|1 |​ ​Author – title Articel…………………………………

JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit), 7 (x): x-xx, Date
201x
Website:​ ​http://journal.umy.ac.id/index.php/mrs
DOI:​ 10.18196/jmmr.6101.

Distribution Channel Analysis of Medical Rehabilitation at 

the Early Phase operational in X Hospital  
 
Wiwin Indriani​ *​​ ,​ ​Tita Hariyanti​ ​ ​Ni Luh Putu ​
1​ 1,​ 2

Correspondent author : ​ w ​ i2n.ita@gmail.com

1​
Master Program in Hospital Management, Faculty of Medicine, University of
Brawijaya, Malang, Indonesia

INDEXING ABSTRACT

Keywords: Medical Rehabilitation Clinic is a new service unit in the

The new service; hospital X. Create a new service unit automatically related to
rehabilitation me the marketing program. Marketing new unit requires a
dical units; marketing information system to obtain preliminary data as
distribution capital drafting a marketing plan. The marketing program due
channels, to identify market segments of the rehabilitation
hospital​. medical service units as well as define segments that provide
greater opportunities. Marketers achieve market segment by
channels of distribution (distribution channel). Channels of
distribution is a mean for announcements the products of
services rehabilitation medic to the patient. The purpose of
this study to determine the distribution channel rehabilitation
medic. The collection of data through observation, uptake
primary data medic rehabilitation clinic in the month of
September 2017 and interviews to physicians and patients.
Kata kunci: From the collection of preliminary data obtained information
layanan baru; about market segments The distribution channel is a means to
rehabilitasi deliver services products medic rehabilitation services to
medik; patients.
saluran distribusi
Poliklinik Rehabilitasi Medik merupakan unit layanan baru di RS
X. Membuat unit layanan baru secara otomatis berkaitan
dengan program pemasaran. Pemasaran unit baru
membutuhkan sistem informasi pemasaran untuk
mendapatkan data awal sebagai modal penyusunan rencana
pemasaran. Program pemasaran mengidentifikasi segmen
pasar unit layanan rehabilitasi medik serta menentukan
segmen yang memberikan peluang lebih besar. Pemasar
mencapai segmen pasar menggunakan saluran distribusi
(distribution channel). Saluran distribusi (distribution channel)
merupakan sarana untuk menyampaikan produk jasa layanan
rehabilitasi medik kepada pasien. Tujuan penelitian ini untuk
menentukan saluran distribusi (distribution channel) layanan
rehabilitasi medik. Metode penelitian dilakukan dengan
pengumpulan data yymelalui observasi. Pengambilan data
primer poliklinik rehabilitasi medik di bulan September 2017
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dan wawancara kepada dokter dan pasien. Penelitian

menyimpulkan bahwa saluran distribusi merupakan sarana
untuk menyampaikan produk jasa layanan rehabilitasi medik
kepada pasien.
© 2017 JMMR. All rights reserved

Article history: ​received 5 Feb 2017; revised 15 Sept 2017; accepted 25 Okt 2017

INTRODUCTION
Hospitals are required to develop new units in the midst of the development
of health care system. The development unit noticed the different needs and
the health services market segment served. 1​​ hospital Bulu-lawang area
south of Malang. The hospital did know medic rehabilitation service units.
Products of medical rehabilitation services, as the new service requires the
adoption process. The adoption process is carried out through
marketing programs with regard to the identity and exceed customer
satisfaction of services provided to competitors. 2​​ Development of marketing
strategy starts with getting to know the size, structure and behavior of the
market, followed by ​Positioning​ product and sales. 3​
The new program at the hospital through the early stages of the consumer
adoption process. The adoption process begins with innovation by hospitals by
opening new services. Patients are aware of innovation and need information
about the innovation. Information submitted by the hospital in the form of a
marketing program. 3​
The marketing program noticed hospital services as consideration of the
marketing mix marketing strategy implementation. 4​​ ​Product, price, promotion,
place, people, process and physical evidence​ is a component of mutual
influence and hospitals need to take notes as support the implementation of
the marketing strategy. 1​
Hospitals in organizing medical rehabilitation services, divided into three
classifications. Primary care, secondary and tertiary hospital for class C / D
class and health centers, into the category of primary care. Primary services
include basic medical rehabilitation services, with
standard power-trained general practitioners and therapists (physiotherapists,
occupational therapy, medical rehabilitation nurse) 5​​ .
Flow patient medical rehabilitation services come from the emergency
department, outpatient, inpatient, and the consul's physician practice, a
referral from a hospital or in person. 6​​ Hospitals delivering medical
rehabilitation services in BPJS era through referral system. References are
horizontal and referral vertical, horizontal referral from specialist clinic to clinic
medical rehabilitation. The vertical reference, is a reference from one to the
hospital PPK.
The referral system is applied as a marketing channel. The definition of a
marketing channel is a group of interdependent organizations engaged in the
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manufacturing process of products or services that are provided for use or

