THE ANALYSIS OF PUBLIC
SERVICE QUALITY FOR SATISFACTION: CASE
STUDY ON PARTICIPANTS OF BPJS HEALTH IN YOGYAKARTA SPECIAL REGION
Sri
Haryani
Sekolah
Tinggi Ilmu manajemen YKPN Yogyakarta
ABSTRACT
Social Security Administrator for Health (BPJS Health) is governmental institution giving public service to society, specializing in
health, where participation is obligatory for all Indonesians. Services of BPJS
for health refer to General Guidance of Public Service,
however, as health insurance provider to society,
BPJS Health
must pay attention to the quality of service. Study on “ The Analysis of Public Service
Quality for Satisfaction: Case Study on Participants of BPJS Health in Yogyakarta Special Region” used service
dimensions of tangibles (X1), reliability (X2), responsiveness (X3), assurance
(X4), and empathy (X5) as independent variables and participation
satisfaction
of BPJS Health
(Y) as dependent variables. Collecting
data by questionnaires distributed to respondents amounted to 86, while taking the samples by convenience
sampling method. Data analysis used SPSS Program 17.00, covering
instrument test, classical assumption test, hypothetic test, and multiple
linear regression. Validity test indicates that all items of questions of
variables X1, X2, X3, X4, X5 and Y are valid with t-count value (Pearson
correlation) > t-table (0.214). The whole statement item variables X1,
X2, X3, X4, X5, and Y is proven reliable shown the value of Cronbach 's Alpha >
0.60 The
classical assumption of normality, multicollinearity, and heteroscedasticity
showed normal distribution of data, between independent variables does not
occur multicollinearity problems, and found no problem heteroscedasticity in
regression models.
T-test
indicates that variable of tangibles and assurance partially no affect on participants satisfaction, while variables of
reliability, responsiveness, and empathy effect
participants satisfaction.
F-test indicates that variables of tangibles, reliability, responsiveness, assurance,
and empathy effect
participants satisfaction
simultaneously. Analysis of multiple linear regression in equation Y = – 0.082 – 0.005X1 + 0.424X2 + 0.048X3 + 0.044X4 +
0.560X5. Value of Adjusted R Square = 0.658 indicates that 65.8% of
satisfaction of participants is affected by tangibles, reliability,
responsiveness, assurance, and empathy; while 34.2% of the remaining is
affected by other variables that are not explained in this study.
Keywords: public service,
service quality, satisfaction, BPJS Health.
INTRODUCTION
One main assignment of government
is to provide
public services
for society, consisting of
administrative, goods
and services. Various
types of services that the public needs include education, health, transport,
postal and others. Public
services based on Minister
Decree No.63/2003 on General Guidance of Public Service, states that the provision of public services must
comply with principles of public service consisting of transparency,
accountability, conditionality, participative, equality of rights, and balance between rights and duties.
Social Security Administrator (BPJS) Health is a legal entity set up to organize the health insurance program, in the form of health protection for participants to
benefit health care and protection in fulfilling
basic health needs for any person who has paid contribution (dues) or contribution paid by the government (Presidential Decree No.12/2013). Participation
in health insurance is classified into 2, first, participants of Contribution
Aid Recipients (CAR) consisting of the poor and
disables so that their contribution is paid for by the government. Second,
participants of non-Contribution Aid
Recipients (non CAR),
participants who are
not classified into the poor consisting of wage recipient workers and their
family members, non wage recipient workers and their family members, and non
workers and their family members. Participation in health insurance is
obligatory for both CAR and non CAR
as to cover all Indonesians.
With so many participants BPJS,
large systems, and a relatively new institution, the implementation of BPJS Health facing some obstacles. Preliminary survey the researcher
conducted for 2014 indicates that public
are less responsive to program of BPJS Health.
Some reasons making public
less responsive are generally wage recipient workers have been participated in
health insurance program,
while people
who are classified into the poor and disable have owned Public Health Insurance
(Jamkesmas) and Local Health Insurance (Jamkesda) cards. For the
people who hold the card Jamkesmas and Jamkesda simply by migrating to BPJS,
but for others will
create switching costs, such as registration fees, time, and effort to become a
participant BPJS.
In addition, a new thing also needs new understanding and raises doubt. There are
complaints in the system "hierarchical referral" in which the second
level of health care facilities only given when they can not be handled by
first-level health facilities. To receive services at the second level health
facilities must be accompanied by a referral from a first-level health
facilities. Besides the “perception” of public
indicating that health insurance given by private agency is better than health
insurance given by the government. In relation to entrepreneur, there have not
been clarities in terms of participation for employees who have been included
in health insurance program and Social
Security for employees (Jamsostek), must they be included in BPJS Health? Must family
members of employees be included in program of BPJS Health? Jamsostek
program only provides guarantees for employees
only. For employers which is already using other health insurance, should they be
participants of BPJS Health?
In relation to the questions
above, furthermore, office of BPJS Health in
districts/cities gives socialization to companies/institutions that need it.
Socialization of BPJS Health
can explain valid requirements and conditions in details, answer questions and
discuss problems facing field. Process of socialization approaches BPJS as public service provider with companies and
employees as consumers that will receive service. However, as new institution, people still wait for performance of BPJS Health. Presidential Decree No.12/2013
states that participation in BPJS Health is obligatory
for all Indonesians, so that BPJS Health
has no problems with total participants and loyalty of participants. Participation
in BPJS Health
is not merely determined by assurances given and the services
of the health facilities of the agency in collaboration with the BPJS for Health.
