Relationship Quality Of Health Services With Patient Satisfaction At Lancirang Health Center Mesyia Alfinia * 1 .
Zulkarnain Sulaiman 2 .
Khaeriyah Adri 3 1 Health Administration.
Faculty of Health Sciences.
Universitas Muhammadiyah Sidenreng Rappang 2 Health Administration.
Faculty of Health Sciences.
Universitas Muhammadiyah Sidenreng Rappang 3 Health Administration.
Faculty of Health Sciences.
Universitas Muhammadiyah Sidenreng Rappang Author's Email Correspondence ( * ): alfiniamesyia04@gmail.
ABSTRACT
Patient satisfaction is an important indicator in assessing the success of health services, which is not always in line with the quality of services provided.
In Lancirang Health Center itself, although the quality of service is relatively good, patient satisfaction in 2023 only reached 63.
3%, still below the national target of 95%.
This study aims to determine the relationship between the quality of health services consisting of five dimensions .
eliability, assurance, tangible evidence, empathy, and responsivenes.
with patient satisfaction.
This study uses the quantitative method with a cross-sectional design.
The random sampling technique was used with a total of 218 Data were collected through observation, questionnaires, interviews, and documentation, then analyzed using the chi-square test.
The results showed that each dimension of service quality had a significant relationship with patient satisfaction, with a p value <0.
The reliability dimension showed that 96.
2% of patients who considered the service reliable were satisfied.
Likewise, in the dimensions of assurance, tangible evidence, empathy, and responsiveness, the majority of respondents who rated the service as good in each of these aspects were satisfied.
These findings suggest that the service received by patients has a direct effect on their The authors found that there was a statistically significant correlation between health service quality and patient satisfaction at Lancirang Health Center.
Keywords : Quality of health services.
patient satisfaction.
health centers Published by:
Article history :
Tadulako University Received : 17 04 2025 Address:
Received in revised form : 26 05 2025 Jl.
Soekarno Hatta KM 9.
Kota Palu.
Sulawesi Accepted : 28 08 2025 Tengah.
Indonesia.
Available online : 31 08 2025 Phone: 6282197505707 licensed by Creative Commons Attribution-ShareAlike 4.
0 International License.
Email: preventifjournal.
fkm@gmail.
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INTRODUCTION
Healthcare quality is an important pillar of the global health system.
Developed countries such as Sweden and Norway record patient satisfaction rates above 90%, demonstrating the importance of responsive, high-quality care.
In contrast, in developing countries such as Kenya and India, patient satisfaction rates are low, reaching 4% and 34.
4% respectively.
In Southeast Asia, surveys show that only 35% of patients are satisfied with the care they receive.
Similar conditions also occur in Indonesia.
Despite various quality improvement efforts, the level of patient satisfaction in 2023 is still in the range of 42.
8% to 70%, far from the national target of 95%.
One of the causes is the difference in patient perceptions of medical and non-medical services received.
Aspects such as staff communication, facility comfort, and speed of service play an important role in shaping patient satisfaction.
Several studies in Indonesia show that dimensions of service quality, such as reliability, assurance, tangibles, empathy, and responsiveness have a significant relationship with patient satisfaction.
However, the results of these studies often vary between locations.
For example, in the puskesmas dimension, not all aspects of service quality have a correlation with patient satisfaction.
In contrast, in the community health center, all dimensions have a significant influence.
The Indonesian Ministry of Health has established Permenkes No.
30 of 2022 as a guideline for strengthening service quality through national indicators, including patient satisfaction indicators.
However, its implementation still addresses challenges, especially in regions such as South Sulawesi, where the patient satisfaction rate in 2023 only reached 58%.
In Sidrap District.
Puskesmas Lancirang recorded a patient satisfaction rate of 3% in 2023, despite generally good service quality.
The discrepancy between service quality and satisfaction indicates certain problems such as aspects of staff
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communication, waiting time, and facility conditions.
If not addressed immediately, this could hinder the achievement of national targets and reduce public trust in health center services.
Based on this background.
The objective of this study was to assess the association of health quality service with patient satisfaction in the Lancirang health center working area, using the Servqual dimension approach as the basis for quality evaluation.
METHODS
This study was a quantitative study with an analytic survey design using a crosectional approach.
The research was conducted at Lancirang Health Center.
Pitu Riawa District.
Sidenreng Rappang Regency.
South Sulawesi, from January to March 2025.
Population was all of patients that accessed Lancirang Health Center services, with a sample size of 218 respondents obtained through random sampling techniques.
Sample selection was randomized based on the odd queue number of patients during the study Data collection was conducted through four techniques: direct observation, questionnaire distribution, interviews, and documentation.
