Analysis of the Effect of Public E-Health Service Quality on the

Creation of Public Value

Case Study: PMR Hospital Surabaya City

Ria Rizki Wardani

, Erma Suryani

Magister Manajemen Teknologi Informasi, Institut Teknologi Sepuluh November, Surabaya, Indonesia

Key

words: Customer Satisfaction, Service Quality, E-Health, Public Value, and Partial Least Square (PLS)

Abstract: Utilization of information technology becomes very important role because it has been proven that by using

information technology, effectiveness, efficiency in doing a faster process is achieved. With the existence of

fast and quality health service is expected to increase public value in society. Quality of service could be

obtained from customer satisfaction which is formed by customer perception. One of the emerging areas of

health by adopting information technology is E-Health. E-Health Innovation in Indonesia is spearheaded by

the Surabaya City Government with the aim of making it easier for people to come to the community health

centre (Puskesmas) and hospitals to register online, both new patients and old patients. Thus, no longer long

queues occur and the patient could estimate the time to come to the targeted health facility. Enthusiastic

people of Surabaya in utilizing E-Health online registration system is high enough to spur other private

health agencies to apply a similar system. PMR hospital located in Surabaya City is an international private

hospital that has implemented a similar system. But in reality the system has not been able to create

maximum public value in accordance with hospital expectations. This study is aimed at analysing the

influence of service quality online registration system E-Health Hospital PMR Surabaya city to maximize

the creation of public value. The research method used in this research was descriptive quantitative

approach. Data collection of respondents for quantitative research would be taken in Surabaya City area

based on respondents by using E-Health online registration application. The sampling technique used in this

research was the questionnaire survey using partial least square data analysis (PLS). The number of samples

in this study was 100 respondents. The result showed that E-Health had positive and significant effect to

Public Value with original value sample estimate of 0.267 and t-test result obtained by t-count (3.036) > t-

table (1.96). This means that if the better E-health, then the Public Value was increasing. Recommendations

of research results indicate that there is an improvement in the system by building or adding a service and

system criticism survey system and suggestions on the online registration application of the Surabaya City

PMR Hospital.

1 INTRODUCTION

Rohman (2008) Public services is a service or giving

to public the form of the use of public facilities, both

services and non-services, which are performed by

public organizations in this case a government.

Public service is a must for the state or government

to serve its citizens. Public services are not easy to

do and many countries fail to do good public

services for their citizens, Rohman (2008). The

failure and success of a public service can be

determined by the services quality or services

provided by the public service.

One area of public service is health. Each

healthcare service institution is required to create a

competitive advantage in the face of new

competitors engaged in the same service agency that

must have the ability to develop strategic choices in

order to adapt to a dynamic environment. Health

field is a public service that needs to be improved in

implementation of quality, transparent, easy, cheap,

fast, fair, and fair public service delivery to all

people in order to support the public interest.

In Indonesia the use of information technology

for the health sector has been regulated in Law no.

36 of 2009 on health, where to organize effective

220

Wardani, R. and Suryani, E.

Analysis of the Effect of Public E-Health Service Quality on the Creation of Public Value.

DOI: 10.5220/0007540402200226

In Proceedings of the 2nd International Conference Postgraduate School (ICPS 2018), pages 220-226

ISBN: 978-989-758-348-3

and efficient health efforts required information and

health services conducted through the system

information and through cross-sector. E-health is

one of the innovations undertaken to overcome these

obstacles. According to Wickramasinghe and

Goldberg (2004) that E-Health or electronic health,

which is essentially driven by the use of information

and communication technologies in health has the

potential to transform the health industry worldwide

in terms of infrastructure, cost and quality of service.

The enthusiasm of Surabaya society in utilizing

the online registration system is high enough to spur

other private health agencies to implement similar

systems. PMR hospital located in Surabaya is an

international private hospital selected by the

researcher. PMR hospitals have utilized the E-Health

service-based E-Health website but it is not yet

optimal, as evidenced by the visits of patients who

are admitted to PMR hospitals either directly

registering or through online registration through

websites tend to be quiet or under-capacity (UC). As

preliminary information, PMR hospital has 25 polies

ready to serve outpatients with a maximum capacity

of patient per 25 to 30 patients per day. This

indicates that PMR Hospital with the service

capacity provided has not met the target customer

with maximum. The following is the data obtained

by the researcher for the last 3 (three) months based

on the patient visit in PMR Hospital Surabaya.

