THE EFFECT OF HEALTHCARE PROVIDERS’ SERVQUAL DIMENSIONS ON PATIENT LOYALTY AT ARJASA COMMUNITY HEALTH CENTER
DOI:
https://doi.org/10.31959/jm.v15i2.3744Abstract
Introduction: Community health centers (puskesmas) play a vital role in delivering primary healthcare services, where the quality of medical personnel services is a key determinant of patient loyalty. Despite an improvement in the Community Satisfaction Index (IKM) at Arjasa Community Health Center from 78.5% in 2023 to 81.2% in 2024, patient loyalty has not yet reached an optimal level. This study applies the SERVQUAL framework to examine how service quality influences patient loyalty in a primary healthcare context.
Methods: This study employed an associative quantitative approach with a correlational survey design. Data were collected from 100 patients at Arjasa Community Health Center using a questionnaire consisting of 15 SERVQUAL items and 6 patient loyalty items. Data analysis was conducted in SPSS, including validity and reliability tests and simple linear regression.
Results: The findings indicate that medical personnel’s SERVQUAL has a significant and positive effect on patient loyalty. The regression analysis yielded a correlation coefficient (R) of 0.637 and a coefficient of determination (R²) of 0.405, indicating that 40.5% of the variation in patient loyalty is explained by service quality. The F-test confirmed that the regression model is statistically significant (F = 66.842; p < 0.001). The t-test results showed that SERVQUAL exerts a significant partial effect on patient loyalty (t = 8.176; p < 0.001), with responsiveness and empathy emerging as the most influential dimensions in shaping patient loyalty at the community health center.
Conclusion and suggestion: This study concludes that service quality among medical personnel, measured using the SERVQUAL model, significantly predicts patient loyalty in primary healthcare settings. Responsiveness and empathy play dominant roles in strengthening long-term patient relationships. Accordingly, Arjasa Community Health Center should prioritize the development of interpersonal competencies through communication training, reinforcement of empathetic service attitudes, and improved service time management. Future studies should include variables and samples to enhance generalizability.
Keywords: Community Health Center, Medical Personnel; Patient Loyalty; SERVQUAL
References
Adams, C., Walpola, R., Iqbal, M. P., Schembri, A., & Harrison, R. (2025). The three pillars of patient experience: Identifying key drivers of patient experience to improve quality in healthcare. Journal of Public Health, 33(10), 2105–2113. https://doi.org/10.1007/s10389-023-02158-y
Addo, A. A., Wang, W., Dankyi, A. B., Abban, O. J., & Bentum-Micah, G. (2020). Sustainability of health institutions: The impact of service quality and patient satisfaction on loyalty. European Journal of Business and Management Research, 5(4). https://ejbmr.org/index.php/ejbmr/article/view/345
Adil, A., Liana, Y., Mayasari, R., Lamonge, A. S., Ristiyana, R., Saputri, F. R., Jayatmi, I., Satria, E. B., Permana, A. A., & Rohman, M. M. (2023). Metode Penelitian Kuantitatif dan Kualitatif: Teori dan Praktik. Jakarta: Get Press Indonesia. https://www.researchgate.net/profile/Moh-Rohman-3/publication/377329440_
Adongo, A. A., Mokulogo, R. K., Bodpii, D. N., & Akazili, J. (2025). A comparative study of Patient Perceptions of Public and Private Healthcare Service Quality: Insights from the SERVQUAL Model. https://www.researchsquare.com/article/rs-6874731/latest
Akbar, F. H., Ulfah, U., & Maretta, Y. A. (2020). The effect of health services quality on satisfaction and loyalty in West Sulawesi Province, Indonesia. Open Access Macedonian Journal of Medical Sciences, 8(D), 150–157.
