https://ajhsjournal.ph/index.php/gp 93
Asian Journal of Healthy and Science
p-ISSN: 2980-4302
e-ISSN: 2980-4310
Vol. 3 No. 3 March 2024
THE RELATIONSHIP BETWEEN SERVICE QUALITY AND INDIVIDUAL
CHARACTERISTICS WITH PATIENT SATISFACTION OF
TELEDENTISTRY SERVICE USERS AT RSGM UNIVERSITAS
MUHAMADIYAH YOGYAKARTA
Chindy Alifa Ilmazura, Sri Widiati, Julita Hendrartini
Universitas Gadjah Mada, Indonesia
Email: cindyilmazuraf@gmail.com
Abstract
Teledentistry is the use of information and communication technology in treatment,
counseling, education, to improve dental and oral health during the COVID-19
pandemic. Teledentistry services as a medium for dental and oral health consultation
need to pay attention to the quality of service and individual characteristics which
are the main determinants of health services. The purpose of the study was to identify
the relationship between service quality and individual characteristics with patient
satisfaction of teledentistry service users. Cross sectional type of research. The
technique of taking subjects using simple random sampling. The number of
respondents was 125 renpondents. The research instrument uses servqual with Likert
scale and patient satisfaction instrument with Likert scale. Respondents filled in
individual characteristic data consisting of age, gender, education level and
occupation. Data analysis in this study used pearson correlation test and multiple
linear regression test. The Pearson correlation test showed that there was a
relationship between service quality (p = 0.001) and age with patient satisfaction (p
= 0.001) and there was no relationship between sex (p = 0.076), education level (p =
0.542) and occupation (p = 0.363) with patient satisfaction using teledentistry
services. The results of multiple linear regression tests showed a significant
relationship between service quality (β= 0.126; p= 0.001) and age (β= -0.044;
p=0.025) with patient satisfaction using teledentistry services at RSGM Universitas
Muhammadiyah Yogyakarta. The better the quality of service, the higher the level of
patient satisfaction, the younger the age, the higher the level of patient satisfaction.
There is no influence of gender, education level and occupation on patient
satisfaction of teledentistry service users at RSGM Universitas Muhammadiyah
Yogyakarta.
Keywords: Quality of service, individual characteristics, patient satisfaction,
teledentistry
https://ajhsjournal.ph/index.php/gp 94
INTRODUCTION
The World Health Organization (WHO) declared corona virus disease 2019
(covid-19) as the first pandemic to hit global healthcare systems in March 2020 (Lin
et al., 2022). Solutions that can be provided to overcome dental and oral health
problems during the COVID-19 pandemic are conducting consultations, screening,
and online remote education through teledentistry. Dental health promotion activities
using teledentistry can facilitate the limitations of face-to-face directly in accordance
with health protocols during the COVID-19 pandemic, namely reducing crowds and
maintaining distance (Hervina et al., 2021).
Research states that 82% of teledentistry use using whatsaap is the best choice as
support in oral diagnosis (Petruzzi & De Benedittis, 2016). Teledentistry has proven
effective in answering the challenges of dental and oral health problems during the
COVID-19 pandemic, in the journal it was stated, there were 97% of respondents
who expressed satisfaction in the teledentistry service system (Rahman et al., 2020).
The effectiveness of teledentistry services turns out that there are still perceived
obstacles, thus affecting patient satisfaction. The perceived barriers are that as many
as 48.73% of patients still require the physical presence of a dentist, as many as
48.41% violations of patient privacy, and low education of the population 47.77%
(Aboalshamat, 2020). Other obstacles are in taking photos of teeth 54.3% and
internet connection 48.6% (Aboalshamat et al., 2022).
Some individual characteristics are the main determinants or priority
determinants of health service quality indicators are age, sex, length of treatment,
source of costs to be incurred, disease diagnosis, occupation, income, education,
ethnicity, place of residence, class of care, marital status, and religion (Sangadji &
Sopiah, 2013). The quality of information systems in the context of online-based
services, has an influence on user satisfaction and the benefits felt by users of services.
The modification of SERVQUAL measuring instruments consisting of tangible,
reliability, responsiveness, assurance and empathetic dimensions is an evaluation system
that reflects the perception of service quality for the services received (Lu et al., 2021).
Based on the above background, the author is interested in conducting research on
the relationship between service quality and individual characteristics with patient
satisfaction of teledentistry service users.
