Corresponding Author: Set
Asmapane
E-mail: [email protected]
INTRODUCTION
The importance of equitable health for all Indonesian
people is one of the important aspects of national development that must
receive serious attention from the government. By increasing the level of
health, strong and resilient human resources will be formed. Therefore, the
government issued Law No. 23 of 1992 concerning health, which states that every
citizen of the Republic of Indonesia has the right to obtain optimal health
status and must be involved in government health efforts. (Astuti et al., 2022). One of the main factors affecting the degree of
public health is health services because the availability of health facilities
is very influential in various ways, such as disease prevention, treatment,
health recovery, and care for individuals and groups in need (Eliana et al., 2016). The existence of health facilities is highly
dependent on their location, which must be easily accessible to the community.
Another important factor is health workers who provide services, information,
and motivation to the community to use health facilities. In addition, health
service programs must be tailored to the needs of the people who need them.
This is explained by (Adliyani, 2015).
According to research conducted by (Natasya et al., 2017), hospitals have a crucial role in the healthcare
network, with great responsibilities, burdens, problems, and expectations. The
main focus of hospital operations is to provide optimal health services to
patients. Hospitals as community service institutions must continue to maintain
their existence and demonstrate optimal performance, especially in the midst of
a global crisis that has a broad impact on various economic sectors, including
health services. Effective management in a hospital will reflect the principles
of transparency, independence, accountability, responsibility and fairness,
which will be the key to achieving financial performance in accordance with the
established vision and mission, but the hope for this has yet to be fully
realized. The reason is due to the lack of adequate organizational means to
produce effective management and the lack of a high level of commitment on the
part of hospital managers. This impact results in various forms of
irregularities, misappropriation, violations and acts of corruption, which are
often referred to as fraud.
The phenomenon of fraud is commonplace in hospitals.
The Association of Certified Fraud Examiners (ACFE) divides fraud into three
types, namely illegal asset retrieval, corruption, and financial statement
fraud. (Mardiah, 2021). Like other public sectors, especially in the
government sector that handles public services for the community, the issues of
fraud in hospitals are increasing. (Tama et al., 2022). It can be seen that the government in Indonesia is
trying to eliminate fraud that occurs in government organizations. This effort
can be seen and characterized by the increased functions of the prosecutor's
office, the police, the Corruption Eradication Commission (KPK, Komisi
Pemberantasan Korupsi), and the Corruption Court. Unfortunately, the
commitment to implement this on a regular basis across the board has not been
achieved.
Throughout 2022, Indonesia Corruption Watch (ICW)
identified 21 sectors where corruption was indicated. These sectors include the
village sector, education, health, and investment and capital markets. The monitoring of these sectors is carried out to map
the points that are most prone to corrupt practices. In the health sector in
2022, as a result of corruption cases, the state lost IDR 73,905,212,389. (Anandya et al., 2021). In 2022, the Corruption Eradication Commission (KPK)
also revealed that there were more than 150 cases of alleged corruption in the
health sector. Deputy Chairman of the Corruption Eradication Commission (KPK),
Nawawi Pomolango, revealed that the high budget in the health sector is the
main cause of corruption in this field. In 2022, the health sector received a
budget of Rp108 trillion. KPK pays special attention to corruption in the
health sector due to the size of the budget and the number of corruption cases
that have occurred in this sector. The size of the health budget, which reaches
at least 10% of the Regional Budget (APBD) in each local government, has the
potential to be vulnerable to corruption if not managed properly. Therefore,
strengthening the health sector is needed to mitigate the risk of corruption (Aryan, 2022). The phenomenon of fraud has also recently occurred
in one of the hospitals in Samarinda City, namely AWS Syahranie Regional
General Hospital. Allegedly, there was a corruption case of Employee Income
Supplement (TPP) funds involving ten perpetrators who served as administrative
and financial staff. The case cost the state Rp 6 billion.