The difference
of the characteristics of participants
Contribution Aid Recipients (CAR) and non Contribution Aid Recipients ( non CAR), the needs and expected service is also different. The government shows high commitment in implementing health insurance
that is shown by the establishment of provisions governing the procedures
for the registration and payment of dues by Regulation
of BPJS Health
No. 1/2015. In addition, there is discourse to improve Presidential Decree No.12/2013 as to
comply with need. BPJS for Health
is expected to fulfill or exceed what is public need
and expectation for health insurance. Djatmikowati
(2009) stated that satisfaction of society
for public service can be increased by improving service quality.
The objective of study is to
understand whether service quality dimensions consisting of tangibles, reliability,
responsiveness, assurance, and empathy partially and simultaneously affect the participants satisfaction of
BPJS Health in Yogyakarta Special Region. Implementation of
this study indicates that there is equality
between BPJS Health
and other insurance companies implementing of the health insurance program. It means that, if
insurance companies are analyzed for service quality to correlate to
satisfaction of consumers, then BPJS Health can also be analyzed.
Results of study are expected to be input in increasing service quality in BPJS
Health in Yogyakarta.
LITERATURE REVIEW AND HYPOTHESES
Satisfaction
In genaral, satisfaction is a person’s feelings of
pleasure or disappointment that result from comapring a product’s perceived
performance (or outcome) to expectation
(Kotler and Keller, 2011). BPJS
participants would feel if he was satisfied or not with the services provided
after comparing what happened with expectations or hope. Zeithaml, Berry & Parasuraman (1993)
stated that there are three different levels of customer
satisfaction: 1) desired service, which reflects what customers want; 2)
adequate service, the standar of customers are willing to accept; 3) predicted
service, the level of service cistomers beleive is likely to occur. Expectation of BPJS participants is formed by information provided BPJS own, insurance company as
competitor, hospital, polyclinic, Public Healthcare Center (Puskesmas), and physician
serving the participants of BPJS Health. Expectation is
also formed from their own experiences and experiences of others to BPJS Health service. Satisfaction
also are relative, so that the participants BPJS hopes to one another can vary.
Why is satisfaction of
participants important for BPJS for Health
as service provider? Generally, customer
satisfaction is a key to customer retention. A highly satisfied customer generally stays
loyal longer, buys more as the company introduces new and upgraded
products, and talk favorably to anothers
about the company and its products
(Kotler & Keller, 2011). Although
participation in BPJS Health
is obligatory, but participants who are not satisfied can switch to another
insurance company that provides health insurance. Considering that this health
insurance is also offered by various private and public insurance companies,
both domestic and foreign, participants can feel that service given by BPJS Health is not lower
quality than other health insurance providers. Meanwhile, Milen (2006) stated
that evaluation of service users is a fundamental and integral part in
measuring effectiveness and performance of a policy, even without evaluation of
users, policy legitimacy is doubtful.
BPJS Health participants were
satisfied with services received will convey to others, as to be “free
promotion” for BPJS Health.
Participants feeling satisfaction will also give testimony to other
individuals, that is generally more effective than marketing communication
implemented by BPJS Health.
On the other hand, participants who are not satisfied will convey to others, so it can
be disadvantageous for BPJS Health. Communication
by participants feeling dissatisfaction will form grapevine that will distribute
everywhere and be difficultly controlled by BPJS Health.
Considering the significance of participant satisfaction with
the service provided, many company are systematically measuring how well their
treath customer, identifiying the factors shaping satisfaction, and changing
operation and marketing as a result (Kotler & Keller, 2012). BPJS Health need to measure participant satisfaction,
identify factors that influence satisfaction, and change the services provided
so that it can fullfil or even exceed the expectations of the participants. Fulfillment and
exceeding of expectation of participants
may use some indicators of satisfaction such as convenience felt by
participants when service is given, conviction of participants on given service, interest in
coming again, and satisfaction for service given by employees.
Service quality
The current development shows
the increasing interest of companies and government agencies to service
quality. Companies such as insurance,
hospital, banking, education, and hotel analyze given service quality whether
it can fulfill need and expectation of consumers or not. Companies that can
give more services than need and expectation of consumers will not be left by
consumers. Quality is the totality of features
and characteristics of a product
or service that bear on its aability to satisfy stated or implied needs (Kotler & Keller, 2012). This definition
indicates that quality centered on consumers, whether products or services
given by companies fulfill expectation or not, it depends on perception of
consumers. According to Ziethaml, Parasuraman & Berry (1990), service quality as the
extent of discrepancy between customer’s expectation or desire and their
perception. It means that, a service is declared quality when consumers get
service beyond what they expect or desire.
Service quality is determined by
expectation or desire of customers, so that it is important for company to
understand factors affecting expectation
of customers. Ziethaml,
Parasuraman & Berry (1990) stated that, at least, there are 4
factors affecting expectation of customers. First, what customers hear from
other customers (word of mouth). A customer has expectation of high
service quality, because he/she hears high rate of service quality from his/her
family, friends, or neighbors. Second, characteristics of individuals and surroundings.