RESEARCH METHODS
This study was an analytical observational study with a cross sectional design.
This study was conducted on patients using teledentistry services during February-
April as many as 125 respondents.
This research has been approved by the Ethics Commission of the Faculty of
Dentistry, Universitas Gadjah Mada (21/UN1/KE/FKG-RSGM/EC/2023).
Researchers distributed informed consent to respondents, researchers distributed
questionnaires via smartphones or computers containing 18 questions about service
quality and 3 questions about patient satisfaction using teledentistry services adopted
from previous studies (Lu et al., 2021). Bivariate analysis test using Pearson Product
Moment correlation and multivariate test with Multiple Linear Regression analysis
test
https://ajhsjournal.ph/index.php/gp 95
RESULT AND DISCUSSION
The characteristics of respondents based on Patient Satisfaction of Teledentistry
Service Users at RSGM Universitas Muhammadiyah in this study can be seen in table 1
Table 1 Distribution of Respondent Characteristics based on Patient Satisfaction
of Teledentistry Service Users at RSGM Universitas Muhammadiyah Yogyakarta.
Variabel
Low
Midle
High
n
%
N
%
n
%
Age
18-25
0
0
1
0,8
36
28,8
26-35
0
0
6
4,8
62
49,6
36-55
1
0,8
6
4,8
13
10,4
Gender
Man
1
0,8
10
8,0
49
39,2
Girl
0
0
3
2,4
62
49,6
Education
Senior Higt Scool
0
0
1
0,8
21
16,8
Diploma3
0
0
7
5,6
12
9,6
Bachelor
1
0,8
17
13,6
67
53,6
Magister
0
0
2
1,6
11
8,8
Work
Does not work
0
0
1
0,8
4
3,2
Private employees
0
0
9
10,4
77
61,6
Civil state officials
1
0,8
2
1,6
23
18,4
Police
0
0
1
0,8
7
5,6
Desciprion : n= total respondent %= persentase
Table 1 shows that the majority of respondents, namely the age range of 26-35
years, have a satisfaction level in the high category of 49.6%. The majority of female
respondents had a high satisfaction level of 49.6%. The majority of education levels
of Bachelor (S1) graduates have a satisfaction level in the high category of 53.6%.
Based on the type of work, the majority as self-employed have a satisfaction level in
the high category of 61.6%.
Table 2. The Relationship Between Service Quality based on Patient
Satisfaction of Teledentistry Service Users
Quality of service
Law
Middle
Higt
n
%
n
%
N
%
Bad
0
0,0
0
0
0
0
Middle
1
0,8
12
9,6
2
1,6
Good
0
0,0
1
0,8
109
87,2
Total
1
0,8
13
10,4
111
88,8
Table 2 shows that the majority of service quality has a high level of
satisfaction with teledentistry services (88,8%).
https://ajhsjournal.ph/index.php/gp 96
Table 3. Relationship between Service Quality and Respondent
Characteristics with Patient Satisfaction of Teledentistry Service Users
Variable
Free
Correlation coefficient
p*
Quality layanan
0,680
0,001
Age
-0,400
0,001
Gender
0,159
0,076
Education
0,055
0,542
Work
0,082
0,363
description: *Uji Product Moment Pearson
Table 3 shows that there is a significant relationship between service quality
and patient satisfaction with p value = 0.001 and age with patient satisfaction (p =
0.001). Gender, education and occupation were not significantly associated with
patient satisfaction with services teledentistry (p>0,05).
Table 4. Results of Multiple Linear Regression Analysis Between Service
Quality and Age with Patient Satisfaction of Teledentistry Service Users
Variabel Bebas
Unstandardized coefficient B
p*
Quality service
0,126
0,001
Age
-0,044
0,025
Constanta
4,230
0,003
R square = 0,484
Uji F = 57,111
P sig = 0,001
Bound variables = Patient satisfaction of teledentistry service users
Description:*Multiple Linear Regression Analysis Test
Table 4 shows that there is an effect of service quality and age on patient
satisfaction using teledentistry services (p = 0.001 and p = 0.025). The F test results
show a significance level of P<0.05, so it can be concluded that service quality and
age together affect patient satisfaction of teledentistry service users on dental and oral
health. A summary of the calculation of the constants and beta coefficients of each
variable with multiple linear regression equations obtained the equation, namely:
Y= 4,230 +0,126 Quality of Service -0,044 Age.
