Vol. 5, No. 10, October 2024
E-ISSN: 2723 - 6692
P-ISSN:2723- 6595
http://jiss.publikasiindonesia.id/
Journal of Indonesian Social Sciences, Vol. 5, No. 10, October 2024 2548
The Effect of Competence of Conservative Dentist Specialists
on Patient Satisfaction with Dental Health Services and Its
Relationship to BPJS Patient Loyalty at the Hospital
Jeanny Kathleen Hartini, Kosasih
Universitas Sangga Buana YPKP Lestari, Bandung, Indonesia
Correspondence: [email protected]
*
KEYWORDS
ABSTRACT
Dental specialist competence;
conservative dentistry; patient
satisfaction; patient loyalty;
BPJS; dental health services;
dental care; competency
training; healthcare quality
This study examines the influence of the competence of dental
conservation specialists on patient satisfaction and its relationship
to BPJS patient loyalty in hospitals. The competencies of dental
specialists, including technical expertise, deep knowledge, and
communication skills, are crucial in delivering high-quality and
satisfying dental health services. Patient satisfaction is a key
indicator of healthcare success, especially in dental services, where
procedures such as root canal therapy and dental restoration
require a high level of expertise. This research aims to analyze how
the competence of dental conservation specialists impacts patient
satisfaction and how this satisfaction influences BPJS patient loyalty.
The research utilizes a qualitative approach with a case study
method involving BPJS patients who received dental conservation
services in hospitals. Data were collected through semi-structured
interviews and questionnaires, focusing on patients' experiences
with dental services. The data were analyzed using thematic
analysis, identifying key themes related to dentist competence,
patient satisfaction, and loyalty. The findings highlight the
importance of continuous training for dental conservation
specialists in improving patient satisfaction and fostering loyalty to
the hospital's services. These efforts will not only enhance the
quality of dental care but also support the sustainability of the BPJS
program in providing accessible and affordable healthcare.
Attribution-ShareAlike 4.0 International (CC BY-SA 4.0)
Introduction
In this era of globalization, improving the quality of services to be offered is getting more and
more attention from companies, including in the health sector (Rini & Tamar, 2023). This is because
service quality can be used to achieve a competitive advantage. Health is a critical need for society.
The increasing social status of society at this time affects people's demands for the quality of service
of health service providers. This requires health service providers to always improve the quality of
their services for the better. (Hutabarat, 2023).
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It is not easy for health service providers to provide good service quality because patients
directly feel the services they provide. Even a little negligence in handling patients can hurt patients
and the health service providers themselves (Pogorzelska & Chlabicz, 2022). Therefore, the level of
satisfaction of service recipients can be measured by the success of health service providers
(Finamore et al., 2002). (Finamore et al., 2021)..
Consumer satisfaction is a feeling of pleasure or disappointment that arises from comparing
the perceived performance of a product or service against the results of their international
expectations. (Dubey & Sahu, 2019). A patient is also considered a consumer because he has
experienced health services such as in a hospital. Patient satisfaction can only be achieved by
providing quality service to consumers where, in this case, the patient is a consumer. (Kadwa &
Alshenqeeti, 2020). Efforts are needed to improve service quality to fulfill desires and increase
patient satisfaction. The implementation of service quality carried out by a company engaged in the
health sector is to provide good quality service for patients to create patient satisfaction and an
attitude of loyalty. In evaluating satisfaction with the quality of a particular service or company,
consumers generally refer to several factors or dimensions (Febres-Ramos & Mercado-Rey, 2020).
Oral health is important in maintaining well-being (Kalaja, 2023). With the increasing public
awareness of the importance of good dental care, the demand for quality dental health services is
increasing. One form of dental health service that has a major role in maintaining the patient's
dental health is dental conservation. (Sonza et al., 2021). Conservation dentists are responsible for
performing treatments that aim to save teeth from further damage and restore the function and
aesthetics of teeth that have been damaged. This service, especially in the BPJS scheme, is crucial in
providing the community access to affordable and quality dental health care (Bulutoding et al.,
2020).
Patient satisfaction is one of the leading indicators in assessing the quality of health services,
including dental health services (Pradiani et al., 2022). In this context, especially in hospitals
serving BPJS patients, the competence of conservation specialist dentists plays an important role in
influencing patient satisfaction and loyalty. Dentist competence includes technical expertise in
performing treatment procedures, the ability to communicate, and the professional attitude
demonstrated during patient interactions (Edition, 2021).