Someone classified as "perfectionist" has high quality standards in
all respects, including health quality standards. Similarly, the urban community accustomed to
receiving a quality service, then hopes for the service quality is also high.
Third, the extent of past
experiences with using a service could also influence customer’s
expectation level. Experience
with the services provided by BPJS Health will form service expectations in the future. Services
in the past will become the standard quality of service in the future. Fourth, external communication from service
provider play a key role in shaping customer’s satisfaction. The forms of
marketing communications such as leaflets, brochures, billboards, and anything
delivered by personal selling will affect the quality of service expected by
consumers.
One
instrument to measure service quality is SERVQUAL developed by Ziethaml,
Parasuraman & Berry (1990) consisting of 5
dimensions. First, tangibles:
that is physical appearance of facilities, equipment,
personnel/employees, and communication
materials. Second, reliability: it is competence or ability to perform the promised service dependably and accurately.
Third, responsiveness: it is willingness to help customers and provide prompt services. Fourth, assurance: it is knowledge and courtesy of employees and their ability to
convey trust and confidence. Finally,
empathy: it is caring, individualize attention the firm provides its customers.
From the company standpoint,
the provision of quality services to support the company's sustainability.
High quality is proven as one strategy to win competition, so that companies
such as Mc.Donald’s, Federal Express, American Airlines, American Express,
Domino’s Pizza, Disney World, Marriot, and IBM, that are leading companies, are always obsessed with service excellence Ziethaml,
Parasuraman & Berry (1990). They use service exellence to
differentiate their companies from competitors’, increase productivity, gain
loyalty of customers, get positive
word-of-mouth advertising, and self-protect from price competition.
Results of study by
Kartikasari, Dewanto &
Rochman (2014) indicate that service
quality affects people conviction. BPJS for health as service provider needs
to give quality services to
support sustainability of health insurance program. Legal umbrella to
obligate all Indonesians to be participants of BPJS for Health will force all
Indonesians to be participants. However, if the service provided BPJS can not
fulfill people's expectations, there will be demands for a review of the
provisions of BPJS Health.
Tangible Effect
on the Participant Satisfaction
Tangibles becomes quality
dimension that can be seen directly and really by external parties. By looking
at the tangibles, BPJS participants who have not received services can predict
the quality of the services that will be received A
participants who comes to office of BPJS Health
can perceive service quality from building and outdoor facilities such as parking
lot, yard, terrace, toilet, and waiting room. BPJS participants like clean, orderly, and complete
building and facilities, and they assess
services in office of BPJS for health as
quality if building and facilities are clean, orderly and complete.
After participants entered the room, they will be
served by employees of BPJS Health. Employees who have attractive physical
appearance have high confidence. Employees having confidence will support
services given to participants and communicate to external parties. This
capital of confidence becomes tangibles for participants that they will
accept quality services. Uniform dress of employees consistent with function
and image of company can also form professional image, namely having reliable
work competence consistent with their field. Nevertheless, perceiving work
competence based on appearance is less accurate, but, in fact, appearance
becomes first benchmark to assess one’s competence.
Promotion is believed as “spearhead“ in marketing, although company can produce
quality products and services
and sell these in low price, but, without support of promotion, its marketing
is less successful. From aspect of promotion, customers will perceive product
quality offered from materials used to make brochure, leaflet, banner, and
billboard. If the material used for the promotion qualified, consumers will
assess that goods and services are marketed well qualified.
Reliability
Effect on the Participant Satisfaction
The
meaning of word reliable is
to be believed. In the context of service quality,
reliability is the ability to provide services that are reliable and accurate.
The level of reliability is determined by the competence of personnel sourced
from the expertise, knowledge, and experience. To give quality services,
management must consider competence of employees, it can be conducted by
participating them in training and development program.
To measure service quality from
reliability dimension, such as, by seeing how the company fulfills its promise to do something by certain time.
Participants of BPJS Health perceive that service quality of BPJS is good if process and duration
of
services is same or quicker than promise. For service time, if announcement has
been put, saying that service time is from 08.00 to 14.00, the announcement can
be considered as promise. When his service hours at the
office BPJS not in accordance with the announced, then the service quality of
the reliability dimensions is assessed
low. Service time perceived good is time consistent with announcement. If
service time is over but there are still participants who have not been served,
the participants expect to be served and participants will perceive that
service quality of BPJS Health is reliable.
Reliability dimension can also be
realized when giving services, namely, by giving response and help truly. In
the service process, participants often face the problem that requires the help
of employees.
With the help of conscientious participants expected the problem can be
solved, but the case has not been able to solve the problem of participants,
participants judged that BPJS is still reliable.
First impressions will
determine the quality of service for participants. If the first service process
participants felt that the service provided is exactly as expected or even exceed, the participants assess the quality of service
received is good. With
a good first impression, participants voluntarily will extend its membership.
If at any time the service is not good, the participants still consider that
the quality of service of the institution as a whole remained good. It just
happened at the time of the service received is not as good as the first.
BPJS Health participants considered that the service
receives good quality if BPJS provide services as promised. BPJS as providers
of health insurance programs provide some promises such as giving the identity card, the duration of the
service process, the amount of contributions paid participants, and type of
health services is guaranteed. If
every promise above fulfilled, participants will percieve that the services provided BPJS quality is good.
