Pengaruh Persepsi Pasien tentang Tarif Jasa Pelayanan dan Fasilitas terhadap Keputusan Pasien Memilih Operasi Sectio Caesaria dengan Metode ERACS
DOI:
https://doi.org/10.37481/jmeb.v6i2.1941Keywords:
Service Fees, Hospital Facilities, Patient Decision, ERACS, Caesarean SectionAbstract
The adoption of Enhanced Recovery After Caesarean Surgery (ERACS) has increased due to its clinical advantages; however, patients’ willingness to choose this method remains limited, particularly in relation to economic considerations and hospital service conditions. This study aimed to examine the influence of patients’ perceptions of service fees and hospital facilities on their decision to choose cesarean section using the ERACS method at RSU Prima Medika Tulungagung. A quantitative analytic approach with a cross-sectional design was employed. Data were collected from 43 ERACS patients using structured questionnaires and analyzed through multiple linear regression, supported by t-tests and F-tests at a 5% significance level. The findings revealed that patients’ perceptions of service fees had a positive and statistically significant effect on the decision to select ERACS (β = 0.479; p = 0.002). In contrast, perceptions of hospital facilities did not show a significant effect (β = -0.162; p = 0.341). Simultaneously, service fees and facilities significantly influenced patient decision-making (F = 8.167; p = 0.001), with an adjusted R² value of 0.254. These results indicate that perceived service fees are the dominant factor in patients’ decisions to choose ERACS, while hospital facilities function as a supporting element. Improving cost transparency and strengthening patient education may enhance informed decision-making regarding ERACS services.
References
Alrubaiee, L., & Alkaa’ida, F. (2021). The mediating effect of patient satisfaction in the relationship between healthcare service quality and patient loyalty. International Journal of Business Excellence, 23(1), 1–17.
Amin, M., Rahman, A., & Suryani, D. (2025). The role of hospital facilities and service quality in shaping patient trust and clinical decision-making. Journal of Health Services Research, 18(1), 45–56.
Baines, R., Regan de Bere, S., Stevens, S., Read, J., Marshall, M., Lalani, M., & Bryce, M. (2020). The impact of patient engagement on healthcare quality. Health Services Research, 55(S2), 1–11.
Batbaatar, E., Dorjdagva, J., Luvsannyam, A., Savino, M. M., & Amenta, P. (2019). Determinants of patient satisfaction: A systematic review. Perspectives in Public Health, 139(2), 89–101.
Boonwang, T., Namwaing, P., Srisaphonphusitti, L., Chainarong, A., Kaewwong, S. C., Kaewwong, T., Duangsawang, N., Sawunyavisuth, B., Ngamjarus, C., Sawanyawisuth, K., & Khamsai, S. (2022). Esports may improve cognitive skills in soccer players: A systematic review. Asia-Pacific Journal of Science and Technology, 27(3).
Cosmai, L., Scudeller, L., Porta, C., & Veronesi, G. (2025). Patient perception of healthcare costs and its influence on treatment decision-making. Health Economics Review, 15(2), 1–11.
Doraiswamy, V. A., Akshay, S., & Rao, S. (2021). Enhanced recovery after cesarean delivery: Current evidence and clinical implications. International Journal of Obstetric Anesthesia, 47, 102–109.
Eamudomkarn, N., Kietpeerakool, C., Kaewrudee, S., Jampathong, N., Ngamjarus, C., & Lumbiganon, P. (2018). Effect of postoperative coffee consumption on gastrointestinal function after abdominal surgery: A systematic review and meta-analysis of randomized controlled trials. Scientific Reports, 8(1).
Entwistle, V. A., Cribb, A., & Watt, I. S. (2019). Shared decision-making: Enhancing patient autonomy. Health Expectations, 22(5), 1056–1064.
Fitriah, N., & Rohendi, A. (2022). Persepsi biaya pelayanan kesehatan dan pengaruhnya terhadap keputusan pasien dalam memilih layanan persalinan. Jurnal Administrasi Kesehatan Indonesia, 10(2), 123–131.
Ghozali, I. (2021). Aplikasi analisis multivariate dengan program IBM SPSS. Badan Penerbit Universitas Diponegoro.
Joseph-Williams, N., Elwyn, G., & Edwards, A. (2020). Knowledge is not power for patients: A systematic review. Patient Education and Counseling, 103(1), 5–16.
Karlström, A., Engström-Olofsson, R., Nystedt, A., Thomas, J., & Hildingsson, I. (2019). Women’s decision-making process for caesarean section. Sexual & Reproductive Healthcare, 21, 38–43.
