Community Tendencies in Decision Making towards the Selection of Health Service Places In Makassar City, Indonesia

Hospitals are a very urgent need for people in unstable health conditions. Therefore, people choose hospitals that are able to provide the best service for people in need. The type of qualitative research through a phenomenological approach, while the results showed that the low use of health facilities was often due to the distance between hospitals and communities too far, high tariffs, unsatisfactory services, and that influenced the level of service utilisation, namely from health service providers, namely available facilities, service costs and distance, while the community itself as a user of health services, namely the social and socio-economic status of the community. This study aims to determine the tendency of the community in making decisions on the selection of health services in Makassar city. The population in this study were people who were queuing at several hospitals.


INTRODUCTION
Today globalisation has a major impact on the development of the world of health. Hospitals as health care institutions for the community with their own characteristics that are influenced by the development of health science, technological advances, and the socio-economic life of the community must still be able to improve services that are of higher quality and affordable to the community in order to realise the highest degree of health (Indonesia, 2009 Law).
The hospital is one of the institutions engaged in service, within the framework of the National Health system, the hospital is one of the elements that must fulfil the objectives of health development, namely to achieve the ability to live a healthy life for the entire community in order to realise an optimal degree of public health, as one element of the general welfare of the national goal. As an integral part of the health service system in health development goals.
The growth of hospitals in Makassar city is very rapid, and has a mission to provide quality services and affordable to the community in order to improve the degree of public health. Based on its class, the hospital is categorised into 4 classes, namely: 1) Type A hospital: It is a top hospital that is a central hospital and has complete medical service capabilities. Type A hospitals have basic specialist medical services consisting of internal medicine, paediatrics, surgery and obstetrics and gynaecology, 2) Type B hospital: A hospital that is still included in tertiary level health services that prioritises subspecialist services, and is also a further referral from type C hospitals, 3) Type C hospital: Is a hospital that is an advanced referral level above from primary health care, the services provided are already specialist in nature and sometimes also provide specialist services, and 4) Type D hospital: Is a hospital that provides basic medical services, only limited to basic health services, namely general and dental health. Has facilities and medical service capabilities of at least 2 basic medical services.
As the environment changes rapidly and develops both at the local and global levels, encouraging hospitals to carry out various changes that tend to accelerate with the emergence of various government policies that result in an increasingly sharp competitive situation, the right strategy is needed in managing health services in hospitals (Alhajri et al., 2022;Çınar & Eren, 2015;Ghaderi et al., 2021;Kiely et al., 2021;Mammen et al., 2018).
Increasing competition has made many hospitals compete to provide a wide selection of facilities that are offered to the public. The more hospitals that are built in Makassar city, the higher the public's demand for quality and affordable health facilities. Hospitals must try to survive in the midst of increasingly fierce competition. Service quality is a fundamental strategy in the company's efforts to be successful and sustainable in a fierce business competition environment (Parasuraman et al., 1994(Parasuraman et al., , 1985. Development in the health sector is expected to increase the level of public health and health services and can be felt by the community in general (Leider et al., 2016;Maravilla et al., 2022;Viswanadham, 2022). Health behaviour is a person's response to a stimulus or object related to illness from the health care system, food and drink and the environment, besides the availability of health facilities, easy access, and affordability of the community in general is a consideration in improving the quality of good service to provide quality service to the community.
Quality hospital service is an important thing that must be observed because it will affect the image of the hospital (Alhajri et al., 2022;Knapp, 2006;Zaid et al., 2020). This image will affect people's perceptions of the hospital, the community will consider a service offered by the hospital to be good, if many people use, visit and get to know the hospital's services. This image will be a consideration for the community in the decision to visit or seek treatment at the hospital.
What needs to be known is that those who assess the quality of hospital services are the community or patients who visit the hospital. Surveys are needed to obtain information on service quality attributes that are able to provide good service. the community or patients will feel whether the quality of service provided by the hospital is in accordance with the wishes of the community so that patients will feel comfortable in using hospital services. The main requirements that must be fulfilled by the hospital as a good hospital health service are: 1. Available and sustainable, in which case all types of health services that the community needs are not difficult to obtain 2. Reasonably acceptable, meaning that public health services do not conflict with people's beliefs and beliefs 3. Easy to reach, meaning that public health services can be found in every corner of the location 4. Easy to reach, meaning that the fees charged can be reached by the community 5. Quality, the meaning of quality here is to provide good health services so that it can satisfy the people who use health services Based on secondary data obtained from the community's assessment of hospital services, the results of interviews conducted with people who use health services in Makassar city say that the services provided by the house are quite good, the health workers are friendly and polite, but sometimes the doctor on duty does not arrive on time so they wait too long, and there are also some people who say that seeking treatment at the hospital the cost of treatment is a little expensive, but it is comparable to the service, and sometimes the distance between the hospital and the community's residence is too far away, the community says that the existing facilities are complete enough to support services.