Responsiveness
Effect on the Participant Satisfaction
Services are given to customers
by employees, so this responsiveness is derived from readiness and ability of employees in giving
services. Responsiveness of employees are reflected in conveying
information when a services will be provided. In case of reference services, these services will
only be given if participants have done first level services. Likewise,
participants having more than one health insurance programs, the BPJS Health as
first insurer will assure participants consistent with their rights,
furthermore it is covered
by other insurance or agency.
Responsiveness is also reflected
from services given accurately. First thing to do is to arrange simple
procedure so that participants coming can be served immediately. Service
process can be accelerated by providing adequate quantity of counters as to
minimize queue length. Shorter time to serve participants, service quality of
this responsiveness dimension is higher.
Employees can also increase
responsiveness by getting ready to help participants sincerely. Most of people have not understood
procedure and requirements well to be participants of BPJS Health and how they
use benefits. Responsiveness can be increased by assisting potential participants in process of registration,
concerning requirements, sequence, and period of time. After being participants
of BPJS Health, they may gain benefits of health facilities at first level and
further facilities complying with valid requirements. In addition, participants
of BPJS Health can also join other health insurance programs.
BPJS employee will serve many of the participants, while
participants want to be served completely and unhurried. Therefore BPJS need to
set the services process by differentiate the counter
PBI and not BPI. From counter Not PBI can be divided again into counter workers wage earners, counter workers not wage
earners, and counter not working.
Counters distinction is intended to increase the specialization of employees,
so it can handle problems quickly and completely and simultaneously speed up
service participants.
Assurance Effect on the Participant Satisfaction
Health
insurance became protective effort provided to the public against the risks that
can result in the distractions of normal life
structure. To realize the quality of service assurance dimensions can be done
with confidence BPJS in providing health insurance. Based on Presidential
Decree No. 12 of 2013, the establishment and operationalization BPJS in
Indonesia is legal. With this law, institutional BPJS Health and its employees
will be confident that lead the assessment of the
participants to the high service quality.
Employees of BPJS Health will
always be polite to participants. In normal condition, friendly and polite
attitude will be easily realized, but, in situation in which there are many
participants that must be served and different problems may be cause of less
polite. Services to participants may be given by emphasizing on importance of
communication skill for employees serving in service division.
Service quality of assurance
dimension will arise
if employees have knowledge to answer questions of participants. Therefore,
employees must understand requirements and procedure applicable to BPJS Health,
that may be basis to answer questions of participants. Second, employees need
to understand background of participants such as education, job, economic
level, and domicile so
that employees can estimate what information they have owned and what
information they need. After substance of information is ready to give, finally
information is communicated accurately.
Empathy Effect
on the Participant Satisfaction
Employees who serve with
empathy means serve to put himself in the situation as participants of BPJS Health. In general, people want to be treated fairly, with
dignity, and comfortable.
Therefore, employees should treat
participants as they want to be treated fairly, with dignity, and
comfortable. Fair service can be
realized with who should take precedence in the service, namely came first. Services given to
participants of BPJS also must consider
the aspect of self-esteem and dignity as human, especially in giving services to participants
who are the contribution paid by goverment (CAR). In context of
empathy, word “comfortable” is comfortable in heart, realized from services
that do not make participants of BPJS embarrassed,
humiliated, offended, or angry.
Empathy can also be arise by understanding specific need of participants.
In certain cases, sometimes a person to register as a participant BPJS when
in the process of treatment in
hospital, and expect financing in the hospital can be covered by BPJS Health.
These patients require proof of membership in the
form of an identity card, but the time required of the registration process
until an identity card was completed about 2 weeks. In this situation, the employee can show empathy with finding solutions to
problems faced by the participants.
Currently most companies already involve
employees in health insurance programs. The new regulations require companies
to engage employees in BPJS Health, but there are some employees who retain insurance
during use. Benefits coordination between BPJS
and other health insurance programs is
realization of empathy, indicating that BPJS
understands need of some people on
higher or comprehensive health insurance. Benefits coordination
between BPJS and other health insurance programs can increase satisfaction of participants.
Previous research on BPJS for Health relatively few,
because the
BPJS Health was enacted
in 2013. Study
by Widyasih, Mubin, and Hidayati (2014) on Perception of Public for BPJS Services in Kendal Islamic Hospital
(RSI) and study by Rismawati (2014) on
Services of BPJS Health in Public
Healthcare Center (Puskesmas) of Karang Asam,
Sungai Kunjang, Samarinda. Their research with the object of
health facilities that are used by participants of BPJS Health (hospital and Public Healthcare
Center), whereas in this study object was the office BPJS Health itself. While previous research on the service quality to satisfaction with the subject patient in hospitals
and health centers, such as research Hadi (2014), Kartikasari, Dewanto
& Rochman (2014), Suryani (2013), and Setiyanto (2013).
Based on literature review and
previous research, the following hypotheses are formulated:
1)
Service
quality consisting of tangibles, reliability, responsiveness, assurance, and
empathy partially affects participants satisfaction of BPJS Health in Yogyakarta Special Region.
2)
Service
quality consisting of tangibles, reliability, responsiveness, assurance, and
empathy simultaneously affects participants satisfaction of BPJS Health in Yogyakarta Special Region.
