ANALYSIS OF SATISFACTION OF NATIONAL HEALTH INSURANCE JKN PARTICIPANTS THROUGH QUALITY OF MOBILE SERVICES AND CONFIDENCE MEDIATED BY DECISION TO CHOOSE MOBILE JKN SERVICE ON BPJS KESEHATAN OF PEKANBARU

DOI:10.31933/DIJEMSS Abstract: The purpose of this study is to find out how Analysis of Satisfaction of National Health Insurance JKN Participants through Quality of Mobile Services and Confidence Mediated by Decision to Choose Mobile JKN Service on BPJS Kesehatan of Pekanbaru, by measuring indicators that influence variables service quality, trust, decision and satisfaction. This research applies a descriptive research design using survey methods. Sampling uses certain criteria where the respondent is a health insurance participant as a sampling technique. This study was tested using the structural equation modeling (Lisrel) approach to test the significance of the significance of the overall model and predetermined pathway. The findings show that mobile service quality variables have a positive and significant effect on decisions, trust variables have a positive and significant effect on decisions, decision variables have a positive and significant effect on participant satisfaction, mobile service quality variables have a positive and significant effect on satisfaction and trust variables have a positive and significant effect on participant satisfaction.


INTRODUCTION
BPJS Kesehatan (Social Security Administrative Body for Health) is a State-owned Enterprise specifically tasked by the government to provide health insurance for all Indonesians.
BPJS Kesehatan must be able to improve the quality of their services because good quality of services could play a significant role in improving the image of BPJS Kesehatan and satisfaction of the participants. Similarly, in recent years, the number of participnts of BPJS Kesehatan of Pekanbaru keeps increasing.  Table 1 shows that the number of JKN participants keeps increasing every year. Considering the massive public interest, BPJS Kesehatan of Pekanbaru should be able to improve the quality of the existing services to provide satisfaction for JKN participants. However, the trend of satisfaction of JKN participants based on Participant satisfaction index in recent years lowers, as shown in the following table.  Table 2 shows declining satisfaction index of JKN participants in the last three years. Declining satisfaction of JKN participants is due to increasing number of JKN participants in the last five years, as shown in Table 1 above, due to suboptimal services provided by the Pekanbaru Branch Office of BPJS Kesehatan.
BPJS Kesehatan nationally provides solution for this problem by launching mobile JKN. However, based on data collected from the field, as of today very few JKN participants of BPJS Kesehatan of Pekanbaru have activated mobile JKN [8]. This is shown in the following figure:  Table 1, the number was very small, only 2.85 percent has activated it while 97.15 percent hasn't activated it. The activation trend keeps declining in recent years. Below is the number of visits per service function which should be able to be performed via mobile JKN. Based on the number of visits per service function in Figure 2, all service functions are available on mobile JKN, but as of today mobile services haven't been used optimally by JKN participants and are still performed conventionally face-to-face in BPJS Kesehatan office of Pekanbaru.  Table 3 shows that 30 percent of JKN participants state that they still use services conventionally due to satisfaction when receiving direct services compared with using mobile JKN. 6.67 percent mention lack of socialization by BPJS Kesehatan of Pekanbaru to inform JKN participants, distrust, and difficulty in using mobile JKN, and other reasons as shown in Table 3.
Based on the phenomenon above and lack of study on improving the satisfaction of JKN participants through quality of mobile services and confidence mediated by decision to choose mobile JKN, it's interesting to turn this theme into an empirical study. Therefore, the present research studied the main problem, which is "Analysis of Satisfaction of National Health Insurance JKN Participants through Quality of Mobile Services and Confidence Mediated by Decision to Choose Mobile JKN Service A Study on BPJS Kesehatan of Pekanbaru".

LITERATURE REVIEW
Quality of Mobile Service, service quality is the expected level of excellence and control of the level of excellence is to meet customer desires.
Trust, consumer confidence is a company's willingness to rely on business partner. It depends on a number of interpersonal and inter-organizational factors, e.g. perceived company competency, integrity, honesty, and virtue. Confidence is belief that one will find what they want in exchange partner.
Decision Buying decision is a part of consumer behaviors, which is a study on how individual, group, and organization choose, buy, use, and how goods, services, idea or experience to satisfy their needs and desires.
Consumer satisfaction is a level where estimated product performance is consistent with buyer's expectation. Consumer satisfaction is one's happiness or disappointment which occurs after comparing the performance or outcome of a product with the performance or outcome expected before consuming or using the product.
Framework is narration (description) or statement (proposition) on identified or formulated conceptual problem solving frame. Below is the framework of the present study:

RESEARCH METHODS
The present study was a causal relation using descriptive research method with quantitative approach. The research type was survey research. The research population all participants of JKN and BPJS Kesehatan of Pekanbaru who have used mobile JKN services. The research sampling used non-probability sampling with purposive sampling. The number of samples refer to the criteria proposed by Hair et.al [3] using Maximum Likelihood Estimation (MLE). Good number of samples according to MLE is 100-200 samples.
The data collection method in the present study was questionnaire using likert scale with five research scores administered to 140 respondents who met the sample criteria. The questionnaire was distributed online via google form. In the present study, the variables were categorized into: (1) Independent variables i.e.; (X 1 ) Service Quality and (X 2 ) Confidence (2) and Dependent variables i.e.; (Y 1 ) Decision to Choose and (Y 2 ) Participant Satisfaction.
The data analysis of the present study used LISREL 8.80 for processing primary data

FINDINGS AND DISCUSSION
Validity test shows how far an instrument can measure a variable to be measured. The basis for deciding whether a statement is valid or not is below: (1) if r is positive and r ≥ 0.50, then the statement item is valid, while (2) if r is positive and r < 0.50, then the statement item isn't valid. Based on Figure 3, all statement items are valid because all r values of the statements are ≥ 0.50. Reliability test aims to determine the consistency of an instrument. The basis for deciding whether a research variable is reliable or not is as follows: (1) Table 4 shows that model fitness value is good, i.e. good fit and marginal fit, meaning overall the fitness value of the research model shows good fit.
To test research hypothesis, the significance value (α) is 0.005 or 5% with t value of ≥ 1.96. Table 5.  By analyzing the research result, some suggestions which could be considerations and inputs for National Health Insurance (JKN) and future researchers are: (1) Suggestion for the company BPJS Kesehatan is expected to improve the quality of mobile JKN service as in the present study, it was indicated that speed and ease have the lowest loading factor values. This shows that to improve service quality, the company should also note participant's trouble in accessing mobile JKN service, which is considered slow and difficult to access. Improving the performance of features on Mobile JKN application, e.g. ease of health facility transfer, participant data editing, health screening, ease of payment, history of service, complaint box, etc., will increase participants' decision to use mobile JKN service. (2) BPJS Kesehatan is expected to be able to enhance the confidence of mobile JKN participants as the present study found that consistency with the statement "I feel the data and information consistency through conventional means and Mobile JKN is good" has the lowest loading factor value. It shows that to improve participants' confidence, the company should note the accuracy of data and information provided by conventional and mobile JKN services to JKN participants, so that the participants don't hesitate in deciding to use mobile JKN services.

CONCLUSION AND SUGGESTION
(3) Future studies should add other variables which affect buying decision, e.g. price, word of mouth, trust, security, brand and promotion.