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PATIENT SATISFACTION WITH THE QUALITY OF

COVID-19 INPATIENT SERVICE BASED ON THE
SERVWUAL METHOD
Sri Sulamsih1, Yusup Dwiyanto2, Agus Purnama3, Dyah Rima Pudjiastuti4,
Maladewi5, Edi Yulia Ramdan6, Kristianingsih7, Partini8, Ratna Sari9, Sari
Jiwanti10, Ukin Sukirah11
1
Affilition (University, Country)
2
Affilition (University, Country)
Corresponding author: email address
(10pts; Italic)

ABSTRACT

Background: The spread of Corona Virus-19 (Covid-19) has a direct impact on health
facility services. Efforts to rapidly expand health service facilities, especially isolation
treatment rooms for the handling of covid 19 patients, will make some health services
not focus on quality and patient satisfaction in accordance with the Decree of the
Minister of Health of the Republic of Indonesia No. 340 / MENKES / PER / III / 2010.
Purpose: For this reason, it is necessary to carry out an evaluation that aims to ensure
that the government's efforts to quickly establish health facilities for the treatment of
Covid 19 patients do not diminish patient satisfaction in obtaining maximum health
facilities. Researchers want to find out whether the acceleration of health facilities for
handling Covid 19 still cares about patient satisfaction.
Methods: This research is a descriptive analysis using a quantitative approach. The
design of this study used a cross sectional study using a medoteService Quality
(ServQual). This study used 100 respondents with predefined inclusion and exclusion
criteria.
Conclusion: Research conducted at the Tk. II Moh. Ridwan Meureksa Hospital, from
the Servqual method obtained an average gap value of 0.27, which can be interpreted
using the servqual method, the service for Covid 19 patients was declared satisfactory.

Keywords: Corona Virus-19, Patient Satisfaction, medote Service Quality (ServQual).

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BACKGROUND
In early 2020, the world was shocked by a new epidemic that attacks the respiratory
tract called Corona Virus-19 (Covid-19). The first time Covid 19 was found in Wuhan,
Hubei Province, China, and it spread very quickly to 190 countries, one of which is
Indonesia (WHO, 2020). The spread of this virus has had a very broad impact on health,
social and economic services in all countries. According to the Covid 19 Task Force
data, Indonesia has 977,474 confirmed lives and 243 thousand people in Jakarta, healed
215 thousand people and died 3.9 thousand people. This indicates that Covid 19 still
cannot be resolved, the death rate continues to increase even though it is offset by the
increasing recovery rate (Covid Task Force 19, 2021).
The number of confirmed patients with Covid 19 is increasing and requires hospital
treatment. According to PERSI, in 2021 the BBC News Indonesia Media stated that
around 2,900 hospitals in Indonesia, only 490 have complete facilities to treat Covid 19
patients, while the hospital capacity until January 2021 for the number of beds for
Covid 19 patients has reached 90. % in Indonesia. Meanwhile, in Jakarta the number of
beds that have been used for Covid 19 patients is 80%.
The government has also made efforts to add hospitals to provide health services to the
Indonesian people. But during a pandemic, sometimes the need for health services and
hospitals do not have control over the level of patient satisfaction where patient
satisfaction is in the Decree of the Minister of Health of the Republic of Indonesia No.
340 / MENKES / PER / III / 2010, which states that a hospital is a health service
institution that provides complete individual health services that provide inpatient,
outpatient and emergency services. So that as a health service, the hospital must be able
to meet the needs of patients which can be measured from the level of patient
satisfaction.
Hospital services are also greatly influenced by the quality of service available at the
hospital. Quality health services are one of the basic needs that everyone needs (Wijono
1999; in Corby, 2009). Improving the quality of hospital services is a major requirement
in hospital competition in the era of the Covid 19 pandemic. Hospital agencies must be
able to provide satisfaction to health service users in accordance with the instructions of
the Ministry of Health (Bustami, 2011).
Patient satisfaction with health services can be assumed in physical evidence,
constraints, assurance, and empathy (Billy, 2016). Satisfaction can also be perceived
whether reality is the same as what someone expects (Anggriani, 2011). If the hospital
service is good, the patients there will also feel satisfied, and vice versa, if the service
the patient gets is not what they expect, the patient will feel dissatisfied.
Patient satisfaction is a benchmark for the quality of service in a hospital, especially in
the era of the Covid 19 pandemic, where the government has turned several places into
health services, field hospitals and Covid 19 referral hospitals. Whereas the hospital is
now only trying to provide a place of care with the large number of beds capacity to be
able to provide care to Covid 19 patients due to government demands, regardless of the
number of human resources and existing facilities. For this reason, the researcher
wanted to examine "Patient Satisfaction with the Quality of Covid-19 Inpatient Services
Based on the Servqual Method.

