The Influence of Perceived Service Quality Dimensions on Patients Satisfaction

The purpose of this study was to examine perceived service quality dimensions consisting of ambience, staff attitude, trustworthiness, outcome quality, administrative procedure, clinical procedure, price and billing, waiting time, resource availability, and information availability on patient satisfaction at Rumah Sakit Keluarga Sehat Tayu. The research approach uses quantitative with a questionnaire as a data collection tool. The sampling technique in this study used purposive sampling which obtained 196 respondents. The results of the study explain that perceived service quality dimensions consisting of ambience, staff attitude, trustworthiness, outcome quality, administrative procedure, clinical procedure, price and billing, waiting time, resource availability, and information availability have a very significant effect on patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.


Introduction
Patient satisfaction represents a crucial aspect of attaining excellence (Ahmed et al. 2020), It is of paramount importance for hospitals to achieve higher levels of patient satisfaction if they are to flourish and survive in the long term (Shafiq et al., 2017).In healthcare settings, patient satisfaction is influenced by a number of factors related to the quality of the service provided.These include the delivery of medical care, the conduct of healthcare professionals, the adequacy of resources and administrative processes.
The dimensions of quality of care received at healthcare organisations are perceived by patients through various factors (Strauss & Schoeman, 2022).These factors encompass tangible aspects, including the physical environment and staff behaviour, the reliability and responsiveness of health services, the empathy shown by health services, the affordability of services, and administrative processes (Mohamed & Azizan, 2015).The research was conducted by (Swain & Singh, 2021) patient perceptions of service quality are influenced by a number of factors, including trust, cost transparency, service time, information availability and resource accessibility.In order to maintain high standards of service quality, healthcare organisations, particularly hospitals, must strive to continuously measure and improve their services in order to meet the diverse needs and expectations of patients.By understanding and addressing these dimensions, hospitals can ensure superior healthcare quality and improve patient satisfaction.
The development of hospitals in each region has increased (Nabella & Sulistiadi, 2023).Based on the latest updated data from the Central Bureau of Statistics in Kecamatan Pati is presented as follows: It can be posited that the number of hospitals in Pati District increased in 2020.Maternity hospitals numbered 10 (2019) to 12, while general hospitals remained at 10.Of the 10 hospitals, one that stands out is the Rumah Sakit Keluarga Sehat Tayu (KS Tayu).As reported by patinews.com,KS Tayu was awarded the prestigious national level accolade of Best Committed Advanced Referral Health Facility Hospital (FKTRL) in the National Health Insurance (JKN) programme in 2022 at the national level, in the Class D hospital category.This achievement is a tangible manifestation of KS Tayu's dedication to serving the community.However, if examined more deeply, these achievements are inversely proportional to the number of patient complaints that have not been touched optimally.Data on complaints that occurred at KS Tayu during 2023 can be seen in Figure 2. explains that service and employee friendliness dominate patient complaints with a total of 17 service complaints and 19 complaints on employee friendliness.Furthermore, complaints about facilities owned by KS Tayu Hospital are in third position with a total of 16 complaints.The data explains that service quality issues must be considered considering that service quality is a key element to achieving patient satisfaction at KS Tayu Hospital.As explained in the research (Purwanto, 2020), The text goes on to explain that satisfaction is closely related to service quality.By paying attention ISSN 2721-0960 (Print), ISSN 2721-0847 (online) Copyright © 2024, Journal La Sociale, Under the license CC BY-SA 4.0 to good service quality, organisations can increase satisfaction.The quality of service provided is therefore an appropriate benchmark for measuring satisfaction.
There have been many studies on patient satisfaction (Sitio & Ali, 2019), service quality has a significant positive effect on patient satisfaction.The results of this study are supported by the results of research conducted by Swain (2019) and Ghildiyal et al. (2022) which explains that servqual has an effect on patient satisfaction.However, the results of the study (Surahman et al., 2020) servqual has no effect on satisfaction.Likewise with the results of research conducted by (Solimun & Fernandes, 2018) satisfaction tends to be generated by customers will be actively correlated to the services provided by employees.From the review of the research conducted, it can be concluded that there are still inconsistencies in the research results.
From the explanation of empirical problems and inconsistencies in the results of previous research, research on the effect of perceived service quality dimensions on patient satisfaction (case study at Keluarga Sehat Tayu Hospital) is important to do.This study aims to test the perceived service quality dimensions adopted from research (Mohamed & Azizan, 2015;Swain & Singh, 2021) that ambience, staff attitude, trustworthiness, outcome quality, administrative procedure, clinical procedure, price and billing, waiting time, resources availability, and information availability on patient satisfaction Rumah Sakit Keluarga Sehat Tayu.

