Marketing Mix and Service Quality in Increasing Return-Treatment Decisions Through Patient Satisfaction and Patient Trust in Asyifa Husada Pamekasan Hospital

: With the development of healthcare service trends outside of hospitals, hospitals must strategically manage competition to maintain and increase the number of patients choosing to return for outpatient care. This research aims to delve deeper into the factors influencing patients' decisions to return for outpatient services at Asyifa Husada Pamekasan Hospital. The study utilizes a saturated sample, including all patients who have utilized medical services at Asyifa Husada Pamekasan General Hospital from October 2023 to December 2023, there are 100 individuals. However, only 96 individuals completed the questionnaire. Hypothesis testing in this research is conducted using the Structural Equation Model (SEM) based on Partial Least Square (PLS) approach. Based on the results of hypothesis testing, it was found that out of the 8 hypotheses processed in this study, 1 hypothesis indicated a non-significant influence, while the other 7 hypotheses showed a significant positive impact. In the research findings, the marketing mix variable (X1) and Service Quality (X2) have a positive and significant impact on Patient Satisfaction (Z1). Additionally, Service Quality (X2) has a positive and significant influence on Patient Trust (Z2), while the marketing mix variable (X1) does not have a significant impact on Patient Trust (Z2). Furthermore, the variables Marketing Mix (X1), Service Quality (X2), Patient Satisfaction (Z1), and Patient Trust (Z2) collectively have a positive and significant influence on the Decision to Return for Treatment (Y).


D. Data Analysis Method
Hypothesis testing in this research was carried out using an approach Structural Equation Model (SEM) based Partial Least Square (PLS).PLS is a component or variant-based structural equation model (SEM).Hypothesis testing is carried out to determine whether there is an effect of research variables on the others.This testing is done by analyzing the Regression Weight, i.e.Critical Ratio (CR) and Probability (P) values.The required limits are ≥ 1.96 for the CR value and ≤ 0.05 for the P-value.If the data processing results show a value that meets these requirements, the proposed research hypothesis is accepted.1 Outer Loading above, showing that there are no indicator variables with outer loading values below 0.5, thus all indicators are considered suitable or valid for use in the study and can be used for further analysis.

Table. 2 Convergent Validity Test -Average Varian Extracted (AVE)
Variable Average Varian Extracted (AVE) Marketing Mix (X1) 0,593 Service Quality (X2) 0,678 Patient Satisfaction (Z1) 0,622 Patient Trust (Z2) 0,690 Return-Treatment Decision (Y) 0,620 Source: Data processed by Smart-PLS Based on the data presented in Table 2, it is known that the Average Variance Extracted values for all variables in this study are > 0.5.Therefore, it can be stated that each variable has good convergent validity.In the next section, the results of discriminant validity testing will be explained using Fornell-Larcker and Cross Loading values.An indicator is considered to meet discriminant validity standards if the Fornell-Larcker and Cross Loading values for the indicator on its variable are the highest compared to other variables.The following are the Fornell-Larcker and Cross Loading values for each indicator:  3 and 4, it can be observed that each indicator on the research variable has the highest Fornell-Larcker and Cross Loading values on the variable it forms compared to the Fornell-Larcker and Cross Loading values on other variables.Based on these results, it can be stated that the indicators used in this study have good discriminant validity in constructing their respective variables.This segment outlines the outcomes obtained from reliability testing, employing composite reliability, rho_A, and Cronbach's alpha values as evaluation metrics.To adhere to established reliability standards, an indicator is deemed reliable if its composite reliability values exceed 0.6 (Bagozzi & Yi, 1998;Chin & Dibbern, 2010).Similarly, the reliability is affirmed if rho_A and Cronbach's alpha values surpass 0.7 (Vinzi, Trinchera, & Amato, 2010).The ensuing values represent the composite reliability, rho_A, and Cronbach's alpha for each indicator: Based on the information provided in Table 5, it is evident that the composite reliability values for all the research variables surpass 0.6.Additionally, the values for rho_A and Cronbach's alpha exceed 0.7.These findings collectively signify that each variable satisfies the specified criteria for composite reliability, rho_A, and Cronbach's alpha.Consequently, it is reasonable to conclude that the overall variables exhibit a high level of reliability.

