Patient Satisfaction of Service and Availability of Medical and Drugs among Inpatient Hospital West Sulawesi

DOI: http://doi.org.10.35654/ijnhs.v4i1.402 Abstract. This study discusses the patient’s satisfaction with services and the availability of medical facilities and medicines in the West Sulawesi Provincial Hospital inpatient unit. The method used in this research is descriptive method with a quantitative approach. The population in this study were 2874 patients treated at the West Sulawesi Provincial Hospital. The sample in this study used the accidental sampling technique, so samples of this study amounted to 97 people. Data collection techniques used in this study questionnaires, interviews, review of documents, and documentation. Data analysis using frequency distribution tables and percentage analysis. The results showed the percentage of patient satisfaction with the service and availability of medical facilities and medicines in the West Sulawesi Provincial Hospital inpatient unit in terms of indicators of completeness of medical equipment and laboratory services. Therefore, there was no need to be sent to other hospitals by 66.2%. The indicator of the availability of medicines in hospital dispensaries was 67.4%. The length of service time at hospital dispensaries was 76.1%, and the indicator of service for hospital dispensaries was 75.7%. The calculation of the percentage indicator of all items obtained an average value score of 71.3%. Overall, the service and the availability of medical facilities and medicines in the hospital inpatient units of West Sulawesi province have met patients' expectations.


INTRODUCTION
National and international organizations for assessing health services establish healthcare users' satisfaction as one of the leading indicators for controlling health outcomes. User satisfaction is one of the health care quality indicators. Some authors said that health services could be evaluated based on the service / patient service structure, outcome, and satisfaction. Patient satisfaction is essential as a measure of service quality. It provides information about the provider's success in meeting the patient's values and expectations, where the patient is the highest priority (1,2).
Undang-Undang Nomor 23 Tahun 1992 Pasal 4 about health, it was determined that everyone is entitled to health services. Therefore, every individual, family, and community has the right to receive protection for their health. The state is responsible for fulfilling the right to a healthy life for its inhabitants, including the poor and underprivileged. The government collaborates with local governments with regional officials called the Health Office. Health Department allocated to the Regional Hospital and Health Center are given to people who really can not afford, with the requirements set by the Department of Health (3,4).
In the Undang-Undang Republik Indonesia No. 36 Tahun 2009 about health, stressed that health is "good health, both physically, mentally, spiritually and socially and economically." Health is a public service that is absolute and closely related to the welfare of the community. For all essential services, and apparatus the state is obliged to provide quality services and readily available at all times. One concrete manifestation of public service delivery in the health sector is the existence of the hospital. The main objective is to provide quality health services at a relatively affordable cost for the community, especially those with middle and lower economic classes (5).
Hospitals and primary care institutions deliver most medical care services although, public health agencies and other institutions also play a role. Hospitals can attract more quality resources (such as a health workforce and health technologies) than their primary care counterparts (6).
Patient satisfaction with healthcare services is an important performance measure for healthcare providers. It is one of the universal goals of healthcare providers as patient satisfaction directly reflects any healthcare facility's status. Meeting patient satisfaction is complicated due to the ever-changing demands and healthcare needs of patients. Still, it remains a generally accepted yardstick that equates positive patient feedback to hospital success. Also, patient satisfaction is one of the most critical indicators in determining patient health outcomes. Sustaining patient satisfaction is one of the desired results of care, a crucial element of the health status. All this establishes the importance of the satisfaction or dissatisfaction of patients for the quality of provided care (7) The hospital must do various ways to increase patient visits, so the hospital must present and provide health services. The impact that appears it will cause loyalty to patients will come back to take advantage of the hospital's services. Patient satisfaction depends on the quality of service. Services are all health workers' efforts to meet the patient's wishes with the services to be provided. A service is said to be suitable by the patient, determined by whether the service provided can meet the patient's needs, by using the patient's perception of the service received (satisfying or disappointing, including the length of service time). The consumer who returns several times to buy the service from the same firm is a loyal customer. But customer defection is not the opposite of customer loyalty and vice versa for several reasons like availability or lack of choice. Satisfaction starts from accepting the patient from the first time he arrives until he leaves the hospital (8).
West Sulawesi Provincial Hospital is one of the select hospitals belonging to the West Sulawesi Provincial Government. This hospital has the duty and obligation to assist the government in health development. Health care utilization has received much attention in the medical, public, and political spheres due to the questions and challenges it raises around health care delivery and costs. Therefore, this hospital is required to provide better service than other hospitals by delivering higher quality services. One of the services that need to be improved is that inpatient unit inpatient care is an integral part of hospital services. Inpatient services are individual health services that include observation, diagnosis, treatment, nursing, and medical rehabilitation by staying overnight in inpatient rooms at public and private hospital health facilities, nursing care centers, and maternity hospitals. The disease sufferers must stay overnight (9).
Based on preliminary observations, some patient dissatisfaction was found regarding medical facilities and medicines, where the prescribed drug sometimes had to look outside the hospital. Sometimes, medical devices were not in the hospital, so they had to be transferred to another hospital. This was stated by one of the patients treated at the hospital. The complaining indicated the possibility of patient dissatisfaction with healthcare services provided by the treatment room Regional General Hospital of West Sulawesi province. Therefore, the hospital should pay great attention to increasing inpatient services' satisfaction so that patients do not switch to other hospitals, especially services and the availability of medical facilities and medicines. It was due to perceptions about patient satisfaction with health services, especially for hospitalized patients at the Regional General Hospital of West Sulawesi Province, which is very important to improve better service.

