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JURNAL

JURNAL SOSIAL DAN SAINS

VOLUME 3 NOMOR 10 2023

P-ISSN 2774-7018, E-ISSN 2774-700X

EFFECTIVENESS OF DIGITAL MARKETING ON REVISIT

INTENTION OUTPATIENT OF BREBES REGIONAL

GENERAL HOSPITAL

Shella Vina Putri, Endang Ruswanti, Rokiah Kusumapradja

Universitas Esa Unggul, Indonesia

Email: dr.shella.vp@esaunggul.ac.id, endang.ruswanti@esaunggul.ac.id,

rokiah.kusumapradj[email protected]

Keywords:

Intention,

Promotion,

Process, People,

Physical

Evidence,

Marketing

ABSTRACT

Background: The Covid-19 outbreak turned into a pandemic in Indonesia in 2020. The

patient's intention to visit the hospital due to the pandemic but can be influenced by the

hospital's marketing strategy. Brebes Regional General Hospital before the Covid-19

pandemic used conventional marketing and, in an effort, to increase the number of repeat

visits to patients in the pandemic era and industry 5.0, namely through the most effective

marketing strategy, namely digital marketing.

Purpose: The aim is to determine the influence and effectiveness of digital marketing

in terms of people, physical evidence, process and promotion on the intention to revisit

outpatients at Brebes Regional General Hospital.

Methods: Using the Quasi Experimental Pre and postest method in digital groups and

conventional groups and the Logistic Regression method.

Results: The results showed that there was a difference and there was effectiveness in the

digital marketing group on the promotion variable (0.45), process (0.56), physical evidence

(0.37) and intention (0.54). There is a difference and effectiveness in the conventional group

on the process variable (0.35). There is a simultaneous influence of 4P variables on the

intention to revisit by 70.5%.

Conclusion: There is a difference and effectiveness in patient re-visits in the outpatient

service of the Brebes Regional General Hospital before and after the digital marketing

intervention group on the variables of Promotion, Process, Physical Evidence and Visit

Intention.

INTRODUCTION

The Covid-19 virus outbreak entered the country of Indonesia in 2019. The Covid-

19 outbreak turned into an Indonesian pandemic in 2020. Covid-19 pandemic many citizens

have a low intention to visit the hospital for both inpatient and outpatient care. The decline

in patient visits occurred in all hospitals. Brebes Regional General Hospital received the

first Covid-19 patient in 2020, cases reached 467 inpatient cases (Ramadhan et al., 2021).

The data shows the number of outpatient visits in 2019 - 2020 where in 2019 the number

of outpatients totaled 84,854 and the total number of outpatient visits along with the ER

was 90,374. Furthermore, the number of outpatients at Brebes Regional General Hospital

in 2020 per polyclinic was 58,559 and the total number of outpatient visits along with the

ER was 63,962. In the report on the number of outpatients in 2021, where the number of

Effectiveness of Digital Marketing on Revisit Intention

Outpatient of Brebes Regional General Hospital

2023

Shella Vina Putri, Endang Ruswanti, Rokiah Kusumapradja 1040

outpatients per polyclinic is 40,423 while the total number of outpatient visits along with

the ER in 2021 is 44,238 (Lukito & Widyaningrum, 2022). The report on the number of

outpatients in 2022, that the number of outpatients per polyclinic is 57,985 while the total

outpatient visits along with the ER in 2022 is 62,222. For this reason, it can be concluded

that from 2019 - 2022 there was a decrease in the number of outpatient visits that occurred

in 2020 and 2021 with a 50% decrease and an increase of 10% in 2022 (Exposto et al.,