The value of the R-squared coefficient of determination is 0.484. This shows
that the independent variables of service quality and age simultaneously affect
patient satisfaction of teledentistry service users by 48.4% while the remaining 51.6%
of dependent variables are influenced by other variables such as consultation costs,
knowledge, time-saving, ease of use, internet connection, communication and
convenience.
Service quality has a relationship with respondents' satisfaction with teledentistry
services with a value of p = 0.001. One that affects satisfaction in the health sector is
https://ajhsjournal.ph/index.php/gp 97
the quality of service, the use of health applications can affect the continuity of use
of health applications. Quality of service and trust generate positive behavioral
intentions thus playing an important role in promoting the continued use of app-
based healthcare (Meng et al., 2022).
This is based on the theory that states good service quality can help hospital
management in designing problem-solving programs, improving quality, allocating
resources to be more effective so as to ensure patient satisfaction
(Alrubaiee &
Alkaa’ida, 2011). This study is in line with previous research which stated that there
is a relationship between service quality and patient satisfaction using telemedicine
applications
11
. This study shows that patient satisfaction is strongly influenced by the
quality of service and the ability to communicate between dentists and patients, and
the reality is in accordance with patient expectations.
Online consultation health services using teledentistry require effective
communication between dentists and patients during ongoing dental health
consultations. This is based on a theory that states communication is one of the
predictors of patient satisfaction, effective communication related to complaints felt
by patients can be conveyed to dentists through teledentistry services to obtain
information and treatment plans so as to meet the basic needs of patients (Amtha et
al., 2021).
This is in line with previous research which stated that dentists cannot
completely replace direct consultations during the covid 19 pandemic, but with the
existence of health consultations through teledentistry this can meet the needs of
consultations related to dental and oral health in the era of the covid 19 pandemic
(Ghai, 2020). Previous research also stated that consultation and education on dental
and oral health problems during this pandemic to stay safe is using the teledentistry
service method. Communication can be done remotely using the "surbo chat" and
"dashboard" platforms, the results of this activity found that the most cases are tooth
pain and cavities (Hervina et al., 2021).
Quality of service focuses on a two-dimensional model i.e., functional quality
and technical quality (Grönroos, 1984; Parasuraman et al., 1988). Functional quality
is defined as the patient's perception of the interaction during the service delivery
process between the service provider and the service recipient (Alwan & Rajab,
2021). The quality of service from the interaction between the service provider and
the recipient of the service provided depends on aspects such as timing, absence of
errors and safety in the service (Kowalik & Klimecka-Tatar, 2018). Functional
quality using modification measuring instruments servqual terdiri dari tangible,
reliability, responsiviness, assurance, dan emphaty
15
. Technical quality refers to
components related to the results of the quality of services received by patients.
Output-related health care outcomes that include what patients receive or feel (Fiala,
2012).
Age has a relationship with respondents' satisfaction with teledentistry service
users.The results of negative correlations (p = 0.025 and r = -0.044) on age showed
https://ajhsjournal.ph/index.php/gp 98
that the younger the patient, the higher the patient's satisfaction with teledentistry
services related to oral and dental health. Dental health consultation using
teledentistry services is also influenced by age because as you get older, the need for
the use of online health consultation services is getting higher. Inversely
proportional to old age because the older the age, the more consideration in using
online health consultation technology (Cantor et al., 2021).
The majority of the age range of 26-30 years have satisfaction scores in the
high category of teledentistry services. This is in accordance with previous research
which states that the age range of 26-35 years is more influential on the use of online
health consultation services than the age of >36 years in conducting online health
consultations. This is in accordance with the theory that states the use of teledentistry,
mostly teenagers and young adults, this age group is familiar with digital use thus
facilitating a virtual approach to dental and oral health education (Cantor et al.,
2021). Older people will be less likely to use online consultation media than younger
people, because older people are more conservative users and cannot use advanced
technology (Maulana et al., 2022).
Other studies also state that in old age there are still concerns about their
personal data that will be spread so they are reluctant to conduct examinations using
online health consultation services (Cimperman et al., 2013).
Older people do not
believe the service providers they meet online have the competence or professionals
such as doctors in face-to-face meetings and fear of technology makes older people
less likely to use online health consultation services than younger people who are
more enthusiastic (Terencia et al., 2023).
