International Journal of Health and Medicine E-ISSN: 3047-793X P-ISSN: 3047-7948 Research Article The Strategic Role of Digital Marketing in Moderating the Influence of Digital Literacy, Website Quality, and Ease of Access on the Brand Image Dwi Utami Kusumastuti 1*, Dini Handayani 2, Muhammad Fachrudin Arrozie 3 1-3 Magister Administrasi Rumah Sakit, Universitas Esa Unggul, Indonesia * Corresponding Author: tamirasbery@student.esaunggul.ac.id 1 Abstract: The advancement of digital technology has transformed how people search for information and access health services. RSIA Clas C Cipondoh faces challenges related to its brand image, as indicated by low patient engagement with the hospital’s website and digital platforms, based on a preliminary survey. This study aims to analyze the simultaneous and partial effects of digital literacy, website quality, and ease of access on the brand image with digital marketing strategy as a moderating variable. A quantitative research method with a cross-sectional approach was employed. The study involved 152 outpatient respondents who had accessed the hospital website. Data were analyzed using index analysis with the Three Box Method and Moderated Regression Analysis (MRA) to test the moderating effect. Findings reveal that digital literacy, website quality, and ease of access simultaneously and significantly influence the hospital’s brand image. Partially, each of these variables also has a positive and significant effect on brand image. Moreover, the digital marketing strategy effectively moderates the relationships between digital literacy, website quality, and ease of access with brand image. The Three Box Method analysis indicates that although website quality falls into the high category, weaknesses remain in the interaction quality dimension. The study concludes that strengthening digital literacy, improving website quality, and ensuring ease of access supported by an effective digital marketing strategy can enhance the hospital’s brand image. Hospitals are advised to add interactive features such as chatboxes or live chat to improve patient engagement and online service experience. Keywords: Accessibility; Digital Literacy; Digital Marketing; Ease Access; Website Quality Received: 23 September 2025 Revised: 07 October 2025 Accepted: 21 October 2025 Published: 23 October 2025 Curr. Ver.: 23 October 2025 Copyright: © 2025 by the authors. Submitted for possible open access publication under the terms and conditions of the Creative Commons Attribution (CC BY SA) license (https://creativecommons.org/li censes/by-sa/4.0/) 1. Introduction In the digital era, the brand image of a hospital is no longer formed only through patients' physical experiences but also through digital interactions (Kotler & Keller, 2016). Websites, social media, and health applications have become the main gateway for patients to seek information, make appointments, and assess the credibility of a health institution. A positive brand image in the digital realm can increase trust, loyalty, and become a sustainable competitive advantage (Aaker, 1991). Besides digital marketing, a brand's image is also a factor that needs attention to increase the attention and interest of the general public. Through branding, a hospital will be known and perceived as good or bad by the public. Moreover, the current intense competition in the hospital business requires the managers of these services to be able to manage professionally to compete in serving patients.Brand image is the perception, impression, and association formed in the public's mind about an institution or product. In healthcare services, a positive brand image is crucial as it can increase patient trust, loyalty, and the decision to choose specific health services (Kotler & Keller, 2016). The requirements for a strong brand and image are a relatively consistent perception in the long term. Thus, it is not easy to form a brand image, and once formed, it is difficult to change it. DOI : https://doi.org/10.62951/ijhm.v2i4.525 https://international.arikesi.or.id/index.php/IJHM International Journal of Health and Medicine 2025 (October), vol. 2, no. 4, Kusumastuti, et al. 10 of 17 Amid increasing public awareness of healthcare service quality, research on hospital brand image becomes very relevant. This research is expected to provide an overview of how public perception of a hospital's brand image is formed, what factors influence it, and how that image impacts patient behavior and loyalty. The results of this study can also serve as a basis for hospital management in designing more effective communication and marketing strategies oriented towards public satisfaction and trust. Class C Hospitals face challenges in managing their digital brand image. Based on a preliminary survey on brand image in a Class C hospital, 30% of outpatients did not know the hospital from the internet or social media, 20% of outpatients did not see the hospital's content on social media, 20% of outpatients did not use the hospital website during registration, 20% of patients were not accustomed to seeking health information via the internet, and 20% of outpatients did not open the hospitalwebsite from their mobile phone or laptop. This research examines three main factors believed to influence brand image: patient digital literacy (the patient's ability to understand and use digital information), website quality (perception of usefulness, information, and interaction), and ease of access (perception of the ease of using digital platforms). Furthermore, this research proposes digital marketing strategy not only as an independent variable but as a moderating variable. The main hypothesis is that an effective digital marketing strategy will strengthen the positive impact of digital literacy, website quality, and ease of access on brand image. This approach fills the gap from previous research which often tested these variables separately without looking at the interaction (moderation) effect in the context of hospitals. 