International Journal of Social Science (IJSS) Vol.
5 Issue.
4 December 2025, pp: 461-476 ISSN: 2798-3463 (Printe.
| 2798-4079 (Onlin.
DOI: https://doi.
org/10.
53625/ijss.
THE EFFECT OF SIZE AND FSR ON COMPANY VALUE (PBV)
WITH THE MEDIATION OF LIQUIDITY IN THE
HEALTHCARE SECTOR FROM 2022 TO 2024
Disti Paremono Priatsaleh1.
Andini Nurwulandari2.
Irma Setyawati3
1,2,3
Ilmu Manajemen Fakultas Ekonomi dan Bisnis.
Universitas Nasional E-mail: 1destiparemonopriatsaleh34@gmail.
Article Info Article history:
Received Oct 23, 2025 Revised Nov 17, 2025 Accepted Nov 26, 2025 Keywords:
Firm Size.
Financial Sustainability Ratio (FSR).
Liquidity.
Price-To-Book Value (PBV).
Healthcare Sector.
ABSTRACT
This study examines the effect of firm size and the Financial Sustainability Ratio (FSR) on firm value, measured by Price to Book Value (PBV), with liquidity as a mediating variable in the Indonesian healthcare sector during 2022Ae2024.
The research is motivated by the rapid growth of the healthcare industry post-pandemic, accompanied by dynamic variations in firm value that are not always aligned with company size or financial sustainability.
Using a purposive sampling method, 19 healthcare companies listed on the IDX were selected, with data drawn from annual reports and financial The analysis employed panel data regression with the Random Effect Model (REM) and Sobel tests to assess mediation effects.
The results indicate that both firm size and FSR negatively affect PBV, suggesting that larger firms and those with higher FSR may be perceived as less efficient or riskier by investors.
Similarly, firm size and FSR also negatively impact liquidity (Current Rati.
, showing that business expansion and debt-based structures may reduce short-term solvency.
Regarding mediation, liquidity does not significantly mediate the relationship between firm size and PBV, indicating that market valuation of size occurs directly rather than through However, liquidity is found to significantly mediate the effect of FSR on PBV, implying that firms with balanced financial structures and healthy liquidity levels are more positively valued by investors.
Overall, the findings highlight that in the healthcare sector, investors place greater emphasis on efficiency, growth prospects, and prudent financial management rather than merely company scale or leverage.
This is an open access article under the CC BY-SA license.
Corresponding Author:
Disti Paremono Priatsaleh Ilmu Manajemen Fakultas Ekonomi dan Bisnis.
Universitas Nasional E-mail: destiparemonopriatsaleh34@gmail.
INTRODUCTION
The healthcare sector in Indonesia has experienced significant growth in recent years, particularly following the COVID-19 pandemic, which altered patterns of healthcare service consumption.
Data from the Indonesia Stock Exchange (IDX, 2.
shows that the market capitalisation of the healthcare sector increased by an average of 12.
per year between 2022 and 2024, driven by rising demand for healthcare services, pharmaceutical innovation, and the expansion of medical facilities.
However, behind this positive trend, there are variations in company value performance .
rice to book value / PBV) among issuers that do not always align with company size .
irm siz.
or financial sustainability ratio (FSR).
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| 2798-4079 (Onlin.
Table 1.
Healthcare Sector Companies Code
Company Name
Shares Listing Board
DVLA
Darya-Varia Laboratoria Tbk.
Development INAF Indofarma Tbk.
Special Monitoring KAEF Kimia Farma Tbk.
Development KLBF Kalbe Farma Tbk.
Main
MERK
Merck Tbk.
Development MIKA Mitra Keluarga Karyasehat Tbk.
Main
PYFA
Pyridam Farma Tbk Development SAME Sarana Meditama Metropolitan T Main
SCPI
Organon Pharma Indonesia Tbk.
Special Monitoring SIDO
Industri Jamu dan Farmasi Sido
Main
SILO
Siloam International Hospitals Main
SRAJ
Sejahteraraya Anugrahjaya Tbk.
Development TSPC Tempo Scan Pacific Tbk.
Main
PRDA
Prodia Widyahusada Tbk.
Main
PRIM
Royal Prima Tbk.
Development HEAL Medikaloka Hermina Tbk.
Main
PEHA
Phapros Tbk.
Development IRRA Itama Ranoraya Tbk.
Development SOHO Soho Global Health Tbk.
Development DGNS
Diagnos Laboratorium Utama Tbk Main
BMHS
Bundamedik Tbk.
