The Effect of Outpatient Service Quality on Patient Satisfaction with Perceived Value as a Mediating Variable

Nurwestu Rusetiyanti; Eric Harianto

doi:10.32535/ijabim.v10i3.4510

The Effect of Outpatient Service Quality on Patient Satisfaction with Perceived Value as a Mediating Variable

Nurwestu Rusetiyanti, Eric Harianto

Abstract

Attention to the quality of healthcare services has increased significantly. Healthcare providers are competing to deliver higher-quality healthcare services. Management is required to focus not only on medical technicalities but also on creating perceived value that drives patient satisfaction. Acknowledged as a central metric of healthcare service excellence, patient satisfaction is analyzed in this inquiry alongside the impact of outpatient service quality and perceived value at Nima Medical Center Clinic. The investigation also explores the function of perceived value as an intervening factor in the association between outpatient service quality and patient satisfaction. A quantitative approach was adopted, employing a survey instrument with a 1–5 Likert scale on 96 purposively sampled patients from the Nima Medical Center Clinic in Yogyakarta. Data were initially tabulated in Excel and subsequently analyzed using SmartPLS 4.0, employing the Structural Equation Modeling–Partial Least Squares (SEM-PLS) technique. Evidence shows that outpatient service excellence has a positive but not statistically significant direct link to patient satisfaction. Conversely, perceived worth exerts a robust, significant direct impact on contentment. Notably, the influence of service excellence on satisfaction is significant when it is facilitated by perceived worth. Altogether, these outcomes underscore the vital role of perceived value as a mediating factor between service excellence and patient satisfaction. Consequently, a favorable assessment of service value is essential to improve patient satisfaction in the outpatient department.

Keywords

Service Quality; Patient Satisfaction; Mediation; Perceived Value

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References

Afader, M., Rahman, P. H., & Sunjaya, D. K. (2021). Patients’ Satisfaction in Public and Private Primary Health Care: A Study in Karawang Regency, West Java, Indonesia. Althea Medical Journal, 8(4). https://doi.org/10.15850/amj.v8n4.2340

AlOmari, F. (2021). Measuring Gaps in Healthcare Quality Using the SERVQUAL Model: Challenges and Opportunities in Developing Countries. Measuring Business Excellence, 25(4), 407–420. https://doi.org/10.1108/MBE-11-2019-0104

Anastasya, R., & Gurning, F. P. (2023). Analysis of Health Service Quality Using the SERVPERF and IPA Methods in Outpatients at Malahayati Islamic Hospital Medan. TROPHICO: Tropical Public Health Journal, 3(2), 105–111. https://doi.org/10.32734/trophico.v3i2.13234

Ariany, I. V. (2021). The Effect of Service Quality and Perceived Value on Patient Loyalty: Patient Satisfaction as a Mediating Variable. Journal of Business Management and Entrepreneurship, 5(4), 402–407.

Astuti, E. R. (2024). Factors that Influence the Satisfaction of Health Service Recipients in Hospitals: Systematic Literature Review. Care: Journal of Health Sciences, 12(2), 353–362. https://doi.org/10.33366/jc.v12i2.5947

Baskoro, R. R., Arvianto, A., & Rinawati, D. I. (2016). Assessment of Patient Satisfaction Using the SERVQUAL Method. Industrial Engineering Online Journal, 5(4).

Cengiz, E., & Kirkbir, F. (2007). Customer Perceived Value: The Development of a Multiple Item Scale in Hospitals. Problems and Perspectives in Management, 5, 252–268.

Cronin, J. J., Brady, M. K., & Hult, G. T. M. (2000). Assessing the Effects of Quality, Value, and Customer Satisfaction on Consumer Behavioral Intentions in Service Environments. Journal of Retailing, 76(2), 193–218.

Cronin, J. J., & Taylor, S. A. (1992). Measuring Service Quality: A Reexamination and Extension. Journal of Marketing, 56(3), 55–68.

Cronin, J. J., & Taylor, S. A. (1994). SERVPERF versus SERVQUAL: Reconciling Performance-Based and Perceptions-Minus-Expectations Measurement of Service Quality. Journal of Marketing, 58(1), 125–131.

Dwijayanti, K. A., Wirajaya, I. W. A., Sukadana, K., & Kusuma, N. Y. (2024). Service Quality Factors that Influence Patient Satisfaction at Buleleng Regional Hospital. Jurnal Ilmiah Manajemen Kesatuan, 12(4), 1179–1190. https://doi.org/10.37641/jimkes.v12i4.2722

Erpurini, W., & Saleh, F. D. (2021). Analysis of Patient Service Quality at Kasih Bunda Yanti Rajamandala Primary Clinic. Journal of Management Science.

