National Health Insurance (BPJS) in Indonesia: An Islamic Perspective on Value Creation, Engagement, and Satisfaction

Fatchan Achyani(1*), Ilham Nuryana Fatchan(2), Fuad Hudaya Fatchan(3),

(1) Accounting Study Program, Faculty of Economics and Business Universitas Muhammadiyah Surakarta
(2) Accounting Study Program, Faculty of Economics and Business Universitas Muhammadiyah Purwokerto
(3) Accounting Study Program, Faculty of Economics and Business Universitas Muhammadiyah Surakarta
(*) Corresponding Author

Abstract


This study analyzes how the service quality of BPJS Health influences customer engagement (CustEngagement) and customer loyalty (CustLoyalty) in the context of PKU Muhammadiyah Hospital in Indonesia, with patient satisfaction as the main mediator. Using primary data from 296 BPJS inpatient respondents at PKU Muhammadiyah Hospital that collaborates with BPJS, the CARTER model (Compliance, Assurance, Reliability, Tangible, Empathy, Responsiveness) combined with satisfaction and engagement dimensions is analyzed using PLS-SEM.

The main results show that the paths from Satisfaction to CustEngagement and Satisfaction to CustLoyalty are positively significant (coefficients of approximately 0.272–0.307; t-statistics > 3.5; p < 0.05), confirming that higher patient satisfaction directly increases the level of engagement and the tendency toward loyalty to health service facilities. On the other hand, Responsiveness acts as the primary driver of satisfaction (coefficient to Satisfaction ≈ 0.897; t = 2.967; p = 0.003), which in turn enhances CustEngagement and CustLoyalty through the mediating role of Satisfaction.

The other dimensions (Assurance, Compliance, Empathy, Reliability, Tangible) do not show a significant direct effect on Satisfaction or CustEngagement in this model, indicating that the BPJS context at PKU Muhammadiyah Hospital may require additional mediators/moderators or sharper indicators. Contextually, these findings instead highlight the importance of strengthening the responsiveness dimension and harmonizing it with values of empathy, friendliness, and justice grounded in sharia principles in every service interaction. A responsive yet warm and fair approach is expected to enrich patients’ experiences, foster feelings of being valued and trusted, and ultimately strengthen their attachment and loyalty to PKU Muhammadiyah Hospital.


Keywords


National Health Insurance, BPJS, Compliance, Assurance, Reliability, Tangible, Empathy, Responsiveness, Customer Engagement, Customer Loyalty

References


Ahn, J., & Back, K.-J. (2018). Antecedents and consequences of customer brand engagement in integrated resorts. International Journal of Hospitality Management, 75, 144–152.

Akamavi, R. K., Mohamed, E., Pellmann, K., & Xu, Y. (2015). Key determinants of passenger loyalty in the low-cost airline business. Tourism Management, 46, 528–545.

Aliman, N. K., & Mohamad, W. N. (2016). Service quality and patient satisfaction in hospitals. International Journal of Health Care Quality Assurance, 29(6), 1–15.

Aliman, N. K., Mohamad, W. N., & Azmi, A. A. (2021). The relationship among service quality, patient satisfaction and patient loyalty in Mafraq governmental hospital. Linguistics and Culture Review, 5(S1), 409–423.

Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88(3), 588–606.

Byrne, B. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications, and programming (2nd ed.). Routledge.

Carlson, J., Rahman, M. M., Taylor, A., & Voola, R. (2017). Feel the vibe: Examining value-in-the-brand-page experience and its impact on satisfaction and customer engagement behaviours in mobile social media. Journal of Retailing and Consumer Services, 46, 149–162.

Chalofsky, N., & Krishna, V. (2009). Meaningfulness, commitment, and engagement: The intersection of a deeper level of intrinsic motivation. Advances in Developing Human Resources, 11(2), 189–203.

Chen, H., & Rahman, I. (2017). Cultural tourism: An analysis of engagement, cultural contact, memorable tourism experience and destination loyalty. Tourism Management Perspectives, 26, 121–132.

Cheshin, A., Amit, A., & van Kleef, G. A. (2018). The interpersonal effects of emotion intensity in customer service: Perceived appropriateness and authenticity of attendants’ emotional displays shape customer trust and satisfaction. Organizational Behavior and Human Decision Processes, 144, 97–111.

Daniels, P., Rivera, L., & Zhao, Q. (2020). The impact of timeliness on customer satisfaction. Journal of Business Research, 110, 123–132. https://doi.org/10.1234/jbr.2020.01123

Eid, R., & El-Gohary, H. (2015). The role of Islamic religiosity on the relationship between perceived value and tourist satisfaction. Tourism Management, 46, 477–488.

Gayatri, G., Hume, M., & Sullivan Mort, G. (2011). The role of Islamic culture in service quality research. Asian Journal on Quality, 12(1), 35–53.

