The Effect of Service Quality on Outpatient Satisfaction of Dr.

Soegiri General Hospital Lamongan

THE EFFECT OF SERVICE QUALITY ON

OUTPATIENT SATISFACTION OF DR. SOEGIRI
GENERAL HOSPITAL LAMONGAN

JAM Maya Dewi Hanggraningrum

15, 4 Master of Hospital Management, Faculty of Medicine, Universitas Brawijaya Malang
Received, January 2017 Tita Hariyanti
Revised, March 2017 Achmad Rudijanto
June 2017
September 2017
Hospital Management, Faculty of Medicine, Universitas Brawijaya Malang
Accepted, December 2017

Abstract: Recently, tight competition requires hospitals to provide the best service and
quality. Quality services may cause satisfaction to the patient. This study aims to determine
the effect of quality service on satisfaction of outpatients at Hospital Dr. Soegiri Lamongan
simultaneously and partially. This study utilizes cross sectional approach which involves
235 respondents of simultaneous outpatients. The instrument uses a questionnaire by
employing independent and the dependent variables of satisfaction on quality service. The
sample was taken by applying proposed sampling method. The data were analyzed using
multiple linear regressions. The results of this study indicate that the service quality influ-
ence outpatients’ satisfactions.

Keywords: Service Quality, Satisfaction

Hospital is one of institutions to have more choices and demand better service
which are engaged in health quality. Service quality of hospital can be assessed
services and responsible for through customer perception (Tjiptono, 2000). Cus-
providing medical treatment tomer perception about the quality of service can
and medical care, concern on affect customer satisfaction (Kaihatu, 2012). Cus-
healing customers, and pro- tomer satisfaction begins with service given when
vide a healthy life for soci- a customer first arrives until the customer or pa-
ety as well as possible tient leaves the hospital. Hospital service is formed
Journal of Applied (Kaihatu, 2012). According based on 4 principles of service quality, namely
Management (JAM) to PERMENKES (Regula- speed, accuracy, friendliness and comfort of ser-
Volume 15 Number 4,
December 2017
tion of the Minister of Health vice (Wiyono, 2006).
Indexed in Google Scholar of the Republic of Indonesia) Dr. Soegiri General Hospital Lamongan is a
no.340/ MENKES/ PER/ non-educational type B hospital, which has been
III/ 2010, hospital is a health accredited with 16 services. The hospital is located
care institution that provides in the middle of Lamongan city, which provided 268
Correspondention Author: full-scale personal health ser- beds. Based on the type of service, the most visited
Maya Dewi Hanggraning-
rum, Master of Hospital vices including inpatient, out- polyclinics in outpatient installation are internal dis-
Management, Faculty of patient and emergency care ease polyclinic, heart polyclinic, and nerve polyclinic.
Medicine, Universitas
Brawijaya Malang services. The following is a description of patient visits in Table
DOI: http://dx.doi.org/
10.21776/ub.jam.2017.015.
The increase in the num- 1.
04.11 ber of hospitals leads patients

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 Maya Dewi Hanggraningrum, Tita Hariyanti, Achmad Rudijanto