Special Monitoring RSGK Kedoya Adyaraya Tbk.
Main
MTMH
Murni Sadar Tbk.
Development MEDS Hetzer Medical Indonesia Tbk.
Development PRAY Famon Awal Bros Sedaya Tbk.
Main
OMED
Jayamas Medica Industri Tbk.
Development MMIX Multi Medika Internasional Tbk Development PEVE Penta Valent Tbk.
Development HALO Haloni Jane Tbk.
Development RSCH Charlie Hospital Semarang Tbk.
Development IKPM Ikapharmindo Putramas Tbk.
Development SURI Maja Agung Latexindo Tbk.
Development LABS UBC Medical Indonesia Tbk.
Development OBAT Brigit Biofarmaka Teknologi Tb Development CHEK Diastika Biotekindo Tbk.
Main
MDLA
Medela Potentia Tbk.
Development DKHH Cipta Sarana Medika Tbk.
Development CARE Metro Healthcare Indonesia Tbk Development a.
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5 Issue.
4 December 2025, pp: 461-476 ISSN: 2798-3463 (Printe.
| 2798-4079 (Onlin.
DOI: https://doi.
org/10.
53625/ijss.
The development of the healthcare sector in Indonesia during the 2022Ae2024 period shows complex Although this sector has generally experienced growth in terms of revenue and assets, the value of companies measured by price to book value (PBV) does not always move in line with firm size.
This phenomenon raises the question of whether firm size is indeed the primary factor in determining market value, or whether there are other more dominant variables influencing investor perception.
For example.
PT Kalbe Farma Tbk (KLBF), which has very large assets, experienced a decline in PBV in 2023 due to weakening market sentiment and declining profit Table 2.
Sample Data Supporting the Research Problem in the Healthcare Sector .
2Ae2.
Example Firm Size (Total Assets.
FSR
Likuidity (Current PBV Year Issuer Trillio.
(%) Rati.
2022 KLBF
17,12
2,72
5,12
2022 HEAL
2022 SIDO
4,08
-21,5
4,06
6,71
2023 KLBF
6,18
4,91
3,79
2023 HEAL
1,26
5,61
2023 SIDO
-22,3
4,47
4,83
2024 KLBF
4,73
4,11
3,07
2024 HEAL
1,13
5,45
2024 SIDO
-22,7
Based on the performance data of pharmaceutical and healthcare companies, there is a dynamic development in firm size, revenue growth (FSR), liquidity, and market valuation as reflected in the Price to Book Value (PBV) for the period 2022Ae2024.
KLBF (Kalbe Farm.
consistently demonstrates the largest asset size compared to HEAL (Hermina Hospital.
and SIDO (Industri Jamu Sido Muncu.
This indicates that KLBF has a broader business scale, although FSR growth has declined from 17.
12% in 2022 to just 4.
73% in 2024.
This decline may reflect pressure on sales growth or increased operational costs.
HEAL shows a positive trend in terms of firm size, with assets increasing from IDR 7.
9 trillion in 2022 to IDR 10.
5 trillion in 2024.
This asset growth is consistent with stable financial performance, as indicated by a relatively stable FSR in the range of 8.
1% in 2023Ae2024, after previously standing at 15.
8% in 2022.
HEAL's liquidity is relatively low compared to other issuers .
05Ae1.
, indicating a reliance on operating cash flow to meet shortterm obligations.
However.
HEAL's PBV remains high .
45Ae6.
, indicating investor confidence in the company's long-term growth prospects.
Unlike KLBF and HEAL.
SIDO's performance shows a rather worrying trend.
SIDO's FSR experienced significant negative growth, namely -21.
5% in 2022 and further declined to -22.
7% in 2024.
Although SIDO's liquidity is relatively high .
06Ae5.
, this indicates that the company has excess current assets compared to short-term liabilities, but this is not offset by sales performance growth.
This phenomenon may indicate issues with market expansion strategies or a decline in the competitiveness of herbal medicine products amid modern healthcare industry When viewed from market valuation through PBV, the three issuers show interesting differences.
SIDO,
despite its declining performance, still has a relatively high PBV .
83Ae6.
, indicating that the market still assigns a premium to SIDO's brand value and position in the herbal industry.
KLBF shows a decline in PBV from 5.
12 in 2022 07 in 2024, in line with the decline in FSR growth.
Meanwhile.
HEAL maintains a high PBV in the range of 5.
