Optimizing the Implementation of Regional Public Service Agency Management to Improve Efficiency and Service Quality at Hasanuddin Damrah General Hospital

The implementation of the Regional Public Service Agency (Badan Layanan Umum Daerah/BLUD) management system represents a strategic reform in public hospital governance aimed at improving operational efficiency and service quality. As regional public hospitals increasingly operate under financial constraints while simultaneously facing higher public expectations for service quality and accountability, effective implementation of the BLUD management model becomes essential for ensuring sustainable healthcare delivery. Hasanuddin Damrah General Hospital (HD Manna), a regional public hospital operating under BLUD status in South Bengkulu Regency, presents a relevant case for examining how financial autonomy, performance-based management, and digital innovation interact in a peripheral healthcare setting. This study aims to analyze the strategies, implementation processes, and impacts of BLUD management on operational efficiency and service quality at HD Manna Hospital. A qualitative case study approach was employed, utilizing in-depth interviews, participant observation, and document analysis. Informants included hospital directors, financial managers, heads of service units, quality assurance officers, and administrative staff. Data were analyzed thematically using the Miles and Huberman interactive model. The findings indicate that BLUD management is implemented through an output-based performance approach, particularly incentive schemes derived from BPJS claims, which enhance staff motivation, accountability, and service responsiveness. Financial flexibility under BLUD status facilitates more efficient procurement processes and timely resource allocation. The utilization of the Hospital Management Information System (SIMRS) and digital queue systems has played a crucial role in improving service coordination and efficiency, in line with national guidelines on hospital information system implementation issued by the Indonesian Ministry of Health . However, challenges remain, particularly resistance to organizational change and uneven human resource capacity in digital competencies. In conclusion, optimizing BLUD management positively affects operational efficiency and service quality in regional public hospitals. Strengthening human resource capacity, enhancing performance evaluation systems, and expanding digital innovation are essential to ensure the sustainability of BLUD implementation, especially in resource-constrained settings.