Comparison of Types of Inpatient Services for BPJS Patients and Non BPJS Patients with Patient Satisfaction Level

Patient satisfaction is an indicator of the quality of service we provide and patient satisfaction is a capital to get more patients to get loyal patients. Factors that influence patient satisfaction are product or service quality, price, emotional, performance, service, facilities, atmosphere, and communication. This study aims to determine inpatient services for BPJS and Non-BPJS patients with the level of patient satisfaction in H. Andi Sulthan Daeng Radja Bulukumba Hospital, This study is an analytic observational study with a comparative approach study. This sampling uses a nonprobability sampling method with the sampling technique is a consecutive sampling. The research sample taken amounted to 76 respondents each 38 BPJS patients and 38 Non-BPJS patients from a total population of 305 patients conducted in the inpatient room of H. Andi Sulthan Daeng Radja District Hospital. Bulukumba from May 16 to May 18, 2017. The measuring instrument used was a questionnaire with a Likert scale. The results of this study were 76 respondents from 38 BPJS patients and 38 Non-BPJS patients, from 38 BPJS patients, who were dissatisfied with 6 respondents (7,895), who were satisfied as many as 27 respondents (35,526%), who were very satisfied as many as 5 (6.679%) while from 38 Non-BPJS patients there were no dissatisfied patients, 27 respondents were satisfied (35,526%), who were very satisfied as many as 11 respondents (14.479%). The conclusion was that there were differences in the level of service satisfaction inpatients given to BPJS patients and Non-BPJS patients at H. Andi Sulthan Daeng Radja Bulukumba Hospital in 2017 with p = 0.032 <a = 0.05


INTRODUCTION
Patient satisfaction is an indicator of the quality of service we provide and patient satisfaction is a capital to get more patients to get loyal patients. Loyal patients will reuse the same health services if needed again. It is even known that loyal patients will invite others to use the same health care facilities (Nursalam, 2014). Health service is a product in the form of services or goods produced by a producer, in this case, it can be a provider or health institution, at first glance, health services seem to be the same as other economic goods on the market. However, it must be realized that health services have unique characteristics possessed by other economic goods, so that special attention is needed, the health services referred to here are the Social Security Administering Board (BPJS) and Non-BPJS (general) (Retnaningsih, 2013).
The Social Security Organizing Agency (BPJS) is a public legal entity that functions to organize a health insurance program for all Indonesians including foreigners who work for a minimum of 6 months in Indonesia. BPJS participants consist of Participants in Output Assistance (PBI) consisting of the poor and disadvantaged people, and non-PBI groups or participants from the ASKES transition (BPJS Law, 2011). Non-BPJS (feefree service) is the high cost of health services issued by patients or the guarantor who uses their costs, especially for sophisticated tools based on medical reasons (Retnaningsih, 2013 (Indonesia, Health Profile, 2015).
Previous research on patient satisfaction was conducted (Sari, 2015), which examined the differences in the level of satisfaction of BPJS Patients with General Patients at RSUD Dr. Soediran Mangun Sumarso Wonogiri, several complaints made by patients about administrative services, nurses, doctors, and medicine, so that the conclusion of this study "the level of general patient satisfaction is better than BPJS patients with an average difference of 39.51% in Dr. Sudirman Mangun Sumarso Wonogiri ". Another study was conducted by (Yuliadi, 2012), which examined "differences in the level of satisfaction with the quality of nursing services between patients using JAMKESMAS and general patients at Water Kulos Progo Hospital" researchers conducted interviews with 5 five jamkesmas patients, two of whom said patients had to wait more a long time to get health services compared to general patients who take precedence in getting health services. Recent research conducted by (Riska, 2016), which also examines "differences in the quality of inpatient services for patients using BPJS and Non-BPJS in Samarinda IAMoeis Hospital" researchers write the complaints of some BPJS patients about the speed and friendliness of officers in serving so that patients must wait a long time to receive services and patients are increasingly lackluster whereas for the Non-BPJS complaints like this are rarely encountered because hospital staff is more friendly.
The difference in service satisfaction is felt by several hospitals, one of which is the Regional General Hospital (RSUD) H. Andi Sulthan Daeng Radja Bulukumba which is a hospital that accepts BPJS patients and Non-BPJS patients (general patients).

