Building Patient’s Loyalty: The Role of Trust, Expectations, and Satisfaction Among Outpatient Commitment

Anis Sonia Probowati (Master’s Program in Public Health, Universitas Sebelas Maret)
Endang Sutisna Sulaeman (Master’s Program in Public Health, Universitas Sebelas Maret, Surakarta, Indonesia)
Bhisma Murti
Sumardiyono (Diploma IV of Occupational Safety and Health, Universitas Sebelas Maret, Surakarta, Indonesia)
Revi Gama Hatta Novika (Master’s Program in Public Health, Universitas Sebelas Maret, Surakarta, Indonesia)

Journal of Health Policy and Management
Vol. 11 No. 1 (2026)

Background: Quality health services are the result of cooperation between patients and health service providers in a healthy environment. Hospitals as institutions engaged in service quality are a benchmark for assessing patient loyalty. One of the benchmarks is the quality of service received by patients from a hospital; therefore, it is the obligation of the hospital to maintain a good relationship with patients to create a maximum loyalty value. Based on Law Number 17 of 2023 concerning health, it is stated that local governments and communities are responsible for the implementation of health efforts. The implementation of health services is carried out responsibly, safely, quality, and equitably. The study aims to discover factors that affect the loyalty of outpatients at Klaten Islamic Hospital. Subjects and Method: It was a cross-sectional study conducted at Klaten Islamic Hospital from December 2024 to January 2025. The sample consisted of 200 outpatients selected using the simple random sampling method. The independent variables were hospital image, trust, expectation, past experience, and satisfaction. Meanwhile, the dependent variable was outpatient loyalty. Data collection was carried out using a questionnaire. Data analysis was conducted using path analysis. Results: The results of the path analysis that had been carried out in this study stated that the loyalty of outpatients at Klaten Islamic Hospital was directly influenced by trust (b=-0.02; 95% CI= -0.30 to 0.24; p= 0.831), satisfaction (b=0.44; 95% CI= 0.19 to 0.69; p<0.001), age (b= 0.13; 95% CI= 0.01 to 0.24; p= 0.024), hospital image (b= 0.20; 95% CI= 0.08 to 0.32; p=0.001), Education (b= -0.11; 95%CI= -0.22 to 0.00; p=0.054), gender (b= - 0.00; 95%CI= -0.11 to 0.11; p=0.958). Patient loyalty through patient trust was indirectly influenced by past experience, patient satisfaction, expectations, and polyclinic. Conclusion: The loyalty of outpatients at Klaten Islamic Hospital is directly influenced by trust, satisfaction, age, hospital image, education, and gender. Patient loyalty through patient trust is indirectly influenced by past experience, patient satisfaction, expectations, and polyclinic.