Gender was not associated with respondents' satisfaction with a value of p =
0.076. The female gender in this study had satisfaction with the high category. The
results of this study are not in line with research that states that men are significantly
more satisfied with health services, because men in the way they manage their
relationships tend to be more indifferent to what is stated by women, therefore they
are considered more flexible than women. Women look more at appearance in detail,
while men do not pay attention to it (Oroh et al., 2014). This is according to the
theory that states there is no consistent difference between men and women. Men
and women tend to have the same level of satisfaction with a health service
(Rahmqvist & Bara, 2010).
Education level was not associated with respondents' satisfaction with a value
of p = 0.542. All levels of education (SMA, D3, S1, and S2) feel satisfaction that is
not much different, namely satisfaction in the high category. The level of education
can affect a person's rational and irrational mindset in making decisions, using, or
utilizing a health service (Rizal & Jalpi, 2018). This is in accordance with the theory
that states a person with a higher education, the wider the knowledge of something,
including the optimization of existing technology as part of meeting his needs, for
information and access to appropriate health services (Irianti et al., 2021). This study
is not in line with research that states patients with low levels of education tend to
https://ajhsjournal.ph/index.php/gp 99
feel satisfied quickly compared to patients who are highly educated, it is related to
different levels of knowledge between low education and higher education (Rizal &
Riza, 2014).
Work was not related to respondents' satisfaction with teledentistry service users
with a value of p = 0.363. All types of self-employed jobs, civil servants, and others
feel the same service, namely satisfaction in the high category. This is in line with
research that states someone who works tends to be more demanding and critical of
the service he receives if it is not satisfactory for him compared to someone who does
not work (Rizal & Jalpi, 2018). The level of satisfaction with health services is very
subjective in nature and is influenced by many factors that play a role in individuals.
Work is one of the factors of social structure, so that the existence of this job will
affect someone in utilizing existing health services
CONCLUSION
The better the quality of service, the higher the patient's satisfaction with
teledentistry services and the younger the patient's age, the higher the satisfaction of
patients using teledentistry services. There was no relationship between gender,
education level and occupation and patient satisfaction using teledentistry services.
BIBLIOGRAPHY
Aboalshamat, K. T. (2020). Awareness of, beliefs about, practices of, and barriers
to teledentistry among dental students and the implications for Saudi
Arabia Vision 2030 and coronavirus pandemic. Journal of International
Society of Preventive and Community Dentistry, 10(4), 431–437.
Aboalshamat, K. T., Althagafi, T. K., Alsaeedi, S. A., Alhumaidi, S. N., & Alemam,
A. A. (2022). Accuracy and perceptions of teledentistry in KSA during the
COVID-19 pandemic: A single-centre randomised controlled trial. Journal
of Taibah University Medical Sciences, 17(3), 506–515.
Alrubaiee, L., & Alkaa’ida, F. (2011). The mediating effect of patient satisfaction
in the patients’ perceptions of healthcare quality-patient trust relationship.
International Journal of Marketing Studies, 3(1), 103.
Alwan, Q. N., & Rajab, R. A. (2021). Effect of functional quality on patient
satisfaction through the mental image of hospital. International Journal of
Business Management and Economic Review, 4(3), 10–35409.
Amtha, R., Gunardi, I., Astoeti, T. E., & Roeslan, M. O. (2021). Satisfaction level
of the oral medicine patients using teledentistry during the COVID-19
pandemic: a factor analysis. Journal of International Society of Preventive
and Community Dentistry, 11(4), 414–420.
Cantor, J. H., McBain, R. K., Pera, M. F., Bravata, D. M., & Whaley, C. M. (2021).
Who is (and is not) receiving telemedicine care during the COVID-19
pandemic. American Journal of Preventive Medicine, 61(3), 434–438.
Cimperman, M., Brenčič, M. M., Trkman, P., & Stanonik, M. de L. (2013). Older
adults’ perceptions of home telehealth services. Telemedicine and E-Health,
19(10), 786–790.
https://ajhsjournal.ph/index.php/gp 100
Fiala, T. G. (2012). What do patients want? Technical quality versus functional
quality: a literature review for plastic surgeons. Aesthetic Surgery Journal,
32(6), 751–759.
Ghai, S. (2020). Teledentistry during COVID-19 pandemic. Diabetes & Metabolic
Syndrome: Clinical Research & Reviews, 14(5), 933–935.
Grönroos, C. (1984). A service quality model and its marketing implications.
European Journal of Marketing, 18(4), 36–44.
