P-ISSN: 2827-9832
E-ISSN: 2828-335x
http://ijsr.internationaljournallabs.com/index.php/ijsr
949
THE RELATIONSHIP BETWEEN SERVICE QUALITY AND PATIENT
SATISFACTION AT THE NEUROLOGY POLYCLINIC OF
MOHAMMAD NATSIR HOSPITAL
Fitri Sari Susanty, Nur Afrainin Shah, Wihardi Triman
Faculty of Medicine, Universitas Andalas
fitrisarisusanty@gmail.com, med@unand.ac.id, wihardi_t@yahoo.com
ABSTRACT
Quality health services are the needs and desires of every patient. Patient satisfaction is related to the quality
of service they receive. This study analyzed the relationship between service quality and patient satisfaction
at the neurology polyclinic of the Mohammad Natsir Solok Regional General Hospital (RSUD). Service
quality according to Zeithaml et al has five dimensions, namely: Reliability, Assurance, Tangibles (physical
evidence), Empathy (empathy), and Responsiveness knew as SERVQUAL. The purpose of this study is to
determine the relationship between each dimension of service quality and patient satisfaction and find out
the dimensions that most affect patient satisfaction. This research is a quantitative study with a cross-
sectional study approach with a total sample of 100 people. Data collection using questionnaires. Data
analysis in the form of univariate analysis, bivariate analysis using chi-square, and multivariate analysis
using multiple logistic regression. The univariate analysis found that general patient satisfaction with the
quality of service was 86% satisfied with the service. Bivariate analysis showed a significant relationship
between the dimensions of reliability (p = 0.001), assurance (p = 0.001), tangibles (p = 0.009), empathy
(p = 0.001) and responsiveness (p = 0.001) with patient satisfaction. The multivariate analysis found that the
dimension that most affected patient satisfaction at the neurology polyclinic of Mohammad Natsir Hospital
was the responsiveness dimension (OR = 73,635).
Keywords: Quality of service, patient satisfaction, SERVQUAL
This article is licensed under CC BY-SA 4.0
INTRODUCTION
According to WHO (World Health Organization), hospitals are an integral part of social
and health organizations that provide plenary (comprehensive) services, curative diseases and
disease prevention to the community. According to Permenkes No. 3 of 2020 concerning
Hospital Classification and Licensing, it is stated that hospitals are plenary individual health
service institutions that provide inpatient, outpatient, and emergency services (Permenkes,
2020). In 2021, the number of public hospitals in Indonesia is 2,514 units and special hospitals
are 598 units. A large number of hospitals available will cause competition between these
hospitals in providing the best quality of service for their consumers (RI, 2021).
Service quality is the result of interaction from various aspects, namely the service system,
human resources of service providers, strategies, and customers (customers). According to
Zeithaml et al, the quality of this service can be assessed from 5 dimensions, namely: Tangibles
(related to physical condition), Reliability (reliability), Responsiveness (responsiveness),
Assurance (certainty), and Emphaty (empathy). These dimensions became known as
SERVQUAL dimensions (Mulyawan, 2016). Good service quality has an impact on patient
satisfaction and people's intention to seek treatment. The main goal of quality hospital services
is to understand the needs and desires of patients so that patients feel satisfied (Irbantoro,
Dewanto, & Rachmi, 2015).
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of Mohammad
Natsir Hospital
950 2, 3., February 2023
Patient satisfaction is an evaluative, affective or emotional response related to the quality
of services provided by the hospital and patient expectations of the service. The most popular
method for assessing service quality is SERVQUAL (Mumu, Kandou, & Doda, 2015). A health
service is said to be of high quality if it is able to provide satisfaction for the patients it serves.
Patient satisfaction is one of the indicators of the quality of services provided by hospitals and
is capital to get more and more loyal patients.
Mohammad Natsir Regional General Hospital (RSUD) is a regional general hospital
owned by the West Sumatra Provincial Government and is one of the type B hospitals located
in the Solok City area. Mohammad Natsir Hospital in providing health services is supported
by reliable specialist doctors and supported by adequate medical facilities. Mohammad Natsir
Hospital has 14 outpatient clinics, each of which is served by doctors who are skilled in their
fields. The outpatient polyclinic of Mohammad Natsir Hospital consists of: internal medicine,
pediatric, obstetrics and gynecology, general surgery, bone surgery, neurology, eye, ENT,
heart, lung, skin and genital, mental, dental and oral and geriatric poly.
According to data from the Ministry of Health, stroke is the number one cause of death in
Indonesia. Stroke can lead to permanent disability or death. Stroke also has an impact on the
economic sector due to the high burden of financing its treatment. According to data from the
Social Security Administration Agency (BPJS), stroke is among the top four diseases that
require high costs in treatment and have complications that can be life-threatening. Therefore,
stroke sufferers should routinely control to a neurology specialist. One of the health services in
Solok City that has the services of a neurology specialist is the Neurology Polyclinic of
Mohammad Natsir Hospital.