The high frequency of fraud, deception, and
embezzlement practices in public and private institutions, with a variety of
modes, from simple to very sophisticated and complicated, should trigger all
parties to build a commitment to implementing good governance consistently and
equally at all levels. Without this awareness and commitment, optimal financial
performance in hospitals will not be achieved (Azmi et al., 2021).
According to (Zarlis, 2018), As a health service entity for the community, it is
important to have an understanding of the internal controls that will be
implemented by employees in the hospital. If implemented effectively, this
internal control can prevent fraud or fraud. An effective internal control
system is a crucial component in organizational management because it can
improve compliance with the provisions and regulations that apply to it. The
system can reduce the risk of losses due to irregularities and violations of
prudential aspects. Understanding effective internal control is expected to be
an illustration so that companies can improve and strengthen the internal
controls needed to reduce or avoid these risks (Burhani et al., 2022).
Another factor that can prevent accounting fraud
besides implementing an internal control system is compensation suitability.
According to (Hasibuan 2015) compensation includes all types of income received by
workers, either in the form of money or indirect goods, as compensation for the
services they provide to the company. The implementation of an efficient
compensation system is very important because it helps in attracting and
retaining talented employees. The strategic performance of the company is also
affected by the company's compensation system. Employees may commit fraud
because they are dissatisfied or disappointed with the results or compensation
they receive for the work they have done. One of the fatal consequences of
compensation mismatch is accounting fraud.
The existence of supervision is also a form of
government action aimed at reducing problems of irregularities. Supervision is
a very vital aspect of an organization. In the context of government,
supervision is regulated in the government structure. It can help reduce all
forms of irregularities or fraud (Fikral, 2012). The Inspectorate, as the internal inspection agency
of the local government, has a very important role in the guidance and
supervision function. In an effort to realize good governance at the regional
level, the government needs to make changes in all aspects of regional
financial management. These changes will improve the quality of supervision
carried out by the Inspectorate, thereby improving the quality of the output of
the inspection carried out (Laksita & Sukirno,
2019).
East Kalimantan Provincial Eye Hospital is one of the
provincial-level hospitals in Samarinda City. It was established in 2020. The
researcher chose the eye hospital as the object of research because it is one
of the newly established hospitals related to the dependent variable in this
study, fraud prevention. A newly established agency object is needed so that
the agency can prepare for the challenges that will occur in the future.
Based on the background description and the phenomena
described above, the authors see a problem that needs to be investigated,
namely the role of the internal control system and compensation suitability for
employees, as well as the existence of supervision that might minimize fraud or
even eliminate fraud cases in public and government agencies, especially in
hospitals. Based on this, the purpose of this study is to determine and analyze
the effect of Internal Control System Implementation and Compensation
Suitability on fraud prevention with inspectorate examination as an intervening
variable in the regional public service agency of the eye hospital of East
Kalimantan province.
METHOD
Population is the
total number of objects with predetermined criteria or characters. The
population in this study were all employees of the East Kalimantan Provincial
Eye Hospital, totaling 122 people. The sample is the part that will be studied
in the population; the characteristics of the population must be represented in
the sample. This study used the Roscoe method sample technique and the scatter
plot technique. The Roscoe technique says the appropriate sample size in a
study ranges from 30 - 500 samples.
In contrast, the
scatter plot technique is used to identify outlier data or data that deviates
from the general pattern of the relationship between variables. Based on
calculations from Roscoe, the minimum number of sample members must be ten
times the number of variables to be studied. This study used a sample of 60
respondents.
The type of data
used in this research is quantitative, based on numbers that will be processed
in the analysis tool. The data source used in this research is primary data
obtained directly through interviews and questionnaires with relevant sources
and respondents at the internal eye hospital of East Kalimantan Province.
