Patients Satisfaction with the Chronic Disease Management Program in Indonesia Using the Importance-Performance Matrix

Ramza Aurum Kusumawardana, Deni Kurniadi Sunjaya, Sharon Gondodiputro, Ardini Saptaningsih Raksanagara, Mulya Nurmansyah Ardisasmita, Anggraini Widjajakusuma


Background: Indonesia still has a high prevalence of hypertension and diabetes mellitus. On the other hand, essential health services were disrupted during the COVID-19 pandemic. Hence, the quality of service still needs to be prioritized. The government also obliges the government-owned primary healthcare facilities (Pusat Kesehatan Masyarakat, Puskesmas) to conduct customer satisfaction surveys to evaluate service quality. This study was conducted to analyze patients’ satisfaction with the chronic disease management program (Program Pengelolaan Penyakit Kronis, Prolanis) provided by Puskesmas in Bogor City.

Methods: Quantitative research with a survey approach using the CSI-29 questionnaire was conducted from October to November 2021 on 104 Prolanis participants from 6 Puskesmas in Bogor City, West Java, Indonesia. The variables were 9 dimensions of satisfaction based on the CSI-29 questionnaire. Data was transformed using the Rasch model and analyzed using the Importance-Performance Matrix (IPM).

Results: Of the 104 participants, there were 78 (75%) were satisfied with the Prolanis services provided by the Puskesmas. The IPM analysis showed that the dimensions of requirements, procedures, costs, type of service products, and attitudes of health workers had low expectations and perceived performance level.

Conclusions: Most of the Prolanis participants were satisfied with the Prolanis services provided by the Puskesmas in Bogor City.


Importance-Performance Matrix, prolanis, satisfaction

Full Text:



  1. Kesehatan Kementerian Kesehatan Republik Indonesia. Laporan Provinsi Jawa Barat Riskesdas 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan (LPB); 2019.
  2. BPJS Kesehatan. Buku Panduan Praktis PROLANIS. Jakarta: Humas BPJS Kesehatan; 2015.
  3. Limato R, Tumbelaka P, Ahmed R, Nasir S, Syafruddin D, Ormel H, et al. What factors do make quality improvement work in primary health care? experiences of maternal health quality improvement teams in three Puskesmas in Indonesia. PLoS One. 2019;14(12):1–18.
  4. Sunjaya DK. Validity and reliability of community satisfaction measurement instrument in health care institution. J Kesehat Prima. 2017;15(2):133–40.
  5. Gonçalves JR, Pinto A, Batista MJ, Pereira AC, Bovi Ambrosano GM. Importance-performance analysis: Revisiting a tool for the evaluation of clinical services. Health (Irvine Calif). 2014;6(5): 285–91.
  6. Sever I. Importance-performance analysis: a valid management tool? Tour Manag. 2015;48:43–53.
  7. Sumintono B, Widhiarso W. Aplikasi model Rasch untuk penelitian ilmu-ilmu sosial. Cimahi: Trim Komunikata Publishing House; 2014.
  8. Deng J, Pierskalla CD. Linking importance-performance analysis, satisfaction, and loyalty: A study of Savannah, GA. Sustain. 2018;10(3):1–17.
  9. Sinuraya RK, Abdulah R, Diantini A, Suwantika AA. Satisfaction level of patients, physicians, and private primary health-care center managers with chronic disease management program in Indonesia. Asian J Pharm Clin Res. 2017;10(Special Issue may):131–5.
  10. Akbar JM, Gondodiputro S, Raksanagara A. The elderly satisfaction on the chronic disease management program at the public health center, Bandung City, West Java, Indonesia. Int J Integr Health Sci. 2020;8(1):14–21.
  11. Endra F, Setyawan B, Lestari R. A study of chronic disease management in Indonesian primary health care. Indian J Forensic Med Toxicol. 2022;16(1):472–9.
  12. Soleman SR, Firda A, Sulistiyanto T, Nabila R. Health services quality between hypertension and diabetes mellitus patients in community health services in the Sleman District, Yogyakarta, Indonesia. Malaysian J Public Heal Med. 2020;20(2):141–8.
  13. Presiden Republik Indonesia. Peraturan Presiden Republik Indonesia Nomor 82 Tahun 2018 Tentang Jaminan Kesehatan. Jakarta: Sekretariat Kabinet RI; 2018.
  14. Bertram MY, Sweeny K, Lauer JA, Chisholm D, Sheehan P, Rasmussen B, et al. Investing in non-communicable diseases: an estimation of the return on investment for prevention and treatment services. Lancet. 2018;391(10134):2071–8.
  15. Prado-Galbarro FJ, Cruz-Cruz C, Gamiño-Arroyo AE, Sanchez-Piedra C. Satisfaction with healthcare services among patients with diabetes, hypertension, and/or dyslipidemia in Mexico: a cross-sectional study. Value Health Reg Issues. 2020;23:19–24.
  16. Pramanik GS, Puspitasari IM, Rahayu C, Suwantika AA. Tingkat kepuasan pasien rawat inap diabetes melitus tipe 2 dengan komplikasi ginjal di fasilitas kesehatan tingkat lanjut. Indones J Clin Pharm. 2019;7(3): 217–26.
  17. Jalil A, Zakar R, Zakar MZ, Fischer F. Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan. BMC Health Serv Res. 2017;17(1):1–13.
  18. Hammad MA, Sulaiman SAS, Aziz NA, Noor DAM. Prescribing statins among patients with type 2 diabetes: The clinical gap between the guidelines and practice. J Res Med Sci. 2019;24(1):1–6.
  19. Świątoniowska-Lonc N, Polański J, Tański W, Jankowska-Polańska B. Impact of satisfaction with physician–patient communication on self-care and adherence in patients with hypertension: cross-sectional study. BMC Health Serv Res. 2020;20(1):1–9.
  20. Latifah I, Maryati H. Analisis pelaksanaan program pengelolaan penyakit kronis (Prolanis) BPJS kesehatan pada pasien hipertensi di UPTD Puskesmas Tegal Gundil Kota Bogor. Hearty. 2018;6(2):34–45.


Article Metrics

Abstract view : 189 times
PDF - 49 times

 This Journal indexed by




Creative Commons License
AMJ is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License


View My Stats