Is the Difference in Service Fairness between Private and Public Hospitals Influencing Customer Satisfaction?

Indonesia is one of several low-middle income countries aiming to improve its health financing system
and implement universal health coverage. The implementation of the program caused the fast
increase of healthcare demand. The rapid expansion of insurance coverage, without the development
of infrastructure, will create demand that cannot be met by the existing healthcare system. The
sudden increase in demand will disrupt the delivery of service, especially in public hospitals, which will
influence service satisfaction levels. A preliminary study shows that satisfaction levels of BPJS
Kesehatan patients are still low. The most frequent reasons cited for dissatisfaction are fairness
issues such as different treatments and different processes and procedures. Studies have found that
aside from evaluations of quality, fairness is indeed an important factor that influences satisfaction.
Yet there are limited empirical researches on the effect of service fairness on service delivery,
especially in the healthcare industry. This study addresses the question of whether there are direct
relationships between three variables of fairness and customer satisfaction. In other words, are there
different levels of perceived service fairness in private and public hospitals and, if so, does this have
an impact on customer satisfaction? Using a descriptive quantitative method, this study was
conducted on BPJS Kesehatan members who used 19 public and private hospitals in nine cities in
Java, Indonesia. A six-point Likert scale questionnaire was designed and distributed. Four hundred
and six samples collected were eligible for analysis using descriptive analysis and structural equation
modelling using LISREL. The results show that there is a positive impact of the three variables
regarding service fairness on customer satisfaction in public and private hospitals. However, the
relationship between distributive fairness and customer satisfaction is not significant in public
hospitals. This study strengthens the building evidence that service fairness, in addition to service
quality, influences customer satisfaction, specifically in service delivery in the healthcare industry.