[The 10th ICPH] Topic IV

Health Policy and Management

 THE INFLUENCE OF WAITING TIME ON PATIENT
SATISFACTION: A META-ANALYSIS

Normalia Levi Rismawati, Bhisma Murti

Master’s Program in Public Health, Universitas Sebelas Maret, Indonesia.

ABSTRACT

Background: It is well established that longer wait times are negatively associated with
patient satisfaction with healthcare. This study aimed to estimate the magnitude of the
effect of waiting time on patient satisfaction.
Subjects and Method: This meta-analysis was conducted using the PICO research
question. Population: General patients. Intervention: Long waiting time. Comparison:
Short waiting time. Outcome: Patient satisfaction. The articles were searched from
databases PubMed, PLOS ONE, Google Scholar, and Scopus. Keywords used "Patient
Satisfaction" AND "Waiting Time" OR "Waiting Time for Health Services" AND
"Multivariate" AND "Cross-Sectional". Articles were published from 2015 to 2023. The
data were analyzed using Review Manager 5.3.
Results: The meta-analysis included 9 cross-sectional studies from Malaysia, China,
Ethiopia, and Nigeria. The total sample size was 3,925 patients. Long waiting time
decreased patient satisfaction, and it was statistically significant (aOR= 0.41; 95% CI=
0.33 to 0.52; p<0.001). The funnel plot indicated publication bias that overestimated the
true effect.
Conclusion: Long waiting time decreases patient satisfaction, and it is statistically
significant.

Keywords: waiting time, patient satisfaction.

Correspondence:
Normalia Levi Rismawati. Master’s Program in Public Health, Universitas Sebelas
Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: normalia.-
lecvi.r@gmail.com. Mobile: +6282225093120.

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 META-ANALYSIS: EFFECT OF GENDER, INSURANCE,
AND EDUCATION ON THE USE OF DENTAL HEALTH SERVICE

Qumara Wilda Khulwani, Bhisma Murti

Master’s Program in Public Health, Universitas Sebelas Maret

ABSTRACT

Background: Regular preventive dental checkups are key to maintaining both oral
health and overall health. Checkups not only help prevent tooth decay, gum disease, and
oral cancer, but they also help avoid the pain and costs that dental problems can bring
with them. This study aimed to estimate the effect of gender, insurance, and education
level on the use of dental care services.
Subjects and method: This meta-analysis was conducted based on the PRISMA flow
diagram and the PICO research question. Population: General. Intervention: Women,
with insurance, and higher education. Comparison: Male, without insurance, lower
education. Outcome: Use of dental examination services. The articles were searched
from databases Google Scholar, Elsevier, PubMed, and Springer Link published from
2012 to 2023. Keywords used “Women” OR “Gender” AND “Insurance” AND “Educa-
tion” AND “Dental Care” AND “Cross-sectional”. The inclusion criteria were full text,
cross-sectional design, and reported adjusted odds ratio (aOR). The articles were
analyzed using Review Manager 5.3.
Results: The meta-analysis included 11 cross-sectional studies from Indonesia,
Thailand, South Korea, Iran, Germany, the United States, and Canada. The total sample
size was 210,519 people. The use of dental examination services increased among women
(aOR=1.33; 95% CI= 1.15 to 1.55; p<0.001), with insurance (aOR=1.37; 95% CI= 0.92 to
2.05; p=0.12), and higher education (aOR=1.71; 95% CI= 1.21 to 2.42; p=0.002).
Conclusion: The use of dental examination services increases among women, with
insurance, and higher education.

Keywords: women, insurance, education, dental examination

Correspondence:
Qumara Wilda Khulwani. Master’s Program in Public Health, Universitas Sebelas Maret.
Jl. Ir. Sutami No. 36A, Surakarta 57126, Central Java, Indonesia. Email: qumarawilda13-
@gmail.com. Mobile: +6281228338430.

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 META-ANALYSIS: THE ASSOCIATION BETWEEN
GENDER, EDUCATION, AND HIV TESTING

Sri Rahayu Susilowati, Bhisma Murti

Master’s Program in Public Health, Universitas Sebelas Maret, Indonesia.

ABSTRACT

Background: Nearly 40% of new HIV infections are transmitted by people who don’t
know they have the virus. For people with undiagnosed HIV, testing is the first step in
maintaining a healthy life and preventing HIV transmission. This study aimed to
estimate the association between gender, education, and HIV testing.
Subjects and Method: This meta-analysis was conducted using a PICO research
question. Population: General population. Intervention: Women and higher education.
Comparison: Male and lower education. Outcome: HIV testing. The articles were
searched from databases Google Scholar, Elsevier, PubMed, and Springer Link published
from 2013 to 2023. Keywords used “Female” OR “Sex” AND “Education” AND “HIV
Test” AND “Cross-sectional”. The inclusion criteria were full-text paper, cross-sectional
study, and multivariate analysis with adjusted Odds Ratio (aOR). The articles were
analyzed using Review Manager 5.4.
Results: The meta-analysis included 11 primary studies from Thailand, China, Ethiopia,
Nigeria, Sub-Saharan Africa, South Africa, and the United States. The total sample size
was 1,370,883 women. HIV testing increased in women (aOR: 1.90; 95% CI: 1.29-3.01;
p=0.006) and higher education (aOR: 2.15; 95% CI: 1.66-2.78; p<0.001).
Conclusion: HIV testing increases in women and higher education

Keywords: women, education, HIV testing.