Alabbas, A. M., Alzahrani, F. E., Alsulami, A. A., Almogati, M. W., Alhutayrashi, Y. S., Althobaiti, A. S., Alotaibi, M. M., Alotaibi, M. A., Alofi, A. S., Alsarawani, T. M., Alotaibi, A. N., Allehyani, M. M., Allehyani, M. M., Almatrafi, A. F., Alotaibi, A. O., Almotairi, Y. M., Almalki, H. S., Alrefai, M. S., Aloufi, Y. S., … Albaqami, A. S. (2024). The Effect of Service Quality on Patient Satisfaction at King Faisal Hospital in Saudi Arabia. Journal of Ecohumanism, 3(8). https://doi.org/10.62754/joe.v3i8.4928
Aladwan, M. A., Salleh, H. S., Anuar, M. M., ALhwadi, H., & Almomani, I. (2021). The relationship among service quality, patient satisfaction and patient loyalty: Case study in Jordan Mafraq hospital. Linguistics and Culture Review, 5(S3), 27–40.
Alfiannor, A., Syamsuddinnor, S., & Tusiana, D. (2025). The Influence Of Patient Trust And Service Digitalization On General Patient Satisfaction With Service Quality As An Intervening Variable. Indonesian Financial Management Association (IFMA). http://repository.stimi-bjm.ac.id/id/eprint/11/1/PROSIDING%20INTERNASIONAL%20ALFIANNOR.pdf
Ali, A., & Salameh, A. A. (2024). Financial performance and service quality of Saudi Arabia banks: An analytical approach. Uncertain Supply Chain Management, 12(4), 2795–2806.
Ali, J., Jusoh, A., Idris, N., & Nor, K. M. (2024). Healthcare service quality and patient satisfaction: A conceptual framework. International Journal of Quality & Reliability Management, 41(2), 608–627.
Almomani, R. Z. Q., Al-Ghdabi, R. R., & Banyhamdan, K. (2020). Patients’ satisfaction of health service quality in public hospitals: A PubHosQual analysis. Management Science Letters, 10(8), 1803–1812.
AlOmari, F., & A. Hamid, A. B. (2022). Strategies to improve patient loyalty and medication adherence in Syrian healthcare setting: The mediating role of patient satisfaction. PloS One, 17(11), e0272057.
Alshahrani, A. M. (2023). Predictors of patients’ satisfaction with primary health care services in the Kingdom of Saudi Arabia: A systematic review. Healthcare, 11(22), 2973. https://www.mdpi.com/2227-9032/11/22/2973
Azhari, M. T., Al Fajri Bahri, M. P., Asrul, M. S., & Rafida, T. (2023). Metode penelitian kuantitatif. PT. Sonpedia Publishing Indonesia.
Balaka, M. Y. (2022). Buku Metodologi Penelitian Kuantitatif. Penerbit Widina.
Bentum-Micah, G., Ma, Z., Wang, W., Atuahene, S. A., & Bondzie-Micah, V. (2020). Perceived service quality, a key to improved patient satisfaction and loyalty in healthcare delivery: The servqual dimension approach. Journal of Health and Medical Sciences, 3(2). https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3603338
Brandão, A., & Ribeiro, L. (2023). The Impact of Patient Experience on Loyalty in the Context of Medical-Aesthetic Health Services. Journal of Patient Experience, 10, 23743735231160422. https://doi.org/10.1177/23743735231160422
Chen, M., Guan, Q., & Zhuang, J. (2024). Patient-centered lean healthcare management from a humanistic perspective. BMC Health Services Research, 24(1), 1261. https://doi.org/10.1186/s12913-024-11755-w
Cheng, B. L., Gan, C. C., Imrie, B. C., & Mansori, S. (2019). Service recovery, customer satisfaction and customer loyalty: Evidence from Malaysia’s hotel industry. International Journal of Quality and Service Sciences, 11(2), 187–203.
Creswell, J. W., & Creswell, J. D. (2023). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. SAGE-Publications.
