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In response to the evolving landscape of public healthcare services, hospitals are expected not only to maintain operational efficiency but also to adapt to the shifting needs and expectations of patients as healthcare consumers. The presence of non-BPJS patients in regional public hospitals plays a strategic role not only contributing to revenue diversification but also reflecting service quality, institutional competitiveness, and shaping public perception. The declining trend in outpatient visits by general patients at RSUD Balaraja over the past three years highlights the need to understand the factors influencing consumer behavior in determining revisit intentions. This study examines the effect of co-creation and hospital image on the revisit intention of outpatient general patients at RSUD Balaraja, with patient experience as a mediating variable. The research employed a quantitative explanatory design involving 278 outpatient general patients selected through purposive sampling. Data were collected via structured questionnaires and analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results indicate that patient experience plays a significant mediating role in shaping revisit intention among general outpatients at RSUD Balaraja. These findings confirm that patient experience serves as a central factor in post-service evaluation processes, which ultimately drive patients’ intention to return. Therefore, hospitals need to enhance patient involvement in service processes (co-creation), improve public perception of institutional image (hospital image), and develop patient-centered service systems as a key strategy to increase revisit intention among general outpatients.

In the healthcare sector, patient revisit intention serves as an important measure of hospital success, influencing financial stability, operational effectiveness, and long-term patient retention. With increasing competition, hospitals must strengthen trust, improve service quality, and maintain a positive institutional image to retain patients. This study focuses on the declining number of non-BPJS (non-insured) patients at Cinta Kasih Tzu Chi Hospital, Cengkareng, which impacts revenue sustainability. The research aims to assess how trust and customer perceived value affect revisit intention, and whether hospital image moderates these relationships. A quantitative approach was applied using a structured questionnaire distributed to 95 non-BPJS outpatients who had previously sought treatment more than once. Data were analyzed through Structural Equation Modeling (SEM) using the Partial Least Squares (PLS) method via SmartPLS software. The findings reveal that both trust and perceived value significantly and positively influence revisit intention, implying that patients with strong trust and satisfaction tend to return. Although hospital image directly influences revisit intention, it does not significantly moderate the link between perceived value and revisit intention. Therefore, hospitals are advised to enhance patient trust and perceived value while sustaining a credible institutional image to strengthen loyalty among non-BPJS patients

Non-formulary drug utilization in Harapan Kita Children’s and Mother’s Hospital presents a substantial challenge in healthcare cost management, especially for patients enrolled in the BPJS health insurance program. Given its status as a national referral hospital, Harapan Kita Children’s and Mother’s Hospital encounters a high prevalence of complex maternal and child health cases requiring the use of medications beyond the scope of the national formulary. This research endeavor seeks to examine the patterns and consequences of non-formulary drug use within this context. This study adopted a quasi-experimental design, incorporating both quantitative and qualitative methods, to evaluate the impact of an sosialisation intervention and audit clinic on physician compliance with formulary drug use. A pre-test and post-test design was employed to measure changes in non-formulary drug utilization. Findings indicated a statistically significant decrease in non-formulary drug use from 18% to 13% post-intervention. The integration of a clinical pathway and tailored physician training was instrumental in achieving improved formulary adherence. Given these results, it is recommended to broaden training and surveillance programs, strengthen technological support through the implementation of formulary information systems, and undertake longitudinal research to assess the long-term sustainability of the intervention's effects..

The higher the awareness regarding health, the higher the human need for health services. As a health service center, hospitals have the task of providing complete individual health services, providing inpatient, outpatient and emergency services. Social security provided by the Indonesian state is implemented by the Social Security Administering Body (BPJS) to ensure the certainty of equitable health services. This research is a quantitative descriptive study with an observational method to determine the description of satisfaction of BPJS outpatients regarding pharmaceutical services at Bekasi Hospital using Proportional Random Sampling sampling techniques with sample criteria of BPJS patients aged 17 - 65 years, who receive pharmaceutical services from the Pharmacy Installation Hospital at least 2 times. Based on the data provided, the highest overall satisfaction category is "Satisfied" while the lowest category is "Not Satisfied". These results show that the majority of patients feel a very high level of satisfaction with the services they receive. Based on the results of research conducted at the Bekasi Hospital Pharmacy Installation with 3 hospitals as research objects, it can be concluded that 51% of respondents feel satisfied with the pharmacy services at the hospital.

This study examines the opportunities and challenges of implementing Customer Relationship Management (CRM) in Class C private hospitals in Bogor, Indonesia. Using a mixed-methods approach, the research combines qualitative and quantitative analyses, including SWOT and Quantitative Strategic Planning Matrix (QSPM) methods, to identify the most effective CRM model. Findings reveal the hospital's internal strengths, weaknesses, external opportunities, and threats, offering strategies to improve patient engagement and operational efficiency. The results emphasize the critical role of digital transformation, staff training, and strategic adaptation to meet the needs of non-BPJS patients in a rapidly evolving healthcare landscape. The research contributes significantly to the development of CRM models tailored to healthcare institutions in emerging market..

