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"Kementerian Kesehatan melaksanakan program peningkatan kinerja sumber dayakesehatan melalui pendidikan dan pelatihan; khususnya pelatihan tenaga pelayanankesehatan tradisional; melalui pelatihan pelayanan akupresur bagi Puskesmas; namunpelayanan akupresur belum berjalan di Puskesmas. Di Kota Jakarta Selatan Puskesmasyang sudah menyelenggarakan pelayanan akupresur hanya dua 2 . Penelitian ini adalahpenelitian kualitatif; dan bertujuan untuk menganalisis kebijakan dan implementasipelaksanaan pelayanan akupresur di Puskesmas serta hambatannya. Informan dalampenelitian berjumlah 11 orang; yaitu Kementerian Kesehatan; Sudinkes Jakarta Selatan;Kepala Puskesmas; Dokter poli; pelaksana program. Metode pengumpulan data melaluiWM dan telaah dokumen. Hasil penelitian dari komponen input sudah berjalan; adanyadukungan Kepala Puskesmas; SOP pelayanan; dan SK penugasan namun belum optimalrotasi staf menjadi salah satu kendala; komponen output dan outcome belum optimal.Aspek komunikasi kejelasan dan konsistensi belum efektif tentang informasi regulasikebijakan yang ada dari penentu kebijakan kepada pelaksana; aspek pembiayaan belumdidukung peraturan daerah; aspek birokrasi masih kurang koordinasi dan sosialisasikebijakan dari Dinas Kesehatan ke Sudinkes dan Puskesmas.

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The Ministry of Health is implementing programs to improve the performance of healthresources through education and training; especially training of traditional health careworkers; through the training of acupressure services for Primary Health Care; butacupressure service has not been run in Primary Health Care. In South Jakarta; PrimaryHealth Care that have been providing acupressure service are only two 2. Thisresearch is a qualitative research; and aims to analyze the policy and implementation ofacupressure service in Primary Health Care and its obstacles. Informants in the studyamounted to 11 people; namely the Ministry of Health; Sudinkes South Jakarta; Head ofPrimary Health Care; Doctor; program implementer. Methods of data collection throughWM and document review.

The result of research of input component have beenrunning; existence of support of Head of Puskesmas; service SOP; and SK ofassignment but not optimal rotation of staff become one of obstacle; component ofoutput and outcome not yet optimally. The communication aspect clarity andconsistency has not been effective about the existing policy regulation informationfrom the policy makers to the implementers; the financing aspect has not been supportedby local regulations; the bureaucratic aspects are still lacking coordination and thepolicy socialization from the Health Service to tribe of health service and PrimaryHealth Care. "

"Dalam Peraturan Menteri Kesehatan Nomor 74 Tahun 2016 disebutkan bahwa puskesmas harus melaksanakan pelayanan kefarmasian sesuai standar. Saat ini belum semua puskesmas memenuhi standar pelayanan kefarmasian. Penelitian ini bertujuan untuk menganalisis kepatuhan implementasi standar pelayanan kefarmasian di puskesmas Kota Bekasi sehingga diharapkan penelitian ini dapat memberi masukan agar pelayanan kefarmasian di puskesmas berjalan sesuai standar. Penelitian ini dilakukan dengan pendekatan kuantitatif dengan unit analisis pelayanan kefarmasian meliputi pelayanan resep, pelayanan informasi obat, dan konseling. Untuk memperkuat pembahasan dilakukan pengumpulan data kualitatif. Sampel sebanyak 100 pelayanan kefarmasian diambil dari 10 puskesmas di Kota Bekasi. Pengumpulan data dilakukan dengan pengamatan, pengisian lembar kuesioner, dan wawancara mendalam. Hasil penelitian menunjukan hasil bahwa puskesmas telah melaksanakan pelayanan resep dan pelayanan informasi obat namun belum sesuai standar sedangkan konseling belum dilaksanakan di semua puskesmas. Puskesmas yang memiliki apoteker sebagai penanggung jawab, fasilitas kefarmasian yang baik, standar prosedur operasional, uraian tugas dan mendapatkan komunikasi kebijakan dan supervisi yang baik lebih patuh terhadap standar pelayanan kefarmasian. Pemerintah disarankan untuk merevisi Peraturan Menteri Kesehatan Nomor 75 Tahun 2014 tentang Puskesmas dan Peraturan Menteri Kesehatan Nomor 74 Tahun 2016 tentang Standar Pelayanan Kefarmasian di Puskesmas, menetapkan apoteker sebagai tenaga kesehatan strategis, program internsip dan kebijakan pegawai tidak tetap untuk apoteker. Dinas Kesehatan Kota Bekasi disarankan untuk melakukan advokasi kebijakan penempatan apoteker di puskesmas sesuai analisis beban kerja, pelatihan berkelanjutan, sosialisasi kebijakan kepada tenaga kefarmasian di puskesmas, penyusunan petunjuk teknis pelayanan farmasi klinik, supervisi rutin, dan menetapkan sistem penilaian kinerja perorangan untuk pemberian kompensasi dan sanksi. Puskesmas disarankan untuk merencanakan kebutuhan apoteker sesuai analisis beban kerja, menempatkan apoteker sebagai penanggungjawab pelayanan kefarmasian, menyediakan fasilitas kefarmasian sesuai standar, menyusun standar prosedur operasional, menyusun uraian tugas, supervisi internal, dan menerapkan penilaian kinerja perorangan dan memberikan insentif berbasis kinerja perorangan.