Cui, J., Du, J., Zhang, N., & Liang, Z. (2025). National Patient Satisfaction Survey as a Predictor for Quality of Care and Quality Improvement – Experience and Practice. Patient Preference and Adherence, Volume 19, 193–206. https://doi.org/10.2147/PPA.S496684
Darmawan, D., Ramadhani, Y. R., Harto, P., Gumilar, E. B., Lusiani, L., Pramayanti, D. I., Arsawan, I. W. E., Wicaksono, G., Nisa, T. F., & Tanwir, T. (2024). Metode penelitian kuantitatif. https://repository.penerbiteureka.com/media/publications/568092-metode-penelitian-kuantitatif-1bd2fc11.pdf
Della Puspita, F., & Aryanny, E. (2024). Analysis Quality of Service using Service Performance and Importance Performance Analysis Method at Community Health Center. The Indonesian Journal of Computer Science, 13(3). http://ijcs.net/ijcs/index.php/ijcs/article/view/3949
Edgman-Levitan, S., & Schoenbaum, S. C. (2021). Patient-centered care: Achieving higher quality by designing care through the patient’s eyes. Israel Journal of Health Policy Research, 10(1), 21. https://doi.org/10.1186/s13584-021-00459-9
Faeni, D. P. (2023). SERVQUAL measures: Indonesian government healthcare (BPJS) from a human resource perspective. Journal of Infrastructure, Policy and Development, 8(2). https://doi.org/10.24294/jipd.v8i2.2271
Fu, W. Y., Senathirajah, A. R. bin S., Connie, G., Sheng, L. Y., & San, L. H. (2022). Modeling consumers’ perceptions of service quality: A triangulation approach using phenomenological and structured equation analysis. International Journal of Health Sciences, 6(S5), 10776–10793.
Goodrich, G. W., & Lazenby, J. M. (2023). Elements of patient satisfaction: An integrative review. Nursing Open, 10(3), 1258–1269. https://doi.org/10.1002/nop2.1437
Hazeem AlBalushi, T. (2021). E-Services Quality: A Perspective of Service Providers and Service Users. In K. Kang (Ed.), Digital Service Platforms. IntechOpen. https://doi.org/10.5772/intechopen.97077
Hendarini, Y., Setiawan, R., & Herlambang, T. (2025). The Influence of Supporting Facilities, the Quality of Health Center Services, and the Competence of Medical Personnel on Patient Satisfaction Levels. Proceedings Series on Social Sciences & Humanities, 26, 150–159. https://doi.org/10.30595/pssh.v26i.1819
Holmes Fee, C., Hicklen, R. S., Jean, S., Abu Hussein, N., Moukheiber, L., de Lota, M. F., Moukheiber, M., Moukheiber, D., Anthony Celi, L., & Dankwa-Mullan, I. (2023). Strategies and solutions to address Digital Determinants of Health (DDOH) across underinvested communities. PLOS Digital Health, 2(10), e0000314.
Huo, Y., Kang, X., Zhong, C., Shi, L., Liu, R., & Hu, R. (2023). The quality of migrant patients’ primary healthcare experiences and patient-centered medical home achievement by community health centers: Results from the China greater bay area study. International Journal for Equity in Health, 22(1), 114. https://doi.org/10.1186/s12939-023-01929-z
IKM. (2024). Indek Kepuasan Masyarakat (IKM) Puskesmas Arjasa, Jember 2024. Puskesmas Arjasa.
Janowski, M., Dahlgren, O., Taylor, K.-A., Kaza, I., Alam, A., Papadimos, T. J., Pellegrino, A. N., & Stawicki, S. P. (2021). Creating Long-Lasting Clinical Connections: A Trainee-Centered, Leadership-Based Perspective on Provider-Patient Relationship. In Contemporary Topics in Graduate Medical Education-Volume 2. IntechOpen. https://www.intechopen.com/chapters/74762
Karume, A. K., Nyongesa, K., Okutoyi, L., & Kinuthia, J. (2025). Patient’s expectations and perceptions on quality of care; An evaluation using SERVQUAL gap in Kenya. PloS One, 20(3), e0315910.