Technical competence includes an in-depth understanding of dental care and the ability to
perform procedures well (Afrinis et al., 2020). Conservation dentists with these skills can provide
more effective and efficient treatment, contributing to positive patient outcomes. When patients
feel that they are getting high-quality care, their sense of satisfaction will increase, and this becomes
the foundation for building deeper trust in the doctor and hospital (Rafiza, 2024).
However, communication skills are equally important. Dentists who can explain procedures
clearly, answer patient questions, and listen to complaints with empathy will create a more pleasant
experience. Good communication helps patients feel more involved in the treatment process, which
in turn can increase their satisfaction (Afrinis et al., 2020). When patients feel cared for and
understood, they tend to be more loyal to the services provided, even in the BPJS system, which
often has challenges regarding waiting times and resources (Stambulova et al., 2021).
Professional attitude also contributes significantly to patient satisfaction. Dentists who
exhibit a positive, attentive, and caring attitude toward patient well-being can create a comfortable
and safe environment for patients. This is important, especially in dental healthcare, where many
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patients may feel anxious or fearful of the procedures (Maramis et al., 2022). When dentists can
create a supportive atmosphere, patients will feel calmer and more satisfied with the services they
receive (Dovchin, 2020).
As such, patient satisfaction is determined by the care outcome and how that care is delivered.
All these aspects contribute to patient loyalty towards the hospital. Satisfied patients tend to remain
loyal to the healthcare services they receive, which also positively impacts the hospital's reputation
in the eyes of the community. (Wantu et al., 2021). Therefore, it is important for hospitals serving
BPJS patients to continuously improve the competence of conservation specialist dentists through
continuous training and skills development in order to provide optimal services and meet patient
expectations (Rum et al., 2019).
However, there are several challenges in ensuring that the competence of conservation
dentists is in line with patient expectations. Human resource management, limited facilities, and
long waiting times often affect patient experience. (Manzoor et al., 2019).
In Indonesia’s healthcare system, one of the critical challenges lies in the effective
implementation of services through the National Health Insurance (BPJS). BPJS Kesehatan,
established as a social insurance system, aims to provide affordable healthcare to the Indonesian
population. However, despite its noble goal, there are still significant challenges in delivering
consistent quality care, particularly in specialized services such as dental health. The problem
arises from resource limitations, waiting times, and the variable competency levels of healthcare
providers, which affect patient satisfaction and loyalty. In the BPJS system, dental conservation
services, which focus on preserving and restoring teeth, are essential to public dental health. The
quality of these services, particularly in hospitals with limited resources, significantly impacts
patient satisfaction. Inadequate competencies among conservation specialists—both technical and
communicative—lead to inefficiencies and dissatisfaction, contributing to lower patient loyalty
within the BPJS system. This issue becomes urgent when considering the high expectations of BPJS
patients, who seek cost-effective and high-quality healthcare.
The urgency of addressing this issue is underscored by the increasing demand for quality
dental services and the need for BPJS Kesehatan to maintain public trust. If these challenges are not
met, there is a risk of diminishing patient satisfaction, which can lead to decreased loyalty and the
long-term sustainability of the BPJS program itself. This study is essential in understanding how
enhancing the competencies of conservation specialists can bridge the gap between patient
expectations and service delivery, thereby improving satisfaction and fostering loyalty among BPJS
patients.
Therefore, this study aims to analyze how the competence of conservation specialist dentists
can affect patient satisfaction and how this relates to BPJS patient loyalty in hospitals. This study
aims to analyze the effect of the competence of conservation specialist dentists on the level of
patient satisfaction in dental health services in hospitals. In addition, this study also wants to
determine whether there is a relationship between patient satisfaction and BPJS patient loyalty in
dental health services. Finally, this study aims to examine the role of the competence of
conservation specialist dentists in increasing BPJS patient loyalty in hospitals.
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Materials and Methods
This study employs a qualitative approach with a case study method to analyze the influence
of conservation specialist dentists' competence on patient satisfaction and loyalty among BPJS
patients in hospitals. The qualitative method was chosen to obtain an in-depth understanding of
patient experiences and how the competence of dental specialists impacts both satisfaction and
loyalty.
Research Subject
This study's subjects were BPJS patients who had received services from conservation
specialist dentists at the hospital. The selection of subjects was purposive, with the main criteria
being patients with direct experience with conservation specialist dentists who have undergone
dental treatment in the last six months.
