Covid-19 Patient Satisfaction Analysis Reviewing from the Quality of Health Services and the Performance of Health Personnel
Irsyad Herminofa1, Rahmania Ambarika2
1,2 Institut Ilmu Kesehatan (IIK) Strada Indonesia [email protected]
I. Introduction
Human resources are the main factors that often arise in an organization such as a health care institution. Puskesmas, as one of the health service institutions directly related to the lower community, has a vital role in achieving the quality of health services expected by the community. Human Resources (HR) is the most important component in a company or organization to run the business it does. Organization must have a goal to be achieved by the organizational members (Niati et al., 2021). Development is a change towards improvement. Changes towards improvement require the mobilization of all human resources and reason to realize what is aspired (Shah et al, 2020). The
Abstract
Satisfaction is a feeling of pleasure or disappointment that comes from comparing his impression of the service or result and his expectations. Satisfaction with patients is a pleasant emotional attitude at work. This attitude can be reflected in work morale, discipline, and work performance. In order to achieve the maximum level of patient satisfaction in carrying out tasks, one will always face the given factors that can affect patient satisfaction. So that health service institutions can create conditions that can encourage or improve services to develop and improve their abilities and skills optimally (Arief and Alfarizy 2019). Patient satisfaction is related to fulfilling one's needs with a positive attitude from health workers, which includes feelings and behavior towards their work through assessing one job as a sense of appreciation in achieving a solid job value. (Astari, Noviantani, and Simanjuntak 2021). The type of research used in this research is quantitative research with correlation studies. The sample in this study which was taken using a simple random sampling technique, were Covid-19 patients treated at the Covid-19 Isolation Home UPT Gondang Health Center, totaling 160 respondents. The study was conducted using a questionnaire and analyzed using a logistic regression test. The relationship between service quality and staff performance on patient satisfaction shows that based on the results of logistic regression tests, the dominant variable that affects patient satisfaction is staff performance. This can be seen from the largest Exp. B (OR) value, which is 320, means that the performance of good health workers will affect reasonable patient satisfaction. Research reveals that patient satisfaction during treatment is not only focused on service quality but can be expressed in the form of health care services. The reliable performance will also foster satisfaction for the patients they treat.
Keywords
service quality; staff performance; satisfaction;
treated patients
Budapest International Research and Critics Institute-Journal (BIRCI-Journal) Volume 5, No 3, August 2022, Page: 25340-25349 e-ISSN: 2615-3076 (Online), p-ISSN: 2615-1715 (Print)
www.bircu-journal.com/index.php/birci email: [email protected]
which is better to prepare a future responsibility in achieving organizational goals (Werdhiastutie et al, 2020).By understanding what patients want from the quality of services provided, it will be found added value for the health institution. Quality services play an essential role in shaping the quality and satisfaction of patients. In addition, it is also closely related to creating profits for health service institutions. The higher the quality of service an institution provides, the higher the satisfaction felt by the client.
Problems often found in health service institutions are the lack of patient satisfaction caused by the quality of service and performance of health workers, which include patient safety, pain management, comfort, level of satisfaction with services, self-care, patient anxiety, and patient behavior (Nursalam 2014).
The community in using the services service must get satisfaction. The community is very considerate and sees the quality of service from medical services and chooses a location that is easily accessible. Satisfaction is a feeling of pleasure or disappointment that comes from comparing his impression of the service or result and his expectations.
Satisfaction with patients is a pleasant emotional attitude at work. This attitude can be reflected in work morale, discipline, and work performance. In order to achieve the maximum level of patient satisfaction in carrying out tasks, one will always face the given factors that can affect patient satisfaction. So that health service institutions can create conditions that can encourage or improve services to develop and improve their abilities and skills optimally (Arief and Alfarizy 2019)
A Covid-19 pandemic is an event that spreads the 2019 Corona Virus Disease throughout the world to all countries. This disease is caused by a new type of coronavirus called SARS-CoV-2. The Covid-19 outbreak was first detected in Wuhan City, Hubei, China, on December 31, 2019. It was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. As of November 14, 2020, more than 53,281,350 cases have been confirmed and reported in more than 219 countries and territories worldwide, resulting in more than 1,301,021 people dying and more than 34,394,214 people recovering. Covid-19 cases jumped again from April 2021 to September 2021; many scientists called the Covid-19 attack wave 2 caused by the Delta variant. At that time, the number of cases and deaths due to the delta variant of Covid-19 jumped dramatically. Until now, the status of the Covid-19 pandemic has not been revoked by the President of the Republic of Indonesia. It is possible again that Covid-19 cases will soar again caused by attacks of different variants. Therefore, some senior doctors expect isolation rooms to be available in all health facilities with inpatient status.
