Evaluation of Hospital Accounting System on Outpatient Ser‎vice Efficiency

  • Authors

    https://doi.org/10.14419/95znky09

    Received date: November 25, 2025

    Accepted date: December 4, 2025

    Published date: December 9, 2025

  • Accounting Information Systems; Internal Control Quality; Healthcare Operations; Service Efficiency; Organizational Performance

  • Abstract

    This study examines the transformative role of hospital accounting systems in improving the efficiency of outpatient services, focusing par-‎ticularly on the mediating effect of internal control quality and the moderating effect of the quality of accounting information systems. Using ‎a rigorous methodological approach involving structural equation modelling, the study reveals that key accounting system components, such ‎as recording accuracy, cost control efficiency, system integration and staff competence, significantly strengthen internal control mechanisms. ‎These mechanisms then drive significant improvements in service delivery outcomes. These findings suggest that robust internal control ‎quality is a vital conduit through which the excellence of accounting systems translates into tangible service enhancements. The study also ‎reveals how better information systems can make the connection between integration capabilities and performance outcomes stronger. These ‎ideas provide useful advice for people in charge of healthcare who want to improve their accounting system and control their environment. ‎This research is very important for the study of how organizations are managed. It shows the ways that financial information systems can ‎help to make healthcare more efficient. This is important for making sure that healthcare is available to everyone and for making sure that ‎patients are treated well.