2. Preliminaries or Related Work or Literature Review The Significant Simultaneous Influence of Digital Literacy, Website Quality, Ease of Access on Brand Image with Digital Marketing Strategy as a Moderating Variable Based on Kotler's (2013) brand image theory, Brand image is the result of how patients and the general public perceive the hospital. This includes the associations they have (e.g., child-friendly hospital, best mother and child services, competent doctors, Islamic-nuance hospital), the strength of those associations, their uniqueness compared to competitors, and their overall attitude towards the hospital. A positive brand image will foster trust, loyalty, and word-of-mouth recommendations, which are crucial for the hospital's sustainability. Based on Glister's (1997) digital literacy theory, The digital literacy of patients and potential patients will affect their ability to search for health information online, understand medical content on the hospital website, and interact with the provided digital platforms. The higher the digital literacy of the audience, the more likely they are to find and appreciate the quality information presented by the hospital, which in turn can form a positive brand image. Conversely, low digital literacy can be a barrier, even if the hospital website is of high quality. Based on Stuart Barnes & Richard Vidgen's (2002) theory on website quality (WebQual), it will be assessed by how easily patients and potential patients can navigate the site (Ease of Use), how attractive and interactive their experience is (Experience), how relevant and accurate the provided health information is (Information Quality), and how well the site facilitates communication and integrates with other services (Communication and Integration). A high-quality website will create an impression of professionalism and credibility, which is an important foundation for the hospital's brand image. Based on Davis's (1989) theory of Ease of Access, the Technology Acceptance Model (TAM), primarily related to its digital platforms (website, registration application), will significantly influence the user experience. If the website or online registration system is easy to use, easy to learn, and free from complexity, patients will be more likely to use it. This perception of ease will reduce frustration and increase satisfaction, which indirectly contributes to a positive brand image. Conversely, a system that is difficult to access or use will create a negative experience and damage the hospital's image. Based on Dave Chaffey & Fiona Ellis-Chadwick's (2019) theory of Digital Marketing Strategy in the book Digital Marketing: Strategy, Implementation and Practice, digital marketing strategy will moderate the relationship between website quality, digital literacy, and ease of access on brand image. High-quality website and good ease of access may not fully impact brand image if the digital marketing strategy is ineffective in reaching the right audience, building awareness, and encouraging interaction. Conversely, a strong digital marketing strategy can strengthen the positive impact of the independent variables. Hospitals International Journal of Health and Medicine 2025 (October), vol. 2, no. 4, Kusumastuti, et al. 11 of 17 use social media to interact with patients (Reach, Act), email campaigns to encourage registration (Convert), and educational content to build loyalty (Engage) The results of this study support research by Priyanto & Wibowo (2021), which states that consumer digital literacy strengthens trust in online information from hospitals and impacts brand perception. Furthermore, research by Prasetyo et al. (2020) shows that website quality significantly influences brand trust and the image of healthcare organizations. Research by Arifah & Putra (2022) shows that easy access to hospital information systems influences positive patient perceptions and encourages recommendations. A study by Chaffey (2020) within the Digital Marketing Excellence framework emphasizes that digital marketing success is influenced by the synergy between media, content, and audience literacy. Based on the review of theory and previous research results, the researcher formulates the hypothesis as follows: H1: There is a Significant Simultaneous Influence Between Digital Literacy, Website Quality, Ease of Access on Brand Image With Digital Marketing Strategy as a Moderating Variable. The Significant Influence of Digital Literacy on Brand Image Based on Kotler's (2013) brand image theory, Brand image is the result of how patients and the general public perceive the hospital. This includes the associations they have (e.g., child-friendly hospital, best mother and child