Methods
This study employs an online survey distributed via Google to inpatients for a minimum of two days and patients aged 18 or above.The survey was disseminated between February and April 2024, yielding a total of 196 respondents.The questionnaire items were developed by adopting English items and then translating them into Indonesian.The total number of items was 50, derived from articles published in Scopus international journals.As cited in the research literature (Swain & Singh, 2021); The dimensions of perceived service quality can be measured using 10 antecedents, which include ambience (five items), staff attitude (five items), trustworthiness (five items), outcome quality (four items), administrative procedure (six items), clinical procedure (five items), price and billing (three items), waiting time (four items), resources availability (five items), and information availability (four items).Furthermore, the patient satisfaction variable was derived from the following items on the questionnaire (Rahman et al., 2023).The measurement scale uses a Likert scale of 1 (strongly disagree) to 5 (strongly agree).
The research data was then processed using regression analysis with SPSS v.28 software (Pujianto et al., 2022).The general procedure in regression analysis is to test the effect of the independent variable on the dependent variable.This study also tested the validity and reliability of the instrument (Hair, 2009).Validity is measured by looking at the value of the Corrected item-Total Correlation, while reliability is measured by looking at the Cronbach Alpha value.as the main requirement in the regression test, this study also tested the normal distribution of research data.This study tests the hypothesis using the t test, f test, and R Square test.

Results and Discussion
Explain the results of the research in the form of problem-solving analyzed using relevant theories.The results of the study also revealed the findings of the research.Discussion is accompanied by logical arguments by linking the results of research with theory, the results of other studies.
Based on the results of distributing questionnaires that have been carried out, the following is a description of the distribution of respondents totalling 196 respondents: When viewed from the respondent distribution table, respondents are dominated by female gender (52%) with junior high school education (54%).Furthermore, the occupation is dominated by housewives (29%) with an average income of 0 to 2 million per month (54%).

Validity and Reliability
The validity test is a measure that can be used as a guide to the validity of the research instrument.In this study, the validity test used the Corrected item-Total Correlation value.As explained by (Zijlmans et al., 2019) and (Pujianto, 2021) explains that it is said to be valid if the Corrected item-Total Correlation value is greater than 0.30.Furthermore, the reliability test is a reliability test which means that the reliability test is used to measure the extent to which the research instrument is consistent and reliable.Hair (Yew et al. 2022) explains that the instrument is said to be reliable if the Cronbach Alpha value is greater than 0.6.The hospital serves the welfare of the entire community 0,811 0,962 I feel happy with the doctor's service 0,900 I am happy with the nurse's service 0,883 I believe the hospital provides good service 0,877 It can be seen that of all the research items that have been tested, it can be concluded that they are and reliable.With a validity value of Corrected item-Total Correlation greater than 0.30 and a Cronbach Alpha value greater than 0.6.

Normality test
Normality test is one part of the data analysis requirements.This means that before conducting hypothesis testing, the research data must be tested for normality of distribution.The following presents the results of the Kolmogorov-Smirnov normality test: .425 Based on the results of research data processing, it can be seen that the Asymp.Sig.(2-tailed) of 0.425 is greater than 0.05.Accordance with the decision making in the Kolmogorov-Smirnov normality test, it can be concluded that the research data is normally distributed.Thus, the assumptions or model test requirements are met.