  • References

    1. Abdullahi, Y. B., Ahmed, N. I., Bashir, S. G., Abdi, Y. H., Abdi, M. S., Alhammadi, O. A. S., Okesanya, O. J., Agboola, A. O., & Ahmed, M. M. (2025). Empowering health sovereignty in Africa through innovations for self-reliant healthcare. Discover Public Health, 22(1), 770. https://doi.org/10.1186/s12982-025-01184-3.
    2. Abu Afifa, M., Saleh, I., & Vo Van, H. (2023). Accounting information quality in the digital era – a perspective from ERP system adoption? Global Knowledge, Memory and Communication, 74(5–6), 2022–2046. https://doi.org/10.1108/GKMC-03-2023-0101
    3. Abuelazm, M., Saleh, O., Hassan, A. R., Ahmad, S., Albarakat, M. M., Abdalshafy, H., Katamesh, B. E., Abdelazeem, B., & Paul, T. K. (2023). Sex Difference in Clinical and Management Outcomes in Patients With Takotsubo Syndrome: A Systematic Review and Meta-Analysis. Current Problems in Cardiology, 48(4), 101545. https://doi.org/10.1016/j.cpcardiol.2022.101545
    4. Abuhay, T. M., Tereda, M. W., Adane, L. E., Melesse, M. D., & Robinson, S. (2025). Applications and challenges of simulation for healthcare operations management in Africa. Journal of the Operational Research Society, 76(5), 1000–1018. https://doi.org/10.1080/01605682.2024.2406243.
    5. Adi Wibowo, W. (2024). The Influence of Distinctive Capabilities and Adaptive Capabilities on Business Model Adaptation and MSME Performance. Journal of Economic Business Innovation, 1(3 SE-Articles), 367–384. https://doi.org/10.69725/jebi.v1i3.182.
    6. Al Subarkah, A., & Amrulloh, A. (2024). Enhancing Fraud Detection: The Role of Effective Audits in Financial Statement Integrity. Researcher Academy Innovation Data Analysis, 1(2 SE-Articles), 91–101.
    7. Alfina, K. N., Ratnayake, R. M. C., Wibisono, D., Mulyono, N. B., & Basri, M. (2024). Integrating risk management in implementing circular economy principles in the healthcare sector: a case study from Indonesia. Journal of Responsible Production and Consumption, 2(1), 151–192. https://doi.org/10.1108/JRPC-03-2024-0014.
    8. Amador, L. G., Ramirez-Parada, T. H., Park, I. W., Mazer, S. J., Ellison, A. M., O’Brien, M., Sokol, E. R., Smith, C. A., Davis, C. C., & Record, S. (2025). Bridging data silos to holistically model plant macrophenology. New Phytologist, n/a(n/a). https://doi.org/10.1111/nph.70249
    9. Ana Dewi, P., & Ratri, D. (2024). Evaluating the Efficiency of Public Administration in Today’s Dynamic Environment. Advances in Administration, 1(1 SE-Articles), 13–24.
    10. Andwika, I. B., Yundari, E., & Florenza, Y. (2024). Hospital Management Information System in Increasing Efficiency. Ic-Itechs, 5(1), 890–894. https://doi.org/10.32664/ic-itechs.v5i1.1604.
    11. Asdar, A., & Mujahidah. (2024). Effectiveness of Guessing Game in Improving Student Speaking Skills. Advances Educational Innovation, 1(1 SE-Articles), 36–42. https://doi.org/10.69725/aei.v1i1.85.
    12. Bagherian, A., & Mukherjee, S. (2025). Advancing healthcare innovation with Quality 5.0: a hybrid fuzzy AHP–TOPSIS model for strategic prioritization. International Journal of Health Care Quality Assurance, 38(4), 268–291. https://doi.org/10.1108/IJHCQA-07-2025-0091.
    13. Barney, Jay, Wright, Mike, & KetchenJr., David J. (2001). The resource-based view of the firm: Ten years after 1991. Journal of Management, 27(6), 625–641. https://doi.org/10.1177/014920630102700601 .
    14. Bin-Nashwan, S. A., & Li, J. Z. (2025). AI-infused knowledge and green intellectual capital: pathways to spur accounting performance drawn from the RBV-KBV model and sustainability culture. Technology in Society, 82, 102913. https://doi.org/10.1016/j.techsoc.2025.102913.
    15. Bouzarjomehri, H., Maleki, M., Masoudi-Asl, I., & Ranjbar, M. (2025). Enhancing Transparency: Core Principles for a Developing Health System. World Medical & Health Policy, 17(3), 616–625. https://doi.org/10.1002/wmh3.70029.
