Path Analysis of Factors Influencing the Quality of Health Services and Inpatient’s Satisfaction in Hospitals

Authors

  • Alfian Muhajir Masters Program in Public Health, Universitas Sebelas Maret
  • Didik Gunawan Tamtomo Faculty of Medicine, Universitas Sebelas Maret
  • Bhisma Murti Masters Program in Public Health, Universitas Sebelas Maret

DOI:

https://doi.org/10.26911/thejhpm.2024.09.03.09

Abstract

Background: Quality of health services is an effort to provide health services to individuals and populations in increasing the likelihood of desired health outcomes. Patient satisfaction is an indicator in assessing the quality of health services. This study aims to analyze the factors that influence the quality of health services and satisfaction of inpatients in hospitals.

Subjects and Method: The research, with a cross-sectional study design, was carried out at public and private hospitals in Mataram City from November to December 2023. A total of 207 inpatients were selected using simple random sampling in the study. The dependent variables are health service quality and patient satisfaction. The independent variables are gender, education level, income, BPJS status (payment type), inpatient class, and length of stay. Collecting data on perceptions of health service quality and patient satisfaction using a structured questionnaire prepared based on Parasuraman's Servqual concept (1985).

Results: Patient satisfaction is significantly influenced by perceived quality of health services (b = 0.81; 95% CI = 0.76 to 0.86; p < 0.001) and patient education level (b = -0.08; 95% CI = -0.17 to -0.003; p = 0.04 ). Perceived quality of health services is significantly influenced by income factors (b= 0.22; 95% CI= 0.09 to 0.35; p= 0.001) and patient inpatient room class (b= 0.40; 95% CI= 0.28 to 0.52; p <0.001) . Perception of service quality is not significantly influenced by the factors gender, education, BPJS status, and length of stay.

Conclusion: Patient satisfaction is significantly influenced by the quality of health services and the patient's level of education. The quality of health services is significantly influenced by income factors and the patient's inpatient room class. Service quality is not significantly influenced by the factors gender, education, BPJS status, and length of stay.

Keywords: pathway analysis, inpatients, quality of health services, satisfaction.

Keywords:

pathway analysis, inpatients, quality of health services, satisfaction

References

Abraham A, Olumodeji D, Oluwole E (2015). Influence of socio demographic variables nursing care i on patient’s satisfaction with quality of teaching hospitals in northern Nigeria. IJMHR, 1(3), 18–24. doi:https://doi.org/doi.org/- 10.22-271/ijmhr.

Adhikary GSM (2018). Factors Influencing Patients Satisfaction at Different Levels Of Health Facilities In Bangladesh: Results From Patient Exit Interviews. PLOS ONE, 13(5).

Ahmed S, Miller J, Burrows J, Bertha B, Rosen P (2017). Evaluation of patient satisfaction in pediatric dermatology. PDE, 34(6), 668-672. doi:doi: 10.111-1/pde.13294

AlDamen R (2017). Health Care Service Quality and Its Impact on Patient Satisfaction “Case of Al-Bashir Hospital". IJBM, 12(9), 136. doi:https://doi.o-rg/10.5539/ijbm.v12n9p136

Aliman N, Mohamad W (2016). Linking Service Quality, Patients’ Satisfaction and Behavioral Intentions: An Inves-tigation on Private Healthcare in Malaysia. SBSPRO, 224, 141–148. doi:http-s://doi.org/10.1016/j.sbspro.2016.05.

Alma B (2016). Manajemen Pemasaran dan Pemasaran Jasa (Marketing Management and Services Marketing). Bandung: Alfabeta.

Anelia N, Modjo R (2023). Kepuasan Pasien Jaminan Kesehatan Nasional Terhadap Kualitas Pelayanan Kesehatan di Rumah Sakit: Literature Review (National Health Insurance Patient Satisfaction with the Quality of Health Services in Hospitals: Literature Review). PRE-POTIF, 7(1), 1172-1180.

Antari NK (2019). Gambaran kepuasan pasien rawat jalan terhadap pelayanan kesehatan di UPT Kesmas Payangan Ginyar Bali (Description of outpatient satisfaction with health services at UPT Public Health Payangan Ginyar Bali). ISM. 10(3): 492-496.

Ayuningrum IY, Murti B (2020). Aplikasi Path Analysis & Structural Equation Model dengan STATA (Path Analysis & Structural Equation Model Application with STATA) (1 ed.). Surakarta: Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.

