ANALYSIS OF THE EFFECT OF TOTAL QUALITY MANAGEMENT IMPLEMENTATION ON PATIENT LOYALTY, WITH SERVICE QUALITY AND PATIENT SATISFACTION AS MEDIATING VARIABLES (A Study of Patients at the Dental and Oral Health Clinic of the Poncol Community Health Center in Magetan Regency)
DOI:
https://doi.org/10.59211/mjpjetl.v4i1.322Keywords:
Total Quality Management; Service Quality; Patient Satisfaction; Patient Loyalty; Health Center.Abstract
This study aims to analyze the effect of Total Quality Management (TQM) implementation on patient loyalty with service quality and patient satisfaction as mediating variables at the Dental and Oral Polyclinic of Poncol Health Center, Magetan Regency. This research is motivated by the phenomenon of fluctuating patient revisit rates that showed a declining trend throughout 2025, indicating problems in maintaining patient loyalty. This research employed a quantitative approach with a cross-sectional design. The population consisted of all patients who made revisit visits to the Dental and Oral Polyclinic of Poncol Health Center during the period January-December 2025, totaling 441 people. The sample size was determined using the Slovin formula with a 5% margin of error, resulting in 137 respondents. The sampling technique used purposive sampling. Data analysis was performed using Partial Least Square Structural Equation Modeling (PLS-SEM) with SmartPLS version 4.1.6.6 software. The results showed that: (1) TQM has no direct effect on patient loyalty; (2) TQM has a positive and significant effect on service quality; (3) TQM has a positive and significant effect on patient satisfaction; (4) service quality has a positive and significant effect on patient loyalty; (5) patient satisfaction has no significant effect on patient loyalty; (6) service quality is proven to mediate the effect of TQM on patient loyalty; and (7) patient satisfaction is not proven to mediate the effect of TQM on patient loyalty. These findings reinforce TQM theory (Deming, 1986) and SERVQUAL theory (Parasuraman et al., 1988) which emphasize the importance of quality management implementation in improving service quality, which ultimately can shape patient loyalty. Practically, health center management is advised to focus efforts on improving service quality, particularly on aspects of environmental comfort, service speed, and medical staff interaction with patients, as well as ensuring that every system improvement can be applied to real services that are directly felt by patients.
Downloads
References
[1] Ali, M., & Shafiq, M. (2020). The impact of TQM on customer loyalty: A mediating role of customer satisfaction. Total Quality Management & Business Excellence, 31(5-6), 567-582.
[2] Chen, C., & Lee, S. (2020). The impact of TQM on patient loyalty: The mediating role of service quality and patient satisfaction. Journal of Healthcare Management, 65(4), 245-260.
[3] Demirci, I., Acar, A. Z., & Basim, H. N. (2021). The mediating role of work engagement in the relationship between work-family conflict and Turnover intention. Current Psychology, 40(8), 3895-3905.
[4] Dick, A. S., & Basu, K. (1994). Customer loyalty: Toward an integrated conceptual framework. Journal of the Academy of Marketing Science, 22(2), 99-113.
[5] Garcia, A., Lopez, M., & Martinez, P. (2024). Patient satisfaction as a predictor of loyalty in primary care. Family Practice, 41(2), 123-136.
[6] Gupta, R., & Sharma, V. (2023). TQM practices and patient loyalty in healthcare: A systematic review. International Journal of Healthcare Management, 16(2), 145-158.
[7] Hermawati, A., & Mas, N. (2016). Transglobal leadership, quality of work life, and employee performance in cooperatives in East Java, Indonesia. International Journal of Business Management, 1(1-2016), 1-8.
[8] Hermawati, A., Purbaningsih, Y., Iwe, L., Junaedi, I. W. R., & Wibowo, T. S. (2022). Motivasi Kerja Terhadap Kinerja Tenaga Kesehatan Berbasis Implementasi Kompetensi dan Komunikasi Organisasi. Jesya (Jurnal Ekonomi Dan Ekonomi Syariah), 5(2), 2199-2209.
[9] Kemenkes RI. (2020). Profil Kesehatan Indonesia. Jakarta: Kementerian Kesehatan Republik Indonesia.
[10] Lovelock, C., & Wirtz, J. (2011). Services Marketing: People, Technology, Strategy (7th ed.). New Jersey: Pearson.
[11] Oakland, J. S. (2014). Total Quality Management and Operational Excellence: Text with Cases. London: Routledge.
[12] Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12-40.
[13] Peraturan Menteri Pendayagunaan Aparatur Negara dan Reformasi Birokrasi Republik Indonesia Nomor 14 Tahun 2017 tentang Pedoman Penyusunan Survei Kepuasan Masyarakat Unit Penyelenggara Pelayanan Publik.
[14] Rahman, F., Santoso, B., & Wijaya, H. (2023). TQM implementation and service quality in public health centers. International Journal of Public Health, 68(3), 123-138.
[15] Sugiyono. (2008). Metode Penelitian Kuantitatif, Kualitatif, dan R&D. Bandung: Alfabeta.
[16] Tjiptono, F., & Diana, A. (2016). Total Quality Management. Yogyakarta: Andi.
[17] Wijaya, H., Rahman, F., & Santoso, B. (2023). TQM, kepuasan pasien, dan loyalitas pasien. Jurnal Ilmu Kesehatan, 15(1), 77-92.
[18] Wijaya, H., Santoso, B., & Rahman, F. (2024). Kualitas layanan dan loyalitas pasien di era digital. Jurnal Teknologi Kesehatan, 12(1), 33-48.
Downloads
Published
Issue
Section
URN
License
Copyright (c) 2026 Dyah Ayu Mustikaningsih, Adya Hermawati, Muchlis Mas’ud, Asih Tri Rachmi, Choirul Anam
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors grant the journal the right of first publication. which permits unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited. Authors are responsible for ensuring that any third-party materials included in their work have proper permissions.
Comments
Comments are checked by the editorial team before they appear. Keep to the article's content; personal attacks, advertising and spam are removed.
Write a comment
Please log in to comment. Log in