Collaborative Governance in Medical Tourism Development Policy: A Document-Based Policy Analysis of Bali International Hospital in the Sanur Special Economic Zone
DOI:
https://doi.org/10.55123/toba.v5i3.9099Keywords:
Public Value, Medical Tourism, Bali International Hospital, Collaborative Governance, Healthcare Governance, Special Economic ZoneAbstract
Medical tourism has become a strategic policy that integrates healthcare, tourism, and investment to promote economic growth and public value. Indonesia has established the Sanur Special Economic Zone (SEZ) — inaugurated in June 2025 with Bali International Hospital (BIH) as its anchor — as its first health SEZ, a response to the substantial outflow of citizens seeking treatment abroad, estimated by the government at around USD 11.5 billion (≈ Rp 180 trillion) annually. This study analyses collaborative governance in the medical tourism development policy of the Sanur SEZ, identifies the factors that shape cross-sector collaboration, and proposes a conceptual model for sustainable development. Using a qualitative, document-based policy analysis, the study synthesises government regulations, official reports, and peer-reviewed literature through the Collaborative Governance Regime (CGR) framework of Emerson, Nabatchi, and Balogh, integrated with Moore's Public Value Theory and situated within cross-sector and network-governance scholarship. The analysis proposes that collaborative leadership, institutional capacity, regulatory support, and stakeholder coordination are the conditions most likely to enable effective implementation, and that collaboration among government, state-owned enterprises, private investors, healthcare providers, academia, and communities can advance healthcare quality, destination competitiveness, and economic benefit only when its gains are equitably distributed and the two-tier risks characteristic of medical tourism are actively managed. The study contributes the Medical Tourism Collaborative Value Network (MTCVN), a conceptual model that positions public value creation as the proposed mediating mechanism linking collaborative governance to sustainable medical tourism development, together with six testable propositions and policy recommendations for Indonesia's medical tourism ecosystem.
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References
Ansell, C., & Gash, A. (2008). Collaborative governance in theory and practice. Journal of Public Administration Research and Theory, 18(4), 543–571. https://doi.org/10.1093/jopart/mum032
Asa, G. A., Fauk, N. K., McLean, C., & Ward, P. R. (2024). Medical tourism among Indonesians: A scoping review. BMC Health Services Research, 24(1), 1–11. https://doi.org/10.1186/s12913-023-10528-1
Bryson, J. M., Crosby, B. C., & Bloomberg, L. (2014). Public value governance: Moving beyond traditional public administration and the New Public Management. Public Administration Review, 74(4), 445–456. https://doi.org/10.1111/puar.12238
Bryson, J. M., Crosby, B. C., & Stone, M. M. (2006). The design and implementation of cross-sector collaborations: Propositions from the literature. Public Administration Review, 66(s1), 44–55. https://doi.org/10.1111/j.1540-6210.2006.00665.x
Bryson, J. M., Crosby, B. C., & Stone, M. M. (2015). Designing and implementing cross-sector collaborations: Needed and challenging. Public Administration Review, 75(5), 647–663. https://doi.org/10.1111/puar.12432
Connell, J. (2011). Medical tourism. CABI.
Connell, J. (2013). Contemporary medical tourism: Conceptualisation, culture and commodification. Tourism Management, 34, 1–13. https://doi.org/10.1016/j.tourman.2012.05.009
Creswell, J. W., & Creswell, J. D. (2023). Research design: Qualitative, quantitative, and mixed methods approaches (6th ed.). SAGE Publications.
Dredge, D., & Jenkins, J. (2007). Tourism planning and policy. John Wiley & Sons.
Emerson, K., Nabatchi, T., & Balogh, S. (2012). An integrative framework for collaborative governance. Journal of Public Administration Research and Theory, 22(1), 1–29. https://doi.org/10.1093/jopart/mur011
Ganguli, S., & Ebrahim, A. H. (2017). A qualitative analysis of Singapore's medical tourism competitiveness. Tourism Management Perspectives, 21, 74–84. https://doi.org/10.1016/j.tmp.2016.12.002
Hildayanti, S. K., Nurjana, A., Rachman, M. R., & Abdullah, W. (2025). Menjadikan Indonesia sebagai destinasi unggulan wisata medis di dunia global. JPNM Jurnal Pustaka Nusantara Multidisiplin, 3(4). https://doi.org/10.59945/jpnm.v3i4.872
Howlett, M., Ramesh, M., & Perl, A. (2020). Studying public policy: Principles and processes (4th ed.). Oxford University Press.
Imran, A., & Wijaya, R. (2025). Community participation in sustainable tourism development. Jurnal Ilmu Administrasi, 22(1), 75–90.
Matthoriq, M., Zauhar, S., & Hermawan, H. (2021). Collaborative governance dalam pengelolaan desa wisata berbasis masyarakat. Jurnal Administrasi Publik, 17(2), 145–160.
Miles, M. B., Huberman, A. M., & Saldaña, J. (2020). Qualitative data analysis: A methods sourcebook (4th ed.). SAGE Publications.
Moore, M. H. (1995). Creating public value: Strategic management in government. Harvard University Press.
Peraturan Menteri Kesehatan Republik Indonesia Nomor 1 Tahun 2023 tentang Penyelenggaraan Kegiatan Usaha Rumah Sakit di Kawasan Ekonomi Khusus.
Peraturan Pemerintah Republik Indonesia Nomor 40 Tahun 2021 tentang Penyelenggaraan Kawasan Ekonomi Khusus.
Peraturan Pemerintah Republik Indonesia Nomor 41 Tahun 2022 tentang Kawasan Ekonomi Khusus Sanur.
Pocock, N. S., & Phua, K. H. (2011). Medical tourism and policy implications for health systems: A conceptual framework from a comparative study of Thailand, Singapore and Malaysia. Globalization and Health, 7(1), 12. https://doi.org/10.1186/1744-8603-7-12
Provan, K. G., & Kenis, P. (2008). Modes of network governance: Structure, management, and effectiveness. Journal of Public Administration Research and Theory, 18(2), 229–252. https://doi.org/10.1093/jopart/mum015
Sanur Special Economic Zone Management Agency. (2024). Laporan perkembangan Kawasan Ekonomi Khusus Sanur. Badan Pengelola KEK Sanur.
Sitorus, R., & Nooraini, N. (2025). Smart governance dalam pengembangan kawasan ekonomi khusus. Jurnal Kebijakan Publik, 16(1), 30–47.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333–339. https://doi.org/10.1016/j.jbusres.2019.07.039
Supriadi, Al Aufa, B., Nurfikri, A., & Koire, I. I. (2024). Exploring the potential of a multi-level approach to advance the development of the medical tourism industry in Indonesia. Health Services Insights, 17. https://doi.org/10.1177/11786329241245231
United Nations World Tourism Organization. (2023). International tourism highlights: 2023 edition. UN Tourism.
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