Corresponding Author: Pandu
Lesmana Putra
Email: [email protected]
INTRODUCTION
Marketing is something that is necessary for a
business (Ritter & Pedersen,
2024). Marketing itself can be interpreted as an activity
to find ways to achieve the goals of an organization by anticipating customer
or client needs and directing the flow of goods and services that can meet the
needs of customers or clients from producers of goods or services. To do good
marketing, you can do marketing using tools. One of the tools is the Marketing
Mix (Pinto et al., 2022).
Marketing Mix can be interpreted as a tool used by an
organization so that the organization can survive in a competitive environment (Halim et al., 2021). The marketing mix can also be interpreted as a
marketing tool within an organization or company that can be controlled to get
a market response (Musfar & Se, 2020).
The marketing mix has several strategic components.
These components can be 4P or 7P (Musfar & Se, 2020).
The 4P marketing mix components include product,
place, price, and promotion. The 7P marketing mix component is a 4P marketing
component added with people, processes, and physical evidence (Musfar & Se, 2020). 7P can include 4P components added with packaging,
positioning, and people (Thomas, 2015). Each component has an important role and its
application requires a deep understanding of the company or organization to
maximize marketing success (Utami & Firdaus,
2018).
The marketing mix has several components, each of
which is vital in marketing. Product components are goods or services made or
produced for particular groups (Musfar & Se, 2020). This component examines whether the product or
service suits the market or consumers (Thomas, 2015). Price is the amount that customers need to pay to
enjoy services or goods (Musfar & Se, 2020)
. This component shows whether the price offered for
services or goods is by market realities (Thomas, 2015). Promotion is an aspect of informing customers or
consumers about services or goods and how to market and sell to customers (Thomas, 2015). Place explains the place where products or services are sold or distributed
(Musfar &
Se, 2020); (Thomas,
2015). The concept of place or location explains how
institutions or companies make the products they offer available to target
customers (Armstrong et
al., 2014).
According to Law of the
Republic of Indonesia Number 44 concerning Hospitals, a hospital is a health
service facility that provides complete individual health services (Indonesia,
2009) . The health services provided
include inpatient, outpatient, and emergency services (Indonesia, 2009). Hospitals as an organization
that provides health services need to carry out marketing. Marketing is essential in helping health workers
create, communicate, and provide value to target consumers (Purcarea, 2019).
Marketing in hospitals and the health services sector
is different from other economic sectors because it has specific
characteristics (Thomas, 2015). So, marketing techniques and philosophies from other
fields cannot be fully applied to health services (Susanti &
Prahesti, 2023); (Purcarea, 2019). One different aspect is the importance of patients
in marketing in the healthcare sector (Thomas, 2015); (Purcarea, 2019). Patients are one of the main actors in the health
services' production and delivery process (Purcarea, 2019). Apart from that, different aspects of marketing
health services include health services being more challenging to market,
demand for health services being relatively scarce and difficult to predict,
marketing targets not being meaningful for health service users, services
provided being complex and difficult to categorize, potential consumers not all
are considered desirable, the final results and impact of health services are
difficult to assess, and differences between health organizations and the services
provided are difficult to quantify (Thomas, 2015).
The marketing
mix is carried out in hospital service activities and marketing itself is
carried out by the hospital in its services. One of the steps to creating a
good marketing strategy is to conduct an evaluation (Thomas, 2015). To evaluate marketing, the process or results of a marketing effort can be
assessed (Thomas,
2015). One of the marketing strategy results is the number of
patients and hospital selection. This article was created with the aim of
finding out the influence of the hospital marketing mix on the number of
patients in the hospital and hospital selection by looking at several
scientific journals in hospital marketing.
METHOD
The research was
carried out by conducting a systematic review. The study was conducted on
articles published in the last five years. The study was carried out by
systematically identifying the topic, reviewing references, selecting articles
appropriate to the subject, summarizing and deepening the information, and
compiling the study results. Article searches used the keywords Marketing Mix,
hospital, and patient. Searches were conducted through Scopus, Proquest,
ScienceDirect, and Google Scholar electronic databases. The search will be
limited to articles published from 2018 to 2022. The selection results will be
studied and arranged systematically according to the topic, namely the
influence of the hospital marketing mix on the number of patients and the
choice of hospital or hospital services.
