities and people's purchasing power.
Based on the publication of the Ministry of Manpower, UMP in 2022 increased by
an average of 1.09%. Every year there is an adjustment to the minimum wage that
continues to increase. This is a threat to hospitals where operational costs
are increasing but people's purchasing power is declining because the trend of
salary increases is still below the increase in health cost prices. Therefore,
the low inflation rate is a threat to Bungur Medika Hospital.
Table
9 Economic opportunities and threats
|
Economic Opportunities
|
Increasing economic growth of DKI Jakarta
|
|
The ability of the purchasing power of the
people of DKI Jakarta is high
|
|
Economic Threats
|
INACBGs Package Fare System
|
|
|
Inflation rate that tends to be low
|
2.3.3 Social Analysis
2.3.3.1 Social Opportunity Analysis
Social opportunity analysis includes:
1. Large population.
Figure
7 Population by District and Gender
(Source: Central Bureau of
Statistics)
The large population in the Central Jakarta
area is a good opportunity for the health business sector. This is also a good
opportunity for Bungur Medika Hospital. Based on the age data of the population
of Central Jakarta, it appears that the community is dominated by the young
adult age group. The age group with the highest population is 30-34 years,
then 25-29 years, and followed by 20-24 years. Life expectancy also looks long
where there are still people who reach the age of 75 years. In addition, based
on data displayed by BPJS in the book Central Jakarta In 2021 Figures, the
coverage of education for people in Central Jakarta is high. Overall, only 4%
of people do not have an education.
This shows the ease of the community in
receiving information and understanding, especially about health. A good level
of education in the community will be an opportunity for businesses in the
health sector, especially hospitals. Public awareness of the importance of
health is supported by knowledge motivated by formal education owned by the
community.
This is an opportunity for the implementation
of hospitals, with the number of productive age that dominates the community
and the long life expectancy shows the need for quality health services, with
the target of productive age that is still actively regenerating. In addition,
the longevity rate needs to be a concern to see the characteristics of
degenerative diseases that increase with the age of the population.
Figure
8 Number of Population by Age Group and Gender, 2020
Poverty Rate
Figure
9 Graph of the Number of Poor People in Central Jakarta in 2013-2020
There are still poor people, of course, poor
people need free health services and do not discriminate against every patient
with the same quality standards. This can be an opportunity for hospital
business.
2.3.3.2 Social Threat Analysis
Social threat analysis includes:
1. Existence of Health Facilities
Based on the data below, there are 26
hospitals, 7 Special Hospitals, 3 Maternity Hospitals, and 42 Puskesmas in the
Central Jakarta area. The existence of this health facility both at the first
and advanced levels can be a competitor for the hospital to be built.
Especially there are 5 hospitals in the Senen area according to the location
where the hospital will be built.
Figure
10 Number of General Hospitals, Special Hospitals, Hospitals/Maternity Homes,
Puskesmas, Clinics/Health Centers, Posyandu and Polindes by District, 2020
Education Level
Figure
11 School Enrollment Rate
According to the Age Group and Education Level of the people of
Central Jakarta at school age is quite good. This shows that people have the
ability to capture information and have a good understanding of health. A good
level of education makes people have high expectations or standards for health
services. This is a threat to the hospital's business if it cannot maintain the
quality of service consistently. People will easily leave the hospital and
switch to another hospital that provides better services.
Table
10 Social opportunities and threats
|
Social Opportunities
|
Large population and dominated by young
adults
|
|
Number of poor people
|
|
Social Threats
|
Competitors of health facilities in the
Central Jakarta area
|
|
Higher education level, influencing people's
demands for quality services.
|
2.3.4 Technology Analysis
2.3.4.1 Technology Opportunities
1.
