Comparative Analysis of Financial Resilience between Profit-Oriented and Non-Profit Private Hospitals Following Health Financing Policy Reforms
DOI:
https://doi.org/10.69855/laceri.v2i2.736Keywords:
Financial Resilience, Private Hospitals, Health Financing Policies, Current Ratio, Operating MarginAbstract
Changes in health incentive policies, particularly adjustments to payment mechanisms and National Health Insurance (JKN) claims, require private hospitals to strengthen financial resilience while maintaining service quality. Differences in institutional orientation between non-profit and profit-oriented hospitals may influence their capacity to adapt to these policy changes. This study aimed to analyse differences in financial resilience between non-profit and profit-oriented private hospitals following changes in health incentive policies. A quantitative study with a composite cross-sectional design was conducted at Ibnu Sina Islamic Hospital Bukittinggi (non-profit) and Madina Hospital Bukittinggi (profit-oriented). A total of 48 monthly financial reports from January 2023 to December 2024 were analysed using total sampling. Financial statements served as the primary data source, while structured interviews with financial managers were conducted solely to verify financial policy implementation and support the interpretation of quantitative findings. Interview data were not included in the statistical analysis. Univariate analysis described financial indicators, and differences between hospitals were examined using the Independent Samples t-test with a 95% confidence level. The non-profit hospital demonstrated a significantly higher current ratio than the profit-oriented hospital (2.29 ± 0.38 vs. 1.81 ± 0.34; t(46)=4.61; p<0.001; Cohen's d=1.33). Conversely, the profit-oriented hospital achieved a significantly higher operating margin (13.1 ± 3.4% vs. 9.2 ± 2.7%; t(46)=4.40; p<0.001; Cohen's d=1.27). Composite financial resilience analysis also showed a significant difference between the two hospitals (p=0.002). Institutional orientation significantly influences financial resilience after changes in health incentive policies. Non-profit hospitals demonstrate stronger liquidity, whereas profit-oriented hospitals achieve higher operational profitability. Strengthening revenue diversification, cost efficiency, cash flow management, and adaptive financial strategies is essential to improve resilience under evolving health financing policies.
References
Aljohani, N., Alghamdi, A., Alotaibi, A., & Alqahtani, S. (2023). Forecasting hospital bed demand using machine learning approaches: A systematic review. Healthcare Analytics, 4, 100245. https://doi.org/10.1016/j.health.2023.100245
Bai, G., Anderson, G. F., & Zare, H. (2021). Hospital financial vulnerability and the impact of economic disruption. Health Affairs, 40(12), 1910–1918. https://doi.org/10.1377/hlthaff.2021.00731
Barasa, E., Mbau, R., & Gilson, L. (2021). What is resilience and how can it be nurtured? A systematic review of empirical literature on organizational resilience. Health Policy and Planning, 36(6), 1016–1027. https://doi.org/10.1093/heapol/czab033
Gao, J., Zhong, L., Lopez, D., & Pei, S. (2024). Healthcare system resilience and adaptability to disruptions: Evidence from hospital systems. Health Services Research, 59(4), 1021–1035. https://doi.org/10.1111/1475-6773.14240
Harrison, M. I., Shortell, S. M., & Singer, S. J. (2021). Hospital performance improvement: Current trends and future directions. Medical Care Research and Review, 78(5), 547–560. https://doi.org/10.1177/1077558720914217
Horwitz, J. R., & Nichols, A. (2022). Hospital ownership and financial incentives: Implications for health care quality and efficiency. Health Economics, 31(4), 620–635. https://doi.org/10.1002/hec.4467
Kaufman, B. G., Pink, G. H., Holmes, G. M., & Thompson, K. W. (2022). Financial sustainability and performance measurement in hospitals: A systematic review. Journal of Healthcare Management, 67(3), 177–190. https://doi.org/10.1097/JHM-D-21-00147
Kementerian Kesehatan Republik Indonesia. (2024). Transformasi sistem kesehatan Indonesia: Laporan kebijakan kesehatan nasional. Kementerian Kesehatan Republik Indonesia.
Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., Elorrio, E. G., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., … Pate, M. (2020). High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet Global Health, 8(1), e119–e125. https://doi.org/10.1016/S2214-109X(19)30433-5
Kruse, F. M., & Jeurissen, P. P. T. (2020). For-profit hospitals out of business? Financial sustainability and ownership characteristics. Health Policy, 124(4), 412–418. https://doi.org/10.1016/j.healthpol.2020.02.007
Lua, J., & Park, Y. J. (2025). How do non-profits use profits? Evidence from U.S. non-profit hospitals. Public Management Review, 27(6), 1607–1630. https://doi.org/10.1080/14719037.2024.2308185
Mathauer, I., Vinyals Torres, L., Kutzin, J., Jakab, M., & Hanson, K. (2020). Pooling financial resources for universal health coverage: Options for reform. Health Systems & Reform, 6(2), e1826079. https://doi.org/10.1080/23288604.2020.1826079
Mbau, R., Barasa, E., & Munge, K. (2022). Examining the influence of health financing reforms on health system performance: Evidence from low- and middle-income countries. Health Policy and Planning, 37(8), 1015–1027. https://doi.org/10.1093/heapol/czac033
Nugraheni, W. P., Hartono, R. K., & Djasri, H. (2021). Hospital strategies in adapting to the National Health Insurance implementation in Indonesia. Jurnal Administrasi Kesehatan Indonesia, 9(2), 123–134.
Organisation for Economic Co-operation and Development. (2021). Health at a glance 2021: OECD indicators. OECD Publishing. https://doi.org/10.1787/ae3016b9-en
Papanicolas, I., Figueroa, J. F., Schoenfeld, A. J., & Orav, E. J. (2020). Differences in health care spending and utilization among countries. JAMA, 323(12), 1207–1208. https://doi.org/10.1001/jama.2020.1277
Sagan, A., Webb, E., Azzopardi-Muscat, N., de la Mata, I., McKee, M., & Figueras, J. (2021). Health systems resilience during COVID-19: Lessons for future preparedness. European Observatory on Health Systems and Policies.
World Health Organization. (2021). Building health system resilience for universal health coverage and health security during the COVID-19 pandemic and beyond. World Health Organization.
World Health Organization. (2023). Financing for health system transformation: Spending more or spending better (or both)? European Observatory on Health Systems and Policies.
World Health Organization. (2024). Health system resilience indicators: An integrated package for measuring and monitoring health system resilience in countries. World Health Organization. https://doi.org/10.2471/B09465
Zhong, L., Lopez, D., Pei, S., & Gao, J. (2024). Healthcare system resilience and adaptability to pandemic disruptions in the United States. medRxiv. https://doi.org/10.1101/2024.08.30.2431287
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Journal of Health Service Administration and Hospital Management
This work is licensed under a Creative Commons Attribution 4.0 International License.