OBJECTIVE
The study aimed to describe the patient's satisfaction with services and availability of medical and drug on inpatient units.

METHOD
The descriptive study was applied in this study. This study's populations were all patients and families of inpatient units at the Regional General Hospital of West Sulawesi Province in 2017, namely 2874 people. Determination of the number of samples using the Slovin method with the accidental sampling technique is 97 people. Samples were obtained having a confidence level of 90% of the population (10). The sampling technique used in this research is accidental sampling, a sampling technique based on spontaneity. Anyone who accidentally meets the researcher and according to their characteristics can be used as a sample (respondent). Criteria respondents are patients and families of patients who come treated/visited the General Hospital of West Sulawesi Province. The data processing technique was done by checking the data and tabulating the data. The data analysis technique was carried out by making a frequency distribution table based on the Likert scale. Data Description Based on an average calculation to determine patient satisfaction scores of the following categories: very satisfied (81-100%), content (61-80%), reasonably satisfied (41-60%), less satisfied (21-40 %) and dissatisfied (0-20%) (11).

Respondent Characteristics
In this study, Respondents were patients or relatives of patients in Hospital West Sulawesi, as many as 97 people from space-patient treatment in West Sulawesi province hospitals. Regarding the aged, most of the patients were 17 years of age, able to read and write, and communicate using Indonesian well and while being treated in inpatient care. Respondent data in this study include gender, age, education, occupation, and health facilities used, can be seen in the following data: Respondents by Gender     Table 4 shows the respondent's employment as 37.1% of civil servants, IRT 23.7%. Two jobs offer the same percentage of the private sector employees, etc. (students and unemployed / looking for work) respectively of 15.5%.  Table. 6, results of calculation of the percentage of all items obtained statement percentage of the value of the average score of the 326 with a percentage of 71.3%, which means that patient satisfaction with hospital inpatient services of West Sulawesi province, in terms of indicators of medical facilities and drugs have been satisfactory.

