p-ISSN : 2745-7141 e-ISSN : 2746-1920 Jurnal Pendidikan Indonesia Vol.
6 No.
1 Januari 2025 Structural Model of Antecedents and Consequences of Inpatient Satisfaction at dr.
Haulussy Ambon Regional Hospital Vinsa Delia Luhulima.
Tehubijuluw Zacharias.
Hendry Selanno Universitas Pattimura Ambon.
Universitas Kristen Indonesia Maluku.
Universitas Pattimura Ambon.
Indonesia Email: vinza_luhulima@gmail.
com, tehubijuluwzacharias@yahoo.
INFO ARTIKEL
Kata kunci:
kualitas pelayanan.
rumah sakit.
persepsi harga.
Keywords:
service quality.
price perception.
ABSTRAK
Kepuasan pasien merupakan indikator penting dari kualitas layanan kesehatan dan dapat memengaruhi kepercayaan serta loyalitas pasien terhadap rumah sakit.
Di RSUD dr.
Haulussy Ambon, pemahaman tentang faktor-faktor yang memengaruhi kepuasan pasien rawat inap sangat diperlukan untuk meningkatkan kualitas pelayanan.
Penelitian ini bertujuan untuk menganalisis model struktural anteseden dan konsekuensi kepuasan pasien rawat inap pada RSUD dr.
Haulussy Ambon.
Pendekatan penelitian yang digunakan adalah kuantitatif, asosiatif dengan pengumpulan data cross section, serta metode ex post Populasi yang digunakan dalam penelitian ini adalah seluruh pasien rawat inap non BPJS RSUD dr.
Haulussy Ambon selama bulan Juni-Agustus 2024.
Penentuan sampel secara purposive sebanyak 100 orang pasien rawat inap non BPJS RSUD dr.
Haulussy Ambon.
Data dianalisis dengan analisis Hasil penelitian menunjukkan bahwa .
variabel kepuasan pasien secara empiris menjadi variabel intervening yang mampu memediasi kualitas pelayanan, citra rumah sakit dan persepsi harga terhadap kepercayaan dan loyalitas pasien rawat inap.
variabel kepuasan pasien tidak hanya berperan sebagai independen ataupun variabel dependen tetapi mampu berperan sebagai variabel yang mampu memediasi keterlibatan variabel anteseden ke variabel konsekuensi.
kualitas pelayanan, citra rumah sakit dan persepsi harga merupakan variabel anteseden ke kepuasan pasien: .
kepercayaan dan loyalitas pasien rawat inap merupakan variabel konsekuensi dari kepuasan pasien.
ABSTRACT
Patient satisfaction is an important indicator of the quality of healthcare services and can affect patient trust and loyalty to the At dr.
Haulussy Ambon Hospital, an understanding of the factors that affect inpatient satisfaction is needed to improve the quality of service.
This study aims to analyze the structural model of antecedents and consequences of inpatient satisfaction at RSUD dr.
Haulussy Ambon.
The research approach used is quantitative, associative with cross-section data collection, and ex post facto methods.
The population used in this study were all nonBPJS inpatients at RSUD dr.
Haulussy Ambon during JuneAugust 2024.
The sample determination was purposive as many as 100 non-BPJS inpatients at RSUD dr.
Haulussy Ambon.
Data were analyzed using path analysis.
The results of the study indicate that .
the patient satisfaction variable empirically Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Structural Model of Antecedents and Consequences of Inpatient Satisfaction at dr.
Haulussy Ambon Regional Hospital becomes an intervening variable that is able to mediate service quality, hospital image and price perception towards the trust and loyalty of inpatients.
patient satisfaction variables do not only act as independent or dependent variables but are able to act as variables that are able to mediate the involvement of antecedent variables to consequence variables.
service quality, hospital image and price perception are antecedent variables to patient satisfaction: .
inpatient trust and loyalty are consequence variables of patient satisfaction.
INTRODUCTION
RSUD dr.
Haulussy Ambon is a class B hospital established on March 3, 1954.
It has a vision to become a quality hospital of choice in service, education and research in Maluku province.
With a mission to provide complete quality health services according to community expectations and conduct quality research according to health service RSUD Dr.
Haulussy is a referral center hospital in Maluku province.
Facilities and infrastructure as well as medical equipment are quite complete, 24-hour emergency room service.
Hospitals as one of the health providers in their implementation are required to provide quality services as in Law of the Republic of Indonesia No.