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Regulation of the Minister of Health Number 74 of 2016 states that primary health centers must perform pharmaceutical services according standard. Currently, not all community health centers meet the standard of pharmaceutical service. This study aims to analyze the compliance in the implementation of pharmaceutical services standard in primary health centers in Bekasi so it is expected to provide an input to the pharmaceutical services at primary health centers in order to be implemented in accordance with the standards. This research was conducted with quantitative approach with pharmaceutical services as unit of analysis which including prescription service, drug information service, and counseling. To strengthen the results discussion then in this study also conducted qualitative data collection. Samples of 100 pharmaceutical services were taken from 10 in primary health centers in Bekasi. The data were collected by observation, filling in questionnaire, and in depth interviews. The results showed that the primary health center had performed prescription and medication services but not yet meet with the standard while counseling had not been implemented in all primary health centers. Primary health center that have pharmacists, good pharmacy facilities, standard operating procedures, job descriptions and good policy communication and supervision are more obedient to the standard of pharmaceutical services.

The Government is advised to revise Regulation of the Minister of Health Number 75 of 2014 on Primary Health Center and Regulation of the Minister of Health Number 74 of 2016 on Standard of Pharmaceutical Service in Primary Health Center, establishing pharmacist as strategic health officer, internsip program and non permanent employee policy for pharmacist. Bekasi City Distric Health Office is advised to advocate placement of pharmacist in community health center policy according to work load analysis, continuing professional development, policy communication to pharmacy staff at community health center, preparation of clinical pharmaceutical services technical guidance, routine supervision, and set individual performance appraisal system for reward and punishment. Primary health centers are advised to plan the pharmacist 39 s needs in accordance with workload analysis, placing pharmacists as responsible pharmaceutical services, providing pharmaceutical facilities according to standards, developing standar operating procedures, preparing job descriptions, internal supervision, and applying individual performance assessments and give incentive based on individual performance."

"Meningkatnya Usia Harapan Hidup UHH di Indonesia telah meningkatkan jumlah populasi lansia. Pada 2016, jumlah lansia di Indonesia mencapai lebih dari 7 total penduduk. Meningkatnya UHH menyebabkan angka kesakitan karena penyakit degeneratif semakin tinggi. Akses lansia terhadap pelayanan kesehatan penting untuk diperhatikan karena lansia rentan menderita sakit dan disabilitas. Angka kesakitan lansia tahun 2015 sebesar 25,05 , meningkat dari 24,8 pada tahun 2014. Tujuan penelitian ini untuk mengetahui determinan yang berhubungan dengan pemanfaatan pelayanan kesehatan rawat jalan pada lansia. Penelitian ini merupakan analisis kuantitatif menggunakan data sekunder Susenas 2016 dengan desain potong lintang terhadap 48.971 lansia yang mengalami keluhan kesehatan. Hasil penelitian menunjukan bahwa 58,32 lansia sakit memanfaatkan pelayanan rawat jalan ke FKTP, FKTL, dan fasilitas kesehatan formal lainnya. Faktor yang berhubungan dengan pemanfaatan rawat jalan pada lansia adalah usia lebih dari 90 tahun, kepemilikan jaminan, regional, status ekonomi, rasio puskesmas, jarak ke FKTP, jarak ke FKTL, riwayat rawat inap, status rokok, gangguan aktivitas, dan keparahan keluhan. Gangguan aktivitas merupakan faktor yang paling berhungan dengan pemanfaatan rawat jalan lansia. Saran dari studi ini adalah menerapkan strategi jemput bola agar banyak lansia memanfaatkan Posyandu lansia, memperkuat program home care bagi lansia renta maupun lansia tidak mandiri. Selain itu, memperluas cakupan jaminan kesehatan untuk lansia miskin, meningkatkan jumlah Puskesmas santun lansia, serta meningkatkan koordinasi lintas sektor dalam menciptakan lingkungan yang ramah lansia dan mendukung program kesehatan lansia.

