Business Development of Dental Services Marketing in Hospital: A Systematic Review

One of the health services in the hospital is dental and oral health care. Hospitals must establish a good marketing strategy for their organizations in an effort to continue to improve or maintain the expected position. Based on the above, it is necessary to know what efforts can be made by dental outpatient clinics in developing marketing of dental and oral health services in dental clinics in hospitals to increase patient visits to hospital dental clinics. This study use Systematic Review with PRISMA method retrieved from online database such as ProQuest, willy online, J Store, Scopus and Google Schoolars using a keyword “Dental services", "Dental marketing", "Marketing mix" and "Hospitals". The end of this search got 8 journals. Based on the results of research in several journals it was found that there were many ways to market dental polyclinics in hospitals. starting from strategic planning in setting up a dental polyclinic in a hospital it must be well planned. So that the investment or business that will be run can be successful, then beforehand it is necessary to do the right competitive strategy. An increase in patient visits at the hospital dental clinic can be done with one of the 3.0 marketing approaches. The components like physical evidence, people, and process were mixed to the form of the Service Marketing Mix. Marketing media can be done directly or by utilizing information media that can be accessed by many people online. Marketing efforts must also be in accordance with the law and medical ethics. Business development of dental services must be carried out and in accordance with a good marketing strategy. Good dental marketing will increase patient visits at the hospital.


BACKGROUNDS
The hospital is one of the many health service providers for the community.One of the health services in the hospital is dental and oral health care.Tooth and mouth disease is a serious problem, but people's awareness in care is still very lacking.Tooth and mouth disease is still not a top priority in getting health care.People come to the dentist if they feel they are not enough to withstand the pain caused by tooth and mouth disease.Many factors are less realized when visiting a dentist, namely the lack of information and knowledge about the importance of maintaining dental and oral health.In addition, the lack of promotion and marketing of dental services in hospitals is also one of the contributing factors.At present, the practice of dental health promotion has begun to develop, not only the practice of teeth in health centers and hospitals, but also dental clinics.Good marketing methods for good clinics can be used as an example for marketing outpatient dental clinics in hospitals so as to increase patient visits.Hospitals must be used to provide high-quality services to their customers, so they can use health services in hospitals.Hospitals must establish a good marketing strategy for their organization to continue to improve or maintain the expected position.One method to improve dental polyclinic visits is by marketing 3.0.This method translates customer requirements to produce products based on the customer' s mind, heart and spirit.Kotler et al. (2010) stated that marketing practices will increasingly shift from the intellectual level (marketing 0.1) to emotional (marketing 2.0), and finally to the human psyche (marketing 3.0).

THEORETICAL REVIEW
Value-based marketing is a business model that is in accordance with marketing 3.0 that attaches value to the company' s vision and mission.This idea in the world of marketing will enhance public perceptions and marketing of companies and marketers to include more human vision in choosing their goals (Kartajaya and Darwin, 2010).
The biggest challenge faced by marketers in the health sector is to measure and determine the quality of services.The quality of this service has been understood and applied to improve health service performance, improve patient satisfaction, and create patient loyalty.Patient perceptions are indicators of measurement for service quality in health organizations.Therefore, customer satisfaction is the main tool for making important decisions in determining health care choices (Irfan and Ijas, 2011).Although many factors can influence the attitudes and desires of patients, but the patient' s perception of service quality plays the most important role (Aliman and Mohamad, 2013).The service quality aspects provided will affect patient satisfaction.The patient will compare or ask for recommendations from others for dental treatment instructions.The aspects seen from the quality of service include physical appearance of the dental clinic (tangible), aspects of reliability, responsiveness, assurance, and aspects of empathy (Haryanto and Ollivia, 2009).Service quality can be interpreted as how well the services provided by the clinic are compared to patient expectations (Aliman and Mohamad, 2013).Patients who feel good service from a dental clinic will have an impact on patient satisfaction and increase the desire to seek treatment again (Ramez, 2012).Based on the above, it is necessary to know what efforts can be made by dental clinics in marketing dental clinics in hospitals.

METHOD
This research was carried out by conducting a systematic review using the PRISMA method.Data is taken from online databases such as ProQuest, willy online, J Store, Scopus, and Google scholars using the keywords "Dental services", "Dental marketing", "Marketing mix" and "Hospitals".From these keywords the search engine found 54174 international journals and 10 local journals.This study limit the number of journal papers with duplication and years (2008-1818) which produced 33,413 journal papers.Based on the title, this study selected 1207 journal papers.However, after further reading including the abstract section and got 8 journal papers.This study use Model P.I.C.O; The population is a hospital that conducts Dental Services, the intervention is to find out the efforts of hospitals to do dental marketing, the comparison is dental marketing between all hospitals in the country and abroad, and the aim is to increase patient visits to hospital dental clinics.
Ferti Dwi Ekasari, dkk, Business Development of Dental Services Marketing in Hospital: A Systematic Review Februari 2020

