The Influence of Predisposing Factors, Enabling Factors, and Need Factors on Revisit Intention of BPJS Outpatients

Dwi Wahyu Rusdianita(1*), Mirrah Samiyah(2), Ansarul Fahrudda(3), Sholihul Absor(4)


(1) Magister of Hospital Administration, University of Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(2) Magister of Hospital Administration, University of Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(3) Magister of Hospital Administration, University of Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(4) Magister of Hospital Administration, University of Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(*) Corresponding Author

Abstract


Background:  The implementation of Indonesia’s National Health Insurance (JKN) has increased access to healthcare providers, sustaining patients' intention to revisit remains a major challenge for healthcare providers.  Based on Andersen’s Behavioral Model, healthcare utilization is influenced by predisposing, enabling, and need factors, yet limited studies have examined their role in explaining revisit intention.

Objective: To analyze the influence of predisposing, enabling, and need factors on revisit intention among BPJS outpatients at RS Qona’ah Sampang.

Methods: A quantitative cross-sectional design was employed, with a purposively sampled sample of 160 respondents. Data were collected through structured questionnaires and analyzed using multiple linear regression with SPSS.

Results: Enabling factors (β =0.382; p <0.001) and need factors (β= 0.115; p =0.012) had a significant positive effect on revisit intention, while predisposing factors (β = 0.163; p = 0.256) were not statistically significant. The model explained 73.1% of the variance in revisit intention (R² = 0.731). Patients’ decisions to return are primarily influenced by access to healthcare providers and perceived health needs rather than demographic characteristics

Conclusion: Improving accessibility, administrative efficiency, and responsiveness to patients’ health needs is essential to enhance revisit intention and patient retention in healthcare providers.

Keywords


Predisposing factor; enabling factor; need factor; Andersen’s Behavioral Model; Revisit Intention

Full Text:

PDF

References


Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. MILBANK MEMFD QUART. 1973;51. doi:10.2307/3349613

Andersen RM. National health surveys and the behavioral model of health services use. Med Care. 2008;46. doi:10.1097/MLR.0b013e31817a835d

Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36. doi:10.2307/2137284

Alkhawaldeh A, Albashtawy M, Rayan A, Abdalrahim A, Musa A, Eshah N, et al. Application and Use of Andersen’s Behavioral Model as Theoretical Framework: A Systematic Literature Review from 2012–2021. Iranian Journal of Public Health. 2023. doi:10.18502/ijph.v52i7.13236

Cheng Q, Fattah RA, Susilo D, Satrya A, Haemmerli M, Kosen S, et al. Determinants of healthcare utilization under the Indonesian national health insurance system – a cross-sectional study. BMC Health Serv Res. 2025;25. doi:10.1186/s12913-024-11951-8

Idris H, Mursyid RS. Factors affecting the utilization of health services among diabetic people in Indonesia. Malaysian Journal of Public Health Medicine. 2023;23. doi:10.37268/mjphm/vol.23/no.1/art.994

Nguyen NT, Nguyen LHA, Tran TT. Purchase Behavior of Young Consumers Toward Green Packaged Products in Vietnam. Journal of Asian Finance, Economics and Business. 2021;8. doi:10.13106/jafeb.2021.vol8.no1.985

Putra TDM, Romadhona NL, Abdullah TMohdK. Enhancing Patient Revisit Intention and Positive Word of Mouth: An Empirical Study of Medical Tourism. Jurnal Manajemen dan Kewirausahaan. 2024;12. doi:10.26905/jmdk.v12i1.11459

Syah TYR, Suyitno E. How to create patients revisit intention? A study on private hospitals in Indonesia. Innovative Marketing. 2025;21. doi:10.21511/im.21(1).2025.07

Setyaningrum D, Sriatmi A, Arso SP. Patient Satisfaction on Hospital Outpatient Service Quality Based on the Donabedian Model. Journal of Public Health for Tropical and Coastal Region. 2024;7. doi:10.14710/jphtcr.v7i3.24229

Hair JF, Anderson RE, Tatham RL, Black WC. Multivariate Data Analysis, Multivariate Data Analysis. Book. 2019.

