<![CDATA[Healthcare quality is increasingly determined by the capacity of primary healthcare facilities to integrate quality management, patient safety, and patient-centered service delivery. This study aims to analyze the effects of quality management and patient safety on healthcare service quality and BPJS patient satisfaction, as well as to examine the mediating role of healthcare service quality at UPTD Puskesmas Tubaan, Berau Regency, Indonesia. A quantitative approach was employed using a cross-sectional survey of 82 BPJS patients selected through Slovin’s sampling formula. Data were collected using a structured questionnaire with a five-point Ordinal scale and analyzed using descriptive statistics, validity and reliability testing, classical assumption tests, multiple linear regression, and path analysis. The results indicate that quality management has a positive and significant effect on healthcare service quality (β = 0.318; p = 0.003), while patient safety also has a positive and significant effect (β = 0.301; p = 0.005). Quality management significantly affects BPJS patient satisfaction (β = 0.271; p = 0.011), as does patient safety (β = 0.279; p = 0.010). Healthcare service quality has a significant positive effect on BPJS patient satisfaction (β = 0.322; p = 0.002). The estimated indirect effects of quality management and patient safety on satisfaction through healthcare service quality are 0.102 and 0.097, respectively. These findings indicate that healthcare service quality represents an important mechanism linking organizational quality practices and patient safety with patient satisfaction. The study highlights the importance of integrating continuous quality improvement, patient-safety practices, staff involvement, service responsiveness, and patient-oriented care to strengthen the experience and satisfaction of BPJS patients in primary healthcare settings.]]>
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