Based on data from the Hospital Management Information System (SIMRS) of
Mohammad Natsir Hospital, the neurology polyclinic occupies the first position as the
polyclinic that has the highest number of patient visits in 2019 and 2020. The number of visits
to the neurology polyclinic in 2019 was 18,614 people and in 2020 it was 10,441 people. The
second position is occupied by the internal medicine polyclinic with number of patients in 2019
as many as 9,276 people and in 2020 as many as 8,081 people. The third position is occupied
by the mental polyclinic with visit figures in 2019 and 2020 of 7,179 people and 7,684 people,
respectively. Although the neurology polyclinic still ranks first as the polyclinic with the
highest number of patient visits in 2020, the number of visits has decreased by 43.9% compared
to 2019.
According to the report on the community satisfaction survey (SKM) of Mohammad
Natsir Hospital in the neurological polyclinic section in 2020, the elements with the lowest
value (< 80%) were obtained for the performance of the existence of cleaning services,
registration waiting times, waiting times for doctor examinations and cleanliness of service
supporting infrastructure (such as waiting rooms, toilets) (Ariany, Kusdarini, & Sitriwanti,
2020). The low value of service performance will have an impact on patient satisfaction.
Decreased service performance will reduce the quality of service quality and result in a
decrease in patient satisfaction.
Therefore, researchers want to know the relationship between service quality and patient
satisfaction at the neurology polyclinic of Mohammad Natsir Hospital. The results of the
research are expected to be used as consideration for planning in improving the service quality.
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of
Mohammad Natsir Hospital
951 2, 3., February 2023
Definition of Healthcare
Health services according to the Ministry of Health of the Republic of Indonesia in 2009
(Depkes RI) are any efforts organized alone or jointly in an organization to maintain and
improve health, prevent and cure diseases and restore health both to individuals, families and
community groups. Plenary health service activities are regulated in Article 52 paragraph (2)
of the Health Law as referred to in paragraph (1), namely:
a) Promotive, an activity and/or series of health service activities that prioritize activities
that are health promotion in nature.
b) Preventive health service, a preventive activity against a health problem/disease.
c) Curative health services, activity, and/or a series of treatment activities aimed at curing
diseases, reducing suffering due to disease, disease control, and controlling disability so
that the quality of sufferers can be maintained as optimally as possible.
d) Rehabilitative health services, activities, and/or a series of activities to return former
sufferers to the community so that they can function again as members of society that are
useful for themselves and the community, as much as possible according to their abilities
(Faith & Lena, 2017).
Forms of Health Services
Based on Article 52 paragraph (1) of the Health Law, health services generally consist
of two forms of health services, namely:
1) Individual health services (medical services)
This health service is organized by individuals independently (self-care), and family
(family care) or community member groups that aim to cure diseases. This service is
carried out in health service institutions. Such as: hospitals, maternity clinics, and
independent practices.
2) Public health service
This public health service is organized by a community group with objectives to maintain
and improve health that refers to actions promotive and preventive. Community service
efforts are carried out at the center. Certain community health centers such as puskesmas
(Faith & Lena, 2017).
Basic Requirements for Health Services
A health service is said to be good if it has the following main requirements:
1. Available and Sustainable
The first basic requirement for good health services is that health services must be
available in the community (available) and sustainable (continuous). This means that all types
of health services needed by the community are not difficult to find and exist at all times.
2. Reasonably Acceptable
The second main requirement for good health services is acceptable to the community
and appropriate. This means that the health service does not conflict with people's beliefs and
beliefs. Health services that are contrary to the customs, culture, beliefs, and beliefs of the
community and are not natural, are not good health services.
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of Mohammad
Natsir Hospital
952 2, 3., February 2023
3. Easy to Achieve
The third basic requirement for good health services is that they are easily accessible by
the community. That is, good health services have good distribution arrangements. Health
services that are concentrated in urban areas and do not exist in rural areas are not good health
services.
4. Easy to Reach
The fourth basic principle of good health services is that they are easily accessible
(affordable) by the community, especially from a cost point of view. B the cost of health
services must be in accordance with the economic capabilities of the community. Health
services that are expensive and only enjoyed by a small part of the community, are not good
health services.
5. Quality
The fifth basic requirement for good health services is quality. The Intention is one that
points to the level of perfection of health services that are organized, can satisfy the users of
services and procedures for their implementation in accordance with the code of ethics and
standards that have been set (Faith & Lena, 2017).
