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The increasing competition in the healthcare industry requires hospitals to establish effective relationship strategies to enhance patient loyalty. This study aims to examine the effect of Customer Relationship Management (CRM) on patient loyalty, with brand salience and customer engagement behavior (CEB) as mediating variables. The research adopts a quantitative approach using Partial Least Squares Structural Equation Modeling (PLS-SEM). Data were collected from 155 outpatients at Cengkareng General Hospital (RSAR) who had experienced CRM-related services, using a structured questionnaire measured on a four-point Likert scale. The findings reveal that CRM has a significant positive effect on brand salience, customer engagement behavior, and patient loyalty. Among these relationships, CRM demonstrates the strongest influence on customer engagement behavior, indicating that relationship-based strategies effectively encourage active patient involvement. Furthermore, customer engagement behavior significantly affects patient loyalty, suggesting that patients who are more engaged—through feedback, recommendations, and participation—are more likely to develop stronger loyalty toward healthcare providers. In contrast, brand salience does not have a significant effect on patient loyalty, indicating that brand awareness alone is insufficient to drive loyalty in the healthcare context. Mediation analysis shows that customer engagement behavior partially mediates the relationship between CRM and patient loyalty, whereas brand salience does not act as a mediator. These results suggest that CRM enhances patient loyalty not only directly but also indirectly through strengthening engagement behavior. This study contributes to healthcare marketing literature by integrating relationship marketing and customer engagement perspectives, highlighting engagement as a more critical mechanism than brand salience in fostering sustainable patient loyalty.

Hospitals as a health service industry are required to provide quality services through marketing strategies so that the quality of health services in hospitals becomes higher. One strategy that can be used by hospitals is to implement the Marketing Mix. From the results of initial interviews, it was found that most patients were elderly patients at RSI Ibnu Sina Bukittinggi who had difficulty getting information through social media, resulting in a backlog of registrations and decreased patient satisfaction. This study aims to determine the relationship between the marketing mix and outpatient satisfaction at RSI Ibnu Sina Bukittinggi. This study uses a quantitative method with a cross-sectional design. The sample used was 100 respondents taken from the outpatient population. Data analysis was carried out using the Chi-Square statistical test at α = 0.05 to see the significance of the relationship between the marketing mix and patient satisfaction. The results of the study found that there was a relationship between the product marketing mix and patient satisfaction and there was no relationship between the marketing mix of price, promotion, people, process, physical evidence and outpatient satisfaction. Based on the results of the study, it is expected that the marketing mix in the Outpatient Unit of RSI Ibnu Sina Bukittinggi will maintain and improve its marketing services.