Relationship Marketing Implementation of Commitment and Satisfaction in Inpatients in Class III of Buleleng District Hospital

Commitment and patient satisfaction in hospital services is a priority of the hospital, especially in the inpatient room. Therefore we need methods to make this happen. The purpose of this study is the Effect of Relationship Marketing Implementation on Satisfaction and Commitment in Inpatients in Class III of Buleleng District Hospital. The research method was observational analytic with cross-sectional design. The population is inpatients in class III with a sample of 174 respondents taken by random sampling techniques according to criteria. Using logistic regression statistical analysis. The results of this study are the influence of Relationship Marketing Implementation on the Satisfaction and Commitment of Inpatients in Class III of Buleleng District Hospital, this is indicated by the p-value <α 0.05 and hospital service factors as well as the characteristics of respondents affect the Satisfaction and Commitment of Inpatients Inpatient in Class III of Buleleng Regency Hospital. In conclusion, the implementation of Relationship Marketing 5 times has the opportunity to increase Satisfaction and Commitment in Inpatients in Class III of Buleleng Regency Hospital, the characteristics of respondents 7 times have the opportunity to increase Satisfaction and Commitment in Inpatients in Class III of RSUD in Buleleng Regency and hospital services 8 times have the opportunity to increase Satisfaction and Commitment to Inpatients in Class III of Buleleng District Hospital. Relationship Marketing implementation concluded that it was good to be implemented in increasing Commitment and Satisfaction in Inpatients in Class III of Buleleng District Hospital.


INTRODUCTION
II room is 86 / month based on the average monthly IRNA patient data in 2018 at the Buleleng Regional General Hospital. When the study was conducted on October 1 to December 12 in 2019. Data collection was carried out for two months, starting in October 2019. The location of this study was Class III Inpatient at Buleleng Regional Hospital.

Data Collection Techniques and Procedures
The data used in this study are primary data and secondary data. Primary data come from the answers filled in by respondents on the questionnaire sheet and the results of interviews conducted by researchers after the respondents filled out the questionnaire. While the secondary data came from the profile of the Buleleng Regional Hospital which was used as the research location. Before collecting primary data, the research instrument will be tested for validity and reliability first. According to Azwar (2000) the instrument or questionnaire is said to be valid if it is known by comparing the Pearson product moment correlation index with a significance level of 5%. While the instrument or questionnaire is said to be reliable if the questionnaire still shows consistent measurement results when repeated measurements are made to different groups of individuals. Reliability measurement using Cronbach's alpha. The instrument is said to be reliable if the Cronbach's alpha value> 0.6.
The research instrument was tested to inpatients at Buleleng Regional Hospital on August 11, 2019. After the validity test, the researcher tested the reliability of the instrument in order to know the consistency of the research instrument when repeated measurements were made on different groups of individuals. The validity test results show Pearson correlation values of more than 5% (0.05) so that all question items are declared valid. While the reliability test results obtained cronbach's alpha value is more than 0.6 so that the questions in all variables are declared reliable.
Data analysis : After the primary data is collected, the researcher processes the data using software with the help of a computer. The purpose of this study was to analyze the Implementation of Relationship Marketing Towards Commitment and Satisfaction in Inpatients in Class III of Buleleng District Hospital. Therefore, researchers use Logistics Regression

RESULTS
Research sites: Buleleng Regency Hospital has 3 Main Buildings, namely: The main building located in the southern part is a building consisting of 4 floors including the RSUD offices in the main Building on the 4th floor. The third building is an inpatient building. The hospital has 153 midwives, 257 nurses, 36 specialist doctors, and 26 general practitioners. In the main building (I) consists of inpatient rooms, emergency room and offices are on the fourth floor.   The results of this study indicate that there is an Effect of Relationship Marketing Implementation on Commitments in Inpatients in Class III of Buleleng District Hospital. In the Relationship Marketing variable includes Communication, Relationship benefits, shaed value and opportunistic inpatients in the District Hospital. Buleleng in 2019 some respondents said they were satisfied with the service in the inpatient room in the Cominication component as many as 127 respondents (73%) expressed satisfaction. Relationship benefits expressed satisfaction as many as 116 respondents (66.7%), shaed value stated very satisfied as many as 95 respondents (54.6%) and opportunistic components expressed satisfaction as many as 116 respondents (93.1%). In a further test the results of the data analysis explained that there was an effect of Relationship Marketing Implementation on Commitment and Satisfaction in Inpatients in Class III of Buleleng District Hospital with a p-value commitment of 0.020 and patient satisfaction p-value of 0.000 showing <α 0.05 and the value of All Old Ratio (AOR) 0, 050 which means Relationship Marketing 5 times has the opportunity to increase patient commitment and satisfaction. This is supported by the results of the questionnaire answers filled out by respondents. On the dimension of Relationship Marketing Communication point empathy that most of the respondents gave strongly agree on point empathy consisting of three (3) questions, one of which was paramedics giving a detailed explanation of how to take medication, the results of the examination so that patients can receive and understand. Another important point is that paramedics listen to patient complaints, when invited to speak do not look away and respond to patient complaints. The results of this qualitative study support the results of statistical tests that there is a significant influence on the implementation of relationship marketing on the commitment of inpatients in class III of Buleleng District Hospital. Morgan and Hunt (1994) argue that relationship marketing is all activity in the field of marketing that is directed at creating developing and maintaining success, an exchange relationship between companies. The key to the success of marketing activities is commitment and trust. On the one hand it is possible for buyers and sellers to carry out transactions that are repeated over time that results in longterm relationships in a transactional model. The results of research conducted prove that trust is the basis for inter-company cooperation that will affect the desire to continue long-term relationships. Where in this study the trust (trust) is the satisfaction of inpatients. This is also influenced by the characteristic factors of respondents including age that most of the age of the respondents are at an average of> 45 years which means the respondent already has a thorough understanding of the good things that must be experienced. Maturity of respondents who are more mature in thinking and working will be more selective in choosing a place for health services. disease can strike at a young age but when age reaches maturity the symptoms of the disease will begin to be felt. So it is important that hospitals provide priority services to the age of patients who are elderly (Ndubisi, 2007).