consumption. 3​

METHODS
The study was using the descriptive method. Research descriptive was a
method of research with the main objective to create a picture or essay about
a situation in an objective to solve or answer problems faced in the present
situation 4​​ . Data retrieval begins with a preliminary study through field
observations, review of documents and unstructured interviews with the
management and staff of the hospital X. Preliminary studies and data retrieval
conducted at the end of August until the end of the month September 2017 in
RS X. From the initial data analysis spider map of the issues raised,
namely, marketing for the new service units of medical rehabilitation clinic.
Followed by a focus group discussion (FGD) to complete the data collection
and enhance problem analysis obtained from preliminary studies. The priority
issue is the introduction of new programs medical rehabilitation services for
employees and patients and work procedures of medical rehabilitation
services. Observatory and analysis of market segments of medical
rehabilitation services implemented on September 24 until October 10, 2017.
The Observatory is equipped with an interview to a specialist doctor in charge
of medical rehabilitation services, as well as patients with regular visits
frequency criteria and orderly schedule. Observations aims to observe clicking
market segments and distribution channels of medical rehabilitation services
the initial period running program. Expected to understand distribution
channel will support the election of the concept of proper marketing
program. Program proper marketing the adoption of new services. The
adoption process is supported by preliminary data analysis of market
segmentation RS X. The population of this research data rehabilitation clinic
patient data in medic on August 28, 2017 until 28 September 2017.

RESULT AND DISCUSSION

Data obtained from the records of 41 patients who visited the clinic of
medical rehabilitation. Demographic segmentation obtains distribution data for
gender and age of the patient to the clinic.
Table 1. Distribution of patients by gender
Gender amount Percentage
Man 15 36.58%
Woman 26 63.41%
Source: Calculation of market segmentation medical rehabilitation clinic in
2017
Table 2. Distribution of patients by age
Age amount percentage
40-44 15 12.19%
45-49 9 7.3%
50-54 34 27.64%
55-59 35 28.45%
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60-64 5 4.06%
65-69 14 11.38%
70-74 10 8.1%
82 1 0.8%
Source: Calculation of market segmentation of medical rehabilitation clinic in
2017
From the data obtained percentage biggest visits between the ages of 50 to
59 years. This condition is in accordance with the previous article stating that
the effects of aging more noticeable over the age of 40 years. Influenced
by genetic factors, lifestyle, and environment further give effect to
malfunction. The tendency of decreasing its functional capacity at the cellular
level and the organ level as age 7​​ .
Table 3. Distribution of patient by Domicile
Residence amount per sentase
Bululawang 26 63.41%
Gondanglegi 6 14.63%
Wajak 3 7.3%
Tajinan 4 9.7%
Bantur 1 2.4%
Ampelgading 1 2.4%
Source: Calculation of market segmentation medical rehabilitation clinic in
2017.
Domicile patient data is dominance comes from the patient
by address Bululawang region, the same region late locations are sick. This
condition is consistent with prior research that says that the convenience of the
public reach the location of health services, is one from five basic requirements
of health services 4​​ .
Table 4. Distribution of patients by the kind of service
Type of Amoun percentage
Service t
ICE 9 3.57%
Tens 71 28.17%
US 6 2.38%
Laser 50 19.84%
Lat Assistive 2 0.7%
EXC 69 27.38%
USD 31 12.30%
IFT 3 1.19%
Cold Pack 6 2.38%
Lat Rom 5 1.98%
Source: Calculation segmentation medical rehabilitation clinic market in 2017.
TENS service type (Transcutaneous Electrical Nerve Stimulation) were the
highest in service options. This service category gives the effect of reducing
pain. Mentioned that combination therapy with TENS further reduce pain in
patients 8​​ .
From the results of focus group obtained the first priority plan for the
introduction of the program to employees and health workers in PPK 1. The
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second priority BPJS be noted that services of medical rehabilitation clinic in