OBJECTIVE

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The Servqual method is a questionnaire that has a function to be able to determine the
level of satisfaction seen from five dimensions, where these dimensions will compare
the patient's expectations and the reality received by patients in undergoing treatment in
the hospital. Covid 19 is a new disease that has become a pandemic that is attacking the
entire world, and requires isolation treatment rooms and new types of diseases whose
treatment rooms also require new adaptations in providing services. For this reason, this
study aims to determine the level of satisfaction of Covid 19 patients in undergoing
treatment at the hospital, so that the hospital can provide maximum service in handling
Covid 19.

METHODS
This research is a descriptive analysis research using a quantitative approach. The
design of this study used a cross-sectional study where the information collected at one
time was to measure the variable tangibles, reliability, responsiveness, assurance, and
empathy using the methodology.Service Quality (ServQual). The ServQual
questionnaire contains 22 questions, including; 4 questions covering the tangible
dimension, 4 questions covering the responsiveness dimension, 5 questions covering the
reliability dimension, 5 questions covering the assurance dimension and 5 questions
covering empathy. The assessment in this question uses a Likert scale where it is used to
measure the attitudes, opinions and receptions of a person or group about the
phenomenon that occurs.
The number of respondents in this study were 100 people, who are currently undergoing
treatment at the Tk. II Moh. Ridwan Meuraksa Hospital. Kinclusion riteria; a). someone
who is undergoing treatment in the covid 19 isolation room; b). > 17 years old; c).
undergoing treatment> 3 days. Exclusion criteria; a). Can not read; b). Patients in
critical condition / support for breathing aids.
The data from the research results will be analyzed using the Servqual value calculation,
where the gap value will be obtained based on the difference between the reality value
and the expected value, and will be analyzed using a diagram of importance
performance analysis or a Cartesian diagram to find out where the gap occurs.

RESULTS
Based on the data on the characteristics of the respondents, it was found that the gender
of the respondents who were inpatient in the Covid 19 isolation room had the same ratio
between men and women, namely 50 people (50%), based on the average age of 26-35
years as many as 29 people ( 29%), whereas the average education status of SMP and
SMA is 35 people (35%), and the length of time for patients undergoing treatment in the
Covid 19 isolation room is an average of 10-15 days as many as 41 people (41%).
Based on the results of the calculation of the gap value based on the five dimensions in
Servqual in table 2, with a tanible gap value of 0.23, responsiveness 0.33, reliability of
0.41, assurance -0.09, and empathy 0.46. These results indicate that in five dimensions
the results of the Servqual questionnaire at Tk. II Moh. Ridwan Meuraksa Hospital has
no gaps in the four dimensions, except in the assurance dimension. The results of this
study indicate that the Tk. II Moh. Ridwan Meuraksa Hospital, providing satisfying
services to service users at the hospital.
In the results of the Servqual calculation which has a five-dimensional factor in
determining patient satisfaction, there is only a negative gap value in Assurance with a

