ECONOMETRICS OF HEALTHCARE WORKERS' PRODUCTIVITY DETERMINANTS WITHIN THE FRAMEWORK OF INCLUSIVE HEALTH TRANSFORMATION

Sri Rahayu Indah Azhari, Ari Sarwo Indah Safitri, Irma Qirani Irma

Abstract

Global health transformation toward inclusive and sustainable healthcare services faces significant challenges regarding productivity disparities among healthcare workers between urban and rural areas. This study aims to analyze the determinant factors of healthcare worker productivity using econometric models within the framework of inclusive health transformation in underserved areas. This cross-sectional quantitative research involved 32 healthcare workers from four Primary Health Centers (Bumbu, Binanga, Keaang, and Tarialu) in West Sulawesi, selected through purposive sampling with a minimum one-year work experience criterion. The research instrument utilized a validated structured questionnaire with a 1-4 Likert scale. The variables examined included work environment (X1), discipline factors (X2), and technology support as moderating variables, with work productivity and performance effectiveness as dependent variables. Analysis employed Structural Equation Modeling (SEM) using PLS. The results demonstrated strong model validity with R-square values of 92.3% for work productivity and 83.4% for performance effectiveness. Work discipline showed a significant positive effect on performance effectiveness (coefficient 1.117, p<0.05), while work environment exhibited a non-significant negative effect on productivity (coefficient -0.058, p>0.05). Technology support revealed opposing moderation paradoxes in both examined relationships. This research unveils the technology paradox phenomenon in inclusive health transformation and confirms work discipline as the primary driver of healthcare worker performance effectiveness, with important implications for more nuanced health technology implementation strategies.

Keywords

econometric analysis, healthcare workers, inclusive health transformation, productivity determinants, technology paradox.

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References

Becker, G. S. (1964). Human capital: A theoretical and empirical analysis, with special reference to education. University of Chicago Press.

Bleakley, H. (2010). Health, human capital, and development. Annual Review of Economics, 2(1), 283-310.

Brynjolfsson, E. (2012). Unraveling the IT productivity paradox: Lessons for health care. Health Affairs, 31(6), 1240-1248. https://doi.org/10.1377/hlthaff.2012.0463

Campbell, J., Buchan, J., Cometto, G., David, B., Dussault, G., Fogstad, H., Fronteira, I., Lozano, R., Nyonator, F., Pablos-Méndez, A., Quain, E. E., Starrs, A., & Tangcharoensathien, V. (2015). Human resources for health and universal health coverage: Fostering equity and effective coverage. Bulletin of the World Health Organization, 93(11), 853-863.

Chen, Y., Liu, X., Zhang, H., & Wang, L. (2024). Human capital investment and health outcomes: Evidence from developing countries. Journal of Health Economics, 45(2), 123-142.

Dugguh, S. I., & Dennis, A. (2014). Job satisfaction theories: Traceability to employee performance in organizations. IOSR Journal of Business and Management, 16(5), 11-18.

Fathoni, A. (2016). Manajemen sumber daya manusia. Rineka Cipta.

Gallup. (2025). State of the global workplace 2025. Gallup Press.

Gjellebaek, C., Bratås, O., Dahl, Y., & Tjøstheim, I. (2022). Digital transformation in healthcare: Technology acceptance and its applications. International Journal of Environmental Research and Public Health, 19(5), 2835. https://doi.org/10.3390/ijerph19052835

Grossman, M. (2000). The human capital model. In A. J. Culyer & J. P. Newhouse (Eds.), Handbook of health economics (Vol. 1A, pp. 347-408). Elsevier.

Harrison, M. I., Ash, J. S., & Koppel, R. (2016). The unintended consequences of health information technology revisited. JAMA Internal Medicine, 176(12), 1752-1754. https://doi.org/10.1001/jamainternmed.2016.6643

International Federation of Gynecology and Obstetrics. (2018). Global healthcare workforce shortage: Implications for maternal health. FIGO Publications.

International Labour Organization, Organisation for Economic Co-operation and Development, & World Health Organization. (2023). Working for health 2022-2030 action plan. World Health Organization.

Investopedia. (2024). Human capital definition. https://www.investopedia.com/terms/h/humancapital.asp

Kiliç, M., Uslukiliç, G., & Yaman, S. (2023). The effect of the hospital working environment on the work limitation of the employees in Turkey: A multivariable analysis. BMC Health Services Research, 23(1), 365. https://doi.org/10.1186/s12913-023-09356-0

Koutsimani, P., Montgomery, A., & Georganta, K. (2019). The relationship between burnout, depression, and anxiety: A systematic review and meta-analysis. Frontiers in Psychology, 10, 284. https://doi.org/10.3389/fpsyg.2019.00284

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., García-Elorrio, E., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., Malata, A., Nash, D., Ng, M., Olson, Z., Singh, A., Veillard, J. H., & Pate, M. (2018). High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet Global Health, 6(11), e1196-e1252.

Li, W., Wang, S., Zhao, Y., Zhang, C., & Xu, Q. (2023). The moderation of satisfaction with working conditions in the association between workload and mental health among healthcare workers collecting test samples in the post-COVID-19 era. Frontiers in Public Health, 11, 1106299. https://doi.org/10.3389/fpubh.2023.1106299

Liu, J. X., Goryakin, Y., Maeda, A., Bruckner, T., & Scheffler, R. (2017). Global health workforce labor market projections for 2030. Human Resources for Health, 15(1), 11.