Data will be
collected through field research methods where information will be obtained
from respondents through the use of questionnaires. The delivery of
questionnaires to respondents will be done through Google Forms with a
predetermined sample size. The questions presented are closed and structured
questions, which means that research participants only have answer options that
the researcher has determined. The questions have been arranged according to
the variables being studied. The data analysis technique used in this study is
to use the Partial Least Squares-Structural Equation Model (PLS-SEM) analysis
tool. The steps in analyzing this research data are descriptive statistics,
outer model and inner model as well as direct effect and indirect effect tests.
RESULTS AND DISCUSSION
Outer Model Results (Measurement Model)
Convergent Validity Test
A convergent validity test is used to determine the
validity of each relationship between indicators and their latent variables.
Table 1. Convergent Validity Test Results
|
Variables
|
Instrument
|
Outer
Loading
|
Description
|
|
Implementation
of Internal Control System
|
X1.1
|
0,773
|
Valid
|
|
X1.2
|
0,805
|
Valid
|
|
X1.3
|
0,811
|
Valid
|
|
X1.4
|
0,773
|
Valid
|
|
X1.5
|
0,862
|
Valid
|
|
X1.6
|
0,777
|
Valid
|
|
X1.7
|
0,767
|
Valid
|
|
X1.8
|
0,839
|
Valid
|
|
X1.9
|
0,828
|
Valid
|
|
Compensation
Fit
|
X2.1
|
0,866
|
Valid
|
|
X2.2
|
0,859
|
Valid
|
|
X2.3
|
0,904
|
Valid
|
|
X2.4
|
0.930
|
Valid
|
|
X2.5
|
0,861
|
Valid
|
|
X2.6
|
0,786
|
Valid
|
|
X2.7
|
0,879
|
Valid
|
|
X2.8
|
0,857
|
Valid
|
|
Fraud
Prevention
|
Y1.1
|
0,735
|
Valid
|
|
Y1.2
|
0,728
|
Valid
|
|
Y1.3
|
0,820
|
Valid
|
|
Y1.4
|
0,828
|
Valid
|
|
Y1.5
|
0,768
|
Valid
|
|
Y1.6
|
0,801
|
Valid
|
|
Inspectorate
Inspection
|
Z1.1
|
0,838
|
Valid
|
|
Z1.2
|
0,904
|
Valid
|
|
Z1.3
|
0,944
|
Valid
|
|
Z1.4
|
0,926
|
Valid
|
|
Z1.5
|
0,953
|
Valid
|
|
Z1.6
|
0,912
|
Valid
|
|
Z1.7
|
0,825
|
Valid
|
The
results in Table 1, presented above, show that all indicators have met the
predetermined requirements, which are> 0.70. Convergent validity can also be
seen from the Average Variance Extracted (AVE) value below.
Average Variance Extracted (AVE)
Average Variance Extracted (AVE) is used to evaluate
convergent validity, provided that the Average Variance Extracted (AVE) value
must be> 0.50.���
Table 2. Results of
Average Variance Extracted (AVE) Value
|
Variables
|
AVE
|
Description
|
|
Implementation of the internal control
system (X1)
|
0,647
|
Valid
|
|
Compensation suitability (X2)
|
0,754
|
Valid
|
|
Fraud prevention (Y)
|
0,610
|
Valid
|
|
Inspectorate inspection (Z)
|
0,813
|
Valid
|
The
results in Table 2 above show that all Average Variance Extracted (AVE) values
are> 0.50, meaning that all variables are valid and meet the standard
criteria for a good Average Variance Extracted (AVE).
Discriminant Validity Test
Discriminant validity is used to measure the extent to
which a construct is truly different from other constructs (constructs are
unique constructs). Discriminant validity can be seen from the amount of
cross-loading value. The cross-loading value on the measured variable must be
greater than the other variables so that it is said to be a valid indicator.