Hypothesis Testing
The picture above can be explained as follows: (a) The ambience variable obtained a statistical t value of 3.206 with a sig value of 0.002 less than 0.05, which means that the ambience variable has a significant positive effect.(b) The staff attitude variable obtained a statistical t value of 1.132 with a sig value of 0.002 less than 0.05, which means that the staff attitude variable has a significant positive effect.(c) The trustworthiness variable obtained a statistical t value of 1.250 with a sig value of 0.026 less than 0.05, which means that the trustworthiness variable has a significant positive effect.(d) The outcome quality variable obtained a statistical t value of 2.186 with a sig value of 0.030 less than 0.05, which means that the outcome quality variable has a significant positive effect.(e ) The administrative procedure variable obtained a statistical t value of 4.636 with a sig value of 0.000 less than 0.05, which means that the administrative procedure variable has a significant positive effect.(f) The clinical procedure variable obtained a statistical t value of 1.907 with a sig value of 0.041 less than 0.05, which means that the clinical procedure variable has a significant positive effect.(g) The price and billing variable obtained a statistical t value of 3.319 with a sig value of 0.001 less than 0.05, which means that the price and billing variable has a significant positive effect.(h) The waiting time variable obtained a statistical t value of 4.638 with a sig value of 0.024 less than 0.05, which means that the waiting time variable has a significant positive effect.(i) The resource availability variable obtained a statistical t value of 5.706 with a sig value of 0.000 less than 0.05, which means that the resource availability variable has a significant positive effect.(j) The information variable obtained a statistical t value of 1.342 with a sig value of 0.001 less than 0.05, which means that the resource availability variable has a significant positive effect.

F test statistics
The F test aims to determine the simultaneous or joint influence of the independent variables on the dependent variable (Aras et al., 2023).The following presents the results of the statistical F test: Based on the research results, it can be explained that the R Square value is 0.903 or 90.3%.This means that the contribution of the independent variables of the study is able to explain the variation in the dependent variable with a high category.

Ambience has a significant positive effect on patient satisfaction
Ambience, also known as atmosphere, within a healthcare facility is crucial in influencing the overall patient experience.Significantly increasing patient satisfaction levels can be done by creating a welcoming and relaxing environment.Patients who are greeted by a hospital environment that exudes comfort and peace are more likely to feel at ease and confident in the quality of care they will receive.This positive atmosphere fosters feelings of confidence and security, which are important elements in ensuring patient satisfaction.In addition, an appropriate ambience can play a role in accelerating the healing process and reducing the recovery time of patients at Rumah Sakit Keluarga Sehat Tayu.The study has been supported by research results (Swain & Singh, 2021) shows that environments characterised by natural light, comfortable furnishings and pleasing aesthetics can have a positive impact on patient outcomes.By developing a healing environment that encourages relaxation and reduces stress, Rumah Sakit Keluarga Sehat Tayu can not only increase patient satisfaction, but also improve the overall effectiveness of medical treatments and interventions.

Staff attitude has a significant positive effect on patient satisfaction
The attitude and behaviour of healthcare workers are very important in influencing the patient experience at Rumah Sakit Keluarga Sehat Tayu.Staff attitude has the potential to significantly influence patients' perceptions of the quality of care they receive.Positive interactions characterised by friendliness, empathy and respect between staff and patients can foster trust and confidence, ultimately resulting in high levels of patient satisfaction.The extent to which patients feel valued and respected by hospital staff plays an important role in shaping their overall healthcare experience, regardless of the specific medical intervention they undergo.Moreover, staff disposition not only impacts patient satisfaction, but also has implications for patient outcomes and adherence to treatment regimens.Sebagaimana hasil penelitian yang dilakukan oleh (Mohamed & Azizan, 2015;Swain & Singh, 2021)

Trustworthiness has a significant positive effect on patient satisfaction
Trust is a fundamental element of patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.
Patients instil a significant level of trust in healthcare practitioners to provide skilled and moral care, which forms the basis of their satisfaction with this facility's offerings.When patients feel that the hospital and its staff prioritise their wellbeing, they are more likely to trust in the care they receive and view the overall experience as a good one (Pratama & Pujianto, 2024) their wellbeing.Therefore, upholding openness, reliability and honesty in every aspect of service provision is essential to foster trust among patients at Rumah Sakit Keluarga Sehat Tayu.In addition, as explained in the research results (Dewi et al., 2022) Trust not only impacts patient satisfaction, but also plays an important role in patient engagement and health outcomes.
Patients who have trust in their healthcare providers are more likely to be actively involved in treatment decisions, adhere to medical advice, and follow prescribed therapies.By placing importance on trust in their transactions and procedures, Rumah Sakit Keluarga Sehat Tayu can not only improve patient satisfaction, but also strengthen the relationship between patients and healthcare providers and contribute to patients' overall health.