Patient satisfaction is related to fulfilling one's needs with a positive attitude from health workers, which includes feelings and behavior towards their work through assessing one job as a sense of appreciation in achieving a solid job value. (Astari, Noviantani, and Simanjuntak 2021). The phenomenon of satisfaction of Covid-19 patients in the isolation house of UPT Puskesmas Gondang Mojokerto Regency is overall satisfaction, which is the simplest and most common way to measure the satisfaction of service users where patients do not feel satisfied with a particular service they have received. Customer satisfaction, Based on the components described previously that there,
patient satisfaction is related to a statement of whether service users get service recommendations by service providers that are used by other parties or their relatives.
The level of utilization of health services at the Puskesmas by patients shows how well the quality of services provided by health care workers is as well as shows the level of patient confidence in the services provided. In general, the measurement of the level of utilization of health services is indicated by the number of visits by a person to these health services. The number of health workers in the isolation house of UPT Puskesmas Gondang Mojokerto Regency in 2021 are 2 doctors, 12 nurses, 2 midwives, 2 laboratory workers, 1 pharmacist, 1 nutritionist, 4 non-health and administrative staff. . (Gondang 2021). Meanwhile, the number of Covid patients isolated in the isolation house of the Gondang Health Center UPT has increased over the last 3 months, from June - August 2021, which was 268 people (Gondang 2021). The phenomenon of satisfaction of Covid- 19 patients based on the results of interviews with Covid-19 patients at the isolation house of the Gondang Health Center UPT on March 10, 2021, obtained data from 15 people, 5 of whom still complained of being dissatisfied with the food given to Covid-19 patients, 4 people said they were not satisfied with the existing rooms and beds, 3 people said they were not satisfied with the friendliness of health workers who carried out periodic PCR swabs every week, 2 people said they were satisfied, and 1 person said it was normal.
The satisfaction of Covid-19 patients at UPT Puskesmas Gondang, Mojokerto Regency, can be influenced by several factors, including the quality of service at UPT Puskesmas Gondang and the performance of existing health workers. If the quality of service and the performance of health workers is good, it will affect patient satisfaction to increase. Quality of service is the expectation of customers, namely patients who are strongly influenced by the information obtained by the patient and the needs required by the patient.
Based on the above background, the researcher wants to link the satisfaction of Covid-19 patients with the quality of health services and the performance of health workers at the isolation house of the UPT Puskesmas Gondang Mojokerto Regency in 2021. The problem in this study is the satisfaction of Covid-19 patients in terms of service quality, health, and performance of health workers in the isolation house of UPT Puskesmas Gondang, Mojokerto district in 2021. The purpose of the study was to analyze the satisfaction of Covid-19 patients in terms of the quality of health services and the performance of health workers in the isolation house of UPT Puskesmas Gondang, Mojokerto district in 2021.
The research hypothesis is an alternative to the likely answer made by the researcher for the problem posed in the study. Arikunto (2010) explains that the likely answer made by the researcher is a temporary truth that will be tested with data collected through research. The hypothesis in this study is that there is a relationship between the quality of service and the performance of health workers with the satisfaction of Covid-19 patients at the Isolation House of UPT Puskesmas Gondang, Mojokerto Regency.
II. Research Method
The type of research used in this research is quantitative research. Quantitative research is "research by examining how much influence the independent variable (independent) has on the dependent variable (dependent)." (Sugiono, Statistics For Research. Bandung: Alfabeta, 2006); quantitative research methods are used to examine specific populations or samples, data collection using research instruments, quantitative/statistical data analysis to test predetermined hypotheses.
The population is the totality of values , both quality, and quantity of specific characteristics regarding a complete set of objects and their properties will be studied (Arikunto, Suharsimi. 2019. "Research Procedure." ). The population in this study were patients from the Covid-19 isolation house at UPT Gondang Health Center. They were treated from June to August, comprising 268 people/patients.
