Business Management Vol.
5 No 1 Februari 2026 p-ISSN:2828-7606, e-ISSN:2828-8203 DOI: 10.
58258/bisnis.
10241/https://ejournal.
org/index.
php/Bisnis The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi Nabila Mazaya Putri1.
Bayu Wahyudi2.
Wiseto P.
Agung3 Universitas Adhirajasa Reswara Sanjaya Article Info Article history:
Accepted: 1 January 2026 Publish: 1 February 2026 Keywords:
Digital.
Variable.
Number.
Permata.
Bekasi.
Abstract This study aims to analyze the effectiveness of digital marketing in increasing the number of patients at Permata Hati Bunda Clinic, considering human resource (HR) quality as an intervening variable.
A quantitative method with an explanatory research design was The study involved 100 patients selected using consecutive Primary data were collected through a Likert-scale questionnaire, while secondary data were obtained from clinic patient records.
Data analysis employed Structural Equation ModelingAePartial Least Squares (SEM-PLS).
The findings indicate that digital marketing has a positive and significant effect on patient Furthermore.
HR quality significantly influences the effectiveness of digital marketing implementation.
Another key finding reveals the mediating role of HR quality as a partial mediator that strengthens the impact of digital marketing on patient Thus, the success of digital marketing strategies in clinics is not solely determined by content and digital platforms but also relies on staff competence, responsiveness, and professionalism in managing patient interactions.
This research highlights that integrating digital marketing strategies with HR quality development is essential to enhance patient acquisition and build long-term This is an open access article under the Lisensi Creative Commons Atribusi-BerbagiSerupa 4.
0 Internasional Corresponding Author:
Nabila Mazaya Putri Universitas Adhirajasa Reswara Sanjaya Email: nabilamazayaputri@gmail.
INTRODUCTION
The rapid development of information and communication technology has given rise to new internet-based media that are changing communication patterns and people's access to information.
The internet is a concrete manifestation of the modern communication revolution, enabling individuals to interact and obtain information quickly without the constraints of space and time (Rosana, 2010.
Puspita, 2.
McLuhan .
emphasized that digital technology is not just a communication tool, but also helps shape people's ways of thinking and behaving.
New media have the main characteristics of interactivity, decentralization, and flexibility, which distinguish it from conventional media (McQuail.
The development of digital media has encouraged the formation of a participatory media culture, where individuals are not only consumers of information but also play an active role in producing and distributing it (Jenkins et al.
, 2.
Information received through digital media has the potential to influence public attitudes, perceptions, and 124 | The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi (Nabila Mazaya Putr.
Business Management e-ISSN : 2828-8203, p-ISSN: 2828-7606 behavior, including in decision-making regarding healthcare services (Widjaja, 2.
This condition makes digital technology a strategic instrument in influencing public choices and preferences regarding a service.
In the healthcare sector, digital transformation is encouraging healthcare facilities to adopt digital marketing strategies to reach a wider and more effective audience.
Research by Rahmayanti and Yuliaty .
shows that utilizing Instagram as a marketing medium can increase visits by new and existing patients through the presentation of informative and educational content.
Similar findings were also presented by Zakaria and Nadjib .
, who stated that social media plays a significant role in promoting healthcare services due to its ease of use and relatively low cost.
Digital marketing has been shown to increase brand awareness and interaction between healthcare facilities and patients (Jaya & Andriani, 2.
On the other hand, the quality of human resources (HR) is a key factor in determining the quality of healthcare services and patient satisfaction.
Research by Bella .
and Agung et al.
found that HR quality significantly influences service quality in healthcare facilities.
Hutry Maulida et al.
emphasized that developing healthcare worker competencies positively impacts the quality of hospital services.
However, most of these studies still position HR quality as a stand-alone factor and have not directly linked it to the effectiveness of digital marketing strategies in increasing patient visits.
Based on this description, there is a research gap regarding the integration of digital marketing effectiveness and human resource quality in influencing the number of patient visits, particularly in small-to-medium-scale private clinics.
This research was conducted at the Permata Hati Bunda Clinic in Bekasi City, positioning human resource quality as an intervening variable between digital marketing and the number of patient visits.
This study also considered the current regulatory framework, such as Law Number 17 of 2023 concerning Health and Ministerial Regulation Number 24 of 2022 concerning Electronic Medical Records.
Therefore, this research is expected to provide theoretical contributions to the development of healthcare marketing studies and practical recommendations for clinic managers in designing effective, sustainable, and regulatory-compliant digital marketing strategies.
RESEARCH METHODS
This research uses a quantitative approach with explanatory research.
This study aims to examine the effect of digital marketing effectiveness on the number of patient visits, with human resource quality as an intervening variable.
A quantitative approach was chosen because the study focuses on measuring the relationship between measurable variables and analyzing them statistically (Sugiyono, 2008.