36 of 2009 Chapter 4 Article 54 states that the implementation of health services is carried out responsibly, safely, with quality, and evenly and non-discriminatory.
Quality health services are health services that can satisfy every user of health services according to the average level of satisfaction of the population and whose implementation is in accordance with the standards and code of ethics of the profession that has been set.
Increasing patient satisfaction is becoming increasingly important in the context of increasingly tight competition in the health industry.
In the era of information and digitalization, patients have easy access to compare services from various hospitals, clinics, and other healthcare facilities.
They tend to choose healthcare providers that have a good reputation and positive reviews from previous patients.
Therefore, hospitals that are able to provide high-quality services and ensure patient satisfaction tend to be superior in attracting and retaining patients.
Patient satisfaction includes various aspects, such as speed and accuracy of service, friendliness of staff, comfort of facilities, and transparency of costs.
By meeting and exceeding patient expectations, hospitals can differentiate themselves from competitors and build a loyal patient base.
(Aqil, 2.
(Maryana & Christiany, 2.
(Christiani Nababan et al.
, 2.
In addition, high patient satisfaction directly contributes to improving the image and reputation of the hospital.
Satisfied patients tend to share their positive experiences with others, either directly or through social media platforms and online reviews.
This creates a strong word-of-mouth effect, which is one of the most effective and low-cost forms of marketing.
On the other hand, hospitals with low patient satisfaction levels are at risk of experiencing a decline in patient numbers and revenue.
Therefore, in the competitive healthcare industry, focusing on improving patient satisfaction is not only Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Vinsa Delia Luhulima.
Tehubijuluw Zacharias.
Hendry Selanno essential to attract new patients but also to maintain and increase the trust and loyalty of existing patients, ensuring the sustainability and growth of the hospital in the long term.
The phenomenon of satisfaction of non-BPJS inpatients at RSUD dr.
Haulussy Ambon reflects how the quality of service, facilities, and interactions with medical personnel are received by patients who pay privately or through private insurance.
The satisfaction of these patients is often higher compared to BPJS patients, because they usually expect and receive faster service, more comfortable facilities, and more personalized attention from medical staff.
Non-BPJS patients tend to be more critical and have higher expectations of the services they receive, considering that they pay directly or through insurance with higher premiums.
Therefore, hospitals need to continue to improve service standards and ensure that every aspect of care meets or exceeds these patients' expectations, in order to maintain a good reputation and encourage loyalty and positive recommendations.
Patient satisfaction is one of the topics of study in the world of health.
Some researchers make patient satisfaction as an influenced variable and others make patient satisfaction as an influencing variable.
Patient satisfaction is important because greater patient satisfaction with care will require greater patient compliance with doctor's orders, greater loyalty, positive word of mouth by patients, reduced number of patient complaints, higher profitability, level of patient loyalty to return visits (Anjayati, 2.
(Nindy et al.
, 2.
(Herman et al.
, 2.
, (Sari et al.
, 2.
Meanwhile, the consequences of satisfaction on increasing patient confidence have been studied by (Wijaya et al.
, 2.
, (B.
Imran & Ramli, 2.
, (Kosnan, 2.
, (Fardiansyah et al.
From the perspective of antecedent variables of satisfaction, one of them is the service quality variable (Mahmud, 2.
, (NurAoaeni et al.
, 2.
, (I.
Imran et al.
, 2.
Likewise, the image variable as studied by (Anfal, 2.
, (Ardiyanto & Tabrani, 2.
, (Nindy et al.
, 2.
Price or tariff as another antecedent variable is also studied by (Wijaya et al.
, 2.
, (Nugraha & Sumadi, 2.
, (Azhari & Fitri, 2.
METHOD
The research approach used is quantitative which starts from theory to data presentation in the form of numbers and is analyzed statistically.
Based on the level of explanation, this research is associative research to determine the influence or relationship between two or more variables.
Meanwhile, based on data collection, this research is a survey research conducted on large or small populations, but the data studied is data from samples taken from the population, to find relative events, distributions, and relationships between variables.
Based on the type of data, the approach used in this study is crosection, namely the collection of research data carried out over a certain period of time.
The ex post facto method is a study conducted to examine events that have occurred and then trace back to find out the factors that can cause the incident.
The research was carried out at the dr.
Haulussy Ambon Regional Hospital.
This research will be conducted for 2 .
months, namely June to August 2024.
The Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Structural Model of Antecedents and Consequences of Inpatient Satisfaction at dr.