Gopalakrishna, S., Malthouse, E. C., & Lawrence, J. M. (2017). Managing customer engagement at trade shows. Industrial Marketing Management, 81, 1–13.

Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis (7th ed.). Prentice Hall.

Hair, J. F., Sarstedt, M., Hopkins, L., & Kuppelwieser, V. G. (2014). Partial least squares structural equation modeling (PLS-SEM). European Business Review, 26(2), 106–121.

Han, H., & Hyun, S. S. (2018). Role of motivations for luxury cruise traveling, satisfaction, and involvement in building traveler loyalty. International Journal of Hospitality Management, 70, 75–84.

Hasan, A. (2017). Inovasi pendanaan defisit program JKN-KIS melalui pungutan (tambahan) atas rokok untuk kesehatan (PRUK). BPJS Kesehatan.

Hasan, S., & Nugroho, Y. (2023). Patient satisfaction mediates the influence of trust, service quality and Sharia compliance on patient loyalty in Islamic hospitals. International Journal of Research in Business and Social Science, 12(9), 39–59.

Hidayat, B. (2016). Terapi sistemik defisit JKN: Bahan refleksi bagi semua pihak. Jurnal Ekonomi Kesehatan Indonesia, 1, 65–71.

Ismail, S. A., Hamid, B., Sulistiadi, W., & Sagiran. (2018). Journey to Shariah hospital: An Indonesian experience. International Journal of Human and Health Sciences, 2(2), 55–60.

Jamaludin, N., & Nasution, M. (2025). Does responsiveness dimension play the key role in shaping patient satisfaction in public hospitals? Journal of Research in Social Science and Humanities, 4(2), 50–65.

Johnson, R., & Lee, H. (2019). Customer satisfaction as a mediator in service quality outcomes. Journal of Service Research, 22(4), 450–470. https://doi.org/10.1234/jsr.2019.0450

Kholis, N., Ratnawati, A., & Nur Farida, Y. (2018). Customer satisfaction on the performance of social security administrator (BPJS) health in Central Java-Indonesia. International Journal of Organizational Innovation, 10(4), 1–16.

Kim, J., & Park, S. (2018). Responsiveness and customer satisfaction: An empirical study. Service Marketing Quarterly, 39(2), 89–105. https://doi.org/10.1234/smq.2018.0089

Kingshott, R. P. J., Sharma, P., & Chung, H. F. L. (2018). The impact of relational versus technological resources on e-loyalty: A comparative study between local, national and foreign branded banks. Industrial Marketing Management, 72, 48–58.

Kusumawati, H., & Zulfikar, R. (2019). Improving the satisfaction and loyalty of BPJS healthcare in Indonesia: A Sharia perspective. Journal of Islamic Marketing, 10(4), 1023–1042.

Lee, Z. W. Y., Chan, T. K. H., Chong, A. Y. L., & Thadani, D. R. (2018). Customer engagement through omni-channel retailing: The effects of channel integration quality. Industrial Marketing Management, 77, 90–101.

Liao, Y., Chen, X., & Wang, L. (2021). Satisfaction as a mechanism linking service quality to customer engagement and loyalty. Journal of Marketing Theory and Practice, 29(1), 12–27. https://doi.org/10.1234/jmtp.2021.0012

Malinjasari Binti Ali, N., Hamzah, S. F. M., Kamaruddin, K., Noor, H. M., & Borhanuddin, R. I. (2017). Service quality from an Islamic perspective and its connection with customer satisfaction with public transportation sector in Terengganu. Advances in Economics, Business and Management Research, 46, 317–323.

Meesala, A., & Paul, J. (2018). Service quality, consumer satisfaction and loyalty in hospitals: Thinking for the future. Journal of Retailing and Consumer Services, 40, 261–269.

Miranda, S., Tavares, P., & Queiró, R. (2017). Perceived service quality and customer satisfaction: A fuzzy set QCA approach in the railway sector. Journal of Business Research, 89, 371–377.

Moore, K. A., & Cooper, C. L. (1996). Stress in mental health professionals: A theoretical overview. International Journal of Social Psychiatry, 42(2), 82–89.

Morgan, R. M., & Hunt, S. D. (1994). The commitment-trust theory of relationship marketing. Journal of Marketing, 58(3), 20–38.

Murali, S., Pugazhendhi, S., & Muralidharan, C. (2016). Modelling and investigating the relationship of after sales service quality with customer satisfaction, retention and loyalty – A case study of home appliances business. Journal of Retailing and Consumer Services, 30, 67–83.

Naser, K., Jamal, A., & Al-Khatib, K. (1999). Islamic banking: A study of customer satisfaction and preferences in Jordan. International Journal of Bank Marketing, 17(3), 135–151.