METHODS
This research was conducted in Yogyakarta Special
Region,
with population of Yogyakarta being participants of BPJS Health, Branch of
Yogyakarta. This research
to be conducted multivariate analysis (multiple linear regression), the number
of sample members at least 10 times the number of variables under research (Sugiyono,
2010). The research sample using six variables, the minimum
number of respondents 60. The research sample using six variables, the minimum
number of respondents 60. To improve the quality of research on aspects of
representation of population characteristics, in this study is taken a sample of 86 respondents. Method of sampling
used Non-probability Sampling, namely, Convenience Sampling that
is technique to determine samples based on accidental, namely, anyone who
accidentally meet researcher could be used as sample, if they fulfills requirements as source of data
(Wiyono, 2011). Requirements as source of data indicate that they have
been one of participants of BPJS Health, Branch of Yogyakarta.
Data were collected by
questionnaires, while scale of measurement uses Likert scale with score ranging
from 1 to 5, where score 1 is very disagree and score 5 is very agree with
questions/statements. Analysis of data used SPSS 17.00, covering instrument
test, classical assumption test, hypothetic test, and analysis of multiple
linear regression intended to understand functional and causal
correlation between tangibles (X1), reliability (X2), responsiveness (X3),
assurance (X4), empathy (X5), for satisfaction of participants of BPJS Health
(Y).
RESULTS AND DISCUSSION
Characteristics of Respondents
Characteristics of respondents give an overview of the respondents surveyed, which can
be the basis for improving the quality of services or to make adjustments to the
services provided during this time. From the 86 respondents, 53.33%
of them are females and 46.67% of them are males. These findings indicate that
proportion of female participants of BPJS Health is higher than male
participants. Relatively balanced proportion indicates that provision of facilities
correlates to gender, such as, toilet and praying room are also in relatively
same proportion.
Based on the education
level, showed that 4.44% of the respondents education level is S2,
28.89% is S1, 32.22%
is Diploma and 34.44% is senior high school. By grouping into two, namely senior high school and
universities/collage indicates
that education levels of some participants coming to office of BPJS Health have
university/college
education (65,56%).
These findings can be basis to give services appropriate with education of
respondents. For example, BPJS Health can give more transparent procedures, and
competent officer to
serve them.
Analysis of respondents based on
job types indicates that most of job types of respondents are private officer, 55.56%. Then
successively followed by laborers (buruh) (20%), civil
servants (15.56%), and self-employment (8.89%). Most of the
participants who need the service in the office BPJS are private sector officer and laborer (75.56%). Both groups
are “wage recipient workers”. These findings can be developed again by advanced
research to respond phenomenon
many private sector officer and workers who
need the service.
Validity and Reliability
Test the validity of this research
is done by looking at the value of Pearson correlation of each item questions/
statements given to the respondent. An item is said to be valid if the Pearson
correlation value is greater than the value of r table at significant level of
0.05 (Wiyono, 2011). Validity test showed that all the instruments or statement
items used to measure the six variables have a value above the Pearson correlation r table (0.214).
Thus, all items of statement are declared
valid.
Table 1. Results of Validity test
|
Variable
|
Question
|
r-count
|
r-table
|
Description
|
|
Tangibles
(X1)
|
1
|
0.717
|
0.214
|
Valid
|
|
2
|
0.795
|
0.214
|
Valid
|
|
|
3
|
0.746
|
0.214
|
Valid
|
|
|
4
|
0.790
|
0.214
|
Valid
|
|
|
Reliability (X2)
|
5
|
0.819
|
0.214
|
Valid
|
|
6
|
0.887
|
0.214
|
Valid
|
|
|
7
|
0.929
|
0.214
|
Valid
|
|
|
8
|
0.871
|
0.214
|
Valid
|
|
|
Responsiveness
(X3)
|
9
|
0.839
|
0.214
|
Valid
|
|
10
|
0.839
|
0.214
|
Valid
|
|
|
11
|
0.786
|
0.214
|
Valid
|
|
|
12
|
0.733
|
0.214
|
Valid
|
|
|
Assurance
(X4)
|
13
|
0.686
|
0.214
|
Valid
|
|
14
|
0.855
|
0.214
|
Valid
|
|
|
15
|
0.853
|
0.214
|
Valid
|
|
|
16
|
0906
|
0.214
|
Valid
|
|
|
Empathy
(X5)
|
17
|
0.819
|
0.214
|
Valid
|
|
18
|
0.767
|
0.214
|
Valid
|
|
|
19
|
0.769
|
0.214
|
Valid
|
|
|
20
|
0.812
|
0.214
|
Valid
|
|
|
Satisfaction
of Participants
(Y)
|
21
|
0.878
|
0.214
|
Valid
|
|
22
|
0.896
|
0.214
|
Valid
|
|
|
23
|
0.851
|
0.214
|
Valid
|
|
|
24
|
0.870
|
0.214
|
Valid
|
Source: Data processed
by SPSS 17.00, 2015
Reliability test using Cronbach's Alpha method in which
the statement assessed reliable if the Cronbach's
Alpha > 0.60. Reliability test results for all of the
variables have Alpha coefficients > 0.60. It can be stated that all items of research
variables are reliable and can be used as the basis for data collection.