services, competent doctors, Islamic-nuance hospital), the strength of those associations, their uniqueness compared to competitors, and their overall attitude towards the hospital. A positive brand image will foster trust, loyalty, and word-of-mouth recommendations, which are crucial for the hospital's sustainability. Based on Stuart Barnes & Richard Vidgen's (2002) theory on website quality (WebQual), it will be assessed by how easily patients and potential patients can navigate the site (Ease of Use), how attractive and interactive their experience is (Experience), how relevant and accurate the provided health information is (Information Quality), and how well the site facilitates communication and integrates with other services (Communication and Integration). A high-quality website will create an impression of professionalism and credibility, which is an important foundation for the hospital's brand image. Research by Christodoulides, et al., 2016: This research found that website quality (especially information quality and design) positively influences brand credibility, which in turn builds brand equity (including brand image). This supports the argument that the website functions as a quality signal that shapes perceptions of credibility and image. Based on the review of theory and previous research results, the researcher formulates the hypothesis as follows: H2: There is a Significant Influence of Digital Literacy on Brand Image. The Significant Influence of Website Quality on Brand Image Based on Glister's (1997) Digital Literacy theory, The digital literacy of patients and potential patients will affect their ability to search for health information online, understand medical content on the hospital website, and interact with the provided digital platforms. The higher the digital literacy of the audience, the more likely they are to find and appreciate the quality information presented by the hospital, which in turn can form a positive brand image. Conversely, low digital literacy can be a barrier, even if the hospital website is of high quality. Based on Kotler's (2013) brand image theory, Brand image is the result of how patients and the general public perceive the hospital. This includes the associations they have (e.g., child-friendly hospital, best mother and child services, competent doctors, Islamic-nuance hospital), the strength of those associations, their uniqueness compared to competitors, and their overall attitude towards the hospital. A positive brand image will foster trust, loyalty, and word-of-mouth recommendations, which are crucial for the hospital's sustainability. The results of this study align with research by Sari et al. (2021), which states that website quality significantly influences brand trust and a hospital's brand image. A comprehensive, fast-accessible, and user-friendly website will create satisfaction and strengthen positive associations with the hospital. A similar study by Pratama & Lestari (2022) also found that the usability and content quality dimensions of private hospital websites in Jakarta play a significant role n strengthening perceptions of professionalism and modernity, ultimately improving brand image. This study aligns with research by Lestari & Pramudito (2021), which shows that easy access to information and services through a hospital's digital media significantly improves brand image. Patients are more trusting and loyal to hospitals that facilitate their access to services. Utami et al. (2020) also found that hospitals with user-friendly and quickly accessible online systems are able to create the impression of professional institutions that are adaptable International Journal of Health and Medicine 2025 (October), vol. 2, no. 4, Kusumastuti, et al. 12 of 17 to technological developments. Another study by Anggraini (2022) stated that ease of digital access, such as online registration and easy access to doctor's schedule information, plays an important role in shaping the impression of hospital efficiency and modernity, which impacts brand perception. Based on the review of theory and previous research results, the researcher formulates the hypothesis as follows: H3: There is a Significant Influence of Website Quality on Brand Image. The Significant Influence of Ease of Access on Brand Image Based on Kotler's (2013) brand image theory, Brand image is the result of how patients and the general public perceive the hospital. This includes the associations they have (e.g., child-friendly hospital, best mother and child services, competent doctors, Islamic-nuance hospital), the strength of those associations, their uniqueness compared to competitors, and their overall attitude towards the hospital. A positive brand image will foster trust, loyalty, and word-of-mouth recommendations, which are crucial for the hospital's sustainability. Based on Davis's (1989) theory of Ease of Access, the Technology Acceptance Model (TAM), primarily related to its digital platforms (website, registration application), will significantly influence the user experience. If the website or online registration system is easy to use, easy to learn, and free from complexity, patients will be more likely to use it. This perception of ease will reduce frustration and increase satisfaction, which indirectly contributes to a positive brand image. Conversely, a system that is