Quality of Health Services
Quality is a level that indicates a series of characteristics that are inherent and meet a
certain size. According to the American Society for Quality Control, quality is the totality of
the form and characteristics of a good or service that demonstrates its ability to satisfy both
obvious and hidden needs. Some quality experts define quality by a variety of interpretations.
Juran defines quality simply as "suitability for use". This definition includes the specialty of
a product that meets consumer needs and is free from deficiencies. Meanwhile, Deming argues
quality is "bringing together the needs and expectations of consumers on an ongoing basis for
the price they have paid". Deming's philosophy establishes quality as a system (Gaspersz,
2007).
Service is an activity that basically involves the fulfillment of a right inherent in everyone,
whether personal or group or organization that is carried out universally. Moenir said that:
"The right to service is universal, applicable to anyone with an interest in that right." To
achieve maximum service quality, a leader must have the ability to measure the quality of
service for district officials in providing services to the community. Measuring service quality
through five standards: tangible; reliability, responsiveness, assurance, and empathy
(Gaspersz, 2007).
Customers are people who bring what they want. Our goal is to deal with those desires
in order to benefit him and ourselves. Another view says that service is not just a service, but
emphasizes excellent service. It is stated by Barata that excellent service is a concern for
customers by providing the best service to facilitate the ease of meeting needs and realizing
customer satisfaction so that they are always loyal to the organization.
If applied to a public body, the form of excellent service provided depends on the type of
public service assigned to that public body. A public body may mention that excellent service
is a service program.
The best that can satisfy society. The best service or service, according to Triguno, is to
serve at all times quickly and satisfactorily, be polite, friendly, and helpful, and professional
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of
Mohammad Natsir Hospital
953 2, 3., February 2023
and capable. Similarly, according to Tjiptono, broadly speaking, there are four (4) main
elements contained in service excellence, namely speed, accuracy, friendliness, and comfort.
Services include services and services, services are commodities, while government
services to the community are related to a right and free from the issue of whether the rights
holder can be burdened with an obligation or not. The quality of service is not viewed from
the point of view of the organizer or service provider. It is the people who consume and feel
the services provided, so they are the ones who are supposed to assess and determine the
quality of services (Gaspersz, 2007).
According to the Institute of Medicine (IOM), the quality of health services is a step
towards improving individual and population health services in accordance with the expected
health outcomes for the latest professional knowledge. The delivery of health services must
reflect the precision of the use of the latest knowledge scientifically, clinically, technically,
interpersonally, manually, cognitively, organizationally, and elements of health service
management (Wijono, 1999).
Dimensions of Service Quality
According to Barata, to measure the quality of service or excellent service, namely: (1)
Ability; (2) Attitude; (3) Appearance; (4) Attention; (5) Action; and (6) Accountability.
Several dimensions or attributes that must be considered in the quality of services are also
stated by Gaspersz as follows: (1) Timeliness of service; (2) Service accuracy; (3) Courtesy
and friendliness in providing services; (4) Responsibility; (5) Completeness; (6) Ease of
service; (7) Variations in service models; (8) Personal service; (9) Convenience in obtaining
services; (10) Other service support attributes (Gaspersz, 2007).
In the field of the service industry, service quality is also known. There are five categories
of service quality referred to as "servqual". The well-known dimensions for measuring
service quality are the concepts of Zaithaml, Parasuraman, and Berry, namely: Reliability
(reliability), Assurance (assurance), Tangible (physical evidence), Empathy (empathy), and
responsiveness (ladder power). To make it easier to remember the five key elements in service
quality, an acronym is used: "RATER".
1. Reliability
Reliability is the ability of the service provider to deliver what is promised to the recipient
of the service (customer) accurately. This attribute relates to the accuracy of error-free service
(Gaspersz, 2007). The dimension of reliability is important because consumer satisfaction will
decrease if the services provided are not as promised. Dimensi reliability is the company's
ability to deliver services appropriately and charge costs appropriately (Lubis & Andayani,
2017).
Reliability can be measured by the following indicators: (Ramadan, Rahmiati, &
Maulana, 2019)
1) Reliability of officers in providing service information
2) Reliability of officers in streamlining service procedures
3) Reliability of officers in facilitating technical service
2. Assurance = guarantee
Assurance relates to the knowledge, courtesy, and ability of the worker (service provider)
to generate a sense of trust and confidence from the recipient of the service (customer) for the
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of Mohammad
Natsir Hospital
954 2, 3., February 2023
services they have received (Gaspersz, 2007). This dimension is very important because it
involves consumer perception of the risk of high uncertainty in the capabilities of service
providers. The company builds consumer trust and loyalty through employees who are
directly involved in dealing with consumers. So the components of this dimension consist of
employee competencies which include skills, knowledge that employees have to perform
services and company credibility related to consumer trust in the company such as, company
reputation, achievements and others (Lubis & Andayani, 2017).