Table
2. Results of Reliability Test
|
Variable
|
Cronbach’s
Alpha
|
Description
|
|
Tangibles (X1)
|
0.754
|
Reliable
|
|
Reliability (X2)
|
0.897
|
Reliable
|
|
Responsiveness (X3)
|
0.788
|
Reliable
|
|
Assurance (X4)
|
0.834
|
Reliable
|
|
Empathy (X5)
|
0.784
|
Reliable
|
|
Satisfaction of
participants (Y)
|
0.896
|
Reliable
|
Source: Data processed
by SPSS 17.00, 2015
Classical Assumption
Test
Requirements to be met in the regression model is the
normal distribution of data. Normality testing with test samples Kolmogorov One-Smirnov, the
data is declared in normal distribution if the
significance is greater than 0.05 (Wiyono, 2011). With a significance level of
0.05, Kolmogorov-Smirnov significance value of 0.200 >
0.05. Thus, the data declared in normal
distribution.
Table
3. Results of Normality Test
|
|
Kolmogorov-Smirnova
|
||
|
|
Statistic
|
df
|
Sig.
|
|
Standardized Residual
|
.077
|
86
|
.200*
|
|
a. Lilliefors Significance Correction
|
|
||
|
Source: Data processed by SPSS 17.00, 2015
|
|||
Requirements
that must be fulfilled in regression model are absence of linear correlation
between independent variables in regression model (there is no
multicollinearity). Multicollinearity testing with value of varince inflation factor (VIF), if VIF
< 5, then inter-independent variables do not face multicollinearity problems
(Wiyono, 2011). Value of variance inflation factor (VIF) of tangibles = 1.606, reliability = 3.235, responsiveness = 3.540,
assurance = 2.192, and empathy = 1.895. The value of
5 variables are less than 5 (< 5), so that it can
be concluded that inter-independent variables do not face multicollinearity
problems.
Table 4. Results of Normality Test
Coefficientsa
|
Model
|
Colinearity of Statistics
|
||
|
Tolerance
|
VIF
|
||
|
1
|
(Constant)
|
|
|
|
|
Tangibles (X1)
|
.623
|
1.606
|
|
|
Reliability (X2)
|
.310
|
3.225
|
|
|
Responsiveness (X3)
|
.283
|
3.540
|
|
|
Assurance (X4)
|
.456
|
2.192
|
|
|
Empathy (X5)
|
.528
|
1.895
|
a.
Dependent Variable: Satisfaction of
participants
Source:
Data processed by SPSS 17.00, 2015
Requirements
that must be fulfilled are absences of variances of residual for all
observations in regression model (there
is no heteroscedasticity).
Heteroscedasticity testing with Park test is regression of residual value (Lnei2)
with each of independent variables. If –t table ≤ t count ≤ t table, then there is no problem with heteroscedasticity
(Wiyono, 2011). Results of heteroscedasticity test indicate that value of t count of tangibles
= –1,551; reliability = 0.777; responsiveness = 0.650; assurance = – 0,467; and empathy = 1.506. While t table with df
= n–2 or 86–2 = 84 is 1.6632. Because value of t count is in –t table ≤ t count ≤ t table, it can be
concluded that no problem of heteroscedasticity is found in regression model.
Table 5. Results of
Normality Test
|
Coefficientsa
|
||||||
|
Model
|
Unstandardized
Coefficients
|
Standardized
Coefficients
|
t
|
Sig.
|
||
|
B
|
Std.
Error
|
Beta
|
||||
|
1
|
(Constant)
|
2.969
|
.833
|
|
3.566
|
.001
|
|
Tangibles (X1)
|
-.075
|
.048
|
-.213
|
-1.551
|
.125
|
|
|
Reliability (X2)
|
.043
|
.056
|
.151
|
.777
|
.439
|
|
|
Responsiveness (X3)
|
.045
|
.070
|
.133
|
.650
|
.517
|
|
|
Assurance (X4)
|
-.025
|
.054
|
-.075
|
-.467
|
.642
|
|
|
Empathy (X5)
|
-.094
|
.062
|
-.225
|
-1.506
|
.136
|
|
|
a. Dependent Variable: Absolute
Residual
|
|
|
|
|||
Source: Data processed by SPSS 17.00, 2015
Hypothetic Test
F test (simultaneous significance test) is used to
determine whether all the independent variables have influence simultaneously on the dependent variable
(Wiyono, 2011). Results of F test in
Table 6 indicate that value of probability Pvalue (sig) = 0,000 is less than 0.05. It indicates that H0 is rejected, it means
that independent variables consisting of variables of tangibles, reliability,
responsiveness, assurance, and empathy simultaneously affect satisfaction of
participants of BPJS Health. These findings support study by Hadi
(2014): service quality simultaneously has significant
effect on satisfaction of patients of RSI Sunan Kudus, Setiyanto (2013): service quality has
significant effect on satisfaction of patients
of RSU Dr. Moewardi, Suryani (2013): services
have effect on satisfaction of patients of RSU Pirngadi Medan, and study by Kartikasari, Dewanto, Rochman, service quality has direct effect on
satisfaction of patients of RS Kandangan Surabaya.
Table 6. Results of F test
|
ANOVAb
|
||||||
|
Model
|
Sum
of Squares
|
Df
|
Mean
Square
|
F
|
Sig.
|
|
|
1
|
Regression
|
959.486
|
3
|
319.829
|
26.469
|
.000a
|
|
Residual
|
918.314
|
76
|
12.083
|
|
|
|
|
Total
|
1877.800
|
79
|
|
|
|
|
|
a.