2023; Ningrum et al., 2023). For this reason, it can be concluded that from 2019 - 2022

there was a decrease in the number of outpatient visits that occurred in 2020 and 2021 with

a 50% decrease and an increase of 10% in 2022. This data is taken from the medical record

installation data of Brebes Regional General Hospital in 2019-2021. The increase in

outpatient visits in 2022 is not optimal for Class B hospitals. The intention of patient visits

to the hospital is also not only due to the pandemic but can be influenced by the hospital's

own marketing strategy (Supriyanto & Ernawati, 2010). Brebes Regional General Hospital

before the Covid-19 pandemic used conventional marketing and in an effort to increase the

number of repeat visits to patients in the pandemic era and industry 5.0, namely through

the most effective marketing strategy, namely digital marketing (Savitri, 2019). The results

of interviews with 50 outpatients showed that 15 patients (30%) complained about the

services of health workers, 14 people (28%) answered that facilities and infrastructure were

incomplete, 13 people (26%) thought that the process was too long and complicated, and 8

people (16%) answered that service promotion was still lacking. So it can be seen that from

the 4P marketing mix that is a problem at Brebes (Liwaul et al., 2022). Regional General

Hospital is people, physical evidence, process and promotion. Based on the description

above, researchers know the effectiveness of digital marketing in terms of people, physical

evidence, process and promotion on patient re-visit intentions in the outpatient service of

Brebes Regional General Hospital.

METHODS

Research type Quasi Experimental Design. The study was conducted to determine

the effect of digital marketing treatment on patient revisit intention in the outpatient

service of Brebes Regional General Hospital (Prasetyo & Sulistiadi, 2019). How to find

out by comparing the intention to revisit between digital and conventional groups. The

digital group was treated with digital marketing, while the conventional group was treated

with conventional marketing. Quasi Experimental Design used in this study is Pretest &

Posttest Non Equivalent Control Group Design, which is a design that provides a pretest

before intervention and conducts a posttest after intervention in both groups (Kukanja et

al., 2017).

RESULTS AND DISCUSSION

Data Characteristics and Homogeneity Test

Table 1. Respondents Digital Group and Conventional

Characteristics

Digital

Conventional

p-value

Age (mean ± SD)

Min-Max

36.34±11.956

14 - 58

39,74±13,550

7 - 62

0.414*

Gender

1 = Male

2 = Female

28,6

71,4

25.7

74.3

0.788**

Education

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*Levene Statistic**Chi Square

Table 2. The Effect of Confounding Variables of Education on Digital Marketing Group

Visit Intention

Table 3. Difference Test and Effectiveness of Digital Group and Conventional.

Statistics

Variable

Group

Mean±SD

Pre test

Mean±SD

Post test

P-Value

Effectiveness

Promotion

Digital

15.66±2.155

16.63±2.088

0.015*

0.45 (Medium)

Conventional

15.29±3.006

15.97±2.007

0.275*

People

Digital

28.91±4.705

30.31±3.160

0.092*

Conventional

29.66±3.955

29.74±3.744

0.972*

Process

Digital

26.89±5.126

29.43±3.845

0.002**

0.56 (Medium)

Conventional

27.49±3.958

28.83±3.761

0.043**

0.35(Low)

Physical

Evidence

Digital

28.31±3.479

29.36±3.703

0.032*

0.37(Low)

Conventional

29.09±3.649

27.92±3.883

0.968*

Intention

Digital

16.89±2.111

17.97±1.855

0.028*

0.54 (Medium)

Conventional

17.54±1.884

17.14±2.840

0.581*

*Wilcoxon **Paired t-test ***Effect Size

Table 4. Multivariate Analysis Test (Promotion, People, Process, Physical Evidence) on

Simultaneously to Visit Intention in the Digital Group and Conventional

Group

Omnibus Test

Nagelkerke Square

Digital

0.000

0.705 / 70.5%

Conventional

0.001

0.578 / 57.8%

Table 5. Multivariate Analysis Test Promotion, People, Process, Physical Evidence on Partial

to Visit Intention in the Digital Group and Conventional

Characteristics

Digital

Conventional

p-value

1 = No Education

2 = Elementary school

3 = Junior High School

4 = Senior High School

5 = College

5,7

2,9

8,6

82,9

2.9

11.4

8.6

31.4

45.7

0.027**

Job

1 = No Job

2 = Government Employees

3 = Self-Employed

4 = Housewife

5 = Other

11,4

22,9

25,7

14.3

11.4

20.0

31.4

22.9

0.198**

Characteristics

No Intention of

Visiting

Intention

of Visiting

p-value

1 Education

- College

- Not College

37.1%

8.6%

45.7%

8.6%

0.817*

Variable

Digital

Conventional

Exp (β)