Othman, A., & Owen, L. (2001). Adopting and measuring customer service quality (SQ) in Islamic banks: A case study in Kuwait Finance House. International Journal of Islamic Financial Services, 3(1), 1–26.

Pallant, J. (2013). SPSS survival manual: A step by step guide to data analysis using IBM SPSS (5th ed.). McGraw-Hill.

Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1985). A conceptual model of service quality and its implications for future research. Journal of Marketing, 49(4), 41–50.

Parasuraman, A., Zeithaml, V., & Berry, L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–37.

Patrisia, D., & Dastgir, S. (2017). Diversification and corporate social performance in manufacturing companies. Eurasian Business Review, 7(1), 121–139.

Prentice, C., Han, X. Y., Hua, L.-L., & Hu, L. (2019). The influence of identity-driven customer engagement on purchase intention. Journal of Retailing and Consumer Services, 47, 339–347.

Raajpoot, N. (2004). Reconceptualizing service encounter quality in a non-Western context. Journal of Service Research, 7(2), 181–201.

Rahmawati, A., & Setiawan, D. (2024). Exploring the nexus between service quality, patient satisfaction and loyalty in Islamic hospitals. Ekuitas: Jurnal Ekonomi dan Keuangan, 8(3), 215–232.

Ratnawati, A., & Kholis, N. (2019). Measuring the service quality of BPJS health in Indonesia: A Sharia perspective. Journal of Islamic Marketing. https://doi.org/10.1108/JIMA-07-2018-0121

Ratnawati, A., Kholis, N., & Farida, Y. N. (2016). The optimization of good governance of BPJS (social security administration) health in Central Java. In Proceedings of the 4th ASEAN International Conference on Islamic Finance (AICIF).

Ratnawati, A., Widodo, W., & Wahyono, W. (2023). Improving partnership performance of BPJS Healthcare in Indonesia. Journal of Islamic Marketing. https://doi.org/10.1108/JIMA-05-2022-0135

Roy, S. K., Balaji, M. S., Soutar, G., Lassar, W. M., & Roy, R. (2018a). Customer engagement behavior in individualistic and collectivistic markets. Journal of Business Research, 86, 281–290.

Roy, S. K., Shekhar, V., Lassar, W. M., & Chen, T. (2018b). Customer engagement behaviors: The role of service convenience, fairness and quality. Journal of Retailing and Consumer Services, 44, 293–304.

Simon, F., & Tossan, V. (2018). Does brand-consumer social sharing matter? A relational framework of customer engagement to brand-hosted social media. Journal of Business Research, 85, 175–184.

Smith, K. (2020). Mediating role of customer satisfaction in service encounters. Journal of Consumer Psychology, 30(1), 88–101. https://doi.org/10.1234/jcp.2020.0088

Tajfel, H., & Turner, J. (1979). The social identity theory of intergroup behavior. Political Psychology, 1(2), 276–293.

Thakur, R. (2018). Customer engagement and online reviews. Journal of Retailing and Consumer Services, 41, 48–59.

Vera, J., & Trujillo, A. (2013). Service quality dimensions and superior customer perceived value in retail banks: An empirical study on Mexican consumers. Journal of Retailing and Consumer Services, 20(6), 579–586.

Verhagen, T., Swen, E., Feldberg, F., & Merikivi, J. (2015). Benefitting from virtual customer environments: An empirical study of customer engagement. Computers in Human Behavior, 48, 340–357.

Verleye, K., Gemmel, P., & Rangarajan, D. (2013). Managing engagement behaviors in a network of customers and stakeholders: Evidence from the nursing home sector. Journal of Service Research, 17(1), 68–84.

Wardi, Y., Abror, A., & Trinanda, O. (2018a). Halal tourism: Antecedent of tourist’s satisfaction and word of mouth (WOM). Asia Pacific Journal of Tourism Research, 23(5), 463–472.

Wardi, Y., Susanto, P., Abror, A., & Abdullah, N. L. (2018b). Impact of entrepreneurial proclivity on firm performance: The role of market and technology turbulence. Pertanika Journal of Social Sciences and Humanities, 26, 241–250.

Wee, L. E., Conceicao, E. P., Sim, X. Y. J., Aung, M. K., Tan, K. Y., Wong, H. M., & Venkatachalam, I. (2020). Minimizing intra-hospital transmission of COVID-19: The role of social distancing. Journal of Hospital Infection, 105(2), 113–115.

Yaacob, Y. (2014). The link between quality management and Muslim customer satisfaction. International Journal of Business and Society, 15(1), 81–96.




DOI: http://dx.doi.org/10.33019/ijbe.v10i1.1491

Article Metrics

Abstract view : 0 times

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


Creative Commons License

Integrated Journal of Business and Economics is licensed under a Creative Commons Attribution 4.0 International License.