Logistics Indicators Could Improve Logistics Performance of Hospitals

Hospitals are institutions in which numerous transactions take place. A significant amount of those transactions happen in the realm of logistics. Logistifics is one of the concern of the hospital’s managing entities. Hospitals must provide a variety of logistics within a limited amount of time. The implementation of hospital logistics indicators were expected to assist the management in improving performance in the logistics units of hospitals in the Province of Jakarta. It was expected that by attending to a number of variables, namely information technology support, logistics management, logistics business intelligence, and logistics performance, such improvement could be achieved. The result of this study provided a description of major indicators that could improve the logistics performance in hospital industry located within the Province of Jakarta.


Introduction
Globalization has resulted to many alterations within the practice of free trade which, consequently, brought about positive impacts for the international community and Indonesia.Those alterations, combined with the level of competitiveness of a country's industry, constitute a factor which can influence a country's trade position.Indonesia, considering its current context and situation, has seen its industry spending a lot more in terms of production of goods and services in comparison to other countries.One of the factor that underlies such phenomenon is the slow development of logistics performance or capacity that is implemented within the country [1].
Logistics Performance Index was introduced by World Bank through one of its study [2].The study on logistics performance was explored further, by focusing on time, cost, and reliability of logistics [3].
Asian Development Bank (ADB) conducted a research on a macro level which reviewed a country's condition.On the other hand, a country's logistics activities could also be observed from many industries, such as logistics activities in hospital industry.An example for such observation is documented in a study of several hospitals in ASEAN countries which was conducted by Hoeur and Kritchanchai (2015) [4].
Hospital logistics cover a variety of activities, such as those related to medicine logistics, medical devices, food and beverage, consumable materials, office stationeries, and linen.

Figure 1. Logistics performance index of regions according to ADB [3]
Considering the fact that the majority of funding in a hospital is allocated to logistics, amounting to 46% of the total funding in a hospital [5], inefficient logistics activities would spike the cost charged to the patients, as well as making the hospital performance as a whole unsatisfactory.As a consequence, there might be a chance for a hospital to shut down due to the poor condition of its logistics financing.
Olaru (2014) mentioned that a factor which influences a hospital's logistics performance lies on its ability to implement a good business intelligence [6].Meanwhile, Coyle, et al. (2013) [7] and Taylor (2007) [8] claimed that the implementation of a wholistic logistics management would enable the hospital to manage the total cost of logistics, therefore influencing the logistics performance of hospitals.On the other hand, logistics management and business intelligence require support from information technology in order to make the existing data processible and meaningful for the managing entities of the hospital [9].

Problem formulation
The root of the problem in hospital logistics in particular stems from its procurement activities.This is due to the fact that purchasing department needs to be able to determine materials and products required by the hospital, as well as pointing suppliers who are able to fill those deficits, aside from purchasing activities conducted in relatively routine manner.
By taking into account the connection between IT Support, Logistics Management, Logistics Business Intelligence, and Logistics Performance, the aforementioned variables would be able to be observed through a correct and accurate operationalization of those variables.
Figure 2 provides an explanation regarding literature study and theories which are used, as well as setting the foundation and framework in giving recommendations of solutions for existing problems.
3 Literature review

Information system
According to O'Brien and Marakas (2013), a system is a set of related components with clear distinctions which aim to reach a desired goal by gaining inputs and providing outputs in a process of transformation.
Processed data and data which are meaningful to humans are referred to as information [9].According to O'Brien and Marakas (2013), information is data which has become a useful context for the end users of the system.According to Stair and Reynolds (2012), information is a collection of facts with added values to them [10].
According to several definitions regarding information system, it can be inferred that information system comprise of several components, such as software, hardware, human, communication network as well as coordinated data to conduct information gathering, processing, and storing in order to support decisionmaking process, control activities, conduct coordination, analyze problem, and conduct visualization inside an organization.

Hospital information system
Information system inside hospitals are specific developments of information system which are implemented within the hospital industry.This system will gather, process, store, and spread real-time information according to the data entered by every operator within the hospital's information system, specifically the hospital's supporting department which is responsible in managing patients' medical data.These medical data will then be used in the process of making coordinated decision regarding a patient's health.Currently, many hospitals are willing to move from paper-based information systems to electronic information systems in order to support patients' care [11].

Figure 2. Theoretical foundations of the study
Hospital information system has a significant potential in reducing the cost of patient's care, as well as providing a satisfactory end result [12].It is also predicted to provide similar positive outcomes for the logistics department of the hospital.