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Life expectancy in Indonesia has improved, consequently it increased number of elderly population in Indonesia. In 2016, the number of elderly people reached more than 7 of the total population. In addition, the number of morbidity due to degenerative diseases is increase. In 2015, the morbidity rate of elderly people in Indonesia was 25.05 , increased from 24.8 in 2014. Health conditions of the elderly and their access to care are important for policy makers to develop a better plan This study was conducted to determine the use of outpatient health services among elderly. This research was using secondary data from Susenas 2016. The study design was cross sectional covering 48,971 elderly in Indonesia who experienced perceived health symptom. The results of the study showed that 58.32 of sick elderly used outpatient services to the primary care FKTP , secondary care FKTL , and other formal health facilities. Factors related to the utilization of outpatient health services by elderly were age more than 90 years , health insurance, regional, economic status, availability of health centers, distance to health facilities, history of hospitalization, smoking status, activity disorder and perceived severity of illness. Disorder in doing daily activity is the dominant factor that related to the use of outpatient care among the elderly. This study suggests to initiate effort that proactively involve elderly to utilize Posyandu, strengthen home care program, increase number of elderly friendly health center, expand health insurance coverage for poor elderly, and improve cross sectoral coordination in creating elderly friendly environment as well as supporting elderly health program."

"Puskesmas sebagai pelaksana pelayanan JKN berfungsi sebagai gatekeeper menuju pelayanan kesehatan tingkat lanjutan. Konsep gatekeeper terdiri dari kontak pertama, berkelanjutan, koordinasi, dan komprehensif. Penelitian ini ingin melihat implementasi konsep gatekeeper pada pelayanan UKP di Puskesmas X. Penelitian menggunakan metode kuantitatif dan kualitatif. Pengumpulan data kualitatif melalui wawancara mendalam, sedangkan pengumpulan data kuantitatif dilakukan melalui survey kepuasan pasien. Hasil penelitian kualitatif menunjukkan bahwa struktur pada UKP masih kurang pada jumlah tenaga kesehatan, jenis pelayanan, dan fasilitas yang tersedia. Pada proses, masalah yang ditemui adalah waktu tunggu yang terlalu lama sebelum diperiksa, sedangkan durasi pemeriksaan terlalu cepat. Hasil penelitian kuantitatif pada unsur hasil, menunjukkan bahwa kepuasan terhadap pelayanan mencapai 89,13%, kepuasan tertinggi berasal dari dimensi tampilan yaitu 91,67%. Karena jam buka pelayanan hanya sampai pukul 13:00 dan pelayanan hanya sampai hari Sabtu, kontak pertama masih kurang. Banyak kasus yang harus dirujuk karena keterbatasan fasilitas dan prasarana. Implementasi berkelanjutan di Puskesmas X terlihat dari rawat jalan prolanis. Pelayanan UKP di Puskesmas X belum tersedia layanan IGD dan home visit. Koordinasi terlihat dari hubungan Puskesmas X dengan fasilitas kesehatan lain. Implementasi konsep gatekeeper pada Puskesmas X masih kurang pada unsur komprehensif dan kontak pertama, sehingga dapat ditingkatkan dengan penyediaan pelayanan dan penambahan tenaga kesehatan.