Data Collection Technique
Data was collected through three main techniques:
− Semi-structured interviews: Interviews were conducted with patients and medical personnel
to gain perspectives on service quality, doctor competence, patient satisfaction, and patient
loyalty to the services received. These interviews were designed to explore the subjective
experiences of respondents.
− Questionnaire: Patients fill out a questionnaire containing questions about dental health
services received by patients after receiving treatment from a conservation specialist dentist.
Data Analysis Technique
The collected data was analyzed using the thematic analysis method, which involves
identifying, grouping, and interpreting the themes that emerged from the interviews and
observations. This analysis process included:
1. The transcription of interview and observation data is to be coded.
2. Theme groupings related to doctor competence, patient satisfaction, and loyalty.
3. Interpretation and triangulation of data from interviews, observations, and documentation
to ensure validity of findings.
Validity and Reliability
To maintain data validity and reliability, this study used data source triangulation
techniques by comparing the results of interviews, observations, and documentation data. In
addition, researchers also conducted discussions with dental health experts to ensure the validity
of the interpretation of the research results.
Results and Discussions
Competence of Conservation Specialist Dentist
According to Abdullahi et al. (2021), in general, competence is an ability or proficiency
possessed by a person in carrying out a job or task in a particular field by the position he holds.
Another opinion says competence is a skill, knowledge, basic attitude, and value contained in a
person reflected in the ability to think and act consistently. (Hati & Pratiwi, 2019). In other words,
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competence is not only about a person's knowledge or ability but the willingness to do what is
known to produce benefits (Hussain et al., 2019).
According to Afrashtehfar et al. (2020), there are 6 aspects contained in the concept of
competence, namely:
1. Knowledge
2. Understanding
3. Skills
4. Value
5. Attitude
6. Interest
According to Elbaz et al. (2023), is a measure or something that is used as an example or a
valid basis for measurement. Meanwhile, the meaning of national is nationality. The national
standard of education is the minimum criterion for the education system in all jurisdictions of the
unitary state of the Republic of Indonesia, so the national standard of education is the minimum
limit for education providers of the Republic of Indonesia (Budianto, 2020). So, education is the
minimum limit on the education system for national standards for education providers to carry out
an educational process throughout the jurisdiction of the unitary state of the Republic of Indonesia.
(Owolabi et al., 2021).. The National Education Standards serve as the basis for planning,
implementing, and supervising education in order to realize quality national education. (Chen et al.,
2022).
The competence of conservation specialist dentists is a professional ability that includes
knowledge, skills, and attitudes in carrying out actions to treat and restore damaged teeth, such as
root canal treatment and tooth restoration. (Nasution et al., 2020). This competency is very
important because it determines the success of the treatment and affects the quality of the patient's
results. According to Frihatni et al. (2023), the competence of conservation specialist dentists
includes technical ability, in-depth knowledge of dental anatomy, and expertise in the use of the
latest medical technology.
In addition, conservation specialist dentists must have good communication skills to ensure
that each patient understands his or her dental health condition and the type of treatment to be
performed. (Sofiany et al., 2022). Explaining clearly and convincingly is key to building trust
between doctors and patients (Nurliana et al., 2020). Proper explanations of procedures, benefits,
and risks of treatments help patients feel more comfortable and make better decisions regarding
the care they need (Budianto, 2020).
Effective communication can also reduce patient uncertainty and anxiety, especially in dental
conservation treatment cases, which often involve complex and potentially uncomfortable
procedures. (Bose & Makri, 2021). Through open communication, conservation dentists can clearly
understand the treatment steps to be taken so that patients can confidently follow each stage
(Frihatni et al., 2023). In addition, doctors can adjust how information is conveyed according to the
patient's background and knowledge, which helps increase patient satisfaction and trust in the
services received (Siregar, 2021).
Good communication skills include the doctor's ability to listen attentively to patients'
complaints and concerns. This allows the doctor to provide more appropriate and personalized
solutions for each patient and strengthens the relationship between doctor and patient. Patients
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who feel listened to and cared for individually tend to have higher satisfaction levels and are more
loyal to the services provided. Thus, in addition to technical skills, good communication is important
in maintaining the quality of dental health services, especially in the context of BPJS patient services.
Patient Satisfaction
Patient satisfaction is a level of patient feelings arising from the performance of health
services obtained after the patient compares with what he expected (Pohan, 2007). Good service
quality in the hospital can create satisfaction for its patients. (PratiwI & Susanto, 2016).
