Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 75 The Analysis of Services Quality and Satisfaction of BPJS Patient at X Public Health Center Counter Kediri City Mohamad As’ad Efendy1*, Elon Bora Bili2 1,2 Department of Nursing, Institut Ilmu Kesehatan STRADA Indonesia, Indonesia *Corresponding author: surel.asad@gmail.com ABSTRACT Background: There are still many people who do not know about the National Health Insurance itself, the ease of treatment using the National Health Insurance has not been fully successful, because of the length of bureaucracy and the lack of facilities and infrastructure to support the National Health Insurance program. Purpose: The purpose of this study was to see correlation between services quality and satisfaction BPJS Patients. Methods: A correlational study methodology was used with a group of BPJS Patients. To obtain 30 individuals, a consecutive sampling procedure was used. The data was analyzed using the Spearman rho statistical test, with a significance threshold of = 0.05. Results: The data revealed that, of the 30 respondents, the majority, 26 respondents (80 percent), stated that the services quality was good, and the majority had adequate satisfaction, 25 respondents (83 percent ). The results of the analysis of the spearman rho test obtained a p-value = 0.000 which is less than the value of alpha (0.05) so it can be concluded that H0 is rejected, meaning that there is a relationship between the services quality and the satisfaction of BPJS patients at X Public Health Center Kediri City. Conclusion: Based on the study's findings, it is possible to conclude that there is a link between the services quality and the satisfaction of BPJS patients. The study's findings also suggest that services quality can increase satisfaction because patient will have loyalty if public health center can ensure services quality to BPJS patient. Keywords: BPJS, satisfaction, services quality Received August 10, 2022; Revised September 12, 2022; Accepted October 3, 2022 DOI: https://doi.org/10.30994/jnp.v6i1.294 The Journal of Nursing Practice, its website, and the articles published there in are licensed under a Creative Commons Attribution-Non Commercial- ShareAlike 4.0 International License. https://thejnp.org/ mailto:surel.asad@gmail.com https://doi.org/10.30994/jnp.v6i1.294 Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 76 BACKGROUND One of the health problems faced by Indonesian people today is is that there are still many people who do not know about the National Health Insurance alone, convenience treatment with use Guarantee Health National even not yet fully successful, due to the length of the bureaucracy and the lack of supporting facilities and infrastructure the National Health Insurance program (Yustisia, 2019). In running the service program Guarantee Health National the, BPJS Health cooperate with various facility health services such as Puskesmas, Posyandu, and Hospitals to provide health services for the community, especially those with low incomes in the hope of being able to provide service health which worthy and quality because limitations financial (Thabrany, 2020). Service health quality is factor which important in reach satisfaction patient. Satisfaction patient is feeling patient which arise as consequence from performance service the health he gets after the patient compares With what what he expected (Department of health, 2020). Factors which cause patient dissatisfaction BPJS among them a lot patients who must be served at the First Provider (PPK 1) causes the queue to become longer, The examination is carried out quickly and seems rushed so that the patient feels that it is not enough time to consult a doctor (Muninjaya, 2019). Restricted drug administration makes patients are not comfortable, because BPJS Health participants have to queue back and forth for treatment again. By using a tiered referral system, patients feel that the referral process takes longer (Alamsyah, 2019). Giving referrals is also not as easy as when it was Askes or Jamsostek or Jamkesmas. Limited service time or practice hours at Family Doctors also cause complaints from patients related to the tiered referral system (Bustami, 2018). Satisfaction BPJS participants on the quality of hospital services really need to be monitored. Because if the patient BPJS participants did not get satisfaction, so it is not impossible that people who have not registering as a BPJS service participant will not want to register himself. Until the program government will also be difficult to realize (Purwanto, 2018). In this case reviewing from the goal The government from the BPJS Health program above to improve hospital services that maximum and could realize registered whole people Indonesia in program. In repair facility service health