difficult to access or use will create a negative experience and damage the hospital's image. The results of this study align with research by Siregar and Hidayat (2022), which showed that a good digital marketing strategy increases public engagement with healthcare information, which in turn improves trust and brand image in hospitals. Nugroho (2021) also stated that professionally managed hospital social media can create positive perceptions, increase the number of new patients, and build loyalty among existing patients. Another study by Putri & Kurniawati (2023) showed that educational content, digital health campaigns, and patient testimonials on digital platforms significantly influence brand image formation in the health car sector. Based on the review of theory and previous research results, the researcher formulates the hypothesis as follows: H4: There is a Significant Influence of Ease of Access on Brand Image. The Significant Influence of Digital Marketing Strategy on Brand Image Based on Kotler's (2013) brand image theory, Brand image is the result of how patients and the general public perceive the hospital. This includes the associations they have (e.g., child-friendly hospital, best mother and child services, competent doctors, Islamic-nuance hospital), the strength of those associations, their uniqueness compared to competitors, and their overall attitude towards the hospital. A positive brand image will foster trust, loyalty, and word-of-mouth recommendations, which are crucial for the hospital's sustainability. Based on Dave Chaffey & Fiona Ellis-Chadwick's (2019) theory of Digital Marketing Strategy in the book Digital Marketing: Strategy, Implementation and Practice, digital marketing strategy influences brand image. A high-quality website and good ease of access may not fully impact brand image if the digital marketing strategy is ineffective in reaching the right audience, building awareness, and encouraging interaction. Conversely, a strong digital marketing strategy can strengthen the positive impact of the independent variables. Hospitals use social media to interact with patients (Reach, Act), email campaigns to encourage registration (Convert), and educational content to build loyalty (Engage). The application of these models will ensure that the hospital's digital marketing efforts are planned, measurable, and effective in shaping the desired brand image. This research aligns with research by Hasanah & Nugroho (2022), which states that digital literacy has a positive influence on a hospital's brand image. However, this effect is significantly enhanced if the hospital has targeted and professional digital content management. The results of this study align with research by Siregar and Hidayat (2022), which showed that a good digital marketing strategy increases public engagement with healthcare information, which in turn improves trust and brand image in hospitals. Nugroho (2021) also stated that professionally managed hospital social media can create positive perceptions, increase the number of new patients, and build loyalty among existing patients. Another study by Putri & Kurniawati (2023) showed that educational content, digital health campaigns, and patient testimonials on digital platforms significantly influence brand image formation in the healthcare sector. International Journal of Health and Medicine 2025 (October), vol. 2, no. 4, Kusumastuti, et al. 13 of 17 Based on the review of theory and previous research results, the researcher formulates the hypothesis as follows: H5: There is a Significant Influence of the Implemented Digital Marketing Strategy on Brand Image. The Influence of Digital Marketing Strategy Strengthens the Effect of Digital Literacy on Brand Image Based on Kotler's (2013) brand image theory, Brand image is the result of how patients and the general public perceive the hospital. This includes the associations they have (e.g., child-friendly hospital, best mother and child services, competent doctors, Islamic-nuance hospital), the strength of those associations, their uniqueness compared to competitors, and their overall attitude towards the hospital. A positive brand image will foster trust, loyalty, and word-of-mouth recommendations, which are crucial for the hospital's sustainability. Based on Dave Chaffey & Fiona Ellis-Chadwick's (2019) theory of Digital Marketing Strategy in the book Digital Marketing: Strategy, Implementation and Practice, digital marketing strategy will strengthen the influence of digital literacy on brand image. A highquality website and good ease of access may not fully impact brand image if the digital marketing strategy is ineffective in reaching the right audience, building awareness, and encouraging interaction. Conversely, a strong digital marketing strategy can strengthen the positive impact of the independent variables. Hospitals use social media to interact with patients (Reach, Act), email campaigns to encourage registration (Convert), and educational content to build loyalty (Engage). The application of these models will ensure that the hospital's digital marketing efforts are planned, measurable, and effective in shaping the desired brand image. Based on Glister's (1997) theory, The digital literacy of patients and potential patients will affect their ability to search for health information online, understand