Proposed Marketing Strategy to Increase a Positive Brand Image of RSUD Subang

: Health is a mandatory responsibility of the regional government regarding essential services, as stated in Article 12, Paragraph (1), Letter b of Law Number 23 of 2014 concerning regional government, which has undergone several amendments, most recently by Law Number 11 of 2020, known as the Cipta Kerja Law. According to research conducted by the Badan Pusat Statistik (Central Statistics Agency) in 2022, out of a total of 2,514 public hospitals, 329 of them are situated in West Java, accounting for 13% of the total. This finding reaffirms that West Java continues to have the highest number of public hospitals in Indonesia. One of these hospitals is the Rumah Sakit Umum Daerah (Regional General Hospital) in Subang, owned by the Regional Government of Subang Regency as a Special Organizational Unit, in accordance with Subang Regent Regulation Number 102 of 2021. However, in early March, there was a negative perception among the public about RSUD Subang, potentially stemming from instances of patient rejection leading to death. The objective of this research is to propose a marketing strategy to improve the healthcare industry's brand perception in Subang. The research will employ a quantitative methodology, utilizing questionnaires distributed to both patients treated at Subang Hospital and residents of Subang to gather precise data. Once the data is collected, it will be processed using SMART PLS (Partial Least Squares) analysis. The research findings indicate that companies can implement marketing activities that positively influence electronic word of mouth, thereby enhancing the brand image. Consequently, this approach can help rectify the negative perception of RSUD Subang prevalent in society. Based on these findings, the author provides several recommendations derived from internal and external analyses, including a SWOT (Strengths, Weaknesses, Opportunities, and Threats) and TOWS (Threats, Opportunities, Weaknesses, and Strengths) analysis for RSUD Subang. The suggestions involve implementing a social media plan, conducting marketing campaigns

Based on the research conducted by Badan Pusat Statistik in 2022, from the total of 2,514 public hospitals, 329 of them are located in West Java (13%).This result still makes West Java as the province that has the highest number of public hospitals in Indonesia.
In addition, West Java added 20 new public hospitals in its province throughout 2021.According to Kedoya Adyaraya's prospectus, population growth will affect additional health care facilities.With the increasing population in Indonesia, additional health service facilities are needed in the form of the Jaminan Kesehatan Nasional (JKN) program to support the health of the Indonesian people.
During the Covid-19 pandemic that already happened for three years, there were many problems shown up in Subang (health service facility, availability of bed for treatment, insufficient human resource, other supporting facilities and infrastructure, etc.).RSUD Subang as the only hospital owned by the Regional Government of Subang Regency is required to be able to answer any health problems, especially in handling the Covid-19 pandemic and handling other non-Covid-19 health.Moreover, RSUD Subang is asked to always follow the developments in hospital regulations and society demands for a better quality of health services.

Company Profile 1.2.1
Company Background Rumah Sakit Umum Daerah Subang is a hospital owned by the Regional Government of Subang Regency in the form of a Special Organizational Unit in accordance with Subang Regent Regulation Number 102 of 2021 concerning the organizational structure of regional apparatuses, which was determined and promulgated and placed in gazette of Subang district on December 28, 2021.This hospital has also implemented the regional public service agency financial management pattern since December 17, 2008 through the regent's decree number 900/Kep.626-DPPKAD/2008 of 2008, concerning designation of Rumah Sakit Umum Daerah Subang as a Regional Public Service Agency (BLUD).

Vision and Mission  Vision
In order to develop the hospital organization and improve the quality of its services to the society, Rumah Sakit Umum Daerah Subang has the following organizational vision: "Becoming the chosen and trusted hospital of society of Subang" • Mission ○ Run high quality hospital services with customer satisfaction orientation.○ Increase resources in order to develop the hospital's business.○ Develop a professional, transparent and accountable management system.○ Building a hospital with the concept of requirements for safety, health, comfort and convenience.

Business Issues
Most of the profit in the past 3 years that earned by RSUD Subang is coming from COVID-19 cases.Since the number of cases in Indonesia is decreasing, this will have a huge negative impact on the income of the company.Moreover, it can be seen from the data above that RSUD Subang never reached the target of patient visits for the past 3 years.Since RSUD Subang is a hospital owned by the Regional Government of Subang Regency, the majority customer of RSUD Subang is a BPJS card holder.This indicates that the company hasn't maximized their potential to reach other segment markets (non-BPJS market) and only rely on people who got an allowance from the government.This situation got worse since the government's new regulation stated that BPJS card holders were also allowed to get treatment from selected private hospitals.This condition is getting worse by the case that happened to RSUD Subang related to patient rejection which led to death.Bad opinion circulated in the society and created a bad perception of RSUD Subang.In fact, this hospital did not refuse the pregnant woman to give birth.A pregnant woman came to the Subang Hospital to give birth but due to administrative problems and the hospital's full capacity, the hospital finally reluctantly refused the patient and was referred to a provincial level hospital.
Unfortunately, the patient died on the way to the referral hospital due to the long distance.
Based on the business issues above, the writer made preliminary research in order to collect some sample data regarding the awareness of RSUD Subang.Majority of respondents stated that RSUD Subang is not the first option when it comes to medical treatment because this hospital is having a bad perception in the society since there were many cases that happened such as corruption, poor services, unmaintained facilities, and etc.As private hospitals and clinics are growing in Subang, they prefer to go there because those hospitals are able to fulfill the demand of society in the healthcare sector.In addition, 6 out of 7 respondents also won't recommend their family or relatives to have medical treatment in RSUD Subang if they had another option.