Outcome quality has a significant positive effect on patient satisfaction
At Rumah Sakit Keluarga Sehat Tayu, the importance of patient outcome quality is crucial to ensure a high level of patient satisfaction.When patients undergo efficient treatment and produce positive outcomes, their satisfaction with the overall hospital experience will increase.Therefore, Rumah Sakit Keluarga Sehat Tayu concentrates on implementing evidence-based methodologies, recruiting proficient healthcare personnel, and utilising cutting-edge medical technology to improve patient outcomes and satisfaction.Moreover, the direct link between quality of outcomes and patient satisfaction demonstrates the hospital's commitment to providing exemplary healthcare services (Pujianto et al., 2022).By consistently delivering outstanding results, Rumah Sakit Keluarga Sehat Tayu not only meets but also exceeds the expectations of its patients, thereby earning their trust and loyalty in return.Patients who experience successful treatment and good health outcomes are likely to recommend the hospital to others and return for future healthcare needs, thus strengthening the hospital's position in the community.

Administrative procedures have a significant positive effect on patient satisfaction
Effective implementation of administrative procedures plays an important role in influencing patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.Streamlining administrative processes, from appointment scheduling to billing and discharge, ensures a smooth experience for patients, reducing the likelihood of delays and frustration, which in turn increases satisfaction levels.In addition, streamlined administrative processes demonstrate professionalism and attention to detail, which can increase patient confidence in the hospital's overall operations and quality of care (Mohamed & Azizan, 2015).Therefore, Rumah Sakit Keluarga Sehat Tayu places a high priority on optimising administrative procedures to ensure a positive and hassle-free experience for each patient, ultimately contributing to their satisfaction with the healthcare services provided.

Clinical procedure has a significant positive effect on patient satisfaction
Clinical procedures have a major impact on patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.The way clinical procedures (De Miguel et al., 2023)  who experience successful and efficient clinical procedures tend to report higher levels of satisfaction with their overall healthcare experience at Rumah Sakit Keluarga Sehat Tayu.Therefore, the hospital prioritises continuous improvement and adherence to evidence-based clinical practices to ensure patient satisfaction and optimal quality of care (Ghildiyal et al., 2022;Swain & Singh, 2021).

Price and billing have a significant positive effect on patient satisfaction
The implementation of price transparency and fair billing practices has been shown to have a significant positive influence on patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.
When patients have a clear understanding of the costs associated with their healthcare services and receive transparent and accurate billing statements, they feel empowered and reassured about their financial obligations.Furthermore, fair billing practices (Febryanto & Bernarto, 2018) that prioritise affordability and offer flexible payment options can reduce financial stress for patients, thereby increasing their overall satisfaction with hospital services.Furthermore, transparent pricing and fair billing contribute to the establishment of trust and credibility between patients and hospitals (Shafiq et al., 2017;Sitio & Ali, 2019).When patients feel that a hospital is transparent in its pricing and billing, they tend to trust the institution and feel confident in its integrity.This trust is critical to building long-term relationships with patients and fostering loyalty to Rumah Sakit Keluarga Sehat Tayu.

Waiting time has a significant positive effect on patient satisfaction
Minimising waiting times is critical to optimising patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.Long waiting times can lead to frustration, anxiety and dissatisfaction among patients, which negatively impacts their overall perception of the quality of care received (Kuluski et al., 2021).Patients often perceive shorter waiting times as a sign of efficient and well-organised healthcare, which contributes to a positive healthcare experience.Reducing waiting times not only increases patient satisfaction, but also improves healthcare outcomes.Patients who experience shorter waiting times are more likely to receive timely medical interventions, leading to better health outcomes and overall satisfaction with the care provided (Dewi et al., 2022;Sitio & Ali, 2019).Therefore, Rumah Sakit Keluarga Sehat Tayu prioritises strategies such as appointment scheduling, triage systems and workflow optimisation to minimise waiting times and improve the overall patient experience.

Resources availability has a significant positive effect on patient satisfaction
Resource availability plays an important role in shaping patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.When patients have access to essential resources such as medical equipment, medicines, diagnostic tools and skilled healthcare personnel, they feel confident in the hospital's ability to provide high-quality care.The availability of adequate resources not only ensures timely and effective medical interventions (McKimm et al., 2022), but also contributes to a sense of comfort and security among patients (Febryanto & Bernarto, 2018;Solimun & Fernandes, 2018).In addition, the availability of resources directly impacts the overall patient experience and perceptions of hospital competence.Patients who feel that the hospital has sufficient resources to fulfil their healthcare needs are likely to report higher levels of satisfaction.Conversely, a lack or inadequacy of resources can lead to treatment delays, suboptimal care, and decreased patient satisfaction.