    16. Chamorro-de-Vega, E., González, C. M., Menchén, L., Baniandrés, O., Herranz, A., Lobo-Rodríguez, C., Romero-Jiménez, R., Ais-Larisgoitia, A., Lobato-Matilla, E., López-Esteban, A., López-Calleja, A., Marín-Jiménez, I., Monteagudo, I., de Los Ríos, P. M., Nieto, J. C., Ferris-Villanueva, M., Lizcano, M. J., Simón Moreno, M. P., Sanjurjo, M., & de Sanjosé, S. G. (2025). New Model of Integrated Care for Patients with Immune-Mediated Inflammatory Diseases. International Journal of Integrated Care, 25(2), 19. https://doi.org/10.5334/ijic.7741.
    17. Conica, S., Browne, N., & Danyll, R. (2024). Leveraging Machine Learning to Enhance Occupational Safety and Health in Hospital. Safety and Health for Medical Workers, 1(2 SE-Articles), 78–94. https://doi.org/10.69725/shmw.v1i2.150.
    18. Couture, V., Roy, M. C., Dez, E., Tremblay, F., & Bélisle-Pipon, J. C. (2025). Ethical issues raised by artificial intelligence and big data in population health: a scoping review. Frontiers in Sociology, 10(September). https://doi.org/10.3389/fsoc.2025.1536389.
    19. Dany, Y. A., & Pribadi, F. (2025). TRENDS OF RESEARCH IN HOSPITAL FINANCING AND HEALTH INDUSTRY 4.0/5.0: A BIBLIOMETRIC ANALYSIS. Asia Pacific Journal of Health Management, 20(1). https://doi.org/10.24083/apjhm.v20i1.3695.
    20. Davidson, S. R. E., Haskins, R., Ingham, B., Gallagher, R., Smith, D., Donald, B., Henderson, J., Edger, M., Barnett, C., & Williams, C. M. (2025). Service redesign for outpatient services: Strategies to improve the wait. Public Health, 242, 214–219. https://doi.org/10.1016/j.puhe.2025.03.011.
    21. Dinda, N., & Anis, Y. (2025). Blockchain Integration for Secure and Transparent Health Administration System. Applied Health Administration, 1(1 SE-Articles), 1–10.
    22. Dong, X., & Wu, J. (2025). Does DRG-based payment lead to unintended effects on care quality? A case under global budget with price adjustment in China. BMC Health Services Research, 25(1), 1448. https://doi.org/10.1186/s12913-025-13625-5.
    23. Dwianto, A. (2024). Sustainability Environmental Performance Future Investment for Company Value. Journal of Ecohumanism. https://doi.org/10.33182/joe.v3i2.3193
    24. Gandasari, A. (2024). Anxiety and Stress Levels of Health Workers at Health Centers During the COVID-19 Pandemic. Safety and Health for Medical Workers, 1(1 SE-Articles), 1–9. https://doi.org/10.69725/shmw.v1i1.12.
    25. Garzoni, A., L’Abate, V., Raimo, N., & Vitolla, F. (2024). Exploring online sustainability disclosure in the healthcare industry: Evidence from best international hospitals. Business Strategy and the Environment, 33(4), 2669–2682. https://doi.org/10.1002/bse.3625.
    26. Giuliani, G., & Gitto, S. (2025). What is the difference between specialisation and diversity in hospitals? Investigating their relationship with efficiency. Socio-Economic Planning Sciences, 100, 102251. https://doi.org/10.1016/j.seps.2025.102251.
    27. Gualandi, R., Masella, C., & Tartaglini, D. (2019). Improving hospital patient flow: a systematic review. Business Process Management Journal, 26(6), 1541–1575. https://doi.org/10.1108/BPMJ-10-2017-0265
    28. Guo, Z., & Cugurullo, F. (2025). Smart Urbanism Through Artificial Intelligence (AI)-Megaprojects: The Case of China’s Healthcare Services. Public Administration and Development, 45(3), 296–312. https://doi.org/10.1002/pad.2111.
    29. Hair, J., & Alamer, A. (2022). Partial Least Squares Structural Equation Modeling (PLS-SEM) in second language and education research: Guidelines using an applied example. Research Methods in Applied Linguistics, 1(3), 100027. https://doi.org/10.1016/j.rmal.2022.100027.
    30. Han, A., Lee, K.-H., & Park, J. (2022). The impact of price transparency and competition on hospital costs: a research on all-payer claims databases. BMC Health Services Research, 22(1), 1321. https://doi.org/10.1186/s12913-022-08711-x.
    31. Hu Zhangze, V., & Wang Y. L, L. (2025). Corporate Social Responsibility Market Reaction and Accounting Conservatism with Investor Protection and Stock Liquidity. Advances in Accounting Innovation, 1(2 SE-Article), 147–166.
    32. Huang, W.-H., & Lu, C.-T. (2025). The effect of hospital budgeting system on physician-executives’ budget cognitive consciousness and medical decision making. Cost Effectiveness and Resource Allocation, 23(1), 22. https://doi.org/10.1186/s12962-025-00629-5.