Haulussy Ambon Regional Hospital population used in this study were all non-BPJS inpatients at the dr.
Haulussy Ambon during June-August 2024.
Determination of purposive sampling of 100 non-BPJS inpatients of RSUD dr.
Haulussy Ambon.
Data analysis using path analysis.
RESULT AND DISCUSSION
RESULT
This study attempts to examine the extent to which the variables of service quality, hospital image and price perception influence trust and loyalty through the mediation of satisfaction variables.
For this purpose, a statistical test of path analysis was conducted as shown in the following table:
Parameter structure X1 to Z .
Table 1.
Statistical Test of Path Analysis Path Coeff.
0,229 0,061 3,918 1,960 Prob.
Decision 0,000 Accepted H1 X2 to Z .
0,589
0,055
10,080
1,960
0,000
Accepted H1 X3 to Z .
-0,137
0,010
-2,857
1,960
0,005
Accepted H1 X1 to Y1 .
Y1.
0,224
3,300
1,960
0,001
Accepted H1 X2 to Y1 .
Y1.
0,091
1,118
1,960
0,265
X3 to Y1 .
Y1.
-0,008
-0,148
1,960
0,882
Z to Y1 (Py1.
0,449
0,063
5,543
1,960
0,000
Not Accepted H1 Not Accepted H1 Accepted H1 X1 to Y2 .
Y2.
0,210
3,085
1,960
0,002
Accepted H1 X2 to Y2 .
Y2.
0,186
2,295
1,960
0,023
Accepted H1 X3 to Y2 .
Y2.
-0,004
-0,074
1,960
0,941
Z to Y2 (Py2.
0,374
1,960
0,000
Not Accepted H1 Accepted H1 R2 (X1.
X2.
X3 to Z) 0,564 F count
82,342
R2 (X1.
X2.
X3.
Z to Y.
0,456 F count
39,851
R2 (X1.
X2.
X3.
Z to Y.
0,453 F count
39,350
The analysis results in the table show the path coefficients from the test results.
From the individual test results, for the first path, the path coefficients of variables X1.
X2, and X3 to Z are statistically significant, so H0 is rejected and H1 is accepted.
While for the second path, the path coefficients of variables X1 and Z to Y1 are significant, but X2 and X3 are not significant for the third path, the path coefficients of variables X1.
X2 and Z to Y2 are significant, but X3 is not significant.
Furthermore, the analysis results in the table above are translated into a path diagram as in the following diagram:
Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Vinsa Delia Luhulima.
Tehubijuluw Zacharias.
Hendry Selanno Figure 1 Structure of Relationship Between Variables X1.
X2.
X3 with Variables Y1.
Y2 Through Intervening Variable Z Based on the table above, the direct and indirect influences can be seen as follows:
Table 2.
Direct and Indirect Influences Influences Direct to Z
0,052
0,346
Direct to Y1
0,050
0,008
Direct to Y2
0,044
0,034
Indirect to Y1 through Z
0,753
0,555
Indirect to Y2 through Z
0,235
0,519
0,018
0,000064
0,000016
0,219
0,157
0,201
0,139
Furthermore, to determine the role of patient satisfaction as a mediating or intervening variable, a Sobel test was conducted, as shown in the following table:
Independen Variable Services quality (X.
Hospital image (X.
Price perception (X.
Services quality (X.
Hospital image (X.
Price perception (X.
Table 3.
Sobel Test Results Dependen
Intervening Variable Variable Patient trust
Patient
Patient trust
Patient
Patient trust
Patient
Patient loyalty Patient
Patient loyalty Patient
Patient loyalty Patient
P Value Note
0,0009
Significant 0,0000 Significant 0,0000 Significant 0,00112 Significant 0,0000 Significant 0,0000 Significant DISCUSSION In this section, a discussion will be presented that focuses on the results of hypothesis testing, which will provide answers to the formulation of research problems.
The discussion of each hypothesis test result is described as follows:
Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Structural Model of Antecedents and Consequences of Inpatient Satisfaction at dr.
Haulussy Ambon Regional Hospital The effect of service quality, hospital image and price perception on patient .
The effect of service quality on patient satisfaction Based on the results of the analysis, it is known that service quality has a significant effect on patient satisfaction.
This means that the quality of service provided by the hospital, such as staff friendliness, speed of service, completeness of facilities, room comfort, and other aspects of health services, have a real and strong relationship with the level of satisfaction of patients being treated.