the hospital administratively cannot serve directly referral of KDP 1.
From observations and interviews to patients and medical rehabilitation
specialists, obtained the expectations and opinions about the medical
rehabilitation services in hospitals X. Expectations reflected doctor executor of
execution interviews to specialist medical rehabilitation on Saturday September
16, 2017. The location is in the practice room in a friendly and quiet
atmosphere.
"The ​basic​ suit pain conditions and the surrounding communities and
adapted to market segments how ..., generally rehab first base, in terms of
disease we include all, but for this initial condition match the amount of our
energy. Especially geriatric patients, with problems often encountered ie
stroke, complications of diabetes, if the disease degenerative are LBP, OA,
CRS ... " "That's we cover first."
From interviews expectations doctor at an early stage is
a basic medical rehabilitation services to adjust to market segment and
resource conditions at the hospital. This condition is in accordance with the
standards of primary medical rehabilitation services in hospitals type D focus
on basic services to the human resources of trained doctors, and therapists
(physiotherapists, occupational therapists and a nurse medical
5​
rehabilitation) ​ . Services focused on degenerative diseases for medical
rehabilitation services is an aspect which must exist in the health care of
elderly 7​​ .
Patient expectations extracted from interviews to patients of medical
rehabilitation clinic on Friday, September 30, 2017, Patient referral of Polyclinic
In the DM complications. Patient asked to comment on what he felt and his
experience in the clinic to receive services Medical Rehabilitation.
"... sampun mboten cekot2 kantun teng ngriki often swollen, if the road is
much, ... first ndak can be held, the same doctor rayed gini-gini (while
moving the hands back and forth in gian ba feet) .... No progress
.. not swelling, not cekot2 ...... .seneng ngriki ya teng therapy development
that, if a bit loud treated me happy ... (intended patient feels hard
is her stun ...) "
"... it does not hurt, only in this part is often swollen if it goes away, ... .dulu
t idak can be held, by a doctor therapy ... there is progress, it is not easy
bengkan, no pain ... .senang dition therapy because of its development, if
treated" rather loud "I love ..." (which is hard patient is perceived intensity of
electric current large)
Patients are given information service process,
"... ..dari received smoothly, poly nerves, good, satisfactory service
...... now friends really long queue numbers since there is then submitted the
first coming that, cepet, Hurry before ..."
Patients provide information about services in the polyclinic of Medical
Rehabilitation
".... pity alone if the patient much more kasian (sorry for the officer
physiotherapy patient if the patient much being alone), ... ooo
|6 ​| ​Author – title Articel…………………………………

