ANALYSIS OF THE EFFECT OF SERVICE QUALITY ON PATIENT SATISFACTION IN RSUD ACEH TAMIANG

The purpose of this study was to identify and analyze the effect of service quality on patient satisfaction. The object of this research is RSUD Aceh Tamiang. This study uses a sampling technique using accidental sampling, which is a technique of determining the sample by chance, meaning that anyone who meets the researcher can be used as a sample. The analysis in this study uses multiple linear regression analysis, the results of this study indicate that partially tangible, realibility, responsiveness, assurance, and empathy variables have a positive and significant effect on patient satisfaction at RSUD Aceh Tamiang. The results of this study indicate that the tangible, realibility, responsiveness, assurance, and empathy variables simultaneously have a positive and significant effect on patient satisfaction at RSUD Aceh Tamiang.


INTRODUCTION
Hospital is a health service institution that provides complete individual health services that provide inpatient, outpatient and emergency services. Services in the health sector are one of the most needed forms of service by the community. The hospital is one of the health care facilities that has a very important role in providing health services to the community.
The hospital is an institution in the chain of the national health system and has the task of providing services to the entire community, because the development and implementation of health in hospitals needs to be directed at national goals in the health sector. Therefore, services in the health sector need to be addressed in order to provide the best service for the community. The best service in question is fast, precise, friendly and cheap service. To retain customers, hospitals are required to always maintain consumer trust. Hospital patients not only expect good medical and nursing services, but also want comfort and a harmonious relationship between patients and nurses and hospital staff.
Patients will assess their satisfaction and dissatisfaction after using hospital services, this will be a public assessment of the quality of service at the hospital. Patients will give their perception about the quality of service provided by nurses in the hospital and will provide this information to others by word of mouth. This information will later become information about the good and bad image of the hospital. Providing the best service is not an easy thing for hospital staff and nurses, because it involves the quality of life of their patients. If there is an error in medical action, the hospital must improve the quality of providing facilities, services and independence.
In relation to customers or patients and the quality of service at RSUD Aceh Tamiang, it turns out that the quality of service is still experiencing problems with complaints based on patient recognition. Based on Tangibles, it is considered negative due to poor physical appearance such as buildings and patient rooms, such as faded or peeling paint in the inpatient rooms, AC that does not work properly, there is a broken window and window covering, a broken toilet door due to a loose key. The availability of parking spaces but there are still parking that is not in place, the lack of cleanliness in addition to the patient room because there is still garbage scattered around the room, and the comfort of the room is still lacking.
Meanwhile, reliability is considered to still have shortcomings because there are still general practitioners who diagnose patients' diseases inaccurately, the length of time to find out the diagnosis, the lack of blood stock for patients, and the presence of doctors who are not disciplined in filling their working hours, so that patients feel disappointed with the services of RSUD Aceh Tamiang.
Judging from the complaints submitted by patients. Responsiveness is also considered not able to provide a response or alertness of doctors, nurses, and employees in assisting patients in providing fast and responsive services and making patients not wait long. In fact, judging from the patient's complaints, there are still patients who are still waiting a long time and have not yet received an inpatient room, so patients have to wait a long time to get service from the hospital, sometimes the patient's family feels disappointed and even angry at the hospital.
Assurance, patients still feel lacking in the quality of services provided by doctors, nurses, and employees for their attention and courtesy in providing services.
Empathy (empathy), there are still many patients who have not received the sincere and individual or personal attention given by RSUD Aceh Tamiang to patients by trying to understand their wishes. There are even doctors who are reluctant to see and meet directly with the patient's family because they see the background of the patient and differentiate in providing services, that's where sometimes patients feel sadness and disappointment because there is no direct attention from the doctor who treats them.
In this study, it was also found that several respondents were satisfied with the services of RSUD Aceh Tamiang. This shows a good thing where RSUD Aceh Tamiang continues to improve the quality of its services. Where the reliability and skills of officers in providing health services are important things that must be met. In addition, matters relating to the skills and competencies of health workers must always be updated (upgraded) in accordance with the times. Where health technology and rapidly growing information systems require hospital managers to have a measurable, implementable and scheduled guideline.
Based on the background of the research above, the problem can be formulated, namely (1). How does Tangibles influence patient satisfaction at RSUDAceh Tamiang? (2). How does reliability affect patient satisfaction at RSUDAceh Tamiang? (3). What is the effect of Responsiveness on patient satisfaction at RSUDAceh Tamiang? (4). How is the influence of Assurance on patient satisfaction RSUDAceh Tamiang? (5). How is the influence of Empathy on patient satisfaction at RSUDAceh Tamiang? (6). What is the effect of Tangibles, Reliability, Responsiveness, Assurance, Empathy on patient satisfaction RSUDAceh Tamiang?