Primary data was obtained from the results of filling out questionnaires and also from interviews, while supporting the data was obtained from internal reports of the health center and other supporting Data processing and analysis were carried out with the help of SPSS software.
The univariate test was used to describe the characteristics of the respondents, while the bivariate chi-square method was used to test the relationship between the dimensions of service quality .
eliability, assurance, tangible evidence, empathy, and responsivenes.
and patient satisfaction.
The results of the analysis are presented in the form of tables and narrative descriptions to provide an overall picture of the research findings.
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RESULTS
This study was conducted on 218 respondents who were patients of Lancirang Health Center.
The characteristics of the respondents showed that most were female .
7%) and were in the age range above 50 years .
1%).
In terms of education, most respondents were elementary/junior high school graduates .
3%) and the majority had visited the health center 1-3 times .
4%).
Table 1 Respondent Characteristics Characteristics of Respondents Gender Male Female Ages < 20 years 21-30 years 31-40 years 41-50 years > 50 years Last Education Elementary/Middle School High School/Vocational Diploma / Bachelor's Degree Postgraduate Others Visit to Health Center The First-time 1 - 3 Views 4 - 6 Views Over 6 Times Every Month Source: Primary Data, 2025 Univariate analysis showed that 87.
2% of respondents were satisfied with the services they received.
This indicates that in general, quality services at Lancirang Health Center have met the expectations of most patients.
However, there were still 12.
8% who PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XV1 NOMOR 2 were dissatisfied, indicating the need for improvement in certain aspects of the service as described in Table 2.
Table 2 Distribution of Patient Satisfaction at Lancirang Health Center Patient Satisfaction Not Satisfied Satisfied In Total Source: Primary Data, 2025 In the service quality dimension, most respondents rated the services at Lancirang Health Center as reliable .
%), guaranteed .
3%), adequate in terms of facilities .
%), empathetic .
7%), and responsive .
8%).
This shows that the five dimensions of quality measured in this study have generally been implemented well.
can be seen in Table 3
Distribution of Respondents' Perceptions of Service Quality Dimensions Quality of Service Reliability Reliable 157 72,0 Not Reliable 61 28,0 Assurance Guaranteed 175 80,3 Not Assured 43 19,7 Tangibles Adequate 170 78,0 Not Adequate 48 22,0 Empathy Empathic
178 81,7
Not Empathic
40 18,3
Responsiveness Responsive 174 79,8 Not Responsive 44 20,2 Source: Primary Data, 2025
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Bivariate analysis using the chi-square test showed that there was a relationship between all dimensions of service quality and patient satisfaction .
< 0.
Patients who rated the service as reliable had a higher level of satisfaction than those who rated the service as unreliable.
Similar findings were also seen in the assurance dimension, where patients who felt assured tended to be satisfied.
Similarly, physical facilities, empathy of health workers, and speed and responsiveness in providing services all showed significant positive correlations with patient satisfaction, as can be seen in Table 4.
Table 4
Relationship between Service Quality Dimensions and Patient Satisfaction Patient's Satisfaction pQuality Not Satisfied Satisfied Dimension Reliability Not Reliable 63,9 0,000 Reliable Assurance Not Assured 48,8 0,000 Guaranteed Tangibles Not Adequate 56,3 0,000 Adequate Empathy Not Empathic
21 52,5
47,5 0,000
Empathic Responsiveness Not Responsive 20 45,5 54,5 0,000 Responsive Source: Primary Data, 2025 From these results, the quality dimensions that most affect satisfaction are empathy and assurance, both of which show a large contrast between satisfaction and This shows that a friendly attitude, clear explanations, and attention from the staff are instrumental in creating satisfaction with the service.
Meanwhile, the tangible dimension is also important, but there is still room for improvement, especially in the comfort of the waiting room and other physical facilities.
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The results of the study involving 218 respondents at the Lancirang Health Center revealed that 87.
2% of patients were satisfied with the services received.
While this indicates a generally positive perception, the remaining 12.
8% who expressed dissatisfaction highlight specific gaps in service delivery.
Chi-square analysis confirmed significant correlations .
< 0.
between each of the five service quality dimensionsAi reliability, assurance, tangibles, empathy, and responsivenessAiand patient satisfaction.
Specifically, patients who perceived the services as reliable .
2% satisfactio.
, assured .
6%), empathetic .
1%), responsive .
4%), and supported by adequate tangibles .
9%) were significantly more satisfied.
These findings reinforce the multidimensional impact of perceived quality on satisfaction, underscoring the necessity of strengthening all aspects of service delivery.
DISCUSSION
The results of this study indicate that the quality of health services has a significant relationship with the level of patient satisfaction at Lancirang Health Center.
The five dimensions described reliability, assurance, tangible evidence, empathy, and responsiveness contribute significantly in shaping patient perceptions of service quality.