Research Scope and Limitations
The scope of this research is to focus on proposing a marketing strategy to create a good brand perception in the healthcare industry in Subang.This research will use quantitative methodology.Questionnaires were given to people who had been treated at Subang Hospital and also people living in Subang in order to have more precise data.The research was conducted from February 2023 until May 2023, so the result may change in the future.Furthermore, this research was specifically done for people in Subang.Therefore, the result of this study cannot be used as a reference for hospitals in other regions.This thesis consists of 5 chapters with the following details: • Chapter 1 mainly discusses the introduction, which will consist of background of the study, company profile, company background, company vision and mission, company motto, structure organizational, business issues, research questions, research objective, research scope and limitation.• Chapter 2 mainly discusses the literature review, which consists of theoretical foundation and conceptual framework. Brand attitude is influenced by the relevant motivation at a given time.Consequently, if a buyer's motivation changes, their perception of a brand may also change accordingly. Brand attitude comprises both cognitive and affective elements.The cognitive aspect, rooted in logical beliefs, guides behavior, while the affective aspect, driven by emotional feelings, energizes behavior. The cognitive component of brand attitude can consist of a series of specific benefit beliefs.These beliefs, on their own, do not constitute the attitude but rather serve as the rationale behind the brand attitude. Brand attitude is a relative concept.In nearly any product category, consumers seek a brand that comparatively better fulfills their underlying motivation when compared to alternative brands (Percy, 1992).

2.1.4
Purchase Intention Purchase intentions is the intention of customer choose a particular and specific goods and services of the brand.These intentions can be defined as the effort that consumers are willing to make to purchase products or brands.Attitudes, evaluations and expectations of products may be the key reasons driving buying intentions (Moreira, A. C., Fortes, N., & Santiago, R., 2017).
The measurement of purchase intention is often conducted by evaluating three aspects: priority, periodicity, and spontaneity.Priority items are those that hold significant importance, such as food and petrol.On the other hand, periodicity reflects the frequency at which consumers plan to buy a particular product.Certain items exhibit a high level of periodicity, indicating that consumers purchase them at regular and predictable intervals of time (Chuchu, de Villiers, & Chinomona, 2018).

CHAPTER 3. RESEARCH METHODOLOGY
In this chapter, the author will explain the research design which will include every step of the research process.There are two types of data collection method that used in this research, which are primary and secondary data.Data analysis method will also be discussed by the author through validity and reliability test.Marketing Mix Marketing mix is a set of controllable marketing tools used by a company for creating a desired response in the targeted market.To create a desired response from the targeted market, marketing mix is needed by the marketer to formulate the marketing strategy (Riaz, Waheed and Tanveer, & Asif, n.d).There are two types of benefit that company will get.First, the marketing mix is an important tool for considering aspects of marketing as a manager's task that determines individual strengths over others (Goi L. C., 2009).The next benefit is that it helps reveal other dimensions of marketing.
• Product Product is something that can be offered to the potential customer in order to fulfil their needs (Riaz, Waheed and Tanveer, & Asif, n.d).In the service context, product can be offered in to two things.Main service will represent the benefit that potential customer gets and the secondary services which reflect tangible and augmented product levels (Khan, 2014).

• Price
Consumer choice is heavily influenced by the price of a product, making it a crucial factor.Within the marketing mix, pricing stands out as an essential component that directly affects the organization's revenue.This is because pricing is the only element that generates turnover for the company (Khan, 2014).There are 4 types of pricing strategies to enter the market, which are cost-based pricing, break-even pricing, competition-based pricing, customer value-based pricing (Riaz, Waheed and Tanveer, & Asif, n.d).

• Promotion
Promotion is an important component of business and its marketing process.Promotion is a selling method to execute the marketing program that already been formulated, and this marketing activity will be involving communication.There are many methods for the marketer to promote their product, which are sales promotion, advertising, personal selling, public relations and direct marketing (Khan, 2014).

• Place
Place is known as a strategy to allocate the product or service they are offering to the customer (Goi L. C., 2011).Place is important for business in order to be reached easier by the potential customer.There are many places that can be utilized for the company to distribute their product such as websites, e-commerce, social media, physical locations, and delivery services.
• People People will highly contribute in the business process for a company that offer services.Therefore, personal interactions between customers and the site's employees will influence the customer's perception of service quality (Khan, 2014).

• Process
A process is described as a set of actions and functions that aim to add value to products while keeping costs low and providing high benefits to customers.Processes are particularly important in the service industry compared to the production of goods (Muala & Qurneh, 2012).

• Physical Evidence
Physical Evidence is a tangible asset that owned by business owner that will contribute to deliver the services (Muala & Qurneh, 2012).This aspect plays an important role for any business owner since usually potential customer will judge the service quality of a company through their visuals (Khan, 2014).

3.2.2
Segmenting, Targeting, & Positioning Marketing segmentation is a process of classifying groups of targeted customers that shares the same interest with the products (Andaleeb S. S., 2017).Therefore, market segmentation is one of the important action that need to be taken for a company to group their targeted market and later it will make them easier to formulate a right strategies to reach their targets.
• Market Segmentation Market segmentation is differentiated in to four factors, which are geographic, demographic, psychographic and behavioural.By classifying the segment, it will help any business owner to develop the segment profile (Kotler, Marketing Management (14 ed), 2011).1. Geographic: Needs are created based on targeted customer's location.This can be influenced by several factors such as weather, infrastructure, facilities, and others.Therefore, any business owner may see this as an opportunity to fulfill customer's needs.2. Demographic: Customer's personal data are the main source for any business owner to define the demographic factors.
This can be differentiated through people's age, gender, income, occupation, marital status, family size, race, religion and nationality (Camilleri, 2017).3. Psychographic: Lifestyle would become the main consideration to classify targeted customer.This may include activities, interests, habit, opinions, and others (Prasad & Aryasri, 2011).4. Behavioral: Purchase behavior is created through perceived value of each customer.This will help the customer to decide on which products they will choose (Camilleri, 2017).