very need existence survey satisfaction patient (Supartiningsih, 2017). Patient satisfaction is one of the standard measures that have been set for measure succeed or whether or not service health (Arsepta, 2018). Satisfaction patient Becomes part integral from activity guarantee quality service health. That is, the measurement of the level of patient satisfaction must be an activity that cannot be separated from patient satisfaction measurement of the quality of health services. Dimensions of patient satisfaction become one dimension of quality service health which very important (Kurnia, 2018). Quality service which good will cause satisfaction on customer or user service service (BPJS) (Wahyuni, 2019). With holding system Guarantee Health National (JKN) expected satisfaction patient could increases along with the increase in the quality of health services (Irawan, 2018). OBJECTIVE The objective of this study was to see correlation between services quality and satisfaction BPJS Patients. https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 77 METHODS The research design used in this study is a correlational study with cross sectional approach. The sampling technique used is Consecutive Sampling which meet the inclusion and exclusion criteria. The population is 1,662 with a sample of 30 people. In this study the independent variable is service quality and the dependent variable is satisfaction in counter Public health center X on patient BPJS. Test statistics which used is Spearman Rank with score ️ = 0.05. RESULTS Data General Age Frequency Percentage (%) < 25 Year 7 23 25-35 Year 19 64 > 35 Year 4 13 Amount 30 100 Type Sex Frequency Percentage (%) Man 10 33 Woman 20 67 Amount 30 100 Education Frequency Percentage (%) SD 5 17 JUNIOR HIGH SCHOOL 10 33 SENIOR HIGH SCHOOL 14 47 Diploma/PT 1 3 Amount 30 100 Work Frequency Percentage (%) Farmers/IRT 9 30 Entrepreneur/Trade/Entrepreneur 14 47 Employee Private 6 20 Employee Country Civil (PNS/TNI/POLRI) 1 3 Amount 30 100 Based on table on showing that age respondent is known part big respondent with Age 25-35 Year that is as much 19 (64%) respondents. Type sex it is known that most of the respondents are female, as many as 20 (67%) respondents. Education respondent is known almost half from respondent with level education SENIOR HIGH SCHOOL that is as much 14 (47%) respondents. Work respondent is known almost half of respondent work as Trader that is as much 14 (47%) respondents. https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 78 Data Special No Quality Service Frequency Percentage (%) 1 Not enough 1 3 2 Enough 3 10 3 Well 26 87 Amount 30 100 No Satisfaction At the counter Public health center X On Patient BPJS Frequency Percentage (%) 1 Very Not Satisfied 1 3 2 Not Satisfied 1 4 3 Satisfied 3 10 4 Very Satisfied 25 83 Amount 30 100 Based on table on showing that Quality Service Counter Registration in Puskesmas X is known to almost all respondents as many as 26 (87%) respondents in the Good category. Satisfaction at the counter Public health center X on BPJS patient almost known whole respondent as much 25 (83%) respondent in category Very Satisfied. Analysis Data Results Test Statistics Spearman Rank Variable Level Significance Quality Service 0.00 0 Satisfaction In Counter Public health center X On Patient BPJS The results of data analysis show that the significance level is 0.000 < = 0.05 so that H0 rejected and H1 is accepted thus there is a relationship between service quality and satisfaction in Counter Public health center X On Patient BPJS. DISCUSSION Quality Service Counter Registration In Public health center X Based on results study is known that Quality Service Counter Registration in Puskesmas X is known to almost all respondents as many as 26 (87%) respondents in the Good category. This is in accordance with the results of the questionnaire that the officer at the registration counter is always there time of service, officers at the counter to serve patients quickly and uncomplicated, always polite in providing service, have a sympathetic attitude and understand the wishes patient, no give attention which special to patient, officer in counter look skilled, careful, and thorough in providing services, always recording identity patient, give convenience in service registration, officer in counter registration look neat and room wait in counter registration clean and comfortable. https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 79 Department of health (2021), explain that quality service could interpreted as level perfection of health services in accordance with standards required service by the community to meet patient demands. The more obedient officers (profession) to standard service, so the more quality also service health which given. Quality Health care is meeting and