B. Evaluation of Structural Model/ Inner Model Figure 3 Inner Model
Based on the inner model scheme displayed, it can be explained that the largest path coefficient value is the influence of service quality on patient satisfaction of 13,616, then the influence of patient satisfaction on the decision to return for treatment is 7,293, while the smallest influence is the marketing mix on patient satisfaction of 1,713.This shows that if the greater the value of the path coefficient on an exogenous variable on an endogenous variable, the stronger the influence will be.Based on the table above, it can be seen that of the 8 hypotheses processed in this research, it can be declared accepted or significant if the Pvalue Values < 0.05 and T -Statistics > 1.96.There is 1 hypothesis which states that the effect is not significant while 7 other hypotheses state that it has a significant positive effect.

H1: Marketing Mix influences Patient Satisfaction
The finding that the marketing mix has a significant effect on patient satisfaction at Asyifa Husada Pamekasan Hospital illustrates the complexity in the relationship between service marketing strategies and patient perceptions of health services.One reason may lie in the suitability of marketing strategies to patient needs and preferences.Further analysis is needed to evaluate the extent to which marketing strategies can reflect patient expectations for healthcare services.There is a trend that non-marketing factors, such as medical staff interactions, waiting times, and quality of service, have a greater impact on patient satisfaction.Therefore, it is necessary to involve a deeper understanding of these elements and determine improvement strategies that can improve overall service quality.Additionally, there may also be psychological factors or patients' preconceived perceptions of the hospital, which may influence how they respond to marketing efforts.Evaluation of patient attitudes and perceptions can provide greater insight into the factors that may have shaped their views of the hospital.To address these significant outcomes, hospitals can consider adapting their marketing strategies to better suit patient needs and preferences, making improvements to high-impact service factors, and improving communication with patients to clarify the value and benefits of healthcare services.they offer.Thus, this analysis can provide guidance for more effective steps in increasing patient satisfaction.These results are supported by research conducted by Nurbani, A., et al (2019), and Khusnul Khotimah (2023) who said that the service marketing mix has a significant positive effect on customer satisfaction.Likewise, research conducted by Taroreh, S.F., et al (2023) said that product quality is clear starting from taste and cleanliness, affordable prices, strategic locations and easy to find as well as promotions in various social media is one strategy that can be used to provide a good identity so that it is better known and easier to remember by consumers.

H2: Marketing Mix influences Patient Trust
The finding that the marketing mix has no significant effect on patient trust at Asyifa Husada Pamekasan Hospital is that there is not sufficient evidence to support the existence of a significant relationship between the Marketing Mix and Patient Trust in the sample tested.These results imply that, at least in the context of this sample, it cannot be assumed that there is a meaningful relationship between the Marketing Mix variables and Patient Trust and potentially does not have a large impact in the healthcare context.This positive influence shows that the marketing strategy implemented has not been effective in building trust among patients.Further analysis can focus on the extent to which each element of the marketing mix contributes to the formation of patient trust.For example, perhaps high quality medical services or effective communication through promotions have a greater impact on perceptions of trust.The negative impact of the marketing mix on patient trust can mean decreased patient retention, loyalty, and adherence to recommended medical treatments.In addition, weak trust can give a hospital a bad image, thereby reducing the incentive for patients to refer others to another hospital, and can play a role in a patient's decision not to return for treatment in the future.With the understanding that the marketing mix does not significantly decrease patient trust, hospitals cannot continue with this strategy, instead focusing on elements proven to have a positive impact, and improving certain aspects to strengthen patient trust.As a result, this can help create better patient relationships, provide a positive experience, and again improve the hospital's reputation in the eyes of the community.These results contradict research conducted by Akbar R.M (2018), which said that the marketing mix has a significant effect on consumer trust.Likewise, research conducted by Nurbani, A (2019) said that the dimensions of the marketing mix can create positive value for consumer trust.The better the marketing mix, the more consumers in Harvest City will trust the company in this matter.The lack of access to renewable technology can be a major factor so that, supported by the marketing mix of services, Asyifa Husada Pamekasan Hospital has not been able to gain great trust from patients.