Assurance indicators as below: (Ramadan, Rahmiati, & Maulana, 2019)
1) Administrative capabilities of officers
2) Technical ability of service personnel
3) The social delights of the waitresses
3. Tangibles = physical evidence
Physical evidence relates to the physical facilities, equipment, and appearance of the
service giver (Gaspersz, 2007). The appearance and ability of the company's physical
facilities and infrastructure and the surrounding environment are tangible evidence of the
services provided by the service provider which includes physical facilities for equipment,
employees, and communication facilities. Good tangible affect customer perception (Lubis
& Andayani, 2017).
Measurable Tangible Indicators: (Ramadan, Rahmiati, & Maulana, 2019)
1) Ministry room
2) Service counter
3) Appearance of service personnel
4. Empathy = empathy
Empathy is closely related to the attention and concern from the service provider to the
recipient of the service (customer) (Gaspersz, 2007). So the components of this dimension
are a combination of access (access), namely the ease of utilizing the services offered by the
company (Lubis & Andayani, 2017).
Empathy can be measured by the following indicators: (Ramadan, Rahmiati, & Maulana,
2019)
1) Attention of service personnel
2) Officer concerns
3) Officer's friendliness
5. Responsiveness = ladder power
Responsiveness is related to the responsibility and desire to provide excellent service and
help service recipients (customers) in dealing with problems related to the services provided
by the service provider (Gaspersz, 2007). Responsiveness can foster a positive perception of
the quality of services provided. This includes if there is a failure or delays in the delivery of
services, the service provider tries to correct or minimize consumer losses immediately. This
dimension emphasizes the attention and speed with which employees respond to requests,
questions and complaints from consumers. This dimension consists of the employee's agility
in serving customers, the speed of employees in serving customers and handling customer
complaints (Lubis & Andayani, 2017).
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of
Mohammad Natsir Hospital
955 2, 3., February 2023
Responsiveness can be measured by the following indicators: (Ramadan, Rahmiati, &
Maulana, 2019)
1) Officer's response to customer complaints
2) Officer's response to customer suggestions
3) Officers' response to customer criticism
Patient Satisfaction
A health service is said to be of high quality if it is able to cause satisfaction for the
patients it serves. Satisfaction is one of the indicators of the quality of hospital services which
is the capital in getting more patients and loyal. Loyal patients will reuse the same health care
when they need it and will invite others to use the same facility (Sesrianty, Machmud, & Yeni,
2019).
Patient satisfaction occurs when what is his need, desire or expectation can be met.
Therefore, patient satisfaction is the difference between the services received by the patient
and the patient's expectations (Sesrianty, Machmud, & Yeni, 2019).
According to Sabarguna, patient satisfaction is a subjective value to the quality of services
provided but still has an objective basis. That is, although the assessment is based on past
experiences, education, psychic situations, and environmental influences at the time, it is still
based on existing objective truths and realities (Ramadan, Rahmiati, & Maulana, 2019).
Patient Satisfaction Measurement Methods
According to Kotler, et al in Tjiptono and Gregorius there are several methods that can
be used to measure and monitor customer satisfaction, namely: (Tjiptono & Gregory, 2016)
1. Complaints and Advice System
Every customer-oriented institution needs to provide easy and convenient opportunities
and access for its customers to submit their suggestions, criticisms, opinions and complaints.
The media used can be in the form of suggestion boxes placed in strategic locations, comment
cards sent via post, toll-free telephone lines, websites and others.
2. Ghost Shopping (Mystery Shopping)
Companies use others as ghost shoppers, to play or pretend to act as potential customers
and then report their findings about the strengths and weaknesses they experience while
buying the company's products and competitors' products.
3. Lost Customer Analysis
Customers who stop buying or who have moved suppliers wherever possible are
contacted by the company to learn and understand why it is happening and to be able to take
policies for further improvements/improvements. Companies must also pay attention to and
monitor the customer loss rate where the increase indicates the company's failure to satisfy its
customers.
4. Customer Satisfaction Surveys
Most customer satisfaction research is carried out by survey methods either by post,
telephone, e-mail, websites, or direct interviews. The company provides a list of questions
whose content is an assessment of various aspects of the company's performance and the
products produced. Through surveys, the company will get feedback directly from customers
and also give a positive impression that the company pays attention to its customers.
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of Mohammad
Natsir Hospital
956 2, 3., February 2023
Patient satisfaction Indicators
Satisfaction indicators according to Tjiptono consist of: (Ramadan, Rahmiati, & Maulana,
2019)
a. Conformity of expectations
Is the level of conformity between the product performance expected by the customer and
the perceived by the customer including:
1) The products obtained are in accordance with or exceed the expected.
2) Service by employees obtained in accordance with or exceeding as expected.