exceeding customer needs and expectations through continuous improvement over the entire process (Wijono, 2020). Customers include patients, family, and other which come for get service doctor, employee. Quality Health services are assessed from 5 dimensions, namely reliability (ability to fulfill promises), responsiveness (response in give service), assurance (ability give guarantee service), empathy (ability understand desire customer), and tangibles (physical view of the service). These five dimensions of service quality are the concept of Service Quality is a measuring tool for the quality of health services (Tjiptono, 2020). Factors related to the quality of health services is a predisposing factor (predisposing) factors) include demographics (age, gender, socioeconomic status), social structure (ethnic, race, culture, occupation, education), beliefs (belief in disease, doctors, health workers). Enabling factors include the quality of health services, service distance, socioeconomic status, service needs (needs), tariffs or fees, facilities, personnel services, location, speed and ease of service, information, decisions to utilise service health. According to opinion researcher that quality service Public health center very important, because affect patient satisfaction. The quality of good health services can create a sense of satisfied on self every patient. Satisfaction customer which low will impact to decline amount visit patient which will influence profitability facility health. In addition, the important role of each system is to ensure service quality given health. With increasing attention to quality improvement health services, understanding of the approach to health service quality assurance is becoming increasingly important. So it can be said that the better the quality of health services given by the registration counter officer, the level of satisfaction will also increase patients on the quality of services provided. On the other hand, the lower the service quality health services provided by the health center then it will be lower satisfaction patient against quality service service which given. Satisfaction In Counter Health Center X Pada Patient BPJS Based on the results of the study, it was found that satisfaction at the Puskesmas X counter at BPJS patients are known to almost all of the respondents as many as 25 (83%) respondents in the category Very satisfied. This is in accordance with the results of the questionnaire that the physical facilities of the registration counter (building, living room) waiting time, room temperature, etc.) that the patient received at the Puskesmas was satisfactory, the patient also felt satisfied with the performance of the registration officer at the registration counter, the counter officer is not favoritism in providing health services and the counter staff is always on time in carrying out registration, patients feel comfortable during the registration process at the registration counter and service in units registration always get impression which good. Irawan (2020), explains that patient satisfaction is a feeling of pleasure and satisfaction because hope and his wish achieved after accept service which given. Satisfaction patient is a patient's feeling that arises as a result of poor health service performance got it after patient compare it with what which he hoped. Level satisfaction patient BPJS in on quality service in Public health center could Becomes reject measuring the success of the BPJS program specifically at the health center which is the guard front for serve the community. The BPJS program itself is still in its journey of many shortcomings and complaints from BPJS participants include, BPJS patient inpatient rooms are often full, referral problems make it difficult for critical patients, lack of socialization about the BPJS https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 80 program, slow work system and verification claim action which slow (Tjiptono, 2020). The more tall level quality health services, the greater the perceived patient satisfaction and vice versa, the more low level quality service health so the more small satisfaction patient which felt. Quality service health is size evaluation thorough on a level good health services. While patient satisfaction will be known before after the patient feels the results of the quality of health services received which is influenced by also by hope previously and needs will service health that (Department of health, 2021). In the opinion of researchers that health workers can maximize performance in service and pay attention to things that can help the patient's problems and all meet customer needs, it is possible to increase the level of customer satisfaction that can increase customer confidence in the services provided