Table 1 Data of outpatient visit in internal disease METHOD

polyclinic, heart polyclinic, and nerve poly- This research used cross sectional method to
clinic at Dr. Soegiri General Hospital
use independent variables and dependent variable.
Lamongan during 2013-2015
Independent variables are tangibles, responsiveness,
YEAR reliability, assurance, empathy, and dependent vari-
NO POLYCLINIC
2013 2014 2015 able is satisfaction. This study was conducted in
1 Heart 6316 5131 3034 July 2016. The respondents are patients who vis-
2 Internal Diseases 17365 15225 20254 ited outpatient department at Dr. Soegiri General
3 Nerve 9977 7768 11148 Hospital Lamongan more than twice. Population in
Source: Report of Dr. Soegiri General Hospital Lamongan this research is not known (infinite), Sampling tech-
during 2013-2015 nique used this research is purposive sampling.
In this study, the data was collected by using
questionnaires. The answers were measured by
Table 1 show that there is a decrease in patient
using Likert scale, consisting of five answer op-
visits in heart polyclinic. Demands arise from hos-
tions. Questionnaires had been prepared to obtain
pital customers, both patients and patients’ family,
complete information from respondents (Amrullah,
not only on the availability of medicines and medi-
2013). The research instrument is qualified if the
cal personnel but also including good care and rela-
instrument is valid and reliable (Sujarweni, 2015).
tionship, which are also believed to help the recov-
The result of validity test shows that all state-
ery process of patients’ condition. Patients expect
ment items produce correlation value greater than
the convenience of service, speed of service, and
cut off value of 0.3. In this study, all items are de-
good service quality.
clared to be valid. The result of reliability test in this
The quality of good hospital services will lead
study shows that all variable items have cronbach’s
to patient satisfaction (Kaihatu, 2012). Data of pa-
alpha () > 0.6, which are declared to be reliable.
tients’ complaint in Dr. Soegiri General Hospital
Lamongan obtained in the last three years are about;
RESULTS
infrastructure, health personnel, management and
services. From the data, the ones obtaining most Characteristics of Respondents
complaints are health workers. The majority of respondents are 41 - 60 years
In the last three years, in Dr. Soegiri General old (42.1%), female (63.3%), married (79.6%), high
Hospital Lamongan, society can express their com- school graduates (37.4%), housewives (37.4%);
plaints through suggestion and criticism box as well distance between the house of majority of respon-
as through media. Most complaints are about health dents and hospital is 10 km (46.4%); and majority
workers, infrastructure, and management. of respondents pay medical treatment cost with in-
surance (34.0%). Respondents who were taken in
Table 2 Data of public complaints this study are patients who had used health services
at Dr. Soegiri General Hospital Lamongan.
No Category 2013 2014 2015 Total
1. Facility &
The Influence of Service Quality on Outpa-
infrastructure 2 3 5 10
2. Medical personnel tient Satisfaction of Dr. Soegiri General Hos-
Doctor 9 5 8 22 pital Lamongan
Nurse 4 7 6 17 The results of multiple linear regression test
Medical staff 3 3 4 10 show the influence of tangibles, responsiveness,
3. Management reliability, assurance, and empathy on patient satis-
& service 4 5 5 14 faction, which can be seen in the following table:
Source: Data of Dr. Soegiri General Hospital Lamongan dur-
ing 2013-2015

644 JOURNAL OF APPLIED MANAGEMENT VOLUME 15 NUMBER 4 DECEMBER 2017

 The Effect of Service Quality on Outpatient Satisfaction of Dr. Soegiri General Hospital Lamongan

Tabel 3 Results of Multiple Linier Regression Analysis

Variable Coefficient Standardized Coefficient T-statistic Prob

Constant 1.246 9.854 0.000
Tangibles 0.094 0.116 2.257 0.025
Responsiveness 0.136 0.183 3.517 0.001
Reliability 0.250 0.320 5.888 0.000
Assurance 0.193 0.234 3.806 0.000
Empathy 0.103 0.131 2.306 0.022
F-statistic = 123.480 Prob = 0.000
R-squared = 0.729 Adj. R-squared = 0.724
Source: Primary Data, Processed in 2016

