QUALITY MANAGEMENT OF HEALTH SERVICES ON PATIENT SATISFACTION AT MONTELLA PRIVATE HOSPITAL WEST ACEH DISTRICT

The world of health is one of the most important factors in life. Over time, it is only natural for the world of health to provide fast and appropriate services in order to create a comfortable, conducive and motivated work environment. Hospital health services are one type of public service that is often accessed by the public. At any time the community will always demand quality services, even though these demands are often not as expected, because services still display a convoluted, slow, expensive and tiring nature because the community is still positioned as the party serving not being served. The purpose of this study was to determine the effect of the quality of health services on patient satisfaction at the Montella Private Hospital, West Aceh District. The method used in this study is simple linear regression where this method is used to determine the linear relationship between the independent variable (X) and the dependent variable (Y). In addition, the simple linear regression method aims to determine the direction of the relationship between the independent variable and the dependent variable. whether positive or negative and to predict the value of the dependent variable if the value of the independent variable increases or decreases. The data used is data from the answers to the questionnaire using a Likert scale. Based on the results of the study, it can be concluded that testing from previous observational data indicates that the magnitude of the influence of Health Service Quality on Patient Satisfaction at Montella Private Hospital as measured through the questionnaire question indicators distributed to respondents in the Very high and good category because it is influenced by 97.50% ( R Square value) so that it is proven that the variable Quality of Health Services has a large positive and significant effect on patient satisfaction at Montella Private Hospital, while the remaining percentage value of 2.50% affects variables not examined in this study's observations.


INTRODUCTION
The world of health is one of the most important factors in life.As time goes by, it is fitting for the world of health to provide a fast and precise service in order to create a comfortable, conducive and motivated work environment.Health services are one type of public service that is often accessed by the public.Every time the community will always demand quality service, even though these demands are often not in accordance with what is expected, due to the fact that service still displays convoluted, slow, expensive and tiring characteristics because the community is still positioned as the party serving not the one being served.(Wijaya, 2018).
Service quality is very influential on service including there are two main factors that influence service quality, namely the expected service and perceived service.If the services received or felt by consumers are as expected, then the service quality is perceived as good and satisfactory (Bakhtiar, 2010).Service is an action or activity that can be offered by one party to another, so that the service process that is specifically directed by the service provider can fulfill general interests in the right way and satisfy the party served, namely consumers (Wibowo, 2014) One of the health institutions that is often accessed by the public is a hospital.Hospitals are health organizations that directly provide overall health services to the community because in hospitals there are many labor-intensive institutions with various characteristics, characteristics and special functions in the process of producing medical services and have various professional groups in hospital services (Arfan , 2010).These various professional groups will produce individual behavior and group behavior which ultimately results in organizational behavior in carrying out their duties and functions (Gita, 2016).
Montella Hospital is one of the private hospitals in West Aceh district which relies on professional medical staff as the front guard.Based on the results of initial observations, one of the health service providers for the community has not been fully able to meet the quality of service desired by health service users, where health service users feel several complaints about the quality of health services provided by Montel Hospital, such as employees of Montella Hospital who arrive late.and there were those who left the hospital before it was time to go home, the slow performance of drug collection staff, the long process of registration and the alertness of medical staff and employees in carrying out their duties were also complaints from health service users.This will affect patient satisfaction, so that with patient dissatisfaction it is necessary to conduct research on the quality management of health services at Montella Hospital which affects patient satisfaction.
The method used in this study is simple linear regression in which this method is used to determine the linear relationship between the independent variable (X) and the dependent variable (Y), besides that the simple linear regression method aims to determine the direction of the relationship between the independent variable and the dependent variable.whether positive or negative and to predict the value of the dependent variable if the value of the independent variable increases or decreases.The data used is data from the results of questionnaire answers using a Likert scale.
The purpose of this study was to determine the effect of the quality of health services on patient satisfaction at the Montella Private Hospital, West Aceh District.Based on this, the authors are interested in conducting research with the title "Quality Management of Health Services on Patient Satisfaction at Montella Private Hospital, West Aceh District".

