The Influence of Hospital Brand Image and Service Quality On The Patient 2
The Influence of Hospital Brand Image and Service Quality On The Patient 2
The Influence of Hospital Brand Image and Service Quality On The Patient 2
Eni Trismiati
Program Studi Magister Manajemen, Universitas Esa Unggul, Jakarta. Indonesia
Tel : +622185718001885/ E-mail: enitrismiatisularso@yahoo.co.id
Abstract
Brand image and service quality are crucial for hospitals to make patients feel
satisfied with the services provided, which will eventually improve the patients
loyalty. The formulation of the problem in this study is to find out whether
hospital's brand image, service quality and patients satisfaction influence
patients loyalty. This research aims to determine the effects of hospital brand
image and service quality on patients loyalty mediated by the patients
satisfaction in outpatient hospital units of Qadr Hospital Tangerang. The design of
this research is explanatory research. The population in this study are outpatients
treated at the Qadr Hospital with a sample of 150 respondents. Sampling
technique used is accidental sampling method. The data quality testing
used Factor Analysis for validity test and Cronbach's Alpha for reliability
test. The collected data is processed by using SEM (stuctural Equation Model).
The results show that hospital brand image has a significant and positive effect on
patients satisfaction, brand image has a significant influence and positive impact
on patients loyalty, service quality has a significant and positive effect on
Patients Satisfaction, Service quality has a significant and positive influence on
patients loyalty, and Patients Satisfaction has a significant and positive impact
on patients loyalty. In conclusion, it is proven in this study that hospital brand
image and good quality service can improve patients satisfaction and loyalty. It is
recommended that the management of Qadr Hospital improve the hospital brand
image and service quality so that both can have an impact on patients satisfaction
and increase patients loyalty.
THEORETICAL BACKGROUND
Brand Image
Brand image is a set of customers confidence in a particular brand (Kotler
and Armstrong). According to Supranto and Limakrisna, brand image is what
customers think and feel when they hear or see a brand and what customers learn
about the brand. Brand image is also called a schematic memory brand, containing
the interpretations of the target market on the product characteristics, product
benefits, usage situation and marketing characteristics. Another definition
of Brand Image is a set of customers confidence in various brands (Kotler &
Armstrong). While Aaker said that the brand association is something that relates
to the brand in the minds of customers (Aaker)
Service Quality
According to Parasuraman, et al in MN Nasution: Service quality is a
global judgements or attitude concerning the superiority of the services performed
by comparing customers perceptions and expectations. According to Lovelock
and Lauren: Service qualitys is a long-term customers cognitive evaluation of the
delivery of services of a company. Tjiptono and Gregory, Berry, Parasuraman in
MN Nasution has identified five groups of characteristics used in evaluating
customers service, as follows: (1) Tangible, in the form of appearance of physical
facilities, equipment, personnel and means of communication; (2) Reliability, the
ability of health services to provide the promised services immediately and
satisfactorily; (3) responsiveness, namely the willingness of staff to assist
customers and provide responsive services; (4) Insurance, included in it the
ability, courtesy, and trust worthiness performed by the staff who are free from
danger, risk or doubt; (5) Empathy, which includes the ease of relationships, good
communication, and understanding of customer needs
Patients Satisfaction
According to Oliver in MN Nasution Customers satisfaction is an after-
sale evaluation, on which the perception of the performance of selected products
meets or exceedspre-sale expectations. If the performance does not meet the
expected perception, dissatisfaction occurs, according to Kotler and Keller
(2009). Meanwhile, according to Tse and Wilton in Tjiptono and Gregory,
customers satisfaction is the customers responses to the perception evaluation on
the difference between the initial expectations and the perceived service after the
consumption of the product. Aditama identifies that patients are those treated in
hospital. To create patients satisfaction, Hospitals must create and manage a
system to obtain more patients and to retain patients. However, the efforts to
improve the perfection of satisfaction to grab customers can be done in a variety
of strategies.
