THE INFLUENCE OF INFRASTRUCTURE AND SERVICE QUAL-ITY ON COMMUNITY SATISFACTION AT THE REGIONAL GENERAL HOSPITAL BUMI PANUA OF POHUWATO REGENCY

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INTRODUCTION
Health service agencies are a part of public service institutions.The hospital is one of the service sectors with the main goals for referral services with the hope of patient satisfaction.These goals can be realized when the services provided are following the expectations and needs of the patient.The hospital in its activities carries out 2 (two) functions, namely an economic function with a profit orientation that also promotes social functions.To achieve the desired goals to achieve profit, the hospital must improve the quality of service.To improve the quality of care, efforts must be made to identify the various expectations and needs of patients.Quality in health services is a series of characteristic forms of goods and services that show their ability to satisfy customers, for service companies providing quality services to customers is an obligation that must be carried out to achieve success [2].
Health services in Indonesia have good experienced development and have good economic prospects.Therefore, these conditions make the competition even more competitive.Every company relating to the health service industry must be able to use various methods to attract customers through quality service.Health service providers are aware of this, so they continue to try to achieve customer satisfaction with various strategies to retain their customers."Satisfaction is an attitude that is decided based on the experience gained.Satisfaction is an assessment of the characteristics or features of a product or service, or the product itself, which provides a level of consumer pleasure related to meeting consumer consumption needs [4].The good feeling that you have when you achieved something or when something that you wanted to happen does happen [10].
The efforts of strategies carried out by service providers in the hospital have a major problem regarding whether the services provided are by patient expectations or not.Therefore, the hospital is required to always maintain patient trust by improving the quality of its services.Several assumptions state that quality health services are can satisfy every user of health services according to the level of satisfaction and whose administration is by established standards and ethical codes.The production factor of the quality of health services comes from the officers/staff owned by the hospital itself, including doctors, nurses, administrative officers, and other officers [8].Hospitals need to provide services according to what patients expect, with appropriate services so that the patient's expectations of service can be fulfilled so that it has an impact on patient satisfaction.Hospitals need to know how to serve patients effectively and quickly.Services have been patient-oriented because the measure of perceived quality is not in the view of the health care provider but the patient.
One of the accreditation standards contained in the group of patient-focused service standards is patient and family rights.The hospital has a process to respond to the requests of patients and their families, for spiritual services or the like regarding the patient's religion and beliefs.Each patient is unique, with individual needs, strengths, values, and beliefs.The hospital builds trust and open communication with patients to understand and protect the cultural, psychosocial, and spiritual values of each patient.Spiritual services at RSUD Bumi Panua can be said to have run well, where patients and families who need clergy or special worship will be facilitated by health workers by presenting clergy needed by patients and families.
Besides, to improve the quality of services provided to consumers, hospitals also need to think about infrastructure or the existence of health service support facilities.The existence of facilities such as suggestion and complaint boxes will assist the hospital in obtaining information about what the customers want and need.Customers will find it easier to convey things that are dissatisfied with getting service.Improvement of hospital facilities and infrastructure also needs to be done to prevent the emergence of obstacles in the provision of quality health services.With the improvement of facilities and infrastructure, it is hoped that the hospital will be able to anticipate various technical problems faced by patients in getting quality services.The facility is a means that makes it easier for consumers to carry out an activity.Facilities are one of the considerations for consumers in making choices.At almost the same price level, the more complete the facilities provided by the hospital, the more satisfied the customer will be and he will continue to choose the company as the priority choice based on the perception he gets of the available facilities.Facilities and infrastructure are often equated with facilities.Health service infrastructure can be defined as a collaborative process for the utilization of all health facilities and infrastructure effectively and efficiently to provide professional services in the field of facilities and infrastructure in an effective and efficient health service [7].
In the service sector, there is a description of the task of handling complaints as stated in the Decree of the Director of Bumi Panua Hospital No.19 of 2018 concerning the service standards of RSUD Bumi Panua, Pohuwato Regency, however, for Standard Operating Procedures (SOP) and the flow of complaint handling has not been written including the time provisions (response time) the length of time the complaint was handled.