• Targeting
Determining target market would be the next step after segmenting their market.This can be done by deciding on which segment that need to be prioritized by the business owner and which one is not (Andaleeb S. S., 2017).Effectivity will become the main reason behind this step-in order to target the potential customer accurately.This will also impact on how much marketing expenses that they want to spend.

• Positioning
After the company successfully classify and target on which market, they are going to enter, positioning would become the last step to finalize this marketing strategy.According to Andaleeb (2017), Brand positioning is a stage where the company need to make a differentiation between their competitors that will attract minds of customers, prospects, and another stakeholder.This strategy can be done by creating brand image, so that customer will easily remember their brand when it comes to certain needs.

3.2.3
VRIO Analysis VRIO analysis is a framework that helps internal company to analyse and define competitive advantage in order to compete with their competitors.VRIO that stands for Valuable, Rareness, Imitable, and Organized, was found by Jay B. Barney in 1991.
a) Value Value is becoming the main reason why customer would buy things from any specific brand.Therefore, this opportunity needs to be maximized their value in order to compete with other competitors who offer the same products.b) Rareness It is hard for any business owner to compete in a red ocean business situation where they have the same valuable resources, and also utilize it the same way (Cardeal, 2012).Therefore, business owner innovation is needed to create rare product by finding different resources and also formulating new strategies.c) Imitable In many cases, a value product that is valuable and having rare resources is still hard to compete with others if their products are easy to imitate.This can be happened because competitor just simply copy their product and add other competitive advantage (Cardeal, 2012).This will become a threat for any business owner if their competitor can imitate their product and combine it with other advantages such as greater quality, cheap price, and others.d) Organized Competitive advantage can be formulated if the company have a great organization.This may include the system, procedure, and also the culture of the organization.

Porter 5 forces Analysis • Threat of New Entry
The entry of novel firms into an industry-yield augmented production capacities and a robust drive to acquire an expanded market share.As a consequence, competitive dynamics arise, influencing price levels, expenditure patterns, and the requisite magnitude of investment to sustain competitiveness (Porter, 2008) Power of suppliers exercise their leverage by appropriating an increased share of value through escalated pricing, restricted quality or services, or the transference of costs onto industry participants.These formidable suppliers, including those in the labour sector, possess the capability to undermine industry profitability in situations where cost escalations cannot be offset by corresponding price modifications imposed upon customers (Porter, 2008).

• The Power of Buyers
Power of buyers can secure a greater portion of value by exerting downward pressure on prices, insisting on improved quality or enhanced services (thus increasing costs), and effectively pitting industry participants against each other, resulting in diminished industry profitability.Buyers possess significant power when they hold advantageous negotiating leverage over industry participants, particularly if they display sensitivity to price and employ their influence primarily to demand price reductions (Porter, 2008).

• The Threat of Substitutes
A product substitute serves the same or a similar purpose as the product offered by an industry, but through alternative means.At times, the substitution threat may be downstream or indirect, wherein a substitute replaces the product of the buyer industry (Porter, 2008).

• Rivalry among existing competitors
The competition among current competitors encompasses various well-known manifestations, such as price reductions, the introduction of new products, advertising initiatives, and enhancements in services.Elevated rivalry curtails the profitability of an industry.The extent to which competition diminishes the profit potential of an industry is contingent upon both the intensity of competitive interactions among companies and the fundamental basis on which they engage in competition (Porter, 2008).

3.3.2
Competitor Analysis The primary goal of conducting competitor analysis is to gain sufficient knowledge about a competitor, enabling one to adopt a similar mindset and develop a competitive strategy that considers the anticipated actions and responses of the competitor.In practical terms, a strategist must be able to put themselves in the shoes of the competitor, comprehending their perspective and analyzing it in order to determine the actions they would likely take to maximize their results.This understanding allows the strategist to assess the real financial and personal consequences resulting from the competitor's strategic decisions (Czepiel & Kerin, 2012).

3.3.3
Customer Analysis The significance of a customer lies in their ability, both quantitatively and qualitatively, to contribute to the goals of an organization.The value of a customer is not solely measured by their monetary impact on the income or profits of the organization.It also encompasses other aspects such as providing valuable information, potential for cross-selling, fostering a positive brand image, and referring new customers.Therefore, the value of a customer goes beyond financial contributions and encompasses various activities that enhance the overall success of the organization (Radulescu & Cetina, 2012).

3.3.4
SWOT Analysis SWOT analysis is a widely employed strategic management instrument utilized to assess an organization's internal resources and external surroundings.Conventional SWOT analysis entails the identification of factors falling under four categories (Strengths, Weaknesses, Opportunities, and Threats) through a series of subjective qualitative evaluations (Gürel, E. & Tat, M., 2017).
 Strength: An internal factor that enhances competence, valuable resources, or attributes. Weakness: An internal factor that inhibits the competence, resources, or attributes required for success. Opportunity: An external factor that enhances performance and can be pursued or exploited for advantage. Threat: An external factor that inhibits performance and has the potential to diminish achievements (Leigh, D., 2010).