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Loyalty
Customer loyalty is a repeat purchase made by a customer for a
commitment to a brand or company. Kotler (2009) Mowen and Minor in
Suningsih defines loyalty as a condition where the customers have a positive
attitude toward a brand, have a commitment to the brand, and intend to continue
to purchase in the future. Another definition of loyalty from Dhammesta says
that customers loyalty shows a tendency to use a particular brand with a high
level of consistency. This means that loyalty is always associated with customers
preferences and actual purchase. Meanwhile, according to Sheth and Mittal in
Tjiptono, customers loyalty is customers commitment to a brand, stores or
suppliers, based on a very positive attitude and is reflected in a consistent repeat
purchases.
Hospital
Hospital is a public facility that serves as a center for health care, which
includes the prevention and cure for diseases, as well as the maintenance,
improvement and complete health recovery. Based on Law No. 44 of 2009 on
hospitals, a hospital is a health care institution that organizes complete personal
health services that provides inpatient, outpatient and emergency health care.
WHO (World Health Organization) explains that hospital is an integrated social
and medical organization that serves as a center for health care providers, both
preventive healing and training center and social-biological research.
Research Framework
A hospital must try to follow a strategy of how to improve the quality of service
so that patients were satisfied with the services provided. Therefore, hospitals
must have a brand image positive hospital by providing complete services to
patients. Satisfactory service is expected to affect the loyalty of patients resulted
in increased patient visits.
Brand Image Hospital (X1) has a reputation that is a good indicator of a hospital,
a comfortable environment, Trust Hospital, Right Attitudes of Physicians. While
Quality of Service (X2) can be seen from the five dimensions namely Tangible,
Reliability, Responsiveness, Assurance and Empathy. Patient satisfaction (Y1)
into mediation to the loyalty of patients who have an indicator that patients are
satisfied with the services provided by the hospital. Further more, the influence of
patient satisfaction with the hospital's brand image and quality of service are
positive, it will affect the Patient Loyalty (Y2) having an impact on repeated visits
to hospital patients. Picture of the general framework of this study can be
explained in the figure below:
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H2
Hospital
Brand H1
Image Patient H5 Patient
X1 Satisfaction Loyalty
Y1 Y2
Figure
H3 1 : Research Framework
Service
Quality H4
X2
Marilees and Fry discovered that image has a direct effect on loyalty. Image is
an obvious predictor of customers loyalty. Good image will form a public
mindset on where to go to get health services, that when people have health
problems, they accordingly will think of a hospital based on their experiences or
based on the information they have received. The 2nd hypothesis can be
formulated as follows:
H 2: Hospital brand image has an affect on the increase of patients loyalty
Wu, said that high service qualityis correlated with high customers
satisfaction. Patients satisfaction serves as a medium for service quality and
behavioral intentions. The quality of health care is not just concerned with how
medical personnel provides services to patients, but also how the patient feels
comfortable with the conditions and situations that hospitals create. Thus the 3rd
hypothesis is put forward, as follows:
H 3: Service quality has an affect on the increase of patients satisfaction
services will increase. Based on this hypothesis, the 4th hypothesis is proposed as
follows:
H 4: Service quality has an affect on the increase in patients loyalty.
METHOD
Measures
The data collection is conducted to obtain data, namely the primary
data,to solve the problem. In this study, primary data is obtained by distributing
questionnaires to 150 respondents. The sampling technique used in this study
is Accidental Sampling.
The research statement has six responses which use linkert scale type,
ranging from score 1 for strongly disagree response to score 6 for strongly agree
response. Statements for the variable of the brand image consists of facilities,
comfortable environment, confidence in the hospital and the proper attitudes of
the doctors. Research statements for the variable ofservice qualityrefer to the
instrument created by Parasuraman et.al which consist of tangible, Reliability,
Responsiveness, Assurance and Empathy. The research statements on patients
satisfaction consist of satisfaction with hospital services, and research statements
forthe variableof Loyalty statement consist of preferences and intention to return
despite relatively high prices.
From all the questionnaires distributed, the data obtained shows that the
gender characteristic of the most respondents was 56.7% female, the age
characteristic was 45.4% between 35-49 years, and the educational characteristic
was 34.7% educated in high school, the work characteristic was 50.7% working in
private sectors, the financing characteristic was 55.3% using private financing. Of
all respondents, as many as 77.3% respondents visited Qadr Hospital more than 3
times.
