Comparison of Community Satisfaction Index and Waiting Time at Four Community Health Centers in Lampung

Abstract

Background: Patient satisfaction and waiting time are core indicators of primary health care quality and are routinely required for public accountability under Indonesia's Community Satisfaction Survey (Survei Kepuasan Masyarakat/SKM) regulation. Objective: To compare the Community Satisfaction Index (Indeks Kepuasan Masyarakat/IKM) and outpatient waiting time across four community health centers (Puskesmas) in Lampung Province. Method: This study used a descriptive comparative design with a cross-sectional approach. Respondents were 120 outpatients (30 per Puskesmas) selected by accidental sampling, assessed on nine SKM elements (scale 1-4). Waiting time was measured directly by trained observers from registration until the patient was first examined. Data were analyzed descriptively and compared using the Kruskal-Wallis test with Dunn's post-hoc test, and the association between IKM and waiting time was tested with Spearman correlation.

Results: The IKM ranged from 76.11 (PKM X Kab, category C-Kurang Baik) to 89.81 (PKM A Kota, category A-Sangat Baik), with PKM B Kota (82.22) and PKM Y Kab (78.52) in category B-Baik. The Kruskal-Wallis test showed a significant difference in IKM between the four Puskesmas (H=57.62; p<0.001), with the largest gap found between PKM A Kota and the other three sites. Mean waiting time ranged from 24.80 minutes (PKM A Kota) to 32,37 minutes (PKM Y Kab), but the difference was not statistically significant (H=7,77; p=0,051). A weak negative correlation was found between waiting time and IKM (rs=−0,225; p=0,013).

Conclusion: Community satisfaction differed significantly among the four Puskesmas, while outpatient waiting time did not differ significantly, indicating that satisfaction is shaped by more than time efficiency alone-particularly staff competence, procedures, and facilities.