According to the complaint data from the service sector, it shows that the total of patients complaining about services at the RSUD Bumi Panua in 2016 was 131 people, increasing in 2017 to 343 people and 247 in 2018.The total of patient complaints according to the statements of many service officers was not recorded because it is light and is immediately resolved in-service units.
From 721 complaints during the 3 years, it was identified that most cases were the use of unclear guarantee cards by patients.Patients or patients' families convey complaints about hospital services through various ways, for example by coming directly to service units or the service sector, through mass media (newspapers), Facebook (social media) through call centers.Various causes that can lead to complaints include communication problems with officers, waiting times, unclear procedures and information, tariffs or service fees, and others such as problems with hospital facilities, security, and others.
From the 721 complaints that were recorded, 1 case destroyed hospital facilities and infrastructure, 1 case caused the hospital to provide compensation money, 1 case eventually led to a community demonstration coming to the hospital, almost beating the officers, 3 cases entered the mass media causing the directors of the RSUD Bumi Panua to be summoned by the Regional Government (Bupati) who is the owner of the RSUD Bumi Panua to be asked for information regarding the problem of patient complaints against services.By the serious impact of these complaints and the 6 cases that have not been resolved with explanations, effective and efficient management of patient complaints at Bumi Panua Regional General Hospital, especially from the perspective of officer communication, needs to be used as a study material.
Besides, from the results of preliminary observations, there were several complaints from the public as a user of RSUD Bumi Panua, Pohuwato Regency, including; There is a lack of doctors and specialist doctors in the hospital so that it has an impact on slow response time, handling of community complaints that are not well organized so that there are still many families who complain through social media, the existence of changing BPJS rules results in community complaints only to the hospital.
From some of the phenomena above, the researcher interested in conducting scientific research in the form of a thesis with the title "The influence of infrastructure and service quality on community satisfaction at the Regional General Hospital Bumi Panua of Pohuwato Regency" Satisfaction is a function of the perceived performance differences with expectations.If the performance is below expectations, the community will be disappointed.If the performance is in line with expectations, the community will be satisfied.Meanwhile, if the performance exceeds expectations, the community will be very satisfied.Community expectations can be shaped by past societies, comments from relatives and promises and information from marketers and rivals.Satisfied citizens are loyal longer, are less price sensitive and comment favorably on public organizations.
The word satisfaction (satisfaction) comes from the Latin "satis" (meaning good enough, adequate) and "facio" (doing or making) so that satisfaction can be interpreted as "an effort to fulfill something" or "make something adequate".Satisfaction is a feeling of pleasure or disappointment in someone who arises after comparing their perceptions/impressions of the performance of a product and expectations [2].
Satisfaction is an attitude that is decided based on the experience gained.Satisfaction of consumer orders regarding the characteristics or features of the product or service, or the product itself, which provides a level of consumer satisfaction related to meeting consumer needs.Customer satisfaction can be created through quality, service and value.The key to generating customer loyalty is to provide high customer value [4].
If the performance exceeds expectations, the customer will be very satisfied.Satisfaction can be defined as "an effort to fulfill something" or "to make something adequate".Oxford Advanced Learner's Dictionary describes satisfaction as "the good feeling that you have when you achieved something or when something that you wanted to happen does happen which means the pleasant feeling you feel when you achieve something or when something is expected to happen, true -lt happened [10].
Satisfaction is a kind of behavioral assessment that occurs after the experience of consuming services [4].Customer satisfaction is a customer response to a perceptual evaluation of the difference between initial expectations before purchase (or other performance standards) and the actual performance of the product as perceived after using or consuming the product in question.Most research results indicate that confirmation or disconfirmation of pre-consumption expectations is a determining factor of satisfaction.The assessment results will be labeled with positive disconfirmation if the service is better than expectations, negative disconfirmation if the service is worse than expectations, and regular confirmation if the service is in line with expectations.
The implementation of public services by government officials to the community is closely related to efforts to create community satisfaction as service recipients.This is actually an implication of the function of the state apparatus as a public servant.Therefore, the position of the government apparatus in public services is very strategic because it will determine the extent to which the government is able to provide the best possible service to the community, which will thus determine the extent to which the state has carried out its role properly in accordance with the objectives of its establishment.