Kijima, T., Matsushita, A., Akai, K., Hamano, T., Takahashi, S., Fujiwara, K., Fujiwara, Y., Sato, M., Nabika, T., Sundquist, K., Sundquist, J., Ishibashi, Y., & Kumakura, S. (2021). Patient satisfaction and loyalty in Japanese primary care: A cross-sectional study. BMC Health Services Research, 21(1), 274. https://doi.org/10.1186/s12913-021-06276-9
Kurniawan, S., & Rahman, M. A. (2025). Customer loyalty in the culinary product market: The role of satisfaction in mediating the relationship between service quality, product value, and pricing. Journal of Economic, Business & Accounting Research, 3(1), 77–89. https://doi.org/10.61511/jembar.v3i1.2025.1692
Lampus, N. S., & Wuisan, D. S. (2024). Correlation between doctor-patient communication with patient satisfaction and loyalty. Medical Scope Journal, 6(2), 149–158.
Lerch, S. P., Hänggi, R., Bussmann, Y., & Lörwald, A. (2024). A model of contributors to a trusting patient-physician relationship: A critical review using a systematic search strategy. BMC Primary Care, 25(1), 194. https://doi.org/10.1186/s12875-024-02435-z
Li, L., Zhang, Q., Zhu, L., Zeng, G., Huang, H., Chen, Z., Zhou, X., Wang, X., Xu, Z., Wu, C., Yang, D., Zhai, X., Yang, S., Lu, Z., Gan, Y., & Lu, Z. (2025). Patients’ loyalty to primary care institutions and associated factors in China: A cross-sectional study. BMC Health Services Research, 25(1), 162. https://doi.org/10.1186/s12913-025-12244-4
Li, M., Zhang, X., Tang, H., Zheng, H., Long, R., Cheng, X., Cheng, H., Dong, J., Wang, X., & Zhang, X. (2024). Quality of primary healthcare for chronic diseases in low-resource settings: Evidence from a mixed methods study in rural china. medRxiv, 2024–05.
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.
Mardaleta, M., Lubis, A. R., Diantimala, Y., & Fahlevi, H. (2022). Determinants of patient behavioural loyalty on primary health centres: Evidence from a cross-sectional study in Indonesia. F1000Research, 11, 440.
Mei, Y., Xu, X., & Li, X. (2020). Encouraging patient engagement behaviors from the perspective of functional quality. International Journal of Environmental Research and Public Health, 17(22), 8613.
Memon, M. A., Ting, H., Cheah, J.-H., Thurasamy, R., Chuah, F., & Cham, T. H. (2020). Sample Size for Survey Research: Review and Recommendations. Journal of Applied Structural Equation Modeling, 4(2), i–xx. https://doi.org/10.47263/JASEM.4(2)01
Mohd‐Any, A. A., Sundramohana, M., & Sarker, M. (2022). Does patient empowerment matter in building loyalty? International Journal of Consumer Studies, 46(2), 653–675. https://doi.org/10.1111/ijcs.12718
Muslimin, D., Majid, M. N., Effendi, N. I., Simarmata, N., Ristiyana, R., Langelo, W., & Januarsi, Y. (2023). Metodologi Penelitian Kuantitatif dan Kualitatif. Pertama, Global Eksekutif Teknologi. Pertama. Edited by N. Mayasari. Padang.
Nasser Albarqi, M. (2024). Continuity and sustainability of care in family medicine: Assessing its association with quality of life and health outcomes in older populations—A systematic review. PloS One, 19(12), e0299283.
Oster, A., Wiking, E., Nilsson, G. H., & Olsson, C. B. (2024). Patients’ expectations of primary health care from both patients’ and physicians’ perspectives: A questionnaire study with a qualitative approach. BMC Primary Care, 25(1), 128. https://doi.org/10.1186/s12875-024-02389-2
Parasuraman, A., Zeithaml, V. A., & Berry, L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. 1988, 64(1), 12–40.
Pertiwi, I. (2021). Unlocking Patient Satisfaction Exploring the Important Link Between Health Care Professional Services and Outpatient Satisfaction. Journal of Health Literacy and Qualitative Research, 1(1), 10–17.
Prabaharan, T., & Thishopana, B. (2024). Optimizing Queue Management in Healthcare Settings: Enhancing Patient Satisfaction through Strategic Approaches. Asian Journal of Economics, Business and Accounting, 24(5), 525–534.