More specifically, if the quality-of-service increases .
or example, doctors and nurses are more responsive, waiting times are shorter, or hospital facilities are more adequat.
, then patient satisfaction also tends to increase significantly.
Conversely, if the quality-of-service decreases, the level of patient satisfaction can decrease.
This statement is often based on the results of research or surveys that use statistical data to show that there is a positive and significant relationship between the two This is in line with previous research conducted by (Ardoni et al.
, 2.
the dimensions of service quality .
angible, responsiveness, assurance and empath.
have an effect on increasing patient satisfaction.
Service quality is a must that must be done by companies in order to survive and continue to gain customer trust.
Customer consumption patterns and lifestyles require companies to be able to provide quality services.
(Hosang et al.
, 2.
stated that service quality is the level of excellence expected and control over that excellence to meet customer desires.
The influence of hospital image on patient satisfaction Based on the results of the analysis, it is known that hospital image has a significant effect on patient satisfaction, this is in accordance with research (Ardiyanto & Tabrani, 2.
which revealed that a good hospital image not only increases patient satisfaction through direct patient loyalty, but also increases The image of RSUD dr.
Haulussy Ambon which has a significant effect on inpatient satisfaction shows that the public's positive perception of this hospital plays an important role in determining the level of patient satisfaction.
Hospital image includes reputation, trust, professionalism of medical personnel, and the quality of the facilities offered.
If the public and patients have a good view of the hospital, they tend to have high expectations but still feel satisfied if the service meets or exceeds those expectations.
When the hospital image is viewed positively, patients usually feel more confident and comfortable undergoing treatment.
This is due to the belief that the hospital is able to provide the best service according to the expected standards.
Conversely, a bad image can affect the level of satisfaction even if the service provided is actually quite good.
Thus, image is not only about the reality of service, but also public perception formed by personal experience, testimonials from other patients, and hospital communication and promotion.
Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Vinsa Delia Luhulima.
Tehubijuluw Zacharias.
Hendry Selanno For RSUD dr.
Haulussy Ambon, maintaining and improving a positive image is a strategic step to increase patient satisfaction.
Hospitals must ensure that all aspects of service, from interactions with patients to the provision of health facilities, reflect the values of professionalism and care.
When patients feel that the image of the hospital matches their direct experience, the level of satisfaction will increase significantly.
This not only affects patient loyalty but also the reputation of the hospital in the wider community.
Service Quality is one of the critical points for hospitals engaged in the Service sector.
Patient Satisfaction is a fundamental thing that cannot be ignored for a hospital.
Because patient satisfaction is an important aspect to maintain the image of the Hospital in the wider community, so that quality services for patients need to be improved (Nindy et al.
, 2.
(Asmoro P.
et al.
, 2.
The influence of price perception on patient satisfaction Based on the results of the analysis, it is known that price perception has a significant effect on inpatient satisfaction, although it is very low.
The study is less appropriate by research (Herman et al.
, 2.
and (Hosang et al.
, 2.
which explains that there is an influence of price on satisfaction.
Where the hospital will have a strong reputation for the rates set by the hospital will give patients a lot of confidence that they will get high value when buying it.
Price perception has a significant but small influence on inpatient satisfaction because the price factor is often not a top priority for patients who need health care.
Patients tend to focus more on the quality of service, comfort, and treatment results they receive compared to the amount of costs incurred.
However, price perception remains important, especially if the patient feels that the costs charged are appropriate or comparable to the quality of service received.
The small influence of price perception on patient satisfaction can also be caused by the existence of subsidy mechanisms, health insurance, or government programs such as BPJS.
This makes most inpatients not directly feel the financial impact of treatment costs.
Therefore, although price contributes to satisfaction, its impact tends to be smaller compared to other factors such as professionalism of medical personnel, availability of facilities, and hospital atmosphere.
In addition, price perceptions can be influenced by personal experiences or information from other patients.
If prices are perceived as fair or transparent, patients tend to be more satisfied even though cost is not the main factor.
However, if patients feel that the cost does not match the quality of service, their satisfaction may decrease, although the effect is still relatively small.
This emphasizes the importance of hospitals, including RSUD dr.
Haulussy Ambon, to ensure that price information is easy to understand and the services provided are perceived as valuable by patients.
The influence of service quality, hospital image and price perception directly on patient trust .
The influence of service quality directly on patient trust Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Structural Model of Antecedents and Consequences of Inpatient Satisfaction at dr.
