Volume 7.
Number 1, 2026 https://ijble.
com/index.
php/journal/index Analysis of Patient Service Quality with IOM Indicators in the Dental Polyclinic of Bhayangkara Hospital.
Polri Education and Training College Vivi Astriany.
H1.
Dr.
Alih Germas Kodyat.
SKM.
MARS.
Ahdun Trigono.
SKM.
Kes.
Ph.
3, dr.
Andy Chandra.
1Mahasiswa Magister Administrasi Rumah Sakit.
Fakultas Pascasarjana.
Universitas Respati Indonesia 2,34Dosen Magister Administrasi Rumah Sakit.
Fakultas Pascasarjana.
Universitas Respati ABSTRACT High-quality healthcare services are essential to ensure patient satisfaction and sustainable hospital performance.
This study aims to analyze patient service quality at the Dental Clinic of Bhayangkara Lemdiklat Police Hospital using the Institute of Medicine (IOM) framework, which includes six dimensions: safety, effectiveness, patientcenteredness, timeliness, efficiency, and equity.
A quantitative descriptive design with a survey approach was employed.
A total of 94 patients were selected through purposive sampling.
Data were collected using a structured questionnaire measuring patientsAo expectations and perceived The instrument was tested for validity and reliability, and the data were analyzed using descriptive statistics, paired sample t-tests, regression analysis, and ImportanceAePerformance Analysis (IPA).
The results indicate that overall service quality is perceived as good, particularly in effectiveness, safety, and patient-centered care, which obtained the highest mean scores.
However, gaps remain in equity, timeliness, and efficiency.
Equity showed the lowest mean value and the highest variability, suggesting that patients still perceive unequal treatment and service procedures.
Paired sample correlations revealed strong and significant relationships among the IOM dimensions, implying that improvements in one aspect may positively influence others.
Regression and ANOVA results indicate that service quality does not significantly differentiate patient types .
eneral and BPJS).
The IPA analysis places effectiveness, safety, and patient-centeredness in the Aumaintain performanceAy quadrant, while timeliness, efficiency, and equity require strategic improvement.
These findings highlight the importance of continuous quality enhancement, particularly in ensuring fair, timely, and efficient dental services Keywords: Service IOM indicators.
Dental clinic.
DOI.
https://doi.
org/10.
56442/ijble.
INTRODUCTION
High-quality health care is a prerequisite for improved population health and for sustaining public confidence in health systems.
hospitals as referral institutions are therefore expected to provide care that is safe, effective, timely, efficient, patient-centered, and equitable (Institute of Medicine, 2001.
Donabedian, 1988.
Kruk et al.
, 2.
Quality of care extends beyond technical or clinical outcomes to encompass the degree to which services meet patientsAo needs, expectations, and experiences across the care continuum, and these patient-facing dimensions increasingly inform performance measurement and improvement initiatives (Donabedian, 1988.
Institute of Medicine, 2001.
Kruk et al.
, 2.
Growing public awareness of health rights and patient-centered models has heightened demand for systematic performance evaluation and continuous quality improvement within hospital services (Kruk et al.
, 2018.
Institute of Medicine, 2001.
Donabedian, 1.
Volume 7.
Number 1, 2026 https://ijble.
com/index.
php/journal/index The Institute MedicineAos aimsAisafety, patient-centeredness, timeliness, efficiency, and equityAiprovide a widely used conceptual framework for assessing health-care quality and for prioritizing improvement actions (Institute of Medicine, 2.
These domains together emphasize minimizing harm, applying evidence-based practice, respecting patient preferences, reducing waiting times, optimizing resource use, and assuring fair access irrespective of socioeconomic status (Institute of Medicine, 2001.
World Health Organization, 2018.
Kruk et al.
, 2.
In the Indonesian context, the rollout of the National Health Insurance scheme (Jaminan Kesehatan Nasional.
JKN) has substantially broadened financial access to hospital and outpatient services.
however, expanded coverage frequently generates operational challengesAisuch as increased patient volumes and constrained resourcesAithat can widen gaps between patient expectations and perceived service performance (World Health Organization.
Kruk et al.
, 2018.
Institute of Medicine, 2.
The Dental Clinic of Bhayangkara Lemdiklat Police Hospital provides oral health services to both general and insured populations and thus plays a key role in local primary and referral dental care (Glick et al.
, 2.
Oral health services typically require technical precision, timely delivery, and clear clinicianAepatient non-technical service elements strongly influence patient satisfaction, adherence, and perceived quality (Epstein & Street, 2011.
Glick et al.
Parasuraman.
Zeithaml, & Berry, 1.
Given the heterogeneity of patient needs and potentially high demand for care, systematic evaluation of service quality using the IOM domains can identify strengths and shortcomings and guide managerial decisions for quality improvement.