Table 1.1: Data on patient visit in PMR Hospital 2017.

Source: Internal data of PMR Hospital visitors’

statistics (2017)

Benefit to be gained by PMR Hospital by

improving service quality is able to create maximum

public value. The technique used in this study is

non-probability sampling, where all elements of the

population do not have the same opportunity or

opportunity to be a member of the research sample

and the type of non-probability sampling used in this

study is purposive sampling that is sampling

technique based on criteria and the characteristic of

the specified sample. Data collection used direct

survey method with questionnaires instrument. For

further analysis, used Partial Least Square (PLS)

method and analysis technique. PLS was chosen by

the researchers with the consideration that PLS is a

powerful analytical method because it can be applied

to any data scale, does not require many assumptions

and the sample size does not have to be large. PLS is

a more appropriate approach for predictive purposes,

especially in conditions where indicators are

formative.

2 LITERATURE REVIEW

Service quality is closely related to the customer

epuasan k are believed to be major factors that

significantly impact customer value. Customer was

believed to be a significant impact on the increase in

revenues. This becomes something that is important

for profit-seeking companies.

Some studies conclude that customer satisfaction

does not have a significant impact on customers,

customers also have no significant impact on

corporate profits. The theories used in this study

include from various literature journals, guidebooks

of quality Partial Least Square (PLS), online

media, as well as one of the object of One Hospital

which became the research place. In this case the

health agency company which is the object

of research is PMR Hospital in Surabaya city .

2.1 Quality of Service

Kotler & Keller (2009) state that service quality is

the totality of features and characteristics of products

or services that are capable of satisfying the stated or

implied customer requirements.

A qualified

company is a company capable of delivering its

products or services to meet or exceed customer

expectations.

From the definition of service quality can be

concluded that the quality of service is all forms of

activities undertaken by the company to meet

consumer expectations.

Service in this case is

defined as services or services delivered by the

owner of services in the form of ease, speed,

relationship, ability and hospitality addressed

through the attitude and nature in providing services

for customer satisfaction.

2.2 Public Service

Gronross (2013) states that service is an activity or

a series of activities that are invisible (not palpable)

that occur as a result of interaction between

consumers with employee or other things provided

by the company service providers intended to solve

consumer or customer problems.

Analysis of the Effect of Public E-Health Service Quality on the Creation of Public Value

221

Ratminto and Atik Septi Winarsih (2006)

conclude that public service or public service is as

any form of service, either in the form of public

goods or public services which in principle is the

responsibility and implemented by government

agencies in central, regional, and in the environment

of State-Owned Enterprises, in an effort to meet

the needs of the community as well as in the

implementation of the provisions of the laws and

regulations.

2.3 Public Value

Customers have the same needs, but the wish of

each customer is different. This causes the

customer's perception of the product or service

offered by the company will give different value in

customer's eyes. Value is something that is

individual because something that is valuable to

someone is not necessarily valuable to

others. Sometimes customers value a product or

service based on the merits of the product or service,

but in another situation the customer judges a

product or service based on the employee's service

or friendliness in serving the customer regardless of

the benefits of the product or service.

The public value / customer value is a level of

satisfaction determined when a customer sees more

value from a product and the service performance

received from a process of purchasing a product or

service (Lupiyoadi, 2006). The more value to

customers given by a product or service is a

customer's answer to determine his

choice. On basically the customer is looking for the

greatest value provided by a product or service.

2.4 E-Health

E-Health is an internet application or other related

technology in the healthcare industry that aims to

improve access, efficiency, effectiveness, and

quality of medical and business processes, involving

the organization of medical services (hospitals or

clinics), medical practitioners (physicians or

therapists) laboratories, pharmacies, insurance, and

patients as consumers. Solutions on offer

E-

Health

including products, systems and services,

for example

, health information, electronic medical

records, drug purchasing services, communication

systems between users, and other information on

disease prevention, diagnosis, treatment, health

monitoring and lifestyle management.

E-Health can be seen from corporate or corporate

solutions in the health sector

that involves support of

all aspects of government structure, such as

hospitals, health centers, health offices,

pharmaceutical industries, higher education (health-

related), and polyclinics.

If E-Health is fully

supported by the population and community

administration within the scope of the region, city,

province, or national, then E-Health will be a future

application in order to optimize the public health

system.

