Determinants of Outpatient Satisfaction Based on Health Service Quality Dimensions in Primary Health Care

Authors

  • Wahyu Ratri Sukmaningsih Politeknik Indonusa Surakarta
  • Wahyu Wijaya Widiyanto
  • Meldha Ayu Subekti
  • Joaquim Gregório de Carvalho

DOI:

https://doi.org/10.47701/bmrw4f15

Keywords:

Health Service Quality, Outpatients, Patient Satisfaction, Primary Health Care, SERVQUAL

Abstract

Primary health care performance is closely linked to patient satisfaction, which reflects the extent to which services meet patient expectations. This study aimed to identify the determinants of outpatient satisfaction based on health service quality dimensions at Puskesmas Simo, Boyolali. A cross-sectional analytical observational design was applied involving 100 outpatient respondents selected through convenience sampling. Data were collected using a validated and reliable structured questionnaire and analyzed using univariate, bivariate, and multivariate logistic regression methods. Results showed that the majority of respondents rated service quality positively across all SERVQUAL dimensions, with 90% reporting satisfaction. Multivariate analysis revealed that four dimensions of reliability (OR = 6,08), responsiveness (OR = 4,20), assurance (OR = 2,66), and empathy (OR = 5,09) significantly influenced outpatient satisfaction (p < 0,05), whereas tangibles did not (p = 0,220). Reliability was the strongest determinant, indicating that patients perceiving consistent, timely, and accurate services were more than six times likely to report satisfaction. These findings highlight that non-physical aspects of service quality, including interpersonal interactions and service process effectiveness, are more decisive than physical infrastructure in determining patient satisfaction. Strengthening staff competencies, ensuring standardized procedures, and promoting patient-centered care are recommended to enhance service quality in primary health care.

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References

1. Anwary AZ. Hubungan Kualitas Pelayanan dengan Kepuasan Pasien di Puskesmas Durian Gantang Kabupaten Hulu Sungai Tengah. Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan. 2020;11(1):397-409.

2. Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 43 Tahun 2019 tentang Puskesmas. Jakarta: Kementerian Kesehatan RI; 2019.

3. Shabri IY, Nugraha T, Syamsul D. Analisis Persepsi Kualitas Layanan terhadap Kepuasan Pasien Puskesmas Terakreditasi Aek Loba Kabupaten Asahan. An-Nadaa: Jurnal Kesehatan Masyarakat. 2020;6(1).

4. Basri M, Syakur R, Pakingki O. Analysis of the Quality of Health Services on Outpatient Satisfaction at the Outpatient Clinic of Kolodale Regional Hospital, North Morowali Regency, Indonesia. 2023;9(12):11342–50

5. Agustian I. The Relationship between Service Quality and Outpatient Satisfaction at the Langga Payung Health Center , South Labuhanbatu Regency in 2022. 2022;10(5).

6. Rizal F, Marwati TA, Solikhah S. Dimensi Kualitas Pelayanan dan Dampaknya terhadap Tingkat Kepuasan Pasien: Studi di Unit Fisioterapi. Jurnal Kesmas (Kesehatan Masyarakat) Khatulistiwa. 2021;8(2):54–62.

7. Dwijayanti KA, Wirajaya IWA. Service Quality Factors that Influence Patient Satisfaction at Buleleng Regional Hospital. 2024;12(04):1179–90.

8. Niawati W, Berliana N, Marisdayana R. Analisis Kualitas Pelayanan Terhadap Kepuasan Pasien Di Puskesmas Kenali Besar Kota Jambi Analysis of Service Quality on Patient Satisfaction at the Recognition Health Center , Jambi City. 2020;6(2):826–36.

9. Safira RN, Wolok T, Juanna A. Pengaruh Kualitas Pelayanan Terhadap Kepuasan Pasien KIS Di Puskesmas Kota Selatan. 2021;4(2):116–20.

10. Siregar RM, Owildan WB, Ahmad H, Hadi AJ, Majid A. Analisis Mutu Pelayanan Kesehatan terhadap Kepuasan Pasien di Rumah Sakit Umum Daerah Sipirok Kabupaten Tapanuli Selatan. Media Publikasi Promosi Kesehatan Indonesia (MPPKI). 2023;6(6):1193–1199.

11. Harahap PS, Siregar PA, Gurning FP. Determinants of patient satisfaction in health center services in Indonesia. 2025;13(1).

12. Afrioza S, Baidillah I. Hubungan Tingkat Kepuasan Pasien terhadap Pelayanan Kesehatan di Puskesmas Sepatan. Journal of Nursing Practice and Education. 2021;1(2):169–180.

13. Jonkisz A, Karniej P. The Servqual Method as an Assessment Tool of the Quality of Medical Services in Selected Asian Countries. 2022;1–15.

14. Wu J hui, Lee K tsung, Cheng K i, Du J kang, Lee C yi. Patient perception of service quality to preanesthetic oral examination : a cross- sectional study using the SERVQUAL model. 2024;1–8.