Table 3. Discriminant
Validity Test Results
|
|
Variable 1
(X1)
|
Variable 2
(X2)
|
Variable 3
(Y)
|
Variable 4
(Z)
|
|
X1.1
|
0,773
|
0,685
|
0,717
|
0,687
|
|
X1.2
|
0,805
|
0,720
|
0,713
|
0,651
|
|
X1.3
|
0,811
|
0,705
|
0,684
|
0,568
|
|
X1.4
|
0,773
|
0,616
|
0,643
|
0,528
|
|
X1.5
|
0,862
|
0,756
|
0,737
|
0,566
|
|
X1.6
|
0,777
|
0,597
|
0,663
|
0,699
|
|
X1.7
|
0,767
|
0,620
|
0,603
|
0,545
|
|
X1.8
|
0,839
|
0,730
|
0,748
|
0,618
|
|
X1.9
|
0,828
|
0,734
|
0,773
|
0,764
|
|
X2.1
|
0,750
|
0,866
|
0,719
|
0,614
|
|
X2.2
|
0,767
|
0,859
|
0,717
|
0,629
|
|
X2.3
|
0,748
|
0,904
|
0,672
|
0,624
|
|
X2.4
|
0,774
|
0,930
|
0,655
|
0,635
|
|
X2.5
|
0,781
|
0,861
|
0,598
|
0,617
|
|
X2.6
|
0,708
|
0,786
|
0,625
|
0,506
|
|
X2.7
|
0,729
|
0,879
|
0,652
|
0,646
|
|
X2.8
|
0,670
|
0,857
|
0,567
|
0,598
|
|
Y1.1
|
0,673
|
0,580
|
0,735
|
0,598
|
|
Y1.2
|
0,630
|
0,535
|
0,728
|
0,482
|
|
Y1.3
|
0,692
|
0,626
|
0,820
|
0,645
|
|
Y1.4
|
0,671
|
0,536
|
0,828
|
0,579
|
|
Y1.5
|
0,719
|
0,565
|
0,768
|
0,670
|
|
Y1.6
|
0,690
|
0,669
|
0,801
|
0,676
|
|
Z1.1
|
0,738
|
0,708
|
0,730
|
0,838
|
|
Z1.2
|
0,662
|
0,624
|
0,674
|
0.904
|
|
Z1.3
|
0,698
|
0,654
|
0.701
|
0,944
|
|
Z1.4
|
0,701
|
0,612
|
0,728
|
0,926
|
|
Z1.5
|
0,747
|
0,669
|
0,743
|
0,953
|
|
Z1.6
|
0,710
|
0,617
|
0,756
|
0,912
|
|
Z1.7
|
0,692
|
0,634
|
0,594
|
0,825
|
The results of Table 3 above show that the blocked
numbers are numbers that are greater than the other numbers, meaning that all
indicators have met the requirements.
Reliability Test
The reliability test can be seen through the composite
reliability and Cronbach alpha values. For both tests, the standard value must
be greater than 0.7 to be considered reliable.
Table 4. Reliability Test Results
Table
4, presented above, shows that the composite reliability score and Cronbach
alpha above 0.70 are in accordance with the requirements, meaning that the
level of reliability of these variables is acceptable.
Inner Model Results (Structural
Model)
R-Square Result
The R-Square statistical measure describes the amount of variation
in endogenous variables that can be explained by other exogenous/endogenous
variables in the model. The criteria for the R-Square statistic according to
Ghozali and Latan (2015), are 0.25 is categorized as weak, 0.50 is categorized
as moderate, and 0.75 is categorized as strong.
Table 5. R-Square
Results
|
Description
|
R-Square
|
|
Fraud prevention (Y)
|
0,787
|
Based on Table 5, which was presented above, it can be
concluded that the magnitude of the influence of the implementation of the
internal control system and compensation suitability on fraud prevention with
the mediation of inspectorate inspection is 78.7%, which is categorized as a
strong influence.
Q-Square Result
The Q-Square statistical measure is used to measure
prediction accuracy in Partial Least Squares (PLS) analysis, namely how well
changes in exogenous/endogenous variables can predict endogenous variables.
Q-Square is a form of validation in PLS that shows the suitability of model
predictions (predictive relevance). If the Q-Square value is greater than 0, it
indicates that the model has good predictive relevance.