give. In addition, officers must always be polite and master the knowledge and skills Skills which needed for handle every question or problem customer. In addition, the researcher assumes that the registration counter clerk must: more discipline in carry out tasks, especially those related to health so that things do not happen wants and misunderstandings between patients and healthcare workers. In addition, the health center provide means and infrastructure like corner read for patient which wait and complete akat health in because means and infrastructure very important in increase quality service so that creation satisfaction patient. Officer officer counter registration is also not allowed to be favoritism and must show empathy in giving service to patients. This the registration counter officer has a very important role important in service because it is the door or the front line to the patient get service health. The Relationship between Service Quality and Satisfaction at the X Health Center Counter for Patients BPJS. The results of data analysis show that the significance level is 0.000 < = 0.05 so that H0 rejected and H1 is accepted thus there is a relationship between service quality and satisfaction in Health Center Counter X for BPJS Patients. The quality of service is in good category so that satisfaction at the Puskesmas X counter for BPJS patients is known to almost all respondents as many as 25 (96%) respondents in the category of Very Satisfied. According to the opinion of related researchers the difference between the preliminary study data and the results of the research obtained, it is known that the number of BPJS patients who visit Puskesmas X in very large numbers and where in the distribution of questionnaires also not to patients who were interviewed when researcher take the initial data so that possible interview results obtained not in accordance with the results of research that has been carried out by researchers. Besides that too The service quality of the counter staff is also related to the period of service, because of the good experience owned in give service is wrong one factor in increase patient satisfaction. The patient's perception of the length of work or tenure of the officer, where the patient will satisfied to performance officer counter registration. BPJS participants' satisfaction with the quality of hospital services really needs to be monitored. Because if the BPJS participant patient does not get satisfaction, then it is not impossible people which not yet register as participant service BPJS no will want to register himself. So that government programs will be difficult to materialize. In this case review from the Government's goal of the BPJS Health program above to improve services maximum hospital and can realize the registration of all Indonesian people in the program. In repair facility service health very need existence survey patient satisfaction (Supartiningsih, 2017). Patient satisfaction is one of the standard measures which has set for measure succeed or whether or not service health (Singh, 2018). Satisfaction patient Becomes part integral from activity guarantee quality service health. That is, measuring the level of patient satisfaction must be an activity that cannot be separated from the measurement of the quality https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 81 of health services. Dimensions of patient satisfaction are wrong a very important dimension of the quality of health services. Good service quality will cause satisfaction on customer or user service service (BPJS). (Wahyuni, 2019). CONCLUSION Based on the results of the study, it can be concluded that the Service Quality of the Registration Counter in Puskesmas X, it is known that almost all respondents as many as 26 (87%) respondents in the Good category. Almost all of the satisfaction at the Puskesmas X counter for BPJS patients is known respondents as many as 25 (83%) respondents in the category of Very Satisfied. The results of data analysis show that the significance level is 0.000 < = 0.05 so that H0 is rejected and H1 is accepted therefore There is a Relationship between Service Quality and Satisfaction at the X Health Center Counter for BPJS Patients. It is recommended that health workers can improve health services and be able to assess at a time determine solution best for reach satisfaction patient participant BPJS In Counter Optimal registration by improving the quality of health services. For respondents to can provide information and knowledge about the quality of health services and patients BPJS users can participate to provide constructive criticism and suggestions for Health services at Puskesmas X Kediri City. For further researchers, it is hoped that can be used as input and basic data for further research and can examine factors other factors such as officer communication factors, work experience, length of service at the registration counter relate with satisfaction in counter Public health center X on patient BPJS. REFERENCES A. Aziz, Alimul Hidayat. 