Risk-Based Regulatory Model for Healthcare Workers with Communicable Diseases in Ensuring Patient Safety in Indonesia
Main Article Content
Anak Agung Gede Jaya Semara
I Nyoman Bayu Mahendra
Background: Patient safety is a fundamental principle in healthcare systems aimed at ensuring safe and high-quality healthcare services. However, Indonesian regulations concerning healthcare workers with communicable diseases remain inadequate, particularly regarding periodic health screening and risk-based practice restrictions. This study aimed to analyze the Indonesian legal framework from a patient safety perspective and to formulate a risk-based regulatory model.
Methods: This study employed normative legal research using statutory, conceptual, and comparative approaches. The statutory approach examined Indonesian laws and regulations related to patient safety, healthcare workers, infection prevention and control, and labor law. The conceptual approach analyzed principles of health law and bioethics, including patient safety, non-maleficence, beneficence, and the precautionary principle. The comparative approach compared Indonesian regulations with international standards issued by the Centers for Disease Control and Prevention (CDC) and the National Health Service (NHS). Data were collected through documentary and library research using primary, secondary, and tertiary legal materials. Data analysis was conducted qualitatively through grammatical interpretation, systematic interpretation, and legal harmonization analysis.
Results: The study found that Indonesian regulations have not comprehensively regulated periodic health screening, risk-based practice restrictions, and monitoring systems for healthcare workers with communicable diseases. Significant normative gaps and legal uncertainty remain regarding the balance between healthcare workers’ rights and patient safety. Compared with CDC and NHS standards, Indonesia has not yet optimally implemented a risk-based regulatory approach.
Conclusion: Indonesia requires a comprehensive risk-based health regulatory framework integrating patient safety, healthcare workers’ rights, and proportional supervisory mechanisms. The proposed “Risk-Based Integrated Health Regulation” model may serve as a foundation for future health law reform and patient safety protection in Indonesia.
Auraaen, A. S. K. K. N. (2020). System governance towards improved patient safety. https://doi.org/10.1787/2abdd834-en
Beers, R. A. (2021). Preventing Transmission of Infectious Diseases. In Anesthesia Equipment (pp. 332–350). Elsevier. https://doi.org/10.1016/B978-0-323-67279-5.00015-7
Bowdle, A., & Munoz-Price, L. S. (2020). Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics. Anesthesiology, 132(6), 1292–1295. https://doi.org/10.1097/ALN.0000000000003295
Domer, G., M. Gallagher, T., Shahabzada, S., Sotherland, J., N. Paul, E., Kumar, K.-N., Wilson, B., Salpekar, S., & Kaur, P. (2022). Patient Safety: Preventing Patient Harm and Building Capacity for Patient Safety. In Contemporary Topics in Patient Safety - Volume 1. IntechOpen. https://doi.org/10.5772/intechopen.100559
Güerri-Fernández, R., Benet, J., & Vargas, C. (2024). Medical-legal aspects in infectious diseases. Medicina Clínica (English Edition), 163(9), e98–e102. https://doi.org/10.1016/j.medcle.2024.06.005
Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020).
Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview
. Risk Management and Healthcare Policy, Volume 13, 1765–1780. https://doi.org/10.2147/RMHP.S269315Hartuti, E. P., Suryani, D., Edwin, V. A., & Suyitno, M. (2021). The obedience of medical personnel to using personal protective equipment in preventing the transmission of COVID-19 at a private hospital in Indonesia. Public Health of Indonesia, 7(2), 67–74.
Hebo, H. J., Gemeda, D. H., & Abdusemed, K. A. (2019). Hepatitis B and C Viral Infection: Prevalence, Knowledge, Attitude, Practice, and Occupational Exposure among Healthcare Workers of Jimma University Medical Center, Southwest Ethiopia. The Scientific World Journal, 2019, 1–11. https://doi.org/10.1155/2019/9482607
Henderson, D. K., Dembry, L.-M., Sifri, C. D., Palmore, T. N., Dellinger, E. P., Yokoe, D. S., Grady, C., Heller, T., Weber, D., del Rio, C., Fishman, N. O., Deloney, V. M., Lundstrom, T., & Babcock, H. M. (2022). Management of healthcare personnel living with hepatitis B, hepatitis C, or human immunodeficiency virus in US healthcare institutions. Infection Control & Hospital Epidemiology, 43(2), 147–155. https://doi.org/10.1017/ice.2020.458
Henriot, P., Castry, M., Luong Nguyen, L. B., Shimakawa, Y., Jean, K., & Temime, L. (2022). Meta‐analysis: risk of hepatitis C virus infection associated with hospital‐based invasive procedures. Alimentary Pharmacology & Therapeutics, 56(4), 558–569. https://doi.org/10.1111/apt.17106
Herisasono, A., Darmawan, D., Gautama, E. C., & Issalillah, F. (2023). Protection of Patient Rights in the Perspective of Law and Medical Ethics in Indonesia. Journal of Social Science Studies, 3(2), 195–202.
Millar, M. (2011). Patient rights and healthcare-associated infection. Journal of Hospital Infection, 79(2), 99–102. https://doi.org/10.1016/j.jhin.2011.04.031
Nardodkar, R., Pathare, S., Ventriglio, A., Castaldelli-Maia, J., Javate, K. R., Torales, J., & Bhugra, D. (2016). Legal protection of the right to work and employment for persons with mental health problems: a review of legislation across the world. International Review of Psychiatry, 28(4), 375–384. https://doi.org/10.1080/09540261.2016.1210575
Perhimpunan Nefrologi Indonesia. (2006). Pengendalian Infeksi Virus Hepatitis B, Virus Hepatitis C Dan Human Immunodeficiency Virus / HIV Pada Unit Hemodialisis di Indonesia.
Rahman, T., Ahmed, R., & Mahmud, A. (2023). Patient safety culture plays an essential role to ensure safe patient care and quality in healthcare services. Pulse, 53–61. https://doi.org/10.3329/pulse.v14i1-3.66902
Sacuk, A. V., Solopova, G. G., & Ploskireva, A. A. (2021). A systematic review of outbreaks of bloodborne infections (hepatitis B and C, HIV) transmitted from patient to patient in healthcare settings. Journal of Microbiology, Epidemiology and Immunobiology, 98(3), 319–330. https://doi.org/10.36233/0372-9311-112
Suryani, D., Suyitno, S., Maretalinia, M., Juliansyah, E., Saki, V. Y., & Tantrakarnapa, K. (2021). Knowledge, Attitudes, and Practices of Health Personnel in Responding to the COVID-19 Outbreak in Indonesia. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal), 16(4).
Tavoschi, L., Mason, L., Petriti, U., Bunge, E., Veldhuijzen, I., & Duffell, E. (2019). Hepatitis B and C among healthcare workers and patient groups at increased risk of iatrogenic transmission in the European Union/European Economic Area. Journal of Hospital Infection, 102(4), 359–368. https://doi.org/10.1016/j.jhin.2019.03.004
Walshe, K., & Boaden, R. (2005). Patient safety: Research into practice. McGraw-hill education (UK).
World Health Organization. (2021a). Global patient safety action plan 2021-2030: towards eliminating avoidable harm in health care. World Health Organization.
World Health Organization. (2021b). Global patient safety action plan 2021-2030: towards eliminating avoidable harm in health care. World Health Organization.




