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Copyright (c) 2026 Laurencya Stephanie Rusli, Aditia Prasetianto, Lina Lina (Author)
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Hospital Digitalization Effects on Patient Outcomes Mediated by Usability Pathways
Corresponding Author(s) : Lina Lina
Jurnal Minds: Manajemen Ide dan Inspirasi,
Vol. 13 No. 1 (2026): June
Abstract
This study examines how administrative and patient service digitization influence patient satisfaction and loyalty in hospital settings. It advances digital health literature by demonstrating that hospital digitalization effects on patient outcomes are mediated by usability pathways rather than direct technological deployment, while also revealing the contingent role of digital literacy across service domains. Using a PLS-SEM approach with a sample of 196 patients, the findings indicate that digitalization does not directly enhance satisfaction or loyalty but operates through perceived ease of use, whereas perceived usefulness remains non-influential. Digital literacy strengthens the impact of administrative digitization on satisfaction but weakens the effect of patient service digitization. Satisfaction emerges as the primary driver of patient loyalty. These findings imply that hospital digital transformation strategies should prioritize usability optimization and tailor digital services to patient capability levels.
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- Alalwan, A. A., Dwivedi, Y. K., Rana, N. P., & Williams, M. D. (2021). Consumer adoption of mobile health applications: Examining the role of perceived usefulness, ease of use, and trust. International Journal of Information Management, 58, 102407. https://doi.org/10.1016/j.ijinfomgt.2021.102407
- Alhassan, R. K., Nketiah-Amponsah, E., & Akazili, J. (2023). Digital health integration and patient literacy: A pathway to improved satisfaction in Ghanaian hospitals. Global Health Action, 16(1), 2183456. https://doi.org/10.1080/16549716.2023.2183456
- Alshahrani, S., & Alalwan, A. A. (2022). Digital transformation in healthcare: A systematic review of challenges and success factors. Journal of Health Management, 24(1), 45–62. https://doi.org/10.1177/09720634221075589
- Anderson, J. E., Chang, D. C., & Davis, K. L. (2023). Digital health transformation in emerging markets: A systematic review of outcomes and implementation challenges. The Lancet Digital Health, 5(4), e245–e258. https://doi.org/10.1016/S2589-7500(23)00012-4
- Baron, R. M., & Kenny, D. A. (2018). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/psp0000146
- Chen, X., Wang, L., & Liu, Y. (2023). The paradoxical effect of digital literacy on patient satisfaction with telemedicine services: A mixed-methods study. Journal of Medical Systems, 47(2), 45–58. https://doi.org/10.1007/s10916-023-01935-2
- Chung, K., Park, J., & Lee, S. (2021). Patient satisfaction and revisit intention in digital hospital services. Healthcare Informatics Research, 27(2), 120–128. https://doi.org/10.4258/hir.2021.27.2.120
- Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13(3), 319–340. https://doi.org/10.2307/249008
- Famor Pratami, J., Gaffar, V., Dirgantari, P. D., Furqon, C., & Maryati, M. (2023). Managing patient loyalty through digital patient experience. Journal of Eastern European and Central Asian Research, 10(4). https://doi.org/10.15549/jeecar.v10i4.1356
- Gupta, R., & Sharma, S. (2024). Technology acceptance in healthcare: A meta-analytic review of mediating mechanisms. International Journal of Medical Informatics, 181, 105–123. https://doi.org/10.1016/j.ijmedinf.2023.105123
- Hu, S., Song, D., Wan, S., Zhang, S., Luo, C., et al. (2025). Digital health: Current applications, challenges, and future directions for enhancing healthcare quality and safety. Frontiers in Public Health, 13, Article 1646802. https://doi.org/10.3389/fpubh.2025.1646802
- Kementerian Kesehatan Republik Indonesia. (2024). Strategi transformasi digital kesehatan nasional 2024. Jakarta: Kemenkes RI.
- Kordzadeh, N., Warren, J., & Michailidis, T. (2023). The moderating role of digital literacy in patient engagement with health technologies. Journal of Biomedical Informatics, 139, 104343. https://doi.org/10.1016/j.jbi.2023.104343
- Kotler, P., & Keller, K. L. (2016). Marketing management (15th ed.). Pearson Education.