DISCUSSION
Researchers' observations showed that the medical equipment in the inpatient room of the West Sulawesi Provincial Hospital was complete. Still, maybe some were damaged due to the device's age factor so that it could no longer be used, as well as laboratory services had not been used. Effectively due to moved rooms/moved hospitals, the patient temporarily cannot use hospital laboratory services. The total percentage score for indicators of medical facilities and drugs completeness medical equipment and laboratory services, so it does not need to be sent to another hospital that is as much as 66.2%, and this percentage is included in the satisfactory category. This indicates that respondents were satisfied with the completeness of medical equipment and laboratory services at the infirmary Hospital West Sulawesi province. One of the efforts to achieve quality health services is the completeness of medical equipment and adequate laboratory services. Patients no longer need to be sent to other hospitals to get health services. Availability and access to laboratory services quality are among the significant challenges contributing to delay or inappropriate responses to outbreaks of disease control and patient management. When quality health services have been achieved, such as the completeness of medical equipment and laboratory services, it will affect patient satisfaction, which in turn can increase trust in the hospital (12) The results of observations made by researchers on the availability of medicines in hospitals to support the health of patients who are being treated show a neatly arranged drug storage area in a drug storage warehouse, as seen in the following figure. Besides that, it is based on interviews conducted by researchers in the availability of medicines in pharmacies RS, related to patients who complain of drug availability. Chief pharmacy hospital explained that sometimes there are drugs out of stock to point to pharmacies outside the hospital. In contrast, the factor emptiness of drugs for RS BLU yet, still use budget funds are liquid only once a year, and the procurement of a new drug can be done once a year. So, the existing drug stocks do not match the number of requests from patients, both inpatient and outpatient. So, it can be concluded that it is natural that there are few complaints about the availability of drugs in hospital pharmacies. The availability of medicines in hospital pharmacies aims to ensure that the medicines needed can always be available at any time in sufficient quantities, the right type, on time, and guaranteed quality and used rationally. If management is not efficient, it negatively affects the hospital medically and economically, but it also impacts patient satisfaction as recipients of health services.
The observations that researchers have conducted that the waiting time of service at the hospital pharmacy-daily goes well is evidenced by the absence of a patient who complains about the long queues or long waits ministry. All the prescription drugs needed by patients were dealt with quickly by the officers' hospital pharmacy. Although we know that the waiting time for drugs is different from concocted drugs, hospital dispensaries are considered capable of providing good service to their patients, so not many complaints about this. Highspeed prescription services are needed by patients, considering that patients who come for treatment are people who are not healthy, so that slow prescription services will make it more difficult for patients. Patients were treated according to the queue and expected to facilitate the service because it will make the patient feel more comfortable when redeeming the drug without scrambling with the other patients. Those who expressed less satisfaction as one respondent (1%) and 0 respondents were not satisfied. Patients complain about the length of time this service is the patient who can not wait to line up, while in the hospital pharmacy, patients should always be queued if they want to pay for healthcare. Therefore, this patient was not satisfied with the service he received. The length of time waiting for service at the hospital pharmacy is one factor that affects patient satisfaction. Long waiting time is one component that could potentially cause patient dissatisfaction. If the waiting time is long, it will reduce patient comfort and affect patient utility in the future.
The results of the observation of researchers to service personnel hospital pharmacy, which was obtained by an officer of the hospital pharmacy that is looking for medication as a prescribed drug taken by the patient, as shown in the following figure, the clerk carefully searched for drugs so needed by the patient. Officers pharmacy prescriptions that patients should act and behave regardless of social status. Services hospital pharmacy personnel in responding to complaints of the patient must communicate well with patients, give earnest attention, and treat patients with patience. This can make the patient feel valued and respected because they have the right to express everything related to health care, so it will create the impression of satisfying the health services that have been received, mainly services the hospital pharmacy clerk.

CONCLUSION
Based on the results of research on patient satisfaction with the services and the availability of medical facilities and drugs, it could be concluded that the total percentage of 71.3% in the category satisfying. However, some respondents expressed less satisfaction, i.e., with a percentage of 16.5%, it always must be considered and corrected to improve the quality of inpatient care in hospitals of West Sulawesi.