RS. Bungur Medika will use SIMRS which integrates Front Office and Back
Office modules
including electronic medical records bridging with BPJS. This
SIMRS was created to integrate all health service business processes at Bungur
Medika Hospital into one coordination network that connects reporting and
administrative procedures to be able to access information quickly and
accurately. SIMRS is in the form of an open source web so that
development can be carried out to improve future improvements. In addition,
this SIMRS will also be integrated with BPJS, INA CBGs in accordance with
hospital accreditation commission standards. This will be an opportunity for
hospitals to provide solutions in improving service quality, especially those
related to patient waiting times.
2.
Based on data from the 2020 DKI Jakarta Provincial Sectoral
Statistics Portal, as many as 84.32% of DKI Jakarta residents have used
Information Communication Technology devices in the form of mobile phones or
computers, while 73.46% have accessed the internet. This can be an opportunity
in hospital development by prioritizing digitalization of telecommunications
information technology. The flow of communication with the community who will
become patients can become easier. Hospitals are expected to develop
applications that make it easier for patients, such as the registration
process, public health data, and remote health services.
2.3.4.2 Technology Threats
1.
Based on data from the 2019 DKI Jakarta Technology, Information,
Communication and Internet usage survey, it appears that 76.09% of people use
social media. This can be a threat to hospitals, because if there is
dissatisfaction in the community, people are very easy to upload their
complaints on social media, regardless of the truth of the news.
Figure
12 Experience of Community Activities While Using the Internet
2.
The development of medical technology is growing rapidly,
currently starting to lead to robotic technology. The
development of technology requires a large cost of investment for hospitals.
This will certainly burden new hospitals that have just started their
operations.
Table
11 Technology Opportunities and Threats
|
Technology Opportunities
|
Hospital Management Information System which
increasingly encourages hospitals towards system digitalization
|
|
Smartphone ownership in the community
|
|
Technology Threats
|
Social media that is increasingly used by
many people
|
|
The development of medical technology
demands high costs.
|
The External Factor Evaluation (EFE)
matrix is an external matrix that shows how effective the company's strategy is
in responding to existing opportunities and threats. This analysis must also
pay attention to several things such as: competitors, changes in demand,
changes in technology, economic changes, demographic shifts and also government
policies that can hinder the achievement of company goals.
Table
12 External Factor Evaluation – EFE RS Bungur Medika
|
KEY EXTERNAL FACTORS
|
|
Opportunities
|
|
1
|
RPJMN Policy 2020-2024 in the health sector
|
|
2
|
National Social Security System Policy
|
|
3
|
Increasing economic growth of DKI Jakarta
|
|
4
|
The ability of the purchasing power of the
people of DKI Jakarta is high
|
|
5
|
Large population and dominated by young
adults
|
|
6
|
Number of poor people
|
|
7
|
Hospital Management Information System which
increasingly pushes hospitals towards system digitization
|
|
8
|
Smartphone ownership in the community
|
|
Threat
|
|
1
|
Luxury Tax Policy for medical devices
|
|
2
|
Tariffs that haven't changed since 2016
|
|
3
|
INACBGs Package Fare System
|
|
4
|
Inflation rate that tends to be low
|
|
5
|
Competitors of health facilities in the
Central Jakarta area
|
|
6
|
Higher education level, influencing
society's demands for quality services
|
|
7
|
Social media that is increasingly used by
many people
|
|
8
|
The development of medical technology
demands high costs
|
CONCLUSION
Based on the
results of the study, it can be concluded that there are several external
factors that affect the development of health services at Bungur Medika
Hospital, namely social, political, economic, and technological factors. The
social factor that influences is the community's need for quality and
affordable health services. Influencing political factors are government
policies related to health and regulations that must be obeyed by Bungur Medika
Hospital. Economic factors that influence are the economic condition of the
community and the cost of developing health services at Bungur Medika Hospital.
The influencing technological factor is the development of technology that can
help improve the quality and efficiency of health services at Bungur Medika
Hospital.
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External
Factor Analysis in the Development of Health Services at Bungur Medika Hospital