Budiman A (2014). Kapita Selekta Kuesioner Pengetahuan dan Sikap dalam Penelitian Kesehatan (Capita Selecta Questionnaire on Knowledge and Attitudes in Health Research). Jakarta: Salemba Empat.

Burhan IR (2018). Analisis Pengaruh Kualitas Pelayanan Terhadap Kepuasan Pasien Peserta JKN di Poliklinik Semen Padang Hospital (Analysis of the Influence of Service Quality on Patient Satisfaction of JKN Participants at the Semen Padang Hospital Polyclinic). JKA, 7(3), 394.

Darsini, Fahrurrozi, Cahyono EA (2019). Knoowledge; Artikel Review . J-Kp, 12(1), 95-107.

Datuan N, Darmawansyah, Daud A. (2018). Pengaruh Kualitas Pelayanan Kesehatan Terhadap Kepuasan Pasien Peserta BPJS Di Rumah Sakit Umum Daerah Haji Makassar (The Influence of Health Service Quality on Patient Satisfaction of BPJS Participants at the Makassar Haji Regional General Hospital). JKMM, 3(1), 291-300.

Diskominfotik NTB (2021). NTB Satu Data. [Online] Available at: https://data.ntb-prov.go.id/dataset/jumlah-sarana-kesehatan-menurut-kepemilikan-di-provinsi-ntb/resource/125558a8-3536-4679-8bf4#{view-graph:{graphOptions:-{hooks:{processOffset:{},bindEvents:{}}}},graphOptions:{hooks:{processOffset:{},bindEvents:{}}},view- [Accessed 10 10 2023].

Djafar I, Irwan, Amalia L (2023). Persepsi Pasien Peserta BPJS Penerima Ban-tuan Iuran (PBI) Terhadap Kepuasan Pelayanan Kesehatan di Puskesmas Toto Utara (Perceptions of BPJS Participant Patients Receiving Contribution Assistance (PBI) on Satisfaction with Health Services at North Toto Community Health Center). GOJHES, 7(4), 315-327.

Fadhilah IQ, Murti B, Prasetya H (2020). Factors Affecting the Quality of Out-patient Registration Service and Pati-ent Satisfaction at the Community Health Center in Surakarta and Karanganyar, Central Java. JHPM, 5(2), 92-102.

Gurning FP (2018). Dasar administrasi dan kebijakan kesehatan masyarakat (Basics of public health administration and policy) (MY Pratama, ed.). Yogyakarta: K-Media.

Halawa FY, Nadapdap TP, Silaen M (2020). Analisis tingkat kepuasan pasien rawat inap pengguna Jaminan Kesehatan Nasional di Rumah Sakit Bhayangkara Tingkat II Medan (Analysis of satisfaction levels of inpatients using National Health Insurance at Bhayangkara Level II Hospital, Medan). JPMS, 2(2), 52-61. doi:https://do-i.org/10.34012/jpms.v2i2

Hutahaean S, Nababan D (2022). Analisis Hubungan Lama Perawatan dan Jenis Pelayanan Dengan Kepuasan Pasien di RS X (Analysis of the Relationship between Length of Treatment and Type of Service with Patient Satisfaction at Hospital). JKWGI, 6(3), 255-260. doi:DOI. 10.52020/jkwgi.v6i3.4899,

Islam S (2018). Understanding Health Consumer Value: Service Marketing Perspective. SAJBS, 7(1), 2-21. doi:https://doi.org/10.1108/SAJBS-04-2017-0051

Iwaarden JV, Wiele TV, Ball L, Millen R (2003). Applying SERVQUAL to Web sites: an exploratory study. IJQRM. 20(8): 919-935.

Kadir A (2022). Petunjuk Teknis Kesiapan Sarana dan Prasarana Rumah Sakit dalam Penerapan Kelas Rawat Inap Standar Jaminan Kesehatan Nasional (Technical Instructions for Readiness of Hospital Facilities and Infrastructure in Implementing National Health Insurance Standard Inpatient Classes). Jakarta: Direktorat Jenderal Pelayanan Kesehatan Republik Indonesia.