15. Lin Q, Hao H shuh, Zhang D. Assessing Quality Gap of Outpatient Service in Public Hospitals : A Cross-Sectional Study in China. 2023;

16. Kashfi SM, Karimian E, Ravangard R, Mehralian G, Bastani P. Service Quality in Outpatient Teaching Hospital Pharmacies based on the SERVQUAL Model : An assessment in the South of Iran. 2022;30(February):153–9.

17. Khoso AR, Akhtar F, Narejo AA, Mallah SA, Vighio K, Sanjrani DK. Comparative Analysis of Service Quality Between Public and Private Hospitals Using SERVQUAL Model: A Case Study Of Peshawar, Pakistan. Medfarm: Jurnal Farmasi dan Kesehatan. 2022;11(2):240–252. p-ISSN: 2354-8487. e-ISSN: 2715-9957.

18. Alrwashdh S, Alishaq M. Analytical study to assess the impact of health service quality on patient satisfaction in Hamad Medical Corporation Hospitals in Qatar : using SERVQUAL. 2023;1–8.

19. Lahaji LC, Wowor RE, Esther G, Korompis C. Journal of. 2020;1(April):1–5.

20. Mahmud A. The Effect of Service Quality Dimensions on Patient Satisfaction : Quantitative Study of Regional Public Hospital. 2022;2(2):38–48.

21. Sasmita O, Azhmy MF. Entrepreneurship and Tourism The effect of Service Quality on Outpatient Satisfaction at RSAU Lanud Sulaiman Bandung Journal of Management , Entrepreneurship and Tourism. 2024;2(2):155–75.

22. Rahmatullah R, Hardono H, Elasari Y, Pringsewu UA. Patient Satisfaction with Prolanis Services at Pulau Panggung Health. 2025;16(2):263–72.

23. Farrokhi P, Aryankhesal A, Bagherzadeh R, Aghaei Hashjin A. Evaluation of outpatient service quality: What do patients and providers think? Int J Healthc Manag [Internet]. 2023 Jul 3;16(3):394–403. Available from: https://doi.org/10.1080/20479700.2022.2110195

24. Vanichchinchai A. Relationships among lean, service quality expectation and performance in hospitals. Int J Lean Six Sigma [Internet]. 2021 Jul 14;13(2):457–73. Available from: https://doi.org/10.1108/IJLSS-11-2020-0210

25. Fernandes NV, Nurvita S. Hubungan Mutu Pelayanan Kesehatan Dengan Tingkat Kepuasan Pasien Di Rumah Sakit Kota Lospalos Tahun 2022 Manajemen Informasi Kesehatan , Universitas Nasional Karangturi Email : nintorio140@gmail.com. 2022;2(2):17–28.

26. Uprety V. Assessing Patient Satisfaction by Measuring Service Quality in Outpatient Service of a Public Hospital in Bagmati. 2025;

27. Dayan M, Al Kuwaiti IA, Husain Z, Ng PY, Dayan A. Factors influencing patient loyalty to outpatient medical services: an empirical analysis of the UAE’s government healthcare system. Int J Qual Reliab Manag [Internet]. 2021 Mar 19;39(1):176–203. Available from: https://doi.org/10.1108/IJQRM-11-2020-0373

28. Hosseinzadeh M, Pouladzadeh M, Eskandari A. Assessment of Healthcare Service Qualit y and Patient Satisfaction Using the SERVQUAL Questionnaire in Khuzestan Province During 2022 - 2023. 2024;13(4).

29. Illyyin Y Al, Ramdini DA, Rahayu ID. Patient Satisfaction with Pharmaceutical Services at the Outpatient Pharmacy Installation of Hospital X , Bandar Lampung City. 2025;16(03):1347–59.

30. Yunike Y, Tyarini IA, Evie S, Hasni H, Suswinarto DY. Mutu Pelayanan Kesehatan Terhadap Tingkat Kepuasan Pasien Pendahuluan. 2023;183–9.

31. Ashraf A, Kuyini AB, Albalas S. Exploring the Gap Between Patients ’ Expectations and Perceptions of Healthcare Service Quality Exploring the Gap Between Patients ’ Expectations and Perceptions of Healthcare Service Quality. 2022;

32. Akbari VS, Kusuma SL, Kunaedi A, Setyaningsih I. Pasien Rawat Jalan di Rumah Sakit Umum Daerah Sumedang Tahun 2022. 2022;5(2):118–25.

33. Gavahi SS, Hosseini SMH, Moheimani A. An application of quality function deployment and SERVQUAL approaches to enhance the service quality in radiology centres. Benchmarking An Int J [Internet]. 2022 Jun 14;30(5):1649–71. Available from: https://doi.org/10.1108/BIJ-07-2021-0411

34. Olidya D, Ginting R, Siagian M, Yulizal OK, Lumbantobing CJRE. Health service quality and outpatient hypertension patient satisfaction : A cross-sectional study. 2025;4(1):108–13.