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gap value of - 0.09. thus, what needs to be prioritized in improvement is assurance. This
can be due to the limited need for a bed for the Covid 19 isolation treatment room, even
though the Tk. II Moh. Ridwan Meuraksa Hospital is a referral place for covid patients
19. In the importance performance analysis diagram or Cartesian diagram it is clear that
it is known that the Gap is divided into 4 parts, namely; Patient satisfaction at Tk. II
Moh. Ridwan Meuraksa Hospital, seen from the 5 servqual dimensions, has a
satisfaction (reality) of 6.75 and a value (expectation) of 6.49, so that the gap value is
0.27.
If the result of the gap value shows negative, it means that the reality does not match the
expectations of the patient, which indicates that the quality of services provided to
patients is not good. but in this study illustrated by the diagram above shows that the
quality of services provided by the Tk. II Moh. Ridwan Meuraksa Hospital did not show
a very significant gap, this will be explained as follows;
1. Quaternary I (top priority) is an attribute or item that affects patient satisfaction. The
results of the servqual questionnaire found no gaps, but the hospital must still pay
attention to and prioritize the interests of service users. The attributes included in
this quadrant are item number 4,6,8,12,14,17, namely the willingness of services
according to the type of service offered, the medical and medical team responding to
my request quickly and efficiently, the medics are willing to fulfill the request and
my special needs, the medical team provides the right and necessary information,
the medical team is reliable, the medical team and the medical team are
knowledgeable
2. Quadrant 2 (maintain achievement) is an attribute or item that affects patient
satisfaction. The results of the servqual questionnaire did not find any gaps, but the
hospital must still pay attention to them, because in general the implementation has
been according to patient expectations, so that it can be said to satisfy the patient.
The attributes included in this quadrant are numbers 2,10,13,15,16,19, namely a
comfortable hospital environment, the medical team is reliable, trustworthy, the
patient feels safe when interacting with the medical team, the medical team is polite
and friendly. , health services started on time.
3. Quadrant 3 (low priority) is an attribute or item that affects patient satisfaction,
being in this quadrant is considered not so important to patients and its
implementation is considered normal. The attributes included in this quadrant are
item number 3,18,22, namely hospital employees who have a neat and clean
appearance, the medical team is sincere in dealing with patient problems, the
medical team pays attention to patient needs.
4. Quadrant 4 (excessive) is an attribute or item that affects patient satisfaction. This
has a positive impact on patient satisfaction. But this excess also needs to be paid
attention by the hospital. The questions included in this quadrant are numbers
1,5,7,9,11,20,21, namely the latest equipment, the communication of the medical
team is precise, accurate and clear, the medical team always helps patients, the
medical team has provided correct services since the first time. being treated, the
medical team pays individual attention to the patient, the medical team takes the
patient's interests seriously.

DISCUSSION

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Cartesian diagram analysis is the basis for management in making decisions about what
actions to take to be able to provide hospital services and increase customer satisfaction
(Ade, 2014). The results of the Cartesian diagram from respondents' statements using
the servqual method where the average value of the expected service and the reality
value in the five dimensions of tangible, responsiveness, reliability, assurance, and
empathy are used to determine the position of variable placement on the Cartesian
diagram (Katiandagho, et al., 2014).
Based on the average value of each variable answer to the questionnaire and based on
the level of importance as measured by the indicators above, it is then translated into a
Cartesian diagram (importance performance analysis), namely by connecting the
average value of value and expectation. Meanwhile, the average value of all
expectations and realities is used as a barrier in quadrants 1, 2,3 and 4.
Based on the results of the suitability test, it was found that the middle assessments
were achieved by the Tk. II Moh. Ridwan Meuraksa Hospital is in reality 6.75 and hope
is 6.49, it is found that the reality value is greater than the expectation, so it is stated that
the level of patient satisfaction with services at the Tk. II Moh. Ridwan Meuraksa
Hospital was said to be satisfactory. Meanwhile, it can also be seen from the quadrant 2
cartesian diagram, which has more questions than quadrant 1. This means that the
overall services provided at the Tk. II Moh. Ridwan Meuraksa Hospital has been
decisive enough. This can be assumed because during the pandemic, many hospitals
were overloaded in overcoming covid 19, but the Tk. II Moh. Ridwan Meuraksa
Hospital continues to provide excellent service to Covid 19 patients.
Maintaining patient satisfaction in the use of services, especially hospital services, is
very difficult, so it is necessary to measure it as an evaluation step in maintaining the
quality of service. The things that need to be maintained and maintained in providing
services include a comfortable hospital environment, the medical team is reliable,
trustworthy, patients feel safe when interacting with the medical team, the medical team
is polite and friendly, health services are started on time. This is in accordance with
Katiandagho, et al., (2014), which explains that the quality of health services in terms of
hospital services can also be felt directly by service users by maintaining the physical
appearance and cleanliness of the hospital, availability of parking, cleanliness, tidiness.
and the comfort of the room, the appearance of the officer,
Timely examination and service of the medical team will also be a benchmark and need
to be maintained in order to maintain patient satisfaction with the quality of the hospital.
This is regulated in the health minister's decision number 463 / Menkes / SK / VI / 1993
regarding hospital service standards and hospital obligations, which states that all
patients who are hospitalized must be given medical care, nursing care and midwifery
care as well as possible without distinction. -different classes of care. This research has
also been researched by Hermanto, (2010) which shows that 95% of respondents stated
that they were satisfied if doctors and medical personnel provided timely services by
means of visites every day. As well as research reports at dr.
Maintaining patient satisfaction in providing quality services at the hospital is not easy,
because patient satisfaction is a feeling of pleasure or disappointment that arises after
someone gets services that are not in accordance with desired expectations (Nursalam,
2011). For this reason, the hospital needs to conduct an evaluation in maintaining
patient satisfaction in order to provide quality and professional services.