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Puskesmas as the implementer of JKN services serves as a gatekeeper to advanced health services. The gatekeeper concept consists of the first contact, sustainable, coordinated, and comprehensive. This research would like to see the implementation of gatekeeper concept in the service of UKP in Puskesmas X. The research used quantitative and qualitative methods. Qualitative data collection through in-depth interviews, while quantitative data collection is conducted through patient satisfaction surveys. The results of qualitative research indicate that the structure in the UKP is still lacking in the number of health workers, types of services, and facilities available. In the process, the problem encountered is the waiting time is too long before being checked, while the duration of the inspection is too fast. The result of quantitative research on the element of results, shows that the satisfaction of the service reaches 89.13%, the highest satisfaction comes from the tangible dimension that is 91.67%. Since the service hours are only until 13:00 and service is only until Saturday, the first contact is still lacking. Many cases have to be referred to due to limited facilities and infrastructure. The ongoing implementation at Puskesmas X is seen from outpatient prolanis. UKP service in Puskesmas X is not available IGD service and home visit. Coordination can be seen from the relationship between Puskesmas X and other health facilities. Implementation of the concept of gatekeeper at Puskesmas X is still lacking in the comprehensive element and the first contact, so that it can be increased with the provision of services and the addition of health personnel."

"Keberhasilan suatu program berhubungan dengan kinerja petugasnya. Penelitian ini bertujuan untuk mengetahui kinerja petugas Manajemen Terpadu Balita Sakit (MTBS) dan hubungan antara variabel indepeden yang terdiri dari faktor individu (umur, masa kerja, pengetahuan dan motivasi), dan faktor organisasi (pelatihan, fasilitas, kepemimpinan) dengan variabel dependen yaitu kinerja petugas MTBS. Jenis penelitian yang digunakan adalah kuantitatif dengan rancangan penelitian cross sectional. Jumlah sampel 50 responden petugas MTBS.Pengumpulan data dilakukan dengan pengisisan kuesioner dan wawancara serta observasi.Pengolahan data dengan menggunakan perangkat lunak computer, analisis data dengan univariat, bivariat dengan uji statistik chi-square dan multivariat dengan uji statistik multipel regresi logistik. Hasil penelitian menunjukkan bahwa 62% petugas MTBS mempunyai kinerja baik. Terdapat hubungan antara umur, masa kerja, pengetahuan, motivasi, fasilitas dan kepemimpinan dengan kinerja petugas MTBS. Faktor dominan yang mempengaruhi kinerja petugas MTBS adalah masa kerja dan kepemimpinan.

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The success of a program related to the performance of its officers This study aims to determine the performance of Integrated Management of Childhood Illness (IMCI) officers and determine the relationship between the independent variables consisting of individual factors (age,length of work, knowledge and motivation) and organizational factors (training, facilities, leadership) with the dependent variable which is the performance of IMCI officer.

This type of research is quantitative with cross sectional study design. The sample of 50 respondents IMCI officer.Collecting data by filling the questionnaire and interviewing and observation.Processing data using computer software, data analysis with univariate, bivariate statistical test chi-square and multivariate multiple logistic regression statistical test.

The results of this study showed that 62% good performance of IMCI officer. There was correlation between age, length of work,knowledge, motivation, training and leadership with performance of IMCI officer. The dominant factor affecting performance is the IMCI officers working life and leadership."

"Akreditasi Puskesmas merupakan upaya peningkatan mutu dan kinerja pelayanan Puskesmas sebagaimana tercantum dalam Permenkes Nomor 46 Tahun 2015. Dari 38 puskesmas di Kabupaten Brebes baru 10 puskesmas yang terakreditasi. Dasar pengajuan roadmap akreditasi puskesmas di Kabupaten Brebes hanya berdasarkan penunjukkan langsung, tanpa mengukur kesiapan puskesmas baik dari segi kelengkapan dokumen, penilaian assessment, serta ketersediaan sumber daya meliputi SDM, dana dan fasilitas sarana prasarana sesuai standar instrumen akreditasi puskesmas. Tujuan penelitian ini adalah mengetahui kesiapan akreditasi puskesmas di Kabupaten Brebes ditinjau dari sisi input, proses dan output berdasarkan variabel sumber daya dan tahapan kesiapan prasurvei akreditasi. Penelitian kualitatif ini proses pengumpulan datanya dilakukan dengan wawancara mendalam dan telaah dokumen. Hasil penelitian menunjukkan bahwa ketersediaan dana, sarana dan prasarana dinilai cukup siap untuk mendukung penilaian akreditasi puskesmas, namun hasil skoring assessment pada keterpemenuhan kompetensi SDM dan kelengkapan dokumen masih rendah. Rekomendasi yang diajukan adalah memenuhi syarat pengembangan kompetensi SDM, dan melengkapi dokumen serta melakukan self assessment secara rutin dan terjadwal.

