ANALISIS MULTILEVEL HUBUNGAN KEPEMIMPINAN TRANSFORMASIONAL, BUDAYA ORGANISASI, DAN KINERJA TENAGA KESEHATAN DENGAN MUTU PELAYANAN KESEHATAN DI RSUD DR. SOEHADI PRIJONEGORO SRAGEN

Oleh :
Edy Sutikno - S022502024 - Sekolah Pascasarjana

ABTRACT Background: Healthcare service quality is a key indicator of hospital performance and is influenced by both individual and organizational level factors. The increasing number of patient complaints at dr. Soehadi Prijonegoro Regional General Hospital, Sragen, highlights the need to evaluate organizational determinants, particularly transformational leadership, organizational culture, and healthcare worker performance. This study aimed to examine the associations between these organizational factors and healthcare service quality using a multilevel analytical approach.Methods: A cross-sectional analytic observational study was conducted involving 500 patients from 25 inpatient wards at dr. Soehadi Prijonegoro Regional General Hospital, Sragen. Healthcare service quality was assessed at the individual level using the SERVQUAL instrument. Transformational leadership, organizational culture, and healthcare worker performance were measured at the ward level using the Multifactor Leadership Questionnaire (MLQ), the Organizational Culture Assessment Instrument (OCAI), and a performance assessment instrument adapted from Mathis and Jackson, respectively. Data were analyzed using multilevel mixed-effects linear regression.Results: Transformational leadership (b = −0.15; 95% CI = −0.34 to 0.30; p = 0.101), organizational culture (b = 0.06; 95% CI = −0.05 to 0.17; p = 0.313), and healthcare worker performance (b = −0.15; 95% CI = −0.57 to 0.27; p = 0.492) were not significantly associated with healthcare service quality. The intraclass correlation coefficient (ICC) was 8.63%, indicating that only a small proportion of the variation in healthcare service quality was attributable to differences between wards, whereas 91.37% of the variation was explained by individual-level factors or other unmeasured variables. A significant likelihood ratio test (LR = 18.57; p < 0.001) supported the use of multilevel analysis.Conclusions: Transformational leadership, organizational culture, and healthcare worker performance were not significantly associated with healthcare service quality at Dr. Soehadi Prijonegoro Regional General Hospital, Sragen. Nevertheless, the observed between-ward variation supports the application of multilevel modeling. Future efforts to improve healthcare service quality should consider additional organizational and individual factors, including healthcare provider communication, patient safety culture, resource adequacy, and hospital service delivery systems.  Keywords: healthcare service quality; healthcare worker performance; multilevel analysis; organizational culture; transformational leadership.