The Effect of Relationship Marketing Implementation on Satisfaction in Inpatients in Class III of Buleleng District Hospital
The results of data analysis explain that there is a significant effect of Relationship Marketing Implementation on Commitment and Satisfaction in Inpatients in Class III of Buleleng District Hospital with the implementation of Relationship Marketing 5 times as likely to increase patient commitment and satisfaction. The results of the analysis of this study were examined from the results of a questionnaire answered by respondents that on the dimensions of the Relationship Benefits point Emotional and social benefits, the majority of respondents responded strongly agree that the hospital provides convenience in providing services to patients, the hospital provides a waiting room for patient visitors, and paramedics always smile in serving patients. The results of this qualitative analysis provide statistical test results that there is a significant effect of Relationship Marketing Implementation on Patient Satisfaction in class III inpatients in Buleleng Hospital.
Communication in relationship marketing is related to the value obtained by the patient, providing accurate and reliable information as well as information about changes in services offered, and proactive communication when problems occur between the hospital and the patient (Morgan and Hunt, 1994). Patients always want effective communication with the hospital, good communication can certainly increase the patient's commitment to the hospital. Patients who do not understand the services provided, will begin to ask the officer or the hospital which is the right of the patient. The hospital in this case must provide an explanation in a friendly and appropriate procedure. Therefore opportunistic behavior influences research so that it is used as a variable in this study. The relationship marketing dimension is an embodiment to achieve the goals of relationship marketing that can directly affect patient loyalty and satisfaction. Relationship marketing creates a strong relationship between the hospital and the patient, so the hospital can understand the needs and desires of the patient's customers.

Influence of patient characteristics on the implementation of Relationship Marketing in Inpatients in Class III of Buleleng District Hospital.
The results showed there was an influence of the characteristics of the respondents in this study including age, education, occupation and gender of inpatients in class III Buleleng Hospital. The results found are the respondents in this study found the characteristics of respondents average age> 45 years as many as 103 respondents (59.2%), with the majority of male sex as many as 123 respondents (70.7%) and education mostly graduated from elementary school as many as 77 respondents (44.3%). Most respondents work as laborers as many as 72 respondents (41.4%). In the test results of the regression effect that the characteristics of respondents 7 times the opportunity to increase patient commitment and patient satisfaction in class III inpatient rooms.
The regional general hospital of Buleleng Regency is a hospital located in the downtown area of the Regency of Buleleng. Health services. disease can strike at a young age but when age reaches maturity the symptoms of the disease will begin to be felt. So it is important that hospitals provide priority services to the age of patients who are elderly (Ndubisi. 2007) Work is also a factor that indirectly requires respondents to get the best service in the hospital. This intention arises when the respondent feels that there is an income in him. To get satisfaction, although an effort is needed by the respondent to get satisfaction and this is very influential on the willingness of hospitalized patients in class III. Families with low economic status naturally rule out the need for information that is not a primary need (Ulfiana, 2013)

Influence of hospital factors on the implementation of Relationship Marketing in Inpatients in Class III of Buleleng District Hospital.
The results showed that there was an effect of the implementation of Relationship Marketing on hospital factors in Inpatients in Class III of Buleleng District Hospital. Hospital services in most types of in-patient health services use government BPJS guarantees of 95 respondents (54.6%). On the variable value of patients in hospital services mostly good as many as 111 respondents (63.8%). The test results of the influence that home services have eight times the opportunity to increase patient commitment and patient satisfaction in class III inpatients at Buleleng Hospital. Patient value is the patient's view of the condition of the hospital, both from services, facilities, hospital rates which will later be a benchmark of hospital quality today and from this factor can affect patient satisfaction with the hospital.
Relationship Marketing covers the form of share value in services in hospitals, especially in the inpatient unit which can be in the form of share of wallet and share of mind and heart. Share of wallet is the first perception when choosing a product or service without thinking about financial or financial aspects. Share of wallet is a behavior that refers to customers who buy exclusively or mostly only one brand. While the share of mind and heart is having an emotional attachment to the brand, likes it more than others, and even loves the brand. Share value in hospital services has a role that is the hospital in providing services to exchange cultural values where the hospital must be able to provide comfort and friendliness to patients so that patients provide a good value or perception.

Conclusion
1. There is an effect of Relationship Marketing Implementation on Commitment in Inpatients in Class III of Buleleng District Hospital with a p-valuae value of 0.020 which means <α 0.05 and Relationship Marketing 5 times has the opportunity to increase patient commitment 2. There is an Effect of Relationship Marketing Implementation on Satisfaction in Inpatients in Class III of Buleleng District Hospital with a p-valuae value of 0,000 which means <α 0.05 and Relationship Marketing 5 times has the opportunity to increase patient commitment 3. There is an influence of patient characteristics on the implementation of Relationship Marketing in Inpatients in Class III of Buleleng District Hospital with a p-valuae value of 0,000 which means