Kementerian Kesehatan Republik Indonesia. (2022). Peraturan Menteri Kesehatan Republik Indonesia Nomor 30 Tahun 2022 tentang Indikator Nasional Mutu Pelayanan Kesehatan Tempat Praktik Mandiri Dokter dan Dokter Gigi, Klinik, Pusat Kesehatan Masyarakat, Rumah Sakit, Laboratorium Kesehatan, dan Unit Transfu (Regulation of the Minister of Health of the Republic of Indonesia Number 30 of 2022 con-cerning National Indicators for the Quality of Health Services for Inde-pendent Practice Places for Doctors and Dentists, Clinics, Community He-alth Centers, Hospitals, Health Labo-ratories and Transfu Units). Indonesia: Kementerian Kesehatan Republik Indonesia.

Kementerian Kesehatan Republik Indonesia. (2019). Peraturan Menteri Kesehatan Republik Indonesia Nomor 30 Tahun 2019 Tentang Klasifikasi dan Perizinan Rumah Sakit (Regulation of the Minister of Health of the Republic of Indonesia Number 30 of 2019 concerning Hospital Classification and Lice-nsing). Jakarta: Kementerian Kese-hatan Republik Indonesia.

Kementerian Kesehatan Republik Indonesia. (2020). Rencana Strategis Kementerian Kesehatan Tahun 2020-2024 (Ministry of Health Strategic Plan 2020-2024), Jakarta: Kementerian Kesehatan Republik Indonesia.

Kementerian Kesehatan Republik Indonesia. (2021). Cetak Biru Strategi Transformasi Digital Kesehatan 2024 (2024 Health Digital Transformation Strategy Blueprint). Jakarta: Kementerian Kesehatan Republik Indonesia.

Kementerian Kesehatan Republik Indonesia (2022). Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/ME-NKES/1128/2022 Tentang Standar Akreditasi Rumah Sakit, Jakarta: Kementerian Kesehatan.

Kim C, Shin J, Lee J, Lee Y, Kim M, Choi A, Ha I (2017). Quality Of Medical Service, Patient Satisfaction And Loyalty With A Focus On Interpersonal-Based Medical Service Encounters And Treatment Effectiveness: A Cross-Sectional Multicenter Study Of Complementary

Kippenbrock T, Emory J, Lee P, Odell E. (2019). A national survey of nurse practitioners’ patient satisfaction outcomes. Nursing Outlook. 67(6): 1-6.

Kotler P, Keller, KL (2012). Marketing Management (14 ed.). Jakarta: Erlangga.

Kraska R, Weigand M, Geraedts M (2017). Associations Between Hospital Characteristics and Patient Satisfaction in Germany. HEx, 20(4), 593–600. doi: ht-tps://doi.org/10.1111/hex.12485

Kuntoro W, Istiono W (2017). Kepuasan Pasien Terhadap Kualitas Pelayanan di Tempat Pendaftaran Pasien Rawat Jalan Puskesmas Kretek Bantul Yog-yakarta. JKV, 2(1), 140-147.

Kurniawan HD, Tamtomo D, Murti B. (2019). Contextual effect of community health center on patient satisfaction of health care service in Ngawi, East Java. JHPM. 4(1): 23-30.

Kurniawan V, Susanto S (2014). Pengaruh Kualitas Pelayanan dan Harga terha-dap Kepuasan Pasien pada Kelas Vip, 1, 2, dan 3 (Studi pada RSU PKU Muhammadiyah Gamping YOGYAKARTA) (The Influence of Service Quality and Price on Patient Satisfaction in Classes VIP, 1, 2, and 3 (Study at RSU PKU Muhammadiyah Gamping YOGYAKARTA)). JMMR, 3(2).

Liang LJ, Choi HC, Joppe M (2016). Understanding repurchase intention of Airbnb consumers: perceived authenticity, electronic word-of-mouth, and price sensitivity. J Travel Tour Mark. 35(1): 1-17.

Mirshanti F, Tamtomo D, Murti B (2017). The Asssociations Between Accre-ditation Status, Patient Socio-Economic Factors, Insurance Type, Patient Perceived Quality Of Service, And Satisfaction At Community Health Center. JHPM, 2(1), 91-101. doi:https://doi.org-/10.26911-/thejhpm.2017.01.-02.08.

Murti B (2019). Prinsip dan metode riset epidemiologi (Principles and methods of epidemiological research). Surakarta: Program Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.