The responses and expectations of the customer community for the services they receive, both in the form of goods and services, will create satisfaction in them.This is in line with the objectives of public services in general, namely to prepare these public services that are wanted or needed by the public, and how to properly state to the public about their choices and how to access them that are planned and provided by the government to create satisfaction in the public.
Service efforts taken in order to create public satisfaction are generally carried out by determining the public services provided, of any kind, treating service users, as customers, trying to satisfy service users, according to what they want, looking for the best way of service delivery and quality.This effort departs from the problem of public satisfaction with what is provided by the servants in this case, namely that public administration is the government itself with what they want, that is to what extent the public hopes for what they ultimately receive.
Patient satisfaction is closely related to comfort, friendliness, and speed of service.Patient satisfaction is an indicator related to the number of patient or family complaints, criticism in the column of practicing mall complaint readers, reports from staff and nurses and so on.Satisfaction is often associated with quality.Quality means customer satisfaction, both internal and external.Satisfaction is not only for customers or patients but will be felt by health workers.If the satisfaction of health satisfaction is met, it is hoped that it will provide services that satisfy patients or customers.In the health sector, quality is the fulfillment of the desires of a person who most needs health services that satisfy customers in accordance with the average level of customer satisfaction and are provided according to professional ethics.
Infrastructure is often equated with facilities.Health service infrastructure can be defined as the process of collaborating the utilization of all health facilities and infrastructure effectively and efficiently to provide professional services in the field of facilities and infrastructure in an effective and efficient health service process [7].Completeness of good infrastructure is very important in creating customer satisfaction.
Facilities, namely everything to support consumer convenience provided/prepared by service sellers/agencies, namely in the form of physical equipment [2].Meanwhile, states in service purchase transactions, for several types of services, the patterned perception/image of the interaction between service users and facilities will have a significant effect on service quality in the eyes of service users.
From this understanding it can be understood that the community in providing an assessment of service quality is based on a comparison of their experiences with what is expected for the service.As previously explained that in an organization, the concept of service quality is a measure of organizational success, the success of the organization in question both in business organizations and also in organizations that are tasked with providing public services.
In the administration of public services, the government in the Law on public services Number 25 of 2009 and the Decree of the Minister of State Apparatus Empowerment Number 63/KEP/M.PAN/ 7/2003 has formulated what are the principles, principles, and standards of public services.This aims to improve the quality of public services.However, from the observations of researchers that the principles and standards of public services outlined by the government are very difficult to operationalize to measure the quality of public services, because basically in quantitative research a clear concept is needed as a basis for researchers to conduct research in order to describe a more real measurement according to the situation and conditions in the field.

RESEARCH METHOD
The research method used in this research is a descriptive quantitative research method, namely by looking for information about existing symptoms, clearly defined goals to be achieved, planning the approach, collecting data as material for making reports.In this research, the researcher wanted to analyze the influence of infrastructure and service quality on patient satisfaction.The research variables to be examined in this research are divided into two main variables, namely the independent variable (X) which consists of two variables, namely infrastructure (X1) and Service Quality (X2).While the dependent variable (Y) consists of one variable, namely community satisfaction.
This study uses an explanatory survey method.This survey research is quantitative and generally uses a questionnaire as a means of collecting data.The explanatory research is to explain the position of the variables under research and the relationship between one variable and another [9].Following the hypothesis proposed by the researcher, this research will use appropriate statistics for a cause and effect relationship.Although the content also contains descriptions, as associative explanatory research, the focus of the study lies in explaining the relationships between variables.By using the methods and approaches mentioned above, the researcher conducted observations to obtain an overview of the three variables, namely the infrastructure, service quality, and community satisfaction variables and analyzed whether there was an influence of infrastructure and service quality on community satisfaction in BLUD Bumi Panua Pohuwato Regency.
This research was conducted at BLUD Bumi Panua Hospital, Pohuwato Regency.With a research period of 3 months from May to July 2020.The population in this study were the public and patients who had enjoyed services at BLUD of Bumi Panua Hospital, Pohuwato Regency.The sampling technique used non-probability sampling, namely accidental sampling.Accidental sampling is a technique of determining a sample based on chance, that is, people who accidentally/incidentally meet with researchers can be used as samples of people who happen to be met are suitable as data sources [9].In drawing the total sample, if the exact population is not known (accidental sampling) then a technique or formula is used following Malhotra's theory which must be at least four or five times the number of question items.In this study, there were 26 question items.So the number of samples taken in this study was 104 samples (26 question items x 4) [5].