medical content on the hospital website, and interact with the provided digital platforms. The higher the digital literacy of the audience, the more likely they are to find and appreciate the quality information presented by the hospital, which in turn can form a positive brand image. Conversely, low digital literacy can be a barrier, even if the hospital website is of high quality. This research aligns with research by Hasanah & Nugroho (2022), which states that digital literacy has a positive influence on a hospital's brand image. However, this effect is significantly enhanced if the hospital has targeted and professional digital content management. A study by Wijayanti (2023) confirmed that high digital literacy does not necessarily increase public trust in healthcare services unless accompanied by strategic digital communication from the service provider. Research by Rizky & Utami (2021) also shows that digital marketing strategies that present educational, accessible, and interactive content strengthen the relationship between users' digital literacy levels and positive perceptions of healthcare institutions. Ferdinandus et al. (2022) in their research stated that digital marketing strategies can strengthen the relationship between digital literacy and consumer brand loyalty. Digitally literate consumers are quicker to grasp the value offered by a brand if the content is presented in an engaging, informative, and appropriate manner for the media they use. Based on the review of theory and previous research results, the researcher formulates the hypothesis as follows: H6: There is an Influence of Digital Marketing Strategy Strengthening the Effect of Digital Literacy on Brand Image. The Influence of Digital Marketing Strategy Strengthens the Effect of Website Quality on Brand Image Based on Kotler's (2013) brand image theory, Brand image is the result of how patients and the general public perceive the hospital. This includes the associations they have (e.g., child-friendly hospital, best mother and child services, competent doctors, Islamic-nuance hospital), the strength of those associations, their uniqueness compared to competitors, and their overall attitude towards the hospital. A positive brand image will foster trust, loyalty, and word-of-mouth recommendations, which are crucial for the hospital's sustainability. Based on Dave Chaffey & Fiona Ellis-Chadwick's (2019) theory of Digital Marketing Strategy in the book Digital Marketing: Strategy, Implementation and Practice, digital marketing strategy will strengthen the influence of website quality on brand image. A highquality website and good ease of access may not fully impact brand image if the digital marketing strategy is ineffective in reaching the right audience, building awareness, and encouraging interaction. Conversely, a strong digital marketing strategy can strengthen the International Journal of Health and Medicine 2025 (October), vol. 2, no. 4, Kusumastuti, et al. 14 of 17 positive impact of the independent variables. Hospitals use social media to interact with patients (Reach, Act), email campaigns to encourage registration (Convert), and educational content to build loyalty (Engage). The application of these models will ensure that the hospital's digital marketing efforts are planned, measurable, and effective in shaping the desired brand image. This research aligns with Prasetya & Rachmawati's (2021) research, which states that website quality impacts brand image, especially when accompanied by a regular and interactive promotional content strategy through digital media. Hanum et al.'s (2020) study in the healthcare sector found that a high-quality website is insufficient to build a brand image without consistent and planned digital promotion. Putri & Fadhilah's (2023) research states that digital marketing strategies strengthen the relationship between website quality and brand image. A good hospital website is only recognized by the public if it is introduced through an active digital campaign that is relevant to user needs. Based on Stuart Barnes & Richard Vidgen's (2002) theory on website quality (WebQual), it will be assessed by how easily patients and potential patients can navigate the site (Ease of Use), how attractive and interactive their experience is (Experience), how relevant and accurate the provided health information is (Information Quality), and how well the site facilitates communication and integrates with other services (Communication and Integration). A high-quality website will create an impression of professionalism and credibility, which is an important foundation for the hospital's brand image. A study by Wijayanti (2023) confirmed that high digital literacy does not necessarily increase public trust in healthcare services unless accompanied by strategic digital communication from the service provider. Research by Rizky & Utami (2021) also shows that digital marketing strategies that present educational, accessible, and interactive content strengthen the relationship between users' digital literacy levels and positive perceptions of healthcare institutions. Ferdinandus et al. (2022) in their research stated that digital marketing strategies can strengthen the relationship between digital literacy and consumer brand loyalty. Digitally literate consumers are quicker to grasp the value offered by a brand if