35. Lubis B. The Influence of The Quality Of General Health Center Unit on Patient Satisfaction in The Primary Health Centers of South Lampung Regency, Lampung Province. 2023;6(1)).

36. Battiling F, Uly N, Al-Maidin ARM, Zamli. Relationship Between Patient Satisfaction and Pharmaceutical Services at Scholoo Keyen Regional Hospital. Media Publikasi Promosi Kesehatan Indonesia (The Indonesian Journal of Health Promotion). 2024;7(8):2128–2133.

37. Thanh ND, Thi B, Anh M, Xiem CH, Anh PQ. Patient Satisfaction With Healthcare Service Quality and Its Associated Factors at One Polyclinic in Hanoi ,. 2022;67(November):1–8.

38. Pratama RA, Nurlaeli L, Maju UI. Tingkat Kepuasan Pasien BPJS Terhadap Pelayanan di Depo Farmasi Rawat Jalan RSUD Kota Bogor Tahun 2024. 2025;03(01):1–10.

39. Christiany M. Hubungan Aspek Kualitas Pelayanan Dengan Kepuasan Pasien Rawat Inap Program Studi Ilmu Keperawatan , Stikes Citra Delima Bangka Belitung * Email : maryana385@yahoo.com. 2022;5(2):105–12.

40. Guo X. Evaluation of Outpatient Service Quality using SERVQUAL Model: A Case Study of A Public Chinese Hospital [master’s thesis]. Lisboa: ISCTE – Instituto Universitário de Lisboa. 2022; Oktober .

41. Al-Balas SM, Al-Maqableh HO, Athamneh S, Odeibat AM. Quality status: A SERVQUAL approach to evaluate the effect of the quality of healthcare services on patient satisfaction in Jordan. Int J Healthc Manag [Internet]. 2025 Apr 3;18(2):351–67. Available from: https://doi.org/10.1080/20479700.2024.2310375

42. Fitriyani NE, Dewi IR, Novita OD. Level of Patient Satisfaction with Pharmaceutical Services in The Outpatient Pharmaceutical Room, Mandiraja Community Health Center 1. Diponegoro Medical Journal. 2023;12(5):265–270. doi:10.14710/dmj.v12i5.39231.

43. Farrokhi P, Bagherzadeh R, Zozani MA, Zarei E. Assessing the quality of hospital outpatient services in Iran : a systematic review and meta ‑ analysis. BMC Health Serv Res [Internet]. 2023;1–9. Available from: https://doi.org/10.1186/s12913-023-09506-4

44. Akhtar F, Narejo AA, Mallah SA, Vighio K, Sanjrani K. Comparative Analysis of Service Quality Between Public and Private. 2022;11(2):240–52.

45. Lubis RA, Putri AD, Ginting T, Utara S. Pasien Rawat Jalan di Puskesmas Sei Mencirim Medan Tahun 2020. 2020;3(1).

46. Utino L, Birhanu B, Getachew N, Ereso BM. Perceived quality of medical services at outpatient department of public hospitals in Dawro Zone , Southern Ethiopia. BMC Health Serv Res [Internet]. 2023;1–10. Available from: https://doi.org/10.1186/s12913-023-09178-0

47. Hutabarat A, Manurung K, Lina Tarigan F, Nababan D, Sipayung R. Evaluation of the Relationship Between Health Service Quality and Patient Satisfaction in the Outpatient Department of Tarutung Regional Public Hospital in 2023. J Pharm Sci [Internet]. 2025 Mar 13;8(1 SE-Original Articles):480–93. Available from: https://journal-jps.com/new/index.php/jps/article/view/781

48. Nguyen BQ, Thi C, Nguyen T. An Assessment of Outpatient Satisfaction with Hospital Pharmacy Quality and Influential Factors in the Context of the. 2022;

49. Sinata N, Laia CO, Fadhika E, Ramadhani D, Marlina L, Siregar A, et al. Analisis Kepuasan Pasien Terhadap Pelayanan Instalasi Farmasi Di Puskesmas Sail Pekanbaru. 2025;3:725–33.

50. Kurti S, Kalaja R. Factors Affecting Patient Satisfaction with The Quality of Primary Healthcareservices : A Cross-Sectional Study in Albania. 2023;18(1):11–26.

51. Değer MS, İşsever H. Service Quality and Related Factors in Primary Health Care Services: A Cross-Sectional Study. Vol. 12, Healthcare. 2024. p. 965.

52. Strzelecka A, Stachura M, Wójcik T, Kordyzon M. Determinants of primary healthcare patients ’ dissatisfaction with the quality of provided medical services. 2021;28(1):142–8.

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Published

2026-02-14

How to Cite

Determinants of Outpatient Satisfaction Based on Health Service Quality Dimensions in Primary Health Care. (2026). Infokes: Jurnal Ilmiah Rekam Medis Dan Informatika Kesehatan, 16(1), 16-24. https://doi.org/10.47701/bmrw4f15