Patients or the public see quality health services as a health service that can meet their
perceived needs, is organized politely and courteously, is on time, responsive, able to cure their
complaints, and prevent the development or spread of disease. In addition to being every
customer's right, quality service is needed because it can provide opportunities to win competition
with other health providers.
The assessment of health service providers' abilities has two elements: medical techniques
and interpersonal relationships. These two elements relate to providing information to patients
about their illnesses and making decisions with patients about the actions that will be taken on
them. This interpersonal relationship relates to providing information, empathy, honesty, sincerity,
sensitivity, and trust about patient privacy.
Patient satisfaction is the result of comparing the patient's expectations of the services
received, and the reality felt after receiving these services. Kotler (2020) states that patient
satisfaction is closely related to the quality of service provided, including the professional attitude
of medical personnel, the comfort of the service environment, and the result of treatment. In the
context of dental health services, patient satisfaction is not only related to the success of treatment
but also to the overall experience that patients feel during the treatment process, such as waiting
time, adequate facilities, and the relationship between doctors and patients. High satisfaction
increases patient loyalty and strengthens trust in the health services provided.
Dental Health Services
Service satisfaction in hospitals can be measured by its level based on the experience of
visitors/patients who are felt in receiving the services provided (Stiyawan & Ainy, 2023). In
addition, trust is crucial in customer satisfaction in the service sector to maintain that consumers
can consistently meet their needs.
Patient satisfaction surveys can be conducted by conducting satisfaction surveys and
providing service recipients with a means of complaint by providing criticism and suggestions for
the services provided. Measurement of patient satisfaction carried out by service providers is
carried out to overcome problems that occur in difficult situations by thinking about solving these
problems.
Dental health, often referred to as oral health, is the state of the oral cavity, including the teeth
and supporting tissue structures, free from disease and pain and functioning optimally. This will
increase confidence and interpersonal relationships.
Dental health is one aspect of overall health resulting from physical, mental, and social
interaction. The physical aspect is the state of oral hygiene, the shape of the teeth, and saliva, which
can affect oral health. Dental and oral hygiene is the state of the teeth in the oral cavity in a clean
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state, free from plaque and other impurities above the surface of the teeth, such as debris, tartar,
and food debris.
The main effort to maintain dental health should be to control the growth of bacteria in the
oral cavity because uncontrolled oral bacterial growth is the leading cause of oral and dental
problems.
Some things that can be done to reduce plaque growth are as follows:
1. Brush your teeth at least twice a day with fluoride-containing toothpaste in the morning after
breakfast and at night before bed.
2. Brush your teeth properly and correctly by reaching the entire surface of the teeth from the
gums to the teeth.
3. Use dental floss to clean food debris between the teeth.
4. Gargle after eating or brushing your teeth with a non-irritating mouthwash.
5. Avoid sugar-containing foods such as candies or starchy, as the leftovers can stick to the teeth.
6. Eat more fruits and vegetables, such as apples, carrots, and celery, that can clean your teeth.
Dental health maintenance, especially in preventing improper plaque growth, can lead to
various diseases of the teeth and supporting tissues. Plaque not cleaned regularly will undergo a
calcification process that causes hardening, resulting in tartar formation. This tartar not only affects
aesthetics but is also a major risk factor in the development of more serious dental diseases. Dental
plaque also increases the pathogenicity of caries and periodontal disease, both of which can result
in permanent damage to the teeth and supporting tissues if left untreated.
Dental health services include a series of preventive, curative, and rehabilitative measures
aimed at maintaining and improving the community's oral health. This service involves various
types of treatment ranging from tooth cleaning and root canal treatment to conservation and oral
surgery. Competent medical personnel, complete facilities, and a good service management system
must support quality dental health services. Under the BPJS scheme, dental health services focus on
accessibility and affordability, although sometimes the quality of service is affected by the large
number of patients and limited resources.
Patient Loyalty
Customer loyalty is more associated with behavior (behavior) than attitude. One way
consumers show their loyalty to a company's products is by recommending them to other
consumers. In contrast, negative attitudes are shown by using negative words (word of mouth) to
other consumers and switching to other companies. Loyalty does not arise without coercion but by
itself.
According to Anggara (2023), consumer loyalty is loyalty to companies, brands and products.
According to Marzuki et al. (2020)(2020), loyal consumers will generally purchase the brand even
though they are faced with many alternative competing product brands that offer superior product
characteristics viewed from various angles.