TOWS Matrix
The TOWS matrix, introduced by Weihrich in 1982, is a tool that builds upon a previously conducted SWOT analysis.It demonstrates how external threats (T) and opportunities (O) can be matched with internal weaknesses (W) and strengths (S).As a result, four groups of alternative strategies are formed:  Maxi-Maxi: These strategies maximize both strengths and opportunities (SO).They exploit the company's internal strengths by capitalizing on external opportunities. Maxi-Mini: These strategies maximize strengths and minimize threats (ST).They leverage the company's strengths by avoiding or mitigating the impact of external threats. Mini-Maxi: These strategies minimize weaknesses and maximize opportunities (WO).They address internal weaknesses by capitalizing on environmental opportunities. Mini-Mini: These strategies minimize both weaknesses and threats (WT).They are defensive strategies aimed at reducing internal weaknesses and avoiding environmental threats (Escalona, Koch, & Rossi, 2022).

3.3.6
PESTLE Analysis PESTLE Analysis is known as an analytical tool to consider external factors and help in the analysis of the impacts.This analysis will assist any business owner to define what are the external factors that can be maximized as the opportunities and minimize threats.Thus, PESTLE analysis will create efficiency for business owner to run their marketing strategy.a) Political: Government interventions and political lobbying activities in an economy are categorized in political aspects (Ho, 2014).As a business owner, we need to obey the regulation that made by the government and forecast for the upcoming law and intervention that will affect the business process.This will help the business process run smoothly.b) Economical: Economic issues such as inflation and interest rate will highly impact to the company's achievement (Fairlie, 2022).Therefore, a company should aware of this aspect since it will influence spending power of consumers and business (Tan, Chua, Chow, Chong, & Chew, 2012).c) Social: Social aspects will cover social, cultural and demographic factors of the external environment (Ho, 2014).
Therefore, it can be concluded that social aspect is highly impact on what is happening in the society.d) Technological: Since the development of technologies went rapidly, many businesses may have difficulties on adjusting to their new products, technologies and services.Therefore, it is essentials for any business owner to utilize the technology from all aspects (Fairlie, 2022).e) Legal: Legal aspects will mainly cover national and global legislation that existed in the location where the business run (Tan, Chua, Chow, Chong, & Chew, 2012).Therefore, any business owner should obey to the regulations that is still align with the business process.f) Environmental: Environmental issues is become the main concern for the company to run their business process.Pollution that generates from the production process will become the consideration whether they run a business that good for the environment or not.Global warming is also important to remember since many productions will also give impact to it (Tan, Chua, Chow, Chong, & Chew, 2012).

Data Collection Method Primary Data
The primary data will be collected by several technique, which are: a) Observation The author makes an observation of RSUD Subang through opening their website, social media platform (Instagram, Facebook, and YouTube) in order to understand the promotional activities that already done before.The author also observe several digital news article regarding RSUD Subang to know the brand perception after the patients experience on having treatment in this hospital.b) Questionnaire A questionnaire will be used to conduct the study by identifying the factors that influence purchasing decisions.This questionnaire will be distributed to approximately 200 respondents as the sample of this research.The Likert scale utilized in the questionnaire comprises five levels, providing an interval scale for respondents to express their opinions.The distribution of the questionnaire will be conducted online.Thereby, the author attaches the list of questionnaires below: The questionnaire is distributed to 220 respondents, and here are the respondents' profile: Gender Based on the results of the data above, the respondents were dominated by men with the percentage of 56.4%, while the female percentage is 43.6%.there was no significant difference with the respondence since there is no corelation between gender preference and the topic.The majority of respondence were aged around 22-26 with 38.2%, followed by aged around 37-41 with 14.5%.From this result, it can be concluded that majority of respondence were in the productive age.This questionnaire was response by people with various types of occupation.From the pie chart above, it can be seen that college student and employee have the same result with 25.5%.This case is also happened with business owner and house wife who shared the same result with 18.2%.Income per Month Based on the data collection above, the majority expense per month of respondence is around Rp 3.000.001-Rp 4.000.000with 29.1%, followed by ≤ Rp 3.000.000with 25.5%.

Data Analysis Method
Smart-PLS was used to process the data that already collected by online survey using quantitative method.SmartPLS is a wellknown software tool designed for performing Partial Least Squares Structural Equation Modeling (PLS-SEM).PLS-SEM is a valuable approach for conducting structural equation modeling in practical research endeavors, especially when there are few participants and an unbalanced distribution of data (Wong, 2013).

3.5.1
Validity Test According to Malhotra (2010: 288), Face validity refers to a form of validity where the content of a measuring tool, such as a scale, is evaluated in a subjective yet structured manner to determine how accurately it reflects the intended purpose of measurement.Criteria:  if the Pearson Correlation value is > 0.

