Hospital Tariff Setting, Patient Experience, and Patient Satisfaction under New Public Management Reforms: A Systematic Review

I Gusti Agung Ayu Eka Mahastuti; Agus Fredy  Maradona; Adhar Arifuddin

doi:10.56303/jhnresearch.v5i2.1456

Authors

I Gusti Agung Ayu Eka Mahastuti Universitas Pendidikan Nasional, Bali, Indonesia
Agus Fredy Maradona Universitas Pendidikan Nasional, Bali, Indonesia
Adhar Arifuddin Department of Epidemiology, Faculty of Public Health, Tadulako University, Indonesia

Keywords:

Hospital Tariff, Patient Experience, Patient Satisfaction, New Public Management, Public Hospitals, Provider Payment, Health Financing, Price Transparency

Abstract

Public hospitals are under sustained pressure to reconcile fiscal sustainability, service quality, and equitable access. New Public Management (NPM) reforms influence tariff setting by expanding managerial autonomy, output-based financing, performance measurement, and market-like incentives. This review aims to synthesize evidence on how NPM-oriented hospital tariff and provider-payment policies influence patient experience and patient satisfaction in public hospitals. Methods: A systematic review was conducted according to PRISMA 2020. Scopus, Web of Science, PubMed/MEDLINE, ScienceDirect, and SAGE Journals were searched for English-language literature published from January 2019 to June 2026, while seminal older works were retained for theoretical framing. After duplicate removal and screening, 45 sources were included in thematic synthesis, comprising 31 primary empirical studies, 8 review articles, and 6 conceptual or policy analyses. Tariff and payment reforms may improve cost control, technical efficiency, and managerial responsiveness, but the included literature also links poorly calibrated tariffs with cost shifting, service selection, shortened length of stay, coding pressure, and distrust when payment rules are opaque or misaligned with actual service costs. Patient experience described what patients actually encountered during care, including access, waiting, communication, billing clarity, and affordability, whereas patient satisfaction reflected evaluative judgment against expectations and perceived value. Hospital tariff reform is a governance intervention rather than a purely technical pricing exercise. Sustainable reform requires periodic cost review, quality-sensitive payment design, transparent patient-facing communication, and safeguards for equity.

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References

Mbau R, Musiega A, Nyawira L, Tsofa B, Mulwa A, Molyneux S, et al. Analysing the Efficiency of Health Systems: A Systematic Review of the Literature. Appl Health Econ Health Policy. 2023 Mar;21(2):205–24. doi:10.1007/s40258-022-00785-2 PubMed PMID: 36575334; PubMed Central PMCID: PMC9931792.

Kutzin J. Health financing for universal coverage and health system performance: concepts and implications for policy. Bull World Health Organ. 2013 Aug 1;91(8):602–11. doi:10.2471/BLT.12.113985

Hood C. A public management for all seasons? Public Adm. 1991 Mar;69(1):3–19. doi:10.1111/j.1467-9299.1991.tb00779.x

Dunleavy P. New Public Management Is Dead--Long Live Digital-Era Governance. J Public Adm Res Theory. 2005 Sep 15;16(3):467–94. doi:10.1093/jopart/mui057

Tsuei SH, Yip W (Chi‐Man). How hospital autonomy affects provider payment reform effectiveness. Int J Health Plann Manage. 2024 Sep;39(5):1350–69. doi:10.1002/hpm.3806

Mathauer I, Wittenbecher F. Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries. Bull World Health Organ. 2013 Oct 1;91(10):746-756A. doi:10.2471/BLT.12.115931

Irwandy, Sjaaf AC, Achadi A, Nadjib M, Ayuningtyas D, Junadi P, et al. The efficiency and productivity of Public Services Hospital in Indonesia. Enferm Clínica. 2020 Oct;30:236–9. doi:10.1016/j.enfcli.2020.06.054

Suryanegara FDA, Iskandar D, Ekaputra E, Kuntjoro E, Setiawan D, Postma MJ, et al. Costs analysis of radiotherapy for breast cancer in Indonesia: a comparison between reimbursement tariffs and actual costs. BMC Health Serv Res. 2025 May 28;25(1):766. doi:10.1186/s12913-025-12849-9

Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018 Nov;6(11):e1196–252. doi:10.1016/S2214-109X(18)30386-3

Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1):e001570. doi:10.1136/bmjopen-2012-001570