Haulussy Ambon Regional Hospital Based on the results of the analysis, it is known that the quality of service has a direct and significant effect on the trust of inpatients.
This means that the quality of service provided by the hospital, such as the competence of medical personnel, friendliness of staff, speed of treatment, cleanliness of facilities, and openness of information, has a direct impact on the level of patient trust in the hospital.
If the quality of service received by patients is considered satisfactory and meets expectations, then patients tend to trust the hospital, both in terms of medical ability and commitment to provide the best service.
This trust is important because it encourages patients to feel more comfortable during treatment, be more compliant with medical recommendations, and be more willing to return if they need treatment in the future.
Conversely, if the quality of service is low, such as slow treatment, unfriendly attitudes, or inadequate facilities, patient trust can decrease.
This shows that RSUD dr.
Haulussy Ambon needs to ensure consistent service quality in order to maintain and increase patient trust, which ultimately has an impact on their loyalty to the hospital.
This study is in line with (Wijaya et al.
, 2.
(Pratama Saanin et al.
, 2.
that service quality has a significant influence on patient trust in a hospital.
When patients receive high medical services, such as accurate diagnosis, effective treatment, and attentive care from competent medical personnel, their trust in the hospital increases.
In addition, the friendly and professional attitude of non-medical staff, the cleanliness and comfort of the facilities, and the ease of the administrative process also contribute to positive perceptions.
High patient trust not only makes them more likely to return for future care but also increases the likelihood that they will recommend the hospital to others.
Thus, maintaining and improving service quality is key to building and maintaining patient trust.
The influence of hospital image directly on patient trust Based on the results of the analysis, it is known that hospital image does not directly have a significant effect on patient trust, this is not in line with research (B.
Imran & Ramli, 2.
that trust will be stronger if the hospital is more responsive to customer needs and can help convince the meaning of these needs for customers, so that it will create a positive world of mouth, can improve the image and bring benefits to the hospital.
Hospital image may not have a significant effect on inpatient trust because trust is more often built from the patient's direct experience than just the general perception or reputation of the hospital.
Patients who are hospitalized tend to assess their trust based on aspects such as the competence of medical personnel, quality of care, comfort during treatment, and the results of treatment that are felt directly.
their experience does not match the widely known image of the hospital, then the image does not automatically affect the level of trust.
In addition, hospital image is often influenced by marketing communications, public testimonials, or reputation in the media, which can be different from the reality experienced by patients.
In the context of inpatient care, personal Jurnal Pendidikan Indonesia.
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Therefore, although hospital image has strategic value, its impact on inpatient trust may be less significant if their actual experiences do not support that image.
This emphasizes the importance of hospitals ensuring consistency between the projected image and the quality of services actually provided.
The direct influence of price perception on patient trust Based on the results of the analysis, it is known that price perception does not have a significant effect on patient trust.
This is not in line with research (Tanaka & Darmawan, 2.
(Azhari & Fitri, 2.
(Pratama Saanin et al.
, 2.
which concluded that price perception has a significant effect on patient trust in a hospital.
If patients feel that the price charged is commensurate with the quality of service provided, they tend to be satisfied and trust the hospital.
Transparency in costing, clarity of information regarding additional costs, and honesty in billing also play an important role.
Conversely, if patients feel that the price is too high or there are hidden costs that are not previously informed, their trust may decrease.
Therefore, ensuring that the price charged is in accordance with the quality of service and maintaining transparency in communication regarding costs can help increase patient trust in the hospital.
Patient perception of price may not have a significant effect on the trust of inpatients because trust is built more through direct experience of the quality of service, the competence of medical personnel, and treatment outcomes.
Patients tend to prioritize the effectiveness and safety of the care they receive over the amount of money they have to pay.
In this case, even if the price is considered high or low, it does not always affect the patient's level of trust if the quality of service is still felt to be satisfactory and meets expectations.
In addition, perceptions of price are often subjective and influenced by financial conditions or financing programs such as BPJS Kesehatan.
Because most inpatients do not pay the full fee directly, their focus on price becomes smaller compared to their experience of the service they receive.
Trust is more related to how the hospital handles their medical needs professionally and transparently, not solely on price perceptions.
Therefore, although price perceptions are important, their influence on inpatient trust is relatively low.
The influence of service quality, hospital image and price perception directly on patient loyalty .