the content is presented in an engaging, informative, and appropriate manner for the media they use. Based on the review of theory and previous research results, the researcher formulates the hypothesis as follows: H7: There is an Influence of Digital Marketing Strategy Strengthening the Effect of Website Quality on Brand Image. The Influence of Digital Marketing Strategy Strengthens the Effect of Ease of Access on Brand Image Based on Kotler's (2013) brand image theory, Brand image is the result of how patients and the general public perceive the hospital. This includes the associations they have (e.g., child-friendly hospital, best mother and child services, competent doctors, Islamic-nuance hospital), the strength of those associations, their uniqueness compared to competitors, and their overall attitude towards the hospital. A positive brand image will foster trust, loyalty, and word-of-mouth recommendations, which are crucial for the hospital's sustainability. Based on Dave Chaffey & Fiona Ellis-Chadwick's (2019) theory of Digital Marketing Strategy in the book Digital Marketing: Strategy, Implementation and Practice, digital marketing strategy will strengthen the influence of ease of access on brand image. A highquality website and good ease of access may not fully impact brand image if the digital marketing strategy is ineffective in reaching the right audience, building awareness, and encouraging interaction. Conversely, a strong digital marketing strategy can strengthen the positive impact of the independent variables.Hospitals use social media to interact with patients (Reach, Act), email campaigns to encourage registration (Convert), and educational content to build loyalty (Engage). The application of these models will ensure that the hospital's digital marketing efforts are planned, measurable, and effective in shaping the desired brand image. Based on Davis's (1989) theory of Ease of Access, the Technology Acceptance Model (TAM), primarily related to its digital platforms (website, registration application), will significantly influence the user experience. If the website or online registration system is easy to use, easy to learn, and free from complexity, patients will be more likely to use it. This perception of ease will reduce frustration and increase satisfaction, which indirectly contributes to a positive brand image. Conversely, a system that is difficult to access or use will create a negative experience and damage the hospital's image. International Journal of Health and Medicine 2025 (October), vol. 2, no. 4, Kusumastuti, et al. 15 of 17 Previous research by Imatupang & Yuniarti (2021) found that ease of access significantly impacts a hospital's brand image, especially when combined with digital promotions through social media and patient testimonials. Research by Zahra & Wicaksono (2022) found that digital marketing strategies increase the perception of easy access to online hospital services, thereby strengthening a positive public image. Research by Nurfadillah et al. (2020) found that the public more quickly forms an image of a hospital as "accessible" if features such as e-registration, e-medical records, and queue tracking are accompanied by educational content through video content or campaigns on Instagram and TikTok. Based on the review of theory and previous research results, the researcher formulates the hypothesis as follows: H8: There is an Influence of Digital Marketing Strategy Strengthening the Effect of Ease of Access on Brand Image. 3. Materials and Method This research uses a causal quantitative design. Data collection was conducted in JuneJuly 2025 by distributing questionnaires to 152 respondents who were outpatients at a Class C Hospital. The questionnaire measured five variables: Digital Literacy (X1), Website Quality (X2), Ease of Access (X3), Digital Marketing Strategy (Z), and Brand Image (Y) using a 1-4 Likert scale.The research instrument has been tested for validity and reliability. The validity test used Pearson Product-Moment correlation and all items were declared valid (r-count > r-table 0.361). The reliability test used Cronbach's Alpha and all variables were declared reliable (Alpha value > 0.60). Data analysis was performed using Moderated Regression Analysis (MRA) with SPSS 23. The regression equation model used was: Y = α + β1X1 + β2X2 + β3X3 + β4Z + β5(X1*Z) + β6(X2*Z) + β7(X3*Z) + ε Which means that if digital literacy, website quality, ease of access and digital marketing strategy are increased by 1 unit, then the brand image will increase by 47.3% through digital literacy, 26.9% through website quality, 34.0% through ease of access and 110.9% on digital marketing strategy, and digital marketing strategy positively interacts the influence of digital literacy, website quality, ease of access on brand image, so that with the moderating role of digital marketing strategy, brand image can increase by 52.2% through digital literacy, 62.0% from website quality, 46.2% from ease of access. This is reinforced by the coefficient of determination value being 99.1%> compared to without the role of digital marketing strategy as a moderating variable, and this strengthens that digital marketing strategy is a moderating variable. Classical assumption tests (normality, multicollinearity, and heteroscedasticity) have been conducted and all assumptions are met, so the regression model is feasible to use. Figure 1. Conceptual Framework. 