Integration of importance-performance analysis into testing of the relationship between hospital service performance, satisfaction and loyalty with PLS-SEM approach

Improvement of service performance, customer satisfaction, and loyalty give a significant contribution to business performance and profitability. This study aims first to identify the most critical factors related to hospital service performance in predicting the patients satisfaction. Second, to examine the effect of patient satisfaction on patient loyalty. This research is a quantitative study with a cross-sectional approach, involving 280 outpatients conducted in two hospitals. Finally, the partial least square-structural equation modelling (PLSSEM) approach was performed to analyze the data. The result showed the lowest index performance is the outcome quality (49.84), and the highest is the quality of personnel (72.49). The calculation of the patient satisfaction index (PSI) is 67.48. Patient satisfaction is significantly influenced by the quality of personnel, outcome quality, social responsibility, administrative procedure, and physical aspect. Patients satisfaction has a significant effect on patient loyalty. However, health insurance, quality of medical care, and quality of pharmaceutical care have no significant effect on patient satisfaction. The map of importance-performance analysis (IPA) suggest the hospital institution needs to improve the physical aspect, administrative procedure and outcome quality. The overall patient are satisfied with the performance of hospital services. Patients are objective controls of an organization. Therefore, the focus of hospital managers on strategies for building relationships with patients.