H3: Service Quality influences Patient Satisfaction
The finding that service quality has a positive and significant effect on patient satisfaction at Asyifa Husada Pamekasan Hospital is a very satisfying result.This positive influence suggests that efforts to improve service quality, including aspects such as care effectiveness, communication, empathy, and administrative processes, effectively increase patient satisfaction.Further analysis can be carried out to understand the extent to which each service quality element contributes to increased patient satisfaction.For example, clarity of communication or a patient's sense of security during care may have a greater impact on satisfaction.The positive impact of service quality on patient satisfaction has a broad positive impact.Satisfied patients tend to have higher levels of compliance with recommended medical care, as well as being more likely to recommend the hospital to others.This can also contribute to a good reputation for the hospital in the community and increase patient loyalty.With the understanding that quality of service significantly increases patient satisfaction, hospitals can continue to focus on improving and maintaining high quality standards in their health services.Continuously monitoring and evaluating the aspects of quality of care that are most important to patients can help improve the overall patient experience and support achieving the goal of optimal patient satisfaction.These results are supported by research conducted by Boediono, M., et al (2018), Anggraini, F., et al (2020), Ismal, T., et al (2021), and Erpurini, W., et al (2022) who said that Service quality has a significant positive effect on customer satisfaction.Likewise, research conducted by Cesariana, C., et al (2022) states that the better the quality of service received by consumers, the greater the satisfaction felt by customers.Of course, the better the service provided by Asyifa Husada Pamekasan Hospital, the greater the level of satisfaction felt by patients.

H4: Service quality influences patient trust
The research results showing that service quality has a significant effect on patient trust at Asyifa Husada Pamekasan Hospital is the focus of attention that requires in-depth analysis.This significant finding may be caused by several factors, such as slight differences in patient perceptions of the service quality elements measured or the presence of external factors that have a greater influence on patient confidence.External factors may also be key determinants of patient trust, where a hospital's reputation, recommendations from others, or past experiences may have a greater impact than the quality of service.In addition, the discrepancy between expectations and reality Marketing Mix and Service Quality in Increasing Return-Treatment Decisions Through Patient Satisfaction and Patient Trust in Asyifa Husada Pamekasan Hospital regarding service quality may also be an aspect that influences patient trust.If patient expectations are met, it will be easy to gain their trust in the hospital.The communication aspect needs to be improved, where certainty or clarity in conveying action times as an effort to improve the quality of service to patients can create confusion or misunderstanding, affecting patients' perceptions of trust.Variability in methods of measuring service quality may be a factor, where certain elements may not fully reflect the concept of service quality in the patient's view.An in-depth analysis of these factors can provide a more comprehensive and in-depth understanding of how service quality significantly influences patient trust.By understanding the complexity of these dynamics, Asyifa Husada Pamekasan Hospital can formulate more appropriate strategies to improve the relationship between service quality and patient trust.These results are supported by research conducted by Pasi, L.N.K., et al (2021), and Erpurini, W., et al (2022) which states that service quality has a significant positive effect on consumer trust.Likewise, research conducted by Ryana, R.M., et al (2023) said that consumers place their trust when a company is able to guarantee good quality service and benefits for consumers.Of course, patient trust will continue to grow in Asyifa Husada Pamekasan Hospital as long as they continue to provide the best service and guarantee a high recovery rate.

H5: Marketing Mix influences Return-Treatment Decision
The finding that the marketing mix has a significant influence on return-treatment decision at Asyifa Husada Pamekasan Hospital invites further analysis regarding these significant factors.One of the main considerations is the potential for a more dominant influence from external factors, such as recommendations from doctors, previous patient experiences, or influence from family and friends, which may have more influence on the patient's decision to return to treatment.Assessing the role of direct patient experiences during care is also important, including interactions with medical staff, comfort of facilities, or timeliness of services, as these may have a greater impact on return-to-treatment decisions than elements in the marketing mix.In addition, evaluation of patient satisfaction as a separate variable needs to be considered, because patient satisfaction may have a more significant role in influencing return-to-treatment decisions than marketing elements.Variability in marketing mix measurement is also an important aspect to consider to ensure that each marketing element is measured accurately and includes aspects that patients consider important.Psychological factors and patient perceptions of marketing efforts are also relevant considerations, where the success of marketing messages in creating connections and influencing patient views of healthcare needs to be assessed.By understanding these dynamics holistically, Asyifa Husada Pamekasan Hospital can take informed steps to improve elements in its marketing mix more effectively and formulate marketing strategies that better suit patient needs and preferences, with the aim of increasing return-to-treatment decisions.patient.These results are supported by research conducted by Andriyanto, L., et al (2019), Sangadji, S.S., et al (2019), Randhy, A., et al (2020) and Mayasari, I., et al (2021) saying that the service marketing mix significant positive effect on purchasing decisions.This marketing mix strategy certainly needs to always be considered, considering that this factor is one of the determining factors for patients in choosing a place for treatment as well as their decision to choose another place, in this case the Asyifa Husada Pamekasan Hospital, for treatment.

