Analysis of Patient Satisfaction in The Context of Health Worker Performance at The Community Health Center Ngoro District Mojokerto In 2023

Human Resources are the main factor of problems that often arise in an organization such as in health service institutions. Puskesmas as a health service that is directly related to the lower community has an important role in achieving the quality of health services. the phenomenon of patient satisfaction the results of interviews with researchers at UPT Puskesmas Ngoro in July 2023 obtained data, out of 15 people, 10 still complained that they were not satisfied, and 7 were satisfied with the performance of health workers. The purpose of this study was to analyze patient satisfaction with the performance of health workers at UPT Puskesmas Ngoro in 2023. The research method used in this research is quantitative survey research (survey research). Research design in this study is quantitative research with cross sectional method. The sampling technique used accidental sampling and data analysis using the Spearman Rank statistical test. The results showed that of the 68 respondents, most (73.5%) stated that the performance of health workers was very good, namely 50 respondents. From the results of this study indicate that the level of patient satisfaction from each dimension of satisfaction ranges from 87% to 90%, which is very satisfied, meaning that patients at the puskesmas have rated well the services provided by the puskesmas. Based on the Spearman Correlation test using SPSS, the p value is 0.008 α 0.05, meaning that H0 is rejected and H1 is accepted, which can be concluded that this study shows that there is a relationship between the performance of health workers and the level of patient satisfaction at UPT Puskesmas Ngoro, Mojokerto Regency in 2023.


INTRODUCTION
Human resources are a key factor that is a problem that often arises in an organization such as a health facility.Puskesmas as a health service organization that is directly related to the grassroots community has an important role in achieving the quality of health services expected by the community.By understanding what patients expect from the quality of services provided, added value will be obtained for the health facility.Service quality plays an important role in the quality and satisfaction of patients.In addition, it is also closely related to profit generation for health service organizations.The higher the quality of the organization's services, the more satisfied customers will be.The problem that often occurs in health care facilities is the lack of patient satisfaction with the quality of service and performance of health workers, including patient safety, pain management, and pain management, comfort, service satisfaction, personal care, patient worry.and patient behavior (M.Nursalam 2014).
People who use certain services must have satisfaction, the community is very interested, checks the quality of health services and chooses a place that is easily accessible.Satisfaction is a feeling of satisfaction or disappointment that arises because of the comparison between his impression of the service or result with his expectations.Patient satisfaction is a pleasant emotional attitude at work.This attitude can be reflected in work enthusiasm, discipline and performance in the workplace.To achieve the maximum level of patient satisfaction in carrying out tasks, there are always factors that can affect patient satisfaction.So that health service organizations can create conditions to encourage or improve services to develop and improve capacity and skills optimally (Arief and Alfarizy 2019).
Patient satisfaction is related to the fulfillment of their needs with a positive attitude of health workers, including emotions and behavior towards their work, by valuing their work as respect when achieving a job that is of high value.(Astari, Noviantani and Simanjuntak 2021).The phenomenon of patient satisfaction at UPT Puskesmas Ngoro Mojokerto Regency is overall satisfaction, which is the simplest and most common way to measure user satisfaction with the services received by patients, not satisfied with a particular service they receive.Customer satisfaction.Based on the factors described above, the patient is dissatisfied with the service.Confirmation of expectations.Satisfaction is not measured directly but is inferred based on the fulfillment of service users' expectations of the services provided, namely staff are less willing to listen to patient responses so that this causes dissatisfaction with the service.Rebate interest, where the agent is less interested in solving the patient's problem, makes the patient more likely to refer to the nearest hospital.Referral readiness in this case patient satisfaction is related to the perception that a service user receives a referral from a service provider used by others or their relatives.
The level of utilization of medical services by patients at a health facility reflects the quality of services provided by medical personnel and the level of patient confidence in the services provided.In general, the size of health service utilization is expressed by the number of times a person comes to use the health service.
The phenomenon of patient satisfaction based on the results of interviews with patients of UPT Puskesmas Ngoro Mojokerto Regency in July 2023 obtained data, out of 15 people, 10 of them still complained that they were not satisfied with the way health workers worked, and 5 people stated that they were satisfied with the way health workers worked.
Patient satisfaction can be influenced by several factors, including the quality of service and the performance of existing medical personnel.If the quality of service and performance of medical personnel are good, patient satisfaction will be affected.Service quality is a customer expectation, especially patients, which is strongly influenced by the information obtained by the patient and the needs he requests.A good form of health service is a public need and is often a measure of the success of human development in a country.Realizing that health services are indispensable for all citizens, the government from time to time tries to develop programs that can improve health services in general and can provide direct and indirect benefits to the community in its working area, starting from the Puskesmas level and other medical institutions such as hospitals and other health service facilities.(Sudibyo, 2014)

METHOD
The research method used in this research is quantitative survey research (survey research), which is research conducted to determine the value of variables, either one or more variables (independent) without making comparisons or relationships with other variables.Research design in this study is quantitative research with cross sectional method.The independent variable is the performance of health workers and the dependent variable is patient satisfaction.sampling techniques using Accidental Sampling techniques, population and samples are patients who come to the poly of the Technical Implementation Unit of the Ngoro Public Health Center, Mojokerto Regency from July to August 2023, a total of 68 respondents.Data analysis using the Spearman Rank Test.The results presented in Table 4 show that the majority of 68 respondents, 50 people (73.5%) rated the performance of health workers as very good.The quality of health services is a key factor in the sustainability of health service providers.An integrated quality revolution is essential for organizational survival and growth.In this case, innovation is needed to ensure public satisfaction with the quality of health services.Intense competition in the health care workforce requires every facility, including health centers, to become a reliable, professional competitor, and provide the best service to its customers.In 2018, WHO introduced the People-Centered Integrated Health Framework, which outlines seven dimensions of healthcare quality.These aspects include safety, efficiency, individuality, timeliness, efficiency, equity and inclusion.Service quality in this study was measured based on these dimensions.Patients' perception of medical service quality is influenced by many factors such as age, gender, education level, occupation, socioeconomic status, culture, environment, personality, and life experience.Patients tend to evaluate functional aspects such as clinical hygiene more than technical aspects.To evaluate health impact, it is important to refer to service standards in accordance with standard operating procedures (SOPs), the researchers said.However, in the field, many patients do not clearly understand the service process provided.From the existing data and theory, it can be concluded that the performance of medical personnel has a significant influence on patient experience in using health center services.