.. doctor thumb, (patient, holding up his right hand thumb) ... I like it .. I
was looking for the doctorso that the dock, invited by the enaaak, patient
complaints were aware of .... "
From interviews were obtained the impression of the patient. First was long
registration process and patients want a shorter one. The Second was services
with frequency therapy "hard". Third as the service by a friendly doctor where
patient feel comfort and listening by the doctor what their complaints. The
four patients plus physiotherapist expect. Patients pay attention to the process
of hospital services provided. It was mentioned in a previous study that factors
in the process of marketing mix is a major factor. Processes in hospital services
activities include the provision of information to customers, registration,
inspection, investigation, payment and referral 1​​ .
Medic rehabilitation program at Hospital X is a new service
program. Medical rehabilitation services is health care to physical disruption
and function caused by circumstances / conditions of illness, disease or injury
through medical intervention alloys, physical and or rehabilitative keterapian to
achieve optimal functional capability. Medical rehabilitation services in hospitals
are developed towards the improvement of quality, service range and referral
system with the aim of the patients to obtain services optimally and
plenary. 5​​ . Medical rehabilitation services is a service with a multidisciplinary
approach consisting of medical rehabilitation specialist doctors, nurses,
physiotherapists, occupational therapy 9​​ .
The new service according to the ​chart​ included in the ​product
live​ ​cycle​ introduction stage. At this stage of growth is marked by a rapid
increase in sales. Concentration in the promotion to introduce and educate
the market. In the growth stage, companies / hospitals can use to strategy of
growth through product improvements quality and style of service, adding new
product models, entering new market segments, Enhancing distribution range
and enter new distribution channels 1​​ ,​​ 3​​ .
Marketing orientation through the approach of a few things, namely
customer orientation, competitor orientation, cross-functional
orientation, environmental orientation, orientation agents and providers,
performance orientation, long-term orientation and employee orientation. A
strong marketing orientation will support a marketing program to be easily
accepted. 10 ​
Distribution of visits based on data obtained in accordance with the planning
of medical rehabilitation specialist doctors namely the focus of geriatrics and
degenerative diseases. Medical rehabilitation services program is a component
of the elderly health care advocates. Diseases of the elderly have a tendency to
experience disability sikori 7​​ . From the data segment of the market, the
majority coming from geographically located Bululawang area within the
hospital, the condition is consistent with research that one of the basic
requirements of health services are easily accessible in terms of location 4​​ . The
market segment dominated in terms of age group 50-59 years of age, it is in
accordance with the original purpose of medical rehabilitation services focus on
geriatric group. In terms of payment of all patients who come at the time of
research using BPJS facilities, patients benefit with this facility because with
|7 ​| ​Author – title Articel…………………………………

the insurance system ease medical rehabilitation services. This is consistent

with previous studies in Batu stating that financing sources JKN participants
who use medical rehabilitation services is BPJS 11​
​ .
Data on marketing mix towards services in the rehabilitation clinic m edicts
into capital or hospital instrument to recognize the desired response of the
patient. Promotional factors in the marketing mix are the determinants of the
success of marketing programs. Distribution channels based on data, through
KDP 1, Polyclinics specialist in KDP 2 and the unit of medical rehabilitation
polyclinic service. Distribution channels is a series of interdependent
organizations and involved in the process of making goods or services ready
for consumption ​12​ . Channels selected by the hospital determine the
marketing process to be performed hospital. Distribution channels
gives function as a means of information, information about customers,
competitors and suppliers in this regard suppliers connect with the resources
necessary to provide services ​13
Distribution channel description
Saluran Distribusi
PPK 1
Rujukan
Rujukan
internal
Pelayanan
Pasien
PPK 2
Layanan
Rehab Medik
Rehab Medik
PPK 2
Layanan
PPK 1
Pasien
Aliran Informasi Dan Promosi
Bank
PPK 2
BPJS
Pasien
Aliran Pembayaran

The collection of data from focus group discussions, get results that matter
in the form of grooves patient management and provision of rehabilitation
services medic need attention. D irencanakan program SOP development and
manufacture of medical rehabilitation services brochure. Hospitals as health
care organizations to ensure the implementation of the programs, the
necessary Standard Operating Procedure (SOP). SOP is a document that
describes the day-to-day operational activities, with the aim that the work is
carried out correctly, appropriately, and consistently, to produce products
according to the standards set. Based on ISO 9001: 2008 clause 7.5 requires
that organizations must plan and carry out production and service under
controlled conditions ​14​ . Based on observations, the number of workers who
provide services there is one physiotherapist. Correlation with interview result
of patient got information that service personnel amount to one person need
addition. Based ketanagaan standard for medical rehabilitation services in
|8 ​| ​Author – title Articel…………………………………

hospitals type D is two to five people with the composition of each one for
physiotherapists, occupational therapists and paramedics medical
rehabilitation ​5​ .
CONCLUSION
The new program took a lot of consumer adoption
process. Pro's ice adoption patients need to be introduced to the innovations
made by the hospital through the information. The information process
involves officers from three service groups. Hospitals need to routinely transfer
information to external parties, namely the KDP 1 and internally to specialists
at the hospital. The process of marketing the new service units need to pay
attention to distribution channels and market segments of medical
rehabilitation services.
|9 ​| ​Author – title Articel…………………………………

ACKNOWLEDGMENT
This section is written if desirable. Loading gratitude and appreciation to
those who significantly contribute in the completion of the study.

APPENDIX
Loaded data or instrument which support the research.

REFERENCE
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