4. Results and Discussion Results Respondens Characteristics The respondents in this study consisted of 152 patients. Among them, the largest age group was 41–50 years old, comprising 52 individuals (34.21%), while the smallest group was those aged over 50 years, with a total of 11 individuals. In terms of gender composition, the majority were female, accounting for 122 respondents (80.27%), compared to 30 males (19.73%). Regarding educational background, most respondents had a senior high school qualification, totaling 70 individuals (46.05%), followed by 40 respondents (26.32%) with a International Journal of Health and Medicine 2025 (October), vol. 2, no. 4, Kusumastuti, et al. 16 of 17 diploma degree. These findings clearly illustrate that the majority of respondents were female with a senior high school education.. Hipotesis Test The construction of the structural model test path diagram in this study uses 3 exagenous variables and 2 endogeneous variables which describe the relationship between variables as shown in Simultaneous Hypothesis Test (Uji F) Tabel 1. F-test results. Model Regression Residual Total Sum of Squares 29,875 0,249 30.123 df 7 144 151 Mean square 4,268 0,02 F 2471.090 Sig 0,000 The research results indicate that there is a positive and significant influence of digital literacy, digital marketing strategy, website quality, and ease of access on brand image. Tabel 2. Partial Hypothesis Test. Digital literacy  Brand image Website quality  Brand image Ease of access  Brand image Strategi of digital marketing  Brand image Path Coefficient 0,473 P Value 0,002 Hypotesis Accepted 0,269 0,001 Accepted 0,340 0,008 Accepted 1,109 0,000 Accepted Based on table, the research results show that all variables have a positive and significant relationship. Digital literacy has a significant influence on brand image, website quality significantly affects brand image, ease of access also significantly influences brand image, and digital marketing strategy has a significant effect on brand image as well. These findings indicate that improvements in digital literacy, website quality, ease of access, and digital marketing strategies collectively strengthen the hospital’s brand image. This suggests that effective management of digital aspects plays a crucial role in building a positive public perception of the hospital’s brand. Tabel 3. Moderat Hypotesis Test. Path Coefficient P value Hypotesis Digital literac * Strategi of digital marketing Brand image 0.552 0.025 Accepted Website quality * Strategi of digital marketing  Brand Image 0.620 0,018 Accepted Ease of access * Strategi of digital marketing  brand Image 0,462 0,000 Accepted Based on table The results of the study indicate that digital marketing strategy acts as a moderating variable that strengthens the relationship between digital literacy, website quality, and ease of access on brand image. This is evidenced by the t-statistic values of each interaction being greater than the t-table value and the significance levels being below 0.05. The positive coefficients in all three relationships confirm that the more effective the implementation of digital marketing strategies, the stronger the influence of digital literacy, website quality, and ease of access in enhancing the hospital’s brand image. Discussion International Journal of Health and Medicine 2025 (October), vol. 2, no. 4, Kusumastuti, et al. 17 of 17 The findings of this study confirm that in the digital era, intangible assets such as audience literacy and the quality of digital platforms are important predictors of a hospital's brand image. Digitally literate patients are able to appreciate a quality and easily accessible website, which in turn forms a positive perception. However, the most significant finding is the moderating role of digital marketing strategy. These results show that investment in website or application development alone is not enough. Without a targeted communication strategy to promote these advantages, whether through social media, SEO, or educational content, their positive impact on brand image will be limited. The digital marketing strategy functions as a megaphone that disseminates the value and quality possessed by the hospital to the right audience. For example, high ease of access will only strongly shape the brand image as a responsive and modern hospital if this advantage is actively communicated through digital campaigns. Similarly, quality health content on the website will be more effective in building the image of a "credible hospital" if it is strategically distributed to the audience in need. 5. Conclusion Digital literacy, website quality, and ease of access have a significant positive influence on the brand image of Class C Hospitals. The role of digital marketing strategy proves to be crucial, not only as a directly influential factor but also as a moderating variable that significantly strengthens the relationship between these digital assets and brand image. To build a superior brand image in the digital era, Class C hospitals must integrate the development of digital platforms with a planned and audience-oriented digital marketing strategy. References Aaker, D. A. (1991). Managing brand equity. The Free Press. 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