A Mixed-Methods Analysis of the 7P Marketing Mix and Outpatient Visit Interest at a Regional Public Hospital in Indonesia
Abstract
Public hospitals frequently face challenges in maintaining competitiveness due to sub-optimal service delivery and marketing strategies. This study examines the influence of the 7P marketing mix (Product, Price, Place, Promotion, People, Process, Physical Evidence) on public interest in utilizing outpatient services at RSUD Bengkalis. Employing a mixed-methods approach with a sequential explanatory design, this research integrates quantitative analysis via multiple linear regression with qualitative insights derived from fishbone diagrams. Primary data were collected from general-paying patients through structured questionnaires, followed by in-depth qualitative interviews. Quantitatively, simultaneous analysis reveals that all seven marketing mix elements significantly influence visit interest, with an Adjusted R² value of 81%, indicating high predictive power. Partially, Product, Place, People, and Physical Evidence exert a positive and significant impact on patient interest. Conversely, Price, Promotion, and Process show no statistically significant effects. Qualitative findings clarify that the insignificance of Process and Promotion stems from operational barriers, specifically inefficient manual queuing systems and restricted promotional outreach for specialized services targeting general patients. In conclusion, while the hospital’s core service offerings, accessibility, personnel, and infrastructure successfully attract patients, administrative inefficiencies and weak marketing limit its full potential. To enhance public interest and institutional competitiveness, the management of RSUD Bengkalis must prioritize the digital transformation of administrative and registration workflows, streamline the patient flow, and consistently improve staff hospitality to foster sustainable patient loyalty.
Full text article
References
World Health Organization, “Global health services outlook,” Geneva, Switzerland, 2023.
[2] A. Radulian, I. Cetină, and N. Manea, “Particularities of marketing application in medical services,” Res. Sci. Today, vol. 23, no. 1, pp. 51–57, 2022.
[3] Republic of Indonesia, “Law No. 17 of 2023 concerning Health,” Jakarta, Indonesia, 2023.
[4] M. Mutia and P. Pujiyanto, “Literature review: Application of the 7P mix marketing on patient satisfaction at hospitals,” J. Pendidik. Tambusai, vol. 6, no. 2, pp. 11677–11686, 2022.
[5] R. Rindu, M. Hafizurrachman, A. N. Haryanto, and W. N. A. Zakaria, “The 7Ps marketing mix in hospital services: A systematic mapping of applications through a scoping review,” J. Pendidik. Keperawatan Indones., vol. 10, no. 1, pp. 1–12, 2025.
[6] Kementerian Kesehatan Indonesia, “Transformation of healthcare services in Indonesia,” Jakarta, Indonesia, 2022.
[7] N. F. Dewi, R. Setiawati, R. K. Santoso, and N. Rahma, “Marketing mix and customer loyalty in Hermina Galaxy Hospital,” Proc., vol. 83, no. 1, pp. 1–8, 2022.
[8] S. Alfani, B. Widjanarko, and A. Sriatmi, “Service marketing mix (7P) and patient decisions in selecting hospital services: Literature review,” Holistik J. Kesehat., vol. 17, no. 1, pp. 45–53, 2023.
[9] E. N. Berkowitz, Essentials of Health Care Marketing, 5th ed. Burlington, MA, USA: Jones & Bartlett Learning, 2022.
[10] Y. D. Lubis, R. B. Suroyo, and A. D. Fitriani, “Marketing mix analysis on outpatient satisfaction at Medan Haji General Hospital,” J. Asian Multicult. Res. Med. Health Sci. Study, vol. 3, no. 2, pp. 45–52, 2022.
[11] T. Lestari, P. Purwadhi, and Y. R. Widjaja, “Evaluation of the implementation of the 7P marketing mix in executive outpatient services,” J. Pengabdi. Nas. Indones., vol. 6, no. 3, pp. 615–634, 2025.
[12] K. Brittain, J. Taylor, and C. Wu, “Healthcare service quality and patient satisfaction trends,” Health Serv. Manage. Res., vol. 35, no. 2, pp. 80–88, 2022.
[13] G. Abedi et al., “How marketing mix (7Ps) affect the patients’ selection of a hospital,” BMC Health Serv. Res., vol. 20, no. 1, pp. 1–10, 2022.
[14] H. Wati, “The influence of marketing mix on patient interest in healthcare services,” J. Hosp. Adm., vol. 4, no. 2, pp. 120–128, 2022.
[15] I. A. Priyanka and I. D. Hardy, “Marketing mix and outpatient visits in regional hospitals,” Indones. J. Public Health, vol. 17, no. 1, pp. 88–96, 2023.
[16] D. N. Marpaung, E. Ernawaty, D. Prayoga, and S. Lailiyah, “Implementation of marketing mix 7P on patient satisfaction in hospitals,” VISIKES, vol. 20, no. 1, pp. 30–38, 2022.
[17] M. Mardiah and S. Wahyu, “The role of hospital marketing mix to the selection of hospital consumers,” Proc. Int. Conf. Appl. Sci. Health, vol. 4, pp. 1065–1071, 2022.
[18] N. Q. Batubara and A. Wibowo, “The influence of marketing mix to patient satisfaction in hospitals: Narrative review,” Proc. Int. Conf. Appl. Sci. Health, vol. 4, pp. 1042–1050, 2022.
[19] V. A. Zeithaml and M. J. Bitner, Services Marketing: Integrating Customer Focus Across the Firm, 8th ed. New York, NY, USA: McGraw-Hill, 2023.
[20] R. M. Andersen, “Revisiting the behavioral model and access to medical care,” J. Health Soc. Behav., vol. 64, no. 1, pp. 1–15, 2024.