MATERIAL AND METHODS
Research design is a model or method used by researchers to conduct research that gives direction to the course of research (Dharma, 2011). This type of research is a quantitative study using an analytic observational design using a comparative study approach, research using a comparative study method is done by comparing similarities and differences as phenomena to look for what factors, or what situations lead to the occurrence of certain events both on the object under study and the object being compared (Notoatmodjo, 2012). In this study, researchers will analyze the comparison of types of inpatient services for BPJS patients and Non-BPJS patients with the level of patient satisfaction in H. Andi Sulthan Daeng Radja Bulukumba Hospital.
Population is a generalization area that consists of objects/subjects that have certain quantities and characteristics determined by researchers to be studied and then drawn conclusions (Sugiyono, 2012). The population in this study is the subject (for example humans; clients) who meet the established criteria. The population in this study was 305 patients. Sampling techniques are the methods taken in taking samples, to obtain samples that are truly following the overall object of research (Nursalam, 2016). The sampling technique used in this study is Non Probability Sampling, with consecutive sampling technique that is sampling technique all subjects that come, can be reached and meet the sample selection criteria until the number of subjects fulfilled ..
The number of samples in this study were 76 patients.
The research instrument is a tool used by researchers to observe, measure or assess a phenomenon (Dharma, 2011). The instrument used in this study used questionnaire sheets and interviews. Bivariate analysis is an analysis carried out by more than two variables that serve to determine the relationship between variables (Sujarweni, 2011).
Data obtained through questionnaire sheets were analyzed using the alternative chisquare test for Smirnova with the help of the SPSS program.  Based on table 2 above shows that of the 76 respondents based on health services, respondents who used BPJS and Non-BPJS respectively 38 respondents (50%).

RESULTS
Characteristics of respondents based on the level of patient satisfaction, the highest distribution of respondents feeling satisfied as many as 54 respondents (71.1%) and the lowest distribution of respondents feeling dissatisfied as much as 6 respondents (7.9%).

DISCUSSION
The results showed that of 38 respondents, who were dissatisfied as many as 6 respondents (7,895), who were satisfied as many as 27 respondents ( (Sari, 2015).
Patient dissatisfaction is more related to the attitude and behavior of hospital staff, delays in the service of doctors and nurses, doctors are difficult to find, doctors are less communicative and not informative (even though the doctor and patient interactions are an internal part of the therapy process and are key to the patient's recovery process ), nurses who are less friendly and responsive to patient needs, the length of time waiting for the examination, order, and comfort and safety of the hospital. (Satrianegara, 2014).
According to the researchers' analysis, the difference felt by patients from before and after the BPJS program. The patient turned out to be satisfied with the existence of BPJS to be more fulfilled for treatment because it does not cost more. But there are some things that are still awkward such as the services provided are still not in accordance with the expectations of the patient and his family so that patients still feel dissatisfied such as nurses who are not friendly, the environment is very hot, doctors who are not on time, although not all patients say that, in research conducted in the inpatient room of H.
Andi Sulthan Daeng Radja Bulukumba Hospital there were 6 respondents (7.895%) who were dissatisfied even though there were some respondents who felt satisfied with the services provided.
The results showed that of the 38 respondents who used Non-BPJS (general patients) there were no patients who were dissatisfied, 27 respondents (35,526%) were very satisfied, who were very satisfied as many as 11 respondents (14.479%). This study is in line with research conducted by (Sari, 2015) on the Difference between BPJS

Patient Satisfaction Levels and General Patients in Dr. Soediran Mangun Sumarso
Wonogiri in 2015, where the results of the study showed that there was a significant difference between the level of satisfaction of BPJS patients and General patients at RSUD Dr. Soediran Mangun Sumarso Wonogiri with p-value (sig) = 0.001.
Fee-free service is a payment based on per item services such as diagnostic procedures, treatment services, and medical measures. Each action is calculated and the costs are added up. So the cost of medical services incurred by patients will cost more with personal money (Maulida, 2015). Services obtained from the place of first-time admission (IGD), to patients who visit to get the services needed by patients, because it can be said that this is where patients first get a good or bad impression of hospital services, if the patient feels satisfied then the patient will come back to get better service.
According to the analysis of Non-BPJS, patient researchers here are patients who do not use any health insurance or in other words, general patients, the pattern of payments made is also different because in the services provided patients have to spend their own costs such as doctors, nurses, taking drugs carried out by own families, and patients also assume that the more costs incurred the better the services provided to patients so that patients will feel satisfied.
The Where the results of the study showed that there were differences in the level of satisfaction of BPJS patients with the level of satisfaction of Non-BPJS patients in RSPAU dr. Hardjolukito with p-value = 0,000.
The results of this study are not in line with research conducted by (Riska, 2016)