Definition of Quality
Quality is where the dynamic conditions associated with products, services, human resources, environmental processes that have met or exceeded customer expectations, or an overall improvement in both the quality of processes, products, people, environment and services in order to be able to face competitive organizational competition.the higher it is.Quality is also interpreted as a dynamic condition in which those related to products, services, people, processes and the environment meet and exceed expectations as a promise of service so that those served feel benefited (Rosnaini, 2017).
According to Wijaya (2018) quality is everything that is capable of fulfilling customer activities or needs.Service quality starts with customer needs and ends with customer satisfaction and positive perceptions of service quality.Service quality can be interpreted as the ability of a company and its staff to meet customer expectations consistently, so that the characteristics and characteristics of a product/service in terms of its ability to meet predetermined needs or characteristics.

Health Services
Understanding the patient's needs and wants is an important thing that affects patient satisfaction.Satisfied patients are a very valuable asset because if patients are satisfied they will continue to use the services of their choice, but if patients feel dissatisfied they will tell others about their bad experience twice as much so as to create patient satisfaction, health workers must creating and managing a system to obtain more patients and the ability to retain patients (Mundakir, 2016).Service is an activity that is invisible (cannot be touched) that occurs as a result of interactions between consumers and employees or other things provided by service-providing organizations that are intended to solve consumer or customer problems.Service processes that are specifically directed by service providers to fulfill public interests/private interests through appropriate ways and satisfy those served (Supardi, 2014).
Health services are something that is suitable for use, this implies that an item or service can fulfill what is expected by its users because health services are services provided by health workers who can satisfy every user of health services in accordance with the average satisfaction level.on average, the implementation is in accordance with the standard professional code of ethics (Samsul, 2016).Health services for a patient cannot be separated from a patient's satisfaction with the service received, where good quality is associated with recovery from illness, increased health status, speed of service, pleasant care environment, friendliness of staff, ease of procedure, completeness of tools, medicines.-Medicines and affordable costs (Handayani, 2016).

Quality of Health Services
The ability to provide professional services is a demand that cannot be negotiated, considering that consumers in this case are always at a disadvantage, this has been strengthened by the enactment of Law no.24 of 2011 concerning consumer protection, which basically regulates consumer rights, where consumers must be treated or served properly and honestly, not discriminatory, and to hear their opinions and complaints about the goods and/or services they use, so that there is no alternative.another for companies engaged in the field of services and public services to try to improve their service levels to a better level for their consumers (Wijaya, 2018) The quality of health services is the service provided by health workers to their patients, although it is a subjective value, there is still an objective basis based on past experience, education, psychological situation at the time of service and environmental influences.Specifically regarding the performance assessment of health service providers, there are two elements that need attention, namely medical techniques and interpersonal relationships (Marliadawaty, 2018).
According to Santoso, (2011) the quality of health services is meeting the needs and demands of users of health services, which if successfully fulfilled will be able to lead to a sense of satisfaction with the health services provided.The perfect quality of health services provided, the more perfect the satisfaction and the better the quality of health services provided by an organization in preventing and curing disease.Radito, (2014) also expressed his opinion regarding the quality of health services, which is the level of perfection of health services that are carried out in accordance with the established code of ethics and service standards, giving rise to satisfaction for each patient.The quality of health services is a health service that is needed, in this case it will be determined by the health care profession and at the same time desired by both patients and the public and affordable by the purchasing power of the people, while the guarantee of the quality of health services is a systematic and continuous effort in monitoring and measuring quality.as well as making the necessary quality improvements so that the quality of health services is always in accordance with the agreed health service standards (Ferdiana, 2017).The quality of health services is also the degree of service perfection of health services in accordance with professional standards and service standards by using the potential resources available at hospitals or health centers in a reasonable, efficient and effective manner and provided safely and satisfying norms, legal ethics, and socio-culture.taking into account the limitations and capabilities of the government and consumer society (Mundakir, 2016).
According to the Regulation of the Minister of Health of the Republic of Indonesia Number 30 of 2022 which is contained in Article 3 Quality Indicators in Hospitals consist of: 1. adherence to hand hygiene; 2. adherence to the use of personal protective equipment; 3. adherence to patient identification; 4. emergency cesarean section response time; 5. outpatient waiting time; 6. postponement of elective surgery; 7. adherence to doctor visits; 8. reporting of critical laboratory results; 9. adherence to the use of the national formulary; 10. adherence to clinical pathways; 11. compliance with patient fall risk prevention efforts; 12. speed of complaint response time; And 13. patient satisfaction.