Hafidz and Muslimah (2023), define consumer loyalty as people who buy, especially those who
buy regularly and repeatedly. Customers are said to be loyal if these customers continuously or
repeatedly come to the same place to satisfy their desires by owning a product or getting a service
and paying for the product or service.
There are seven key steps to realizing and maintaining customer loyalty:
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1. Commitment and top management involvement: All company activities result from
management decisions, so the company's progress depends on its management.
2. Internal benchmarking When retaining customers is realized, conduct internal benchmarking
to determine the current status or position. Internal benchmarking includes measuring and
assessing the company's management, organization, systems, and services. The measures used
include customer loyalty (number, percentage, and permanence), core customer value-added,
and costs due to poor quality.
3. Identifying Customer Requirements Several methods, such as value research, customer
window models, and sensitivity analysis, can be used to identify customer requirements.
4. Assess competitive capabilities To win the competition, competitors' capabilities must be
carefully identified and assessed; a technique that can be used to assess competitors'
capabilities and determine the customer satisfaction gap between the company and they can
be done with a marketing intelligence system.
5. Measuring customer satisfaction and customer loyalty. Customer satisfaction concerns what
the customer expresses, while customer loyalty concerns what the customer does. Therefore,
the parameters of customer satisfaction are more subjective and difficult to measure. The
number and continuity of core customers can measure customer loyalty. Nonetheless, data for
customer satisfaction and loyalty is solely obtained from customer feedback, which can be
collected through various means that vary in effectiveness.
6. Analyzing customer feedback from former customers, non-customers, and competitors. The
scope of the company's analysis needs to be expanded to include former customers and non-
customers so that the company can better understand the factors that support customer
satisfaction and loyalty and the negative factors that have the potential to cause customer
defections.
Patient loyalty refers to a patient's willingness to continue using the same health service
repeatedly and recommend it to others. This loyalty arises from patients' positive experience with
the health services provided, both in terms of quality of care, relationships with doctors, and the
results of these services.
Marzuki et al. (2020) stated that patient loyalty is essential for the sustainability of a hospital
or clinic because loyal patients tend to have greater trust in the services provided and do not easily
switch to other health service providers. This loyalty benefits institutional sustainability and
creates a mutually beneficial long-term relationship between patients and service providers. Loyal
patients often recommend the service to others, which in turn helps improve the reputation of the
hospital or clinic. (Hutauruk, 2021).
However, patient loyalty is a challenge in the BPJS system. This is due to limited resources,
such as the number of doctors and facilities that may not be proportional to the high number of
patients served. This condition can affect the patient experience, ranging from longer waiting times
to suboptimal quality of interactions with medical personnel. Therefore, building patient loyalty in
the BPJS system requires more intensive efforts to increase the competence of medical personnel
and improve service management.
Service providers must provide high-quality care despite limited resources to maintain
patient satisfaction and trust in BPJS services (Lestari, 2017). In situations where patient numbers
are high and facilities are limited, consistent quality of care is key to maintaining patient trust. This
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includes the ability of medical personnel, especially conservation dentists, to provide efficient and
effective services without compromising the quality of treatment outcomes (Rahmanti &
Pamungkas, 2022).
A strategic approach is needed to achieve this, such as optimal time management, supporting
technology, and continuous training for medical personnel. Although the number of patients to be
treated is large, competent doctors can still provide adequate services through good
communication and appropriate medical actions. This quality of service will encourage patients to
remain loyal, even in the BPJS system, which often faces challenges in capacity and facilities. Patient
satisfaction is a key factor that will ensure continuity of service and support the creation of long-
term loyalty.
The Relationship between the Competence of Conservation Specialist Dentists and Patient
Satisfaction with Dental Health Services and its Relationship to BPJS Patient Loyalty at the
Hospital
The competence of conservation specialist dentists plays an important role in determining
patient satisfaction. According to research conducted by Tanaem et al. (2019), good technical and
communication competence of conservation dentists significantly increases patient satisfaction,
especially in services that require a high level of expertise, such as root canal treatment and tooth
restoration. This high satisfaction then impacts patient loyalty, where patients feel confident in the
treatment results and are more likely to return to the service.
In the context of BPJS, accessibility and cost of care are two main factors determining the
quality of health services, including dental health services. The BPJS Kesehatan program is designed
to provide more affordable access to health care for the community, thus enabling patients from
various social groups to obtain health services. However, although BPJS offers benefits in cost relief,
challenges remain in ensuring that patient's quality of care matches their expectations (Nurhaeni
et al., 2022). In this case, the competence of dentists, especially conservation dentists, becomes
crucial to maintaining the balance between affordable costs and optimal quality of care.