Fatimah, S., Idrus, M., Mukhtar, A., Salam, K. N., & Ismawati. (2022). Study on Service Quality on Customer Satisfaction and Loyalty. Jurnal Manajemen, 26(3), 512–532. https://doi.org/10.24912/jm.v26i3.938

Ferreira, D. C., Vieira, I., Pedro, M. I., Caldas, P., & Varela, M. (2023). Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare, 11(5). https://doi.org/10.3390/healthcare11050639

Gallarza, M. G., Saura, I. G., & Arteaga, F. (2023). The Quality-Value-Satisfaction-Loyalty Chain in Tourism: A Meta-analysis. Tourism Management, 94.

Ge, Y., Yuan, Q., Wang, Y., & Park, K. (2021). The Structural Relationship among Perceived Service Quality, Perceived Value, and Customer Satisfaction. Sustainability, 13(15). https://doi.org/10.3390/su13158633

Ghimire, P., Bista, N., & Collao, M. R. (2022). Evaluation of Patients’ Satisfaction Using the SERVQUAL Questionnaire Model. Journal of Chitwan Medical College, 12(4), 68–72. https://doi.org/10.54530/jcmc.650

Hair, J. F., Hult, G. T. M., Ringle, C. M., Sarstedt, M., Danks, N. P., & Ray, S. (2021). Mediation Analysis. In Partial Least Squares Structural Equation Modeling (PLS-SEM) Using R. Springer. https://doi.org/10.1007/978-3-030-80519-7_7

Hasibuan, C. F. (2020). The Measurement of Customer Satisfaction towards the Service Quality at XYZ Wholesale by Using the Fuzzy Service Quality Method. 909(1). https://doi.org/10.1088/1757-899X/909/1/012053

Hsu, C. L., & Lin, J. C. (2023). Understanding the Role of Perceived Value in E-commerce Platform Loyalty. Electronic Commerce Research and Applications, 58.

Jonkisz, A., Karniej, P., & Krasowska, D. (2021). SERVQUAL Method as an Old New Tool for Improving the Quality of Medical Services: A Literature Review. International Journal of Environmental Research and Public Health, 18(20). https://doi.org/10.3390/ijerph182010758

Kawisana, M. G., & Ekawati, N. W. (2024). The Role of Perceived Value in Mediating the Influence of Service Quality on Customer Satisfaction. Jurnal Impresi Indonesia, 3(1), 48–58. https://doi.org/10.58344/jii.v3i1.4602

Kim, Y. T., & Lee, C. W. (2025). The effect of health service quality on health service value and satisfaction. Productivity Research, 39(7), 77–107.

Ledden, L., Kalafatis, S. P., & Samouel, P. (2024). The mediating role of perceived value in higher education service quality and student satisfaction. Studies in Higher Education, 49(3), 412–432.

Lestari, R. B., Widagdo, H., & Meirisa, F. (2024). The Role of Perceived Value in Mediating the Effect of Service Quality on Customer Satisfaction. Forum Bisnis Dan Kewirausahaan, 13(2), 484–492.

Lienata, A., & Berlianto, M. P. (2023). The Effect of Service Quality and Clinic Image on Satisfaction to Mediate Revisit Intention and Loyalty in the Beauty Clinic Industry. Daengku: Journal of Humanities and Social Sciences Innovation, 3(4), 551–563. https://doi.org/10.35877/454RI.daengku1735

Liu, S., Hu, Y., Lu, C., Li, D., & Zhang, Z. (2023). Identifying Patient Perceived Values During Outpatient Encounters: An Empirical Study from Chinese Public Hospitals. BMC Health Services Research, 23, 852. https://doi.org/10.1186/s12913-023-09817-6

Mabini Jr., S. P., Narsico, L. O., & Narsico, P. G. (2024). Service Quality, Patient Satisfaction, and Improvement Indicators. International Journal of Multidisciplinary: Applied Business and Education Research, 5(4), 1331–1345. https://doi.org/10.11594/ijmaber.05.04.18

Ministry of Health of the Republic of Indonesia. (2018). Minister of Health Regulation No. 26 of 2018 on Integrated Electronic Business Licensing Services in the Health Sector. https://farmalkes.kemkes.go.id/unduh/permenkes-26-2018/

Novitasari, D. (2022). Hospital Quality Service and Patient Satisfaction: The Role of Service Excellence and Service Quality. Journal of Information Systems and Management, 1(1).

Noviyani, A., & Viwattanakulvanid, P. (2025). Service Quality as a Driver of Perceived Value, Satisfaction, and Revisit Intention in Indonesia. Scientific Reports, 15. https://doi.org/10.1038/s41598-025-29414-3

Oliver, R. L. (1980). A cognitive model of the antecedents and consequences of satisfaction decisions. Journal of Marketing Research, 17(4), 460–469. https://doi.org/10.1177/002224378001700405

Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–40.