Figure 1.
Study Selection Process
RESULTS AND DISCUSSION
I found 262 articles from the initial search. Of the 262
articles, 191 articles were excluded because they were not published between
2018 and 2022 and did not have a related title. Then, 58 articles were excluded
because they did not have an associated title. The article was excluded because
it did not discuss the marketing mix and did not focus on hospitals. Seven of
the thirteen articles screened were excluded because one was a duplicate, and
six were not in full text. After the process, six articles were included in the
systematic review.
The studies come from two countries. Three studies were
conducted in Indonesia, and three other studies were conducted in Iran. The six
articles are quantitative studies with publication years between 2018 and 2020.
All articles discuss the marketing mix. One article relates marketing mix to
patient visit rates. One article discusses marketing mix to patient repeat
visits. Four articles relate the marketing mix to patient preferences or
preferences for hospitals and two of the four articles discuss it through the
perspective of nurses or staff from health facilities. Six articles discuss the
7P marketing mix, and one article discusses the 4P marketing mix.
Table
1. Characteristics of Included Articles
|
Writer
|
Place,
Year
|
Study
Method
|
Marketing
Mix
|
Sample
Size
|
Topic
|
Results
|
|
(Yasni et al., 2020)
|
Indonesia,
2020
|
Quantitative,
cross-sectional
|
7P
|
67 samples
|
Marketing mix with patient
repeat visits
|
Price, place, promotion, people,
physical evidence, and process are related to patients' repeat visits.
|
|
(Farantika et al., 2019)
|
Indonesia
|
Quantitative,
cross-sectional
|
4Ps
|
94 samples
|
The relationship between
marketing mix and selection of outpatient health services
|
Product, price, and promotion
are associated with the decision selection process in choosing outpatient
services
|
|
(Lestari, 2018)
|
Indonesia
|
Quantitative,
cross-sectional
|
7P
|
37 samples
|
The relationship between
marketing mix and patient visit levels
|
Product, promotion, place,
people, process, and physical evidence have a relationship with the level of
visits
|
|
(Ravangard et al., 2020)
|
Iran
|
Quantitative,
cross-sectional
|
7P
|
300 samples
|
Relationship between marketing
mix and patient hospital choice
|
The promotion component is the
component that has the least influence on patient selection and the physical
component is the most influential component. The process component has a
higher correlation than other components
|
|
(Abedi et al., 2019)
|
Iran
|
Quantitative,
cross-sectional
|
7P
|
235 samples
|
Nurses' perceptions of the
impact of the marketing mix on hospital choice tendencies
|
Product, place, promotion,
physical assets components. people and processes can cause patients to choose
private hospitals
|
|
(Yaghoubian et al., 2018)
|
Iran
|
Quantitative
|
7P
|
400 samples
|
The role of the marketing mix in
patients' propensity for hospital ownership
|
Place,
price, personnel and product factors in teaching hospitals are the main
components of marketing and place, price and personnel factors are the main
components in hospitals with social security.
|
Their
study discussed the relationship between the marketing mix and choosing
outpatient services (Farantika et al., 2019). The
marketing mix used in the study is 4P (product, place, price, promotion). The
study found a weak relationship between the marketing mix of product, price,
and promotion and the decision to choose outpatient services. The study states
that products are services provided to patients. This is related to the place
aspect. In the study, the place aspect did not influence the patient's choice
of decision because the hospital was in a strategic location and had complete
facilities and services compared to government-owned hospitals in the hospital
area, making patients willing to travel long distances to get better health
services. Price and promotion aspects have a weak influence on patients'
decisions to choose outpatient services. Rational pricing of health services
influences patient choices. Even though the promotional activities carried out
by the hospital are not optimal, the hospital has branded the hospital area as
a government hospital, a referral center with complete facilities so that the
population or community continues to use the hospital facilities.
(Yasni et al., 2020) discusses
the influence of the marketing mix on patient repeat visits. In this article,
the seven aspects of the marketing mix (product, place, price, promotion,
people, physical evidence, process) are related to the patient's decision to
make a repeat visit to the hospital. The study was conducted at a
government-owned hospital. In this study, researchers said that the product and
physical evidence aspects are related to the patient's decision to make a
repeat visit. Studies state that quality products and good physical evidence
and comfort are considerations for patients to return to the hospital. (Yasni et al., 2020) assumes
that although the place aspect is related to the
patient's decision for a return visit, the patient has considered a return
visit after receiving the services received even though the hospital location
is far from the patient's residence so the place aspect has no influence.