The influence of service quality directly on patient loyalty Based on the results of the analysis, it is known that service quality has a direct and significant effect on loyalty, meaning that the quality of services provided by the hospital, such as the friendliness and competence of medical personnel, comfort of facilities, speed of treatment, and treatment results, play an important role in encouraging patients to continue choosing the hospital in the future.
patients feel that the services they receive are of high quality and meet their Jurnal Pendidikan Indonesia.
Vol.
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1 Januari 2025 Structural Model of Antecedents and Consequences of Inpatient Satisfaction at dr.
Haulussy Ambon Regional Hospital expectations, they tend to be more loyal, namely willing to return to the hospital for further treatment, recommend to others, and provide positive reviews.
This loyalty also reflects patient trust and satisfaction with the consistency and professionalism of hospital services.
Conversely, low service quality, such as slow treatment, unfriendly staff attitudes, or inadequate facilities, can reduce patient loyalty.
This emphasizes the importance of RSUD dr.
Haulussy Ambon to maintain and improve service standards in order to maintain and increase the loyalty of inpatients, which ultimately contributes to the sustainability of the hospital amidst competition in health services.
This study is in accordance with the results of research (Herman et al.
, 2.
which concluded that service quality has a close relationship with patient loyalty, service quality provides an encouragement for patients to establish a relationship with the hospital, in the long term this kind of bond understands carefully what the patient's expectations are.
Each hospital carries out various service strategies that are oriented towards patient satisfaction so that the hospital continues to grow.
Patient satisfaction will be fulfilled if the process of delivering health services from the hospital to consumers is in accordance with what the patient perceives.
Satisfied patients are a very valuable asset because if patients are satisfied, they will continue to use the services of their choice.
However, if patients are dissatisfied, they will tell others about their bad experiences (Dewi et al.
, 2.
The direct influence of hospital image on loyalty Based on the results of the analysis, it is known that hospital image has a direct and significant effect on loyalty, meaning that the public's positive perception of the reputation and credibility of this hospital influences the tendency of patients to continue choosing this hospital in the future.
A good hospital image reflects the belief that the hospital has quality services, professional medical personnel, adequate facilities, and a commitment to patient health.
Patients who have a positive view of the hospital's image tend to feel trusting and comfortable, so they are more loyal in using hospital services, recommending them to family or friends, and considering this hospital as the main choice if they need further care.
Thus, a positive image not only strengthens long-term relationships with patients, but also becomes a strategic asset for RSUD dr.
Haulussy Ambon to compete in the increasingly competitive world of health This is in line with(Dewi et al.
, 2.
which states that the image of the hospital functions as a liaison and maintains the harmony of its relationship with their customers.
Likewise (Hasan & Putra, 2.
that in order to realize a good hospital image in the eyes of the public, the government must analyze the management elements that have been implemented and change the paradigm of Jurnal Pendidikan Indonesia.
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The influence of price perception directly on patient loyalty Based on the results of the analysis, it is known that price perception directly does not have a significant effect on inpatient loyalty.
Patient perception of price may not have a significant effect on inpatient loyalty because loyalty is more determined by direct experience of service quality and treatment outcomes.
Patients who are satisfied with the care they receive, such as the competence of medical personnel, friendliness of staff, and comfort of facilities, tend to be loyal even though they have a high price perception.
Conversely, even though the cost is considered low, if the service is not satisfactory, patient loyalty can remain low.
Therefore, loyalty is more influenced by the value perceived by patients than simply the perception of cost.
In addition, many inpatients use insurance facilities or programs such as BPJS Kesehatan, so price perception is often not their main concern.
Patients focus more on how the hospital provides adequate care and meets their expectations.
Factors such as trust in medical personnel, treatment outcomes, and comfort during hospitalization play a bigger role in building loyalty.
Thus, although price is important, its influence on inpatient loyalty tends to be insignificant compared to other aspects of service.
This study is not in line with the research conducted by (Herman et al.
, 2.
which concluded that some people decide to use health services based on promotions they have seen, either through print or electronic media or from other people, price is no less important in choosing a hospital by patients, with affordable prices, patients refer the hospital to other patients or their families and it is the patient's final decision to seek treatment at the same place.
Understanding references is very important for hospital management because it is proof of patient .
The influence of patient satisfaction on trust and loyalty .
The direct influence of satisfaction on trust Based on the results of the analysis, it is known that patient satisfaction has a significant effect on the trust of inpatients.