Patient Satisfaction
According to Fahrozy, (2017), a patient is someone who receives medical treatment.In Indonesia, patients are sick people (who are treated by doctors), sufferers (sick).The Law of the Republic of Indonesia Number 24 of 2011 concerning Medical Practice states that a patient is any person who consults about his health problems to obtain the necessary health services either directly or indirectly from a doctor (Samsul, 2016).According to Handayani, (2016), patient satisfaction is a patient's feeling that arises as a result of the performance of health services received after the patient compares it with what is expected by understanding the patient's needs and desires is an important thing affecting patient satisfaction because satisfied patients are a very valuable value.because if patients are satisfied they will continue to use the services of their choice but if patients feel dissatisfied they will tell others about their bad experience twice as much so that in creating optimal patient satisfaction health workers must manage a system to get patients who are satisfied more and the ability to retain his patients.
Satisfaction is a very important variable for measuring the marketing of health care services with repeat buying habits or behavior (intention to return) which produces a maximum measure of satisfaction because patient values and expectations determine the interpersonal aspect of quality because patient satisfaction is an indicator of communication care to service providers relating to the needs and expectations of patients have met the needs and expectations of patients and can be a prediction about the patient's interest in returning (Arfan, 2010).
According to Tjiptono, (2016)  patient's response to what is felt is between previous expectations and the performance results obtained afterwards, to make it easier to recognize patient satisfaction, including if the performance exceeding expectations, the patient will be very satisfied, if the performance is the same as the expectation, the patient will be satisfied, but if the performance is less than expectations, the patient will be disappointed.Factors that influence patient satisfaction according to Rahadi, (2010) include: 1. Quality of product or service, patients will be satisfied if the results of their evaluation show that the product or service used is of high quality.The patient's perception of product or service quality is influenced by two things, namely the fact of product or service quality and company communication, in this case the hospital or health center in advertising the place.The quality of health products or services includes the appearance of the hospital/puskesmas building, cleanliness and inpatient rooms provided and their accessories.2. Quality of service, patients will be satisfied if they get good service or as expected.The quality of service includes the friendliness of hospital/puskesmas staff, speed of service.Hospitals and health centers are considered good if in providing services they pay more attention to the needs of patients and other people who visit to check their health.3. Emotional factors, patients feel proud, satisfied and amazed at the health services provided by the hospital/puskesmas.4. Price, the more expensive the price of care, the patient has greater expectations, while care of the same quality but low price gives higher value to patients.5. Cost, patients who do not need to incur additional costs or do not need to waste time getting services, then patients tend to be satisfied with these services.6. Facilities, the completeness of hospital/health center facilities also determines the assessment of patient satisfaction, for example health facilities both facilities and infrastructure, parking lots, comfortable waiting rooms.7. Image, namely the image, reputation and care of nurses for their patients.8. Communication, how complaints from patients are quickly received by nurses.
Indicators of patient satisfaction according to (Ferdiana, 2017), namely: 1. Satisfaction with access to health services Satisfaction with access to health services is expressed by attitudes and knowledge about: 1) The extent to which health services are available at the time and place when they are needed.
2) Ease of obtaining health services, both in normal circumstances and in emergency situations.
3) The extent to which patients understand how the health care system works, the benefits and availability of health services.

Satisfaction with the quality of health services
Satisfaction with the quality of health services is expressed by attitudes towards: 1) Technical competence of doctors and/or other health care professionals related to patients.
2) Outcome of the disease or how changes are felt by patients as a result of health services.
3. Satisfaction with the health service process and human relations.Health care processes and human relations are determined by measuring: 1) To what extent is the availability of health services according to the patient's assessment.
2) Perceptions about the attention and care of doctors.
3) The level of trust and confidence in doctors.
4) The level of understanding of the condition or diagnosis.2) The agreement system, including waiting for their turn, waiting time, utilization of time while waiting, attitude of wanting to help or caring for personnel, mechanisms for solving problems and complaints that arise.
3) Scope and nature of health service benefits offered METHOD 1.

Type of Research
The research method used in this research is quantitative descriptive research with the aim of looking for the influence of the independent variable on the dependent variable.This study used a questionnaire instrument which was distributed to patients at the Montella Hospital in West Aceh District.Place and Time of Research, namely at the Montella Hospital in West Aceh District.The location of this research was chosen with the consideration that it is easier for researchers to obtain research data, both primary data and secondary data.The research time is approximately 6 months starting from June 2022 to November 2022.

