The Effect Of The Mediation Role Of Value Co-Creation On Loyalty At Hospital

 Customer relationship management with customers/patients will make patients comfortable and persistent, gradually increasing their loyalty to the hospital. As Maulana and Putri (2018) research state, if relationship management with customers is good, it will also cause loyalty to increase. In addition, with customer relationship management, it is possible to maintain good health services and the value of the co-creation process by the Tasikmalaya Islamic Hospital with patients following expectations, and loyalty will be created.

The initial observations made on the patients of the Tasikmalaya Islamic Hospital resulted in the conclusion that the communication created by the hospital was not optimal, so a good relationship between the patient and the hospital was not created.

Based on the initial observations of 30 patients of the Tasikmalaya Islamic Hospital, the integrated process between humans and the application of technology in medical services is still not optimal, which is 83% considered less than optimal. Thus, a good relationship between patients and the hospital is not optimal, whereas as many as 57% stated so. In addition, 77% of the patients sampled in the preliminary observation responded that the information technology support with the communication process of the Tasikmalaya Islamic Hospital was still not optimal.

Hospitals can provide the health services needed and follow patient expectations. This can create value co-creation that can create loyalty. The research of Maduka (2016) and Raza et al. (2020) concluded that value co-creation can affect customer loyalty. Hospitals should continue to strive to increase value added. Patients and the community get medical services and a good experience when visiting or being treated at the hospital. Value co-creation is the hospital's effort to provide patients' medical needs so that patient satisfaction is created and is expected to build high loyalty.

In line with this, Harkison's (2018) research states that the impact of value co-creation has moved organizations to rethink their focus on services and products and look to involve their customers in shaping the experience, not just looking at consumers as sales objects. Co-creation refers to an interactive process involving at least 2 (two) actors involved in a specific form of mutually beneficial collaboration and creating value for those actors (Frow et al., 2015). Based on the initial observations of 30 patients at the Islamic Hospital of Tasikmalaya, there is still a limited amount of capital to support the medical service process at the Islamic Hospital, with a percentage of 90%. Meanwhile, the interaction built is still not optimal, and there is a desire for patients to share knowledge.

Patients can contribute together with the hospital in creating an innovation in medical products and services that will later impact the formation of a memorable experience, as in the research of Chathoth et al. (2016) regarding consumers and companies creating innovations in goods/services. In addition, co-creation activities began with a shift in the view of initially product-centric consumers to experience-centric (Ramaswamy & Ozcan, 2018). Therefore, the hospital must reconsider the role of the patient in shaping an experience for satisfaction and expectation (Chathoth et al., 2016).

The researcher is interested in conducting in-depth studies on the influence of patient participation, customer relationship management (CRM), and value co-creation on patient loyalty at the Tasikmalaya Islamic Hospital. Based on the description of the background of the research above, the formulation of this problem is the effect of the mediation role of value co-creation on patient participation and Customer Relationship Management (CRM) on outpatient loyalty at the Obstetrics and Gynaecology Polyclinic of the Islamic Hospital Tasikmalaya.

Loyalty

Patient loyalty, according to Oliver (2010: 156), is a profoundly enduring customer commitment to resubscribe or re-purchase the selected product/service consistently in the future, although the influence of the situation and marketing efforts have the potential to cause behavioral changes (Andr et al., 2016). In addition, Griffin (2010: 67) states that loyalty is aimed at consumer behavior by making regular purchases based on decision-making units. Based on several definitions of loyalty, it can be concluded that patient loyalty is the patient's consistency in making purchases, in this case, using medical services from the hospital and making it possible to make repurchases and recommend them to others.

Customer loyalty can be used as a management strategy because the ultimate goal of a business is the formation of profits. Profit can be achieved through business strategy, namely through the formation of solid customer loyalty. The concept of loyalty needs to be measured to see the strength of the concept through the dimension of the concept size. According to Griffin (2010: 67), there are 4 (four) dimensions of consumer loyalty, including: 

Make regular repeat purchases, which is the average repurchase by repurchasing a lot of products or services and buying additional services or products;