Priyantini, D., Marini, G., Ulfa, A., & Uliyah, M. (2023). Excellent Service and Patient Satisfaction in Health Clinic Services. Fundamental and Management Nursing Journal, 6(1), 18–24. https://doi.org/10.20473/fmnj.v6i1.45670

Rahma, A. Z., Yanuar, T., & Syah, R. (2023). The Relationship Between Service Quality, Patient Satisfaction, Behavioral Intentions, and Prices in Outpatient Healthcare in the Hospital Industry. Jurnal Ekonomi, 12(2).

Rahman, F., Islam, Md. A., & Hadiuzzaman, Md. (2023). Paratransit Service Quality Modeling Reflecting Users’ Perception: A Case Study in Dhaka, Bangladesh. IATSS Research, 47(3), 335–348. https://doi.org/10.1016/j.iatssr.2023.07.001

Satyawati, & Berlianto, M. P. (2022). Service Quality, Patient Satisfaction, and Its Impact on Patient Loyalty at X Hospital. The Enrichment: Journal of Management, 12(4), 2572–2581.

Sinollah & Masruroh. (2019). Measurement of Service Quality (Parasuraman SERVQUAL) in Building Customer Satisfaction to Create Customer Loyalty. https://doi.org/10.36636/dialektika.v4i1.285

Sinyiza, F. W., Kaseka, P. U., Chisale, M. R. O., Chimbatata, C. S., Mbakaya, B. C., Kamudumuli, P. S., Wu, T. S. J., & Kayira, A. B. (2022). Patient Satisfaction with Health Care at a Tertiary Hospital in Northern Malawi: Results from a Triangulated Cross-Sectional Study. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08087-y

Sugiyono. (2025). Statistics for Research. Alfabeta.

Sweeney, J. C., & Soutar, G. N. (2001). Consumer Perceived Value: The Development of a Multiple Item Scale. Journal of Retailing, 77(2), 203–220.

Utami, I. H., Syah, T. Y. R., & Rokiah. (2024). The Effect of Service Quality and Customer Perceived Value: The Intention to Do a Medical Check-Up with Patient Satisfaction as a Mediating Variable at Medika BSD Hospital. Devotion: Journal of Research and Community Service, 5(9), 1137–1147.

Utari, I., Kosasih, & Asnar, E. (2025). Analysis of Service Quality on Patient Satisfaction and Its Implications for Inpatient Patient Loyalty. Jurnal Ners, 9, 6887–6896. https://doi.org/10.31004/jn.v9i4.50384

Vargo, S. L., & Lusch, R. F. (2024). Service-Dominant Logic 5.0: Advancing the Study of Value Co-Creation and Institutions. Journal of Service Research, 27(1), 5–23.

Waty, D. S., Saputri, M. E., & Helen, M. (2025). The Relationship Between Service Quality and Patient Satisfaction in the Primary Clinic of the Directorate General of Regional Development, Ministry of Home Affairs. Journal of Nursing Culture and Technology, 2(1).

Wijaya, T. W., Wiramijaya, F., & Christin, Y. (2023). Descriptive Analysis of Google Reviews to Measure Participant Satisfaction at Branch Offices within Regional Deputy Area XII. Jurnal Jaminan Kesehatan Nasional, 3(2), 11–22. https://doi.org/10.53756/jjkn.v3i2.171

Wulandari, R., Doddy, I. P., & Indaryani, L. (2024). Measuring the Impact of Healthcare Service Quality of Hospitals on Customer Satisfaction. Corporate and Business Strategy Review, 5(1), 336–345. https://doi.org/10.22495/cbsrv5i1siart8

Yogyakarta City Government. (2023). Number of Health Facilities by Subdistrict in Yogyakarta City in 2023. https://dataset.jogjakota.go.id/dataset/kyda2023-23/resource/feefaa53-a403-40e1-b1e8-d2a25b9b2fb5

Yusri, C. R., Hidayat, M., & Djuhaeni, H. (2017). Role of Satisfaction with Health Care Services in Increasing Patient Loyalty: An Ambulatory Setting. Althea Medical Journal, 4(3), 329–334.

Zeithaml, V. A. (1988). Consumer Perceptions of Price, Quality, and Value: A Means-End Model and Synthesis of Evidence. Journal of Marketing, 52(3), 2–22.

Zeithaml, V. A., Verleye, K., Hatak, I., Koller, M., & Zauner, A. (2020). Three Decades of Customer Value Research: Paradigmatic Roots and Future Research Avenues. Journal of Service Research, 23(4), 409–432.

DOI: https://doi.org/10.32535/ijabim.v10i3.4510