FINDING AND DISCUSSION
Based on Table 5, it can be seen that of the 68 respondents, most (77.9%) were very satisfied, namely 53 respondents.According to Kotler and Keller in Priansa (2018), consumer or customer satisfaction is a person's feeling of satisfaction or disappointment that arises after comparing the expected performance (outcome) of a product with the expected performance (or outcome) of a product.In addition, according to Priharto (2020), customer satisfaction is the level of consumer satisfaction after comparing the service or product received with what is expected.According to the researcher, the level of patient satisfaction varies, but in fact patient satisfaction can be seen from how often patients make follow-up visits.The results showed that the level of patient satisfaction in each aspect of satisfaction ranged from 87% to 90%, namely very satisfied, namely patients seeking treatment at the puskesmas rated the services provided by the puskesmas as good.
The results of the study in table 6 show that of the 68 respondents, most (55.9%) were very satisfied with the excellent quality of health worker work services as many as 38 respondents.From the results of the Spearman Correlation test, it is found that the p value is 0.008 < α = 0.05, which means that H0 is rejected and H1 is accepted, meaning that there is a relationship between the performance of health workers and the level of patient satisfaction at UPT Puskesmas Ngoro, Mojokerto Regency in 2023.According to the opinion of Rifai A, (2019), the main factor determining patient satisfaction is the perception of service quality.There are several approaches to achieving satisfaction as follows; 1. Reduce the gap that occurs between management and the community 2. Public institutions must be able to build a joint commitment to create opinions in improving the service process 3. Make it easy for the public to convey complaints by creating a system of criticism and suggestions 4. Advance services to achieve community satisfaction and expectations.In general, it is stated that what is meant by quality health services is health services that can satisfy every user of health services in accordance with the average level of satisfaction of the population, as well as those whose implementation is in accordance with the code of ethics and health service standards that have been determined.satisfied customers will tell two other people about their satisfaction, while disappointed consumers will tell ten other people about their disappointment.People are very responsive to the disappointment of others.For example, the impact of a disappointment published in a letter to the editor is enormous.Thousands of consumers and potential consumers will be affected.If a friend tells you about a bad brand he bought, you will think twice about buying the same brand unless you have to, or if you are not sure about the friend's story.
From all the data and theories above, it shows that what can influence the factors that affect respondents' satisfaction is the quality of service provided by health workers.So that the response given is the harmony between the satisfaction felt and has a big influence in realizing better service quality.The latest education and occupation greatly affect the patient's assessment of the performance of health workers.
Based on table 4.2, it shows that of the 68 respondents, most (60.3%) had the latest basic education (elementary school, junior high school), namely 41 respondents.Basic education includes elementary, junior high and equivalent education.This education is a level of education that must be carried out by Indonesian citizens because it is basic education.
The quality of health services is the core of the survival of a health service provider institution, therefore the integrated quality revolution movement is a demand that cannot be ignored if an institution wants to exist and develop.In providing health services, innovation is needed to support public satisfaction with the quality of health services.There are many health service provider institutions and such intense competition, so every health service institution including puskesmas must be ready to become a competitor that can be taken into account for its credibility and professionalism, and become a service provider and service institution that always spoils customers or consumers with the best service (excellent) (Mujiarto et al., 2019).Health care is an important process in improving the degree of health and well-being of every human being throughout the world.Everyone has the right to obtain health services and the government is responsible for the availability of all forms of health efforts that are quality, safe, efficient, and affordable by all levels of society (Article 19 of Law No. 36 of 2009).
Satisfactory service quality is the key to the existence of a public service institution, which should not be ignored, because the increasingly intense competition will require a service provider institution to always pay more attention to customers or consumers by providing the best service (Barahama et al., 2019).Health services are all activities that directly or indirectly attempt to produce health services needed or demanded by the community to overcome their health problems.Health services are also a place or facility to obtain health services facilitated by the local government which aims to serve people who need health services which contain 4 main service elements consisting of preventive, promotive, curative, and representative health service elements.Based on the four basic health services that are comprehensive and at the same time are the leading health service facilities at the village level, namely puskesmas (community health centers) (Mujiarto et al., 2019).

CONCLUSION
Most (73.5%) at the Wangi-wangi Wakatobi Health Center stated that the performance of health workers was very good, namely 50 respondents.Almost all (77.9%) respondents at the Ngoro Puskesmas Technical Implementation Unit, Mojokerto Regency, stated that they were very satisfied with immunization services, namely 53 respondents.Based on the results of the Spearman Correlation test, the p value of 0.008 < α = 0.05, which means that H0 is rejected and H1 is accepted, meaning that there is a relationship between the performance of health workers and the level of patient satisfaction at the Technical Implementation Unit of the Ngoro Health Center, Mojokerto Regency in 2023.

Table 2
Characteristics of respondents based on the last education of the patient

Table 5
Frequency distribution based on the relationship between the performance of health workers and the level of patient satisfaction