Accordingly, this study aims to analyse patient-perceived service quality at the Dental Clinic of Bhayangkara Lemdiklat Police Hospital using the six IOM quality indicators to inform continuous quality METHODS Study design, setting, and sampling: This investigation employed a quantitative descriptive .
ross-sectional surve.
design to assess patient perceptions of service quality at the Dental Clinic of Bhayangkara Lemdiklat Police Hospital.
Data were collected from June to August 2025.
The sampling frame comprised all patients who received dental services during the study period.
a purposive sample of 94 respondents was selected to satisfy the inclusion criteria .
ged Ou17 years, having received dental care at the clinic during the study window, and providing voluntary The cross-sectional survey approach and purposive sampling strategy are standard for facility-based assessments that target service usersAo experiences when the population of interest is well defined (Creswell, 2014.
Etikan.
Musa, & Alkassim.
Sedgwick, 2.
Data collection, instrument, and analysis: Data were collected using a structured questionnaire explicitly mapped to the six IOM quality domains .
afety, effectiveness, patient-centeredness, timeliness, efficiency, equit.
Respondents rated both expectations and perceived performance for each item on a five-point Likert scale.
Instrument validity was evaluated using PearsonAos product-moment correlation, and internal consistency reliability was assessed with CronbachAos alpha ().
alpha was used as the primary indicator of internal reliability (Cronbach, 1.
Data analysis comprised descriptive statistics to summarise respondent characteristics and domain scores, paired-sample t-tests to examine expectationAe Volume 7.
Number 1, 2026 https://ijble.
com/index.
php/journal/index performance gaps, and ImportanceAePerformance Analysis (IPA) to prioritise areas for managerial improvement (Martilla & James, 1.
The study protocol received approval from the institutional Health Research Ethics Committee, and written informed consent was obtained from all participants in accordance with the Declaration of Helsinki (World Medical Association, 2.
Creswell.
Research design: Qualitative, quantitative, and mixed methods approach .
th ed.
SAGE.
RESULTS AND DISCUSSION
Respondent Characteristics Tabel 1.
Distribution of Respondents by Gender Gender Frequency Percentage (%) Male Female Total 94 Table 1 shows that of the 94 respondents at the Dental Clinic of Bhayangkara Lemdiklat Police Hospital, 60 .
8%) were female, while 34 .
2%) were male.
This finding indicates that female patients utilize dental services more frequently than male This pattern is consistent with previous studies reporting that women tend to be more concerned about oral health and more proactive in seeking healthcare services than men.
Tabel 2.
Distribution of Respondents by Patient Type Patient Type Frequency Percentage (%) General BPJS Total Table 2 shows a balanced distribution between general patients and BPJS patients, with 47 respondents in each group .
%).
This balance provides an advantage for analysis, as it allows a more objective comparison between the two groups when evaluating service quality.
General patients often have higher expectations because they pay out of pocket, whereas BPJS patients are often associated with longer administrative processes.
Therefore, equal representation strengthens the validity of comparative interpretations.
Instrument Testing Tabel 3.
Validity Test Results Dimension r Count r Table Sig.
Remark Safety 000 Valid Effectiveness 003 Valid Patient-centered 0.
000 Valid Timeliness 000 Valid Efficiency 000 Valid Equity 000 Valid Table 3 shows that all questionnaire items meet the validity criteria with r-count values exceeding the r-table value .
and significance values below 0.
Therefore, all measurement items are declared valid for assessing service quality using the IOM indicators.
Volume 7.
Number 1, 2026 https://ijble.
com/index.
php/journal/index Tabel 4.
Multicollinearity Test Results Dimension Tolerance VIF Interpretation Safety 382 No multicollinearity Effectiveness 202 No multicollinearity Patient-centered 0.
496 No multicollinearity Timeliness 630 No multicollinearity Efficiency 472 No multicollinearity Equity 382 No multicollinearity The tolerance values (>0.
and VIF values (<.
indicate that there is no serious multicollinearity among the independent variables, indicating that each IOM dimension contributes independently to the analysis.
Tabel 5.
Reliability Test CronbachAos Alpha Number of Items A CronbachAos Alpha value of 0.
963 indicates excellent internal consistency, confirming that the instrument is highly reliable for measuring patient service quality.
Univariat Analysis Tabel 6.
Descriptive Statistics of IOM Dimensions Dimension Mean Std.
Deviation Safety Effectiveness Patient-centered 23.
Timeliness Efficiency Equity Table 6 shows that the highest mean score is found in effectiveness .
ean = .
, indicating that patients perceive clinical services as appropriate and beneficial.
The lowest mean score is equity .
ean = 20.
, with the highest variability, suggesting that patients still perceive unequal treatment in service delivery.
Overall, patients report relatively good satisfaction in safety, effectiveness, and patientcentered care.
Bivariate Analysis Tabel 7.