Information availability has a significant positive effect on patient satisfaction
Information availability significantly affects patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.When patients have access to clear, accurate, and timely information about their health condition, treatment options, and healthcare processes, they feel empowered and involved in their care journey.Accessible information allows patients to make informed decisions, understand their treatment plan, and actively participate in their healthcare, leading to higher levels of satisfaction with the overall healthcare experience (Pratama & Pujianto, 2024;Swain, 2019).Additionally, the availability of information fosters trust and transparency between patients and healthcare providers (Ninaus et al., 2021).When patients feel that their questions are answered, and their concerns are addressed, they develop trust in the hospital's commitment to their well-being.This trust is critical to building strong relationships between patients and healthcare providers and encouraging collaboration in healthcare decision-making.
Tayu Healthy Family Hospital recognises the importance of information availability in improving patient satisfaction and prioritises communication and education initiatives.By providing comprehensive information through various channels such as verbal communication, written materials, and digital resources, the hospital ensures that patients are well informed and supported throughout their healthcare journey.This proactive approach to information sharing not only improves patient satisfaction, but also contributes to better health outcomes and strengthens the hospital's reputation as a patient-centred healthcare provider.

Conclusion
The factors of ambience, staff attitude, trustworthiness, outcome quality, administrative procedure, clinical procedure, price and billing, waiting time, resources availability, and information availability have a significant influence on patient satisfaction at Rumah Sakit Keluarga Sehat Tayu.A comfortable atmosphere, good staff attitude, and strong trust form an important foundation in creating a positive experience for patients.These three factors are interrelated and play a role in building a good relationship between patients and healthcare providers, which in turn influences patients' perceptions of the quality of services and outcomes they receive.In addition, factors such as quality of outcomes, administrative procedures, and clinical procedures also have a significant impact on patient satisfaction.Patients want good outcomes from their medical care and expect efficient and well-organised administrative and clinical processes.
The availability of clear and accurate information is also an important factor in helping patients make informed decisions regarding their treatment and increasing their trust in the hospital.
Equally important, factors such as fair pricing and billing, minimal waiting time, and availability of resources also contribute to patient satisfaction.Patients want affordable and efficient healthcare services, as well as easy access to necessary resources.Together, these factors are interrelated and form a complete picture of how the patient experience at Rumah Sakit Keluarga Sehat Tayu can be improved.By paying attention to all these factors in a holistic and sustainable manner, Rumah Sakit Keluarga Sehat Tayu can continuously improve the quality of service and ensure that every patient receives optimal and satisfactory care.It is not just about providing good medical care, but also about creating an environment that is supportive and attentive to patients' needs and overall satisfaction.
The limitation of this study is the level of homogeneity of respondents, therefore further research can consider choosing subjects with more homogeneous conditions so as to avoid bias or minimise the occurrence of bias.Future research can also consider other variables e.g.complaint handling, patient emotions, and patient loyalty.

1045Figure 1 .
Figure 1.Number of hospitals in Pati sub-district Source: Central Bureau of Statistics in Pati DIstrict (BPS), 2024

Figure
Figure 3. Hypothesis Testing

Table 1 .
Description of Respondents

Table 4 .
F Test clinical procedures, price and billing, waiting time, resource availability, and information availability simultaneously have a significant positive effect on patient satisfaction.
The results of data processing in the table above show that the F value is 192.052 with a significance level of 0.000 smaller than 0.05, so it can be concluded that overall the variables of ambience, staff attitude, trustworthiness, outcome quality, administrative procedures, ISSN 2721-0960 (Print), ISSN 2721-0847 (online) Copyright © 2024, Journal La Sociale, Under the license CC BY-SA 4.0 are performed greatly influences patients' perception of the quality of care they receive.When clinical procedures are performed with precision, empathy and adherence to best practices, patients tend to feel comfortable, respected and confident in the care they receive.In addition, effective clinical procedures contribute to better health outcomes, which are closely linked to patient satisfaction.Patients ISSN 2721-0960 (Print), ISSN 2721-0847 (online) Copyright © 2024, Journal La Sociale, Under the license CC BY-SA 4.0