Quality of Health Care Services of National Health Insurance (JKN) Program in East Java: The Impact on Patient Satisfaction and Loyalty

General Hospitals as one of the health care service providers to participants of the National Health Insurance (JKN) Program or Healthy Indonesia Card (KIS) Program have a very strategic role in accelerating the improvement of public health status. Its role gets strenuous due to the implications of service liberalization in the globalization era. Hospitals providing health care services to JKN-KIS participants should be able to meet the community needs in response to those changes by improving the quality of their health care services, so much that those JKN-KIS users will feel satisfied and become
loyal. This paper sought to determine and analyze factors affecting the quality of health care services of JKN-KIS participants and their effects on patient satisfaction and loyalty. By employing ex-post facto design, associative explanatory level based causal variables relationship, and quantitative approach, all patients of JKN-KIS participants at main referral hospitals in East Java were taken as the population. The sample amounted to 218 respondents taken through accidental sampling. Data were analyzed by path analysis test. The results of hypothesis testing revealed a significant direct influence between the quality of health care services and patient satisfaction. While patient satisfaction had a significant effect on patient loyalty, the quality of health care services did not directly affect patient loyalty. The results of hypothesis testing on indirect effect also found a strong impact on the quality of health care to patient loyalty due to patient satisfaction. Social Security Agency of Health (BPJS-Kesehatan) as the operator of JKN-KIS program administers the health care service program through mutual partnerships with all eligible public and private hospitals. As a result, free competition in health care services occurs among them which benefits patients to have a better choice of health care service providers. Therefore, the hospitals belonging to government, should improve their service quality as well to satisfy their customers.