45Ae 52, reflecting investors' positive expectations for the long-term growth of the hospital sector in Indonesia.
Overall, this data illustrates that although the three issuers operate in relatively similar sectors, their financial performance dynamics and market perceptions vary.
KLBF faces challenges in terms of growth decline despite maintaining a leading position in terms of company size.
HEAL shows promising long-term prospects despite low liquidity, while SIDO faces a decline in sales performance despite still having a relatively high market valuation.
This underscores the need for investors to consider more than just asset size, but also growth performance, operational efficiency, and market perception before making investment decisions.
Global market trends, such as increased awareness of sustainability or changing consumer preferences, may encourage companies to pay more attention to financial sustainability as part of a long-term strategy.
Companies that are able to adapt to these trends are likely to be priced higher by the market as they are perceived to have sustainable a.
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4 December 2025, pp: 461-476 ISSN: 2798-3463 (Printe.
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added value.
Thus, the interaction of these factors creates a complex framework, within which companies must adjust their internal policies to remain relevant and competitive in the global market (Priatsaleh & Nurwulandari, 2.
Another issue that arises is the lack of previous research examining the relationship between firm size.
FSR, and PBV while considering liquidity as a mediating variable, particularly in the Indonesian healthcare sector.
Most existing studies focus on the manufacturing or banking sectors, while the healthcare sector has unique financial characteristics, such as high capital investment requirements, long cash cycles, and high dependence on government This research gap is an important area that needs to be addressed to gain a more comprehensive understanding of the factors influencing company value in this sector.
LITERATURE REVIEW
Firm Size and Firm Value Company size reflects the capacity of resources and scale of operations that a company possesses.
According to Chen & Chen .
, large companies tend to have easier access to external funding, better risk diversification, and stronger bargaining positions in the market, thereby increasing PBV.
Financial Sustainability Ratio (FSR) and Company Value A high FSR indicates that a company has the ability to maintain its financial performance in the long term.
the context of the healthcare industry, this sustainability is important because continuous R&D investment can strengthen competitiveness.
Liquidity as a Mediating Variable Good liquidity can increase investor confidence and ensure operational smoothness.
According to research by Rahmawati & Hidayat .
, high liquidity plays a role in strengthening the influence of firm size and FSR on PBV.
Relationship between Variables The theoretical framework refers to signalling theory and agency theory.
Companies that are able to maintain healthy asset size.
FSR, and liquidity send positive signals to the market, thereby increasing company value.
RESEARCH METHODOLOGY
Type of Research This study employs a quantitative method with an explanatory research approach, aiming to test the causal relationship between variables.
This method was chosen because it can identify the extent to which independent variables .
irm size and financial sustainability rati.
influence the dependent variable .
rice to book valu.
through the mediating variable .
Population and Sample The research population consists of all healthcare sector companies listed on the Indonesia Stock Exchange (IDX) during the 2022Ae2024 period.
The sample was selected using purposive sampling based on the following criteria:
The company published complete annual financial reports for the period 2022Ae2024.
Data related to firm size.
FSR, liquidity, and PBV were available consistently.
The company did not experience delisting during the research period.
Tabel 3 Current No Code Company Name Tahun SIZE .
n millio.
FSR (%) PBV
Ratio
Darya-Varia
DVLA
Laboratoria Tbk.
2,009,139.
KAEF
Kimia Farma Tbk.
2,042,171.
2,161,538.
8,179,802.
5,208,682.
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5 Issue.
4 December 2025, pp: 461-476 ISSN: 2798-3463 (Printe.
| 2798-4079 (Onlin.
DOI: https://doi.
org/10.
53625/ijss.
KLBF
MERK
MIKA
SAME
SIDO
SILO
SRAJ
TSPC
PRDA
Kalbe Farma Tbk.
Merck Tbk.
Mitra Keluarga Karyasehat Tbk.
Sarana Meditama Metropolitan T Industri Jamu dan Farmasi Sido Siloam International Hospitals Sejahteraraya Anugrahjaya Tbk.
Tempo Scan Pacific Tbk.
Prodia Widyahusada Tbk.
3,932,651.
27,241,313.
27,057,568.
29,429,727.
1,037,647.
957,814.
956,936.
6,918,090.
7,340,842.
8,247,188.
5,140,003.
5,364,778.
5,558,310.
4,081,442.
3,890,706.
3,939,625.
9,665,602.
10,982,062.
14,206,336.
5,749,600.
5,606,291.
5,683,022.
11,328,974.
