Public Trust versus Private Engagement: A Comparative Analysis of Digital Health Communication Strategies on Instagram

Abstract

This study examines the implementation of Cyber Public Relations within the Instagram health communication strategies of Indonesian public and private hospitals. A qualitative content analysis of 3,658 posts (December 2024 to February 2025) revealed distinct strategic approaches. Public hospitals (RSCM, RSUP Fatmawati) emphasised evidence-based infographics, constituting 46-70% of their content, yet achieved lower engagement (averaging 150 likes/post). In contrast, private hospitals (Siloam, Mayapada) attained significantly higher interaction (averaging 1,500 likes/post) through emotional appeals such as patient testimonials, albeit with less medical rigour. Thematically, public hospitals focused on disease prevention (e.g., RSCM: 46% of content), while private hospitals highlighted lifestyle promotion (Mayapada: 35%) and service offerings (Siloam: 25%). Framed by theories of Two-Way Symmetrical Communication and Uses and Gratifications, the results indicate superior audience engagement by private hospitals, evidenced by a 90% call-to-action rate for Mayapada, compared to the limited responsiveness of public hospitals (e.g., RSCM: 25% reply rate). Strategies for countering misinformation also differed: public hospitals directly debunked myths with authoritative sources, whereas private hospitals employed indirect, preventive health education. The study proposes a hybrid model that merges the credibility of public hospitals with the participatory engagement tactics of private institutions. This research offers a practical framework for digital health public relations in resource-limited settings, providing actionable insights for healthcare communicators and policymakers to bridge gaps in public trust and digital engagement