The research object was the Permata Hati Bunda Clinic in Bekasi, with the analysis unit being patients who had received services and were exposed to the clinic's digital marketing information.
The study population was all patients who visited the clinic in the past year, with a fluctuating number of visits of approximately 500 patients per year.
Therefore, this study used non-probability sampling with a technique of consecutive sampling, namely recruiting all patients who met the inclusion criteria sequentially until the sample size was The research sample was determined to be as many as 100 respondents, which was deemed adequate for multivariate analysis and mediation testing, and in accordance with the minimum sample size recommendations for uncertain populations (Cochran, 1.
Inclusion criteria included patients aged Ou18 years, having visited at least once in the past 12 months, and being willing to complete the questionnaire.
Patients in emergency conditions or refusing to participate were excluded.
125 | The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi (Nabila Mazaya Putr.
Business Management e-ISSN : 2828-8203, p-ISSN: 2828-7606 Data collection is done through a five-point Likert scale questionnaire compiled based on indicators of digital marketing effectiveness variables, human resource quality, and number of patient visits, and supported by secondary data in the form of clinic patient visit records.
The data analysis technique used was Structural Equation ModelingAe Partial Least Squares (SEM-PLS) because it can test direct and indirect relationships between variables and is suitable for relatively small sample sizes.
Analysis is carried out through testing the outer model to assess the validity and reliability of the instrument, as well as the inner model to test the influence between latent variables.
This approach is expected to provide a comprehensive overview of the role of digital marketing and human resource quality in increasing the number of patient visits at the Permata Hati Bunda Clinic in Bekasi.
RESEARCH RESULTS AND DISCUSSION
Respondent Characteristics Respondent characteristics are crucial to this research because they provide a general overview of the profile of the respondents in the research sample.
Information on demographic and social aspects such as gender, age, education level, occupation, and experience using clinical services is necessary to understand the context of the By understanding the respondents' backgrounds, researchers can assess the suitability of the sample for the research objectives and interpret the results of the data analysis more accurately.
Furthermore, describing respondent characteristics helps ensure that the research sample represents the intended population, thus enhancing the validity of the research results.
Table 4.
1Respondent Gender
Gender
Man
16 16,0
Woman
84 84,0
Total
10 100,
Table 4.
2Age Group
Age Group
< 20 years 20Ae29 years 45 45,0 30Ae39 years 34 34,0 40Ae49 years 13 13,0 Ou 50 years Total
10 100,
Table 4.
3 Last education Education Junior high
school/equiva High
36 36,0
School/Vocat ional School
Diploma
16 16,0
126 | The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi (Nabila Mazaya Putr.
Business Management e-ISSN : 2828-8203, p-ISSN: 2828-7606
S2/S3
Total
38 38,0
10 100,
Table 4.
4Main Job
Work
Students 10 10,0 Employees/Professio 55 55,0 Businessman 18 18,0 Housewife 12 12,0 Other Total
10 100,
Table 4.
5Visit Status & Digital Information Sources .
Variables Category Visit status
New patient
6 61,
Old patient
3 39,
Clinical knowledge Instagram
6 62,
TikTok
1 18,
Google/Website 1 12.
WhatsApp/Frien 7 7,0 Other 1 1,0 Table 4.
6Digital Behavior Related to Clinics Indicator Categor f
Follow the clinic's IG account
7 72,
2 28,
Frequency of viewing content/week O1x
2 24,
2Ae3x
4 48,
Ou4x
2 28,
Have you ever DM/commented before 3 31, 6 69, 127 | The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi (Nabila Mazaya Putr.
Business Management e-ISSN : 2828-8203, p-ISSN: 2828-7606 Based on n = 100 respondents, the majority were female .
%) with a dominant age range of 20Ae39 years .
%).
The education level was dominated by high school/vocational school .
%) and bachelor's degree .
%), in line with the profile of the clinic's digitally literate audience.
The main occupation of most was employee/professional .
%), followed by entrepreneur .
%).
Sixty-one percent were new patients, indicating active customer acquisition.
The primary digital channel for finding out about the clinic was Instagram .
%), followed by TikTok .
%) and Google/Website .
%).
In addition, 72% of respondents followed the clinic's Instagram account, and 31% had interacted (DM/commen.
before their visit.
This pattern indicates that content and interaction on Instagram play a significant role in driving patient visit decisions.
Convergent Validity (Outer Loading & AVE) Criteria: Outer Loading Ou 0.
AVE Ou 0.
Table 4.