11,315,730.
12,489,189.
2,669,591.
2,708,056.
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| 2798-4079 (Onlin.
PRIM
HEAL
PEHA
IRRA
SOHO
DGNS
BMHS
MTMH
MEDS
Royal Prima Tbk.
Medikaloka Hermina Tbk.
Phapros Tbk.
Itama Ranoraya Tbk.
Soho Global Health Tbk.
Diagnos Laboratorium Utama Tbk Bundamedik Tbk.
Murni Sadar Tbk.
Hetzer Medical Indonesia Tbk.
2,840,136.
1,034,519.
1,030,788.
1,084,556.
7,591,485.
8,802,651.
10,577,680.
1,806,280.
1,768,708.
1,430,039.
733,925.
1,058,886.
1,658,962.
4,474,599.
4,746,960.
5,412,023.
239,935.
271,475.
300,022.
2,968,785.
3,083,162.
3,446,360.
3,879,559.
4,085,637.
4,122,356.
60,579.
64,338.
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php/IJSS International Journal of Social Science (IJSS) Vol.
5 Issue.
4 December 2025, pp: 461-476 ISSN: 2798-3463 (Printe.
| 2798-4079 (Onlin.
DOI: https://doi.
org/10.
53625/ijss.
PRAY
OMED
MMIX
MDLA
DKHH
CARE
Famon Awal Bros Sedaya Tbk.
Jayamas Medica Industri Tbk.
Multi Medika Internasional Tbk Medela Potentia Tbk.
Cipta Sarana Medika Tbk.
Metro Healthcare Indonesia Tbk 65,306.
4,835,689.
4,987,325.
5,072,590.
2,541,036.
2,789,567.
2,825,331.
305,897,256,148.
325,445,123,173.
407,818,563,926.
4,416,000,000,000.
4,695,000,000,000.
5,761,000,000,000.
230,018,739,706
268,216,703,847
330,019,410,960
4,234,621.
4,137,006.
4,021,105.
Types and Sources of Data The data used in this study are secondary data obtained from annual financial statements, annual reports, and stock trading data from the Indonesia Stock Exchange (IDX).
Data sources also include publications from the Financial Services Authority (OJK).
IDX Statistics, and the official websites of each listed company.
Operational Definition of Variables Firm Size (X.
Measured using the natural logarithm of the companyAos total assets:
Financial Sustainability Ratio (FSR) (X.
Represents the companyAos ability to maintain financial sustainability, measured by:
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Likuidity (Z) Measured using the Current Ratio:
Firm Value (Y) Measured using the Price to Book Value (PBV):
Data Analysis Method Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) through SmartPLS 3 software.
The analytical steps include:
Outer Model: to test indicator validity and reliability.
Inner Model: to assess direct, indirect, and total effects.
Bootstrapping: to test the significance of relationships among variables.
RESULTS AND DISCUSSION
Descriptive Statistical Test Table 2.
Descriptive Statistical Test Results Variable Obs Mean Std.
Dev.
Min Max Source: Processed data, 2025 Based on the results of the descriptive statistical analysis, the Size variable (X.
has 78 observations with an average value .
35 and a standard deviation of 4.
The minimum value was recorded at 11.
01, while the maximum value was 29.
This indicates a variation in company size within the study sample, with most companies being mid-sized, but there is a significant difference between the smallest and largest companies.
Furthermore, the FSR variable (X.
showed an average value of 4.
29 with a fairly large standard deviation of The data range is very wide, ranging from a minimum value of -54.
33 to a maximum of 165.
This high standard deviation indicates significant fluctuations in the FSR variable between companies.
The negative minimum value also indicates that there are companies with less stable financial conditions in the study sample.
For the Current Ratio (Z) variable, the average value was recorded at 3.
19 with a standard deviation of 2.
The minimum value is 0.
32, with a maximum value of 15.
This indicates a wide variation in companies' liquidity capabilities, with some companies experiencing low liquidity while others exhibit very high levels.
Finally, the Price to Book Value (PBV) variable (Y) has an average value of 2.
79 with a standard deviation The minimum value is 0.
20, and the maximum value is 17.
These results indicate a significant variation in companies' market values compared to their book values.
Companies with high PBVs are said to have better growth prospects and are valued more highly by investors, while companies with low PBVs tend to be less attractive in the capital market.
Regression Analysis Model 1 Table 4.