[21] Wasiyem et al., “Analisis Strategi Manajemen Kesehatan dalam Memaksimalkan Mutu Pelayanan di Rumah Sakit: Literature Review,” J. Ilmu Kedokt. dan Kesehat. Indones., vol. 5, no. 2, pp. 325–334, 2025.
[22] H. Syahrizal and M. S. Jailani, “Jenis-Jenis Penelitian Dalam Penelitian Kuantitatif dan Kualitatif,” QOSIM J. Pendidik. dan Hum., vol. 1, no. 8, pp. 13–23, 2023.
[23] R. A. Siroj, W. Afgan, Fatimah, D. Septaria, and G. Z. Salsabila, “Metode Penelitian Kuantitatif Pendekatan Ilmiah Untuk Analisis Data,” J. Rev. Pendidik. dan Pengajaran, vol. 7, no. 3, pp. 1861–1864, 2024.
[24] Y. A. Puspitasari and I. U. Septialisman, “Pengaruh Persepsi Harga Tiket dan Keamanan terhadap Minat Menggunakan Maskapai Wings Air,” J. Kewarganegaraan, vol. 6, no. 1, pp. 1145–1155, 2022.
[25] F. Aryanti, Q. F. P. Wahyono, C. D. Araminta, and L. K. Jannah, “Uji Validitas dan Reliabilitas dengan Software SPSS,” Algoritm. J. Mat. Ilmu Pengetah. Alam, vol. 2, no. 5, pp. 1–8, 2024.
[26] M. T. D. Haq et al., “Pendekatan Analisis Kualitatif dalam Pelayanan Kesehatan,” Manuju Malahayati Nurs. J., vol. 2, no. 3, pp. 641–648, 2022.
[27] J. Pallant, SPSS Survival Manual: A Step by Step Guide to Data Analysis Using IBM SPSS, 8th ed. London, U.K.: Routledge, 2022.
[28] J. W. Creswell and J. D. Creswell, Research Design: Qualitative, Quantitative, and Mixed Methods Approaches, 6th ed. Thousand Oaks, CA, USA: Sage, 2023.
[29] M. Taherdoost, “Validity and Reliability of Research Instruments in Healthcare Studies,” J. Healthc. Eng., vol. 2022, pp. 1–10, 2022.
[30] R. Lopez and A. Martin, “Ethical considerations in research involving healthcare students,” J. Med. Ethics, vol. 49, no. 4, pp. 245–251, 2022.
[31] Y. Zhang, H. Sun, and L. Chen, “Service quality and patient satisfaction in public hospitals: Evidence from healthcare marketing perspective,” BMC Health Services Research, vol. 22, no. 1, pp. 1–12, 2022.
[32] A. S. Wiyono and R. D. Pratama, “Determinants of patient revisit intention in hospital services: The role of service quality and perceived value,” International Journal of Healthcare Management, vol. 15, no. 4, pp. 312–321, 2022.
[33] M. A. Rahman, S. S. Khan, and T. Islam, “Accessibility and healthcare utilization in developing countries: A spatial analysis approach,” Health Policy and Planning, vol. 37, no. 6, pp. 721–732, 2022
[34] J. K. Lee and S. H. Park, “Geographical accessibility and hospital choice behavior: Evidence from urban and rural healthcare systems,” International Journal of Environmental Research and Public Health, vol. 19, no. 8, pp. 1–14, 2022.
[35] N. F. Abdullah and M. Y. Ali, “Human resource quality and patient trust in healthcare services,” Journal of Healthcare Quality Research, vol. 37, no. 2, pp. 98–106, 2022.
[36] S. K. Gupta and R. Verma, “Empathy in healthcare services and its impact on patient satisfaction and loyalty,” Journal of Patient Experience, vol. 9, 2022.
[37] L. H. Nguyen, T. T. Pham, and D. Q. Tran, “Physical environment of hospitals and its effect on patient perceived service quality,” Journal of Health Management, vol. 24, no. 3, pp. 245–256, 2022.
[38] A. K. Smith and J. Brown, “Healthcare facility design and patient experience: Evidence from modern hospitals,” Health Environments Research & Design Journal, vol. 16, no. 1, pp. 50–63, 2023.
[39] R. J. Andersen and M. Davidson, “Behavioral model of health services use revisited: Insurance and healthcare access,” Medical Care Research and Review, vol. 80, no. 2, pp. 123–140, 2023.
[40] P. C. Liu and H. Wang, “Cost sensitivity and hospital choice under insurance-based healthcare systems,” Health Economics Review, vol. 13, no. 1, pp. 1–10, 2023.
[41] T. R. Morgan and J. L. Lee, “Referral systems and patient decision-making in public healthcare institutions,” Social Science & Medicine, vol. 318, 2023.
[42] M. K. Sharma and P. Gupta, “Healthcare marketing strategies and digital transformation in hospital promotion,” Journal of Medical Marketing, vol. 23, no. 2, pp. 88–97, 2023.
[43] E. H. Kim and J. S. Choi, “Service process efficiency and patient satisfaction in hospitals,” BMC Health Services Research, vol. 23, no. 1, pp. 1–13, 2023.
[44] D. R. Patel and S. Mehta, “Waiting time and patient tolerance in public hospitals: A behavioral perspective,” International Journal of Public Health, vol. 68, no. 1, pp. 1–9, 2023.
[45] P. Kotler and K. L. Keller, Marketing Management, 16th ed. Harlow, UK: Pearson, 2022.
[46] J. H. Lee, S. Y. Kim, and M. Park, “Application of 7P marketing mix in healthcare service selection: A structural equation modeling approach,” BMC Health Services Research, vol. 24, no. 1, pp. 1–15, 2024.
Authors
Copyright (c) 2026 Azwan Rahmadhan Putra, Edi Prasetyo, Mia Mariani, Dicky Budiman
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlikel 4.0 International (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).