Electronic Theses and Dissertation

Aceh memiliki tingkat kerentanan tinggi terhadap bencana geologis dan hidrometeorologis, sehingga rumah sakit dituntut untuk mampu mempertahankan fungsi esensialnya dalam keadaan darurat. konsep resiliensi rumah sakit menjadi krusial karena mencakup kemampuan fasilitas kesehatan untuk tetap beroperasi selama bencana serta memulihkan layanan pascabencana seiring dengan meningkatnya intensitas dan kompleksitas bencana akibat perubahan iklim. kondisi ini menggarisbawahi kebutuhan pembaharuan yang dapat memetakan dimensi resiliensi rumah sakit secara terukur sebagai dasar penguatan kapasitas di masa mendatang. penelitian ini memberikan kontribusi strategis melalui indikator, framework dan instrumen yang dapat menjadi dasar pengambilan kebijakan terkait resiliensi rumah sakit dalam menghadapi bencana. desain kualitatif dan kuantitatif digunakan dalam penelitian ini. ada tiga tahapan penelitian yaitu identifikasi indikator, pengembangan framework dan instrumen, serta penilaian tingkat resiliensi rumah sakit di aceh menghadapi bencana. tahap pertama yaitu menelaah 28 referensi ilmiah dan dilanjutkan dengan mengidentifikasi indikator sehingga menghasilkan delapan domain utama, yaitu information and technology, training and research, governance, workforce, financing, infrastructure, service, dan business continuity. tahap kedua mengembangkan framework resiliensi rumah sakit serta melakukan validasi menggunakan intraclass correlation coefficient didapatkan nilai average measure 0,894 (good agreement), hal ini menunjukkan nilai validasi berada pada kategori baik. lalu hasil nilai content validity ratio pada tujuh pakar berada pada angka 0,99 yang menunjukkan bahwa seluruh item dalam instrumen memenuhi standar esensialitas yang dipersyaratkan. nilai content validity index terhadap 111 item pernyataan, yang menunjukkan validitas sangat baik dengan nilai s-cvi/ave 0,993 dan s-cvi/ua 0,955 yang menyimpulkan bahwa nilai relevansi dan kejelasan setiap item secara lebih rinci tergolong “diterima” atau sangat baik. tahap ketiga yaitu menerapkan penilaian instrumen pada delapan rumah sakit di provinsi aceh untuk menggambarkan tingkat resiliensi aktual. understanding tercatat sebagai dimensi dengan persentase tertinggi, sedangkan rebuilding memiliki persentase paling rendah. pada indicator score, indikator information and technology menunjukkan indikator dengan persentase tertinggi, sementara business continuity berada pada tingkat paling rendah. analisis grafik spider memperlihatkan kemampuan setiap rumah sakit dalam menghadapi bencana masih beragam. ada indikator yang kuat di satu rumah sakit tetapi lemah di rumah sakit lain. ketidakseimbangan ini menunjukkan bahwa resiliensi rumah sakit belum berjalan secara menyeluruh dan terpadu. penelitian ini menekankan perlunya penguatan resiliensi rumah sakit di aceh melalui pengembangan regulasi yang lebih komprehensif pada lintas sektor, serta adanya mekanisme monitoring berkelanjutan untuk manajemen bencana yang lebih efektif. kata kunci: aceh, kerangka kerja, kapasitas sistem kesehatan, resiliensi rumah sakit.

Aceh has a high level of vulnerability to geological and hydrometeorological disasters, requiring hospitals to maintain their essential functions during emergency situations. Hospital resilience has therefore become a critical concept, encompassing the capacity of health facilities to continue operating during disasters and to restore services in the post-disaster phase, in line with the increasing intensity and complexity of disasters driven by climate change. This condition underscores the need for systematic approaches that can map the dimensions of hospital resilience in a measurable manner as a foundation for strengthening future capacity. This study provides a strategic contribution through the development of indicators, a framework, and an assessment instrument that can serve as a basis for policy decision-making related to hospital resilience in disaster contexts. A mixed qualitative and quantitative research design was employed, consisting of three stages, namely indicator identification, framework and instrument development, and assessment of hospital resilience levels in Aceh. The first stage involved reviewing 28 scientific references and identifying resilience indicators, resulting in eight main domains, namely information and technology, training and research, governance, workforce, financing, infrastructure, service, and business continuity. The second stage focused on developing the hospital resilience framework and conducting validation. The Intraclass Correlation Coefficient analysis yielded an average measure of 0.894, indicating good agreement among experts. In addition, the Content Validity Ratio assessed by seven experts reached 0.99, confirming that all instrument items met the required standards of essentiality. The Content Validity Index across 111 statement items demonstrated excellent validity, with an S-CVI/Ave of 0.993 and an S-CVI/UA of 0.955, indicating that the relevance and clarity of all items were rated as acceptable to very good. In the third phase, the assessment instrument was implemented across eight hospitals in Aceh Province to evaluate their current level of resilience. The results showed that the understanding dimension achieved the highest score, whereas rebuilding emerged as the weakest dimension. At the indicator level, information and technology demonstrated the strongest performance, while business continuity was identified as the lowest-scoring indicator. Spider chart analysis revealed substantial variation in resilience profiles among hospitals, with certain domains well developed in some facilities but underperforming in others. These inconsistencies indicate that hospital resilience has not yet been established as a fully integrated and holistic system. Accordingly, this study highlights the importance of strengthening hospital resilience in Aceh through more integrated cross-sectoral regulations and the implementation of continuous monitoring mechanisms to enhance the effectiveness of disaster management. Keywords: Aceh, framework, health system capacity, hospital resilience.