The Effect of Brand Image and Service Quality on Outpatient Loyalty Mediated by Patient Satisfaction
DOI:
https://doi.org/10.37287/ijghr.v8i4.2348Keywords:
brand image, patient loyalty, patient satisfaction, psychiatric hospital, service qualityAbstract
Patient loyalty is a strategic indicator for hospitals, particularly in mental health services where continuity of care is essential. This study analyzed the effect of brand image and service quality on outpatient loyalty mediated by patient satisfaction at RSJD Atma Husada Mahakam, a type A psychiatric referral hospital in East Kalimantan, Indonesia. An explanatory quantitative survey with a cross-sectional design was conducted among 200 outpatients selected using purposive sampling. Data were collected using a structured Likert-scale questionnaire measuring brand image, service quality, patient satisfaction, and patient loyalty. Data were analyzed using descriptive statistics, Pearson correlation, and partial least squares structural equation modeling (PLS-SEM) with SmartPLS. The measurement model met validity and reliability criteria, with AVE values ranging from 0.546 to 0.649 and composite reliability values ranging from 0.902 to 0.924. The structural model showed that brand image positively affected patient satisfaction (beta = 0.318; t = 3.934; p < 0.001) and loyalty (beta = 0.210; t = 2.920; p = 0.004). Service quality positively affected satisfaction (beta = 0.515; t = 7.648; p < 0.001) and loyalty (beta = 0.273; t = 4.042; p < 0.001). Patient satisfaction also had a positive effect on loyalty (beta = 0.408; t = 4.794; p < 0.001). Indirect effect testing confirmed that satisfaction significantly mediated the influence of brand image (beta = 0.130; t = 2.715; p = 0.003) and service quality (beta = 0.210; t = 4.113; p < 0.001) on loyalty. The findings indicate that strengthening service quality, maintaining a positive hospital image, and systematically managing patient satisfaction are central strategies for building outpatient loyalty in psychiatric hospital services.
References
Aaker, D. A. (2012). Building Strong Brands. Simon and Schuster.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research. Journal of Personality and Social Psychology, 51(6), 1173-1182.
Dabri, R. A., Paranoan, D. B., & Paselle, E. (2013). Analisis hubungan kualitas pelayanan dengan tingkat kepuasan pengunjung pasien kelas III Rumah Sakit Jiwa Daerah Atma Husada Mahakam Samarinda tahun 2013.
Duryadi. (2021). Teknik Metode Penelitian Empiris Model Path Analysis dan Analisis Menggunakan SmartPLS. Yayasan Prima Agus Teknik.
Ghozali, I. (2021). Structural Equation Modeling: Metode Alternatif dengan Partial Least Squares (PLS). Badan Penerbit Universitas Diponegoro.
Griffin, J. (2005). Customer Loyalty: How to Earn It, How to Keep It. Jossey-Bass.
Grönroos, C. (2021). Service Management and Marketing: Managing the Moments of Truth in Service Competition (5th ed.). Wiley.
Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2017). A Primer on Partial Least Squares Structural Equation Modeling (2nd ed.). Sage.
Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2021). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM) (3rd ed.). Sage.
Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based SEM. Journal of the Academy of Marketing Science, 43(1), 115-135.
Kotler, P., & Keller, K. L. (2016). Marketing Management (15th ed.). Pearson Education Limited.
Kurniawan, T. R., Herman, H., Wicara, D. G., & Rofidah, S. (2025). Pengaruh kualitas pelayanan terhadap kepuasan pasien dengan loyalitas pasien sebagai variabel mediasi di Rumah Sakit Umum Daerah Riau. Jurnal Daya Saing, 11(1).
Ni'am, M. K. (2021). Pengaruh Brand Image dan Kualitas Pelayanan terhadap Loyalitas Pasien melalui Kepuasan Pasien sebagai Variabel Mediasi. Institut Teknologi Ahmad Dahlan.
Nurfitriani, N. (2023). Pengaruh brand image terhadap loyalitas pasien instalasi rawat jalan RSUD Haji Provinsi Sulawesi Selatan tahun 2022. Jurnal Anestesi, 1(4), 363-372.
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing.
Sarstedt, M., Ringle, C. M., & Hair, J. F. (2022). Handbook of Market Research: Partial Least Squares Structural Equation Modeling. Springer.
Setiawan, S. (2011). Loyalitas Pelanggan Jasa. IPB Press.
Yamin, S. (2023). Partial Least Squares Structural Equation Modeling (PLS-SEM): Metode, Aplikasi, dan Analisis. PT RajaGrafindo Persada.
Zeithaml, V. A., Bitner, M. J., & Gremler, D. D. (2020). Services Marketing: Integrating Customer Focus Across the Firm (8th ed.). McGraw-Hill Education.
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