The Influence of Outpatient Service Quality and Patient Characteristics on BPJS Patient Satisfaction at Hospital X Mediated by Doctor-Patient Relationship
Keywords:
doctor patient relationship, outpatient service quality, patient characteristics, patient satisfaction
Abstract
The performance of nurses needs attention from health service providers because it can be related to the quality of health services. This study aims to analyze the effect of outpatient service quality and patient characteristics on patient satisfaction through the mediation of the doctor-patient relationship. Respondents in this study were 294 outpatients using BPJS at Hospital X. The type of research used is descriptive quantitative and was conducted at one point in time (cross sectional). The sampling technique used purposive sampling with predetermined criteria. The questionnaire was distributed online via a Google Form link that was distributed to outpatients participating in BPJS who were treated at Hospital X. This study used a multivariate analysis method with the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique. This study concludes that service quality has a positive and significant effect on the doctor-patient relationship. Patient characteristics do not significantly affect the doctor-patient relationship. The doctor-patient relationship has a positive and significant effect on patient satisfaction. Service quality has a positive and significant effect on patient satisfaction mediated by the doctor-patient relationship. Patient characteristics do not significantly affect patient satisfaction through the mediation of the doctor-patient relationship. Hospitals that focus on improving the quality of their services, especially in outpatient services, will provide a positive experience for BPJS patients during treatment, as well as improve the medical and non-medical abilities of doctors. The relationship between doctors and patients is an important factor in shaping a positive patient experience during the process of providing outpatient health services in hospitals.
References
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Alghamdi, F. S. (2014). The impact of service quality perception on patient satisfaction in Government Hospitals in Southern Saudi Arabia. Saudi Medical Journal, 35(10), 1271.
Alibrandi, A., Gitto, L., Limosani, M., & Mustica, P. F. (2023). Patient satisfaction and quality of hospital care. Evaluation and Program Planning, 97, 102251.
Anggraeni, R., Rizki, F., & Basman, M. H. (2020). Does the health insurance governance system support health care programs? Enfermería Clínica, 30, 13–16.
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Azam, P., Akhlaq, A., Niazi, M. M., & Nawaz, S. (2023). Impact of Outpatient Quality Services on Patient Satisfaction. National Journal of Health Sciences, 8(4), 162–167.
Birkeland, S., Bismark, M., Barry, M. J., & Möller, S. (2022). Is greater patient involvement associated with higher satisfaction? Experimental evidence from a vignette survey. BMJ Quality & Safety, 31(2), 86–93.
Bowling, A. (2023). Research methods in health: investigating health and health services. McGraw-hill education (UK).
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Centeno-Gándara, L. A. (2021). Improving the physician-patient relationship utilizing psychodynamic psychology: a primer for health professionals. Health Psychology and Behavioral Medicine, 9(1), 338–349.
Chipidza, F. E., Wallwork, R. S., & Stern, T. A. (2015). Impact of the doctor-patient relationship. The Primary Care Companion for CNS Disorders, 17(5), 27354.
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Jin, H.-J., Cheng, A.-L., Qian, J.-Y., Lin, L.-M., & Tang, H.-M. (2021). Effect and satisfaction of outpatient services by precision valuation reservation registration. World Journal of Clinical Cases, 9(26), 7750.
Karasan, A., Erdogan, M., & Cinar, M. (2022). Healthcare service quality evaluation: An integrated decision-making methodology and a case study. Socio-Economic Planning Sciences, 82, 101234.
Keij, S. M., Branda, M. E., Montori, V. M., Brito, J. P., Kunneman, M., & Pieterse, A. H. (2024). Patient Characteristics and the Extent to Which Clinicians Involve Patients in Decision Making: Secondary Analyses of Pooled Data. Medical Decision Making, 44(3), 346–356.
Keij, S. M., de Boer, J. E., Stiggelbout, A. M., de Bruin, W. B., Peters, E., Moaddine, S., Kunneman, M., & Pieterse, A. H. (2022). How are patient-related characteristics associated with shared decision-making about treatment? A scoping review of quantitative studies. BMJ Open, 12(5), e057293.