H6: Service quality influences Return-Treatment Decision
The research results which show that service quality has a significant influence on return-treatment decision at Asyifa Husada Pamekasan Hospital have interesting implications in the context of health service management.Although quality of care is often considered a key element in influencing patient satisfaction and retention, these findings highlight that other factors may have a more dominant role in patient decision making.These findings highlight the importance of understanding more deeply the dynamics of patient decisions.Factors such as affordability, physician recommendations, or economic factors may have a greater impact on return-to-treatment decisions than the experience of the service itself.Therefore, hospitals may need to broaden their outlook to design strategies that are more representative and suited to patients' unique needs.Another impact is the importance of adjusting service management strategies.Service quality dominates the decision to return to treatment, so it is necessary to identify other elements that need to be improved or highlighted.This may involve further emphasis on aspects such as communication, efficiency of administrative processes, or development of relationships between patients and medical staff.Thus, these results challenge hospitals to better understand the dynamics of patient decisions and adopt a more comprehensive approach to improving patient retention.In conclusion, while quality of care remains important, hospitals need to understand that patient experience and other factors can play a significant role in building trust and motivating patient return-totreatment decisions.These results are supported by research conducted by Boediono, M., et al (2018), Adabi, N (2019), Tanady, E.S., et al (2020), and Pasi, L.N.K., et al (2021) which states that service quality has a significant positive effect on purchasing decisions.Likewise, research by Cesariana, C., et al (2022) states that if a company provides the best service in the form of a quick response when responding to consumer complaints, then consumers will feel satisfied with the service provided and it will become the place where consumers go to make purchases.Likewise, Asyifa Husada Pamekasan Hospital responds quickly to problems faced by patients, making patients feel comfortable, which can increase the decision to return for treatment.

H7: Patient satisfaction influences Return-Treatment Decision
The research results show that patient satisfaction has a positive and significant influence on return-treatment decision at Asyifa Husada Pamekasan Hospital, providing a fairly good and meaningful indication in the management of health services.These findings confirm that the level of patient satisfaction has a substantial impact in shaping patient loyalty and desire to return for treatment at the same hospital.These findings also provide a basis for improving marketing strategies and service management.Hospitals can use these results to emphasize the importance of providing satisfactory service and strengthen aspects that create patient satisfaction, such as personal interaction, quality of care, and open communication.In addition, these findings can strengthen the urgency to continue to improve overall service quality.If patient satisfaction makes a significant positive contribution to the decision to return to treatment, consideration should be given to identifying specific areas in the service that can be improved to increase patient satisfaction.The positive impact of the relationship between patient satisfaction and the decision to return to treatment can also help build a hospital's reputation.Satisfied patients tend to provide positive recommendations, promote the hospital, and help expand the scope of services.Thus, these results provide a strong basis for Asyifa Husada Pamekasan Hospital to maintain and improve their service standards, with the aim of building strong relationships with patients, promoting retention, and advancing a positive image in the community.These results are supported by research conducted by Marlina, S (2018), Naninsih, N., et al (2019), and Simanjuntak, D.C.Y., et al (2020) who said that customer satisfaction has a significant effect on purchasing decisions.Likewise, research by Cesariana, C., et al (2022) says that the company will strive to produce high quality products and services that can meet consumer expectations, so that consumers feel satisfied and are more inclined to make purchases.Asyifa Husada Pamekasan Hospital's quick response to patient problems has a positive impact on patient comfort, which of course can increase the patient's tendency to choose to return for treatment at the hospital.