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CONCLUSION
Research results in Tk hospital. II Moh. Ridwan Hospital, with the servqual
questionnaire method, it was found that the average value of reality was greater than the
average value of expectations, so that the services provided for Covid 19 patients were
stated by the respondents to be satisfactory. In the Cartesian diagram results, it was
found that the covid 19 patient patients were quite satisfied in getting the services
available at the Tk. II Moh. Ridwan Hospital.
The use of the servqual method is a questionnaire tool that can provide an evaluation of
a service that has been provided by a service provider, in order to determine the level of
service user satisfaction.

CONFLICTS OF INTEREST
This research has no personal or commercial interests, this study only aims to provide
insight into the evaluation of maintaining the quality of services available in the hospital
using the servqual method.

REFERENCES

Ade Nur AFrilianti. (2016). Patient Satisfaction Against Quality of Inpatient Services
Based on the Servqual Method. At Cilegon Hospital, 2014.
Anggriani. (2011). Patient Satisfaction. accessed on 2 February 2021 at 21.55 WIB
Online available:http://repository.unand.ac.id/article/998
Billy, M. (2016). Relationship Between Service Quality and Patient Satisfaction in the
Inpatient Room of Pancaran Kasih Menado Gmim Hospital. Thesis. Menado:
Faculty of Public Health, Sam Ratulangi University.
Bustami. (2011). Quality assurance of health services & acceptability. Jakarta:
Erlangga.
Croby B. (2009). Quality Management, Total Quality Management. Revised Edition,
Yogyakarta.
Hermanto, Dadang. (2010). The Influence of Perceptions of Quality of Midwifery
Services on Satisfaction of Inpatient Obstetrics at RSUD Dr. H.
SoemarnoSosroatmodjo Bulungan, East Kalimantan. (thesis). Semarang.
Diponegoro University.
Katiandagho, Christian. Silvya L. Mandey, Lisbeth Mananeke(2014). The Influence of
Work Discipline, Leadership and Motivation on Employee Performance at PT.
PLN (Persero) Suluttenggo Manado Area. EMBA Journal Vol.2 No.3 September
2014, p. 1592-1602.
Nursalam. (2011). Nursing Management Applications in Professional Nursing Practice.
Jakarta: Salemba Medika.

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Permenkes No 340 / Menkes / per / III / 2010. About Hospital Classification, 2010.
PERSI. (2021). Media BBC News Indonesia. Association of Hospitals throughout
Indonesia. 2021. Visited February 2,
2021;https://www.bbc.com/indonesia/indonesia-55889006
World Health Organization (WHO). (2020). Coronarivirus Disease (COVID-19)
Pandemic Update January, 24, 2021:https://www.who.int/emergencies/diseases/novel-
coronavirus-2019

Covid-19 task force. (2021) Data on the Distribution of Covid 19 Patients in Indonesia.
Visited January 24, 2021;https://covid19.go.id/

TABLE CAPTIONS
Table 1. Respondents Characteristics Data
Characteristics Frequency Percentage Total
Gender
Women 50 50 50
Man 50 50 50
Age
17-25 years 5 5 5
26-35 years 29 29 29
36-45 years 15 15 15
46-55 years 17 17 17

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55-65 years 23 23 23
> 66 years 11 11 11
Education
SD 13 13 13
Junior High 35 35 35
High school 35 35 35
Diploma 9 9 9
Bachelor 8 8 8
Length of Care
3-5 days 41 41 41
6-10 days 33 33 33
> 11 days 26 26 26

Table 2. Gap Value Calculation Results Based on Five ServQual Dimensions

Servqual Dimensions Reality Hope Gap
Tangible 6.73 6.50 0.23
Responsiveness 6.69 6.37 0.33
Reliability 6.87 6.46 0.41
Assurance 6.77 6.86 -0.09
Emphaty 6.71 6.26 0.46
Average 6.75 6.49 0.27

FIGURE CAPTIONS

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Figure 1. Cartesian diagram

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