Social Class Low-Middle Class
Positioning  Target market: RSUD Subang is targeting their potential customer to people who lives in Subang area. Problem: fulfilling the needs of society in the healthcare sector in an affordable price, and also good quality services. Frame of Reference: RSUD Subang is focusing on people that have low-mid income.Therefore, the selection of supporting facilities is also adjusted to the selected target market. Basic Requirements: RSUD Subang provides facilities that directly supports the treatment such as medical devices, medicine, treatment bed, etc.In the other hand, this hospital also provides facilities that indirectly supports the treatment such as parking lot, canteen, mosque, etc.  Unique Value Proposition: RSUD Subang is a hospital that subsidies by the government, and also receive the largest BPJS holder in Subang.Therefore, this hospital offers an affordable price and suitable for people that has low-mid income. Reason to Believe: RSUD Subang is accredited by Lembaga Akreditasi Rumah Sakit Damar Husada Paripurna in this early of 2023.This hospital received "paripurna" (5 stars), which can be the main consideration for people to have a treatment here. Distinguished from competition: located in the city center of Subang, where all the business activities and government activities take place. Emotional and Benefit: People of Subang feel helped by the presence of a hospital since they can provide medical needs in an affordable price.Positioning statement: RSUD Subang is a hospital owned by the Regional Government of Subang Regency that focusing on fulfilling the needs of society in healthcare sector.RSUD Subang also provides many various type of health services and supported facilities, so people in Subang will have easier access to get a treatment.

4.1.2
Marketing Mix Product As a hospital, RSUD Subang provides many services that may fulfill the needs of society in the healthcare sector.There are 10 main services that the hospital provides such as: 1. Rawat Jalan.8. Pelayanan Anesthesia.9. Sarana Penunjang Lainnya (Ambulance, Instalasi Pemeliharaan Sarana Rumah Sakit, etc.).10.Sarana Pendukung lainnya (keamanan, kantin, masjid, etc.).Price RSUD Subang implemented cost-based pricing strategy to run and compete in the healthcare industry.This strategy was declared by the director of RSUD Subang, dr.Ahmad Nasuhi through media.He stated that in 2022, the pricing was increase from IDR 15,000.00 to IDR 90,000.00 or an increase of 500% for registration fee for treatment.The increase in service rates this time will be carried out in stages and will start on March 1, 2022.The reason behind the increase in the price of public service rates for treatment registration is because of the large number of medical devices and the cost of treatment which requires quite high costs.Place RSUD Subang is located in Jl.Brigjen Katamso No.37, Dangdeur, Kec.Subang, Kabupaten Subang, Jawa Barat 41211.This address is known in a city center of Subang, where all the business and government activities take place.Unfortunately, the location of RSUD Subang is hard to be reached by the entire people of Subang since the infrastructure is not well-supported.Ambulance is also provided by the hospital if the patient did not have an access to go to the hospital.

Figure 4. 1 Location of RSUD Subang
Promotion RSUD Subang start to focus on communicating the services of the company and its image to the public.Unfortunately, this hospital did not have a specific division that focuses on public relation.The only promotion that RSUD Subang did before was through advertising (billboard, poster, etc.).RSUD Subang did not spent a lot of budget on promotion since this is a referral hospital for BPJS holder.Therefore, this hospital did not put a lot of effort on promoting because it's a compulsory for people who hold BPJS to get treatment there.Employees that mainly contribute in the business process are doctors and nurses.Doctors are focusing on diagnose and treat the patients while nurses will be focusing on helping the doctor such as preparing the bed, doing the general check-up, fill in the patient status, and others.There are also other employee that helps the doctors in other field such as receptionist that responsible on administration tasks.Pharmacist will also contribute by making and preparing the medicine right after they receive the recipe from the doctor.Process RSUD Subang can be experienced by all people that need a medical treatment, especially people who lives in Subang.All patients may easily access the services directly to the hospital, which is located in the city centre of Subang.Moreover, ambulance service is also provided in order to help people who does not have any vehicles to reach RSUD Subang.Right after the patient arrived at RSUD Subang, they will directly go to the receptionist to input their data.If the patient has been treated here before, the officer will found the data as long as their medical records during treatment here.Then, the patient will be asked to wait according to the queue number that has been given by the officer.After that, the nurse will be calling the patient to come to the medical room, and general check-up will be done before the doctor diagnose the disease.If the results of the examination do not require the patient to be hospitalized, they will be asked to wait for the medicine that has been prepared by the pharmacist.Later, the medicine can be picked up at the pharmacy after the payment process at the reception has been made.Physical Evidence RSUD Subang provides facilities that will support their business process such as availability treatment bed, medical devices, emergency room, various types of treatment rooms (class1 -VIP room), ICU rooms, and others.Convenience is also one of the main indicators for RSUD Hospital to provide the best service for its customers.Therefore, this hospital also provides canteen, mosque, and parking lot.4.1.3VRIO Framework VRIO Analysis will help the writer to identify the internal strength of RSUD Subang, that later will become the competitive advantage for them to able to compete in the healthcare industry.This framework will be identified based on valuable, rare, costly to imitate, and organized.Thus, the result is shown below.The threat of new entrants to the market for RSUD Subang is medium.RSUD Subang was known as one of the biggest companies in Subang's healthcare industry.Moreover, there are lot of investment needed to enter healthcare industry such as license, professional workforce, supported facilities, and others.Therefore, entering this industry would be challenging for local clinic since there would be a lot of things that need to be prepare before opening a medical practice.Threat of Substitute Products -Moderate Threat of substitution can be categorized as medium due several factors.People of Subang have many options if they need to do treatment such as local clinic and traditional medication.This may become an alternative solution for them if they met some circumstances in accessing RSUD Subang.Therefore, they would prefer to go to local clinic and traditional treatment.Bargaining Power of Suppliers -High The power of suppliers is high since RSUD Subang really depend on third parties to provide many things such as medical devices, medicine, and others.If the supplier decides to stop the supply, Subang Hospital will face many problems because it will highly impact the business process.In a long term, patient will change their consideration when it comes to healthcare industry since RSUD Subang cannot fulfil their needs.Bargaining Power of Buyers -High RSUD Subang is known located in the city centre.This will become a threat for the company since Subang is a big regency and not all patient have an easy access to reach the hospital.Therefore, competitor may see this as an opportunity by opening clinic in a specific area with the same services.

