This study aims to identify the effect of internal audit quality, the use of information technology, management support, and the implementation of SPI implementation guidelines on the effectiveness of internal audit in preventing and detecting fraud. Quantitative research with the Partial Least Square-Structural Equation Modeling (PLS-SEM) method approach was conducted on 385 hospital internal auditors from all over Indonesia through filling out online questionnaires on Google Form. The results of hypothesis testing with Two-Tailed T-Test on the PLS-SEM inner model construct concluded that the variables of guideline implementation (path coefficient = 0.642, t-statistic = 8.467, p-value = 0.0005), audit quality (path coefficient = 0, 156, t-statistic = 2.185, p-value = 0.024), and management support (path coefficient = 0.191, t-statistic = 2.347, p-value = 0.019) have a significant influence on the effectiveness of internal audit in preventing and detecting fraud. The application of guidelines has a very high influence on the effectiveness of internal audit in preventing and detecting fraud at the structural level (F-Square = 0.557). Coefficient of Determination testing shows that the joint effect of audit quality, use of information technology, management support, and implementation of guidelines has a high effect on the effectiveness of internal audit in preventing and detecting fraud, which is 73.2% (R-Square = 0.732). This study provides practical implications for hospitals to improve audit quality, use of information technology, management support, and implementation of SPI organizational guidelines in the internal audit process to encourage internal audit effectiveness in fraud prevention and detection. Further research is expected to be developed by examining other factors that can affect the effectiveness of internal audit in preventing and detecting fraud.