    33. Huong, N. T., & Dinh, D. Van. (2025). Accounting information systems and business capabilities’ role impacting the Viet Nam-listed corporates’ resilience: the smart-PLS SEM approach. Journal of Accounting & Organizational Change. https://doi.org/10.1108/JAOC-07-2024-0250
    34. Indah Sri Astuti, O. W. T. (Author). (2025). Workforce Wellbeing and Burnout Mitigation in Health Administration Practices. Applied Health Administration, 1(1 SE-Articles), 42–53.
    35. Kayvanfar, V., Baldacci, R., & Govindan, K. (2025). An integrated approach for enhancing operating room management: capacity planning, fair scheduling, and surgeon resilience. Annals of Operations Research, 350(3), 1385–1412. https://doi.org/10.1007/s10479-025-06565-0.
    36. Ker, J.-I., Wang, Y., & Hajli, N. (2018). Examining the impact of health information systems on healthcare service improvement: The case of reducing in patient-flow delays in a U.S. hospital. Technological Forecasting and Social Change, 127, 188–198. https://doi.org/10.1016/j.techfore.2017.07.013
    37. Khandelwal, R., Kolte, A., & Rossi, M. (2021). A study on entrepreneurial opportunities in digital health-care post-Covid-19 from the perspective of developing countries. Foresight, 24(3–4), 527–544. https://doi.org/10.1108/FS-02-2021-0043.
    38. Lestari, H., & Nasrifah, L. (2024). Assessment of Occupational Health and Safety Management System Implementation in General Hospital. Safety and Health for Medical Workers, 1(2 SE-Articles), 65–77. https://doi.org/10.69725/shmw.v1i2.117.
    39. Lisa, G., & Macle, E. (2024). Exploring the Societal Impact of Death Anxiety on Mental Health Among Nurses: A Positive Psychology Perspective. Safety and Health for Medical Workers, 1(3 SE-Articles), 142–154. https://doi.org/10.69725/shmw.v1i3.154.
    40. Liu, H., & Walker, A. (2025). Transformations in doctor–patient responsibilities in China’s quasi-marketised healthcare system. International Journal for Equity in Health, 24(1), 313. https://doi.org/10.1186/s12939-025-02690-1
    41. Lutfi, Abdalwali, Al-Okaily, Manaf, Alsyouf, Adi, Alsaad, Abdallah, & Taamneh, Abdallah. (2020). The Impact of AIS Usage on AIS Effectiveness Among Jordanian SMEs: A Multi-group Analysis of the Role of Firm Size. Global Business Review, 26(2), 538–556. https://doi.org/10.1177/0972150920965079.
    42. Magsoudhi, K., & Haghighat, A. (2024). Radiation to Chemicals Unpacking Occupational Safety Hazards in Educational Hospital through the HOSHRA Lens. Safety and Health for Medical Workers, 1(2 SE-Articles), 50–64. https://doi.org/10.69725/shmw.v1i2.116.
    43. Matha, R., Mukherjee, S., Panigrahi, R. R., & Shrivastava, A. K. (2025). A bibliometric analysis of industry 5.0 and healthcare supply chain research: Emerging opportunities and future challenges. Supply Chain Analytics, 10, 100125. https://doi.org/10.1016/j.sca.2025.100125.
    44. Michiel, S., Moissact, I., & Sean, C. (2024). REDECA Framework Enhancing Occupational Safety and Health Through Artificial Intelligence Applications. Safety and Health for Medical Workers, 1(2 SE-Articles), 95–110. https://doi.org/10.69725/shmw.v1i2.151.
    45. Monteiro, A. P., Vale, J., Leite, E., & Lis, M. (2024). Linking quality of accounting information system and financial reporting to non-financial performance: The role women managers. International Journal of Accounting Information Systems, 54, 100692. https://doi.org/10.1016/j.accinf.2024.100692.
    46. Mwogosi, A. (2025). Determinants of EHR systems’ usability and provider satisfaction in public primary healthcare facilities in Tanzania. Health Policy and Technology, 14(6), 101076. https://doi.org/10.1016/j.hlpt.2025.101076.
    47. Naida, N. (2024). The influence of the implementation of regional government information systems and internal government control systems on the quality of financial reporting. Community Service Research Innovation, 1(2 SE-Articles), 101–110. https://doi.org/10.33830/jfba.v4i1.9816.2024.