Hospital
The utilisation of hospitals in Makassar city as a means of health care is inseparable from the factor of choosing alternative means of health care, namely the choice of hospitals whose medical costs are also still affordable by the community with good quality of service. The existence of these health service providers, makes people more selective and start trying to get health services in different places in the hope of getting better service. That way people can compare the health services they receive based on the perceptions and impressions they get while getting service.
A hospital is an organisation engaged in health services that is in daily contact with the community. Therefore, a hospital must be able to fulfil the needs required by patients so that it can improve the degree of public health and provide services to the community. The aspect of trust in health services at the hospital is the patient's level of confidence in the hospital's ability to meet the expectations of the community or the extent to which the community believes in the expertise of the hospital. This can be shown by public confidence in the credibility of the hospital, service guarantees and goodwill from the hospital. According to (Kozuch et al., 1995) states that there is a relationship in tariff income, distance of place, family role. In this case, the amount of costs that will be incurred by the community in carrying out the health service process will lead to perceptions about the costs incurred will get good service results from the hospital.

Quality of public health services
Education and knowledge possessed by the community have a very big influence on people's decisions in determining the place of health services in Makassar city, because the higher the education and knowledge of people who will use health services, it will be easier to access and find information about good services in each hospital. This is in line with research conducted

Jurnal Ilmiah Ilmu Administrasi Publik: Jurnal Pemikiran dan Penelitian Administrasi Publik
Volume 12 Number 2, July-December 2022. Page 523-528 by (Luo et al., 2018) which states that with good education and knowledge possessed by patients, it will show potential and positive benefits when deciding on treatment. Benefits have an impact on people's health status, people who have high education and knowledge are more likely to have better health. In contrast to people with low education, they are not influenced or choose community services.
From the results of the study, the researcher argues that economic factors are also very influential in choosing a place of health care, community, because the cost of health services at the hospital is relatively expensive and the average respondent comes from a low economic level. If people do not have health insurance, it will be difficult to pay for hospital services. Modern society with a high economic level will choose doctors and services to overcome their illness.

Health care facilities
Factors that influence decision making in choosing treatment are experience factors and factors of encouragement from the social environment. The experience factor where the community has had experience or has visited the hospital so that the community knows the available facilities owned by the hospital, a hospital that has complete facilities will be a reference for the community to choose and perform health services at the hospital. While the factor of encouragement from the social environment in the form of information that the community gets from the surrounding environment or neighbours or from the closest family that is positive about health care facilities in the environment, is a reference for choosing recommended health services (Feroz et al., 2020;Lal et al., 2020;Laukka et al., 2021). Of the several factors above, education has a very large influence in the selection of health care facilities in addition to the support of the family.

The role of public health services in improving community health
The demands of the community are the optimal services provided by the hospital, where health services try to fulfil the wishes of the community by improving the quality of services provided to the community, the hospital functions to provide complete health services, according to (Ahmed et al., 2020) states that facilities are everything that can facilitate and smooth the implementation of an effort. Mamik's opinion is associated with facilities in the hospital, namely equipment and equipment owned by the hospital to support the smooth running of examination, treatment and care. The hospital always makes it easy for the community to get information with the information board placed in front of the procedure / procedure for services, registration and always strives and creates the right service pattern according to the type of service desired by the community.

CONCLUSION
This study found that community behaviour in the selection of health services in Makassar city is with the level of knowledge or information about the types of health services, which are needed by the community, as well as community confidence in the use of health services, because confidence is very influential on the benefits we will get in health services and a sense of community comfort in the use of health services, where the hospital also always provides quality health services to meet the needs of patients or the community.