Paired Sample t-Test Results Variable Pair Sig.
-taile.
Interpretation Safety Ae Patient-centered 1.
No difference Effectiveness Ae Efficiency 0.
Significant difference Timeliness Ae Equity No difference The results show significant gaps between effectiveness and efficiency .
< .
, indicating that although services are effective, they are not always delivered Other dimensions show no statistically significant differences.
Tabel 8.
Paired Sample Correlations Pair N Correlation Sig.
Safety Ae Patient-centered 94 0.
Effectiveness Ae Efficiency 94 0.
Timeliness Ae Equity All correlations are strong and significant, implying that improvements in one dimension tend to enhance perceptions of other related dimensions.
Volume 7.
Number 1, 2026 https://ijble.
com/index.
php/journal/index Regression and ANOVA Results Tabel 9.
Model Summary R Square Adjusted RA Only 4% of the variance in patient type is explained by service quality indicators, indicating a very weak relationship.
Tabel 10.
ANOVA Test Source Sum of Squares df Mean Square F Sig.
Regression 0.
Residual 22.
Total The ANOVA results show that F = 0.
612 with p = 0.
720 (>0.
, meaning the regression model is not statistically significant.
Service quality does not differ significantly between patient types .
eneral vs.
BPJS).
Importance Performance Analysis (IPA) The Cartesian diagram divides indicators into four quadrants.
The interpretation Quadrant II (Maintain Performanc.
: Effectiveness.
Safety.
Patient-centered.
Quadrant i (Low Priorit.
: Timeliness.
Efficiency.
Equity.
Quadrant I and IV: No indicators classified.
Although equity appears in Quadrant i, it shows the lowest mean score and highest variance, making it the most critical dimension requiring improvement.
Discussion The results indicate that overall service quality at the Dental Clinic of Bhayangkara Lemdiklat Police Hospital is perceived as good, particularly in effectiveness, safety, and patient-centered care (Batbaatar et al.
, 2016.
(Zarei et al.
Patients feel that treatments are appropriate, safe, and delivered with sufficient attention and communication (Batbaatar et al.
, 2016.
(Zarei et al.
, 2.
These findings underscore the importance of clinical competence and interpersonal interaction in dental services (Zarei et al.
, 2.
However, gaps remain in equity, efficiency, and timeliness (Rezaei et al.
, 2018.
Kashkoli et al.
, 2.
Patients perceive differences in service processes and waiting times, especially related to administrative procedures and treatment duration (Rezaei et al.
, 2018.
Kashkoli et al.
, 2.
Interestingly.
BPJS patients reported slightly more positive perceptions, suggesting that general patients may hold higher expectations due to direct payment mechanisms (Rezaei et al.
, 2018.
Kashkoli et al.
, 2.
The strong correlations among IOM dimensions imply that service quality is holistic: improving efficiency may also improve perceived effectiveness and fairness (Dey et al.
, 2.
Therefore, managerial strategies should focus on optimizing workflows, improving queue systems, and strengthening communication to reduce perceived delays and inequality (Dey et al.
, 2.
Implications The findings support the theoretical model of expectationAeperception gaps in healthcare quality (Chakravarty, 2.
Practically, hospital management should prioritize equity improvement through standardized service protocols for all patients, better scheduling systems, patient education regarding treatment duration, and staff training in patient-centered communication (Chakravarty, 2.
Continuous monitoring and evaluation are essential to ensure sustained quality improvement and enhanced patient satisfaction (Chakravarty, 2.
Volume 7.
Number 1, 2026 https://ijble.
com/index.
php/journal/index CONCLUSION This study demonstrates that the quality of services at the Dental Clinic of Bhayangkara Lemdiklat Police Hospital is generally perceived as satisfactory, especially in terms of effectiveness, safety, and patient-centered care.
Patients feel that clinical procedures are appropriate, safe, and supported by adequate communication and attention from healthcare providers.
These dimensions represent the dental clinic's main strengths and should be consistently maintained.
Nevertheless, several aspects still require improvement, particularly equity, efficiency, and timeliness.
The lowest performance was found in equity, indicating that patients may still perceive differences in treatment or service processes.
In addition, delays in service flow and procedural complexity contribute to inefficiency and longer waiting times.
These gaps between patient expectations and actual performance may reduce overall satisfaction if not addressed.
The strong correlations among the IOM dimensions indicate that service quality is holistic.
improvements in efficiency and fairness are likely to enhance perceptions of effectiveness and patient-centered care.
Therefore, hospital management should prioritize standardizing service procedures, optimize queue and schedule systems, enhancing communication with patients, and strengthening staff capacity to ensure equal, timely, and efficient services.
Continuous evaluation using the IOM framework is recommended to support sustainable quality improvement and higher patient satisfaction in dental healthcare services.
Reference