Correspondence:
Sri Rahayu Susilowati. Master’s Program in Public Health, Universitas Sebelas Maret. Jl.
Ir. Sutami No.36A, Surakarta 57126, Central Java, Indonesia. Email: drsrirahayu-
susilowati@gmail.com. Mobile: +6282133348510.

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 META-ANALYSIS: ASSOCIATION BETWEEN
EMPATHY AND PATIENT SATISFACTION
OF HEALTHCARE SERVICES

Dewi Utary1,2)
1)Master’s Program in Public Health, Universitas Sebelas Maret, Indonesia.
2)Faculty of Medicine, Universitas Islam Al-Azhar Mataram, West Nusa Tenggara

ABSTRACT

Background: Empathy is a characteristic of patient-physician communication that

forms the backbone of the patient-physician relationship. Studies show a good correla-
tion between physician empathy and patient satisfaction and a direct positive relation-
ship with strengthening patient enablement. Empathy lowers patients’ anxiety and
distress and delivers better clinical outcomes. This study aimed to estimate the asso-
ciation between empathy and patient satisfaction with healthcare services.
Subjects and Method: This meta-analysis was conducted using a PRISMA flow
diagram. The articles were searched using keywords based on the PICO research
question. Population: Patient. Intervention: Good empathy. Comparison: Poor empathy.
Outcome: Patient satisfaction. The articles were searched from 3 databases PubMed,
Google Scholar, and Science Direct. Keywords used "service quality" AND "patient
satisfaction" AND "hospital" AND "health facility" AND "cross-sectional". The inclusion
criteria included a full-text paper, cross-sectional study, multivariate analysis with
adjusted Odds Ratio (aOR), and published from 2017 to 2022. The articles were analyzed
using Review Manager 5.3.
Results: The meta-analysis included 9 primary studies from Indonesia, Malaysia,
Ethiopia, Nigeria, the United States of America, and Brazil. Patients experiencing good
empathy were 1.43 times more likely to be satisfied than poor empathy, and it was
statistically significant (aOR= 1.43; 95% CI= 1.00-2.03; p=0.001).
Conclusion: Good empathy increases patient satisfaction by 1.43 times compared to
poor empathy.

Keywords: patient, satisfaction, empathy

Correspondence:
Dewi Utary. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami
no. 36A Surakarta 57126, Central Java. Email: sydneydewi01@gmail.com. Mobile:
+6287839291063.

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 ASSOCIATIONS BETWEEN INSTITUTIONAL TRUST
AND HEALTH-SEEKING BEHAVIOR IN TELUK NARA
VILLAGE, EAST NUSA TENGGARA

Alfian Muhajir1), Baiq Novaria Rusmaningrum2), Luh Komang Kartini

Srianjaswari2), Made Aryduta Sutasoma2), Nanda Dwi Lestari2), Ni Luh Yosi
Andarini2), Putu Candra Dewi2), Sri Warni2), Wahyu Kurniawan2)
1)MastersProgram in Public Health, Universitas Sebelas Maret
2)Faculty of Medicine, Universitas Islam Al-Azhar, Mataram, East Nusa Tenggara

ABSTRACT

Background: In rural and remote areas in Indonesia, inappropriate health-seeking

behavior (HSB) persists. The Indonesian Bureau of Statistics reported that the
percentage of healthcare facilities utilization remains low. Inappropriate HSB has been
related to poorer health outcomes, higher morbidity and mortality. The purpose of this
study was to investigate factors related to HSB toward formal healthcare providers in
rural areas.
Subjects and Method: This was a cross-sectional study conducted in Teluk Nara,
Malaka village, North Lombok, East Nusa Tenggara, Indonesia, from July to August
2023. A sample of 110 people was selected by convenience sampling. The dependent
variable was health-seeking behavior toward formal healthcare providers. The indepen-
dent variable was institutional trust. The data were collected by a questionnaire and
analyzed using multiple logistic regression.
Results: Health-seeking behavior toward formal healthcare providers significantly
increased with institutional trust (OR= 3.67; 95% CI= 1.42 to 9.47; p= 0.007).
Conclusion: Health-seeking behavior toward formal healthcare providers significant-
ly increases with institutional trust in rural areas.