3) Supporting facilities obtained in accordance with or exceeding the expected
b. Revisiting interest
Represents the customer's willingness to revisit or repurchase related products, including:
1) Interested in revisiting because the service provided by employees is satisfactory
2) Interested in revisiting because of the value and benefits obtained after consuming the
product
3) Interested in visiting again because the supporting facilities provided are adequate
c. Willingness to recommend
It is the customer's willingness to recommend products he has tasted to friends or family,
including:
1) Advise friends or relatives to buy products or services offered because of satisfactory
service
2) Advise friends or relatives to buy the products offered because the supporting facilities
provided are adequate
3) Advise friends or relatives to buy the products or services offered because of the value
or benefits obtained after consuming a service product.
Benefits of Measuring Patient Satisfaction
The benefits of measuring patient satisfaction according to Dr. Sri Astuti Soeparmanto,
namely:
a) knowing the shortcomings of each level of weakness in service delivery
b) knowing the performance of service delivery that has been carried out by the service unit
c) as material for determining policies that need to be taken and efforts that need to be made
d) knowing the public satisfaction index in public services within the scope of central and
regional governments
e) spurring positive competition between service delivery units in an effort to improve
service performance
f) For the public, they can find out an overview of the service performance of the unit
concerned.
According to Permenkes No.129 of 2008 concerning Hospital Minimum Service
Standards, the customer satisfaction value in outpatient services is ≥ 90%.
METHOD
This research is a quantitative study with a cross-sectional study approach, the total
sample is 100 respondents. The sampling technique using consecutive sampling is a sampling
determination technique where all subjects who come and meet the selection criteria are
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of
Mohammad Natsir Hospital
957 2, 3., February 2023
included in the study until the required number of subjects is met.
8
This research was
conducted at the Neurology Polyclinic of Mohammad Natsir Hospital in March – April 2022.
The data analysis technique used is an inferential statistical technique. In the univariate
analysis, an overview of the quality of service with patient satisfaction at the neurology
polyclinic of Mohammad Natsir Hospital was obtained. Bivariate analysis was carried out
using the chi square method and obtained a relationship between service quality and patient
satisfaction at the neurology polyclinic of Mohammad Natsir Hospital. Multivariate analysis
was carried out using multiple logistic regression methods and obtained the dimensions of
service quality that most affected patient satisfaction at the neurology polyclinic of Mohammad
Natsir Hospital.
RESULTS AND DISCUSSION
Univariate Analysis of Respondent Characteristics Overview
The description of the characteristics of respondents in this study was divided according
to gender, age, occupation, education, type of payment, and number of visits. Based on the
processing results of the respondents' questionnaire answers, the results are obtained as shown
in the following table:
Table 1. Frequency Distribution Based on Respondent Characteristics
No.
Characteristics of
Respondents
f
%
Gender
1.
Man
41
59
41
59
2.
Woman
Age (Years)
1.
≤ 53
52
52
2.
> 53
48
48
Work
1.
Work
41
41
2.
Not Working
59
59
Education
1.
Finished Elementary School
21
21
2.
Finished junior high school
14
14
3.
Finished High School
30
30
4.
Graduated from Higher
Education (PT)
35
35
Payment Type
1.
BPJS
95
95
2.
Common
5
5
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of Mohammad
Natsir Hospital
958 2, 3., February 2023
Number of Visits
1.
≤ 5 times
59
59
2.
> 5 times
41
41
Based on the table above, it is known that amount female respondents were 59% and men
41%. Based on age, the median value was 53 years old. Therefore, respondents were grouped
into 2 age groups, namely the age of less or equal to 53 with a total of 52% and the age of more
than 53 years with a total of 48%. According to the job distribution, 59% of respondents are
not working and 41% of respondents are working. Based on the distribution of education levels,
the most respondents were 35% of college graduates, 30% of high school graduates, 21% of
elementary school graduates and 14% of 14% of junior high school graduates. Based on the
type of payment, 95% of respondents use health insurance (BPJS). Based on the distribution
of the number of visits, the median value is obtained 5 times. So based on the number of visits
respondents are divided into 2 groups, namely respondents with a frequency of visits 1-5 times
by 59% and respondents with a frequency of visits more than 5 times by 41%.
Univariate Analysis of Patient Satisfaction Overview
Analysis of the general picture of patient satisfaction at the neurology polyclinic of
Mohammad Natsir Hospital as follows:
Table 2. Patient Satisfaction Overview
Patient Satisfaction
f
%
Unsatisfied
14
14
Satisfied
86
86
Total
100
100
Based on the table above, it is known that the percentage of patient satisfaction in general
with the quality of service at the Neurology Polyclinic of Mohammad Natsir Hospital is 86%.