Sampling is the process of selecting a portion of the population to be able to represent the population (Nursalam, 2020). Sampling is often used due to the impossibility of examining the entire population, so the sample must genuinely represent the existing population.
The sample size uses the Slovin sample formula in the book (Nursalam, 2020) as follows:
n = N Nd2 +1 n = number of samples
N = (population 268)
d2 = precision (set 5% with 95% confidence level)
Based on this formula, the number of samples is obtained as follows:
Of the 268 patients treated at the Covid-19 Isolation Home UPT Gondang Health Center, 160 research samples were obtained (using the SLOVIN formula). Collecting data through a survey using a questionnaire instrument. Data Processing Techniques are Editing, Coding, Scoring, Transfering, and Tabulating. This study analyzes data with Univariate, Bivariate, and Multivariate compiles the variables that have the most influence on patient satisfaction, and compiles research reports.
This research is planned to be carried out at the Covid-19 Isolation House UPT Puskesmas Gondang. 2022 - August 2022.
A variable is a characteristic, trait, or measure obtained by a study of a particular concept of understanding (Notoatmodjo, 2018). The variables are classified into various types to explain their use in research (Nursalam, 2020). The variables in this study consisted of independent (free) and dependent (bound) variables. The independent variables in this study are service quality and officer performance. The dependent variable in this study was the satisfaction of patients treated at the Covid-19 isolation house at UPT Puskesmas Gondang.
This study uses a research instrument in the form of a questionnaire. The questionnaire is a list of questions that have been carefully arranged so that respondents only need to give answers or with sure signs (Notoatmodjo, 2018). The questionnaire used in this study is service quality, staff performance, and patient satisfaction.
The validity and reliability testing in this study is planned to be carried out at other clinics in the Mojokerto Regency area because it has almost the same characteristics as the research site. Testing the validity and reliability was conducted on 20 respondents with a confidence level of 90%. Validity is an index that shows the measuring instrument measures what is being measured. The validity test was carried out using the bivariate person correlation formula with the SPSS version of the IBM 21.0 program. The questionnaire item in the validity test is said to be valid if the value of R count > R table at a significance value of 5%. On the other hand, the item is said to be invalid if the value of R count < R table at a significance value of 5%. Reliability is an index that shows the extent to which a measuring instrument can be trusted or reliable. In contrast, the reliability test calculation uses SPSS (Notoatmodjo, 2018). The question items on the questionnaire were tested using the Cronbach Alpha formula. An item is said to be reliable if the value of the item is greater than the value of the table. The measuring instrument is said to be good if the Cronbach's Alpha ranges from 0.7 to 0.95.
In the process of collecting data for this study, before collecting data, the researcher submitted a cover letter from the Master of Public Health Study Program to the National and Political Unity Agency of Mojokerto Regency and the Mojokerto Regency Health Office. After getting permission, the researcher conducted an ethical test at IIK Strada Indonesia Kediri. Then, after being declared to have passed the ethical test, the researcher conducted the research, beginning by selecting a sample according to the criteria.
III. Result and Discussion
The results of this study used correlation analysis. The sampling technique in this study used a simple random sampling technique. The number of samples in this research is 160 people. The results of this study are univariate analysis, bivariate analysis, and multivariate analysis.
3.1 Characteristics of Univariate Respondents
Characteristics of respondents based on age, education, occupation, gender, and length of stay are as follows:
Table 1. Frequency distribution of respondent characteristics
No Respondent
characteristics F %
1 Respondent's age
17 – 24 Th 27 16.9 %
25 – 34 Years 60 37.5%
35 - 49 Years 60 37.5%
50 – 64 Years 13 8.1 %
2 Gender
Male 90 56.3%
Female 70 43.8%
3 Respondent's Education
SD 17 10.6%
Junior 15 9.4 %
Senior High School 51 31.9 %
Diploma 13 8.1 %
Bachelor's Degree 64 40.0%
4 Respondent's Occupation
Student/Student 18 11.3%
Civil Servants 20 12.5%
Private Employees 61 38.1 %
Traders 61 38.1 %
5 Length of Hospitalization
< 3 Days 40 25.0%
3 – 6 Days 105 65.6%
7 – 15 Days 13 8.1 %
> 15 Day 2 1.3%
people (37.5%), and aged 35-49 years, as many as 60 people (37.5%). The level of employment of most of the private sector employees is 61 people (38.1%), and traders are 61 people (38.1%). The education level of most S1 is 64 people (40.0%).
