HEALTH SERVICES QUALITY BETWEEN HYPERTENSION AND DIABETES MELLITUS PATIENTS IN COMMUNITY HEALTH SERVICES IN THE SLEMAN DISTRICT, YOGYAKARTA, INDONESIA
Keywords:Hypertension, diabetes, health service quality, community health services
The implementation of the Chronic Disease Management Program or PROLANIS has been adopted in Indonesia by National Social Security Implementation on Health Agency (BPJS-K) since 2015. The program focuses on hypertension (HT) and diabetes mellitus (DM). However, since the first time the program was implemented, there was no comprehensive evaluation of it. The aim of this study was to analyze health service quality among HT and DM patients based on five dimensions of quality in 25 community health services (CHSs) in the Sleman district, Yogyakarta, Indonesia. This is a cross-sectional study with a simple random sampling technique that included 230 respondents from 25 CHSs. The instrument was SERVQUAL that consisted of 35 items of a questionnaire. The data were analyzed by a gap analysis, Customer Satisfaction Index (CSI) and Importance Performance Analysis (IPA); meanwhile, a Man–Whitney test was proposed to determine differences in health services quality in the PROLANIS program. Based on the gap analysis, it was found that whole dimensions were below 0-point; the CSI analysis obtained 74.45 for HT and 75.15 for DM; and the IPA analysis found that the distribution of respondents’ answers in the questionnaire were in quadrants 1 and 2. The Man–Whitney analysis was used to get the assurance aspect correlated with health service quality in DM and HT patients (p = 0.001). Health service quality in the PROLANIS program was based on five dimensions of quality was low, unless assurance dimension. The government should improve health services quality in aspects of tangibility, responsiveness, empathy, and reliability to get satisfaction among HT and DM patients in the PROLANIS program.
Nugent R, Bertram MY, Jan S, et al. Investing in noncommunicable disease prevention and management to advance the Sustainable Development Goals. Vol. 391, The Lancet Taskforce on NCDs and economics 1. 2018. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30667-6/fulltext (accessed 18 March 2020).
Niessen LW, Mohan D, Akuoku JK, et al. Tackling socioeconomic inequalities and noncommunicable diseases in low-income and middle-income countries under the Sustainable Development agenda Vol. 391, The Lancet Taskforce on NCDs and economics 2. 2018.http://dx.doi.org/10.1016/S0140-6736(18)30482-3(accessed 18 March 2020).
Kementrian Kesehatan Republik Indonesis. Hasil utama riset kesehatan dasar (RISKESDAS) 2018. https://www.kemkes.go.id/resources/download/info-terkini/hasil-riskesdas-2018.pdf (accessed 20 February 2020).
Murray C. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016 : a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1980–2016.
adan Penyelenggara Jaminan Sosial Kesehatan. Panduan praktis PROLANIS (program Pengelolaan Penyakit Kronis). Jakarta: BPJS Kesehatan; 2016. 1–10 p. https://bpjs-kesehatan.go.id/bpjs/dmdocuments/06-PROLANIS.pdf. (accessed 20 February 2020)
Parasuraman A, Zeithaml V, Berry L. SERVQUAL : A Multiple-Item Scale for Measuring Consumer Perceptions of Service Quality. Spring. 1988;64(1):1-
Riono R, Ahmadi A. Analysis of healthcare services quality using servqual - fuzzy method. Int J Econ Manag Sci 2017;6(6):1–7.
utt MM, Run EC. Private healthcare quality : applying a SERVQUAL model. IJHCQA. 2010;23(7):1–17.
Teshnizi SH, Aghamolaei T, Kahnouji K,et al. Assessing quality of health services with the SERVQUAL model in Iran. systematic review and meta-analysis. Int J Qual Heal Care. 2018;30(2):82–9.
Hill S, Mhs G, Mha DH, et al. A gap analysis needs assessment tool to drive a care delivery and research agenda for integration of care and sharing of best rractices across a health system. Jt Comm J Qual Patient Saf 2017;43:18–28.
Staszkow M. Use of customer satisfaction index on the example of office rental services. Intercathedra. 2014;29(3):1–6.
Gonçalves JR, Pinto A, Batista MJ, et al. Importance-performance analysis : Revisiting a tool for the evaluation of clinical services. Health 2014;6(5):285–91.
Widyahening IS, Thuraiappah DM, Han TM, et al. Indonesian primary care physicians profile in 2011 : Did practicing hours and conversion program for family medicine differentiate their services and continuing medical education activities ? Asia Pac Fam Med 2014;13(16):1–6.
Busari J. Comparative analysis of quality assurance in health care delivery and higher medical education. Adv Med Educ Pract 2012;3(12):1–7.
Helia VN, Abdurrahman CP, Rahmillah FI. Analysis of customer satisfaction in hospital by using Importance- Analysis of customer satisfaction in hospital by using Importance-Performance Analysis (IPA) and Customer Satisfaction Index (CSI). MATEC Web Conf 2018;154:1–6.
Satibi S, Diah Ayu P, Stefanie S, et al. Factors affecting patient satisfaction in JKN system: study on patient characteristics, JKN services and pharmacy services. Indones J Pharm 2010;26(4):233–40.
Kurniawan HD, Tamtomo D, Murti B. Contextual effect of community health center on patient satisfaction of health care service in Ngawi, East Java. J Heal Policy Manag 2019;4(1):23–30.
Tang L. The influences of patient ’ s trust in medical service and attitude towards health policy on patient ’ s overall satisfaction with medical service and sub satisfaction in China. BMC Public Health 2011;11(472):1–8.
Zeithaml A, Berry L, Parasuraman A. Behavioral Consequences of Service. J Mark 1996;60(2):31–46.
Jonge De, Nicolaas JS, Leerdam ME, et al. Overview of the quality assurance movement in health care. Best Pract Res Clin Gastroenterol 2011;25(3):337–47.
Perides M. Book review : An introduction to quality assurance in health care. Vol. 15. 2003. 357–358 p.https://www.researchgate.net/publication/31461602_An_Introduction_to_Quality_Assurance_in_Health_Care (accessed 20 February 2020).
Sankar P, Moran S, Merz JF, Jones NL. Patient Perspectives on Medical Confidentiality. JGIM 2003;3308(18):659–69.