    48. Nhis Puanarak, C. N. (2025). Sustainable Leadership Models for Resilient and Adaptive Health Administration Systems. Applied Health Administration, 1(1 SE-Articles), 11–21.
    49. Pai, R. R., & Pendyala, J. P. (2026). Optimizing Healthcare Pipelines for Patient Benefit: A Data Engineering Perspectives on Preauthorization Delays and Denials BT - Software and Data Engineering (N. Rahimi, V. Margapuri, & N. A. Golilarz (eds.); pp. 40–52). Springer Nature Switzerland. https://doi.org/10.1007/978-3-032-08649-5_3.
    50. Pattanayak, S., Ramkumar, M., Goswami, M., Chan, F. T. S., & Rana, N. P. (2025). Blockchain and supply chain performance: leveraging digital transformation-enabled operational and strategic dynamic capabilities. Journal of Enterprise Information Management, 1–40. https://doi.org/10.1108/JEIM-10-2024-0585
    51. Prayitno, M., Kanzunnudin, M., Saif, G. M. S., & Dwianto, A. (2025). Adaptive Curriculum, Digital Literacy, and Global Collaboration for Enhancing Multicultural Competence in Higher Education. International Journal of Learning, Teaching and Educational Research, 24(8), 296–320. https://doi.org/10.26803/ijlter.24.8.13.
    52. Pribadi, F., Surwanti, A., & Shih, W. C. (2024). Hospital Funding System by Crowd Funding: A Start-Up Company. In Y. X.-S., S. S., D. N., & J. A. (Eds.), Lecture Notes in Networks and Systems: Vol. 1014 LNNS (pp. 619–628). Springer Science and Business Media Deutschland GmbH. https://doi.org/10.1007/978-981-97-3562-4_49.
    53. Ratta, P., Kaur, A., Sharma, S., Shabaz, M., & Dhiman, G. (2021). Application of Blockchain and Internet of Things in Healthcare and Medical Sector: Applications, Challenges, and Future Perspectives. Journal of Food Quality, 2021(1), 7608296. https://doi.org/10.1155/2021/7608296
    54. Robertson, C., Rose, S., & Kesselheim, A. S. (2012). Effect of Financial Relationships on the Behaviors of Health Care Professionals: A Review of the Evidence. Journal of Law, Medicine & Ethics, 40(3), 452–466. https://doi.org/10.1111/j.1748-720X.2012.00678.x.
    55. Sa’diyah, K. (2024). Occupational Health and Safety, Training, and Teamwork for Hospital Medical Performance. Safety and Health for Medical Workers, 1(1 SE-Articles), 29–38. https://doi.org/10.69725/ehxp3d73.
    56. Savarese, G., Lindberg, F., Cannata, A., Adamo, M., Ambrosio, G., Ameri, P., Anker, M. S., Bäck, M., Bayes-Genis, A., Ben Gal, T., Braunschweig, F., Chioncel, O., D’Elia, E., El-Tamimi, H., Filippatos, G., Girerd, N., Hill, L., Jankowska, E., Khunti, K., … Rosano, G. M. C. (2025). Adherence to guideline-directed medical treatments in heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy. European Journal of Heart Failure, n/a(n/a). https://doi.org/10.1002/ejhf.70090.
    57. Septia, N., & Shafiyah, N. (2024). Effective HR Management as a Key Requirement for Successful Business Administration. Advances in Administration, 1(1 SE-Articles), 35–44.
    58. Sharma, S. (2025). Tools and Techniques in Quality Management and Quality Management Models BT - Quality Demystified: A Comprehensive Guide to Quality Improvement, Patient Safety, and Clinical Audit in Healthcare (S. Sharma (ed.); pp. 123–206). Springer Nature Singapore. https://doi.org/10.1007/978-981-95-0339-1_11.
    59. Siddiqui, S., Fatima, S., Ali, A., Gupta, S. K., Singh, H. K., & Kim, S. (2025). Modelling of queuing systems using blockchain based on the Markov process for smart healthcare systems. Scientific Reports, 15(1), 17248. https://doi.org/10.1038/s41598-025-01652-5.
    60. Suroto, H., Wardhani, I. L., Haryadi, R. D., Aprilya, D., Samijo, S., & Pribadi, F. (2022). The Relationship Between Patient Factors and Clinical Outcomes of Free Functional Muscle Transfer in Patients with Complete Traumatic Brachial Plexus Injury. Orthopedic Research and Reviews, 14, 225–233. https://doi.org/10.2147/ORR.S367499.
    61. Tavares, M. C., Pereira, M. A., & Carvalho, A. I. (2025). How Efficient Is the Sustainable Management of Healthcare Supply Chains of the United Nations Member States? Business Strategy and the Environment, n/a(n/a). https://doi.org/10.1002/bse.70208.