Table 6. Q-Square Results
|
Description
|
Q-Square
|
|
Fraud prevention (Y)
|
0,719
|
Based on Table 6, which has
been presented above, the Q-Square value of the fraud prevention variable is
0.719, where this value states that it has high predictive accuracy.
Significance
Test Results
Direct
Effect Test Results (Direct Effect)
Table 7. Direct Effect Test Results
|
|
Original
sample (O)
|
Sample
mean (M)
|
Standard deviation
(STDEV)
|
T
statistics (|O/STDEV|)
|
P Values
|
|
SPI
Implementation →
Fraud
Prevention
|
0,671
|
0,693
|
0,138
|
4,865
|
0,000
|
|
Compensation
Appropriateness → Fraud Prevention
|
-0,009
|
-0,021
|
0,120
|
0,079
|
0,469
|
|
Inspectorate
inspection → Fraud prevention
|
0,267
|
0,259
|
0,135
|
1,978
|
0,024
|
Based on Table 7 presented
above, the following conclusions can be drawn:
1)
The first hypothesis (H1) is accepted. This can be
seen from the path coefficient value of 0.671 and p-values (0.000). This means
that the implementation of the internal control system has a positive and
significant effect on fraud prevention.
2)
The second hypothesis (H2) is rejected. This can be
seen from the path coefficient value of -0.009 and p-values (0.469). This means
that compensation suitability does not affect fraud prevention.
3)
The first hypothesis (H3) is accepted. This can be
seen from the path coefficient value of 0.267 and p-values (0.024). This means
that inspectorate inspection has a positive and significant effect on fraud prevention.
Indirect
affect test results (indirect effect)
Table 8. Indirect Effect Test Results (Indirect Effect)
|
|
Original
Sample
(O)
|
Sample
mean
(M)
|
Standard
deviation (STDEV)
|
T
statistics (|O/STDEV|)
|
P
Values
|
|
SPI
Implementation →
Inspectorate
inspection → Fraud prevention
|
0,177
|
0,168
|
0,097
|
1,833
|
0,033
|
|
Compensation
Appropriateness → Inspectorate Audit →
Fraud Prevention
|
0,036
|
0, 037
|
0,054
|
0,679
|
0,249
|
To determine the role of mediation in intervening variables, the
Variance Accounted For (VAF) formula is used. In the VAF formula, provisions
are given, namely, if VAF> 80%, it is categorized as full mediation; if 20%
≤ VAF ≤ 80% is categorized as partial mediation, while VAF < 20%
is categorized as no mediation. The role of mediation will be calculated as
follows:
1. VAF = 
�=
2. VAF = �= 
Based on Table 8 presented above,
the following conclusions can be drawn:
1)
The fourth
hypothesis (H4) is accepted. This can be seen from the path coefficient value
of 0.177 and p-value (0.033). This means that the implementation of the
internal control system has a positive and significant effect on fraud
prevention through inspectorate checks. The VAF value obtained is 17%.
2)
The fifth
hypothesis (H5) was rejected. This can be seen from the path coefficient value
of 0.036 and p-value (0.249). This means that compensation suitability does not
affect fraud prevention through inspectorate checks. The VAF value obtained is
57%.
Effect of Internal Control System Implementation on Fraud Prevention
Based on research on the first hypothesis regarding the implementation of
the internal control system on fraud prevention, the direct test results have a
path coefficient of 0.671. This influence has a p-value of 0.000. Based on
these results, it can be concluded that the internal control system has a
positive and significant effect on fraud prevention in the regional public
service agency of the eye hospital of East Kalimantan province.
This research is also supported by Azmi
et al. (2021), which shows that the internal
control system affects fraud prevention. The better the implementation of the
internal control system in the hospital, the better the hospital will be
structured and avoid fraud.