This means that the level of patient satisfaction with the services they receive, such as staff friendliness, medical personnel competence, comfort of facilities, and treatment outcomes, directly affects how much patients trust the hospital.
When patients are satisfied, they tend to be more confident that the hospital is able to provide quality services consistently.
Satisfaction creates a positive experience that strengthens the perception that the hospital is committed to the health and well-being of patients.
This makes patients feel confident in the hospital's ability to handle their medical needs in the Thus.
RSUD dr.
Haulussy Ambon must maintain a high level of satisfaction to build and maintain patient trust as part of a long-term, sustainable Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Structural Model of Antecedents and Consequences of Inpatient Satisfaction at dr.
Haulussy Ambon Regional Hospital This study is in line with research (Fajarini & Meria, 2.
which found that customer trust is an after-sales evaluation where the alternative chosen is at least the same or exceeds customer expectations.
There are many benefits received by the company by achieving a high level of customer satisfaction.
A high level of satisfaction will be able to increase customer trust in the company.
The direct influence of patient satisfaction on loyalty Based on the results of the analysis, it is known that patient satisfaction has a significant effect on loyalty, meaning that the level of satisfaction felt by patients plays an important role in determining their loyalty to the hospital.
When patients are satisfied with the services provided, such as the friendliness of the staff, the competence of the medical personnel, the comfort of the facilities, and the suitability between their expectations and experiences, patients tend to return to use the hospital's services in the future.
In addition, satisfaction creates a positive experience that encourages patients to recommend the hospital to others, showing a close relationship between satisfaction and loyalty.
This significant influence also reflects that patient loyalty is not only based on external factors such as price or reputation, but also on the emotional experience and perception of value they feel while receiving service.
When a hospital is able to meet or even exceed patient expectations, they feel confident in making the hospital their primary choice for their medical needs.
Thus, patient satisfaction is the main foundation in building sustainable loyalty, creating a long-term relationship between patients and hospitals This study supports research(Sari et al.
, 2.
that positive patient satisfaction will have an impact on increasing patient loyalty to the hospital.
Likewise (Fajarini & Meria, 2.
that the relationship between satisfaction and loyalty is when consumers reach the highest level of satisfaction which creates strong emotional bonds and long-term commitment.
The influence of service quality, hospital image and price perception indirectly on trust through patient satisfaction .
The influence of service quality indirectly on trust through patient satisfaction Based on the results of the analysis, it is known that patient satisfaction is significant in mediating the influence of service quality on patient trust.
This result is in line with hypothesis 5a that service quality will have an indirect positive influence on trust through patient satisfaction, meaning that patient satisfaction created from this positive experience acts as a mediator that connects service quality with patient trust.
Satisfaction creates a positive perception of the hospital, which then strengthens the patient's belief that the hospital can provide good service When patients are satisfied, they are more likely to trust the hospital in handling their medical needs in the future, both in terms of medical expertise, care, and their safety.
Conversely, dissatisfaction can reduce the level of trust, even though the initial service quality is good.
Indirect influence of hospital image on trust through patient satisfaction Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Vinsa Delia Luhulima.
Tehubijuluw Zacharias.
Hendry Selanno Based on the results of the analysis, it is known that patient satisfaction is significant in mediating the influence of hospital image on trust.
This result is in line with hypothesis 5b that hospital image will have an indirect positive influence on trust through patient satisfaction.
This means that hospital image, which includes reputation, public image, and public perception of the quality of hospital services, functions as a starting point in forming patient expectations.
A positive image can create high expectations of the hospital, and patients who come with positive perceptions tend to expect an adequate experience, based on what they hear or see from external sources .
edia, testimonials, or hospital advertisement.
When patients receive services, their direct experiences begin to play a major role in forming satisfaction.
If the services provided are in accordance with or exceed the expectations formed by the hospital's image, patients will feel satisfied.
This satisfaction is important because it functions as a bridge connecting the hospital's positive image with patient trust.
High satisfaction will strengthen patient trust in the hospital, because they feel that the hospital not only has a good image, but is also able to fulfill the promises contained in the image.
Indirect influence of price perception on trust through patient satisfaction Based on the results of the analysis, it is known that patient satisfaction is significant in mediating the influence of price perception on trust.
This result is in line with hypothesis 5b that price perception will have an indirect positive influence on patient satisfaction through patient satisfaction.
This means that patient satisfaction is the main mediator between price perception and patient trust.
patients are satisfied with the quality of service received, even though the price paid is relatively high, they tend to assume that the price paid is comparable to the benefits received.