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Manzoor, F., Wei, L., Hussain, A., Asif, M., & Shah, S. I. A. (2019). Patient satisfaction with health care services; an application of physician’s behavior as a moderator. International Journal of Environmental Research and Public Health, 16(18), 3318.
Mostafapour, M., Fortier, J. H., & Garber, G. (2024). Exploring the dynamics of physician‐patient relationships: Factors affecting patient satisfaction and complaints. Journal of Healthcare Risk Management.
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Prada-García, C., & Benítez-Andrades, J. A. (2022). Evaluation of the satisfaction of patients seen in the dermatology department of a spanish tertiary hospital. Healthcare, 10(8), 1560.
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Rauf, A., Muhammad, N., Mahmood, H., & Yen, Y. Y. (2024). The influence of healthcare service quality on patients’ satisfaction in urban areas: The case of Pakistan. Heliyon, 10(18).
Salim, N. A. M., Roslan, N. S., Hod, R., Zakaria, S. F., & Adam, S. K. (2023). Exploring critical components of physician-patient communication: a qualitative study of lay and professional perspectives. Healthcare, 11(2), 162.
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Saputra, H., & Istiqomah, R. (2024). Analysis of JKN Mobile Application Service Quality (Case Study Participants of BPJS Health Surakarta Branch Office). Jurnal Jaminan Kesehatan Nasional, 4(1), 66–76. https://doi.org/https://doi.org/10.53756/jjkn.v4i1.180
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Świątoniowska-Lonc, N., Polański, J., Tański, W., & Jankowska-Polańska, B. (2020). Impact of satisfaction with physician–patient communication on self-care and adherence in patients with hypertension: cross-sectional study. BMC Health Services Research, 20, 1–9.
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Vidal-Silva, C., Sánchez-Ortiz, A., Serrano-Malebrán, J., Arriagada, V., Flores, M., Godoy, M., & Vargas, C. (2024). Social influence, performance expectancy, and price value as determinants of telemedicine services acceptance in Chile. Heliyon, 10(5).
Wang, Y., Liu, C., & Wang, P. (2023). Patient satisfaction impact indicators from a psychosocial perspective. Frontiers in Public Health, 11, 1103819.
Wang, Z.-Y., Zhang, X., & Ma, L. (2022). How to Maintain a Sustainable Doctor‐Patient Relationship in Healthcare in China: A Structural Equation Modeling Approach. Journal of Healthcare Engineering, 2022(1), 8251220.
Werdhani, R. A. (2017). Leadership in doctor-patient relationship: Implementation on patient’s case management in primary care. Medical Journal of Indonesia, 26(2), 158–166.
Widada, T., Pramusinto, A., & Lazuardi, L. (2017). Peran badan penyelenggara jaminan sosial (bpjs) kesehatan dan implikasinya terhadap ketahanan masyarakat (studi di rsud hasanuddin damrah manna kabupaten bengkulu selatan, provinsi bengkulu). Jurnal Ketahanan Nasional, 23(2), 199–216.
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Akthar, N., Nayak, S., & Pai, Y. (2023). Determinants of patient satisfaction in Asia: Evidence from systematic review of literature. Clinical Epidemiology and Global Health, 101393.
Al-Shura, A. N. (2019). Perspectives of Ayurveda in Integrative Cardiovascular Chinese Medicine for Patient Compliance: Volume 4. Academic Press.
Alghamdi, F. S. (2014). The impact of service quality perception on patient satisfaction in Government Hospitals in Southern Saudi Arabia. Saudi Medical Journal, 35(10), 1271.
Alibrandi, A., Gitto, L., Limosani, M., & Mustica, P. F. (2023). Patient satisfaction and quality of hospital care. Evaluation and Program Planning, 97, 102251.
Anggraeni, R., Rizki, F., & Basman, M. H. (2020). Does the health insurance governance system support health care programs? Enfermería Clínica, 30, 13–16.