- Lee, H., & Kim, J. (2024). Digital literacy as a resource: Moderating effects on healthcare service satisfaction. Computers in Human Behavior, 151, 107–120. https://doi.org/10.1016/j.chb.2023.107120
- Ng, W. (2022). New directions in digital literacy: Pedagogical perspectives and applications. Routledge. https://doi.org/10.4324/9780367754321
- Oliver, R. L. (1980). A cognitive model of the antecedents and consequences of satisfaction decisions. Journal of Marketing Research, 17(4), 460–469. https://doi.org/10.1177/002224378001700405
- Pahlevi, M., & Saleh, A. (2023). Patient satisfaction and loyalty in Indonesian hospitals: The role of digital transformation. Journal of Health Management, 25(1), 78–95. https://doi.org/10.1177/09720634221144872
- Utami, P., Ardi, A., Waisan, D. S. S., & Sumaryo, R. A. (2025). Service quality and e-health literacy impact on elderly patient loyalty at Hospital X. Indonesian Interdisciplinary Journal of Sharia Economics, 8(3). https://doi.org/10.31538/iijse.v8i3.7551
- Wong, K. L., Tan, S. M., & Chen, Y. (2023). Beyond usefulness: Exploring alternative mediators in healthcare digitalization. Health Policy and Technology, 12(3), 100–115. https://doi.org/10.1016/j.hlpt.2023.01.008
- World Health Organization. (2021). Global strategy on digital health 2020–2025. Geneva: WHO Press. https://apps.who.int/iris/handle/10665/338152
- World Health Organization. (2020). Delivering quality health services: A global imperative for universal health coverage. Geneva: WHO Press.
- Zhang, Q., Li, M., & Wang, J. (2022). Cross-cultural comparison of patient satisfaction determinants in digital healthcare across Asian countries. Health Informatics Journal, 28(4), 1–15. https://doi.org/10.1177/14604582221123456
- Zeithaml, V. A., Berry, L. L., & Parasuraman, A. (2018). Delivering quality service: Balancing customer perceptions and expectations. Simon & Schuster.
- Zeithaml, V. A., Bitner, M. J., & Gremler, D. D. (2020). Services marketing: Integrating customer focus across the firm (7th ed.). McGraw-Hill Education.
- Zhou, T., Li, Y., & Zhang, X. (2022). Digital literacy and patient satisfaction in electronic health record systems: Evidence from Chinese hospitals. BMC Health Services Research, 22(1), 1145. https://doi.org/10.1186/s12913-022-08567-3
References
Alalwan, A. A., Dwivedi, Y. K., Rana, N. P., & Williams, M. D. (2021). Consumer adoption of mobile health applications: Examining the role of perceived usefulness, ease of use, and trust. International Journal of Information Management, 58, 102407. https://doi.org/10.1016/j.ijinfomgt.2021.102407
Alhassan, R. K., Nketiah-Amponsah, E., & Akazili, J. (2023). Digital health integration and patient literacy: A pathway to improved satisfaction in Ghanaian hospitals. Global Health Action, 16(1), 2183456. https://doi.org/10.1080/16549716.2023.2183456
Alshahrani, S., & Alalwan, A. A. (2022). Digital transformation in healthcare: A systematic review of challenges and success factors. Journal of Health Management, 24(1), 45–62. https://doi.org/10.1177/09720634221075589
Anderson, J. E., Chang, D. C., & Davis, K. L. (2023). Digital health transformation in emerging markets: A systematic review of outcomes and implementation challenges. The Lancet Digital Health, 5(4), e245–e258. https://doi.org/10.1016/S2589-7500(23)00012-4
Baron, R. M., & Kenny, D. A. (2018). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/psp0000146
Chen, X., Wang, L., & Liu, Y. (2023). The paradoxical effect of digital literacy on patient satisfaction with telemedicine services: A mixed-methods study. Journal of Medical Systems, 47(2), 45–58. https://doi.org/10.1007/s10916-023-01935-2