Results of Regression Model 1 Selection Test P-Value Result Conclusion LM Test Random Effect Chow Test Fixed Effect Random Effect Hausman Test Random Effect Source: Processed data, 2025 Based on the Chow Test results, a p-value of 0.
0046 was obtained, which is less than 0.
This means that the null hypothesis .
ommon effect mode.
is rejected, and the more appropriate model to use is the Fixed Effect Model (FEM) compared to the Common Effect Model.
In other words, there are significant differences in characteristics between the companies in the research sample that need to be considered.
Furthermore, the Lagrange Multiplier (LM) a.
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Test results showed a p-value of 0.
0221, which is also less than 0.
This indicates that the Common Effect Model is not appropriate, and the more appropriate model is the Random Effect Model (REM).
However, to determine the best model between the Fixed Effect and Random Effect models, a Hausman Test was conducted.
The test results showed a p-value of 0.
1964, which is greater than 0.
This means that the null hypothesis is accepted, and the most appropriate model is the Random Effect Model.
Thus, based on the overall test, it can be concluded that the appropriate panel regression model to use in this study is the Random Effect Model (REM).
The selection of REM indicates that the differences between companies in the sample are more random than having a specific and consistent influence as in FEM.
Hypothesis Testing Model 1 In panel data regression analysis, the t-test is used to examine the partial effect of independent variables on the dependent variable.
With a significance level of 0.
Ho is rejected if the probability value is <0.
05 and Ho will be accepted if the probability value is >0.
Source Number of obs F.
, .
Prob > F R-squared Adj R-squared Root MSE Model Residual Total Coef.
Std.
Err.
P>.
% Conf.
Interva.
_cons Figure 2.
Results of Hypothesis Testing Model 1 Based on the estimation results, the following regression equation is obtained:
Y= 2.
876969 Ae 0.
0037887X1 Ae 0.
The intercept value of 2.
876969 indicates the baseline PBV when both firm size and FSR are equal to zero.
Although in practice these values may not realistically reach zero, the intercept serves as a constant to balance the The coefficient of firm size (Oe0.
carries a negative sign, suggesting that an increase in firm size is associated with a slight decline in PBV.
Specifically, for every one-unit increase in firm size.
PBV decreases by 0038, assuming other factors remain constant.
While the magnitude of the effect appears small per unit, significant changes in firm size could result in a more noticeable impact.
Similarly, the coefficient of FSR (Oe0.
is also negative, meaning that an increase in FSR tends to reduce PBV.
A one-unit increase in FSR is predicted to lower PBV by about 0.
This finding implies that companies with higher FSR values may be less attractive to the market in terms of valuation relative to their book Overall, both independent variables show negative relationships with PBV, indicating that larger firm size and higher FSR are associated with lower firm value in the market.
This could reflect investorsAo perceptions that larger firms or those with higher financial structure ratios may face higher risks, inefficiencies, or limited growth prospects.
Nevertheless, the validity of these interpretations depends on the statistical significance of the coefficients, and further diagnostic tests should be considered to confirm the robustness of the model.
Regression Analysis of Model 2 Table 4.
Results of Regression Model Selection 2 Test P-Value Result Conclusion LM Test Random Effect Chow Test Fixed Effect Random Effect Hausman Test Random Effect Source: Processed data, 2025 a.
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Hypothesis Testing Model 2 Source Model Residual Total Coef.
Std.
Err.
P>.
% Conf.
Interva.
_cons Number of obs F.
, .
Prob > F R-squared Adj R-squared Root MSE Figure 3.
Results of Hypothesis Testing Model 2 Based on the estimation results, the following regression equation is obtained:
Z = 4.
465393 Ae 0.
0792848X1 Ae 0.
The constant value of 4.
465393 indicates the baseline level of Current ratio when both firm size and FSR are equal to zero.
Although this condition may not be practically attainable, the intercept serves as a necessary component of the regression model.
The coefficient of firm size (Oe0.
has a negative sign, meaning that as firm size increases.
Current ratio tends to decrease.
Specifically, for every one-unit increase in firm size.
Current ratio is predicted to decline by This suggests that larger firms within the sample may not always achieve higher Current ratio, potentially due to higher operational costs, inefficiencies, or challenges in maintaining optimal resource allocation as the company grows.
Similarly, the coefficient of FSR (Oe0.
is also negative, indicating that an increase in FSR reduces Current ratio.
For each additional unit of FSR.
Current ratio is expected to decrease by about 0.
This outcome reflects that a higher financial structure ratio may signal financial pressure or less efficient use of capital, which can ultimately weaken profitability performance.