The Effect of Compensation Suitability on Fraud Prevention
The direct test results for the second hypothesis regarding compensation
suitability for fraud prevention have a path coefficient of -0.009 and p-values
of 0.469. Based on these results, it can be concluded that compensation
suitability has no effect on fraud prevention in the regional public service
agency of the East Kalimantan Provincial Eye Hospital. The size of compensation
cannot prevent fraud in the agency.
The results of this study are not in line with research conducted by Novitasari
and Kusumastuti (2019), which states that financial
and non-financial compensation have a positive and significant effect on fraud
prevention. The difference in the results of this study can also be due to
differences in research objects, which result in differences in internal
conditions. Several factors can cause differences in internal conditions
between one agency and another.
The Effect of Inspectorate Examination on Fraud Prevention
In the third hypothesis regarding inspectorate examination on fraud
prevention, the direct test results have a path coefficient of 0.267 and
p-values of 0.024. Based on these results, it can be concluded that the
inspectorate examination has a positive and significant effect on fraud
prevention in the regional public service agency of the eye hospital of East
Kalimantan province.
Inspectorate inspection is an internal government audit that is expected
to improve efficiency, effectiveness, and organizational performance. The main
objective of an inspectorate examination is to evaluate compliance with
regulations set by the government or the competent authority within its scope.
The Effect of Internal Control System Implementation on Fraud Prevention
through Inspectorate Examination
In the fourth hypothesis regarding the implementation of the internal
control system on fraud prevention through inspectorate examinations, the
indirect test results have a path coefficient value of 0.177, and this effect
has a p-value of 0.033. These results can be concluded that the implementation
of the internal control system has a positive and significant effect on fraud
prevention through inspectorate examinations at the regional public service
agency of the eye hospital of East Kalimantan province.
The better the internal control system implemented by the hospital
internally, the better it will avoid problems such as irregularities and fraud.
This means that hospitals should design good internal controls, and in
accordance with internal conditions, the design can include policies and
procedures that are expected to reduce the risks of fraud. The existence of the
Inspectorate as an internal audit is also considered capable of minimizing
fraud.
The Effect of Compensation Suitability on Fraud Prevention Through
Inspectorate Examination
In the fifth hypothesis regarding the suitability of compensation for
fraud prevention through inspectorate examination, the indirect test results
have a path coefficient value of 0.036, and this effect has a p-value of 0.249.
These results can be concluded that compensation suitability does not affect
fraud prevention through inspectorate checks.
All compensation examined by the Inspectorate will be audited through a
performance audit; the Inspectorate will adhere to applicable regulations in
accordance with government inspection standards. The Inspectorate conducts
inspections of employee compensation to ensure that the inspected organization
complies with applicable rules and standards and to identify and prevent
potential problems or abuses related to the management of employee
compensation. This is intended to create a work environment that is fair,
transparent, and in accordance with the principles of good ethics and
compliance.
CONCLUSION
This study concludes
that the implementation of the internal control system has a positive and
significant effect on fraud prevention at the East Kalimantan Provincial Eye
Hospital, indicating that the better the internal control system, the less
likely fraud will occur. Conversely, compensation suitability does not affect
fraud prevention, meaning that the size of compensation does not affect the
possibility of someone committing fraud. Inspectorate examination also has a
positive and significant effect on fraud prevention; the better the
examination, the smaller the chance of fraud. However, the inspector
examination does not mediate the effect of internal control system
implementation or compensation suitability on fraud prevention.
The weakness of this
study is the poor quality of respondent data, causing high cross-loading
numbers and indicating that many indicators need to be able to distinguish the
measured constructs clearly. Suggestions for the East Kalimantan Provincial Eye
Hospital are to implement a better internal control system and pay attention to
employee compensation. The suggestion for the Inspectorate is to increase
guidance and supervision so that agencies avoid irregularities and achieve the
services expected by the community. For future researchers, it is recommended
to deepen research related to compensation suitability and consider intervening
variables, as well as using area-based random samples for inspectorate
inspection variables, especially in the finance division.
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