Asare, A. A., Otchi, E., & Manu, A. (2024). Relevance of meeting general outpatients’ information needs to their perceptions of healthcare quality in a hospital in Ghana: a Healthcare Quality Survey using modified SERVQUAL analysis. BMJ Open Quality, 13(2), e002683.
Azam, P., Akhlaq, A., Niazi, M. M., & Nawaz, S. (2023). Impact of Outpatient Quality Services on Patient Satisfaction. National Journal of Health Sciences, 8(4), 162–167.
Birkeland, S., Bismark, M., Barry, M. J., & Möller, S. (2022). Is greater patient involvement associated with higher satisfaction? Experimental evidence from a vignette survey. BMJ Quality & Safety, 31(2), 86–93.
Bowling, A. (2023). Research methods in health: investigating health and health services. McGraw-hill education (UK).
BPJS. (2024). Data JKN. https://www.bpjs-kesehatan.go.id/#/
Cahyani, N. R., Wardani, T. N. D., Wardhani, H. S., & Wulandari, R. D. (2021). Correlation Of Patient Characteristics And Patient Satisfaction With Patient Loyalty In Public Health Center. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 6(3).
Centeno-Gándara, L. A. (2021). Improving the physician-patient relationship utilizing psychodynamic psychology: a primer for health professionals. Health Psychology and Behavioral Medicine, 9(1), 338–349.
Chipidza, F. E., Wallwork, R. S., & Stern, T. A. (2015). Impact of the doctor-patient relationship. The Primary Care Companion for CNS Disorders, 17(5), 27354.
Clarkson, J., Dean, J., Ward, J., Komashie, A., & Bashford, T. (2018). A systems approach to healthcare: from thinking to practice. Future Healthcare Journal, 5(3), 151–155.
Cohen, J. (2013). Statistical power analysis for the behavioral sciences. routledge.
de Waard, C. S., Poot, A. J., den Elzen, W. P. J., Wind, A. W., Caljouw, M. A. A., & Gussekloo, J. (2018). Perceived doctor-patient relationship and satisfaction with general practitioner care in older persons in residential homes. Scandinavian Journal of Primary Health Care, 36(2), 189–197.
Değer, M. S., & İşsever, H. (2024). Service Quality and Related Factors in Primary Health Care Services: A Cross-Sectional Study. Healthcare, 12(10), 965.
Endalamaw, A., Khatri, R. B., Erku, D., Nigatu, F., Zewdie, A., Wolka, E., & Assefa, Y. (2023). Successes and challenges towards improving quality of primary health care services: a scoping review. BMC Health Services Research, 23(1), 893.
Ferreira, D. C., Vieira, I., Pedro, M. I., Caldas, P., & Varela, M. (2023). Patient satisfaction with healthcare services and the techniques used for its assessment: a systematic literature review and a bibliometric analysis. Healthcare, 11(5), 639.
Forsey, J., Ng, S., Rowland, P., Freeman, R., Li, C., & Woods, N. N. (2021). The basic science of patient–physician communication: a critical scoping review. Academic Medicine, 96(11S), S109–S118.
Gala, P., Sriram, V., Kotian, C., Ballala, K., Vedanthan, R., Perish, E., Umakanth, S., & Meltzer, D. (2022). Perceptions of the doctor-patient relationship among patients in a private, secondary-level hospital in Southern India. Frontiers in Public Health, 9, 768705.
Hair, J. F., Babin, B. J., Black, W. C., & Anderson, R. E. (2019). Multivariate Data Analysis. Cengage. https://books.google.co.id/books?id=0R9ZswEACAAJ
Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43, 115–135.
Henseler, J., & Schuberth, F. (2023). Partial least squares as a tool for scientific inquiry: Comments on Cadogan and Lee. European Journal of Marketing, 57(6), 1737–1757.
Jin, H.-J., Cheng, A.-L., Qian, J.-Y., Lin, L.-M., & Tang, H.-M. (2021). Effect and satisfaction of outpatient services by precision valuation reservation registration. World Journal of Clinical Cases, 9(26), 7750.