(Terengganu et al., 2021)..
Patients who are members of the BPJS program generally have the exact high expectations
regarding quality of care as non-BPJS patients. They expect services that meet clinical standards
and provide a positive experience throughout the treatment process, from diagnosis to medical
actions taken. The competence of conservation specialist dentists plays a vital role in meeting these
expectations. With in-depth knowledge, good technical skills, and the ability to communicate
effectively with patients, conservation dentists can provide services that meet patient expectations
even in a lower-cost scheme (Christiani, 2021).
This competency becomes even more important when considering the usually larger number
of BPJS patients than non-BPJS patients. Hospitals serving BPJS patients often face challenges
regarding longer waiting times and limited resources (Sari et al., 2021). Under these conditions,
competent conservation specialist dentists can manage patients more efficiently without
compromising the quality of care. They can identify problems quickly and provide appropriate
solutions for the patient's medical condition. In addition, dentists who can communicate well can
help reduce patient anxiety and clearly explain the procedures to be carried out, making patients
feel more comfortable and satisfied with the treatment (Khoiriyah, 2021).
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The success of dental health services under the BPJS scheme also highly depends on how
conservation specialist dentists can maintain professionalism standards (Quality, On, & Post, 2021).
Although there are limitations in terms of facilities and time, doctors who have high competence
can still provide satisfying services and generate patient loyalty. Patients who feel they are getting
quality service tend to continue to use BPJS services at the hospital and even recommend it to
others. Thus, the competence of conservation specialist dentists not only contributes to patient
satisfaction directly but also has a positive impact on patient loyalty in the long term. (Putri &
Utomo, 2021)
Therefore, hospitals serving BPJS patients should continuously improve the competence of
medical personnel, especially conservation specialist dentists, through continuous training and the
use of the latest technology. This will not only improve the quality of care but also support the
sustainability of the BPJS program in providing access to quality and affordable health services for
all levels of society (Hutauruk, 2021).
Dentists who can provide quality services according to patient expectations will find it easier
to maintain the satisfaction and loyalty of BPJS patients. Other research by (Nidianti et al., 2019)
shows a significant positive relationship between dentist competence and patient loyalty in
hospitals serving BPJS patients, reflecting the importance of increasing competence in maintaining
patient trust and satisfaction.
Thus, it is concluded that improving the competence of conservation specialist dentists is
very important in maintaining patient satisfaction and loyalty, especially in hospitals serving BPJS
patients. High competence not only ensures the quality of care that meets patient expectations but
also plays a role in maintaining patient trust and loyalty. Research Lestari (2017) reinforces this
view by showing a significant positive relationship between physician competence and BPJS patient
loyalty. Therefore, continuous training and the use of the latest technology must ensure that the
health services provided remain of high quality and affordable, supporting the sustainability of the
BPJS program that serves all levels of society.
Conclusion
Based on the study, the competence of conservation specialist dentists significantly affects
patient satisfaction and BPJS patient loyalty at the hospital. Competence that includes technical
ability, knowledge, and effective communication can improve treatment outcomes and positive
patient experiences, increasing patients' satisfaction. This satisfaction is closely correlated with
BPJS patient loyalty, where satisfied patients tend to return to use the same service and recommend
it to others. Thus, improving the competence of conservation specialist dentists is key to
strengthening BPJS patient loyalty in hospitals. From a practical perspective, hospitals and
healthcare providers within the BPJS system must prioritize continuous training and development
of dental specialists, particularly those in conservation services, to improve technical skills and
communication abilities through targeted professional development programs, which can lead to
enhanced patient outcomes and greater satisfaction. Additionally, fostering an environment that
encourages effective communication between doctors and patients will build trust and loyalty,
which is essential for retaining patients in the BPJS system despite its inherent challenges. Future
research could delve into other factors affecting patient satisfaction and loyalty within the BPJS
framework, such as organizational aspects like hospital management practices, resource
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availability, and the role of technology in improving service delivery. Studies could also explore the
impact of patient demographics, including age and socioeconomic status, on satisfaction and
loyalty, potentially enabling more tailored strategies for various patient segments. Lastly, a
comparative study between BPJS and non-BPJS patients might reveal differences in expectations
and experiences, offering valuable insights for improving the overall healthcare system.
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