Table 2. Frequency distribution of Health Service Quality
N %
No. Quality of Health Services
1 Good 136 85 %
2 Less 24 15 %
Total 160 100 %
The level of service quality consists of 2 categories, namely excellent and poor. The results of data collection can be seen, on average, 85% of the quality of health services in the excellent category and 15% in the poor category.
Table 3. Frequency distribution of Health Officer Performance
N %
No. Performance of Health Officers
1 Good 116 72.5%
2 Less 44 27.5%
Total 160 100%
Officers' performance level consists of 2 categories, namely excellent and poor. The data collection results can be seen, an average of 72.5% of the performance of health workers in the excellent category and 27.5% in the poor category.
Table 4. Frequency distribution of Patient Satisfaction
N %
No. Patient Satisfaction
1 Good 123 76.9%
2 Less 37 23.1%
Total 160 100%
The level of patient satisfaction consists of 2 categories, namely excellent and poor.
The data collection results can be seen, an average of 76.9% patient satisfaction in the excellent category and 23.1% in the poor category.
3.2 Characteristics of Respondents
Bivariate Analysis Bivariate analysis aims to prove the relationship between service quality and patient satisfaction and staff performance with patient satisfaction.
Bivariate analysis of the relationship between service quality and patient satisfaction with the results of the chi-square test obtained a significant p-value: of 0.00, meaning that there is a positive correlation between patient satisfaction with the quality of health services. The correlation value obtained of 0.475 belongs to the medium category. It shows
a significant relationship between patient satisfaction and the quality of health services (p
= 0.00; = 0.05).
Bivariate analysis of the relationship between staff performance and patient satisfaction, namely the results of the chi-square test, obtained a significant p-value: of 0.00, meaning that there is a positive correlation between patient satisfaction with the performance of health workers. The correlation value obtained is 0.426 belonging to the medium category and shows a significant relationship between patient satisfaction and the performance of health workers (p = 0.00; = 0.05).
3.3 Characteristics of Respondent's Multivariate Analysis
From the results of the bivariate test, all variables that have a p-value <0.25 will be included in the multivariate test. It was found that all variables had p < 0.25. Service quality, staff performance, and patient satisfaction using the enter method included in the logistic regression test.
Table 4. Frequency distribution of Patient Satisfaction
B SE Wald df Sig. Exp(B)
Quality of
Service -1.735 .663 6.842 1.009 .176 Officer Performanc
e -1.139 .565 4.060 1 .044 .320
Based on the results of the logistic regression test above, the dominant variable influencing patient satisfaction is performance. This can be seen from the largest Exp. B (OR) value, which is .320, means that the performance of good health workers will affect reasonable patient satisfaction.
3.4 Discussion
a. The Relationship Between Service Quality and Patient Satisfaction.
The relationship between service quality shows that 123 respondents with good quality and reasonable patient satisfaction were 116 (94%), compared to 7 (6%) respondents with poor quality and reasonable patient satisfaction. Meanwhile, among 37 respondents with good quality and less patient satisfaction, 20 (54%) respondents compared to 17 (46%) respondents with poor quality and less patient satisfaction.
Service quality is all forms of activities carried out by the company in order to meet consumer expectations. Service, in this case, is defined as a service or service delivered by the service owner in the form of convenience, speed, relationship, ability, and hospitality aimed at the attitude and nature of providing services for customer satisfaction. According to Suprihanto (2018), service quality can be determined by comparing consumers' perceptions of the services they receive/get with the services they expect/want for the service attributes of a company.
respondents. Meanwhile, out of 37 respondents with good performance and poor patient satisfaction, 14 (38%) respondents compared to 23 (62%) respondents with poor performance and poor patient satisfaction.
Mangkunegara's (2005) performance results from work in quality and quantity achieved by an employee in carrying out tasks following the responsibilities given to him.
c. The Relationship Between Service Quality and Staff Performance on Patient Satisfaction The
Relationship between Service Quality and Staff Performance on Patient Satisfaction is based on the results of logistic regression tests. The dominant variable affecting patient satisfaction is performance. This can be seen from the largest Exp. B (OR) value, which is 320, means that the performance of good health workers will affect reasonable patient satisfaction.