Bivariate Analysis of the Relationship of Service Quality to Patient Satisfaction
Analysis of the Relationship of Reliability Dimensions to Patient Satisfaction
Table 3. Percentage of Patient Satisfaction with Reliability Dimensions
No.
Question
%
Classification
1.
Outpatient waiting time ≤ 60 minutes (from
registered patient to doctor-serviced)
61
Unsatisfied
2.
The nurse provides information about the
examination to be performed to the patient
97
Satisfied
3.
4.
Nurses skilled in performing services
The doctor performs the examination well to the
patient
98
97
Satisfied
Satisfied
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of
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959 2, 3., February 2023
5.
The doctor provides information regarding the
patient's illness
94
Satisfied
From all the items of questions regarding the reliability dimension, it was found that
outpatient wait time satisfaction was only 61%. This indicates that the patient is not satisfied
with this dimension. The outpatient waiting time at the Neurology Polyclinic of Mohammad
Natsir Hospital exceeds the standard set by the National System of Hospital Accreditation
(SNARS) of 60 minutes. The length of the outpatient waiting time is due to the length of time
the patient's status comes to the polyclinic and the length of time the specialist doctor comes to
the polyclinic. The causes of the length of time the patient's status comes to the polyclinic
include: the slow work of medical record officers in seeking status, the status of patients who
are scattered because they are still in the treatment room, and the status of missing patients.
Meanwhile, the cause of the length of time the specialist doctor comes to the polyclinic is
caused by the delay in the doctor coming to the hospital, and the obligation of the specialist
doctor to conduct an examination of the inpatient (visite).
Table 4. The Relationship of Reliability Dimensions to Patient Satisfaction
Category Reliability
Patient Satisfaction
Total
p-value
Unsatisfied
Satisfied
f
%
f
%
f
%
Not Reliable
49
98
1
2
50
100
0,001
Reliable
8
16
42
84
50
100
Total
57
57
43
43
100
100
From the table above, it is known that 42 (84%) respondents were satisfied with the service
because it was reliable and 1 (2%) respondents who were satisfied with the service rated the
service as unreliable. Statistically, it was found that there was a relationship between the
reliability dimension and patient satisfaction with a p-value of 0.001.
The results of this study are the same as the research of Ayu Aulia Septiani (2015), it was
found that there was a relationship between the dimensions of reliability of outpatient health
services and patient satisfaction at the Poncol Semarang Health Center with a p-value of 0.017.
The results of this study are also the same as the research of Maya Dewi Hanggraningrum
(2017), there is a positive and significant relationship between the reliability variable and
outpatient satisfaction at Dr. Soegiri Lamongan Hospital with a result of 5,888 and a p-value
of 0.001. The results of this study are in line with the research of Ronal Riandi (2018), it was
found that there is a relationship between the dimensions of reliability and outpatient
satisfaction at the Wonorejo Samarinda Health Center with a p value of 0.015. The results of
the study by Rita Juniarni Gultom et al (2021) also concluded that there is a significant
relationship between the reliability dimension and outpatient satisfaction at Bhayangkara
Hospital TK III Tebing Tinggi with a p-value of 0.001. However, the results of this study are
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of Mohammad
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different from the research of Djeinne Thresye Pangerapan et al (2018), namely there is no
relationship between reliability and patient satisfaction at the Internal Medicine Polyclinic of
GMIM Pancaran Kasih Manado Hospital.
Analysis of the Relationship of Assurance Dimensions to Patient Satisfaction
Table 5. Percentage of Patient Satisfaction with Assurance Dimensions
No.
Question
%
Classification
1.
The ability of patient reception counter nurses in
serving patient queues is good
93
Satisfied
2.
Nurses and doctors give patients the opportunity to ask
questions
97
Satisfied
3.
The creation of a safe and peaceful atmosphere in the
hospital environment
96
Satisfied
4.
Creation of a family atmosphere between patients,
nurses and doctors
95
Satisfied
5.
Doctors are able to give the patient a sense of
confidence to recover
97
Satisfied
All items of inquiry regarding the assurance dimension were found that the value was more
than 90% which indicates that the patient is satisfied with this dimension. The highest value is
seen in the question item, namely doctors and nurses give the patient the opportunity to ask
questions and the doctor is able to give the patient confidence to recover.
Table 6. The Relationship of Assurance Dimensions to Patient Satisfaction
Category
Assurance
Patient Satisfaction
Total
p-value
Unsatisfied
Satisfied
f
%
f
%
f
%
No Assurance
7
50
7
50
14
100
0,001
Assurance
6
7
80
93
86
100
Total
13
13
87
87
100
100
From the table, it is known that 80 respondents (93%) were satisfied because of assurance
services and 7 respondents (50%) who were satisfied rated the service as not assurance.
Statistically, it was found that there was a relationship between the assurance dimension and
patient satisfaction with a p-value of 0.001.