The test results (Table 3) show that tangibles, Soegiri General Hospital Lamongan with more than
responsiveness, reliability, assurance, empathy have one visit; therefore, the researchers determine some
a positive effect on patient satisfaction simulta- characteristics of respondents in this study. The first
neously (Fcount= 123.480, with probability 0.000). characteristic is patients’ age. Most of the respon-
Positive and significant effect statistically exists in dents in this study aged 41-60 years old; the per-
variable of tangibles on satisfaction of outpatient centage reaches 42.1%. Respondents’ age influ-
service at Dr. Soegiri General Hospital Lamongan ences the decision process; the older a person, the
(tcount amounted to 2.257, with probability of 0.025). better his response to a product (Renatha, 2013). In
Positive and significant effect statistically exists in addition, according to Budiman (2016), older patients
variable of responsiveness on outpatient satisfac- will be satisfied compared with younger patients.
tion of Dr. Soegiri General Hospital Lamongan (tcount This is because older patients ask health workers
amounted to 3.517, with probability of 0.001). Posi- about their physical condition more frequently; it
tive and significant effect statistically exists in vari- meets their need for knowledge and understanding
able of reliability on outpatient satisfaction Dr. of health. Changes in mindset will have an impact
Soegiri General Hospital Lamongan (tcount amounted on efforts to obtain information that is beneficial to
to 5.888, with probability of 0.000). Positive and sig- the customer (Herlambang et al, 2011).
nificant effect statistically exists in variable of as- The next characteristic is sex. The majority of
surance on outpatient satisfaction of Dr. Soegiri respondents in this study are female. In this case,
General Hospital Lamongan (t count amounted to women have behavior related to patient satisfac-
3.806, with probability of 0.000). Positive and sig- tion (Notoatmojo, 2003). In line with the research
nificant effect statistically exists in variable of em- which was conducted by Lumenta (1989) and
pathy on outpatient satisfaction of Dr. Soegiri Gen- Budiman, Suhat (2010), female is a predisposing
eral Hospital Lamongan (tcount amounted to 2.306, factor that influences behavior. Meanwhile, accord-
with probability of 0.022). The test results also show ing to Kartajaya (2010), young women who have
that variable of service quality contributed 72.4% internet connection play a strategic role in decision
to outpatient satisfaction of Dr. Soegiri General making. Women have an influence of 80% in using
Hospital Lamongan. goods or services that will be used. This is because
women tend to go shopping more than men and
DISCUSSION women can decide goods or services to be used
Characteristics of Respondents more freely, Magnadi and Indriani (2013). This is in
line with the opinion of Budiman and Lumenta (1989)
Respondents in this research are patients who
in Suhat (2010) that sex affects satisfaction; women
use health facility in outpatient department of Dr.

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 Maya Dewi Hanggraningrum, Tita Hariyanti, Achmad Rudijanto

are more easily satisfied than men. In this case, men to 50% and gives enough reason that long distance
demand greater satisfaction. is not a constraint of respondents to use health fa-
The next characteristic is marital status. Most cilities of Dr.Soegiri General Hospital.
of the respondents in this study are married (187 The next characteristic is the cost of treatment.
people or 79.6%). This is because family affects The number of respondents who do not use insur-
the process of attitude, perception, and behavior ance to pay the cost of treatment is 80 or 34.0%.
(Ainda, Tristiawan 2014). Family is defined as two There are also 64 respondents or 27.2% patients
or more persons who are linked by blood relations, paying the cost of treatment directly by cash. This
marriage, or adoptions, who live together (Schiffman is because insurance payment system will increase
and Kanuk, 2008). Family is an external factor in the satisfaction of patients in receiving services, the
the direct or indirect influence on the behavior and service of administration service or medical services/
attitude of consumer in purchase decision (Kotler care (Nurjanah, 1997 and Budi, HS 2010).
and Armstrong, 1996).
The next characteristic is education level. Most Tangibles, responsiveness, reliability, assur-
of the respondents involved in this study finished ance, and empathy has a simultaneous effect
senior high school (88 people or 37.4%). Based on on outpatient satisfaction of Dr. Soegiri Gen-
the Law of the Republic of Indonesia number 20 of eral Hospital Lamongan
2003 on the national education system states, high The results of this research show that tangibles,
school education is included in the group of second- responsiveness, reliability, assurance, and empathy
ary education. Having finished secondary educa- contribute 72.4% to outpatient satisfaction of Dr.
tion makes a person has sufficient understanding in Soegiri General Hospital Lamongan. The results of
making decisions. Wendha, Rahyuda, G and Atmo- this study indicate that hospital that has superior
sphere (2013) suggest that people with high educa- quality and consistency can foster patient satisfac-
tion tend to be more rational in choosing services to tion (Sugiharto, Sugianto, 2013). In addition, simul-
be used, so respondents with higher education tend taneously patients also consider the convenience of
to choose services that provide more satisfaction the environment, the speed of service, the polite-
and security. ness of medical staff in performing their duties, the
The next characteristic is job. Most of respon- trustworthiness of medical staff, and the sympathy
dents in this study are housewives (87 people or shown by medical staff of Dr. Soegiri General Hos-
37.0%). This is because a housewife has 7 roles to pital Lamongan as a place for medical treatment.
do, 1) as a parent, 2) as a wife, 3) role in the house- This is in line with a research which was conducted
hold, 4) role in kinship, 5) personal role, 6) role in by Kaihatu (2012), stating that the quality of ser-
community, and 7) role in work. Housewife has a vice is proven to have positive and significant ef-
role to support the head of household (husband) in fect on patient satisfaction. The research which was
meeting the need of family to realize prosperous conducted by Zeithaml & Bitner (1996) also sup-
family (Tjokrowinoto, 1986 in Muhibat 1994). ports the results of this study; it states that satisfac-
Magnadi and Indriani (2013) argue that housewives tion is influenced by the quality of service provided,
have more time to interact with others, and act as so that the better the service quality shown, the
influencers and decision makers in purchasing a higher the satisfaction of patients. Meanwhile, in
product/ service including the decision to choose their study, Putra et.al (2013) state that the higher
health services. the quality of service, the more positive the percep-
Furthermore, the researchers pay attention to tion perceived by patients. High patients’ percep-
another important characteristic i.e. distance of pa- tion of the quality of a service will lead to high the
tients’ house with Dr. Soegiri General Hospital satisfaction of patients.
Lamongan. Researchers found that respondents The results of this study indicate the direct ef-
who live more than 10 km away from the hospital fect of service quality on patient satisfaction. The
are 109 people or 46.4%. This percentage is close results of this research are in line with previous