Musa-Juroš K, Mijoč J, Horvat J, Ilakovac V, Marković S, Racz A (2018). Measuring healthcare quality - Paradigm of medqual. Acta Clin. Croat. 57(2): 235-242.

Muzer A, Wujoso H, Soepatini (2020). Pengaruh Kualitas Pelayanan, Usia, Tingkat Pendidikan, Jenis Kelamin, dan Status Perkawinan Terhadap Kepuasan Pasien dan Kepercayaan Pasien Rawat Inap di Rumah Sakit Paru Dr. Ario Wirawan Salatiga (The Influence of Service Quality, Age, Education Level, Gender, and Marital Status on Patient Satisfaction and Trust of Inpatients at Dr. Lung Hospital. Ario Wirawan Salatiga). Surakarta: Sekolah Pascasarjana Universitas Muhammadiyah Surakarta.

Novela S, Polla JR, Dharma OM, Walia P. (2018). The influence of service quality, perceived value and corporate image toward inpatient satisfaction on private hospital. J Ecol Econ Stat. 2(1): 9-17.

Olumodeji, Dare AA, Oluwole, Ezekiel. (2015). Influence of socio demographic variables on patient’s satisfaction with quality of nursing care in teaching hospitals in Northern Nigeria. IJMRHS. 1(3): 18-24.

Papanikolaou V, Zygiaris S. (2012). Service quality perceptions in primary health centers in Greece. Health Expectations. 17(2): 1-11.

Parasuraman AP, Zeithaml VA, Berry LL. (1985). A conceptual model of service quality and its implication for future research (SERVQUAL). J. Mark. 49: 41-50.

Pemerintah Indonesia. (2023). Undang-Undang Republik Indonesia Nomor 17 Tahun 2023 Tentang Kesehatan, Jakarta: Presiden Republik Indonesia.

Pemerintah Indonesia. (2021). Peraturan Pemerintah Republik Indonesia No-mor 47 tahun 2021 tentang Penye-lenggaraan Bidang Perumahsakitan, Jakarta: Kementerian Sekretariat Negara Republik Indonesia.

Pemerintah Indonesia. (2003). Undang-Undang Republik Indonesia Nomor 20 Tahun 2003 Tentang Sistem Pendidikan Nasional. Jakarta: Negara Republik Indonesia.

Pemerintah Kota Mataram. (2023). Statistik Daerah Kota Mataram 2023. Mataram: Badan Pusat Statistik Kota Mataram.

Pemerintah Kota Mataram. (2021). Rencana Pembangunan Jangka Menengah Daerah Kota Mataram 2021-2026 (Mataram City Regional Medium Term Development Plan 2021-2026). Mataram: Pemerintah Kota Mataram.

Rahmadianti, 2020. Analisis Faktor-Faktor Kualitas Pelayanan Terhadap Kepuasan Pasien Rawat Inap Di Rumah Sakit Al-Islam Bandung (Analysis of Service Quality Factors on Inpatient Satisfaction at Al-Islam Hospital Bandung). JSMA, 12(2), pp. 77-85.

Romliyadi, Isrizal (2020). Analisis Faktor-Faktor Berhubungan dengan Tingkat Kepuasan Pasien Dalam Pelayanan Perawatan di Rumah Sakit Tahun 2022 (Analysis of Factors Associated with the Level of Patient Satisfaction in Hospital Care Services in 2022). J. Kesehat. Lentera Aisyiyah, 5(2), 644-652.

WHO, 2020. www.who.int. [Online] Avai-lable at: http://www.who.int/news-room/fact-sheets/detail/quality-health-services [Accessed 10 10 2023].

WHO, 2023. World Health Organization. [Online] Available at: https://www.-who.int/health-topics/quality-of-care#tab=tab_1 [Accessed 30 10 2023].

Zun AB, Ibrahim MI, Hamid AA. (2018). Level of satisfaction on service quality dimensions based on SERVQUAL model among patients attending 1 Malaysia Clinic in Kota Bharu, Malaysia. Oman Med J. 33(5): 416-422.

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Published

16-09-2024

How to Cite

Muhajir, A., Tamtomo, D. G., & Murti, B. (2024). Path Analysis of Factors Influencing the Quality of Health Services and Inpatient’s Satisfaction in Hospitals. Journal of Health Policy and Management, 9(3), 406–419. https://doi.org/10.26911/thejhpm.2024.09.03.09

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