The results of this study are in line with the research of Maya Dewi Hanggraningrum et al
(2017), there is a positive and significant relationship between the assurance variable and
outpatient satisfaction at Dr. Soegiri Lamongan Hospital with a t count result of 3,806 and a p-
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of
Mohammad Natsir Hospital
961 2, 3., February 2023
value of 0.001. The results of this study are also the same as Ronal Riandi's research (2018),
which found a relationship between patient satisfaction and quality assurance services with a
p-value of 0.017. The results of the study of Rita Juniarni Gultom et al (2021) also found that
there is a relationship between the dimensions of assurance and patient satisfaction with a p-
value of 0.019. However, the results of this study are different from the research of Djeinne
Thresye Pangerapan et al (2018), namely, there is no relationship between guarantees and
patient satisfaction at the Internal Medicine Polyclinic of GMIM Pancaran Kasih Manado
Hospital.
Analysis of the Relationship of Tangibles Dimensions to Patient Satisfaction
Table 7. Percentage of Patient Satisfaction with Tangibles Dimension
No
Question
%
Classification
1.
Poly neurology patient reception counter in a
clean and comfortable state
93
Satisfied
2.
Clean neurological poly waiting room
96
Satisfied
3.
Seating in the poly neurology waiting room is
sufficient
78
Unsatisfied
4.
Poly neurology examination room is clean and
comfortable
96
Satisfied
5.
Nurses dressed neatly and cleanly
91
Satisfied
6.
Specialist doctor dressed neatly and cleanly
90
Satisfied
Of all the question items regarding the dimensions of tangibles, there is a low-value
question item, namely the question about the number of seats in the waiting room of the
neurological polyclinic. Patient satisfaction for this item is only 78%, meaning that patients
feel that the number of seats in the neurology polyclinic is still lacking. This happens because
of the accumulation of patients due to long queues.
Table 8. The Relationship of Tangibles Dimensions to Patient Satisfaction
Tangible
Categories
Patient Satisfaction
Total
p-value
Unsatisfied
Satisfied
f
%
f
%
f
%
Not Tangible
6
100
0
0
6
100
0,009
Tangible
41
43,6
53
56,4
94
100
Total
47
47
53
53
100
100
From this, it was found that 41 respondents (43.6%) rated dissatisfied with tangible
services and services. Meanwhile, 6 respondents (100%) rated the service as dissatisfied and
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of Mohammad
Natsir Hospital
962 2, 3., February 2023
unsustainable. Statistically, it was found that there was a relationship between the tangible
dimension and patient satisfaction with a p value of 0.009.
This is in line with the results of Ayu Aulia Septiani's research (2015), it was found that
there is a relationship between the tangible dimensions of outpatient health services and patient
satisfaction at the Poncol Semarang Health Center with a p-value of 0.043. The results of this
study are the same as the research of Maya Dewi Hanggraningrum et al (2017), there is a
positive and significant relationship between the assurance variable and outpatient satisfaction
at Dr. Soegiri Lamongan Hospital with a calculated result of 2,257 and a p-value of 0.025. The
results of this study are also in line with the research of Novagita Tangdilambi (2019), there is
a relationship between physical evidence to outpatient satisfaction with a p-value of 0.001. The
results of the study of Rita Juniarni Gultom (2021), also found that there was a significant
relationship between the physical evidence dimension with patient satisfaction with a p-value
of 0.004.
Analysis of the Relationship of Empathy Dimensions to Patient Satisfaction
Table 9. Percentage of Patient Satisfaction with Empathy Dimension
No.
Question
%
Classification
1.
Health workers are always friendly and polite in
serving patients
97
Satisfied
2.
Health workers pay attention to patients
95
Satisfied
3.
Health workers care for patients
95
Satisfied
From all question items regarding the empathy dimension, it was found that the patient
satisfaction score was more than 90% with the highest score lying in the question, namely the
officer was friendly and polite to the patient.
Table 10. The Relationship of the Empathy Dimension to Patient Satisfaction
Categories
Empathy
Patient Satisfaction
Total
p-value
Unsatisfied
Satisfied
f
%
f
%
f
%
No Empathy
12
100
0
0
12
100
Empathy
1
1,1
87
98,9
88
100
0,001
Total
13
13
87
87
100
100
From the table above, it is known that 87 respondents (98.9%) were satisfied because the
service was empathy and none of the respondents were satisfied to rate the service as not
empathy. Statistically, there is a relationship between the empathy dimension and patient
satisfaction with a p-value of 0.001.