Overall, both independent variables demonstrate a negative effect on Current ratio.
This finding highlights that neither larger firm size nor higher FSR necessarily contributes to improved profitability in the transportation and logistics sector.
On the contrary, these factors may reduce the firmAos ability to generate returns, signaling the importance of efficient management practices and optimal financial structures to maintain Current ratio.
Path Analysis Test Source Number of obs F.
, .
Prob > F R-squared Adj R-squared Root MSE Model Residual Total Coef.
Std.
Err.
P>.
% Conf.
Interva.
_cons Figure 5.
Results of Hypothesis Testing Model 3 Based on the estimation results, the following regression equation is obtained:
Y = 2.
949959 Ae 0.
0050847X1 Ae 0.
0049423X2 Ae 0.
The intercept value of 2.
949959 reflects the baseline PBV when all independent variables are zero.
While such a situation may not exist in practice, the intercept functions as the modelAos constant term.
The coefficient of firm size (Oe0.
is negative, meaning that as firm size increases.
PBV decreases.
Specifically, a one-unit increase in firm size reduces PBV by around 0.
0051, assuming other variables remain constant.
This suggests that larger companies in the sample tend to have lower valuations relative to their book value, possibly due to slower growth potential or greater operational complexity.
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DOI: https://doi.
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53625/ijss.
The coefficient of FSR (Oe0.
also has a negative sign, showing that higher financial structure ratios are associated with lower PBV.
A one-unit increase in FSR reduces PBV by about 0.
This finding implies that a higher FSR may signal financial pressure or inefficiencies, which investors interpret as a risk, leading to lower firm value in the market.
Most importantly, the coefficient of the current ratio (Oe0.
indicates that liquidity, as measured by CR, has a negative effect on PBV.
For every one-unit increase in CR.
PBV decreases by about 0.
This counterintuitive result suggests that high liquidity does not necessarily enhance firm value.
Instead, very high CR values may signal that companies hold excessive idle assets or are not utilizing their resources effectively to generate returns, which may reduce investor confidence.
In conclusion, firm size.
FSR, and current ratio all have negative impacts on PBV.
This means that larger firms, those with higher financial structure ratios, and even companies with stronger liquidity do not necessarily gain higher market valuations.
These findings highlight that investors in the transportation and logistics sector may place greater emphasis on efficiency, growth opportunities, and balanced financial management rather than simply larger size or higher liquidity levels.
Sobel Test 1 Figure 6.
Sobel Test Results Based on the Sobel test results, the significance value of the indirect effect of Size on PBV through CR is Since the p-value obtained is >0.
05, it is concluded that CR does not mediate the indirect effect of Size on PBV.
Sobel Test 2 Figure 7.
Sobel Test Results a.
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Based on the Sobel test results, the significance value of the indirect effect of FSR on PBV through CR is Since the p-value obtained is < 0.
05, it is concluded that CR does mediate the indirect effect of FSR on PBV.
DISCUSSION
The Effect of Size and FSR on Company Value (PBV) in the Healthcare Sector From 2022 to 2024 The regression results indicate that both firm size and financial structure ratio (FSR) negatively influence company value (PBV) in the healthcare sector during 2022Ae2024.
The intercept value of 2.
876969 shows the baseline PBV level when both firm size and FSR are set to zero, although this situation is unlikely in practice.
The negative coefficient of firm size (Oe0.
suggests that as firms expand in scale, their market valuation relative to book value tends to decline.
Even though the effect per unit is relatively small, the cumulative impact of significant changes in firm size could lead to substantial differences in PBV.
This finding highlights that in the healthcare sector, larger firms may be perceived as less efficient or face difficulties in maintaining profitability and growth, which reduces their attractiveness to investors.
Similarly, the coefficient of FSR (Oe0.
indicates a negative association with PBV, implying that higher financial structure ratios are correlated with lower firm value.
This result can be interpreted as a signal that firms with higher FSR, which may reflect higher leverage or financial dependency, are seen as riskier by the market.
Consequently, investors may discount their valuation due to potential financial instability or reduced flexibility in managing future investments.
This supports the idea that conservative financial structures may be more favorable in maintaining firm value, especially in sectors like healthcare where long-term sustainability is crucial.
When compared with previous studies, these findings show both similarities and differences.
For instance, some prior research has found that firm size often has a positive effect on PBV, as larger firms tend to benefit from economies of scale, stronger market presence, and higher investor confidence .
