A CIRO-Based Evaluation of Context, Input, Reaction, And Outcome in The Management of The HSC Massage Therapy Clinic, Yogyakarta State University

This study aims to evaluate the management of the Physical and Manipulative Therapy Clinic at the Health and Sport Center of Yogyakarta State University based on the four components of the CIRO model (Context, Input, Reaction, Outcome) and to assess the level of management optimization. The study uses a mixed methods approach with the CIRO model as an evaluative framework, integrating quantitative and qualitative data to obtain a comprehensive picture. Purposive sampling was used to select participants consisting of one manager, two front office staff, twelve therapists, and fifty-six active patients who had undergone therapy for at least two years. Data were collected through in-depth interviews, documentation, and a five-point Likert scale questionnaire. The results of the descriptive analysis show that all CIRO components are in the high category, namely Context (M = 4.20; SD = 0.55), Input (M = 4.25; SD = 0.56), Reaction (M = 4.18; SD = 0.60), and Outcome (M = 4.22; SD = 0.58). Spearman's correlation test revealed a very strong and significant relationship between components (r = 0.723–0.852; p < 0.01), indicating that improvements in one aspect contribute directly to improvements in other aspects. Qualitatively, the results showed that the clinic met health service standards through the presence of certified therapists, adequate facilities, and effective administrative and promotional systems. However, improvements were needed in the integration of service information systems and digital data-based evaluation to support managerial efficiency. Overall, the management of the Physical and Manipulative Therapy Clinic is considered effective, adaptive, and has a positive impact on patient satisfaction and the effectiveness of therapy services, thus proving the relevance of the CIRO model as an evaluative approach in the context of health services.