Rivalry of Competitors -High
The level of industry rivalry in the market for RSUD Subang is categorized as high.The amount of local clinic and traditional medicine clinic is increasing in Subang.Moreover, health consultation can now be accessed through digital platform.Therefore, patient don't need to go to the hospital and they can order any medicine if needed.Therefore, the rivalry of competitors can be concluded as high.

PESTEL Analysis Political (Opportunity)
The Minister of Health (Menkes) Budi Gunadi Sadikin revealed that as the COVID-19 pandemic trend is going down, the government's priority in the health sector shifted to improving the quality of public health services.In addition, Ministry of health will provide sufficient budget allocations for the revitalization of health facilities to programs that are promotive and preventive.Along with the recession, the IMF also lowered its forecast for global economic growth to only 2.9 percent in 2023.The Covid-19 pandemic lasted more than two years proves that the health sector is what is most needed by the community.Although this country will predict recession in 2023, health sector is still needed in order to maintain productivity.In other words, the health sector will always be needed under any circumstances.Social (Threat) Bad perception about RSUD Subang was created in the society due to the case that happened lately.Many people start to switch their mind to private hospital because they feel disappointed with the service that offered by RSUD Subang.Moreover, this case may become a trigger for other customer that having bad experiences after having treatment there to talk and share their opinion in public.

Technological (Opportunity)
The use of technology in the healthcare sector has helped hospital management in serving patients.One of them is with a mobile app to monitor doctor's availability, which can be done easily via a smartphone.The problem of patient accumulation at the registration desk can also be avoided by having an online queuing application.With the help of the mobile app, hospitals can help prospective patients to self-register online and monitor hospital queues easily and quickly.The use of online applications has been used quite widely in various sectors, so hospitals can use it to improve the quality of the health services provided.Environmental (Threat) Subang is categorized as a big regency in West Java.Thus, there are certain area that did not have good access to reach the hospital due too bad infrastructure.Moreover, the road condition will become worst due to rain season.Legal (Threat) Dewan Jaminan Sosial Nasional (DJSN) stated that private hospitals are allowed not to provide inpatient BPJS Health Class Standards.In accordance with the provisions of Government Regulation Number 47 of 2021, hospitals must provide BPJS Standard Class inpatient care, namely 60% for government-owned hospitals and 40% for private hospitals (Putri, 2022).Due to this regulation, RSUD Subang will find some difficulties to compete with competitors since BPJS holder now have many options to get a medical treatment.Moreover, the facilities that private hospital offers are more complete and have a better management.

4.2.3
Customer Analysis PLS-SEM software will be utilized to perform an investigation aiming to test the suggested hypotheses and gain understanding about the factors that significantly influence purchase intention in relation to product attributes.The first step of the analysis includes evaluating reliability and validity through the outer model, after which hypothesis testing will be conducted using the structural model.
   Discriminant Validity Result Cross-loading demonstrates the presence of discriminant validity.Another approach to assess discriminant validity involves comparing the square root of the average variance extracted (AVE) for each construct with the correlations between the construct and other constructs in the model.When the AVE root for each construct exceeds the correlation between that construct and other constructs, it indicates that the model possesses satisfactory discriminant validity. R Square The R-square value serves as an indicator of the extent to which a research model accurately represents the phenomenon under investigation.It quantifies the proportion of the variance in the dependent variable that can be explained by the independent variables in the model.Therefore, it provides insights into the model's explanatory power and its ability to capture the underlying phenomenon.Without the specific results at hand, here are the outcomes of the analysis: The provided table indicates that all the statistical T values are greater than 1.96.Therefore, we can infer that the relationship between the latent variables is statistically significant, suggesting a positive influence.These findings reflect the agreement among respondents regarding the impact of variable x on variable y, as assessed through the questionnaire questions.
 P Value Significance also can be tested by looking at the p-value.while the criterion is significant if the p-value < 0.05.Here are the results:

Accepted
Electronic word of mouth has a positive and significant impact on brand image.
Electronic word of mouth has a positive and significant impact on brand attitude.

Accepted
Electronic word of mouth has a positive and significant impact on brand attitude.
Electronic word of mouth has a positive and significant impact on purchasing intention.

Rejected
Electronic word of mouth does not have a positive and significant impact on purchasing intention.Brand image has a positive and significant influence on purchasing intention.

Accepted
Brand image has a positive and significant influence on purchasing intention.Brand attitude has a positive and significant impact on purchasing intention.

Accepted
Brand attitude has a positive and significant impact on purchasing intention.Brand image has a positive and significant impact on consumers' attitude toward the brand.

Accepted
Brand image has a positive and significant impact on consumers' attitude toward the brand.

4.2.4
Competitor Analysis  Hamori Hospital is a member of "JIH" Group.group are known as the best hospitals managed by international standards, which prioritize service quality and are also supported by professional staff and sophisticated medical devices.Promotion RSUD Subang is focusing on word-of-mouth promotion method and digital advertising board to reach their potential market.This hospital also have several social media in order to reach their market through online such as Instagram, YouTube, and Facebook.
Since RS Hamori is new to this industry in Subang, they massively promote their hospital through online platform such as websites, social media platform (Facebook, Instagram, TikTok, YouTube, and Twitter).
PMC promote their brand through several platform such as digital advertising board and social media (Instagram and Facebook).