Logistics performance
Gil-Saura, et al. (2010) claimed that logistics performance is not merely about logistics operational activities, but that it serves as a main factor and strategic variable in fulfilling consumers' satisfaction [13].The fact is that if a consumer's needs is not fulfilled, the result of that dissatisfaction will lead the consumers to search for other service providers which will be able to provide for their needs, due to the negative experience that the consumers felt with the initial service provider [14].
Logistics performance is a result of a good logistics activities aimed at optimizing quality, cost, and time.

Logistics management
It is a field of science concerning the process behind planning and conducting needs assesment for procurement, distribution, maintenance, and storage, as well as rescission of materials/instruments from the logbook.Therefore, logistics management will be able to explain the means to achieve the goal of procurement of materials/products when they are needed and can be used optimumly [15].Logistics management is a logistics activity such as planning, executing, and monitoring of incoming and exitting items in order to create an organization that runs optimally.

Business intelligence
It is a means to gather, store, organize, reshape, and summarize data, as well as providing information, be it company's internal business activities, or its external activities, including the business activities of its competitors which are easy to access and analyze for many managerial activities [16].
Business Intelligence is an analytical instrument used to consolidate, analyze, store, and access data in order to assist the decision making process, akin to a software for query database and reporting, multidimensional data analysis tool and data mining [9].
Logistics business intelligence is an activity of collecting, storing, and analyzing logistics data in hospitals as well granting access to user for sake of a better decision-making process within a certain period.

Information technology support
According to Raymond McLeod, IT Support is a collection of data which can be processed in order to provide a certain meaning as well as values [17].Meanwhile, according to James O'Brien, it is a form of data existing within a context, which indicates that it has meaning and is useful for end user [18].According to Laudon, it is a form of data which has been processed and the outcome is a meaningful and useful data for human lives [9].
Information Technology Support is every kind of technology implemented to process, form, shape, and spread information electronically.

Framework
Inferring from the literature review conducted in this study, there several gaps that serves as grounds for furthere research.These gaps include variables of information technology support, logistics management, logistics business intelligence and logistics performance.The discussion within each reviewed article only touched one or two of the aforementioned variables.In this article, however, the discussion of all four variables will be advanced.
Logistics performance is a logistics activity aimed to optimize quality, cost, and time in order to ensure that patient's needs are fulfilled through the existence of logistics management which consist of logistics activities such as planning, executing, and monitoring the movement of incoming and exitting logistics supply in order to ensure a more optimum service for the patients.Due to the variety and large amount of logistics activities data, an implementation of logistics business intelligence is needed, namely an activity of collecting, storing, and analyzing logistics data as well as granting access to user in order to create a good decision-making process, which will certainly require an IT support which is every kind of technology implemented to process, form, shape, and spread information electronically.

Model Analysis
Data collected from 45 hospitals located in the Province of Jakarta by simple random sampling from the population of 81 hospitals, ranging from those of class A, B or C, were processed using SmartPLS 2.0.After running the application all the indicators were valid (loading factor > 0,5 and t-statistics >2,0.

Figure 3. Theoretical framework
After checking the loading factor, the next process is the resampling process using bootstrapping with 1000 samples.
From the evaluation of convergent validity through the states of evaluation, validity indicator and reliability construct (variables) that indicates condition of available data from variable information technology support has the biggest impact, variable logistics management does not have much influence in this research, variable logistics intelligence with indicator adding service value has the biggest impact in the model and indicator regularly is the biggest impact for logistics performance variable (Table 1).

Conclusion
The study has identified three major indicators that could significantly affect the performance of logistics, including reliability tracking which will greatly assist the hospital in the process of tracking, in order to find an item / product that is needed by patients, to determine the existence.And indicator adding service value could be considered as an important factor in creating customer satisfaction (patients and families) in Jakarta.In additioin to that, the quality of information provided on a regular basis to solve the problem together with third parties.
By implementing those indicators (Table 1), it is expected that hospitals will be able to have references in calculating their logistics performance, because previously, the system which is used in hospitals have yet to have a standard of reference in terms of logistics.Yet by identifying and defining the dominant indicator that affects the dimensions and variables could increase the performance of logistic.As a consequence, hospitals will be able to monitor and control the logistics performance in order to reach an improved optimum level.On a macro level, Indonesian government will be able to have an higher LPI in contrast to other countries within the same region.