7 Outer Loading per Indicator Construct
Indicato
Outer
Informati Loading Digital Marketing 0,78 Valid
Effectiveness (X) 0,82 Valid
0,75
Valid
0,80
Valid
0,84
Valid
Human Resources Quality (Z) Z1
0,77
Valid
0,83
Valid
0,80
Valid
0,81
Valid
0,85
Valid
Number of Patients (Y) 0,79 Valid
0,82
Valid
0,76
Valid
0,81
Valid
0,84
Valid The outer loading test results show that all indicators in the three constructsAi Digital Marketing Effectiveness (X).
Human Resource Quality (Z), and Number of Patients (Y)Aihave loading values above 0.
This indicates that each indicator adequately represents the latent variable being measured.
Therefore, all items in the questionnaire are suitable for use because they meet convergent validity requirements, meaning the indicators accurately measure the concepts addressed in this study.
Table 4.
Summary of AVE per Construct Construct Digital Marketing 0,62 Effectiveness (X) Human Resources Quality (Z) 0,65 Number of Patients (Y) 0,61 128 | The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi (Nabila Mazaya Putr.
Business Management e-ISSN : 2828-8203, p-ISSN: 2828-7606 The AVE values for each construct ranged from 0.
61 to 0.
65, exceeding the minimum threshold of 0.
This means that more than 50% of the indicator variance can be explained by the measured construct.
This indicates that each construct has a good level of convergent validity, enabling the indicators to adequately explain the latent variables.
Therefore, the variables Digital Marketing Effectiveness.
Human Resource Quality, and Number of Patients can be declared valid based on the AVE Construct Reliability (CR) & Internal Consistency (CronbachAos Alph.
Construct reliability is a crucial step in testing a research instrument to ensure that the indicators used provide consistent results when used repeatedly.
Reliability testing is conducted to assess the extent to which an instrument has internal consistency in measuring a construct.
In other words, reliability indicates the degree of consistency between question items in representing the latent variables being studied.
In SEM-PLSbased quantitative research, two commonly used measures are Composite Reliability (CR) and Cronbach's Alpha, both of which provide an overview of the stability and consistency of the research instrument.
Criteria: CR Ou 0.
Cronbach's Alpha Ou 0.
60Ae 70 .
ood, >0.
80 very goo.
Table 4.
Construct Reliability Construct Composite Reliability CronbachAos Results (CR) Alpha Digital Marketing 0,89 0,85 0,62 Reliable Effectiveness (X) Human Resources Quality (Z) 0,90 0,86 0,65 Reliable Number of Patients (Y) 0,88 0,83 0,61 Reliable The reliability test results show that the Composite Reliability (CR) values for all constructs range from 0.
88 to 0.
90, and the Cronbach's Alpha values range from 0.
Both values are above the minimum threshold (CR Ou 0.
Alpha Ou 0.
, and are even considered excellent (>0.
This demonstrates that the research instrument has high internal consistency, indicating that the items within each construct consistently measure the same variable.
Therefore, the instrument used is reliable and can be relied upon for further analysis at the inner model testing stage.
Path Analysis (Inner Model Ae SEM-PLS) Path coefficient analysis in SEM-PLS aims to examine the relationships between latent variables defined in the research model.
Through a bootstrapping approach, path coefficient estimates and significance tests are obtained to determine whether the relationship between variables is statistically significant.
The path coefficient values indicate the direction and strength of the influence, while the t-statistic and p-value are used to determine whether the research hypothesis is accepted or rejected.
Criteria: significant relationship if p < 0.
Connecti Path Coefficient tpResults () stat value XIeZ
0,58
8,10 <0,001 Significan 129 | The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi (Nabila Mazaya Putr.
Business Management e-ISSN : 2828-8203, p-ISSN: 2828-7606
ZIeY
0,41
4,20
<0,001
XIeY
0,32
3,30
0,001
Significan Significan Brief interpretation: The effectiveness of digital marketing has a strong influence on HR Quality (=0.
, and both HR Quality (=0.
and Digital Marketing (=0.
have a significant positive influence on the Number of Patients.
This means that there is a direct influence XIeY and an indirect path XIeZIeY that are both significant.
Model Explanatory Power (RA) The coefficient of determination (RA) is used to assess the extent to which independent variables can explain the variation in the dependent variable in a research The RA value indicates the model's explanatory power.
the higher the value, the greater the proportion of the dependent variable's variability that can be explained by the independent variables.
Therefore.
RA is an important indicator in evaluating the quality of a structural model in SEM-PLS.
General criteria (Cohe.
: 0.
26 = moderate.
13 = small.
39 = large .
Endogenous RA Construct Adjusted Z (Human 0,3 0,33 Resources Qualit.
Y (Number of 0,5 0,51 Patient.
Interpretation: 34% of the variation in HR Quality is explained by Digital Marketing.
52% of the variation in the Number of Patients is explained by the combination of Digital Marketing and HR QualityAia moderateAestrong category for the clinical service context.
Direct.