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of
Mohammad Natsir Hospital
963 2, 3., February 2023
The results of this study are in line with the research of Maya Dewi Hanggraningrum
(2017), there is a positive and significant relationship between the empathy variable and
outpatient satisfaction at Dr. Soegiri Lamongan Hospital with F count results of 123,480 and
p value of 0.001. The results of Ronal Riandi's research (2018) found a relationship between
patient satisfaction and empathy service quality with a p-value of 0.014. The results of the
study by Rita Juniarni Gultom (2021), also found that there is a relationship between the
dimension of empathy and patient satisfaction with a p-value of 0.036. However, neovagina
Tangdilambi's research (2019) found that there was no relationship between friendly attitudes
toward outpatient satisfaction with a p-value of 0.353.
Analysis of the Relationship of Responsiveness Dimensions to Patient Satisfaction
Table 11. Percentage of Patient Satisfaction with The Responsiveness Dimension
No.
Question
%
Classification
1.
Poly neurology patient reception counters serve
quickly
96
Satisfied
2.
Poly neurology nurses skilled at work
99
Satisfied
3.
The doctor's skills in examining patients are good
96
Satisfied
From all the question items regarding the responsiveness dimension, it was found that the
average patient satisfaction value was 97% which indicates that the patient is satisfied with
this dimension. The highest score (99%) was found in the question item: poly neuro nurses
skilled at work.
Table 12. The Relationship of Responsiveness Dimensions to Patient Satisfaction
Responsiveness
Categories
Patient Satisfaction
Total
p-value
Unsatisfied
Satisfied
f
%
f
%
f
%
Not Responsive
9
100
0
0
9
100
0,001
Responsive
0
0
91
100
91
100
Total
9
9
91
91
100
100
From the table above, it is known that 91 respondents (100%) were satisfied because the
service was responsive, and none of the respondents who were satisfied rated the service as
not responsive.
Statistically, it was found that there was a relationship between the responsiveness
dimension and patient satisfaction with a p-value of 0.001.
The results of this study are in line with the research of Ayu Aulia Septiani (2015), it was
found that there is a relationship between the dimension of responsiveness of outpatient health
services and patient satisfaction at the Poncol Semarang Health Center with a p-value of 0.024.
The results of the research by Djeinne Thresye Pangerapan (2018) showed that there was a
relationship between responsiveness and patient satisfaction at the Internal Medicine
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of Mohammad
Natsir Hospital
964 2, 3., February 2023
Polyclinic of GMIM Pancaran Kasih Manado Hospital with a p-value of 0.047. In the
Novagita Tangdilambi study (2019), it was also found that there was a relationship between
responsiveness to outpatient satisfaction with a p-value of 0.00. In Hasbina Wildani's research
(2020), there is a relationship between responsiveness and outpatient satisfaction with a p-
value of 0.001.
Multivariate Analysis of the Relationship of Service Quality Dimensions to Patient
Satisfaction
Table 13. Relationship of Dimensions of Reliability, Assurance, Tangible, Empathy,
and Responsiveness with Patient Satisfaction
Dimension
BE
Wald
Sig.
Exp (B)
Reliability
4,056
5,045
0,025
57,714
Assurance
3,381
5,386
0,020
29,413
Tangibles
3,680
0,617
0,423
39,631
Empathy
3,231
4,009
0,045
25,294
Responsiveness
4,299
8,922
0,003
73,635
Constant
-23,634
12,973
0,001
0,001
Based on multiple logistic l regression tests conducted on the five dimensions of service
quality and their relationship with patient satisfaction found that all dimensions had a p-value
of < 0.05. That is, statistically, the five dimensions have a significant influence on patient
satisfaction. Table 13 shows that the dimension of service quality most dominantly affects
patient satisfaction is the responsiveness dimension (p-value = 0.003). Statistically, the
responsiveness dimension has the greatest relationship with patient satisfaction. The
responsiveness dimension has an Exp (B) or odds ratio of 73,635 meaning that the
responsiveness dimension will increase patient satisfaction by 73,635 times. Patients highly
value the speed and skill of officers in providing services so as to avoid mistakes in the
services they receive.
CONCLUSION
Based on the results of research and discussion on the relationship between the dimensions
of service quality and patient satisfaction at the Neurology Polyclinic of Mohammad Natsir
Hospital, conclusions can be drawn, namely: there is a relationship between the dimensions
of reliability (reliability) and patient satisfaction, there is a relationship between the
dimensions of assurance (guarantee) and patient satisfaction, there is a relationship between
the dimensions of tangibles (physical evidence) and patient satisfaction, there is a relationship
between dimensions empathy (empathy) with patient satisfaction, there is a relationship
between the dimension of responsiveness and patient satisfaction, and the dimension that most
affects patient satisfaction at the Neurology Polyclinic of Mohammad Natsir Hospital is the
dimension of responsiveness.
The Relationship Between Service Quality and Patient Satisfaction at the Neurology Polyclinic of
Mohammad Natsir Hospital
965 2, 3., February 2023
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