Validity Test
In this study, the validity is tested out using analysisfactor. In the factor
analysis, if the KMO value is below 0.5, the factor analysis can not be used or
accepted. The acceptable KMO value is above 0.5, precisely when it is 0.6 to
0.9. KMO value of 0.9 indicates a very satisfactory value, while when KMO value
is below0.5, the factor analysis can not be accepted. From the result of data
validity test conducted, all statements are considered valid and qualified for
further test.
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Reliability Test
Reliability Test is conducted by using Cronbach Alpha test. Of all the data that
was tested, all Items in the questionsare considered very reliable
RESULTS
Evaluation Model Measurements (Outer Model)
In this research, validity and reliability test on each latent variable will be
conducted,namely; variable image of Brand, Service Quality, Satisfaction and
Loyalty with the help of lisrel 8.3. Reflexive individual measurement is
considered valid if it has a loading value () with a measured latent variable
0.5, if one ofthe indicators has a loading value () <0.5, the indicator should be
dropped because it would indicate that the indicator is not good enough to
accurately measure latent variables. To measure the reliability,the value of
Construct Reliability should be (CR> 0.70) and Variance Extract should
be (VE>0.50). If they meet the requirements, indicators are able to represent the
latent variables.
Based on table above, it can be concluded that all indicators have loading
values greater than 0.5 and t value is greater than t table (1.96). This means that
none of the indicators were dropped and all indicators are valid to measure latent
variables.
DISCUSSION
Hypothesis 1, brand image has a significant influence and positive impact
on patients satisfaction, with a path coefficient of 0.35 and t value of 9.15, and t
value greater than t table (1.96). Hypothesis 2, brand image has a significant
influence and positive impact on patients loyalty, with a path coefficient of 0.21
and t value of 9.15. Hypothesis 3, Service quality has a significant and positive
effect on patients satisfaction, with a path coefficient of 0.65 and t value of
14.74. Hypothesis 4, Service quality has a significant influence and positive
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CONCLUSION
Based on data obtained and the analysis conducted, it can be concluded as
follows: Brand image has a significant influence and positive impact on patients
satisfaction. The first hypothesis that brand image has an influence on patients
satisfactionis statistically proven. Therefore, to improve patients satisfaction,
Qadr Hospital is expected to continue to maintain the good brand image of the
hospital. Then, the second hypothesis that brand image has a significant influence
and positive impact on patients loyaltyis alsostatistically proven. This suggests
that a good brand image can increase loyalty, which, in the end of the day, will
affect the profitability of Qadr Hospital. Service Quality has a significant
influence and positive impact on patients satisfaction, this third hypothesis that
the quality of the service has an influence on patients satisfactionis statistically
proven. This shows the importance of service quality in improvingpatients
satisfaction. Therefore, the Qadr hospital should pay very much attention to the
service quality given to its patients. Service quality has a significant influence and
positive impact on patients loyalty.This fourth hypothesis that the service quality
has an influence on patients loyaltyis also statistically proven. Good quality
services will have an impact on patients satisfaction and will contribute to
patients retention and loyalty. The hospital profitability will increase along with
the increase in patients loyalty. Patients satisfaction has a significant influence
and positive impact on patients loyalty. This fifth hypothesis that the service
quality has an influence on patients loyaltyis statistically proven. Patients who
are satisfied with the services will remain faithful to Qadr hospital in the future.
Managerial Implications
For the managerial implication of the study, the writer dicovered that this
study could become an input for the management of the Qadr Hospital, Islamic
Village Tangerang, which will implicate on the managerial policy in accordance
with the hospitals priority. The results could be used as a point for consideration
and evaluation on the hospital brand image, service quality, patients satisfaction
and patients loyalty. In addition to that, the results of this study can be used to
determine factors that can increase a hospital brand image, service quality,
patients satisfaction and patients loyalty. It is recommended that the
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management of Qadr Hospital be able to improve the brand image of this Islamic-
nuanced hospital. Maintaining a good brand image can be carried out by
minimizing errors in running the operations of the hospital. In doing so, i.e,
immediately following up complaints of patients such as dirty environment,
doctorstardiness and others are some of the occurring errors.
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