The
study (Lestari, 2018) discusses
the influence of the marketing mix (7P) on the level of patient visits. The
study concluded that product, place, promotion, people, physical evidence, and
process aspects were related to the level of patient visits. The price aspect
of the hospital where the study is located does not influence the level of
patient visits, and the study states that people will choose hospitals that
provide prices according to the services offered. The hospital product aspect
is considered good and has a relationship with the level of patient visits. The
promotion aspect is carried out to provide information, remind and influence
the market and the hospital where the study has carried out promotional
activities which are considered quite good by carrying out promotional
activities and collaborating with those who provide patient referrals. The
hospital is located in a strategic position in the heart of the capital city,
so the location influences the number of patient visits. The people and
physical evidence aspects are considered to control the level of patient visits
because the quality of hospital human resources is good, and the hospital's
physical environment is good. The process aspect is seen from the process and
flow of hospital services. In the study, it was found that hospitals have
reasonable service procedures, so process aspects are considered to have an
influence on the level of patient visits.
(Ravangard et al., 2020) in
their study said that the marketing mix of promotion and physical environment
or physical evidence and people is the most important marketing mix in choosing
a hospital. Apart from these two components, another component with a positive
aspect is process, which is assessed by the speed of receiving service. The
place aspect has a positive impact on access to hospitals. Products or services
considered important can influence patient satisfaction. The price component
has less influence in choosing a hospital. The promotion component has a lower
value and it is considered that the hospital is not doing enough promotion.
Researchers found a relationship between the components of people, promotion,
process, and price with the decision to choose between a government hospital
and a private hospital. Apart from discussing the relationship between the
marketing mix and patient selection, researchers found that the process
component has a significant relationship with other marketing mix components.
(Abedi et al., 2019) and (Yaghoubian et al., 2018) discuss
the marketing mix with patient tendencies in choosing a hospital. Both studies
were conducted from the perspective of hospital employees, with (Abedi et al., 2019) discussing
the perspective of nurses and S. (Yaghoubian et al., 2018) discussing
the perspective of hospital personnel. (Abedi et al., 2019) discusses
the marketing mix of patients' tendencies to choose hospitals based on hospital
type. The study (Abedi et al., 2019) stated
that the product, promotion, place, people, physical assets, and process
components made patients choose private hospitals compared to government
hospitals. Studies also say low rates or price aspects drive patients to
government-owned hospitals. The study (Yaghoubian et al., 2018) says
that the components of price, personnel, and place significantly affect
patients' tendency to choose hospitals with social security or government
hospitals. Studies state that economic factors, services that are easy to reach
and good staff make patients have a good inclination towards hospitals. The
study (Yaghoubian et al., 2018) also
states that price, personnel, promotion, and place significantly affect trends
in teaching hospitals.
The
seven aspects of the marketing mix can influence patients to choose hospital
services that implement marketing strategies. However, the elements that can
affect patients differ between hospitals. This can happen because the marketing
strategy must focus on consumers, and the company uses strategies appropriate
to the market segment the company occupies to succeed (Armstrong et al., 2014); (Motwani & Shrimali, 2014). A
good marketing strategy also has functions such as providing direction for the
organization or program, focusing on one of the many options, unifying
organizational actions, differentiating the organization from other
organizations, distributing corporate promotional materials, managing corporate
resources, supporting hospital decision-making, make the organization superior
to other market competition, and demonstrate competence to external
stakeholders (Thomas, 2015).
Strategic planning is carried out comprehensively and is carried out to create
specific strategies for the organization so that it can adapt to the existing
environment and reality (Thomas, 2015).
CONCLUSION
This review shows
that the seven aspects of the marketing mix are related to the level of patient
visits and patient choice of service or hospital. Elements
of the marketing mix that have a relationship can differ from hospital to
hospital. So that the hospital marketing strategy has a good effect, the
strategy is created with strategic planning that is appropriate to the
hospital's conditions. Hospitals need to plan a good marketing strategy that
focuses on patients so that patients want to choose or use the service
facilities at the hospital.
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