Karasan, A., Erdogan, M., & Cinar, M. (2022). Healthcare service quality evaluation: An integrated decision-making methodology and a case study. Socio-Economic Planning Sciences, 82, 101234.
Keij, S. M., Branda, M. E., Montori, V. M., Brito, J. P., Kunneman, M., & Pieterse, A. H. (2024). Patient Characteristics and the Extent to Which Clinicians Involve Patients in Decision Making: Secondary Analyses of Pooled Data. Medical Decision Making, 44(3), 346–356.
Keij, S. M., de Boer, J. E., Stiggelbout, A. M., de Bruin, W. B., Peters, E., Moaddine, S., Kunneman, M., & Pieterse, A. H. (2022). How are patient-related characteristics associated with shared decision-making about treatment? A scoping review of quantitative studies. BMJ Open, 12(5), e057293.
Khoirunurrofik, K., & Raras, G. (2021). Health services provision and decision to buy Jaminan Kesehatan Nasional (JKN) in Indonesia. Health Policy OPEN, 2, 100050.
Lazcano-Ponce, E., Angeles-Llerenas, A., Rodríguez-Valentín, R., Salvador-Carulla, L., Domínguez-Esponda, R., Astudillo-García, C. I., Madrigal-de León, E., & Katz, G. (2020). Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico. BMC Medical Ethics, 21, 1–11.
Legler, A., Price, M., Parikh, M., Nebeker, J. R., Ward, M. C., Wedemeyer, L., & Pizer, S. D. (2019). Effect on VA patient satisfaction of provider’s use of an integrated viewer of multiple electronic health records. Journal of General Internal Medicine, 34, 132–136.
Li, H., Li, L., Liu, T., Tan, M., He, W., Luo, Y., Zhong, X., Zhang, L., & Sun, J. (2024). Risk management and empirical study of the doctor-patient relationship: based on 1790 litigation cases of medical damage liability disputes in China. BMC Health Services Research, 24(1), 521.
Lu, L. Y., Korth, M. J. S., Cheng, R. Z., Finlay, A. K., Kamal, R. N., Goodman, S. B., Maloney, W. J., Huddleston III, J. I., & Amanatullah, D. F. (2021). Provider Personal and Demographic Characteristics and Patient Satisfaction in Orthopaedic Surgery. JAAOS Global Research & Reviews, 5(4), e20.
Malley, J., D’Amico, F., & Fernandez, J.-L. (2019). What is the relationship between the quality of care experience and quality of life outcomes? Some evidence from long-term home care in England. Social Science & Medicine, 243, 112635.
Manzoor, F., Wei, L., Hussain, A., Asif, M., & Shah, S. I. A. (2019). Patient satisfaction with health care services; an application of physician’s behavior as a moderator. International Journal of Environmental Research and Public Health, 16(18), 3318.
Mostafapour, M., Fortier, J. H., & Garber, G. (2024). Exploring the dynamics of physician‐patient relationships: Factors affecting patient satisfaction and complaints. Journal of Healthcare Risk Management.
Mullen, J., & Habib, A. (2022). Myasthenic crisis patient characteristics, readmissions, treatments, and outcomes: A single center analysis (P6-13.004). Neurology, 98(18_supplement), 3613.
Navidad, C. J. C., Amon, A., Espino, R. L. J. E., Santos, J. K., Vega, R. L., Cabanias, D. S. F., Cantos, K. A. N. M., Macalino, M. D., Sibulo, M., & Sese, N. (2018). Association of patient’s characteristics on patient’s satisfaction in the Out-Patient Department of a private hospital.
Nguyen, N. X., Tran, K., & Nguyen, T. A. (2021). Impact of service quality on in-patients’ satisfaction, perceived value, and customer loyalty: A mixed-methods study from a developing country. Patient Preference and Adherence, 2523–2538.
Prada-García, C., & Benítez-Andrades, J. A. (2022). Evaluation of the satisfaction of patients seen in the dermatology department of a spanish tertiary hospital. Healthcare, 10(8), 1560.