    62. Tobar, C. I. V., Escandon-Barbosa, D., Salas-Paramo, J., & Giménez, V. (2025). Efficiency dynamics in Latin American healthcare reforms: a comprehensive growth mixture analysis within institutional theory. Journal of Health Organization and Management, 39(9), 158–176. https://doi.org/10.1108/JHOM-11-2022-0347.
    63. Türk, M., & Eroğlu, İ. (2021). Financial Risk Assessment in Healthcare Organizations TT - Sağlık İşletmelerinde Finansal Risklerin Değerlendirmesi. Duzce Medical Journal, 23(Special Issue), 113–121. https://doi.org/10.18678/dtfd.862323
    64. Uysal, İ., Altın, F. G., & Özcan, F. (2025). Predicting medical waste amounts and costs using machine learning and XAI for sustainable waste management in healthcare. International Journal of Environmental Science and Technology, 23(1), 21. https://doi.org/10.1007/s13762-025-06895-3.
    65. Wagner, O., & Tholen, L. (2025). Potential for climate protection in hospitals. E-Prime - Advances in Electrical Engineering, Electronics and Energy, 13, 101037. https://doi.org/10.1016/j.prime.2025.101037.
    66. Wang, Zihao, Rostami-Tabar, Bahman, Haider, Jane, Naim, Mohamed, & Haider, Javvad. (2025). A Systematic Literature Review of Trauma Systems: An Operations Management Perspective. Advances in Rehabilitation Science and Practice, 14, 27536351241310644. https://doi.org/10.1177/27536351241310645.
    67. Wang, J., Lin, A., Huang, Y., Li, G., Chen, T., Sun, C., Qian, W., Ren, S., Wong, H. Z. H., Ding, Y., & Zhang, L. (2025). Medical Data as a Key Asset in the Digital Health Era: A Framework for Challenges and Strategies. IMetaMed, n/a(n/a), e70014. https://doi.org/10.1002/imm3.70014.
    68. Wang, X., Zhang, R., Gao, Z., Xia, M., & Zhang, S. (2025). Patient-Centered Outpatient Process Optimization System Based on Intelligent Guidance in a Large Tertiary Hospital in China : Implementation Report. 13, 1–13. https://doi.org/10.2196/60219
    69. Widayati, C. (2025). Digital Climate Governance, ESG Innovation, and Carbon Risk Management on Credit Risk. Advances in Management Innovation, 1(2 SE-Article Full), 127–140. https://doi.org/10.71222/00d71j98.
    70. William H Delone, & McLean, E. R. (2003). The DeLone and McLean Model of Information Systems Success: A Ten-Year Update. Journal of Management Information Systems, 19(4), 9–30. https://doi.org/10.1080/07421222.2003.11045748
    71. Yasmine, A. Al. (2024). Effectiveness of Health Education Campaigns for Adolescent Smoking Cessation Programs. In Applied Health Promotion Science (Vol. 1, Issues 1 SE-Articles, pp. 43–55).
    72. Yu, D., Lin, H., Tan, X., Zhang, J., Liu, Z., Li, D., & Wang, Z. (2025). Feasibility of intelligent logistics management for operational efficiency in smart hospitals: a case study. Scientific Reports, 15(1), 36336. https://doi.org/10.1038/s41598-025-20227-y.
    73. Yu, Z., Sun, G., Lin, S., Hu, H., & Xu, J. (2025). Operationalizing game-theoretic weighting in public hospital cost control: an implementation framework from Chinese tertiary hospitals. Cost Effectiveness and Resource Allocation, 23(1), 11. https://doi.org/10.1186/s12962-025-00616-w
    74. Yuliani, R., & Catur Widayati, C. (2025). The Effect of Work-Life Balance and Workload on Employee Performance with Motivation as a Mediating Variable. Journal of Economic Business Innovation, 2(1 SE-Articles), 125–144. https://doi.org/10.69725/jebi.v2i1.250.
    75. Zelna, Z., & Nurhidayah, A. (2024). Alleviating Labor Pain with Neroli Aromatherapy and Breath Relaxation: A Clinical Investigation. Innovation Midwifery and Child Health Practice, 1(1 SE-Articles), 25–31. https://doi.org/10.69725/imchp.v1i1.80
    76. Zhang, M., Wu, H., Zhao, X., & Wu, P. (2025). Size demands for outpatient waiting areas in the context of smart healthcare services in China. Journal of Asian Architecture and Building Engineering, 1–21. https://doi.org/10.1080/13467581.2025.2584639 .

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    Fathul Imam Sazali, H., & Pribadi, F. . (2025). Evaluation of Hospital Accounting System on Outpatient Ser‎vice Efficiency. International Journal of Accounting and Economics Studies, 12(8), 278-290. https://doi.org/10.14419/95znky09