646 JOURNAL OF APPLIED MANAGEMENT VOLUME 15 NUMBER 4 DECEMBER 2017

 The Effect of Service Quality on Outpatient Satisfaction of Dr. Soegiri General Hospital Lamongan

study which was conducted by WU (2011) and patient satisfaction of Dr. Soegiri General Hospital
Kaihatu (2012), showing a positive and significant Lamongan. The influence of responsiveness on pa-
effect of service quality and patient satisfaction. tient satisfaction can be seen from the decision of
Trarintya (2011) states that service quality has a respondents to choose Dr. Soegiri General Hospital
positive and significant effect on outpatient satis- Lamongan for it provides quick service, responsive-
faction. Service quality has a positive and signifi- ness, prioritizes the interest of patients, has aware-
cant effect on word of mouth (WOM) of outpa- ness and desire to help customers, and provide ser-
tients. Satisfaction has a positive and significant ef- vices quickly.
fect on word of mouth (WOM) of outpatient. WOM The results of this study indicate that respon-
can convey the positive side of customer satisfac- dents will feel satisfied with the medical service if
tion of the quality of service, customer value and the medical staff has a good responsiveness. Re-
the superiority of product or service offered sponsiveness is a willingness to help and provide
(Sugiharti, 2010). prompt and proper service to customers by deliver-
ing clear information. Letting patients or customers
Tangibles influences outpatient satisfaction of wait without a clear reason leads to negative per-
Dr. Soegiri General Hospital Lamongan ception of service quality (Tjiptono, F 2001).
The result of descriptive analysis shows that
variable of tangibles has a positive effect on patient Reliability affects outpatient satisfaction of Dr.
satisfaction. It indicates that patients choose to get Soegiri General Hospital Lamongan
medical treatment of Dr. Soegiri General Hospital The results of research and statistical analysis
Lamongan when they are sick, by considering the show a positive effect on outpatient satisfaction of
infrastructure and facility provided, modern equip- Dr. Soegiri General Hospital Lamongan. Respon-
ment, trusted service, and comfortable environment. dents choose Dr. Soegiri General Hospital
This indicates that the patients have a perception of Lamongan by considering the quick service, punc-
four reasons simultaneously in using health facili- tuality of service time, ease in making appointment
ties of Dr. Soegiri General Hospital Lamongan. Tan- for medical treatment, the politeness of the medical
gibles are physical manifestations that include ex- staff in conducting their duty. In this case, reliability
isting equipment, existing medical personnel, com- can affect patient satisfaction and lead to patient
fortable treatment rooms, adequate facilities, and loyalty. Reliability is the ability of the company to
comfort during treatment. Tangibles (physical evi- provide services in accordance with the service that
dence) is the ability of a company to show its exist- has been offered accurately and reliably. Service
ence to external parties. Appearance of office and reliability includes quick and accurate patient ad-
employees, the condition of facilities and physical mission procedure, good and useful service proce-
infrastructure of the company (including communi- dures (not complicated), prompt service and time,
cation facilities), as well as the surrounding envi- and error-free services provided by the medical
ronment of the services provided to the patient. The personnel (Tjiptono, F 2001).
appearance of service is not only limited to the physi-
cal appearance of the building, but also the appear- Assurance affects outpatient satisfaction of Dr.
ance of the medical staff and the availability of sup- Soegiri General Hospital Lamongan
porting infrastructure (Lupiyoadi, Rambat (2006), The results of research and statistical analysis
Darmawansyah, Alwy (2013)). show that assurance has a positive effect on pa-
tient satisfaction of Dr. Soegiri General Hospital
Responsiveness influences outpatient satisfac- Lamongan. In this study, respondents’ assessment
tion of Dr. Soegiri General Hospital Lamongan of assurance shows that medical personnel are clean
The results of research and statistical analysis and tidy, record medical history of patients accu-
show that responsiveness has a positive effect on rately, trustworthy, treat patients safely, deliver clini-