Conversely, if the service does not match the price paid, patient satisfaction will decrease, and this can affect their trust in the hospital.
This satisfaction serves as a link that ensures that good or bad price perceptions can be processed in the patient's real experience.
High satisfaction will strengthen patient trust, because they feel that the hospital has provided value that matches the costs they incur.
When patients are satisfied with the care and feel that the hospital provides services that meet their expectations, both in terms of quality and price, they will be more likely to believe that the hospital can meet their medical needs in the future.
On the other hand, dissatisfaction will reduce trust, even if the price paid is in line with expectations.
The influence of service quality, hospital image and price perception indirectly on loyalty through patient satisfaction .
The influence of service quality indirectly on loyalty through patient Based on the results of the analysis, it is known that satisfaction is significant in mediating the influence of service quality on loyalty.
This result is in line with hypothesis 6a that service quality will have an indirect positive influence on loyalty through patient satisfaction, meaning that high satisfaction plays a role in Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Structural Model of Antecedents and Consequences of Inpatient Satisfaction at dr.
Haulussy Ambon Regional Hospital strengthening patient loyalty, because patients who feel satisfied tend to return to the hospital for further treatment, recommend the hospital to others, and remain loyal to using the services offered.
Satisfaction also encourages patients to grow a sense of trust in the hospital, which in turn builds stronger loyalty.
Conversely, if the quality of service received is not satisfactory, even though the hospital initially has a good image or reputation, patient loyalty can decrease.
The indirect influence of hospital image on loyalty through patient satisfaction Based on the results of the analysis, it is known that patient satisfaction is significant in mediating the influence of hospital image on patient loyalty.
This result is in line with hypothesis 6b that hospital image will have an indirect positive influence on loyalty through patient satisfaction.
This means that patient satisfaction is a significant mediator because it ensures that a positive hospital image is translated into a satisfying real experience, which ultimately encourages patients to remain loyal to the hospital.
Without satisfaction, a good image may only result in weak or temporary loyalty.
The indirect influence of price perception on loyalty through patient Based on the results of the analysis, it is known that patient satisfaction is significant in mediating the influence of price perception on patient loyalty.
This result is in line with hypothesis 5c that price perception will have an indirect positive influence on patient loyalty through patient satisfaction.
This means that patient satisfaction acts as a mediator that connects price perception with loyalty.
When patients feel that the price they pay is commensurate with the quality of service received, they will feel satisfied.
CONCLUSION
Based on the results of the study and discussion, several things were concluded Based on the results and discussion, this study found that: first, the patient satisfaction variable empirically becomes an intervening variable that is able to mediate the quality of service, hospital image and price perception towards the trust and loyalty of inpatients.
Second, the patient satisfaction variable not only acts as an independent or dependent variable but is able to act as a variable that is able to mediate the involvement of antecedent variables to consequence variables.
Third, the quality of service, hospital image and price perception are antecedent variables to patient satisfaction.
Fourth, the trust and loyalty of inpatients are consequence variables of patient satisfaction.
To strengthen the image of the hospital.
RSUD dr.
Haulussy is advised to publish achievements, superior services, and competence of medical personnel through social media, websites, or local media.
Relations with the community can also be strengthened through health education activities or social programs that involve the In addition, a fast and transparent patient complaint handling system needs to be built to maintain the hospital's reputation.
In terms of price perception, hospitals can ensure cost transparency and add added value through extra services such as free follow- Jurnal Pendidikan Indonesia.
Vol.
6 No.
1 Januari 2025 Vinsa Delia Luhulima.
Tehubijuluw Zacharias.
Hendry Selanno up consultations or other supporting facilities.
Periodic evaluation of the tariff structure is also important to ensure that prices are in line with people's purchasing power and the quality of services provided.
Patient satisfaction must be optimized because it acts as an important mediator connecting service quality, image, and price perception with patient trust and loyalty.
Patient experience surveys can be used to understand their needs and expectations, while concrete actions to improve satisfaction, such as service personalization, must be High satisfaction will strengthen patient trust through consistent service that is in accordance with hospital operational standards.
In addition, patient loyalty can be managed through post-treatment communication, loyalty programs, and digital service innovations such as applications for booking inpatient services or online consultations.
With these steps.
RSUD dr.
Haulussy Ambon can continue to improve service quality, strengthen relationships with patients, and build ongoing trust and loyalty.
REFERENCE