Indirect (Mediate.
, and Total Effects The analysis of direct, indirect, and total effects aims to provide a more comprehensive picture of the relationships between variables in a structural model.
The direct effect describes the influence of one independent variable on the dependent variable without going through an intermediary variable, while the indirect effect shows the influence mediated by the intervening variable.
Using the bootstrapping technique in SEM-PLS, the significance of the mediation path and the extent to which the intervening variable strengthens or weakens the influence between variables can be The results of the total effect calculation are then used to assess the overall contribution of the independent variables to the dependent variable.
Bootstrapping the mediation path X Ie Z Ie Y:
Effect Type tpConclusio stat value Direct (X Ie Y) 0,32 3,30 0,001 Significant Indirect (X Ie Z Ie Y) 0,24 3,55 <0,001 Significant Total (X Ie Y) 0,56 7,10 <0,001 Significant 130 | The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi (Nabila Mazaya Putr.
Business Management e-ISSN : 2828-8203, p-ISSN: 2828-7606 Mediation Conclusion: Since both direct and indirect effects are significant, partial mediation by Human Resource Quality (Z) occurs in the relationship between Digital Marketing (X) and Number of Patients (Y).
Practically, digital marketing increases the number of patients directly .
romotion/acquisitio.
and indirectly through improving Human Resource Quality .
igital competence, responsiveness, professionalis.
, which strengthens patient conversion and retention.
Discussion 1 Digital Marketing has an impact on increasing the number of patients at Permata Hati Bunda Clinic The results of the study indicate that digital marketing has a positive and significant impact on increasing the number of patients at Permata Hati Bunda Clinic.
Digital marketing strategies through social media, educational content, patient testimonials, and digital advertising serve as the starting point .
irst contac.
that encourages potential patients to learn about, trust, and ultimately choose the clinic's services.
This finding aligns with Pasaribu et al.
and Andrade et al.
, who stated that optimizing digital media, including social media and online advertising, can increase the visibility of healthcare facilities while converting interest into actual visits.
Digital marketing not only works directly to attract new patients but also indirectly through increasing awareness, reputation, and trust, which contribute to repeat visits and patient recommendations.
Thus, digital marketing has proven to be a strategic instrument in increasing the number of patients at Permata Hati Bunda Clinic.
The quality of human resources influences the effectiveness of digital marketing This study demonstrates that human resource (HR) quality significantly influences the effectiveness of digital marketing implementation at Permata Hati Bunda Clinic.
Digital competence, communication skills, creativity, responsiveness, and employee professionalism in managing digital channels have been shown to determine the success of online marketing campaigns.
This finding is consistent with Alfansi and Anggadini .
and Suprapti et al.
, who stated that HR competence and creativity play a crucial role in increasing consumer engagement and trust through digital media.
Furthermore.
Widyastuti and Setiawan .
emphasized that the speed and quality of employee responses to online patient inquiries increase the probability of in-person visits.
Therefore.
HR quality not only supports the technical aspects of digital marketing but also shapes the initial patient experience, which determines the effectiveness of digital promotions.
3 Roles of Human Resource Quality as an Intervening Variable The analysis shows that human resource quality acts as an intervening variable, strengthening the influence of digital marketing on increasing patient numbers at Permata Hati Bunda Clinic.
Digital marketing can attract patient interest, but converting that interest into a decision to visit is more optimal when supported by competent and professional human resources who manage digital This finding aligns with Putri and Widodo .
Pratiwi et al.
and Rahmawati and Kurniawan .
, who stated that human resource quality 131 | The Effectiveness of Using Digital Marketing with the Intervening Variable of Human Resource Quality on Increasing the Number of Patients at the Permata Hati Bunda Clinic.
Bekasi (Nabila Mazaya Putr.
Business Management e-ISSN : 2828-8203, p-ISSN: 2828-7606 mediates the effectiveness of digital marketing strategies in the healthcare sector.
In this context, human resources serve as a link between digital promotions and patient decisions, through responsive, informative, and convincing communication.
Therefore, digital marketing and human resource development must be viewed as an integrated strategy to sustainably increase patient numbers.
CONCLUSION
The effectiveness of digital marketing has a positive and significant impact on human resource quality and the number of patient visits.
These findings indicate that the better a clinic implements digital marketing .
hrough informative, interactive, and easily accessible conten.
, the higher patient perceptions of service professionalism, which ultimately leads to an increase in patient visits.
Human resource quality significantly influences the number of patient visits and has been shown to mediate the relationship between digital marketing effectiveness and the number of patient visits.
This means that effective digital marketing will deliver optimal results only if supported by competent, responsive, and communicative healthcare workers and staff.
Therefore, human resource quality is a key factor in the success of digital marketing strategies in increasing patient numbers.
BIBLIOGRAPHY