Chung, K., Park, J., & Lee, S. (2021). Patient satisfaction and revisit intention in digital hospital services. Healthcare Informatics Research, 27(2), 120–128. https://doi.org/10.4258/hir.2021.27.2.120
Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13(3), 319–340. https://doi.org/10.2307/249008
Famor Pratami, J., Gaffar, V., Dirgantari, P. D., Furqon, C., & Maryati, M. (2023). Managing patient loyalty through digital patient experience. Journal of Eastern European and Central Asian Research, 10(4). https://doi.org/10.15549/jeecar.v10i4.1356
Gupta, R., & Sharma, S. (2024). Technology acceptance in healthcare: A meta-analytic review of mediating mechanisms. International Journal of Medical Informatics, 181, 105–123. https://doi.org/10.1016/j.ijmedinf.2023.105123
Hu, S., Song, D., Wan, S., Zhang, S., Luo, C., et al. (2025). Digital health: Current applications, challenges, and future directions for enhancing healthcare quality and safety. Frontiers in Public Health, 13, Article 1646802. https://doi.org/10.3389/fpubh.2025.1646802
Kementerian Kesehatan Republik Indonesia. (2024). Strategi transformasi digital kesehatan nasional 2024. Jakarta: Kemenkes RI.
Kordzadeh, N., Warren, J., & Michailidis, T. (2023). The moderating role of digital literacy in patient engagement with health technologies. Journal of Biomedical Informatics, 139, 104343. https://doi.org/10.1016/j.jbi.2023.104343
Kotler, P., & Keller, K. L. (2016). Marketing management (15th ed.). Pearson Education.
Lee, H., & Kim, J. (2024). Digital literacy as a resource: Moderating effects on healthcare service satisfaction. Computers in Human Behavior, 151, 107–120. https://doi.org/10.1016/j.chb.2023.107120
Ng, W. (2022). New directions in digital literacy: Pedagogical perspectives and applications. Routledge. https://doi.org/10.4324/9780367754321
Oliver, R. L. (1980). A cognitive model of the antecedents and consequences of satisfaction decisions. Journal of Marketing Research, 17(4), 460–469. https://doi.org/10.1177/002224378001700405
Pahlevi, M., & Saleh, A. (2023). Patient satisfaction and loyalty in Indonesian hospitals: The role of digital transformation. Journal of Health Management, 25(1), 78–95. https://doi.org/10.1177/09720634221144872
Utami, P., Ardi, A., Waisan, D. S. S., & Sumaryo, R. A. (2025). Service quality and e-health literacy impact on elderly patient loyalty at Hospital X. Indonesian Interdisciplinary Journal of Sharia Economics, 8(3). https://doi.org/10.31538/iijse.v8i3.7551
Wong, K. L., Tan, S. M., & Chen, Y. (2023). Beyond usefulness: Exploring alternative mediators in healthcare digitalization. Health Policy and Technology, 12(3), 100–115. https://doi.org/10.1016/j.hlpt.2023.01.008
World Health Organization. (2021). Global strategy on digital health 2020–2025. Geneva: WHO Press. https://apps.who.int/iris/handle/10665/338152
World Health Organization. (2020). Delivering quality health services: A global imperative for universal health coverage. Geneva: WHO Press.
Zhang, Q., Li, M., & Wang, J. (2022). Cross-cultural comparison of patient satisfaction determinants in digital healthcare across Asian countries. Health Informatics Journal, 28(4), 1–15. https://doi.org/10.1177/14604582221123456
Zeithaml, V. A., Berry, L. L., & Parasuraman, A. (2018). Delivering quality service: Balancing customer perceptions and expectations. Simon & Schuster.
Zeithaml, V. A., Bitner, M. J., & Gremler, D. D. (2020). Services marketing: Integrating customer focus across the firm (7th ed.). McGraw-Hill Education.
Zhou, T., Li, Y., & Zhang, X. (2022). Digital literacy and patient satisfaction in electronic health record systems: Evidence from Chinese hospitals. BMC Health Services Research, 22(1), 1145. https://doi.org/10.1186/s12913-022-08567-3