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Accreditation of public health centers is an effort and performance enhancement public health centers services as listed in the Permenkes 46/2015. From 38 public health centers in Brebes District, just 10 public health centers are accredited. The basis of the filing of a roadmap of accreditation of public health centers in Brebes District only upon appointment directly, without measuring the readiness of public health centers both in terms of completeness, valuation assessment documents, as well as the availability of resources includes human resources, funds and facilities infrastructure standard instrument of accreditation of public health centers.

The purpose of this research is to know accreditation readiness of public health centers in Brebes District reviewed the input, process and output based on variable phase and readiness resources preaccreditation survey. Qualitative research is the process of collecting data using in-depth interviews conducted with the review document.

The results showed that the availability of funds and infrastructure are rated quite ready to support, but the public health centers accreditation assessment skoring assessment results on the fulfillment of human resource competency and the completeness of the documents is still low. A proposed recommendation is a qualified human resource competencies, and complete paperwork and do a self assessment regularly and scheduled."

"Tujuan dari penelitian ini adalah untuk mengetahui (1) implementasi program bantuan operasional kesehatan (BOK) di Puskesmas Kota Bekasi, (2) ukuran dan tujuan kebijakan, (3) pelaksanaan program cakupan penanganan komplikasi kebidanan, (4) ketersediaan SDM, (5) disposisi pelaksana dan (6) lingkungan sosial, ekonomi dan politik yang mempengaruhi implementasi bantuan operasional kesehatan (BOK) dengan cakupan penanganan komplikasi kebidanan di puskesmas kota bekasi tahun 2019. Variabel penelitian meliputi sumber daya manusia, anggaran, pedoman, fasilitas, perencanaan, pelaksanaan, monitoring dan evaluasi. Sampel yang terlibat dalam pelaksanaan program bantuan operasional kesehatan di Puskesmas Kota Bekasi terdiri dari 9 responden. Hasil penelitian mengungkapkan bahwa perencanaan anggaran sudah sesuai dengan juknis, kebijakan sumber daya manusia belum memadai, jumlah dana sudah mencukupi dan proses akuntabilitasnya memerlukan pengawasan dan penyederhanaan pelaporan. Pada tingkat capaian program penanganan komplikasi kebidanan, cakupan layanan ada yang telah meningkat, tetapi ada beberapa layanan yang tidak memenuhi target Standar Pelayanan Minimal (SPM).

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The aims of the research are to find out (1) the implementation of health operational assistance (BOK) at Bekasi City Health Center, (2) the size and objectives of the policy, (3) implementation of coverage programs for obstetric complications management, (4) the availability of human resources, (5) implementation disposition and (6) social, economic and political environment that affect the implementation of health operational assistance (BOK) with coverage of obstetric complications management in the Bekasi City Health Center in 2019. Research variables include human resources, budget, guidelines, facilities, planning, implementation, monitoring and evaluation. The sample involved in implemention of health operational assistance (BOK) with coverage of obstetric complications management in the Bekasi City Health Center consisted of 9 respondents. The results of the research revealed that budget planning was in accordance with technical guidelines, human resource policies were inadequate, the amount of funds was sufficient and the accountability process needed supervision and simplification of reporting. At the level of achievement of the obstetric complications management program, service coverage has increased, but there are some services that do not meet the Minimum Service Standards (MSS) targets."