2.5 Relationships between Variables

Theory as the Basis of the

Hypothesis

There are three types of relationships between

variables, namely symmetrical relationships, causal

relationships, and interactive relationships (mutual

influence). To find the relationship between two

variables or more is done by calculating the

correlation between the variables that will look for

the relationship. Correlation is a number that shows

the direction and strength of the relationship

between variables or more. This means expressed in

the form of a positive or negative relationship, while

the strength of the relationship is expressed in the

magnitude of the correlation coefficient.

The relationship of two or more variables is

positive, if the value of one variable is increased, it

will increase the other variable, and vice versa. If the

value of one variable is lowered, it will decrease the

other variable. The relationship of two or more

variables is stated as negative, if the value of one

variable is increased, it will decrease the value of the

other variable, and vice versa. If the value of one

variable is lowered, it will increase the value of

another variable.

2.6 Partial Least Square (PLS) Method

Partial Least Square (PLS) is an alternative method

of estimating models to manage Structural Equation

Modeling (SEM). The PLS design was made to

overcome the limitations of the SEM method. In the

SEM method requires large data, no missing values,

must be normally distributed, and should not have

multi-collinearity, whereas in PLS use a distribution

free approach where data can be distributed in a

certain way. Besides that, PLS can also be used on a

small number of samples.

Yamin and Kurniawan (2009) say that PLS is

used to determine the complexity of the relationship

ICPS 2018 - 2nd International Conference Postgraduate School

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of a construct and other constructs, as well as the

relationship of a construct and its indicators. PLS is

defined by two equations, namely the inner model

and the outer model. The inner model determines the

specification of the relationship between the

construct and its indicators. The extract is divided

into two, exogenous and endogenous. Exogenous

extract is the cause of the constituent, which is not

affected by other constructs. Exogenous extracts

give effect to other constituents, while endogenous

extracts are the extracts described by exogenous

compounds. Endogenous extract is the effect of

exogenous constructs.

According to Gahazali (2006) that PLS method

has its own advantages including: data does not have

to be multivariate normally distributed (indicators

with category scale, ordinal, interval until the ratio

can be used on the same model) and the sample size

does not have to be large.

3 METHOD

The form of this research was descriptive

quantitative research. This research was conducted

by distributing questionnaires to the community,

especially the people who have been treated

outpatient to the hospital in Surabaya City and

conical to the respondent who registered online E-

Health at PMR Hospital Surabaya City.

Figure 3.1: Conceptual Model.

The population in this study was the community

or hospital patients who have done outpatient

treatment. The sample to be used in this study was

the community or patients who registered either

directly or online for outpatient treatment of the

hospital.

Data collection methods in the study used the

instrument in a questionnaire (Arikunto, 2002).

Questionnaires were a number of written questions

that were used to obtain information from

respondent.

The data analysis method was used Smart PLS

software that run with computer media. PLS (Partial

Least Square) was a variance-based structural

equation analysis (SEM) that could simultaneously

perform testing of measurement models as well as

structural model testing. The measurement model

was used for validity and reliability test, while the

structural model was used for causality test

(hypothesis testing with prediction model).

Figure 4.1: Model of Construct Research Structure.

4 RESULT

The results of data processing by using

Smart PLS software tools, obtained the output of the

model of loading factor construction structure that

would explain the relationship between construct

service quality, E-Health, and public value which

was shown in Figure 4. 1 following:

Analysis of the Effect of Public E-Health Service Quality on the Creation of Public Value

223

4.1 The results of Validitas dan

Reliabilitas

Table 4.1 Test Results Validity and Reliability.

Based on Table 4.1, it was known that all queries in

the questionnaire had r counts greater than r table

and the probability value was less than 0.05 (p <

0.05). Thus all questions were declared valid. The

result of reliability test in Table 4.1 stated that the

four variables were reliable. This is evidenced by the

value of Cronbach Alpha was greater than 0.7.

4.2 Discriminant Validity

In testing discriminant validity could be in two

ways, among others:

1. The root of AVE was to know the correlation

between constructs

Testing the validity of the indicator of

the Average Variance Extract (AVE) root

value was compared with the correlation

between constructs with other

constructs. The following values of AVE

and correlation between constructs could be

seen in Table 4.2 below.

Table 4.2: AVE Values & Correlations between

Constructs.

Description: The value in bold is the root value of

AVE.