Amedari MI, Atanda AJ, Amedari IK, Monger M, Walker BH. The association between predisposing, enabling and need factors and oral health care utilization among U.S. working age adults. BMC Oral Health. 2025;25. doi:10.1186/s12903-025-05821-w

Jang SH, Yi YJ. Revisiting the Andersen Model: Transnational Ties With the Home Country and Healthcare Utilization Among Chinese International Students in South Korea. Sage Open. 2024;14. doi:10.1177/21582440241239223

Hajek A, Kretzler B, König HH. Determinants of healthcare use based on the andersen model: A systematic review of longitudinal studies. Healthcare (Switzerland). 2021. doi:10.3390/healthcare9101354

Pan L, Wang C, Cao X, Zhu H, Luo L. Unmet Healthcare Needs and Their Determining Factors among Unwell Migrants: A Comparative Study in Shanghai. Int J Environ Res Public Health. 2022;19. doi:10.3390/ijerph19095499

Zheng H, Yang M, Zeng Q, Liao S, Li P. An analysis of factors influencing the demand for community-based integrated health and social care in Southwestern China. Front Public Health. 2025;13. doi:10.3389/fpubh.2025.1684187

Song Y, Liu J, Yan S, Ma M, Tarimo CS, Chen Y, et al. Factors influencing health service utilization among 19,869 China’s migrant population: an empirical study based on the Andersen behavioral model. Front Public Health. 2025;13. doi:10.3389/fpubh.2025.1456839

Graham A, Hasking P, Brooker J, Clarke D, Meadows G. Mental health service use among those with depression: an exploration using Andersen’s Behavioral Model of Health Service Use. J Affect Disord. 2017;208. doi:10.1016/j.jad.2016.08.074

Jiang L, Ye L, Dai M, Zhou J, Li Q. Use Andersen’s behavior model to explain non-urgent visits in emergency department: A single center study in southwest China. Int Emerg Nurs. 2020;52. doi:10.1016/j.ienj.2020.100845

Başar D, Öztürk S, Cakmak İ. An application of the behavioral model to the utilization of health care services in turkey: A focus on equity. Panoeconomicus. 2021;68. doi:10.2298/PAN171121006B

Krzyż EZ, Antunez Martinez OF, Lin HR. Uses of Andersen health services utilization framework to determine healthcare utilization for mental health among migrants—a scoping review. Frontiers in Public Health. 2023. doi:10.3389/fpubh.2023.1284784

Lily GAY, Siswomihardjo W, Hendrartini J, Dipoyono HM, Wedagama DM. UTILIZATION OF JKN DENTAL PROSTHETIC SERVICES AT FIRST LEVEL DENTAL HEALTH FACILITIES IN BALI. ODONTO : Dental Journal. 2021;8. doi:10.30659/odj.8.2.126-130

Li YN, Nong DX, Wei B, Feng QM, Luo HY. The impact of predisposing, enabling, and need factors in utilization of health services among rural residents in Guangxi, China. BMC Health Serv Res. 2016;16. doi:10.1186/s12913-016-1825-4

Limpuangthip N, Purnaveja S, Somkotra T. Predisposing and enabling factors associated with public denture service utilization among older Thai people: A cross-sectional population-based study. BMC Oral Health. 2019;19. doi:10.1186/s12903-019-0923-1

Rata Mohan DS, Jawahir S, Manual A, Abdul Mutalib NE, Mohd Noh SN, Ab Rahim I, et al. Gender differences in health-seeking behaviour: insights from the National Health and Morbidity Survey 2019. BMC Health Serv Res. 2025;25. doi:10.1186/s12913-025-13020-0

Diliasari K, Ayuningtyas D. Perceived Value of Patients with Intention to Revisit at Health Facilities: A Scoping Review. International Journal of Social Service and Research. 2023;3. doi:10.46799/ijssr.v3i10.559

Islam SB, Bhat SA, Darzi MA, Khursheed SO. Investigating patient revisit intention in community health centres: a mediational study. Int J Pharm Healthc Mark. 2025;19. doi:10.1108/IJPHM-11-2023-0102

Rahajeng Dianing Negari A, Nurida A, Ghufron M, Anas M. Effect on Dimensions of Health Services to Inpatient Satisfaction at Primary Health Care. MAGNA MEDIKA: Berkala Ilmiah Kedokteran dan Kesehatan. 2021 Aug 1;8(2):71-83.


Article Metrics

Abstract view : 20 times
PDF - 1 times

DOI: https://doi.org/10.26714/magnamed.13.2.2026.138-146

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Indexed by

 

      

 

Creative Commons License

MAGNA MEDIKA by APKKM is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.