"ABSTRACTPublic Hospital (RSUD) of Banten Province, as the Province Referral Hospital, is required to always improve the quality of service in every line to achieve excellent service and also to give satisfaction to the public. Public satisfaction is one of the goals that must be considered by Banten Province Public Hospital because one indicator in achieving the success of health services is the achievement of public satisfaction. On this basis, it is important for the Banten Province Public Hospital to make measurements on the public satisfaction. Related to that, this study aims to find out the quality of public services in Banten Province Public Hospital, which is measured through Public Satisfaction Index (IKM), including problems faced in the provision of public health services in Banten Province Public Hospital. The research method used is survey method with a quantitative descriptive approach. The data is obtained through questionnaires, observations, and documentation. The sample size is 100 people, which is determined by quota sampling technique. The results showed that quantitatively, the quality of public service in Banten Province Public Hospital based on Public Satisfaction Index reached 75.71, which is qualitatively categorized as good. Although it has been categorized as good, of the ten elements assessed, there are some elements that need to get serious attention, namely elements of information, complaint handling, the behavior of service personnel, service time, and supporting elements."

"Kepuasan pasien merupakan salah satu indikator untuk menilai keberhasilan layanan rumah sakit yang berguna memberikan feedback bagi pihak manajemen, karena dengan mutu pelayanan yang baik akan dapat memberikan kepuasan. Kepuasan pasien sendiri akan memberikan dampak minat beli ulang pasien dan promosi bagi rumah sakit. Latar belakang penelitian ini adalah kinerja rawat inap RS. Bella yang menurun dan belum adanya informasi mengenai kepuasan pasien beserta hubungannya dengan minat pemanfaatan ulang. Tujuan penelitian ini adalah untuk mengetahui gambaran kepuasan pasien terhadap pelayanan rawat inap dan minat pemanfaatn ulang serta hubungan keduanya. Desain penelitian adalah cross sectional dengan dengan analisis deskriptif dan merupakan penelitian survey terhadap 120 orang pasien yang dirawat di RS. Bella dengan menggunakan kuisioner Parasuraman dkk yang telah disesuaikan dengan kondisi rumah sakit. Kuisioner berisi lima dimensi mutu Servqual yaitu tangibility, reliability, responsiveness, assurance, dan emphaty. Dari hasil penelitian menunjukkan bahwa semua variabel mutu Servqual mempunyai hubungan yang erat dengan kepuasan pelanggan. Metode Servqual bisa digunakan sebagai alat ukur kepuasan pasien terhadap mutu pelayanan di rumah sakit. Hasil penelitian menunjukkan bahwa persentase tertinggi dari kepuasan responden terdapat pada dimensi assurance, dimana 62.5 % responden menyatakan puas dan 37.5% menyatakan tidak puas. Kepuasan tertinggi kedua ada pada dimensi emphaty (51.7%), urutan selanjutnya adalah kepuasan dimensi tangibility (46.7%), dan dimensi reliability (45.8%). Kepuasan terendah ada pada dimensi responsiveness yaitu hanya 40.8% responden yang menyatakan puas sedangkan 59.2% menyatakan tidak puas. Responden yang berminat untuk pemanfaatan ulang pelayanan rawat inap sebanyak 82 orang (68.3%) orang, dan yang tidak berminat sebanyak 38 responden (31.7%). Hasil penelitian diharapkan dapat digunakan oleh Rumah Sakit sebagai salah satu alat untuk menyusun strategi dalam perbaikan mutu pelayanan.

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Patient satisfaction is one of the indicators for measuring hospital service and giving feedback for management, because of good service quality will give satisfaction, in the other hand patient satisfaction will give effect for reutilization interest and hospital promotion.

Background : Hospital effort achievement still low. Surely it’s a challenge for hospital in its effort facing competitions. And ther is no informationabout patient satisfaction related to reuse interest.

Objectives of this research is to describe patient satisfaction and inpatient reutilization interest and the relationship between both.

Method : descriptive analysis with cross sectional design and interviewing to 120 patients. Research methodology is quantitative analysis with univariate analysis, and bivariate analysis (Fisher Test and Parasuraman Corelations).

Results : The results of study are the highest patient satisfaction is dimension of assurance and the lowest satisfaction is dimensions of responsiveness. The results of statistic test are dimension tangibility, responsiveness, assurance and emphatyhave significantly relationship to re- use interest of inpatient care services. Beside that patient satisfactions survey as a tool for observing hospital service quality."