Keywords: health-seeking behavior, formal healthcare providers, rural area

Correspondence:
Alfian Muhajir. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir.
Sutami 36A, Surakarta 57126, Central Java. Email: alfian.muhajir@gmail.com. Mobile:
+6281805273479.

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 META-ANALYSIS: EFFECTS OF COMFORTABLE CONSULTATION
ROOM, DRUG AVAILABILITY, AND LABORATORY
COMPLETENESS ON OUTPATIENT SATISFACTION

Desi Noviani, Rahmi Windhy Astari

Masters Program in Public Health, Universitas Sebelas Maret

ABSTRACT

Background: Patient satisfaction is important to achieve optimal healthcare service

delivery. Satisfied patients are more likely to comply with treatment, take an active role
in their care, continue using health care services, and remain with a health provider. This
study aimed to estimate the effects of comfortable consultation rooms, drug availability,
and laboratory completeness on outpatients' satisfaction.
Subjects and Method: This was a systematic review and meta-analysis by accessing
articles from Google Scholar, PubMed, ResearchGate, and Science Direct. The articles
were searched using the PICO format. Population: Outpatients. Intervention: Comfort-
able consultation room, available drug, and complete laboratory. Comparison:
Uncomfortable consultation room, unavailable drug, and incomplete laboratory.
Outcome: Patient satisfaction. Keywords used “Consultation Room” AND “Drug” AND
“Laboratory” AND “Outpatient Health Services” OR “Satisfaction” AND “Cross-Sectional
Study”. The inclusion criteria were cross-sectional studies, reported in a full text,
published from 2014 to 2022. The articles were screened using a PRISMA flow diagram
and the data were extracted by RevMan 5.3.
Results: This meta-analysis consisted of 18 cross-sectional studies from Malaysia,
Pakistan, and Ethiopia. The total sample was 10,645 participants. Patient satisfaction
increased with comfortable consultation room (aOR= 1.63; 95% CI= 0.99 to 2.67; p=
0.05), drug availability (aOR= 2.21; 95% CI= 1.75 to 2.79; p= 0.001), and complete
laboratory (aOR= 2.15; 95% CI= 1.51 to 3.06; p= 0.001).
Conclusion: Patient satisfaction increases with a comfortable consultation room, drug
availability, and complete laboratory.

Keywords: patient satisfaction, consultation room, drug availability, laboratory test

Correspondence:
Desi Noviani. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir.
Sutami 36A, Surakarta 57126, Central Java. Email: desinoviani49@gmail.com. Mobile:
+6285796702378.

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 FACTORS AFFECTING ANTENATAL
CARE SERVICE UTILIZATION

Fitriani Bancin, Ricca Nophia Amra, Rizka Sititah Rambe

Midwifery Academy of Medica Bakti Persada, Aceh, Indonesia

ABSTRACT

Background: Antenatal care (ANC) is essential for protecting the health of women and
their unborn children. Through this form of preventive health care, women can learn
from skilled health personnel about healthy behaviors during pregnancy, better
understand warning signs during pregnancy and childbirth, and receive social,
emotional, and psychological support at this critical time in their lives. This study aimed
to analyze factors affecting ANC service utilization.
Subjects and Method: This was a mixed-method study conducted at the Simpang Kiri
Health Center, Subulussalam, Aceh from February to July 2023. A total of 83 pregnant
women were selected for this study. The dependent variable was ANC service utilization.
The independent variables were education, knowledge, attitude, income, parity, support
health workers, distance to health services, and maternal health. The qualitative data was
collected by in-depth interviews. The quantitative data was collected by questionnaire
and analyzed by multiple logistic regression.
Results: The use of ANC service in pregnant women decreased with low education
(aOR= 0.02; 95% CI= 0.01 to 0.10; p <0.001); poor knowledge (aOR= o.02; 95% CI=
<0.01 to 0.20; p <0.001); low income (aOR= 0.18; 95% CI= 0.03 to 0.99; p <0.001); lack
of support from health workers (aOR= 0.04; 95% CI= 0.01 to 0.39; p <0.001), and they
were statistically significant. Negative attitudes, multi-parity, long distance to health
services, and poor maternal health, also decreased the use of ANC service, but they were
statistically non-significant.
Conclusion: Low education, poor knowledge, low income, and lack of support from
health workers, reduce the use of ANC service. Negative attitude, multi-parity, long
distance to health services, and poor maternal health, decrease the use of ANC service,
but they are statistically non-significant.

Keywords: antenatal care, health service, pregnant women.

Correspondence:
Fitriani Bancin. Midwifery Academy of Medica Bakti Persada. Jl. Pinang Baris Desa Lae
Oram Dusun Indah No. 193, Simpang Kiri, Subulussalam, 24781, Aceh, Indonesia.
Email: fitribancin03@gmail.com. Mobile: 085372351042.

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https://doi.org/10.26911/ICPH10/Management/2023.07