Yes
Yes No treatment.Supporting facilities also deserve attention in order to increase the comfort level of the patient and the delivery person.With good facilities, of course this can increase customer satisfaction and also generate loyalty for its visitors.Digital marketing can be a strategy in marketing for RSUD Subang in entering the digital world.Please note that people are now spending more time on the internet.Therefore, this can bring great potential for RSUD Subang in promotion.Promotions in the digital world can be executed on several platforms such as social media, websites, SEO, and others.The content that will be provided must also be well-formulated so that it can attract the attention of potential customers.

Create a social media content plan. (W3, O1, O2, O4, O5, O6, O7, O8)
To increase engagement on social media, of course the marketing division must have a plan regarding what content will be shared with followers.There are several contents that may relevant with the business industry of RSUD Subang such as educational content related to the importance of maintaining health, hospital service procedures, or simply an explanation regarding easy access to RSUD Subang.The content ideas above can be executed in several formats such as photos and videos.Consistency is also very important to maintain and increase engagement.Therefore, the timeline regarding uploads on social media must also be scheduled for at least the next month so that the marketing division can monitor its work properly.

Strength -Threat (ST) Strategies 1. Educating society that RSUD is the most suitable hospital for BPJS holder. (S1, S2, T1)
As a hospital that focuses on accommodating BPJS card holder, RSUD Subang must be able to convince its potential customers that their hospital will remain the number 1 choice for BPJS card holders.This can be done by educating the public that this hospital is the largest BPJS patients' receiver in Subang.This may attract the society since private hospital can only accept 40% of BPJS card holder according to the regulation.This education program can be carried out on various platforms, conventional and digital.

Create online doctor consultation through website or WhatsApp (S3, T2)
The presence of technology in the era of globalization forces business owners from various industries to continue to innovate in order to remain competitive with their competitors.In the health industry, online consultations are also starting to appear in Indonesia.Therefore, providing online consultations service via the website or WhatsApp can be a solution for RSUD Subang in competing in the digital world.This of course will also help the hospital in reaching out to the wider community.Another option that Subang Hospital can do is by collaborating with existing application providers.
Weakness -Threat (WT) Strategies 1. Collaborate with Dinas Kesehatan Subang to create marketing campaign (free medical check-up, health counseling for the society, etc.) (W2, T1, T2) Marketing campaigns are considered effective in attracting customers to buy our products or services.In the health industry, there are many marketing campaigns that can be carried out so that awareness of the product is formed, such as collaboration with Dinas Kesehatan for conducting free medical check-ups (checking blood pressure, cholesterol levels, blood sugar levels, uric acid levels).
Another marketing campaign activity that can be carried out is health education for the society.The activities above can both be carried out in open places such as alun-alun, schools, and balai desa.

Maximize customer's testimonial to gain trust from society (W1, W2, T1, T2)
Testimonials have become the biggest consideration for potential customers to make a decision whether they want to buy their product or not.From customer testimonials, the public can find out what positive impacts they get after treatment at RSUD Subang.Theoretical Implication Previous research mentioned that the result of their study is only covered the undergraduate student in certain country.Therefore, the results cannot be expected to explain the effect of electronic word of mouth on brand image and purchasing intention.To overcome this problem, the author tried to reach wider respondence by allowing people to fill in the online survey without age limitation.This will create more various result to identify the variables in the study.It is also highly recommended for future researcher to add several variables such as brand credibility and also brand trust in order to gain more deeper understanding regarding this study.

5.2.2
Practical Implication Based on the research that conducted by the author, it can be concluded that there are certain variables that may affect the purchase intention of RSUD Subang.By focusing on creating positive brand image and highlighting the product attitude of RSUD Subang, this may give a significant impact towards the purchase intention.Therefore, every stakeholder of this hospital needs to work hard on this in order to attract the potential customer.Although electronic word of mouth did not have significant impact on purchase intention in this research, this variable still have a positive influence on brand image and brand attitude.Therefore, marketing activities in digital platform need to be done by expert in order to influence the purchase intention indirectly.

5.2.3
Shortcoming Research There may be some possible limitations in this study, such as lack of previous research studies on the topic and also time constraints.It is very difficult to find journals that cover topics related to marketing in the health industry, since there are only plenty of journals that discuss related to this scope of research.Therefore, the author suggests for the next researcher to find alternative resources such as book or conference in order to support our research.Second limitation is regarding to time constraints.As a final year student, the author needs to focus on finishing the thesis within less than 6 months.In the other hand, the author also needs to manage the time wisely since there are still several courses that need to be taken in this semester.Therefore, timeline and priority scale need to be created to have a well-planned schedule in order to finish all the deadline on time.

5.2.4
For RSUD Subang RSUD Subang need to maximize their marketing activities in order to create a positive brand image in the society.Several marketing strategies that already formulated before may become an option for RSUD Subang to overcome the problem.Those marketing strategies believed are not only create a positive brand image but also increasing the purchase intention in the society.

5.2.5
For Future Researcher In order to obtain a wider range of perspectives for identifying the variables in the study, future researchers can consider increasing the sample size to include a greater number of respondents.It is also highly recommended for future researchers to focus on finding respondents only from people of Subang who have received treatment from RSUD Subang so that the results of the online survey can be even more accurate.