Predictors:(Constant),tangibles, reliability, responsiveness, assurance, empathy
|
||||||
|
b. Dependent Variable: Satisfaction of
participants
|
||||||
Source: Data processed by SPSS 17.00, 2015
T
test (partial significance) shows the extent of the influence of the
independent variables individually in explaining the variation of the dependent
variable (Wiyono, 2011). In this study, t test to determine the effect of
variable tangibles, reliability, responsiveness, assurance, and empathy
partially on participant satisfaction of BPJS Health.
The
results of data processing with SPSS 17:00 shows the significant value of tangibles (X1) is 0.958, higher than
value of significance level (0,05). Thus, H0
is accepted,
it means that partially there is no
effect between tangibles variables on variable of satisfaction of participants.
If BPJS Health intends to increase satisfaction of participants, given efforts
correlating to tangibles such as employees with neat and polite dress,
building, room, and facilities that clean, orderly, comfortable
and visible will not increase satisfaction of participants. These findings
support results of study by Hadi (2014): tangibles of RSI
Sunan Kudus does not significantly affect satisfaction. Nevertheless, in field
of health, tangibles such as cleanliness and orderliness of toilet and waiting
room, and complete equipment and facilities cannot
be ignored by health facilities such as hospital, Public Healthcare Center, and polyclinic as well as BPJS for
Health as health insurance provider.
T significant value for the variable reliability (X2)
0,000 less than the significance level (0.05). Thus H0 is rejected, meaning a
partial there is effect between the
variable reliability to variable participant satisfaction. With employees who
provide services from the beginning, can be trusted,
behave as expected participants, and can be consulted will increase the
satisfaction of participants who come to the office BPJS Yogyakarta. These findings does’t support study by Hadi (2014): reliability does
not have significant effect on satisfaction of patients
of RSI Sunan Kudus.
The speed and accuracy in giving registration services,
process of ICU, treatment control and physician, easy administrative procedure,
and clear details of cost will not have effect partially on satisfaction of
inpatients.
Value of significance t
for responsiveness variable (X3) = 0.002
is higher than value of significance level (0.05). Thus, H0 is rejected, variable of
responsiveness (X3) partially has significant effect on increasing of
satisfaction for participants. Assumption of other independent variables are constant, employees with responsiveness to both services
and answering questions of participants, and readiness to help will increase satisfaction
for participants of BPJS for Health in Yogyakarta. Results of this study are
different from study by Hadi (2014): responsiveness
does not have significant effect on satisfaction of inpatients of RSI Sunan
Kudus. Nurses and physicians with responsiveness to complaint, understand systems and
procedure partially do not have effect on satisfaction of patients.
Value of significance t
for assurance variable (X4) = 0.651 is
higher than value of significance level (0.05).
Thus, H0 is accepted, it means that there is no effect between assurance variables on variable of satisfaction of
participants. Assurance that
establishment and operation of BPJS Health are legal, based on Presidential Decree No.12/2013 does not partially have effect on satisfaction.
Services given
consistent with standard applicable to BPJS Health will not have effect on satisfaction.
Procedure of services used in BPJS Health is perceive complicated by
respondents so that some respondents ever receiving services in office of Yogyakarta BPJS
Health, propose that the procedure is made simple.
Employees must
understand requirements and procedure applicable to BPJS Health, that will be
basis to answer questions of participants. However, understanding of
requirements and procedure has not been sufficient, employees need to
understand backgrounds of participants such as education, job, economic level,
residence and other so that employees can estimate what information they have
owned and what information they need.
Results of this study
are different from study by Hadi (2014): assurance has significant effect on
satisfaction of inpatients of RSI Sunan Kudus. Satisfaction of patients
of RSI Sunan Kudus can be realized by giving sincere and personal attention of
nurses and physicians trying to understand patients’ desire.
|
Table 7. Results of T-test and Regression
Coefficientsa
|
|||||||
|
Model
|
Unstandardized
Coefficients
|
Standardized
Coefficients
|
T
|
Sig.
|
|||
|
B
|
Std.
Error
|
Beta
|
|||||
|
1
|
(Constant)
|
-.282
|
1.490
|
|
-.189
|
.850
|
|
|
Tangibles (X1)
|
-.005
|
.086
|
-.004
|
-.053
|
.958
|
||
|
Reliability (X2)
|
.424
|
.099
|
.486
|
4.272
|
.000
|
||
|
Responsiveness (X3)
|
.048
|
.125
|
.046
|
3.383
|
.002
|
||
|
Assurance (X4)
|
-.044
|
.097
|
-.043
|
-.454
|
.651
|
||
|
Empathy (X5)
|
.566
|
.111
|
.438
|
5.023
|
.000
|
||
|
a. Dependent Variable: Satisfaction of participants
|
|||||||
Source: Data processed by SPSS 17.00, 2015
Value of significance t
for empathy (X5) = 0.000 is lower than value of significance level (0.05). Thus, H0 is rejected, empathy variable (X5) partially has
significant effect on increasing of satisfaction of participants of BPJS Health.