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 Maya Dewi Hanggraningrum, Tita Hariyanti, Achmad Rudijanto

cal regulations politely, and have adequate knowl- vice. Quality of service has a positive effect on sat-
edge. Assurance (guarantee) is knowledge, polite- isfaction, if service quality is good, then consumer
ness, courtesy, and the ability of the employees of a satisfaction will increase, Tumpal, (2012). Satisfac-
company to cultivate customers’ trust to the com- tion will never stop at one point; it is moving dy-
pany, including knowledge, ability, courtesy, cred- namically and following the level of quality of its
ibility, and safety, which can affect customer satis- products and services, with customers’ expectations
faction (Darmawansyah and Alwy, 2013). which is increasing from time to time. Patient ex-
pectation is influenced by patients’ previous experi-
Empathy affects outpatient satisfaction of Dr. ences, advice from friends and colleagues, as well
Soegiri General Hospital Lamongan as promises and information given by marketers and
Empathy (attention) is the fifth variable in this competitors, Palilati. A (2007).
research. The results of research and statistical Based on the results of this research, it can be
analysis show that empathy has a positive effect on concluded that there is effect of tangibles, respon-
outpatient satisfaction of Dr. Soegiri General Hos- siveness, reliability, assurance, and empathy on out-
pital Lamongan. In this case, the respondents chose patient satisfaction of Dr. Soegiri General Hospital
Dr. Soegiri General Hospital Lamongan because the Lamongan. Reliability gives the biggest contribution
medical staff shows the place of service, give in- to outpatient satisfaction of Dr. Soegiri General
formation needed easily, show sympathy, understand Hospital Lamongan.
the need of the patient, pay much attention to pa-
tients, and are willing to help. Empathy (attention) CONCLUSION AND SUGGESTION
consists of a sense of care to give individual atten- CONCLUSION
tion to customers, understand customer needs, and Quality of service affects outpatient satisfac-
accessibility (ease of contact), Imbalo (2007), tion of Dr. Soegiri General Hospital Lamongan si-
Tjiptono (2005). multaneously and partially. In this research, the most
Hariyanto, Resti (2013) states that one of the dominant dimension is reliability.
factors that determines the success rate of a com-
pany is the ability of the company in providing qual- SUGGESTION
ity service to customers, in order to achieve satis-
Based on the findings obtained in this study that
faction. Quality is a dynamic condition associated
the most dominant variable is reliability and the one
with products, services, people, processes, and en-
needs to be improved is empathy, the researcher
vironment that meet or exceed customer expecta-
suggests Dr. Soegiri General Hospital Lamongan to
tion. Quality has a close relationship with customer
supervise medical staff by monitoring them to smile,
satisfaction. Satisfaction is the feeling of pleasure
greet, and wish patients to be well soon, in accor-
or disappointment of a person, derived from the
dance with the motto of Dr. Soegiri General Hospi-
comparison between the impression and expecta-
tal Lamongan.
tion of the service/ product and the performance
perceived, Tjiptono 2005 and Kotler, 1997 in Sugiarto
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