Figure 1 . 1
Figure 1.1 Province with The Most Public Hospital in Indonesia Source: https://goodstats.id

1. 4
Research Questions and Research Objectives 1.4.1 Research Questions • How to increase a positive brand image of RSUD Subang?• What are the factors that influence customers to get treatment in RSUD Subang?• What kind of marketing strategies can be effectively implemented by RSUD Subang to reach a wider potential customer?1.4.2Research Objectives • To to increase a positive brand image of RSUD Subang.• To identify what factors that may influence customers to get treatment in RSUD Subang.• To recommend the best possible marketing strategy for RSUD Subang.
• Chapter 3 mainly discusses the research methodology, which consists of research design, data collection methods, and data analysis methods.•Chapter 4 mainly discusses the results and discussion which consist of analysis, business solution, implementation plan and justification.• Chapter 5 mainly discusses the conclusion and recommendation.
Figure 3. 1 Research Design Source: Author

Figure 4 . 2
Figure 4. 2 Service Blue Print of RSUD Subang Source: Author Fund (IMF) stated that a recession could cause the global economy to lose up to US$ 4 trillion in 2026.

2 .
Expanding the coverage area to reach all Subang Regency.(S1, S2, O1, O2, O3) As already known, Subang is one of the largest districts in West Java with an area of 1,893.95km2.Therefore, RSUD Subang must be able to fulfill the society's need in terms of medical sector.Several action can be taken by adding more ambulance so that patients can get to the hospital more quickly.RSUD Subang also need to have a systematically relationship with Puskesmas.Therefore, it will avoid miss communication among others if one of the patients need to be refer to RSUD Subang.3.Create online call centre for people of Subang.(S3, O3)People nowadays tend to use social media to interact and socialize with others.Therefore, RSUD Subang can also use WhatsApp as the alternative solutions to become their call centre.Like the conventional one, potential patient can also ask regarding the availability of the doctor, room, or even asking about ambulance service.Weakness -Opportunity (WO) Strategies 1. Maximize digital marketing (social media, websites, etc.) as a promotion tool.(W1, O1, O2, O4, O5, O6, O7, O8)

Table 3 .
* Corresponding Author: Muhammad Sultan Shalahuddin Rozi Volume 06 Issue 06 June 2023 Available at: www.ijcsrr.orgPage No. 3601-3634 Agmeka, F., Wathoni, R. N., & Santoso, A. S. (2019) PI 2 I would recommend RSUD Subang if a friend calls me to get my advice in his/her search for health treatment.PI 3 I intend to go back to RSUD Subang if I have a problem with my health.PI 4 I am sure that RSUD Subang will provide what I want.

Table 3 . 3
Electronic Word of Mouth Validity Test

Table 3 . 4
Brand Attitude Validity Test

Table 3 . 5 Purchase Intention Validity Test
As a general rule, composite reliabilities of 0.7 or above are regarded as satisfactory.Criteria: if the Pearson Correlation value is > 0.7 = reliable.The following are the results of questionnaire reliability testing for each variable 3615 * Corresponding Author: Muhammad Sultan Shalahuddin Rozi Volume 06 Issue 06 June 2023 Available at: www.ijcsrr.orgPage No. 3601-3634

Table 3 . 6
Brand Image Reliability Test

Table 3 . 7
Electronic Word of Mouth Reliability Test

Table 3 . 8
Brand Attitude Reliability Test

Table 3 . 9
Purchase Intention Reliability Test

Table 4 .4 Average
Construct ReliabilityAs part of the reliability test, the composite reliability value of the construct indicator is analyzed.The outcome of the Composite Reliability test provides an indication of the reliability and internal consistency of the measurement model.A value greater than 0.6 is considered satisfactory, suggesting that the construct indicator is reliable.
Variance Extracted Result Construct Average variance extracted (AVE)ISSN:

Table 4 . 6
Discriminant Validity ResultBrand Attitude Brand Image Electronic Word of Mouth Purchase Intention

Table 4 .
This model (X1 Electronic Word of Mouth, X2 Brand Image, and Y Brand Attitude)

is only able to explain as much as 34.8% which
represents the phenomenon.The remaining 65.2% cannot be represented (there are outside variables that affect Brand Attitude).R square → 0.032.This model (X Electronic Word of Mouth and Y Brand Image)

is only able to explain as much as 3.2% which
represents the phenomenon.The remaining 96.8% cannot be represented (there are outside variables that affect Brand Image). ISSN:

Table 4 .
Upon examining the table presented above, it becomes evident that all variables exhibit a significant positive influence, except for the variables Electronic Word of Mouth in relation to Purchase Intention.This implies that hypotheses H1, H2, H4, H5 are accepted, while H3 is rejected, as indicated in the conclusion below.

Table 4 .
o Vision  Becoming the Community's Choice Superior Hospital with the Best and Environmentally Friendly Services Towards Healthy Subang for All in 2026.o Mission  Providing fast, responsive, quality and affordable health services for the community  Develop professional, ethical, and high integrity human resources with continuous competency improvement  Develop facilities and infrastructure according to the latest developments in health science and technology  Implement an effective, efficient and relevant management system. Pamanukan Medical Center Hospital (PMC) is a type C hospital that located in Jl.Raya Rancasari Km 4.35 Pamanukan, Subang.This hospital was founded from the concern of doctors who work in Subang for the people of Pamanukan who have difficulty on reaching RSUD Subang due to the long distance.o Vision  Providing professional Prime Health Services and becoming the Hospital of Choice in the North Priangan region.o Mission  Providing Professional and Affordable Basic and Specialist Health Services to All Levels of Society in North Priangan, Especially Subang District. Collaborating with the Regional Government, especially the Subang Regency Health Office in the Context of Improving Public Health. Collaborating with Private Parties in the Context of Improving Hospital Services.PMC o Motto  North Priangan Family Healthy Partners