LITERATURE REVIEW Definition of Service Quality
Service quality is the ability of a company to provide services that have a direct impact on customer satisfaction according to their needs and desires (Kasmir, 2017). The definition of service quality according to Suwithi in Anwar (2002:84) Service quality is the quality of service provided to customers, both internal customers and external customers based on standard service procedures. Then according to Kotler (2000:25), Service quality is the totality of the characteristics of goods and services that show their ability to satisfy customer needs, both visible and hidden. For companies engaged in the service sector, providing quality services to customers is an absolute thing that must be done if the company wants to achieve success. Based on the above understanding, it can be concluded that service quality is an economic activity that is not in the form of consumption products but is intangible which provides added value such as enjoyment, entertainment, and relaxation.
If the service received by the customer is good, then the service quality is perceived as good (ideal), and vice versa if the service received is not good by the customer, then the service is perceived as bad (less ideal). Quality has become an expectation for consumers who buy a product. Here a marketer must really understand the wants and needs of a consumer, then try to fulfill them in order to increase sales. A quality management system can provide assurance to consumers that the product is produced by a quality process. A quality itself is often considered as a relative measure of the perfection or goodness of a product or service. The universally accepted definition of quality has some similarities, namely in the following elements: 1. Quality includes efforts to meet or exceed customer expectations 2. Quality includes products, services, people, processes and the environment. 3. Quality is an ever-changing condition.

Dimensions of Service Quality
According to Parasuraman et al in Lupiyoadi (2014) that there are five main dimensions known as SERQUAL (Service Quality) used by customers to assess the status of service quality, which are as follows: 1. Tangibles The ability of a company to show its existence to external parties. The appearance and ability of the company's reliable physical facilities and infrastructure as well as the state of the surrounding environment is one way for service companies to provide quality service to customers. It can include physical facilities ISSN (e): 2962-973X https://jaruda.org (buildings, books, tables and chairs, etc), technology (equipment and equipment used), and the appearance of employees.

Reliability
The company's ability to provide services in accordance with what was promised accurately and reliably. Performance must be in accordance with customer expectations which is reflected in timeliness, equal service to all customers without errors, sympathetic attitude and high accuracy.

Responsiveness
Willingness to help customers and provide services quickly and precisely with the delivery of clear information. Ignoring and letting customers wait for no apparent reason causes a negative perception of service quality.

Assurance
Knowledge, courtesy and ability of company employees to foster customer trust in the company. This includes several components, including: a. Communication, which is continuously providing information to customers in clear language and use of words so that customers can easily understand what employees are informed and respond quickly and responsively to complaints and complaints from customers. b. Credibility, the need for guarantees for a trust given to customers, believability or honesty, instilling trust, providing good credibility for the company in the future. c. Security, there is a high trust from customers for the service received. Of course the services provided are able to provide a guarantee of trust. d. Competence is a skill that is owned and needed so that in providing services to customers it can be carried out optimally. e. Courtesy, in service there is a moral value owned by the company in providing services to customers. Guarantees of courtesy offered to customers in accordance with existing conditions and situations.

Empathy
Provide sincere and individual or personal attention given to customers by trying to understand consumer desires where a company is expected to have an understanding and knowledge of customers, understand specific customer needs, and have a comfortable operating time for customers.