Sig

Exp (β)

Sig

Promotion

2.750 0.136

2.425 0.191

People

1.377

0.424

1.275

0.379

Process

1.418

0.519

0.867

0.733

Physical Evidence

0.993

0.991

2.203

0.046

Effectiveness of Digital Marketing on Revisit Intention

Outpatient of Brebes Regional General Hospital

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Shella Vina Putri, Endang Ruswanti, Rokiah Kusumapradja 1042

1) Based on the table above, it shows that the p-value on the education variable has a

significance value of 0.817 (p>0.05) so it is concluded that education is not a

confounding variable or confounding variable in this study, meaning that the number

of responses in the higher education category in the digital marketing group has no

effect on visit intentions and is not biased for this study.

2) The test results in the study before and after the digital marketing intervention in the

Promotion variable were 0.015 (<0.05), meaning that there was a difference in the

promotion of digital marketing intervention. The effectiveness test on the Promotion

variable is 0.45 which means it has a "Medium" category effectiveness. This study

illustrates that promotion through digital marketing media has a positive impact which

strengthens the theory of online and social media marketing, namely communication

activities in marketing, which in this case uses electronic media facilities in an effort

to attract customers or companies applied in various forms of writing, images, videos,

to increase awareness, improve the image of the company and increase in the sales

area (Hollensen et al., 2017).

3) The test results in the study before and after the digital marketing intervention on the

People variable are 0.092 (>0.05), which means that there is no difference that means

people or HR on digital marketing intervention. This study illustrates that people or

human resources are not enough to be packaged on social media alone but must also

still be supported by personality and a good attitude to consumers in accordance with

the Theory of Planned Behavior where an individual can evaluate the suggested

behavior as positive (attitude), and if he believes significant others want the person to

do the behavior (subjective norms) the intention (motivation) to perform the behavior

will be greater and individuals will be more likely to perform the behavior (Prayogi,

2019).

4) The test results in the study before and after the digital marketing intervention on the

Physical Evidence variable variable are 0.032 (<0.05), which means that it has a

difference that means the process on digital marketing intervention. The effectiveness

test on the Physical Evidence variable is 0.37 which means it has a "Low" category

effectiveness, meaning that it still has to be optimized for physical and infrastructure

facilities so that comfort increases. This study illustrates that Physical Evidence or

physical and facilities can be packaged both social media and provide an image for

consumers to be more comfortable in waiting in accordance with the theory of

Physical evidence, which is something that influences customer decisions to make

purchases in using the products and services offered (Zeithaml et al., 2018).

5) The test results in the study before and after the digital marketing intervention on the

Visit Intention variable were 0.028 (<0.05), meaning that there was a difference in the

intention to revisit the digital marketing intervention. This study illustrates that there

is an interest in returning to Brebes Hospital after being given a digital marketing

intervention, this theory strengthens the intention or intention of customers to visit a

place within a certain time limit and are willing to make a repeat visit to the Hospital

and marketing with social media is a type of internet-based marketing for marketing

purposes by participating in a social media network scope (Febriani & Surono, 2022).

6) The test results in the study before and after the digital marketing intervention on the

Process variable are 0.002 (<0.05), meaning that there is a difference that means the

process on digital marketing intervention. The effectiveness test on the Process

variable is 0.56, which means it has "Medium" category effectiveness. This study

illustrates that the process in services as a major factor in the service marketing mix

such as service consumers will be satisfied with the service delivery system as part of

the service itself (Fregidou-Malama & Hyder, 2021).