2017. Nursing Research Methods and Data Analysis Techniques. Jakarta : Publisher. Salemba medicine. Alamsyah, D. 2019. Management Service Health. Yogyakarta : Muha medicine. Arsepta, A, A. 2018. Factors Relating to Service Quality Towards Patient Satisfaction of Outpatient Commercial Insurance Participants at Syafira Hospital. Pekanbaru : Thesis STIKes Hangtuah. Azwar A. 2020. Maintaining the Quality of Health Services Application of the Solving Circle Principle problem. Jakarta: ray library hope; 2020. Burhanuddin, N. 2019. The Relationship between Health Service Quality and Patient Satisfaction HOSPITAL Sheikh Yusuf Gowa. Journal MKMI, 12 (1), 41–46. http://journal.unhas.ac.id/index.php/mkmi/article/view/552/377. bustami, 2018. Guarantor Quality Service Health & Accept The stability. field : Erlangga. Dervish, S. D. 2017. Method Research. Jakarta : EGC. Ministry of Health RI. 2021. Health Profile of Indonesia 2021 : Towards a Healthy Indonesia 2020. Jakarta : Department Health RI. Emi Ellia astutic, Ahmad Efrizal Amrullah, Said Madijanto, 2020. Connection Quality Health Services With Patient Satisfaction BPJS Outpatient Participants. Journal Health dr. Soebandi Vol. 8, No. 2 http://journal.stikesdrsoebandi.ac.id/ Publisher : LP3M STICK dr. Soebandi Jember. Etilidawati, E., & Handayani, DY 2018. The Relationship of the Quality of Health Service Quality With Satisfaction Patient Participant Guarantee Health National. designing, 15 (3), 142–147. https://doi.org/10.30595/medesigns.v15i3.2078. https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 82 Hanna Pearl, Diana Mayasari, Eliza Techa Fattima, Cynthia Saputri, 2018. Relationship Quality Service With Satisfaction Patient Participant BPJS in Room Treat stay Internal Medicine RSUD dr. H Abdul Moeloek. JK Unila | Volume 2 | Number 1 | February 2018 | 31. Irawan, handi, 2020. Satisfaction customer . Jakarta : PT Gramedia. References. Irawan H. 2018. The principle of customer satisfaction. Edition 8. Jakarta: Elex media komputindo; 2018. Kurnia, S., Hastuti, W., Mudayana, A. A., & Nurdhila, A. P. 2018. Connection Quality Services with Patient Satisfaction BPJS Participants at Regional General Hospitals Yogyakarta. 11 (2), 161–168. https://doi.org/10.12928/kesmas.v11i2.7260. Marian tonic, Ricky Wiranata, 2020. Connection Quality Service Health With Satisfaction of Inpatients of BPJS Health Participants at Selasih Hospital, Pangkalan Kerinci, Pelalawan Regency in 2015. Journal of Hospital Administration and Management Vol 1, No. 1, June 2020. Maulina, L., Madjid, TA, & Chotimah, I. 2019. Patient Satisfaction of BPJS Participants in Unit Treat stay Public health center Cibungbulang Regency Bogor Year 2019. Journal Student Health society, 2 (2), 130–136. Minister of Health of the Republic of Indonesia, 2019. The legal basis for the implementation of the BPJS program. Muninjaya, 2019. Quality Management of Health Services. Jakarta: EGC; 2019. notoatmodjo, Soekidjo. 2017. Methodology Study Health. Jakarta : Rineka Create. Nursalam, 2017. Draft and Application Methodology Study Knowledge Nursing. Jakarta : Salemba Medika. Nursalam, 2017. Satisfaction Customer. Jakarta : PT Gramedia. Libraries, 2018. Pohan, 2019. Factor - Factor Which Influence Search Service Health. Salemba medicine. 2019. Purwanto, S. 2018. Satisfaction Patient To Service home Sick, http://permatabunda.co.id/index.php/article-kesehatan/85-kepuasan?format=pdf,. in access day Monday 27 April 2018, o'clock 11:35 am. Purwoastuti, E. & Walyani, E, S. 2020. Quality Service Health & Midwifery. Yogyakarta: Pustakabarupress. Patience, 2019. Draft Satisfaction. grammar Indonesia : Jakarta. Sari, 2020. Quality in Goetsh and Davis. Service Quality. Indonesian Gramedia : Jakarta. Sugiyono, 2017. Qualitative Research Methods and R&D ( Revised Edition ). Bandung : CV. Alphabet. Thabrany, H. 2020. National Health Insurance. Jakarta : PT RajaGrafindo Persada. Tjiptono, 2020. Dimension Quality Service. Print Second. Surabaya : Airlangga UniversityPress. Wijono, D. 2020. Management quality service health. Theory, Strategy and Application. Volumes.1. Print Second. Surabaya : Airlangga University Press. https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.75-83 83 wolper, Laurence. 2020. Administration Service Health Principle, Practice, Submission. Jakarta : Publisher Book Medical EGC. Yustisia V. 2019. Guide official get guarantee health from BPJS. Edition I. Jakarta: Visimedia; 2019. Zeitham and Berries in Tjiptono, 2019. Aspect - Aspect Satisfaction patient. Jakarta : PT grammar. References. https://thejnp.org/