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Hospital is one of type effort for service that is now stays in very tightening emulation climate. Struggle to create recuring business with customeroccupies central point in the effort hospital to exeed at long-range emulation. Service quality and cutomer value becomes thing which necessary for hospital. This research analysis factors influence customer satisfaction to create hospital service reference enthusiasm in Hospital PKU Muhamadiyah Gubug Kabupaten Grobogan.Research problem is existence of gap or debate at antecedent research would consequence and from customer satisfaction. Other problems is thehappening of downdraft of number of outpatients continually at last four months and existence of improvement of number sighs from patient. Respondent in this research 120 patients with sampling method applies acidental sampling. This research applies analysis Structural Equation Modeling (SEM) what implemented through program AMOS as a means of assists its the analysis.Result of research proves that service quality, cutomer value and excellence of product has positive influence and signifikan to customersatisfaction. Hereinafter, customer satisfaction of influence positive and signifikan to hospital service reference enthusiasm. Excelsior service quality and cutomer value has customer satisfaction of excelsior and causes home service reference enthusiasm which excelsior.

Decision Support System couple the intellectual resource of individuals with the capabilities of the computer to improve the quality of decision. It's a computer based support system for management decision makers who deal with semi-structured problem. An integrated decision support system for use in an machine mollen product has been developed. It incorporates a linear Programming model that represents the contribution optimal and optimizes the production water pump and mollen machine. An optimization model is performed using a management scient model called linear programming approach in older to determine media selection. To use this model, the DSS needs ti interface with another software. Mathematical Programming is a technique used in mathematical models, particularly optimization models, to assist in decision making. The Simplex Method is "a systematic procedure for generating and testing candidate vertex solutions to a linear program." (Gill, Murray, and Wright, p. -137) It begins at an arbitrary corner of the solution set. At each iteration, the Simplex Method selects the variable that will produce the largest change towards the minimum (or maximum) solution. The  development of computer programs to be used as Decision Support Systems involves several tasks such as mathematical modeling, technical and data collection and development of a user friendly interface.