Hervina, H., Nasutianto, H., & Astuti Ni Kadek, A. (2021). Konsultasi dan
edukasi masalah kesehatan gigi dan mulut serta protokol kesehatan selama
masa pandemi COVID-19 secara online melalui teledentistry. Jurnal
Kreativitas PKM, 299–306.
Irianti, B., Fadly, F., & Nursta’adah, U. (2021). Mendekatkan Pelayanan Bidan
Dalam Masa Covid-19 (Konsultasi Online Kebidanan Pada Masa
Pandemik). Prosiding Penelitian Pendidikan Dan Pengabdian 2021, 1(1),
1119–1125.
Kowalik, K., & Klimecka-Tatar, D. (2018). The process approach to service quality
management. Production Engineering Archives, 18(18), 31–34.
Lin, G. S. S., Koh, S. H., Ter, K. Z., Lim, C. W., Sultana, S., & Tan, W. W. (2022).
Awareness, knowledge, attitude, and practice of teledentistry among dental
practitioners during COVID-19: a systematic review and meta-analysis.
Medicina, 58(1), 130.
Lu, W., Hou, H., Ma, R., Chen, H., Zhang, R., Cui, F., Zhang, Q., Gao, Y., Wang,
X., & Bu, C. (2021). Influencing factors of patient satisfaction in
teleconsultation: A cross-sectional study. Technological Forecasting and
Social Change, 168, 120775.
Maulana, M. R., Setyawardhana, R. H. D., & Hamdani, R. (2022). Hubungan Usia,
Tingkat Penggunaan Teknologi Informasi, dan Pengalaman Kerja Terhadap
Pemanfaatan Teledentistry Pada Dokter Gigi di Banjarmasin. Dentin, 6(2).
Meng, F., Guo, X., Peng, Z., Ye, Q., & Lai, K.-H. (2022). Trust and elderly users’
continuance intention regarding mobile health services: the contingent role
of health and technology anxieties. Information Technology & People, 35(1),
259–280.
Oroh, M. E., Rompas, S., & Pondaag, L. (2014). Faktor-faktor yang berhubungan
dengan tingkat kepuasan pasien rawat inap terhadap pelayanan
keperawatan di ruang interna RSUD Noongan. Jurnal Keperawatan, 2(2).
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). Servqual: A multiple-item
scale for measuring consumer perc. Journal of Retailing, 64(1), 12.
Petruzzi, M., & De Benedittis, M. (2016). WhatsApp: a telemedicine platform for
facilitating remote oral medicine consultation and improving clinical
examinations. Oral Surgery, Oral Medicine, Oral Pathology and Oral
Radiology, 121(3), 248–254.
Rahman, N., Nathwani, S., & Kandiah, T. (2020). Teledentistry from a patient
perspective during the coronavirus pandemic. British Dental Journal, 1–4.
Rahmqvist, M., & Bara, A.-C. (2010). Patient characteristics and quality
dimensions related to patient satisfaction. International Journal for Quality
https://ajhsjournal.ph/index.php/gp 101
in Health Care, 22(2), 86–92.
Rizal, A., & Jalpi, A. (2018). Analisis faktor internal penentu kepuasan pasien
puskesmas kota banjarmasin. Al Ulum: Jurnal Sains Dan Teknologi, 4(1), 1–
6.
Rizal, A., & Riza, Y. (2014). Hubungan kualitas pelayanan kesehatan dengan
tingkat kepuasan Pasien di Bp. Gigi Puskesmas Kelayan Dalam kota
Banjarmasin. An-Nadaa: Jurnal Kesehatan Masyarakat (e-Journal), 1(1), 26–
31.
Sangadji, E. M., & Sopiah, S. (2013). The Effect of Organizational Culture On
Lecturers’ Job Satisfaction and Performance: A Research in
Muhammadiyah University throughout East Java. International Journal of
Learning & Development, 3(3), 1–18.
Terencia, A., Nugroho, D., Wicaksono, H., & Triastuti, I. (2023). Pengaruh Usia
Terhadap Penggunaan Telekonsultasi Sebagai Bagian dari Penerimaan
Telehealth Oleh Masyarakat DI Yogyakarta. Seminar Nasional Riset
Kedokteran, 4(1).
Copyright holders:
Chindy Alifa Ilmazura (2024)
First publication right:
AJHS - Asian Journal of Healthy and Science
This article is licensed under a Creative Commons Attribution-ShareAlike 4.0
International
