Strategic Sustainability Management in Regional Hospitals in Java, Indonesia: A Comparative Assessment

Objective: This study examines Strategic Sustainability Management (SSM) in two Type B regional hospitals in East Java and Central Java, Indonesia, across four dimensions: service, operational, financial, and strategic governance sustainability. Environmental sustainability is excluded from the assessment. Research Design & Methods: A comparative multiple-case design using quantitative scoring of secondary data was employed. Publicly available annual government performance reports were analysed through document content analysis. Indicators were scored on a three-point scale and aggregated into equally weighted dimension indices expressed as percentages. Robustness checks examined alternative scoring assumptions, category thresholds, and indicators reported by both hospitals. The reports covered 2024 for East Java and 2023 for Central Java. Findings: Operational sustainability reached 100% in both hospitals, while strategic governance sustainability ranged from 93.8% to 94.4%. Financial sustainability scored 88.9–100%, placing both hospitals in the sustainable category. Service sustainability was the weakest dimension, with scores of 71.4–73.3%, classified as moderate. No dimension fell into the low category. The service dimension remained the weakest across robustness checks, although its classification depended on the threshold applied. Differences between hospitals should be interpreted cautiously because the reporting years differed. Contributions: This study provides a replicable, document-based method for profiling hospital sustainability using routine government performance reports. The findings highlight potential gaps between strong governance and financial indicators and comparatively weaker service performance. Novelty: Unlike assessments relying on purpose-built indicators, this study applies transparent, rule-based scoring to routine government performance reports, distinguishing management instruments from reported outcomes. The index excludes environmental sustainability and therefore does not constitute a comprehensive sustainability assessment.