Descriptive data analysis is used to provide an overview of the variables studied.The descriptive analysis test includes the average, minimum, maximum, and standard deviation values of the research data.This descriptive statistic provides an overview of the demographics of the research respondents.The demographic data include: the latest educational background, employment, and length of stay.

RESEARCH RESULT
The results of testing the first hypothesis (H1) which states that infrastructure (X1) has a positive and significant influence on community satisfaction (Y), are accepted.It can be concluded that infrastructure (X1) has a positive and significant influence on community satisfaction (Y) at the RSUD of Bumi Panua, Pohuwato Regency.Based on the results of the coefficient analysis on the calculation and table, namely positive.The meaning of the positive coefficient shows that infrastructure (X1) has a good impact on increasing community satisfaction (Y).
Facilities or infrastructure have a significant positive effect on patient satisfaction [1].facilities have a significant positive effect on patient satisfaction [6].Good facilities can establish perceptions in the eyes of customers [11].In several types of services, perceptions from interactions between customers and facilities have an effect on service quality in the eyes of customers.
If a service company has adequate facilities so that can make it easier for consumers to use its services and make consumers comfortable in using these services, it will be able to influence consumers in purchasing services.Besides, companies that provide a pleasant atmosphere with attractive facility designs will influence consumers in making purchases.
Facilities are everything of objects or money that can facilitate the implementation of a certain business.Facilities can also be interpreted as the facilities and infrastructure available in the environment and within the company office, in this case, it is intended to provide maximum service so that consumers or users feel comfortable and satisfied.
The results of testing the second hypothesis (H2) which states that service quality (X2) has a positive and significant effect on community satisfaction (Y), are accepted.Therefore, it is concluded that the quality of service (X2) has a positive and significant effect on community satisfaction (Y) at the RSUD of Bumi Panua, Pohuwato Regency.Based on the results of the coefficient analysis on the calculation and table, namely positive.The meaning of the positive coefficient shows that the higher the quality of service (X2), the more optimal the community's satisfaction (Y) will be.

DISCUSSION
The quality of service has a significant positive effect on patient satisfaction [1].service quality has a significant positive effect on patient satisfaction [6].Service quality has a significant positive influence on patient satisfaction.Quality is something that must be done for service providers properly.The quality of a product or service is a major part of the company's strategy to achieve sustainable excellence, either as a market leader or as a strategy to continue to grow.
Quality must start with what consumers need and end with consumer perceptions.Image quality is not based on the point of view of service providers but based on the point of view or consumer perception.Consumers are the ones who consume and enjoy service products so that they also determine the quality of services.Consumers' perception of service quality is a comprehensive assessment of the superiority of service.However, because service performance is often inconsistent, consumers use intrinsic and extrinsic service cues as references.
Service quality can be defined as the difference between the reality and the expectations of customers for the services they receive.The quality of service can be determined by comparing customers' perceptions of the service they receive.Customer satisfaction or dissatisfaction is a customer's response to a confirmed or nonconformity evaluation that is adjusted between previous expectations (other performance norms) and the actual perceived performance of the product after its use.
Referring to this definition, patient satisfaction can be influenced by his assessment of the quality of the product or service expected [11].Service quality is the level of excellence expected and control over that level of excellence is to meet customer desires.Quality is closely related to customer satisfaction.Quality provides an incentive for consumers to make strong relationships with the company.Because in a long time, the company can understand consumer expectations better and increase customer satisfaction by maximizing pleasant customer experiences and minimizing unpleasant customer experiences.
Consumer satisfaction includes the difference between expectations and performance or perceived results [3].The meeting between these two interests will determine how much the level of consumer satisfaction with a product.Consumer trust is what companies want to get from their customers.Belief in brand attitude, service quality, and many other beliefs that motivate the company to develop its products.The results of testing the third hypothesis (H3) which states that simultaneously (together) infrastructure (X1) and service quality (X2) has a positive and significant effect on community satisfaction (Y) at the RSUD of Bumi Panuaa, Pohuwato Regency, accepted.