Prakash, P. (2024). Servqual method– A tool for quality assurance in health care. IP Annals of Prosthodontics and Restorative Dentistry, 10(2), 101–105. https://doi.org/10.18231/j.aprd.2024.020
Prasetyo, I., Rusdiyanto, R., Asyik, N. F., Aliyyah, N., Haidar, R. L., & Burhan, U. (2024). The Role of Health Facility in Mediating Service Quality and Patient Perceptions of Hospital Patient Satisfaction. Journal of Management World, 2024(4), 662–682.
Pratama, V., & Hartini, S. (2020). The effect of perception of health care service quality on patient satisfaction and loyalty in mother and child hospital. JTheory Appl Manag, 13(3). https://pdfs.semanticscholar.org/d091/a7a88d94633df55cc8672c96c1af041c8735.pdf
Putri, W. T., Suwandi, S., & Susamto, B. (2025). Kyai Hegemony as Proxy Marriage Guardians within Madurese ‘Urf Tradition. Academia Open, 10(2), 10–21070.
Rahmatia, S., Basri, M., Ismail, I., Adi, S., Nasrullah, N., & Ahmad, A. (2025). Service quality in hospital inpatient care: SERVQUAL model approach. Health SA Gesondheid, 30, a3055. https://doi.org/10.4102/HSAG.v30i0.3055
Ramana, Y. V. S. (2025). Modelling the causal relationships between service quality, operational efficiency, and satisfaction of patients in public healthcare systems. International Journal of Applied Mathematics, 38(4s), 389–400.
Razzaq, M., Rasheed, S., Khan, S., & Ahmed, D. S. (2024). The Effect of Service Quality on Patient Loyalty with Mediation of Patient Relationship Management and Moderation of Hospital Brand Image. International Journal of Research and Innovation in Social Science, 8(11), 832–866.
Saksitha, D. A., & Jailani, M. S. (2024). Ragam Pendekatan Penelitian Kuantitatif Dan Kualitatif Serta Tahapan Dalam Penelitian. Jurnal Genta Mulia, 15(1), 15–22.
Secci, F., & Syed, S. (2023). Embedding quality in primary healthcare. Bmj, 381. https://www.bmj.com/content/381/bmj.p883
Setiono, B. A., & Hidayat, S. (2022). Influence of Service Quality with the Dimensions of Reliability, Responsiveness, Assurance, Empathy and Tangibles on Customer Satisfaction. International Journal of Economics, Business and Management Research, 06(09), 330–341. https://doi.org/10.51505/IJEBMR.2022.6924
Setyaningsih, I., & Widagdo, M. B. F. (2023). Service performance of Indonesian private hospitals: An empirical study using the SERVPERF and IPA approach. KINERJA, 27(2), 294–304.
Shie, A.-J., Huang, Y.-F., Li, G.-Y., Lyu, W.-Y., Yang, M., Dai, Y.-Y., Su, Z.-H., & Wu, Y. J. (2022). Exploring the relationship between hospital service quality, patient trust, and loyalty from a service encounter perspective in elderly with chronic diseases. Frontiers in Public Health, 10, 876266.
Sihotang, H. (2023). Metode penelitian kuantitatif. Uki Press. http://repository.uki.ac.id/13063/
Söderberg, D., Bonn, S. E., Sjöblom, L., Dahlgren, A., Muli, I., Amer-Wåhlin, I., Bertilson, B. C., Farrokhnia, N., Hvitfeldt, H., Taloyan, M., Hägglund, M., & Trolle Lagerros, Y. (2024). Visit Experience and Fulfillment of Care Needs in Primary Care Differs for Video Visits Compared to In-person and Chat Visits. Journal of General Internal Medicine, 39(15), 2881–2887. https://doi.org/10.1007/s11606-024-08781-z
Subhaktiyasa, P. G. (2024). Menentukan Populasi dan Sampel: Pendekatan Metodologi Penelitian Kuantitatif dan Kualitatif. Jurnal Ilmiah Profesi Pendidikan, 9(4), 2721–2731.