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7) The results of the research test in the conventional Marketing group for the Promotion

variable 0.275 (>0.05), People 0.972 (>0.05), Physical Evidence 0.968 (>0.05) means

that there is no difference in the three variables, this study illustrates that conventional

marketing is that potential buyers can directly see and try the products that can be

offered so that they can feel more convincing to buy the service products offered while

digital media marketing is marketing using digital media facilities using online

methods and the main purpose of digital marketing is to promote brands, form

preferences and increase sales traffic through several digital marketing techniques.

Digital marketing is internet marketing. Digital marketing is internet marketing. The

role of digital marketing has a very positive impact on business media (Tarigan &

Sanjaya, 2013).

8) The test results on the research before and after in the conventional marketing group

on the Process variable are 0.043 (<0.05), meaning that there is a difference that means

the process in the conventional marketing group. The effectiveness test on the process

variable is 0.37 which means it has "Low" category effectiveness. Conventional group

research has a low impact on researchers who reinforce the Process theory in services

as a major factor in the service marketing mix such as service consumers will be

satisfied with the service delivery system as part of the service itself (Kotler & Keller,

2012).

9) The test result of the effectiveness of digital marketing on the intention of re-visiting

outpatients at Brebes Hospital with social media as an intervention is 0.54, meaning

that the effectiveness of digital marketing with social media as an intervention has

"sufficient" effectiveness. Research theory that service quality, trust and satisfaction

can affect revisit intentions and individual targets are more likely to adopt a behavior

if the individual has a positive attitude towards the behavior, gets approval from other

individuals who are close and related to the behavior and believes that the behavior

can be done well by adding a variable (Lupiyoadi & Hamdani, 2013). Online and

social in digital marketing media is an activity in communicating marketing using

electronic media means to attract customers in various forms of writing, video, images

to increase desire and awareness of the image in the company to increase sales figures

(Liu & Burns, 2018).

10) Table 4 of the omnibus test shows that the significance value of the model is 0.000,

meaning that the four independent variables (promotion, people, process, physical

evidence) simultaneously affect visit intentions.

11) Table 4 negelkerke R square of 0.705 which means that the four independent variables

(promotion, people, process, physical evidence) are able to explain the repeat visit

intention variable by 70.5% and the remaining 29.5% is explained by other factors.

12) Table 5 variables in the equation shows that the significant value of Promotion (0.136)

People (0.424) Process (0.519) Physical Evidence (0.991) where if P>0.05 then the

variable does not have an influence on the dependent variable. Table 4.13 shows that

the exp(β) value for the promotion variable is 2.750 (>1.5), meaning that the

promotion variable has an influence on repeat visits and shows that the more often

digital marketing promotions are carried out, the possibility of increasing repeat visit

intentions is 2.750x higher than not digital marketing, while people (1.377) process

(1.418) Physical Evidence (0.993) means that the people, process and physical

evidence variables do not have their own influence on repeat visit intentions. This

study illustrates that promotion through digital marketing media has a positive impact

which strengthens the theory of online and social media marketing is a marketing

communication activity that uses electronic media in attracting consumers or

companies in various forms (pictures, videos, writings etc.) to increase awareness,

company image and to increase sales (HARIKA, 2018).

13) The results of this multivariate test were carried out to determine the effect of Partial

Effectiveness of Digital Marketing on Revisit Intention

Outpatient of Brebes Regional General Hospital

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Shella Vina Putri, Endang Ruswanti, Rokiah Kusumapradja 1044

(promotion, people, process, physical evidence) on the intention of outpatient re-visit

in the digital marketing group, carried out by logistic regression multivariate test.

Independent variables are said to have an influence on the dependent variable if a P

value <0.05 is obtained.

14) Table 4 of the omnibus test shows that the significance value of the model is 0.001,

meaning that the four independent variables (promotion, people, process, physical

evidence) have a simultaneous or joint effect on visit intentions.