Putra & Dewi, 2.
However, the current result aligns with studies such as Sari .
, which reported a negative relationship between firm size and firm value, especially in industries where larger firms struggle with inefficiencies or rigid structures.
Regarding FSR, the negative relationship with PBV is consistent with the findings of Nugroho .
, who emphasized that higher leverage tends to reduce investor confidence and thus decreases firm value.
On the other hand, some studies .
Rahayu & Pramudita, 2.
noted that moderate levels of financial leverage could enhance firm value through tax shields, although excessive reliance on debt reverses this effect.
Overall, the findings suggest that in the healthcare sector, investors may prefer smaller, more agile firms with balanced financial structures, as they are perceived to have better growth opportunities and lower financial risk.
This reinforces the notion that firm value is not solely determined by scale or financial leverage but also by how effectively companies manage their resources, risks, and growth strategies.
The Effect of Size and FSR on Liquidity in the Healthcare Sector From 2022 to 2024 The regression results show that the constant value of 4.
465393 represents the baseline Current Ratio when both firm size and Financial Structure Ratio (FSR) are equal to zero.
While such a condition is unlikely to occur in real-world situations, the intercept provides a reference point for understanding the variation in liquidity when the explanatory variables are introduced.
This indicates that, without the influence of firm size and FSR, companies in the healthcare sector maintain a relatively high baseline of liquidity.
The negative coefficient of firm size (Oe0.
implies that larger healthcare firms tend to experience a decline in liquidity.
This result suggests that as companies expand, they may face increasing operational costs, higher levels of investment in fixed assets, or more complex resource allocation, which can reduce their ability to maintain liquid assets relative to liabilities.
This aligns with the findings of Singh and Bagga .
, who noted that firm size does not always positively affect liquidity, as larger firms may prioritize long-term investments over maintaining shortterm liquid resources.
Conversely, this finding contrasts with studies such as those by Alarussi and Alhaderi .
, which suggested that larger firms have more diversified operations and better access to financing, enabling them to maintain higher liquidity levels.
Similarly, the coefficient of FSR (Oe0.
also shows a negative relationship with liquidity.
A higher FSR implies greater reliance on debt financing relative to equity, which can increase financial pressure on firms due to interest obligations and repayment commitments.
This reduces their ability to retain sufficient current assets to cover short-term liabilities, leading to a decline in the Current Ratio.
This result is consistent with the findings of Rajan and Zingales .
, who argued that firms with high leverage tend to experience financial distress, thereby weakening a.
Journal homepage: https://bajangjournal.
com/index.
php/IJSS International Journal of Social Science (IJSS) Vol.
5 Issue.
4 December 2025, pp: 461-476 ISSN: 2798-3463 (Printe.
| 2798-4079 (Onlin.
DOI: https://doi.
org/10.
53625/ijss.
It also resonates with more recent research in emerging markets, such as that by Pratama and Wibowo .
, which found that excessive leverage can erode firmsAo short-term solvency positions.
Overall, both firm size and FSR exhibit a negative impact on liquidity in the healthcare sector during the period 2022Ae2024.
This highlights that growth in firm size and financial structuring strategies based heavily on debt do not necessarily enhance liquidity.
Instead, these factors may undermine a firmAos capacity to maintain a healthy Current Ratio.
These results emphasize the importance of effective financial management, particularly in balancing growth and capital structure, to ensure that healthcare firms remain resilient in terms of short-term solvency.
The Effect of Size on Company Value (PBV) With the Mediation of Liquidity in the Healthcare Sector From 2022 to 2024 Based on the Sobel test results, the significant indirect effect of size on company value (PBV) through liquidity (Current Ratio/CR) was 0.
This p-value is greater than 0.
05, thus concluding that CR is unable to mediate the relationship between size and PBV in healthcare sector companies during the 2022Ae2024 period.
This indicates that while company size has the potential to influence company value, liquidity mechanisms are not a significant pathway in strengthening or weakening this influence.
In other words, the role of liquidity as a mediating variable in the relationship between size and PBV in this sector is not statistically proven.
This finding aligns with research by Amidu and Harvey .
, which states that company size often directly influences company value without interfering with short-term financial indicators such as liquidity.
Large companies tend to have a better reputation, access to funding, and bargaining power in the market, so investors value size more than the company's ability to maintain its liquidity ratio.
This contrasts with profitability or leverage, which have been shown in several studies to be stronger mediators.
However, these results contradict the study by Pratama and Wibowo .