This finding strengthens the Servqual theory which states that service quality is measured based on the conformity between expectations and reality received by service .
The dimension of reliability or clarity is one of the important aspects that contribute greatly to patient satisfaction.
Timeliness, accuracy of diagnosis, and consistency in service delivery are the main indicators in this dimension.
This finding is in accordance with a research from Putri et all.
, who said that reliable and timely services increase patient trust and comfort in health care facilities.
When patients feel that medical personnel are able to provide services professionally and according to procedures, they tend to feel more satisfied.
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In the guarantee dimension, the competence of health workers, good communication skills, and courtesy are key factors in shaping satisfaction.
Patients who get clear information and feel safe while undergoing services tend to give positive This is supported by the results of research by Devy Febrianti et al.
which states that patient trust increases along with the quality of communication and professionalism of medical personnel.
Tangible dimensions or physical evidence such as the condition of the waiting room, neatness of facilities, and completeness of medical equipment also show a significant influence on patient satisfaction.
Comfortable and clean environmental services not only give a good impression, but also increase patient perceptions of overall service quality.
Arif et al.
also noted that good physical facilities are an important determinant in the formation of the patient's first impression of the services provided.
The empathy dimension, which emphasizes the empathy that healthcare workers are capable of, which includes the care, concern, and sensitivity of healthcare workers to the patient's condition, was found to strongly influence satisfaction levels.
When healthcare workers demonstrate an empathic attitude, patients feel valued and listened to, which results in a more positive service experience.
These results are consistent with Adri et al.
's .
study, which emphasized that medical personnel empathy can improve patient adherence to treatment and strengthen the relationship between patients and providers.
Meanwhile, the responsiveness dimension also proved to have a significant effect.
The speed of response to patient needs and the readiness of officers to handle complaints are important indicators of responsive service.
When patients feel served quickly and without delay, this creates a high sense of satisfaction.
Research by Saharani et al.
supports this finding, where speed of service is considered as one of the main determinants in assessing the quality of service in primary health facilities.
Overall, the conclusions of this research confirm that perceptions of perceived service quality play an important role in shaping patient satisfaction levels.
The PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XV1 NOMOR 2 dimensions of empathy and assurance are the most prominent aspects of influence at Lancirang Health Center.
This suggests that the interpersonal and communication aspects of health workers are still key in building a good service experience at the primary care level.
In addition, the alignment between good quality and suboptimal satisfaction indicates the need for further evaluation of technical details and humanistic approaches in service delivery.
This study confirms that patient satisfaction is heavily influenced by how well health services meet expectations in terms of communication, professionalism, and facility readiness.
The empathy and assurance dimensions emerged as the strongest contributors to satisfaction, indicating that patients highly value emotional support and clear, respectful interaction with healthcare staff.
However, despite generally high ratings in these areas, dissatisfaction persisted in 12.
8% of respondents.
This signals underlying issues, such as delays in service delivery, limited attention to patient complaints, or discomfort in the physical environment particularly in waiting areas.
These issues may not have been fully captured by broad satisfaction metrics, highlighting the need for qualitative feedback mechanisms.
The results also suggest that although service quality is perceived as good, patient expectations may continue to rise, especially in regions where healthcare access is improving.
CONCLUSIONS AND RECOMMENDATIONS
This study produces findings that show that the quality of health services has a close relationship with the patient level of patient at the Lancirang Health Center.
The five dimensions of quality measured reliability, assurance, tangible evidence, empathy, and responsiveness were all shown to contribute to the formation of positive patient perceptions of the services they received.
The dimensions of empathy and assurance appeared to be the most dominant aspects in influencing satisfaction, emphasizing the importance of caring interactions and professional communication between health
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workers and patients.
Although services were generally rated as good, the fact that there are still patients who are dissatisfied indicates the need for continuous evaluation and improvement in certain aspects, especially physical facilities and waiting time for services Based on the discussion of findings, several strategic recommendations are proposed to address the specific service quality issues identified in this study.
First, improving the comfort, cleanliness, and accessibility of waiting room facilities is essential, as tangible aspects of the service were among those rated lower by respondents.
Second, regular training programs focused on empathetic communication and active listening should be implemented to strengthen the positive impact of the empathy and assurance Third, the health center is encouraged to develop a real-time feedback system at service points to enable timely identification and resolution of patient Furthermore, reducing waiting times through more efficient registration procedures and improved patient flow management is crucial to enhancing overall Lastly, integrating patient satisfaction metrics into routine operational audits is recommended to ensure that perceived service quality remains aligned with actual improvements.
These measures should be prioritized according to their relevance to the key issues highlighted in this research, promoting targeted, evidence based enhancements to primary healthcare service delivery.
BIBLIOGRAPHY