An Integrated Risk Analysis Approach in Military Hospitals: Implications for Public Health Preparedness and Resilience
Abstract
Introduction: Military hospitals perform a dual function by providing healthcare services for soldiers and their families while also supporting public health needs during crises. This dual role generates complex hazards spanning biological, chemical, physical, and psychological dimensions, thereby requiring a comprehensive risk analysis framework. The objective of this study is to develop an integrated risk analysis approach comprising risk assessment, risk management, and risk communicationto strengthen occupational safety in military hospitals, with broader relevance for public health and global health security.
Methods: A mixed methods design was applied. Data were collected through direct observation and in-depth interviews with healthcare personnel, complemented by a structured survey using standardized questionnaires. Qualitative analysis was conducted using NVivo 12 and quantitative analysis using SEM PLS-4. The study involved 100 respondents comprising medical personnel, health workers, and staff at Rumah Sakit Pusat Pertahanan Negara (RSPPN) and Pusat Kesehatan TNI, selected through random sampling.
Results: Qualitative findings derived from NVivo 12 analysis revealed a multidimensional hazard spectrum characterized by weak cross sectoral coordination, limited personnel capacity, and insufficient integration among risk analysis components. Quantitative analysis using SEM PLS-4 further confirmed that Integrated Risk Analysis has a positive and statistically significant effect on Public Health Preparedness and Community Resilience (T-statistic = 11.046 > 1.96; p-value < 0.05); and F-square (0.18- efect moderat).
Conclusion: This study concludes that Integrated Risk Analysis exerts a significant influence on public health preparedness and community resilience in military hospitals. The findings underscore the necessity of strengthening management, integration, and cross sectoral communication. Nonetheless, the contextual limitations regarding research setting and sample size suggest the need for future studies with broader scope and institutional diversity to reinforce the generalizability of the findings.
References
Wu G, Hu Z, Wang H, Liu B. Adding sectors or strengthening ties? Adaptive strategies for cross-sector collaboration in disaster governance. Public Manag Rev. 2024;00(00):1–23.
Glenton C, Javadi D, Perry HB. Community health workers at the dawn of a new era: 5. Roles and tasks. Heal Res Policy Syst. 2021;19(3):1–17.
Mishra A, Bruno E, Zilberman D. Compound natural and human disasters: Managing drought and COVID-19 to sustain global agriculture and food sectors. Sci Total Environ. 2021;754:142210.
Lin BC, Lee CH. Constructing an adaptability evaluation framework for community-based disaster management using an earthquake event. Int J Disaster Risk Reduct. 2023;93(March 2022):103774.
Djalante R, Shaw R, DeWit A. Building resilience against biological hazards and pandemics: COVID-19 and its implications for the Sendai Framework. Prog Disaster Sci. 2020;6:100080.
Hruby A, Lieberman HR, Smith TJ. Symptoms of depression, anxiety, and post-traumatic stress disorder and their relationship to health-related behaviors in over 12,000 US military personnel: Bi-directional associations. J Affect Disord. 2021;283(December 2020):84–93.
Ogunseitan OA. One Health and the Environment: From Conceptual Framework to Implementation Science. Environment. 2022;64(2):11–21.
Hassan EM, Mahmoud H. Healthcare and education networks interaction as an indicator of social services stability following natural disasters. Sci Rep. 2021;11(1):1–15.
Cardwell K, Clyne B, Broderick N, Tyner B, Masukume G, Larkin L, et al. Lessons learnt from the COVID-19 pandemic in selected countries to inform strengthening of public health systems: a qualitative study. Public Health. 2023;225:343–52.
Wolf S, Seiffer B, Zeibig JM, Welkerling J, Brokmeier L, Atrott B, et al. Is Physical Activity Associated with Less Depression and Anxiety During the COVID-19 Pandemic? A Rapid Systematic Review. Sport Med. 2021;51(8):1771–83.
Jensen N, Kelly AH, Avendano M. Health equity and health system strengthening–Time for a WHO re-think. Glob Public Health. 2022;17(3):377–90.
Wiedemann P, Id FUB, Id FF. Effects of communicating uncertainty descriptions in hazard identification , risk characterization , and risk protection. 2021;1–18.
Ellermann C, Mcdowell M, Schirren CO, Lindemann A, Koch S, Lohmann M, et al. Identifying content to improve risk assessment communications within the Risk Profile : Literature reviews and focus groups with expert and non-expert stakeholders. 2022;
Sandoval V, Voss M, Flörchinger V, Lorenz S, Jafari P. Integrated Disaster Risk Management (IDRM): Elements to Advance Its Study and Assessment. Int J Disaster Risk Sci. 2023;14(3):343–56.
Sufri S, Dwirahmadi F, Phung D, Rutherford S. Progress in Disaster Science Review article A systematic review of Community Engagement ( CE ) in Disaster Early Warning Systems ( EWSs ). Prog Disaster Sci. 2020;5:100058.
Torab-Miandoab A, Basiri M, Dabbagh-Moghaddam A, Gholamhosseini L. Electronic health record in military healthcare systems: A systematic review. PLoS One. 2025;20(2 February):1–24.
Amin N, Foster T, Hossain MI, Hasan MR, Sarkar S, Rahman A, et al. Inadequate sanitation in healthcare facilities: A comprehensive evaluation of toilets in major hospitals in Dhaka, Bangladesh. PLoS One. 2024;19(5 MAY):1–24.
Mohammadkhani N. Translation and adaptation of the person-centered maternity care scale to a Persian-speaking population: a confirmatory factor analysis. BMC Public Health. 2024;24(1):1–11.
