Rigiditas anggaran sebagai pemicu kerentanan fungsional rumah sakit berdasarkan hospital safety index modul 4 di Indonesia: A systematic review
DOI: https://doi.org/10.33024/hjk.v20i4.3049
Budget Rigidity Hospital Emergency Management Hospital Preparedness Hospital Safety Index (HSI)
Abstract
Background: Despite significant investment in physical infrastructure, various studies indicate asymmetry in disaster preparedness in Indonesian hospitals: structural safety scores tend to be high, while functional capacity, particularly in the Module 4 Hospital Safety Index, consistently lags behind.
Purpose: To assess budget rigidity as a driver of hospital functional vulnerability based on the Module 4 Hospital Safety Index.
Method: This systematic review study used the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The reviewed articles were sourced from the Garuda platform and Google Scholar. The search period was primarily within the past 10 years (2015-2025) to align with the HSI 2nd edition released in 2015. The search terms were “Hospital Safety Index”, “HSI”, “Hospital Disaster Preparedness”, and “Hospital Evaluation” within the context of Indonesia.
Results: The results indicate a mismatch between the rigidity of government budget regulations and the need for operational flexibility in emergency response. The lack of ready-to-use contingency funds triggers a cascade of disruptions in Module 4 components, including logistical paralysis due to constraints on rapid procurement and stagnation in human resource competency because disaster simulations are often deducted from operational budgets.
Conclusion: The low functional preparedness of hospitals in Indonesia is a systemic problem primarily influenced by funding rigidity, hampering human resource readiness, logistics, emergency communications, and crisis response.
Suggestion: More flexible policy reforms are needed, as well as the integration of disaster risk management into hospital governance, so that health services can continue to function optimally when a disaster occurs.
Keywords: Budget Rigidity; Hospital Emergency Management; Hospital Preparedness; Hospital Safety Index (HSI).
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