H8: Patient confidence influences Return-Treatment Decision
The research results which show that patient trust has a significant influence on return-treatment decision at Asyifa Husada Pamekasan Hospital have interesting implications in understanding the dynamics of the relationship between patient trust and their retention in seeking health services.These findings inspire in-depth reflection regarding other factors that tend to be more dominant in motivating patients to return to treatment.These results indicate that patient confidence may be considered a significant aspect in the context of return-to-treatment decisions.Therefore, hospitals may consider exploring other aspects of the patient-physician interaction or other elements that may better influence the long-term relationship with the patient.The impact also includes the importance of a transparent communication approach and providing information to patients.Patient trust has a significant impact, hospitals need to adapt and add to their communication strategies to place greater emphasis on elements that can build positive relationships with patients.Thus, these results indicate that in managing patient return-totreatment decisions, hospitals need to detail and understand the more dominant factors.Adapting strategies to better capture the most influential elements in patient decisions can help improve patient retention and stronger relationships with the community.These results are supported by research conducted by Simanjuntak, D.C.Y., et al (2020), Adabi, N (2020), Tirtayasa, S., et al (2021) and Nur, D.S., et al (2022) which states that consumer trust has a significant positive effect on buying decision.Likewise, research by Pasi, L.N.K., (2021) which says that If consumers have high awareness because the product meets expectations, purchases will also increase.The provision of services at the Asyifa Husada Pamekasan Hospital is of course based on improving quality in all areas, so that it can build patient trust.The high level of patient trust in this hospital will have an impact on the level of the patient's decision to return for treatment at the Asyifa Husada Pamekasan Hospital.Based on the results of the previous analysis, the marketing mix is also rejected and is not significant on return-treatment decision, so in this case the nature of patient satisfaction as a mediator is No Mediation.No mediation is meant here to mean that the presence of patient satisfaction as a mediator is not expected because the presence or absence of patient satisfaction as a mediator cannot influence the relationship between exogenous (marketing mix) and endogenous variables (return-treatment decision).This states that patient satisfaction still does not mean that the marketing mix can guarantee the patient's decision to return for treatment.With further understanding of the mediating role of patient satisfaction, Asyifa Husada Pamekasan Hospital can design more targeted and holistic marketing strategies to increase patient retention.Additionally, evaluating each element of the marketing mix in the context of return-to-treatment decisions can help hospitals build strong relationships with patients and maintain their competitive advantage in the healthcare marketplace.

H10: The Influence of Marketing Mix on Return-Treatment Decision with Patient Trust as a Mediating Variable
From table 8 above, it can be seen that the original sample value (O) is 0.049, which states that the three variables have a positive relationship.Then by looking at the P-Values value of 0.005, which is below 0.05 and the significance value or t-statistic is 2.791 > 1.96 (greater than 1.96).The P-Values and t-statistics indicate that the Marketing Mix (X1) influences return-treatment decision (Y) with Patient Trust (Z2) as a mediator.Based on the regression results, it can be concluded that the ninth hypothesis was Accepted and Significant.
Based on the results of the previous analysis that the marketing mix is acceptable and significant on return-treatment decision, then in this case the nature of the patient's trust as a mediator is Mediation.What is meant by mediation here is that the patient's trust as a mediator is expected because the patient's trust as a mediator can influence the relationship between exogenous (marketing mix) and endogenous variables (return-treatment decision).This states that with patient trust, the marketing mix can guarantee the patient's decision to return for treatment.Although the Marketing Mix can influence patient confidence, the results of the study show that patient confidence significantly mediates this influence on the decision to return to treatment.Therefore, hospitals need to evaluate and perhaps update their marketing strategies to better emphasize other factors that have a more direct impact on a patient's decision to return for treatment.
Thus, the results of this study provide valuable insights for the development of more effective marketing strategies, considering the role of patient trust as a mediating variable in the context of return-to-treatment decisions.

H11: The Influence of Service Quality on Return-Treatment Decision with Patient Satisfaction as a Mediating Variable
From table 8 above, it can be seen that the original sample value (O) is 0.188, which states that the three variables have a positive relationship.Then by looking at the P-Values value of 0.000, which is below 0.05 and the significance value or t-statistic is 6.423 > 1.96 (greater than 1.96).The P-Values and t-statistics indicate that Service Quality (X2) influences return-treatment decision (Y) with Patient Satisfaction (Z1) as the mediator.Based on the regression results, it can be concluded that the tenth hypothesis was accepted and significant.
Based on the results of the previous analysis, the quality of service was rejected and was not significant on return-treatment decision, so in this case the nature of patient satisfaction as a mediator is Full Mediation.What is meant by full mediation here is that the presence of patient satisfaction as a mediator is highly desirable because the presence of patient satisfaction as a mediator can influence the relationship between exogenous (service quality) and endogenous variables (return-treatment decision).This states that patient satisfaction means that service quality can guarantee the patient's decision to return for treatment.These findings illustrate that improving the quality of service in hospitals contributes positively to the level of patient satisfaction, which in turn, positively and significantly influences the patient's decision to return for treatment in the future.Therefore, it can be considered that service quality has an indirect positive impact on the patient's decision to return for treatment through increasing the level of patient satisfaction.with Patient Trust (Z2) as a mediator.Based on the regression results, it can be concluded that the eleventh hypothesis was accepted and significant.

