This paper aimed to examine a conceptual model for the relationships between hospital service quality, patient satisfaction, hospital utilization, and hospital financial performance. A total of 176 hospitals was selected from California State for this study. The standardized performance measures were used together with precisely defined specifications and standardized data collection protocols. First, an exploratory factor analysis with Varimax rotation was performed. The measurement prop-erties were then assessed in a confirmatory factor analysis (CFA). The analysis results show that quality had a significant effect on satisfaction, which, in turn, affected the financial performance. The results provide support for the previous findings indicated that service quality was positively associated with patient satisfaction and that satisfaction and utilization had a significant positive effect on financial performance. The analysis results provide support for the previous findings that hospital service quality is positively related to patient satisfaction. The findings also show that patient satisfaction and hospital utilization have a significant positive effect on hospital financial performance.

Health services, especially hospitals, are facing significant changes in the industrial era 4.0. Hospital digitization is responsible for building green hospitals and improving service quality in the era of modern technology. Green Human Resources Management (GHRM) is becoming known as the HRM concept that encourages employee commitment and environmental aspects. GHRM is an HR management system suitable for organizations, including hospitals that have a significant environmental impact. Hospitals are very dependent on the quality of service provided to their customers. GHRM as a management model in hospitals is very important to encourage hospital digitization and service quality. This research was conducted to answer the gap in hospital research in seeing the effect of GHRM on service quality in digitizing hospitals in the industrial era 4.0. GHRM and Service Quality is used in the healthcare industry to test its application in hospitals in Indonesia. They are using the SEM PLS method, a variant-based structural equation analysis that focuses on predictive models, to look for predictive linear relationships between variables to process data for 1004 respondents from 19 State-Owned Enterprises' hospitals throughout Indonesia. This research can an-swer research gaps related to the effect of GHRM on Service Quality and Hospital Digitalization in Indonesia. Based on Hospital Digitalization, GHRM affects Service Quality, which is closely related to environmental problems.

Activity based costing (ABC) is a new age accounting system developed to overcome the limitations of traditional costing system, which in today’s technologically advanced world has lost its ability to provide accurate and useful cost information often required in taking various managerial decisions, like setting of selling price, ascertaining profitability of products as well as customers, taking a make or buy decision, eliminating the non-beneficial activities, and rewarding the employees. In this paper, an ABC model is developed for a government hospital in the state of Bihar in India to quantify its various public health related services. Although, there are limited published research papers related to application of ABC model in a specific department or method of a healthcare system, none of them has investigated its scope for organization-wide implementation. The results obtained from the developed ABC model in the public hospital would provide more comprehensive and accurate cost information, and radically contribute to the hospital administration in effective planning, controlling and decision making. This paper also elucidates about various obstructions and difficulties encountered during the implementation phase of ABC model in an Indian healthcare setting.