Maharani, I. R., & Rahmawati, S. (2024). The influence of work discipline and work environment on the work performance of inpatient nurses at Bhayangkara Hospital, Pontianak. International Journal of Health Sciences and Nursing Studies, 5(2), 45-58.

Mazmanian, M., Yates, J., & Orlikowski, W. J. (2016). The practical paradox of technology: The influence of communication technology use on employee burnout and engagement. Communication Monographs, 83(2), 239-263. https://doi.org/10.1080/03637751.2015.1133920

Nepomuceno, T. C. C., Silva, W. M., Costa, A. P. C. S., & Pereira, V. (2025). Efficiency and productivity in healthcare: A systematic review of methods and applications. Health Economics Review, 15(1), 1-18.

Obasan, K. A. (2011). Impact of conflict management on corporate productivity: An evaluative study. Australian Journal of Business and Management Research, 1(5), 44-49.

Oliver Wyman. (2019). The economic burden of non-communicable diseases in Indonesia. Oliver Wyman.

Organisation for Economic Co-operation and Development. (2024). Health at a glance 2024: OECD indicators. OECD Publishing.

Phillips, J., Malliaris, A. P., & Bakerjian, D. (2021). Nursing and patient safety. Springer Publishing.

Rostami, F., Babaei-Pouya, A., Teimori-Boghsani, G., Jahangirimehr, A., Mehri, Z., & Feiz-Arefi, M. (2021). Mental workload and job satisfaction in healthcare workers: The moderating role of job control. Frontiers in Public Health, 9, 683388. https://doi.org/10.3389/fpubh.2021.683388

Rostina, C. F., Muhani, D., & Sinaga, T. (2020). Occupational health and safety, work discipline, leadership style affect employee performance. International Journal of Social Science and Business, 4(4), 429-437. https://doi.org/10.23887/ijssb.v4i4.29076

Ruslan, N. J. B., Nasriani, I., Irma, S., AKM, A. N., & Zulfiqram, A. (2024). Pengaruh budaya kerja, kompensasi dan etos kerja terhadap kinerja karyawan pada PT. Telkom Mamuju. EKOMA: Jurnal Ekonomi, Manajemen, Akuntansi, 3(2), 1075-1087.

Saputra, H., Rahman, A., & Wibowo, S. (2024). Work discipline on employee performance through work productivity. Advances in Human Resource Management Research, 2(3), 166-178.

Scheil-Adlung, X., Carrin, G., Juetting, J., & Xu, K. (2018). What is the impact of social health protection on access to health care, health expenditure and impoverishment? A comparative analysis of 13 developing countries. Social Science & Medicine, 205, 15-27.

Singh, N., Jain, M., Kamal, M. M., Bodhi, R., & Gupta, B. (2024). Technological paradoxes and artificial intelligence implementation in healthcare: An application of paradox theory. Technological Forecasting and Social Change, 198, 122956. https://doi.org/10.1016/j.techfore.2023.122956

Sparkes, S. P., Dimyati, A., Pambudi, E. S., Rullyansyah, A., Siregar, A. Y. M., & Wiseman, V. (2023). An evaluation of the implementation and effects of Indonesia's national health insurance. Health Policy and Planning, 38(2), 231-243.

Suryani, L., Dewanto, A., & Prasetyono, H. (2023). The effect of discipline and work environment on employee performance and job satisfaction as mediation variable. Journal of Management and Business Research, 8(1), 112-125.

United Nations Department of Economic and Social Affairs. (2024). The Sustainable Development Goals report 2024. United Nations Publications.

Wahyuni, A. S., Wahyuliana, E., Azhari, S. R. I., Santoso, I., & Nasrullah, N. (2024). Pengaruh Lingkungan Kerja Dan Disiplin Kerja Terhadap Kinerja Pegawai Upt Puskesmas Binanga Kabupaten Mamuju Sulawesi Barat. Jurnal Review Pendidikan dan Pengajaran (JRPP), 7(1), 1593-1602.

Wang, K., Yang, B., Wu, C., & Zheng, L. (2023). The moderation of satisfaction with working conditions in the association between workload and mental health among healthcare workers collecting test samples in the post-COVID-19 era. Frontiers in Public Health, 11, 1106299.

World Bank. (2024). World development report 2024: Mind, society, and behavior. World Bank Publications.

World Economic Forum. (2024). The future of jobs report 2024. World Economic Forum.

World Health Organization. (2024). World health statistics 2024: Monitoring health for the SDGs. World Health Organization.

Zahid, M., Imran, M., Ahmad, J., Qadeer, A., & Hassan, M. (2022). Impact of employees' workplace environment on employees' performance: A multi-mediation model. Frontiers in Public Health, 10, 890400. https://doi.org/10.3389/fpubh.2022.890400

Ziebland, S., Hyde, E., & Powell, J. (2021). Power, paradox and pessimism: On the unintended consequences of digital health technologies in primary care. Social Science & Medicine, 289, 114419. https://doi.org/10.1016/j.socscimed.2021.114419

DOI: https://doi.org/10.34152/fe.20.2.259-270

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