H12: The Influence of Service
Based on the results of the previous analysis, the quality of service is also rejected and is not significant on return-treatment decision, so in this case the nature of the patient's trust as a mediator is Mediation.What is meant by mediation here is that the patient's trust as a mediator is expected because the patient's trust as a mediator can influence the relationship between exogenous (service quality) and endogenous variables (return-treatment decision).This states that the patient's trust continues to ensure that the quality of service can guarantee the patient's decision to return for treatment.These results provide insight into the complexity of the relationship between quality of care, patient confidence, and return to treatment decisions.Hospitals may want to consider further evaluating specific elements of their services and factors that may further influence patient decisions, to then design a more holistic strategy for management.

VI. CONCLUSION
The research findings emphasize the importance of tailoring marketing strategies to align with patient needs, recognizing the significant impact of non-marketing factors like medical staff interactions and service quality on patient satisfaction.Patient trust, though not directly influenced by the marketing mix, requires strategic evaluation to enhance patient retention.Service quality plays a crucial role in positively affecting both patient trust and satisfaction, suggesting that improvements in specific elements can contribute to an enhanced patient experience.Transparent communication and information are key in building patient confidence and satisfaction, positively influencing their decision to return for treatment.Notably, patient satisfaction acts as a mediator in the relationship between service quality and patient trust, underscoring the importance of focusing on aspects that increase satisfaction for optimal healthcare outcomes.

RECOMMENDATIONS
The following are suggestions that the author can give based on the results of this research, hopefully they can be useful for previous research: 1. Improvement of Staff Training.Conduct regular training to improve communication skills, empathy and friendliness of medical and non-medical staff.This will help create a positive experience during interactions with patients.

Cost Transparency.
Increase cost transparency by providing patients with clear and complete information regarding the costs involved.Avoid unexpected cost surprises to build trust regarding financial aspects.

Figure 2
Figure 2 Outer Model

: Processed data Smart-PLS Based
on the data in the table above, it can be seen that the R-Square value for the Patient Satisfaction and Patient Trust variables is 0.301 and 0.452 respectively, which means the ability of the exogenous variable to explain the endogenous variable is 30.1% (weak) and 45.2% (Moderate/ Medium) where 69.9% and the remaining 54.8% are the influence of other exogenous variables not measured in this study.Meanwhile, the R-Square value for Return-Treatment Decision variable is 0.636, which means that the ability of the exogenous variable to explain the endogenous variable is 63.6% (Moderate), with the remaining 36.4% being the influence of other exogenous variables not measured in this study.

Table . 8 Indirect Effect
Based on the table above, indirect effect or indirect influence through mediating variables, 3 indirect influences are accepted because they have an influence indicated by the P-value Values is < 0.05.Meanwhile 1 is rejected because it has an influence as indicated by the P-Values value being > 0.05.So it can be stated that the influence indirect effect in this study 3 were accepted and 1 was rejected. H9:

The Influence of Marketing Mix on Return-Treatment Decision with Patient Satisfaction as a Mediating Variable
From table 8 above, it can be seen that the original sample value (O) is 0.023, which states that the three variables have a positive relationship.Then by looking at the P-Values value of 0.094, which is above 0.05 and the significance value or t-statistic is 1.678 < 1.96 (smaller than 1.96).The P-Values and t-statistics indicate that the Marketing Mix (X1) has no effect on return-treatment decision (Y) with Patient Satisfaction (Z1) as the mediator.Based on the regression results, it can be concluded that the eighth hypothesis Rejected and Not significant.

Quality on Return-Treatment Decision with Patient Trust as a Mediating Variable
From table 8 above, it can be seen that the original sample value (O) is 0.118, which states that the three variables have a positive relationship.Then by looking at the P-Values value of 0.000, which is below 0.05 and the significance value or t-statistic is 4.036 > 1.96 (greater than 1.96).The P-Values and t-statistics indicate that Service Quality (X2) influences return-treatment decision (Y)