Khan, M. M., Ahmed, S., & Rahman, M. S. (2021). Perceived value and healthcare service choice. Journal of Health Management, 23(3), 385–398.
Kietpeerakool, C., Aue-aungkul, A., Galaal, K., Ngamjarus, C., & Lumbiganon, P. (2017). Nerve-sparing radical hysterectomy compared to standard radical hysterectomy for women with early stage cervical cancer (stage Ia2 to IIa). Cochrane Database of Systematic Reviews, 2017(10).
Kotler, P., & Keller, K. L. (2016). Marketing management (15th ed.). Pearson Education.
Kotler, P., Keller, K. L., Ang, S. H., Tan, C. T., & Leong, S. M. (2021). Marketing management: An Asian perspective (7th ed.). Pearson Education.
Larasati, E. R., Saraswati, W., Setiawan, H. U., Rahma, S. S., Gianina, A., Estherline, C. A., Nurmalasari, F., Annisa, N. N., Septiani, I., & Nugraheni, G. (2019). Motivasi berhenti merokok pada perokok dewasa muda berdasarkan Transtheoretical Model (TTM). Jurnal Farmasi dan Ilmu Kefarmasian Indonesia, 5(2), 85–92.
Lavender, T., Hofmeyr, G. J., Neilson, J. P., Kingdon, C., & Gyte, G. (2020). Caesarean section for non-medical reasons. Cochrane Clinical Answers, 1–5.
Michael, T. O., Agbana, R. D., & Naidoo, K. (2024). Exploring perceptions of Cesarean sections among postpartum women in Nigeria: A qualitative study. Women, 4(1), 73–85.
Mosadeghrad, A. M. (2020). Factors influencing healthcare service quality. International Journal of Health Policy and Management, 9(1), 1–13.
Mubarok, R., & Rohendi, A. (2021). Faktor-faktor yang memengaruhi pengambilan keputusan pasien dalam pemilihan layanan kesehatan. Jurnal Manajemen Pelayanan Kesehatan, 24(3), 145–153.
Naidu, A. (2020). Factors affecting patient satisfaction in healthcare. International Journal of Health Care Quality Assurance, 33(2), 101–115.
Notoatmodjo, S. (2018). Metodologi penelitian kesehatan. Rineka Cipta.
Panda, S., Behera, P., & Das, S. (2022). Enhanced recovery after surgery protocols in obstetrics: A systematic review. Journal of Obstetrics and Gynaecology Research, 48(6), 1341–1349.
Patel, S., Wilson, R., & Blackwell, J. (2023). Implementing ERAS protocols in obstetric surgery. Journal of Obstetric Anaesthesia and Critical Care, 13(1), 12–18.
Prakash, G., & Mohanty, R. (2022). Service pricing and patient trust in healthcare. Journal of Services Marketing, 36(4), 563–576.
Rimin, F., Lestari, E., & Hidayat, R. (2021). Hubungan fasilitas rumah sakit dengan kepuasan dan kepercayaan pasien. Jurnal Keperawatan Klinis dan Komunitas, 5(1), 22–30.
Sugiyono. (2019). Metode penelitian kuantitatif, kualitatif, dan R&D. Alfabeta.
Temilola, T., Olaitan, O., & Adebukola, T. (2025). Caesarean section: Prevalence, determinants, and socio-cultural influences on decision-making. International Journal of Medicine.
Tjiptono, F., & Diana, A. (2020). Service, quality & customer satisfaction. Andi.
Trisnowati, H., Sabariah, E. S., & Rusyani, Y. Y. (2018). Bagaimana motivasi berhenti merokok mahasiswa di kampus kesehatan Yogyakarta? Berita Kedokteran Masyarakat, 7(4).
Veranita, M., Pramesti, A., & Kurniawan, Y. (2024). Hospital environment, patient safety, and decision-making in modern obstetric care. Journal of Hospital Management, 9(2), 67–75.
Wilson, R. D., Caughey, A. B., Wood, S. L., & Macones, G. A. (2021). Enhanced recovery after surgery in obstetrics. American Journal of Obstetrics and Gynecology, 224(2), 137–148.
Zahroh, R. I., Hazfiarini, A., Martiningtyas, M. A. D., Ekawati, F. M., Emilia, O., Cheong, M., Betran, A. P., Homer, C. S. E., & Bohren, M. A. (2024). Rising caesarean section rates and factors affecting women’s decision-making about mode of birth in Indonesia. BMJ Global Health, 9(6).