Definition of Patient Satisfaction
Satisfaction is a person's feeling of pleasure or disappointment that comes from the comparison between his impression of the performance (results) of a product and his expectations (Djaslim Saladin, 2003). The level of satisfaction of a person is different, there are people who feel satisfied quickly and there are also those who do not feel satisfied quickly because of their high perception of satisfaction with themselves. The level of customer satisfaction of health service institutions is an added value for medical, paramedical, pharmaceutical companies, suppliers of medical equipment, including the leadership of institutions providing health services. Value comes from the type of service provided to customers, or the management system of the institution, or something that is emotional. If customers say that their value is quality health services, then customer satisfaction is the quality of health services. If service users say their value is healing from the disease or health problems they suffer, then customer satisfaction Health is a service that guarantees to provide healing to them (Muninjaya, 2012). Customers / or patients will tell about their experiences to their relatives or closest people about their satisfaction. This will be a good and profitable reference for health care provider institutions, if the service received by the patient is in accordance with what he expected, the patient will definitely come back for treatment again at the health service facility. Patients always look for health facilities whose performance can meet the patient's expectations.

Conceptual Framework
Conceptual framework is a model that explains how the relationship between a theory and important factors that have been known in a particular problem. Based on the research objectives, literature review, and previous research results, the conceptual framework can be seen in Figure 1.

Research Hypothesis
Based on the conceptual framework above, the hypotheses in this study are as follows H1: Tangibles have a positive and significant effect on patient satisfaction at RSUD Aceh Tamiang. H2: Reliability have a positive and significant effect on patient satisfaction at RSUD Aceh Tamiang. H3: Responsiveness have a positive and significant effect on patient satisfaction at RSUD Aceh Tamiang. H4: Assurance have a positive and significant effect on patient satisfaction at RSUD Aceh Tamiang. H5: Emphaty have a positive and significant effect on patient satisfaction at RSUD Aceh Tamiang. H6: Simultaneously Tangibles, Reliability, Responsiveness, Assurance, dan Emphaty have a positive and significant effect on patient satisfaction at RSUDAceh Tamiang.

RESEARCH METHODS Object and Location of Research
This research was conducted at RSUD Aceh Tamiang, Jl. Kesehatan, Karang Baru District, Aceh Tamiang Regency, Aceh Province. The subject of this study is the effect of service quality which includes Tangibles, Reliability, Responsiveness, Assurance, and Empathy on patient satisfaction at RSUD Aceh Tamiang.

Population and Sample
Population is a generalization area consisting of objects/subjects that have certain qualities and characteristics determined by researchers to be studied and then drawn conclusions (Sugiyono, 2015). The population in this study were all patients at the RSUD Aceh Tamiang in 2021, totaling 47,629 people, and from the results of calculations using the Slovin formula, the samples obtained were 100 patients (respondents).

Data Collection Technique
This study uses a sampling technique using accidental sampling, namely the technique of determining the sample by chance, meaning that anyone who meets the researcher can be used as a sample. 3. Responsiveness (X3) is desire to help patients and provide services/services that patients need at RSUD Aceh Tamiang. 4. Assurance (X4) is the ability of the hospital's resources to provide services that are in accordance with the standards expected at RSUD Aceh Tamiang. 5. Emphaty (X5) is the ease of getting services, friendliness, communication and the ability to understand the needs of patients at RSUD Aceh Tamiang. 6. Patient Satisfaction (Y) is the feeling of pleasure or disappointment of the patient that arises after comparing the perception or impression of the performance of the medical, paramedic and staff to RSUD Aceh Tamiang and their expectations

Validity Test
According to Ghozali (2011:52) Validity test is used to measure the validity or validity of a questionnaire. A questionnaire is said to be valid if the questions on the questionnaire are able to reveal something that will be measured by the questionnaire.

Reliability Test
According to Ghozali (2011:47) reliability test is a tool to measure a questionnaire which is an indicator of a variable or construct. A questionnaire is said to be reliable or reliable if a person's answer to the statement is consistent or stable from time to time.

Data Analysis Method
The data analysis method in this research is using multiple regression analysis method to find out how much influence the independent variables (tangibles, reliability, responsiveness, assurance, and empathy) have on the dependent variable is customer satisfaction. To obtain more focused results, this research uses the help of SPSS (Statistical Package for the Social Science). The regression equation can be formulated as follows: Y = β0 + β1 X1 + β2 X2 + β3 X3 + β4 X4 + β5 X5 + ε Where: = Assurance X 5 = Emphaty ε = Error term

Hypothesis Tests 1. Partial Test (t Test)
If tcount > ttable and significance value < 0.05, then H1, H2, H3, H4 and H5, which means that the independent variables consisting of Tangibles, Reliability, Responsiveness, Assurance, and Empathy partially have a significant effect on the dependent variable, namely patient satisfaction.
If tcount < ttable and significance value > 0.05, then H1, H2, H3, H4 and H5, which means that the independent variables consisting of Tangibles, Reliability, Responsiveness, Assurance, and Empathy partially have no significant effect on the dependent variable, namely patient satisfaction.