This study examines the quality of outpatient public services for BPJS Health patients at the Regional General Hospital of Dumai City. The purpose of this research is to assess how service quality is experienced by patients and how effectively outpatient services are delivered. A qualitative descriptive approach was used, with data collected through direct observation, in-depth interviews, and documentation. Informants included outpatient service staff and BPJS patients selected purposively to represent both service providers and service users. The analysis focuses on five dimensions of service quality: physical facilities, service reliability, responsiveness, assurance, and empathy. The results indicate that outpatient services are generally perceived as adequate, particularly in terms of physical facilities, diagnostic accuracy, and staff professionalism. However, delays in registration and service processes remain a major concern, mainly due to high patient volume and administrative procedures. In addition, differences in staff communication and interpersonal attitudes lead to variations in patient experiences. Overall, the study highlights the importance of improving service responsiveness and strengthening empathetic communication to enhance patient satisfaction and the effectiveness of public hospital outpatient services.

Pharmaceutical Services at the Hospital is an integral part of the Hospital's health care system that is patient-oriented, providing Pharmaceutical Preparations Medical Devices, and Medical Materials that are quality and affordable for all levels of society including clinical pharmacy services (Anonymous, 2016) Besed on the Decree of the Minister of Health of the Republic of Indonesia No 179 Menkes/SK/11/2008, the SPM indicator of hospital pharmacy services includes the waiting time for drug services to be a maximum of 30 minutes while the maximum concoction drug is 60 minutes, the absence of medication errors, stalaction customers at least 80% and prescription writing all must refer to the Hospital formulary This study aims to find out the Waiting Time (Respond Time) of Prescription Services for Finished Medicines and drugs mixed with BPJS patients Outpatient in Bangil Hospital. This research is a non-experimental research with descriptive approach, namely the type of research approach to obtain an overview of the state of a group of data based on observations the real thing is, data collection is done in the Outpatient Pharmacy Service at Hangil Hospital, and is carried out for three months. The total mumber of prescription samples erered in the pharmacy installation for three months a 12.587 prescriptions with details of 10,770 prescriptions of JKN BPJS 85.27% 1,808 peral recipes 14 66% and 9 other insurance recipes 0.07% Among the recipe for JKN BPIS obtained during the study were 90.23% of non-concoction recipes and 9.77% of recipe recipes. The results of the study were obtaining results, the number of prescriptions from patients was 85.27% more than prescriptions from general patients 14 66% and other insurance 0.07%. The average waiting time for non-concoction recipe services in 25 minutes, and concoctions are 62 minutes

Patient satisfaction is a factor that can be used as a reference in determining the success of a service program. Patient satisfaction will arise when it is supported by good quality service. There are five dimensional aspects known as service quality (SERVQUAL), reliability, responsiveness, assurance, empathy, and tangible. These five dimensions influence patient satisfaction. This research aims to provide an overview of the level of satisfaction of outpatient BPJS patients at Hermina Bitung Hospital, Tanggerang Regency in 2023. This research uses a descriptive method with a quantitative approach with the data that has been collected being processed using SPSS (statistical packagen for the social sciences) then the results analyzed by measuring the average percentage for each patient criterion and a sample size of 76 respondents, from this research it can be concluded that patient satisfaction through the reliability dimension is 56.58%, the responsiveness dimension is 55.26%, the assurance dimension was 53.95%, the empathy dimension was 56.58%, while the direct evidence (tangible) was 51.32%. Thus, the researchers concluded that the number of BPJS patients in outpatient registration services was 52.63%. This result still does not reach the minimum service standard set by the Indonesian Ministry of Health in 2008, which is ≥90%.

Outpatient services are an important part of health services provided by hospitals. However, some BPJS hospitals experience obstacles in providing efficient and quality outpatient services, such as long queues, long waiting times, and lack of a good management system. the application of Lean Management to the outpatient services of BPJS patients in hospitals can help hospitals improve operational performance, so as to increase public trust in BPJS Health. This study aims to analyze the application of Lean Management to the outpatient services of BPJS patients in hospitals. This research uses a literature study method or Systematic Literature Review using the Google Scholar search engine and journal databases, such as Researchgate. The results showed that most outpatient service activities for BPJS patients still have patient waiting times below the established service standards. In analyzing the flow that patients go through, each activity is identified into two groups, namely Value Added (VA) as an activity that is considered necessary and profitable and Non Value Added (NVA) as an activity that is considered unnecessary. Based on the percentage of waste in the form of the largest waiting time can be described, namely, 35.1% in the registration process, 30.2% in the poly examination process, and 20.7% in the process of receiving drugs in the pharmaceutical installation

Maladministration in BPJS Kesehatan services at government hospitals remains a persistent challenge that undermines the principles of good governance in Indonesia. This study examines violations of the General Principles of Good Governance (Asas-Asas Umum Pemerintahan yang Baik/AUPB) in the context of BPJS Kesehatan services at Dr. Wahidin Sudirohusodo Regional General Hospital (RSUD), Makassar, South Sulawesi. This research employs a normative-empirical legal method, combining statutory analysis with field data obtained through interviews and documentation. The findings reveal that maladministrative practices—including procedural delays, discriminatory treatment of BPJS patients, inadequate information disclosure, and arbitrary administrative decisions violate several AUPB principles enshrined in Law No. 30 of 2014 on Government Administration. These violations contravene the principles of legal certainty, impartiality, proportionality, and accountability. The study concludes that institutional reforms, strengthened supervisory mechanisms through the Ombudsman of the Republic of Indonesia, and enhanced legal literacy among healthcare workers are necessary to reduce maladministration. This research contributes to the development of administrative law enforcement in the Indonesian public health sector.