Challenges and Strategies for Fulfilling Specialist and Subspecialist Doctors for Improvement Service Hospital Referral: Systematic Literature Review

Introduction: The availability of specialist and subspecialist doctors in sufficient numbers and with appropriate competencies is an absolute prerequisite for the success of the transformation of referral services. Data from the Ministry of Health in 2024 shows that Indonesia only has 0.18 specialist doctors per 1,000 population spread across various health facilities. This figure is still far below the ideal target of 0.28 per 1,000 population, so an additional 29,179 specialist doctors are needed. Objective: This research aims to identify obstacles that hinder availability doctor specialists and subspecialists at the hospitals, as well as to explore effective approaches to overcome these problems. Method: This study uses the Systematic Literature Review method. The method of selecting articles in this study is to search for articles that meet the inclusion and exclusion criteria through the Google Scholar database with the keywords "efforts to fulfill specialist and subspecialist doctors", "challenges to fulfill specialist and subspecialist doctors", "challenges and strategies to fulfill specialist and subspecialist doctors", "challenges and strategies to fulfill medical personnel". This study conducted a literature review of 14 relevant scientific publications, published in the last five years (2020-2024). Result: The results of the study identified a number of significant obstacles in efforts to increase the availability of specialist and subspecialist doctors in hospitals, including aspects of regulation, budget allocation, human resource management, infrastructure, and monitoring and evaluation mechanisms. Conclusion: The interconnection between these five aspects requires the implementation of a holistic strategy in an effort to increase the availability of specialist and subspecialist doctors in hospitals.