Chawla S, Sareen P, Gupta S, Joshi M, Bajaj R. Technology enabled communication during COVID 19: analysis of tweets from top ten Indian IT companies using NVIVO. Int J Inf Technol. 2023;15(4):2063–75.
Okesanya OJ, Eshun G, Ukoaka BM, Manirambona E, Olabode ON, Adesola RO, et al. Water, sanitation, and hygiene (WASH) practices in Africa: exploring the effects on public health and sustainable development plans. Trop Med Health. 2024;52(1).
Lee J, Perera D, Glickman T, Taing L. Water-related disasters and their health impacts: A global review. Prog Disaster Sci. 2020;8:100123.
Xiao T, Xu P. Energy & Buildings Exploring automated energy optimization with unstructured building data : A multi-agent based framework leveraging large language models. Energy Build. 2024;322(June):114691.
Ali ASMA, Khamees RAA. Living Conditions and Public Health Challenges in Temporary Camps for Displaced Populations in Shendi Locality, Sudan. J Epidemiol Glob Health. 2025;15(1).
Kumar PG, Tejaswini V, Rao PK, Jaya Shankar G. Disaster mitigation and its strategies in a global context - a state of the art. Mater Today Proc. 2020;45(January 2021):6488–92.
Gooding K, Bertone MP, Loffreda G, Witter S. How can we strengthen partnership and coordination for health system emergency preparedness and response? Findings from a synthesis of experience across countries facing shocks. BMC Health Serv Res. 2022;22(1):1–19.
Guenther P, Guenther M, Ringle CM, Zaefarian G, Cartwright S. Improving PLS-SEM use for business marketing research. Ind Mark Manag. 2023;111(March):127–42.
Guenther P, Guenther M, Ringle CM, Zaefarian G, Cartwright S. Improving PLS-SEM use for business marketing research. Ind Mark Manag. 2023;111(October 2020):127–42.
Guenther P, Guenther M, Ringle CM, Zaefarian G, Cartwright S. Improving PLS-SEM use for business marketing research. Ind Mark Manag. 2023;111(April):127–42.
Mennella C, Maniscalco U, De Pietro G, Esposito M. Ethical and regulatory challenges of AI technologies in healthcare: A narrative review. Heliyon. 2024;10(4):e26297.
Amann J, Blasimme A, Vayena E, Frey D, Madai VI. Explainability for artificial intelligence in healthcare: a multidisciplinary perspective. BMC Med Inform Decis Mak. 2020;20(1):1–9.
Amiri Z, Heidari A, Navimipour NJ, Esmaeilpour M, Yazdani Y. The deep learning applications in IoT-based bio- and medical informatics: a systematic literature review. Vol. 36, Neural Computing and Applications. Springer London; 2024. 5757–5797 p.
Liopyris K, Gregoriou S, Dias J, Stratigos AJ. Artificial Intelligence in Dermatology: Challenges and Perspectives. Dermatol Ther (Heidelb). 2022;12(12):2637–51.
Csomós G, Farkas JZ. Understanding the increasing market share of the academic publisher “Multidisciplinary Digital Publishing Institute” in the publication output of Central and Eastern European countries: a case study of Hungary. Scientometrics. 2023;128(1):803–24.
Novelli C, Taddeo M, Floridi L. Accountability in artificial intelligence: what it is and how it works. AI Soc. 2024;39(4):1871–82.
Pinsky MR, Bedoya A, Bihorac A, Celi L, Churpek M, Economou-Zavlanos NJ, et al. Use of artificial intelligence in critical care: opportunities and obstacles. Crit Care. 2024;28(1):1–12.
Collington R. Disrupting the Welfare State? Digitalisation and the Retrenchment of Public Sector Capacity. New Polit Econ. 2022;27(2):312–28.
Tangi L, Rodriguez Müller AP, Janssen M. AI-augmented government transformation: Organisational transformation and the sociotechnical implications of artificial intelligence in public administrations. Gov Inf Q. 2025;42(3):102055.
FakhrHosseini S, Chan K, Lee C, Jeon M, Son H, Rudnik J, et al. User Adoption of Intelligent Environments: A Review of Technology Adoption Models, Challenges, and Prospects. Int J Hum Comput Interact. 2024;40(4):986–98.
de Fine Licht K, de Fine Licht J. Artificial intelligence, transparency, and public decision-making: Why explanations are key when trying to produce perceived legitimacy. AI Soc. 2020;35(4):917–26.
Tinmaz H, Lee YT, Fanea-Ivanovici M, Baber H. A systematic review on digital literacy. Smart Learn Environ. 2022;9(1).
Senadheera S, Yigitcanlar T, Desouza KC, Mossberger K, Corchado J, Mehmood R, et al. Understanding Chatbot Adoption in Local Governments: A Review and Framework. J Urban Technol. 2025;32(3):35–69.
Wyr?bek H. National Security Challenges and Threats. Wiedza Obron. 2022;279(2):109–23.
Afni N, Rahayu S. Analysis of risk factors for death of COVID-19 patients at Undata Hospital Palu. J Public Heal Pharm. 2022;2(2):24–9.
Tombeg Z, Yetti RE, Hadi AJ, Hasibuan AS, Rate S, Handayani FR, et al. Determinants of the Incidence of Acute Respiratory Infections (ARIs) in Children Under Five at the Getengan Community Health Center, Tana Toraja Regency. J Public Heal Pharm. 2024;4(1):10–8.
Meng Q. Strengthening public health systems in China. Lancet Public Heal. 2022;7(12):e987–8.
Newmann WW, and Christiansen WT. Simulating the US National Security Interagency Process: Solid Foundations and a Method of Assessment. J Polit Sci Educ. 2023 Apr;19(2):331–48.
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