15) Table 4 negelkerke R square of 0.578 which means that the four independent variables

(promotion, people, process, physical evidence) are able to explain the revisit intention

variable by 57.8% and the remaining 52.2% is explained by other factors.

16) Table 5 variables in the equation shows that the significant value of Promotion (0.191)

People (0.378) Process (0.733) Pysical Evidence (0.065) where if P>0.05 then the

variable has no effect on the dependent variable. These results indicate that if the

variable is tested alone on visit intention, it has no effect.

17) Table 5 shows that the exp(β) value for the physical evidence variable is 2.203 (>1.5),

meaning that the physical evidence variable has an influence on repeat visit intention

and shows that the better and more comfortable the physical evidence is, the stronger

the repeat visit intention will be.

18) The results of this multivariate test were carried out to determine the effect of Self

(Promotion, People, Process, Physical Evidence) on the intention of outpatient re-visit

in the conventional group, carried out by logistic regression multivariate test.

Independent variables are said to have an influence on the dependent variable if a P

value <0.05 is obtained.

19) Table 4 of the omnibus test shows that the significance value of the model is 0.001,

meaning that the four independent variables (Promotion, People, Process, Physical

Evidence) have a simultaneous or joint effect on visit intention.

20) Table 4 negelkerke R square of 0.578 which means that the four independent variables

(Promotion, People, Process, Physical Evidence) are able to explain the revisit

intention variable by 57.8% and the remaining 52.2% is explained by other factors.

21) Table 5 variables in the equation shows that the significant value of Promotion (0.191)

People (0.378) Process (0.733) Pysical Evidence (0.065) where if P>0.05 then the

variable has no effect on the dependent variable. These results indicate that if the

variable is tested alone on visit intention, it has no effect.

CONCLUSION

Based on the results of a study entitled "Effectiveness of Digital Marketing on

Revisit Intention Outpatient at Brebes Regional General Hospital" which was conducted

at Brebes Regional General Hospital in June - July 2023 using Pretest and Postest

questionnaires that have been intervened to two digital intervention groups and

conventional groups to 85 samples based on inclusion and exclusion criteria.

Questionnaires that have been distributed through google form and manual filling, after

informed consent is obtained as many as 70 answers from respondents who meet the results

of the screening question and have the right to continue to answer questions in this study.

Based on the results of the analysis that has been carried out, the conclusions of the results

of this study are as follows:

1) There is a difference and effectiveness in patient re-visits in the outpatient service of the

Brebes Regional General Hospital before and after the digital marketing intervention

group on the variables of Promotion, Process, Physical Evidence and Visit Intention.

2) There is no difference in the intention to revisit patients in the outpatient service of the

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Brebes Regional General Hospital before and after the digital marketing intervention

group on the People or Human Resources variable.

3) There is a difference in patient re-visit intention in the outpatient service of the Brebes

Regional General Hospital before and after the conventional group on the Process

variable

4) There is no difference in the intention of re-visiting patients in the outpatient services

of the Brebes Regional General Hospital before and after the Conventional Group on

the variables of Promotion, People, Physical Evidence and Visit Intention.

5) The effectiveness of digital marketing on the intention of re-visiting outpatients at

Brebes Regional General Hospital with social media intervention results are Moderate

Effectiveness or moderate.

6) There is an influence of the Promotion, People, Process and Physical Evidence variables

simultaneously or together on the intention to revisit outpatients in the digital marketing

group at the Brebes Regional General Hospital.

7) There is an influence of the promotion variable alone on the intention to revisit

outpatients in the digital marketing group at the Brebes Regional General Hospital

8) There is no influence of the Promotion, People, Process and Physical Evidence variables

simultaneously or together on the intention to revisit outpatients in the conventional

group at the Brebes Regional General Hospital.

9) There is no influence of the promotion, people, process and physical evidence variables

alone on the intention to revisit outpatients in the conventional group at the Brebes

Regional General Hospital.

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