Giving sincere and individual attention will increase satisfaction of
participants. Serve with empathy means serving employees by placing him
on as a participant BPJS. If he wants to be treated fairly, with dignity, and
comfortable should BPJS employee can treat participants like himself would be
treated. Included in understanding the specific needs to the problems faced by
the participants BPJS. The results of this study support the research Hadi (2014):
empathy significant effect on patient satisfaction in RSI Sunan Kudus.
Multiple
Linear Regression
Analysis
of Multiple Linear Regression is
used to determine
how fluctuation and direction of correlation between independent variables of tangibles
(X1), reliability (X2), responsiveness (X3), assurance (X4), and empathy (X5) on dependent variables of satisfaction for
participants of BPJS Health (Y). SPSS 17.00 is used to produce the
following equation of Multiple Linear Regression:
Y = – 0.282 – 0.005X1+
0.424X2 + 0.048X3 –
0.044X4 + 0.560X5
Value of constant is –
0.282, it means that, if all independent variables of X1, X2, X3, X4, and
X5 are equal to 0, there is no variables
of tangibles, reliability, responsiveness, assurance, and empathy, so that
satisfaction rate is negative 0.282 units. It means that participants of BPJS
for Health will feel dissatisfaction at 0.282 units.
Regression
coefficient of tangibles variable (X1) = – 0.005
indicates that each increase of tangibles at 1 unit, with assumption variables of
reliability, responsiveness, assurance, and empathy are constant will decrease satisfaction of
participants (Y) 0.005 units.
Negative valued coefficient means that there is negative correlation
between tangibles and satisfaction of participants of BPJS for Health.
Regression coefficient of
reliability variable (X2) = 0.424 indicates
that reliability variable has positive effect on satisfaction of participants (Y). Each addition of reliability variable at 1 unit, with assumption other variables are constant,
then satisfaction of participants will increasing at 0.424 units.
The regression coefficient variable responsiveness (X3) =
0.048 indicates that any increase in the variable responsiveness (X3) positive
effect on the participants' satisfaction (Y). If there is 1
additional unit of variable responsiveness, there will be an increase in
satisfaction of participants at 0,048 units.
The
regression coefficient assurance variable (X4) of -0.044 show any increase in
the assurance by 1 unit, assuming the variable tangibles, reliability,
responsiveness, and empathy are constant will decrease the participant
satisfaction (Y) amounted to 0,044 units. The coefficient is negative meaning a
negative relationship between the participant satisfaction and assurance of
BPJS. Health.
Regression
coefficient of empathy variable (X5) = 0.560 indicates that empathy variable (X5)
has positive effect on satisfaction of participants (Y). If there is 1
additional unit of variable empathy, there will be an increase in satisfaction of
participants at 0,560 units.
Table 9. Model Summaryb
|
Model
|
R
|
R Square
|
Adjusted R Square
|
Std. Error of the
Estimate
|
Durbin-Watson
|
|
1
|
.824a
|
.678
|
.658
|
1.627
|
1.929
|
a.
Predictor: (constant), tangibles,
reliability, responsiveness, assurance, empathy;
b.
Dependent variable: satisfaction of
customers (Y)
Source: Data
processed by SPSS 17.00, 2015
Value of Adjusted R Square
= 0.658 or 65.8% means that 65.8% of variable of satisfaction of participants
(Y) can be explained by variables of tangibles, reliability, responsiveness,
assurance, and empathy. While the remaining of 34.2% can be explained by other
variables excluded in this study.
CONCLUSIONS
Simultaneously, variables of tangibles,
reliability, responsiveness, assurance and empathy have effect on participants
satisfaction
of BPJS Health. Partially, variables of reliability, responsiveness, and
empathy have effect on satisfaction of participants, while variables of tangibles
and assurance do not have effect on satisfaction of participants of BPJS
Health.
Analysis of Multiple Linear
Regression indicates that variables of reliability, responsiveness, and empathy
have positive effect on satisfaction of participants of BPJS Health, while variables of tangibles and
assurance have negative effect on satisfaction of participants of BPJS Health.
The independent variables that most influence on the
participants' satisfaction BPJS is empathy variable, as indicated by the
regression coefficient is greatest, namely 0.560.
Adjusted R Square = 0.685 means that
variables of tangibles, reliability, responsiveness, assurance and empathy can
explain variation of satisfaction of participants of BPJS Health (Y) = 65.8%.
While 34.2% is explained by other variables excluded in this study.
RECOMMENDATIONS
Variables that affect the satisfaction ie
reliability, responsiveness, and empathy are all human concerns, then to
improve services must be based on the development of human resources. Improvement
human resources can be done in terms of training service excellence, effective
communication and seminars to increase knowledge about the quality of services
and public services. With hope, the employee can improve aspects of
reliability, responsiveness, and empathy in serving participants BPJS.
Although partially variables of tangibles
and assurance do not have effect on participants’ satisfaction of BPJS Health, do not mean that the two variables can be ignored. For assurance variable, appropriate with function as provider
health insurance, BPJS
Health must give health security in order that society gain benefits of health maintenance and assurance in fulfilling basic need of health. For tangibles
variable, although partially it does not have effect on satisfaction, it should
remain to maintain aspects of tangibles in wearing uniform dress, facilities,
building and room, which are clean, orderly and easy to find. In hope is to increase professional image of employees
and reinforce value of health, namely, clean and orderly.
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