Simultaneous Test (F Test)
If Fcount > Ftable and significance value < 0.05, then H6 is accepted, which means that the independent variables consisting of Tangibles, Reliability, Responsiveness, Assurance, and Empathy partially have a significant effect on the dependent variable, namely patient satisfaction.

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If Fcount < Ftable and significance value > 0.05, then H6 is rejected, which means that the independent variables consisting of Tangibles, Reliability, Responsiveness, Assurance, and Empathy partially have no significant effect on the dependent variable, namely patient satisfaction.

Validity test
Validity testing is used to measure whether or not a questionnaire is valid. According to Ghozali (2016) A questionnaire can be said to be valid if the statement that is an indicator of a construct contained in the questionnaire is able to reveal something that will be measured by the questionnaire. Ghozali (2016) explain if r count > r table, it means that the statement or indicator is valid. If r count < r table, it means that the indicator or statement is invalid. From the table above, it can be seen that the calculated r value is greater than 0.166, so it can be concluded that each statement item is declared valid.

Reliability Test
Reliability test is an index that shows the extent to which the measuring instrument is reliable. Ghozali (2011) a construct or variable is said to be reliable if it gives an alpha value > 0.60 meaning that the variable is reliable.

Multiple Linear Regression Coefficient Analysis
Multiple linear regression testing explains the magnitude of the role of the Independent Variable (X) on the Dependent Variable (Y). Data analysis in this study using multiple linear regression analysis using SPSS is described in the following description The results of multiple linear regression analysis can be seen as follows: Y= 5.645 + 0,210X1 + 0,312X2 + 0,245X3 + 0,133X4 + 0,140X5 The description of the multiple linear regression equation above is as follows: 1. The coefficient value of Intangibles (X1) is (0.210), so it can be interpreted that if Tangibles is increased by 1 unit of value, it is predicted that Patient Satisfaction will increase by 0.210. 2. The coefficient value of Reliability (X2) is (0.312), so it can be interpreted that if Reliability is increased by 1 unit of value, it is predicted that Patient Satisfaction (Y) will increase by 0.312. 3. The coefficient value of Responsiveness (X3) is (0.245), so it can be interpreted that if Responsiveness is increased by 1 unit value, it is predicted that Patient Satisfaction (Y) will increase by 0.245. 4. The coefficient value of Assurance (X4) is (0.133), so it can be interpreted that if Assurance is increased by 1 unit of value, it is predicted that Patient Satisfaction (Y) will increase by 0.133. 5. The coefficient value of Empathy (X 5 ) is (0.140), so it can be interpreted that if Empathy is increased by 1 unit of value, it is predicted that Patient Satisfaction (Y) will increase by 0.140. 4. Assurance (X4) has a positive and significant effect on patient satisfaction at the RSUD Aceh Tamiang 5. Empathy (X5) has a positive and significant effect on patient satisfaction at the RSUD Aceh Tamiang 6. Simultaneous testing of tangibles (X1), reliability (X2) responsiveness (X3) assurance (X4) and empathy (X5) variables have a positive and significant effect on patient satisfaction at RSUD Aceh Tamiang

Suggestion
Some suggestions that the author can give include: 1. For RSUD Aceh Tamiang, it is necessary to routinely observe its services in order to maintain the existing advantages and always improve the quality of service on the variables that are still under-assessed or according to the patient's assessment it is not as expected by the patient. this can be done by paying more attention to the needs and desires of patients, improving facilities and infrastructure, guaranteeing a sense of security, comfort, and trust as well as the promised services quickly, accurately and definitely so that it will increase patient satisfaction. 2. For further researchers, it is hoped that it can be continued or developed by adding other variables that can affect patient satisfaction. And it can be seen from the coefficient of determination that the magnitude of the effect of tangibles (X1), reliability (X2), responsiveness (X3), assurance (X4), and empathy (X5) on patient satisfaction (Y) is 40% while the remaining 60% is caused by another variable.