Acceptance and Implementation Challenges of Global Budget Payment Systems in Hospitals: A Literature Review

Global budget payment systems have been increasingly adopted as a strategic health financing reform to enhance cost containment and financial sustainability in hospital services. This study aims to systematically review the literature on hospital acceptance and implementation challenges of global budget payment systems by synthesizing evidence from both international and national contexts. A literature review was conducted using 22 peer-reviewed journals published between 2017 and 2024, comprising 12 Scopus-indexed international journals and 10 SINTA-indexed Indonesian journals. The analysis focused on organizational acceptance, financial risk management, institutional readiness, governance arrangements, and implications for service quality and equity. The findings indicate that while global budget payment systems are effective in improving expenditure predictability and incentivizing cost control, their successful implementation is highly contingent upon robust cost accounting systems, skilled financial and managerial human resources, and integrated health information systems. Challenges related to financial risk, quality of care, and equity persist, particularly in settings with weak risk adjustment mechanisms and limited governance capacity