Sundram, S., Tambvekar, S. E., Sekar, S., Tiwari, S. K., & Gopinathan, R. (2022). The Effect Of Service Quality On Patient Loyalty Mediated By Patient Satisfaction. Journal of Pharmaceutical Negative Results, 13.
Susanto, P. C., Arini, D. U., Yuntina, L., Soehaditama, J. P., & Nuraeni, N. (2024). Konsep Penelitian Kuantitatif: Populasi, Sampel, dan Analisis Data (Sebuah Tinjauan Pustaka). Jurnal Ilmu Multidisplin, 3(1), 1–12.
Syaiful, R., & Astuti, M. (2022). The Effect of Product Quality, Price and Product Design on Purchasing Decisions of Sasword Disutoru Products. Indonesian Journal of Law and Economics Review, 14. https://doi.org/10.21070/ijler.v14i0.750
Ubery, Y. F., & Ernawaty, E. (2024). Determinants of Patient Loyalty: A Systematic Review. MAHESA : Malahayati Health Student Journal, 4(9), 4127–4147. https://doi.org/10.33024/mahesa.v4i9.15612
Wider, W., Tan, F. P., Tan, Y. P., Lin, J., Fauzi, M. A., Wong, L. S., Tanucan, J. C. M., & Hossain, S. F. A. (2024). Service quality (SERVQUAL) model in private higher education institutions: A bibliometric analysis of past, present, and future prospects. Social Sciences & Humanities Open, 9, 100805. https://doi.org/10.1016/j.ssaho.2024.100805
Xavier, P. B., Silva, Í. de S., Dantas, T. H. de M., Lopes, R. H., de Araújo, A. J., de Figueirêdo, R. C., & Uchôa, S. A. da C. (2024). Patient satisfaction and digital health in primary health care: A scoping review protocol. Frontiers in Public Health, 12, 1357688.
Yanuarista, G. S., Arso, S. P., & Winarni, S. (2025). Correlation between Hospital Image and Patient Satisfaction toward Loyalty in Hospital: A Scoping Review. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 8(5), 371–387.
Yunningsih, Y. (2022). Physical Evidence, Reliability, Responsiveness, Assurance And Empathy Of Service Quality On Inpatient Patient Satisfaction: Study A Regional General Hospitals. Journal of Resource Management, Economics and Business, 1(2). https://portal.xjurnal.com/index.php/REMICS/article/view/40
Yusefi, A. R., Davarani, E. R., Daneshi, S., Bastani, M., Mehralian, G., & Bastani, P. (2022). Responsiveness level and its effect on services quality from the viewpoints of the older adults hospitalized during COVID-19 pandemic. BMC Geriatrics, 22(1), 653. https://doi.org/10.1186/s12877-022-03344-5
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Siti Lusiawati, Amin Silalahi , Harmawan Teguh Saputra

This work is licensed under a Creative Commons Attribution 4.0 International License.
Access and Licensing
All articles published in Jurnal Maneksi (Management Ekonomi Dan Akuntansi) are available immediately upon publication without any embargo period. No registration or subscription fees are required to access our content.
To facilitate clarity and ease of reuse, Jurnal Maneksi (Management Ekonomi Dan Akuntansi) adopts Creative Commons licenses. By default, all articles are published under the Creative Commons Attribution License (CC BY 4.0). This license permits unrestricted use, distribution, and reproduction in any medium, provided that proper attribution is given to the original author(s) and source.
Copyright Policy
Authors publishing in Jurnal Maneksi (Management Ekonomi Dan Akuntansi) retain copyright over their work. By submitting and publishing with Jurnal Maneksi (Management Ekonomi Dan Akuntansi), authors grant the journal the right of first publication under their chosen open-access license. This ensures that authors maintain full control over their intellectual property while enabling broad dissemination and reuse of their work.
Authors are also encouraged to:
- Share their published articles in institutional repositories or personal websites, ensuring proper acknowledgment of initial publication in Jurnal Maneksi (Management Ekonomi Dan Akuntansi).
- Enter into non-exclusive agreements for further distribution, such as including their articles in books or other publications.








