Building Patient’s Loyalty: The Role of Trust, Expectations, and Satisfaction Among Outpatient Commitment
DOI:
https://doi.org/10.26911/Abstract
Background: Quality health services are the result of cooperation between patients and health service providers in a healthy environment. Hospitals as institutions engaged in service quality are a benchmark for assessing patient loyalty. One of the benchmarks is the quality of service received by patients from a hospital; therefore, it is the obligation of the hospital to maintain a good relationship with patients to create a maximum loyalty value. Based on Law Number 17 of 2023 concerning health, it is stated that local governments and communities are responsible for the implementation of health efforts. The implementation of health services is carried out responsibly, safely, quality, and equitably. The study aims to discover factors that affect the loyalty of outpatients at Klaten Islamic Hospital.
Subjects and Method: It was a cross-sectional study conducted at Klaten Islamic Hospital from December 2024 to January 2025. The sample consisted of 200 outpatients selected using the simple random sampling method. The independent variables were hospital image, trust, expectation, past experience, and satisfaction. Meanwhile, the dependent variable was outpatient loyalty. Data collection was carried out using a questionnaire. Data analysis was conducted using path analysis.
Results: The results of the path analysis that had been carried out in this study stated that the loyalty of outpatients at Klaten Islamic Hospital was directly influenced by trust (b=-0.02; 95% CI= -0.30 to 0.24; p= 0.831), satisfaction (b=0.44; 95% CI= 0.19 to 0.69; p<0.001), age (b= 0.13; 95% CI= 0.01 to 0.24; p= 0.024), hospital image (b= 0.20; 95% CI= 0.08 to 0.32; p=0.001), Education (b= -0.11; 95%CI= -0.22 to 0.00; p=0.054), gender (b= - 0.00; 95%CI= -0.11 to 0.11; p=0.958). Patient loyalty through patient trust was indirectly influenced by past experience, patient satisfaction, expectations, and polyclinic.
Conclusion: The loyalty of outpatients at Klaten Islamic Hospital is directly influenced by trust, satisfaction, age, hospital image, education, and gender. Patient loyalty through patient trust is indirectly influenced by past experience, patient satisfaction, expectations, and polyclinic.
Keywords:
Patient loyalty, outpatient, pathway analysisHow to Cite
References
Andriani A (2017). The relationship between health service quality and patient satisfaction at the general outpatient clinic of Bukittinggi Public Health Center. J Endurance. 2(1):45–52. http://dx.doi.org/10.22216/jen.v2i1.461.
Andriani R, Setiawan B (2020). The effect of patient satisfaction and hospital image on patient trust and loyalty. JMPK. 8(2):45–56. https://doi.org/10.31967/relasi.v19i1.663.
Anfal A (2020). The effect of service quality and hospital image on inpatient satisfaction at Sundari General Hospital Medan. Excell Midwifery J. 3(2):1–19. https://doi.org/10.55541/emj.v3i2.130.
Ardiyanto MA, Tabrani (2018). The effect of hospital image and service quality on patient loyalty through patient satisfaction at Kardinah Tegal General Hospital. Multiplier J Master Manag. 3(1):389–404. https://doi.org/10.55927/fjmr.v4i1.12952.
Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA (2021). Gender differences in the utilization of health care services. J Fam Pract. 49(2):147–152. https://pubmed.ncbi.nlm.nih.gov/10718692/.
Bolton RN, Lemon KN (2019). A dynamic model of customers’ usage of services: Usage as an antecedent and consequence of satisfaction. J Mark Res. 36(2):171–186. https://doi.org/10.2307/3152091.
Eftitah E (2023). The role of patient care quality in enhancing hospital loyalty. J Kesehat Indones. 18(4):105–118. https://doi.org/10.1108/02634500710722425.
Fadilah A (2017). The relationship between patient satisfaction and hospital loyalty. JKPM. 14(1):50–63.
Griffin J (2010). Customer Loyalty: Growing and Maintaining Customer Loyalty. Jakarta: Erlangga.
Karunia K (2016). The effect of patient satisfaction on hospital loyalty. J Manaj Kesehat. 12(3):125–139. https://doi.org/10.1177/00469580211007221.
Kotler P, Keller KL (2019). Marketing Management. 15th ed. Pearson.
Mayer R (2017). Trust and communication in healthcare organizations. J Health Commun. 22(3):234–245.
Musdalifah, Ellina AD (2024). Correlations between loyalty, health service quality, and patient satisfaction in neurology polyclinic, Dr Mohamad Saleh Hospital Probolinggo. J Health Policy Manag. 9(1):1–9. https://doi.org/10.26911/thejhpm.2024.09.01.01.
Ndubisi NO (2017). Relationship marketing and customer loyalty. Mark Intell Plan. 25(1):98–106. https://doi.org/10.1108/02634500710722425.
Oliver RL (2018). A cognitive model of the antecedents and consequences of satisfaction decisions. J Mark Res. 17(4):460–469. https://doi.org/10.1177/002224378001700405.
O'Malley AS, Sheppard VB, Schwartz M, Mandelblatt J (2021). The role of trust in use of preventive services among low-income African-American women. Prev Med. 53(5–6):372–378. https://doi.org/10.1016/j.ypmed.2004.01.018.
Otani K, Deng Y, Herrmann PA, Kurz RS (2020). Patient satisfaction, quality attributes, and organizational characteristics: A hierarchical linear model approach. J Patient Exp. 7(5):801–806. https://doi.org/10.1177/2374373519892410.
Parasuraman A, Zeithaml VA, Berry LL (2019). A conceptual model of service quality and its implications for future research. J Mark. 49(4):41–50. https://doi.org/10.1177/002224298504900403.
Sirdeshmukh D, Singh J, Sabol B (2022). Consumer trust, value, and loyalty in relational exchanges. J Mark. 66(1):15–37. https://doi.org/10.1509/jmkg.66.1.15.18449.
Wiliana W (2019). The influence of service quality and patient satisfaction on patient loyalty in hospitals. JMPK. 7(2):120–130. https://doi.org/10.38035/dar.v1i3.1050.
Zeithaml VA, Berry LL, Parasuraman A (2020). The behavioral consequences of service quality. J Mark. 60(2):31–46. https://doi.org/10.1177/002224298805200302.
Zeithaml VA, Bitner MJ, Gremler DD (2018). Services Marketing: Integrating Customer Focus Across the Firm. 7th ed. McGraw-Hill Education. https://doi.org/10.1002/9781444316568.wiem01055.