One of the factors that can affect patient satisfaction is the quality of service and officers' performance. Bitner (1990) states that a long relationship between doctors and patients increases patient satisfaction; besides that, the skills of nurses, paramedical staff, and support staff also play an essential role in influencing patient satisfaction.
Zineldin (2004) suggests that the role of management is essential in improving the quality of patient care, impacting the external environment, hospital performance, networking, interaction with patients, and collaboration with other organizations.
IV. Conclusion
The results showed that patients treated at the Covid-19 isolation house at UPT Gondang Health Center stated that the quality of their services was good, as was the performance of the officers at the Covid-19 isolation house at UPT Gondang Health Center while treating patients. However, the most related and dominant factor is the performance of health workers.
We recommend that the quality of service continues to be improved in various aspects and that officers' performance is constantly monitored and evaluated to improve the quality of their performance. For further research, it is hoped that by developing the concept of service quality and the performance of health workers on patient satisfaction.
For the research area, it is hoped that it can add information about the quality of service and the performance of health workers on patient satisfaction. Respondents are expected to find basic information about the quality of service and the performance of health workers in health facilities.
References
Ahri, Reza Aril. (2020). “The Effect of Service Quality on Consumer Satisfaction and Confidence in the Blood Transfusion Unit of the South Sulawesi Provincial Health Office.” Journal of Muslim Community Health 1(3): 16–30.
Arief, Yoyok Suyoto, and Muhammad Yusuf Alfarizy. (2019). “The Effect of Sharia Service Quality on Consumer Satisfaction.” Journal of Islamic Economics and Philanthropy 2(3): 403.
Arikunto, Suharsimi. (2019). “Research Procedure.”
Astari, Dewanti Widya, Afni Noviantani, and Rosdiana Simanjuntak. (2021). “Patient Satisfaction with the Quality of Nursing Services in the Era of the Covid-19 Pandemic at Cicendo Eye Hospital.” The Journal of Hospital Accreditation 3(1): 34–
38.
Busto, Muhammad. (2018). Human Resource Management Theories. Grenada Media.
Dewi, Yoanita Indra Kumala. (2017). “IDENTIFICATION OF OUTSTANDING SERVICES IN THE GENERAL POLICE TOWARDS PATIENT SATISFACTION OF THE KEDIRI Islamic boarding school health center.” Journal of Wiyata: Science and Health Research 2(2): 136–40.
Djuari, Lilik. (2021). Textbook of Health Service Management. Airlangga University Press.
Gondang, UPT Puskesmas. (2021). Profile of UPT PUSKESMAS Gondang, Mojokerto Regency in 2020.
J Winardi, S E. (2015). Organizational Behavior Management. Grenada Media.
Larasati, Sri. (2018). Human Resource Management. Depublish.
Muninjaya, AA Gde. (2011). “Health Service Quality Management.” In EGC.
Muzakki, Rifqi, and Lukmanul Hakim. (2020). “The Influence of Service Quality and Facilities on Outpatient Satisfaction at UPTD Pringsewu Health Center Kab.
Pringsewu." In Proceedings of the Darmajaya National Seminar, 122–34.
Niati, D. R., Siregar, Z. M. E., & Prayoga, Y. (2021). The Effect of Training on Work Performance and Career Development: The Role of Motivation as Intervening Variable. Budapest International Research and Critics Institute (BIRCI-Journal):
Humanities and Social Sciences, 4(2), 2385–2393.
https://doi.org/10.33258/birci.v4i2.1940
Nursalam, Mnurs. (2014). “Nursing Management.” Jakarta: Salemba Medika.
Nursalam. (2016). “RESEARCH METHODOLOGY09162019.pdf.” 415.
http://eprints.ners.unair.ac.id/982/1/RESEARCH METODOLOGY09162019.pdf.
Shah, M. M., et al. (2020). The Development Impact of PT. Medco E & P Malaka on Economic Aspects in East Aceh Regency. Budapest International Research and Critics Institute-Journal (BIRCI-Journal) Volume 3, No 1, Page: 276-286.
Sugiyono. (2007). “Dokupdf_com_ebook_statistik_for_researchers.” Statics For Research 12:1–415.
Sumantri, H. (2015). Methodology of Health Research. Grenada Media.
Supomo, R, and Eti Nurhayati. (2018). “Human Resource Management.”