Data Collection Techniques
The data collection technique used in the activities of carrying out this research was a questionnaire technique by giving questions to the respondents to be answered and a secondary technique, namely collecting data from books and documents.There are several ways of collecting data in this study consisting of: 1. Library Studies, a data collection technique by studying books, documents and records related to the problem being studied.2. The questionnaire given contains written statements and closed statements.The questionnaire used is in the form of a check mark where the respondent chooses the available answers.

Data Source
The data sources used in this study are primary data and secondary data, namely: 1.Primary data is data obtained directly from the object to be studied, namely by distributing questionnaires to patients at Montella Hospital which are still original data collected by the researchers themselves.2. Secondary data is data that is recorded, accessed, or requested standard data from parties who have collected it in the field that still has relevance to research, such as from books and writings from the Montella Hospital.

Population and Research Sample 1. Population
The population in this study were patients who visited for treatment both outpatient and inpatient at the Montella Hospital in West Aceh District using a random sampling technique.1.Because the total population is not greater than 100 respondents, the authors take 100% of the population at Montella Hospital, namely 51 patients.Thus the use of the entire population without having to draw a research sample as a unit of observation is referred to as a sampling technique.

Research Variables
Determination of research variables is based on preliminary studies, literature studies, and the condition of the Service Quality Management provided by the Montella Hospital on patient satisfaction.There are two types of research variables that will be observed in this study, namely: 1.Independent Variable The independent variable or independent variable in this study is service quality.

Dependent Variable
The dependent variable in this study was patient satisfaction with the quality of service provided by the Montella Hospital.

Data Processing Techniques
The data obtained from data collection is then processed.As for processing the data such as calculating determining the Likert scale of the questionnaire and determining the effect of the quality of service provided by the Montella Private Hospital on patient satisfaction using a simple linear regression method with the help of SPSS IBM Version 26.The steps are as follows: 1. Determine the Likert Scale The measurement scale used in each respondent's answer is the Likert Scale.How to evaluate the results of the answers to the questionnaire with a Likert scale is seen in Table 2 below: 2. Simple Linear Regression Testing Simple linear regression testing was carried out in order to be able to test the effect of the independent variable on the dependent variable by measuring the interval scale of the linear formula equation.According to Supomo (2018: 211) Information: Y'= bound variable object to be calculated a = Y value if X = 0 (fixed value) b=Coefficient of regression value, which shows the value of the increase or decrease in the dependent variable based on the independent variable.If the b value is positive (+) then the value will increase, and if the b value is negative (-) then there will be a decrease.X = Objects in independent variables which have a certain value.
So that in determining the value of a and the value of b, it is used with the formula equation according to equations 2 and 3 as follows:

Determination of Patient Characteristics
Based on the results of the research conducted, the data on the distribution of patient characteristics based on gender, age, educational level and occupational level of patients can be described in Table 3  Based on the results in Table 4 above, it shows that all variables X and Y have a significance value above 0.05, for example for variable Y the significance value is above 0.05, which is 2.160.This means that the residual data is normally distributed.This can also be explained by the results of graphical analysis, namely the Normal Probability plot graph as shown in Figure 1  Based on Figure 1 above, the results of the normality test show that the distribution of points from the Normal Figure P-P Plot above is relatively close to a straight line, so it can be concluded that the residual data is normally distributed.These results are in line with the classical assumptions of linear regression with the OLS approach.

Multicollinearity Test
This multicollinearity test is intended to see whether there are independent variables that are linearly correlated.If this situation occurs, we will face difficulties in distinguishing the effect of each independent variable on the dependent variable.To detect the presence of multicollinearity symptoms in the research model, it can be seen from the tolerance value or the Variance Inflation Factor (VIF) value.Tolerance limit > 0.10 and VIF limit < 10.00, so it can be concluded that there is no multicollinearity between the independent variables.The results of the multicollinearity test in this study are shown in Table 5 below: of health services and the patient satisfaction of Montella private hospitals has the correlation coefficient of 0.987 (R).R in the simple linear correlation of the independent variable to the dependent variable shows a simple correlation.The R number is 0987, meaning that the correlation between the variable quality of health services and patient satisfaction at the Montella private hospital has a very close relationship because the value of the correlation coefficient is close to the value 1.The results of this figure also answer the hypothesis about the quality of health services which is thought to have a very large influence on montella private hospital patient satisfaction.
The magnitude of the effect of variable X (Quality of Health Services) on variable Y (Patient Satisfaction at Montella Private Hospital) which was previously described in Table 8 is 0.975 (R Square).The value of this number illustrates that the coefficient of determination is changed in percentage, which means that the effect of the variable Quality of Health Services on Patient Satisfaction at Montella Private Hospital is 97.50% and the total percentage of the remainder is 2.50% where the influence of other variables from Quality of Health Services on Satisfaction Montella Private Hospital patients who were not examined in this study.As for the description of the relationship between the influence of Health Service Quality on Patient Satisfaction at Montella Private Hospital, the researcher describes it in Figure 3 as follows:

Figure3. Illustration of Research Results Model
The results that the researcher describes illustrate the research model shown in Figure 5.It states that the influence of the variable Quality of Health Services on Patient Satisfaction at Montella Private Hospital is 98.70%, and the effect of other variables (epsilon/€) is 1.30%.With regard to the assessment criteria, the percentage of Health Service Quality on Patient Satisfaction at Montella Private Hospital is in the very good category of 98.70%.so that the hypothesis that the researchers put forward has been proven so that it can be accepted if the variable Quality of Health Services has a very large influence on Patient Satisfaction at Montella Private Hospital.
Meanwhile, in order to find out the value of an increase or decrease in the Health Service Quality variable obtained in the Montella Private Hospital Patient Satisfaction variable, the researcher used a simple linear regression test with the formula obtained on the Health Service Quality variable, the researcher used a simple linear regression test: Where: Y' = object in the dependent variable being examined a = Y value if X = 0 (fixed value) what extent is the level of difficulty in understanding the doctor's advice or treatment plan.4. Satisfaction with the health care system is determined by attitudes towards:1) Physical facilities and health service environment.

Volumes 4 No. 2 (2023) 50 PT RADJA INTERCONTINENTAL PUBLISHING
patient satisfaction is a person's feeling of pleasure that arises because the results the patient gets are in accordance with what the patient expects so that the 52 QUALITY MANAGEMENT OF HEALTH SERVICES ON PATIENT SATISFACTION AT MONTELLA PRIVATE HOSPITAL WEST ACEH DISTRICT Mulya Wulandari , Susy Sriwahyuni, Dahlan Gunawan https://medalionjournal.com/

Volumes 4 No. 2 (2023) 50 PT
Samples 3. The sample in this study were patients who visited for treatment both inpatient and outpatient at the Montella Hospital in West Aceh District.The following are the number of inpatients and outpatients as described in Table1.The following: RADJA INTERCONTINENTAL PUBLISHING https://medalionjournal.com/ 2.

Table 4 . Results of the One-Sample Kolmogorov-Smirnov Test Data Normality One-Sample Kolmogorov-Smirnov Test
The classical assumption test is a prerequisite for simple regression analysis, this test must be fulfilled so that the parameter estimates and regression coefficients are not biased.This classic assumption test includes the normality test, multicollinearity test, heteroscedasticity test, autocorrelation test and simple linear regression test.The results of the classical assumption test in this study can be explained as follows: 1. Normality Test In this study, testing for normality of the data used the Kolmogorov-Smirnov test (Kolmogorov-Smirnov Test) by looking at the significance of the resulting residuals and the normal probability plot graphical approach.Detect normality by looking at the spread of data (points) on the diagonal axis of the graph.The results of the data normality test from the residuals obtained are as shown in table 4. as follows:

Table 5 . Multicollinearity Test Results Multikolonieritas Coefficients a
Kepuasan Pasien Rumah Sakit Swasta Montella Based on the results in Table5above, it shows that the tolerance value is greater than the tolerance value limit, namely for the variable Quality of Health Services at Montella Private Hospital the tolerance value is = 1.000> 0.10.This means that the residual data is normally distributed.Meanwhile, the Variance Inflation Factor (VIF) value must be less than 10.00.As for the results obtained for the variable Quality of Service at Montella Private Hospital, VIF = 1.000 <10.00, it can be concluded that multicollinearity does not occur and a simple linear regression model in this study can be used.
3. Heteroscedasticity TestThe heteroscedasticity test aims to test whether in the simple linear regression model there is an inequality of variance from one residual observation to another.If the variance from the residual from one observation to another observation remains, it is called homoscedasticity Volumes 4 No. 2 (2023) 50 PT RADJA INTERCONTINENTAL PUBLISHING https://medalionjournal.com/