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;n71. doi:10.1136/bmj.n71

Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008 Dec;8(1):45. doi:10.1186/1471-2288-8-45

Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ Inf. 2018 Dec 18;34(4):285–91. doi:10.3233/EFI-180221

Akthar N, Nayak S, Pai P Y. Determinants of patient satisfaction in Asia: Evidence from systematic review of literature. Clin Epidemiol Glob Health. 2023 Sep;23:101393. doi:10.1016/j.cegh.2023.101393

Jamalabadi S, Winter V, Schreyögg J. A Systematic Review of the Association Between Hospital Cost/price and the Quality of Care. Appl Health Econ Health Policy. 2020 Oct;18(5):625–39. doi:10.1007/s40258-020-00577-6

Lindaas NA, Anthun KS, Magnussen J. New Public Management and hospital efficiency: the case of Norwegian public hospital trusts. BMC Health Serv Res. 2024 Jan 5;24(1):36. doi:10.1186/s12913-023-10479-7

Milstein R, Schreyögg J. The end of an era? Activity-based funding based on diagnosis-related groups: A review of payment reforms in the inpatient sector in 10 high-income countries. Health Policy. 2024 Mar;141:104990. doi:10.1016/j.healthpol.2023.104990

Meng Z, Hui W, Cai Y, Liu J, Wu H. The effects of DRGs-based payment compared with cost-based payment on inpatient healthcare utilization: A systematic review and meta-analysis. Health Policy. 2020 Apr;124(4):359–67. doi:10.1016/j.healthpol.2020.01.007

Sharkiya SH. Quality communication can improve patient-centred health outcomes among older patients: a rapid review. BMC Health Serv Res. 2023 Aug 22;23(1):886. doi:10.1186/s12913-023-09869-8

Godovykh M, Pizam A. Measuring patient experience in healthcare. Int J Hosp Manag. 2023 Jul;112:103405. doi:10.1016/j.ijhm.2022.103405

Oliver RL. A Cognitive Model of the Antecedents and Consequences of Satisfaction Decisions. J Mark Res. 1980 Nov;17(4):460–9. doi:10.1177/002224378001700405

Zeithaml VA. Consumer Perceptions of Price, Quality, and Value: A Means-End Model and Synthesis of Evidence. J Mark. 1988 Jul;52(3):2–22. doi:10.1177/002224298805200302

Han A, Lee KH, Park J. The impact of price transparency and competition on hospital costs: a research on all-payer claims databases. BMC Health Serv Res. 2022 Nov 5;22(1):1321. doi:10.1186/s12913-022-08711-x

Lin JC, Gillette JS, Zhu AS, French DD, Weir M, Meyers DJ, et al. Outcomes of price transparency policies for healthcare services in the United States: A systematic review. Health Policy Technol. 2025 Feb;14(1):100973. doi:10.1016/j.hlpt.2025.100973

Fancourt D, Baxter L. Differential participation in community cultural activities amongst those with poor mental health: Analyses of the UK Taking Part Survey. Soc Sci Med. 2020 Sep;261:113221. doi:10.1016/j.socscimed.2020.113221

Abdalla R, Pavlova M, Groot W. Association of patient experience and the quality of hospital care. Int J Qual Health Care. 2023 Jul 5;35(3):mzad047. doi:10.1093/intqhc/mzad047

Chen Y jing, Zhang X yu, Yan J qi, Xue-Tang, Qian M cen, Ying X hua. Impact of Diagnosis-Related Groups on Inpatient Quality of Health Care: A Systematic Review and Meta-Analysis. Inq J Health Care Organ Provis Financ. 2023 Jan;60:00469580231167011. doi:10.1177/00469580231167011

Wang Y, Whaley CM, Bai G. Healthcare Price Transparency: Research Findings and Implications for Policy and Practice. J Gen Intern Med. 2025 Apr;40(5):1175–7. doi:10.1007/s11606-024-09295-4

Ferreira DC, Vieira I, Pedro MI, Caldas P, Varela M. Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare. 2023 Feb 21;11(5):639. doi:10.3390/healthcare11050639

Wulandari ARC, Rachmawaty R, Ilkafah I, Erfina E. Patient satisfaction towards healthcare quality in Indonesian Public Hospital. Enferm Clínica. 2021 Dec;31:S745–50. doi:10.1016/j.enfcli.2021.09.006