, which found that liquidity mediates the relationship between company size and firm value in the manufacturing sector.
This difference can be explained by industry characteristics.
In the healthcare sector, the main factors influencing firm value are more related to market growth, service innovation, and revenue stability, while liquidity is not a primary consideration for investors.
Therefore, it can be concluded that in the 2022Ae2024 period, liquidity (CR) is not a factor that strengthens the relationship between size and PBV in the healthcare sector.
This indicates that investors focus more on business scale and long-term prospects than short-term liquidity conditions when assessing companies in this sector.
The Effect of FSR on Company Value (PBV) With the Mediation of Liquidity in the Healthcare Sector From 2022 to 2024 The results of the study indicate that the Financial Structure Ratio (FSR) influences Company Value (PBV), mediated by liquidity (Current Ratio/CR) in the healthcare sector for the period 2022Ae2024.
Based on the Sobel test, the significance value of the indirect effect of FSR on PBV through CR is 0.
Since the p-value is <0.
05, it can be concluded that CR significantly mediates the effect of FSR on PBV.
This indicates that a company's financial structure not only directly impacts firm value but also indirectly through the company's ability to maintain its liquidity levels.
In other words, the better a company's financial structure, the more likely it is to maintain a healthy liquidity ratio, which ultimately can increase investor confidence and increase the company's market value.
This finding aligns with previous research showing that liquidity is often an important mediating variable in explaining the relationship between financial structure and firm value.
For example, research by Wijaya & Sari .
found that liquidity can strengthen the effect of leverage on firm value, as adequate liquidity levels provide a positive signal to investors regarding the company's ability to meet its short-term obligations.
Similarly.
Sitorus .
reported that companies with sound financial structures but low liquidity tend to be negatively valued by the market, ultimately depressing firm value.
However, other studies have found different results.
Putra & Dewi .
showed that the effect of financial structure on firm value is not entirely mediated by liquidity, as external factors such as capital market conditions and dividend policy also play a significant role.
This difference in results can be explained by the characteristics of the industrial sector, where the healthcare sector is relatively more stable and places greater emphasis on liquidity ratios to maintain stakeholder confidence, especially during times of uncertainty such as the post-pandemic period.
Overall, these research findings confirm that in the healthcare sector, liquidity plays a crucial intermediary role in linking FSR to PBV.
This provides practical implications: financial managers need to maintain a balanced capital structure and ensure sufficient liquidity to enhance firm value in the eyes of investors.
Journal homepage: https://bajangjournal.
com/index.
php/IJSS International Journal of Social Science (IJSS) Vol.
5 Issue.
4 December 2025, pp: 461-476 ISSN: 2798-3463 (Printe.
| 2798-4079 (Onlin.
CONCLUSION
Based on the research results regarding "The Effect of Size and FSR on Company Value (PBV) in the Healthcare Sector From 2022 to 2024," it can be concluded that company size (Siz.
and the Financial Structure Ratio (FSR) have a direct, negative effect on company value (PBV).
This means that the larger the company and the higher the debt-based financial structure, the lower the company's value.
This suggests that investors in the healthcare sector value a company's efficiency, profitability, and sustainability more than its sheer scale or reliance on debt financing.
Furthermore, the research also found that both company size and the FSR negatively affect liquidity (Current Ratio/CR).
Larger companies are more likely to experience decreased liquidity due to increased operating expenses and long-term investments.
Similarly, for companies with a high FSR, large debt burdens and financial obligations can reduce the company's ability to maintain liquidity.
This confirms that growth in scale and financing strategies do not always improve short-term financial position, particularly in the healthcare sector.
From a mediating perspective, liquidity variables were shown not to mediate the effect of company size on company value.
In other words, the relationship between size and PBV is more influenced by direct factors such as reputation, access to funding, and growth prospects, rather than short-term liquidity conditions.
Conversely, liquidity is shown to mediate the effect of FSR on PBV, meaning a company's financial structure will influence its value through its ability to maintain liquidity ratios.
This finding indicates that investors consider liquidity as a signal of financial health, especially when the company has a certain level of leverage.
Overall, this study confirms that in the healthcare sector from 2022 to 2024, company value is determined more by a combination of a healthy financial structure, operational efficiency, and the ability to maintain liquidity than simply by size growth.
This provides practical implications: financial managers need to be cautious when expanding their company's scale or increasing the proportion of debt, and should focus on maintaining a balanced capital structure and liquidity to boost investor confidence and maintain company value.
REFERENCES