Differences in Satisfaction Level between Subsidised JKN Patients and Non-Subsidised JKN Patients: A Case Study in a Hospital in Bantul with Quantitative Analysis Approach

Introduction: The National Health Insurance (JKN) organized by BPJS is a guarantee in the form of health protection so that participants get the benefits of health checks and protection in meeting basic health needs given to everyone. Measuring the level of patient satisfaction is needed to determine the level of service provided by a service provider. To identify differences in the satisfaction of JKN class 3 PBI patients and JKN class 3 non PBI patients who received health services at the place research. Materials and Methods: This study used an analytical observational research design with a cross sectional method through a Quantitative Method approach. Data obtained by using questionnaires and interviews with respondents. The level of patient satisfaction was analyzed using GAP scores, CSI, and Independent Samples T Test. Results: The results of the GAP score indicate that JKN class 3 PBI patients have the lowest GAP score on the reliability dimension, which is -0.1733 and the highest GAP score on the assurance dimension with a score of - 0.0875. Meanwhile, JKN class 3 non-PBI patients had the lowest score on the tangibles dimension with -0.1955 and the highest on the reliability dimension with -0.1711. JKN class 3 PBI patients had a CSI score of 69.81% and JKN class 3 non-PBI patients had 66.938%. If statistically tested, there is a significant difference between JKN class 3 PBI patients and JKN class 3 non-PBI patients with p value < 0.05. Conclusion: From the results of the analysis, at the placed research patients are generally satisfied with the services provided. JKN class 3 PBI patients feel more satisfied than JKN class 3 non PBI patients.

dependencies between various components or aspects of service 6 .
The Social Security Administering Body or more commonly known as BPJS is a public legal entity formed to administer social security programs, consisting of BPJS Health and BPJS Employment 7 . In this case, the health insurance provider is a legal entity formed to administer the health insurance program 7  Service is an activity or series of activities that cannot occur due to interactions between consumers and employees or other things caused by the service provider hospital with the aim of solving or resolving consumer problems 15 .
Service quality or service quality can be interpreted as what customers get from service providers and refers to customer satisfaction.
Service is an important parameter for the quality of a service provider because it is defined as the ability of a service provider to deliver maximum service to consumers 16 . Service quality can increase customer satisfaction and ultimately customers become loyal to the service provider.
The quality of service that is real, responsive, The quality of hospital services can be interpreted as the maximum effort of an organization or health service provider in utilizing all available resources with the aim of providing maximum service to patients in accessing good health services 18 . Service quality has benefits for hospitals, namely as the main indicator in improving the quality of hospitals so that they can provide the best benefits for the community. In addition, the quality of health services is useful as part of the business process of a hospital 19 .
Assessment of the level of patient satisfaction can be measured by the concept of service quality (SERVQUAL) which is the most frequently used measurement of satisfaction levels throughout the world 20 . The study conducted by Annisa (2017) stated that the assessment of the level of patient Reliability can be defined as the ability to provide the promised service promptly, accurately, and satisfactorily. This dimension relates to timely service, high professionalism in providing services, and an accurate medical record system 23 .
Responsiveness is the willingness and ability of a health worker to help customers and provide appropriate services 22 . Responsiveness focuses on the speed and professionalism of a health service in responding to requests, statements, complaints, and patient difficulties. A health facility such as a hospital must be able to respond to patient complaints promptly and professionally to improve the quality of health services 22 .
Assurance is related to the knowledge, professional behavior, and abilities of a health worker that fosters trust and a sense of security for patients in a health facility 19 . Assurance and certainty can be described by a doctor or nurse who has extensive knowledge, has the ability to answer patient questions, establish the right diagnosis, be polite to patients, and perform therapy comfortably so that patients feel confident and safe in a health service provider.
Every patient has the hope of being treated well by health workers, so this indicator can affect the level of patient satisfaction (19,24).
Empathy includes individual care and attention given by health workers to patients. This is also related to understanding the problem to the patient so that the patient feels valued and treated well. Empathy can be done by health workers by treating patients with special care and giving personal attention to patient complaints 22 . Every patient has a desire to get attention so that this can affect the level of patient satisfaction.
SERVQUAL measures the level of service quality from the difference between the service received by the patient (perceived service) and the service expected by the patient (expected service). The results of these differences or differences can provide an illustration of the level

Design of Research
The research was conducted on descriptive analysis research using the Quantitative Method approach. The study was conducted by conducting observations without providing intervention on the variables studied as well as in-depth interviews with patients and their guardians. It is hoped that this method, known as the Quantitative method, is able to provide input.

Schedule of Research
The method used in the pilot study is to provide the main questionnaire and the pilot study questionnaire sheet which contains several questions. Respondents were asked to read the entire main questionnaire to be used and then fill out the pilot study questionnaire 22

Sample Size
The total population in this study were all patients

Inclusion and Exclusion Criteria
Inclusion criteria in this study were patients who had an age range of 17-60 years, had the condition of the patient under study stating that he was willing and allowed to fill out the questionnaire proposed by the study. Respondents have received health services at least once.
Respondents are JKN class 3 PBI members and JKN class 3 non-PBI patients. Exclusion criteria in this study were respondents who were unconscious, respondents who had mental illness, respondents who could not read and write. Respondents who use insurance payment methods other than JKN, and respondents who are not willing to be included in the study.

Flow of research data collection
The flow of research data collection in this study is as follows: 1.
Asking Respondents gave their consent by using an informed consent form and then asked to sign a letter of willingness to be a research respondent witnessed by the researcher and witnesses at the place (family or medical officer at the research site). The data obtained will be guaranteed confidentiality by the researcher.

RESULTS AND DISCUSSION
The subjects of this study amounted to 100 respondents which were divided into 50 JKN class 3 PBI patients and 50 JKN class 3 non PBI patients.         T1  T2  T3  T4  T5  T6  T7  T8  T9   GAP         This shows that the "officers respond to your request quickly" at the service at Place of Research is not satisfactory.    indicator (the officer informs you about when the service will be provided) with a score of -0.24.     Emphaty of SERVQUAL Table 6 shows that Indicator E34 is negative in the

CSI Analysis
The average score of the difference between expectations and reality on each dimension is analyzed to obtain a consumer satisfaction index.
From the results listed in Table 7