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Research Article Open access CC BY 4.0

Extending the Andersen Behavioral Model: Service Innovation, Treatment Adherence, and Patient Satisfaction in Malaria Care in Papua, Indonesia

Reynold Rizal Ubra, Bahtiar Usman, Robert Kristaung

Asian Journal of Medicine and Health · pp. 80–95 · Published 19 Oct 2025

10.9734/ajmah/2025/v23i101309

Abstract

Aims: This study aims to examine the direct and indirect effects of treatment adherence on patient satisfaction, incorporating service innovation into Andersen Behavioral Model of Health Service Use. Methodology: A cross-sectional survey of 220 respondents was conducted at the Wania Health Center, Mimika District, Papua. Data were analyzed using SmartPLS 4 with reliability, validity, and structural relationships tested through bootstrapping (5,000 resamples). Results: The results showed that predisposing and reinforcing factors of treatment adherence significantly improved patient satisfaction, while enabling factors had no effect. Service innovation, including streamlined malaria service, home visits, and digital monitoring, partially mediated adherence–satisfaction relationship. The model explained 77.6% of the variance in satisfaction. Conclusion: Service innovation enhances satisfaction both directly and indirectly, extending Andersen Behavioral Model and offering actionable insights for policymakers. The results underscore the need for patient-centered innovation to strengthen malaria elimination strategies in resource-limited settings.

Service innovation patient satisfaction treatment adherence malaria care Indonesia

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