Source: Primary data processed, 2018

The result of the test was satisfied, if the AVE

root was greater than the correlation between

constructs with other constructs. From Table 4.9,

shows that the AVE root value was higher than the

value of correlation among other constructs. More

details can be explained as follows:

a. AVE roots value (

AVE

) E-Health

construct equal to 0,787 higher than

correlation between E-Health with

service quality 0,686, and Public value

0,657.

b. AVE roots value (

AVE

) service

quality construct equal to 0,793 higher

than correlation between service

quality with E-Health 0,686, and

Public value 0,752.

c. AVE roots value (

AVE

) Public

value construct equal to 0,818 higher

than correlation between Public value

with E-Health 0,657, and service

quality 0,752.

Based on the above results, it appeared that the

AVE root value was higher than the value of

correlation among other constructs. This showed that

the constructs in the estimated model meet the

criteria of high discriminant validity, meaning that

the data analysis results were acceptable. It was

because the values that describe the relationship

between constructs develop and the AVE root value

had a value greater than the correlation value

between constructs.

2. Correlation construct with indicator itself

Discriminant validity testing in this way

was said to be valid if the construct

correlation value with its own indicator was

greater than that of other constructs and all

construct correlation values with its own

indicator and other constructs indicates a

positive value.

From the results of processing

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data presented on the table cross loading

could be seen that the requirements have been

met so that all constructs in the model were

estimated to meet the criteria discriminant

validity was good meaning the results of data

analysis can be accepted.

The result of an analysis of the correlation

of the construct with its own indicator or

construct correlation with other indicators

could be presented in

Table 4.3 parts of the

following cross loading.

Table 4.3: Correlation Value of Constructs with Indicator

(Cross Loading).

Description: EH = E-Health;

KP = Quality of service;

PV = Public Value

Data Source: Primary data processed, 2018

4.3 Direct Effect Analysis

The results of testing the direct effects of

each of these research variables could be seen

in Tabe 4.4.

Table 4.4: Hypothesis Test Influence.

Data Source: Primary data processed, 2018

The results of hypothesis testing could

be summarized briefly in Table 4.5 following.

Table 4.5: Hypothesis Testing Results.

Source: Primary data processed, 2018

Results if the data above could be known

in the test of each hypothesis that had been

proposed, namely:

1. Hypothesis Testing 1:

H1: Service quality had positive and

significant effect to Public Value

In test of hypothesis 1 obtained by

original value sample estimate equal

to 0,568 value proves service quality

had positive effect to Public Value

which result also reinforced from

result of t test which obtained by t-

count value (7,324) > t-tabel (1.96).,

So, it could be said that was

significant influence service quality

against Public Value.

So, it could be concluded that was

the service quality had a positive and

significant effect on Public Value,

meaning if the quality of service was

better, then the Public Value was

increasing.

Thus, the first hypothesis

was acceptable.

2. Hypothesis Testing 2:

H2: E-health had a positive and

significant effect on Public Value

In test of hypothesis 2 obtained

original value sample estimate equal

to 0,267 value prove E-health had

positive effect to Public Value which

result also reinforced from t test result

obtained by tcount (3.036) > t-table

(1.96), so it could be said there was

significant influence E-health

Public Value.

So, it could be concluded that E-

Health had a positive and significant

effect on Public Value, meaning that if

the E-health was better, then the

Public Value was increasing.

Thus,

the second hypothesis was acceptable.

Analysis of the Effect of Public E-Health Service Quality on the Creation of Public Value

225

5 CONCLUSION

Based on the results of the research and discussion

above, the conclusion of this study was the service

quality had a positive and significant effect on the

Public Value with the original sample estimate value

of 0.568. Then, the result of t-test obtained t-count

(7,324) > t-table (1.96). This means that if

the service quality was better, then the Public Value

was increasing. E-Health had a positive and

significant effect on Public Value with original value

sample estimate of 0.267 and t-test result obtained

by t-count (3.036) > t-table (1.96). It means that if

E -Health is better, then the Public Value is

increasing. Recommendations of research results

indicate that there is an improvement in the system

by building or adding a service and system criticism

survey system and suggestions on the online

registration application of the Surabaya City PMR

Hospital. This study only identifies the factors that

influence the quality of service in terms of the use of

E-Commerce, namely E-Health in increasing public

value. It is expected that in further research to better

identify other factors that has not been explored yet

in the study.

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