Facilities and service quality simultaneously have a significant positive effect on patient satisfaction [1].Also states that facilities and service quality simultaneously have a significant positive influence on patient satisfaction [6].Likewise, facilities and service quality simultaneously have a significant positive effect on patient satisfaction.Based on the various definitions of satisfaction by experts, a similarity can be drawn, namely that satisfaction involves the satisfaction component or performance expectations.Generally, people's expectations are an estimate or public belief about what they will receive if they buy or consume a product, while the perceived performance is the community's perception of what they receive after consuming the purchased product.In this case, including expectations regarding the quality of services and infrastructure provided.Therefore, community satisfaction is influenced by the fulfillment or unfulfilled factors of the community's expectations of the services received.
Companies that provide facilities are increasingly attractive at prices that are following the quality and quality of good company service, so the higher the likelihood of consumer decisions to buy products [11].Satisfaction as the level of a person's feelings after comparing the performance or perceived results compared to their expectations [2].For this reason, to achieve the level of patient satisfaction, the hospital must be supported by facilities and infrastructure and good quality of service such as a neat and clean, and air-conditioned health service place, to provide comfort to patients and health workers who serve them.The patient waiting room is neat and clean and is equipped with entertainment facilities by the patient's expectations.Bathrooms and toilets are clean, odorless and have enough water, and are cleaned every day.
In this regard, if the research results show the influence of infrastructure and service quality on community satisfaction at the RSUD of Bumi Panua, Pohuwato Regency is positive, this is because good infrastructure and service quality is a tangible manifestation that can be seen and felt by the patient, or the community so that they can quickly judge that the facilities and infrastructure and the quality of services provided and felt have met their hopes or wants and needs or not.When the existence of facilities and infrastructure and service quality meets expectations, then immediately give a positive assessment and are immediately satisfied.If the opposite happens, the patient or the community will be immediately disappointed and dissatisfied with the services provided.Therefore, the proportion of facilities and infrastructure and quality of service to achieve customer satisfaction is also very high.

CONCLUSION
Based on the results of the research and discussion that has been done, it can be concluded that: 1. Infrastructure has a positive and significant effect on community satisfaction with a significant value of 0.029 which is smaller than the significance level of 0.05.Thus the first hypothesis (H1) which states that infrastructure has a significant influence on community satisfaction can be accepted.2. Infrastructure has a positive and significant effect on community satisfaction with a significant value of 0.029, smaller than the 0.05 significance level.Thus the first hypothesis (H1) which states that infrastructure has a significant effect on community satisfaction is acceptable.
Based on the research results and conclusions obtained.So some useful implications are found for: 1. Theoretical implications, the results of this research can add references for further researchers, that infrastructure and service quality either partially or simultaneously affect satisfaction.2. Practical implications, it is expected that the Hospital management will: a) Improve or add to hospital infrastructure, b) Improve service quality, c) Paying attention to the satisfaction of the visitor community and patients From the result of this research is the researcher have the Research Limitations.That is: 1.This research was conducted only to determine the influence of infrastructure and service quality variables on community satisfaction at the RSUD of Bumi Panua, Pohuwato Regency so that the influence of other variables was not known.2. This research was conducted only at the Bumi Panua Regional General Hospital, Pohuwato Regency so that it cannot be used as a general reference about the influence of infrastructure and service quality variables on community satisfaction with other objects.3. The distribution of part of the research questionnaire was carried out by entrusting the work unit without the assistance of the researcher so that there was no direct psychological contact between the researcher and the respondent.
From the results of the research conducted, the researcher expects: 1.The management of Bumi Panua Regional General Hospital, Pohuwato Regency, is advised to continue to improve infrastructure so that they can provide comfort to the community, especially patients so that they feel satisfied.Facilities and infrastructure that still need attention include; Adequate parking lots and parking managers, patient waiting rooms are not equipped with adequate infrastructure such as waiting chairs and air conditioning, nursing places for children and children's playgrounds are still centralized, there are no units and the information system has not fully served comprehensively.2. The management of Bumi Panua Regional General Hospital, Pohuwato Regency is advised to continue to improve the quality of service in serving the community, especially patients so that they feel satisfied.3. Apart from infrastructure and service quality, several other aspects need to be considered by the management of the Bumi Panua Regional General Hospital, Pohuwato Regency, such as human resources.