Do accreditation and managerial innovative capabilities influence Indonesian public hospital performance? The mediating role of service quality

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Type of the article: Research Article

Abstract
The performance of public hospitals in Indonesia is becoming critical amid demands for high-quality care and resource constraints. The role of accreditation and managerial innovative capabilities (MIC) in driving performance, including through quality of care, still requires empirical evidence. This study aims to examine the influence of accreditation and MIC on Indonesian public hospital performance through service quality as a mediating variable. This study uses a quantitative survey-based approach, involving 136 respondents from various Public Service Agency hospitals in Indonesia. Data were collected from September 2024 to January 2025 using a combination of Google Forms and direct surveys conducted at public hospitals. Data were analyzed using SMART-PLS. The findings show that accreditation has a positive and significant influence on hospital performance (β = 0.499, t = 6.367, p = 0.000), as well as on service quality (β = 0.724, t = 20.477, p = 0.000). Service quality has a positive effect on performance (β = 0.417, t = 5.689, p = 0.000). Testing of indirect effects revealed partial mediation, meaning that accreditation influences hospital performance through service quality (β = 0.302, t = 6.046, p = 0.000). Surprisingly, however, MIC did not have a significant effect on hospital performance (β = 0.002, t = 0.035, p = 0.486). The R-squared value of 0.726 indicates moderate-to-substantial explanatory power. Thus, these findings confirm that the impact of accreditation becomes more meaningful when standards are internalized into continuous service quality improvements, making service quality important for enhanced hospital performance.

Acknowledgment
We acknowledge the support funding for the publication of this study from Endowment Fund for Education Agency LPDP Ministry of Finance of Republic Indonesia, Center for Higher Education Funding and Assessment (PPAPT), The Indonesian Education Scholarship Beasiswa Pendidikan Indonesia (BPI) Ministry of Higher Education, Science, and Technology of Republic Indonesia, awarded to Dahlia.

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    • Figure 1. Research model
    • Figure 2. Structural model test results
    • Table 1. Characteristics of respondents
    • Table 2. Descriptive statistics
    • Table 3. Results of model measurement (outer model) using SMART PLS
    • Table 4. HTMT–Discriminant validity
    • Table 5. Results of data analysis on direct and indirect effects
    • Conceptualization
      Dahlia, Nurkholis, Abdul Ghofar, Yeney Widya Prihatiningtias
    • Data curation
      Dahlia
    • Formal Analysis
      Dahlia
    • Funding acquisition
      Dahlia
    • Investigation
      Dahlia, Nurkholis
    • Methodology
      Dahlia, Nurkholis, Abdul Ghofar, Yeney Widya Prihatiningtias
    • Project administration
      Dahlia
    • Resources
      Dahlia
    • Software
      Dahlia
    • Validation
      Dahlia, Nurkholis, Abdul Ghofar, Yeney Widya Prihatiningtias
    • Visualization
      Dahlia, Abdul Ghofar, Yeney Widya Prihatiningtias
    • Writing – original draft
      Dahlia
    • Writing – review & editing
      Dahlia, Nurkholis, Abdul Ghofar, Yeney Widya Prihatiningtias
    • Supervision
      Nurkholis, Abdul Ghofar, Yeney Widya Prihatiningtias