Pramudita, E., Achmadi, H., & Nurhaida, H. (2023). Determinants of behavioral intention toward telemedicine services among Indonesian Gen-Z and Millenials: a PLS–SEM study on Alodokter application. Journal of Innovation and Entrepreneurship, 12(1), 68.
Putri, L. D., Girsang, E., Lister, I. N. E., Kung, H. T., Kadir, E. A., & Rosa, S. L. (2024). Public Health Implications for Effective Community Interventions Based on Hospital Patient Data Analysis Using Deep Learning Technology in Indonesia. Information, 15(1), 41.
Radu, G., Radu, M., Condurache, A., & Purcărea, V. L. (2018). Managerial strategies and policies–Analysis of patient satisfaction based on demographic data. Journal of Medicine and Life, 11(3), 218.
Rauf, A., Muhammad, N., Mahmood, H., & Yen, Y. Y. (2024). The influence of healthcare service quality on patients’ satisfaction in urban areas: The case of Pakistan. Heliyon, 10(18).
Salim, N. A. M., Roslan, N. S., Hod, R., Zakaria, S. F., & Adam, S. K. (2023). Exploring critical components of physician-patient communication: a qualitative study of lay and professional perspectives. Healthcare, 11(2), 162.
Santos-Jaén, J. M., Valls Martínez, M. del C., Palacios-Manzano, M., & Grasso, M. S. (2022). Analysis of patient satisfaction through the effect of healthcare spending on waiting times for consultations and operations. Healthcare, 10(7), 1229.
Saputra, H., & Istiqomah, R. (2024). Analysis of JKN Mobile Application Service Quality (Case Study Participants of BPJS Health Surakarta Branch Office). Jurnal Jaminan Kesehatan Nasional, 4(1), 66–76. https://doi.org/https://doi.org/10.53756/jjkn.v4i1.180
Schwartz, J. S. (2017). Health services research: Translating discovery and research into practice and policy. In Clinical and Translational Science (pp. 111–133). Elsevier.
Shie, A.-J., Huang, Y.-F., Li, G.-Y., Lyu, W.-Y., Yang, M., Dai, Y.-Y., Su, Z.-H., & Wu, Y. J. (2022). Exploring the relationship between hospital service quality, patient trust, and loyalty from a service encounter perspective in elderly with chronic diseases. Frontiers in Public Health, 10, 876266.
Sukartini, T., Arifin, H., Kurniawati, Y., Pradipta, R. O., Nursalam, N., & Acob, J. R. U. (2021). Factors Associated with National Health Insurance Coverage in Indonesia. F1000research, 10, 563.
Świątoniowska-Lonc, N., Polański, J., Tański, W., & Jankowska-Polańska, B. (2020). Impact of satisfaction with physician–patient communication on self-care and adherence in patients with hypertension: cross-sectional study. BMC Health Services Research, 20, 1–9.
Tian, Y. (2023). A review on factors related to patient comfort experience in hospitals. Journal of Health, Population and Nutrition, 42(1), 125.
Vidal-Silva, C., Sánchez-Ortiz, A., Serrano-Malebrán, J., Arriagada, V., Flores, M., Godoy, M., & Vargas, C. (2024). Social influence, performance expectancy, and price value as determinants of telemedicine services acceptance in Chile. Heliyon, 10(5).
Wang, Y., Liu, C., & Wang, P. (2023). Patient satisfaction impact indicators from a psychosocial perspective. Frontiers in Public Health, 11, 1103819.
Wang, Z.-Y., Zhang, X., & Ma, L. (2022). How to Maintain a Sustainable Doctor‐Patient Relationship in Healthcare in China: A Structural Equation Modeling Approach. Journal of Healthcare Engineering, 2022(1), 8251220.
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Published
2025-06-04
How to Cite
Adinda, H. R., & Hendra Achmadi. (2025). The Influence of Outpatient Service Quality and Patient Characteristics on BPJS Patient Satisfaction at Hospital X Mediated by Doctor-Patient Relationship. Kontigensi : Jurnal Ilmiah Manajemen, 13(1), 23-40. https://doi.org/10.56457/jimk.v13i1.659
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Articles
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