Abstract: The shifting paradigm in implementing strategic management accounting (SMA) has become a shared orientation and leads to sustainability. Empirical studies accordingly are needed to elaborate SMA techniques, especially in hospital services. The aim of the research is to analyze the position of clinical pathways and cost awareness in daily activities for sustainable healthcare which is mediated by cost reduction strategies. A mixed method with an exploratory design was chosen based on existing literature studies. Data was collected by distributing questionnaires to 171 respondents selected from the professional caregiving (Profesional Pemberi Asuhan/PPA) population using the Slovin method, Focus Group Discussions, and semi-structured interviews with purposively selected informants. A total of 8 informants came from PPA and 7 others from management, selected based on the research objectives with thematic and regression analysis. The research results show that the shifting paradigm in the accounting management system encourages changes in health services that lead to sustainability. Clinical pathways and cost awareness are designed to support hospitals' efforts to reduce costs while constantly remaining patient-centered. Clinical pathways and cost awareness partially influenced changes in sustainable healthcare through cost-reduction strategies developed by the hospital.

Keywords: Clinical Pathways, Cost Awareness, Cost Reduction, Coronary Artery Bypass Graft (CABG), Coronary Angiography Percutaneous Coronary Intervention (CAG-PCI), Sustainable Healthcare, Strategic Management Accounting

Pages: 366-378