RESULTS AND DISCUSSION
Based on the results of research in several journals it was found that there were many ways to market dental polyclinics in hospitals.Good dental marketing will affect the increase in patient visits at the hospital.Plans for the establishment of a dental polyclinic in a hospital must also be well planned.Strategic planning in the establishment of a hospital dental clinic one of which can use SWOT analysis.SWOT analysis uses a framework of internal strength (strengths), internal weaknesses (weaknesses), external opportunities (opportunities) and external threats (threats).With SWOT analysis, market and marketing aspects will be known before the dental polyclinic starts.Based on the research on the Feasibility Study of Investment Development in the Dental and Oral Hospital of FKG Mahasaraswati University, Denpasar, it is known that market and marketing aspects are the most important aspects and the first is the investment project proposal.who are ready to accept company products.So that the investment or business that will be run can be successful, then beforehand it is necessary to do the right competitive strategy.The element of competition strategy is to determine market segmentation (segmentation), determine the target market (targeting), and determine the market position (positioning), or often referred to as STP.The study also stated that the number of dental and oral patients had a tendency to increase every year.The existence of a high awareness of the community on the importance of oral and dental health is one of the reasons for this increase.Increasing the projection of dental and oral patient visits can be achieved or can be obtained if the marketing efforts are carried out well.
One of the efforts made by the RSGM FKG Mahasaraswati University Denpasar is to hold free medical treatment at social events directly to the community through events such as the foundation' s birthday or other events.
After standing and running a dental polyclinic at the hospital it is expected that patient visits will continue to increase.An increase in patient visits at the hospital dental clinic can be done with one of the 3.0 marketing approaches.This method translates customer needs in order to produce products that are based on the mind, heart and spirit of the customer as was done by Reksa Waluya Mojokerto Hospital.Kotler, et al. (2010) stated that marketing practices will increasingly shift and undergo transformation from intellectual level (marketing 0.1) to emotional (marketing 2.0), and finally to human-spirit (marketing 3.0).Values-based marketing is a business model that fits with marketing 3.0 that attaches values to the company' s vision and mission.This notion in the world of marketing will improve public perception of marketing and guide companies and marketers to incorporate a more human vision in choosing their goals (Kartajaya and Darwin, 2010).
Based on a research journal entitled "Dentists and Romanian consumers' perception regarding marketing activity for dental healthcare services" said that to create marketing strategies, marketing research is needed to find out the consumers' specific specific dental office or clinic.If the dental polyclinic has its own characteristics, it will be a branding image that is always remembered by patients.It should be remembered that the patient' s dental polyclinic consists of various groups, ages and education so it is hoped that we can determine what type of dental clinic can create customer satisfaction, both in terms of price and location that are affordable and easy for patients.A comfortable and unique clinical atmosphere can also create calm and the desire to seek treatment again.
Various efforts can be made to increase profits in the hospital dental polyclinic business.Dentists are service providers, so you need to know some of the marketing strategies.According to the journal entitled "Dental Marketing: What Works, What Doesn' t and What Can' t" when devising a comprehensive marketing plan for any business, the key elements are the "4 P' s" -pricing, product, place, and promotion, -that form the Marketing Mix.The PVC components such as physical evidence, people, and processes were presented in Figure 1.Kolter and Anderson (1970s) defined social marketing as the adaptation of commercial marketing principles to the development of programs in order to influence the behavior of the target audience to improve the physical and mental well-being and / or society of which they are part.Social marketing is like the influence of social behavior not to benefit the marketer, but to benefit the Februari 2020 target audience and the general society, it can be inculcated in promoting dental products.There are several ways of marketing directly to prospective dental polyclinics without using advertising channels that require large fees such as on television and radio.We can use advertising techniques such as distributing brochures, leaflets, promotional letters and street advertisements.Social networking can also be used in building networks through these sites where they have a special page to provide information and knowledge to patients.
One good medium of marketing is to use information media that can be accessed by many people online.
Today almost everyone uses a smartphone that can easily access whatever news is needed.Information such as where the nearest, best and affordable dental clinics can be done using the internet and information is obtained right away.Almost all hospitals have official websites where dentist information, promos and service hours can be easily found by the public.It is recommended that the information content from the website be maintained and updated so that the information provided is the latest information available at the hospital.Research conducted at Al-Islam Bandung Hospital said that the hospital provided easy access to dental polyclinic patients by utilizing media to deliver information through websites and bulletin boards.
From all marketing efforts carried out in developing the business of the dental polyclinic, it is expected that the ethics and legal codes will not be forgotten as a dental profession.The research journal entitled "Ethical and Legal Aspects of Marketing Activity in the Field of Dental Healthcare Services" says that marketing research in general is a specific field of marketing, which by the nature of relationships and types of communication that are engaged with consumers or with other elements of the organization' s micro-environment organizations can be a source of unethical or illegal practices.At present there have been many marketing efforts for dental polyclinics that violate ethics and codes of ethics by using infringing advertisements such as excessive praise, giving discounts below market prices, displaying patient data and photos and documenting service activities without patient consent.
The research journal entitled "General Aspects Related to Dental Services Marketing" says that To manage dental marketing, activities that are common to all types of marketing must be carried out, as follows: market research, marketing research, marketing environment studies, market segmentation, strategic marketing planning.In addition, marketing and brand strategies must be developed, and methods and technologies that can be used to serve the purpose of advertising and sales services, as well as returns on investment and sales must be explored.In addition, the benefits provided by access to technology for dental care must be utilized.Dental care providers who are able to identify customer needs and how they want their needs met through advanced technology, not only in terms of providing services but also in terms of communicating with patients, and for fresh learning and innovative marketing, research and social media approaches, can get results better as far as marketing services are provided.(shown in figure 1 & 2).

CONCLUSION AND RECOMMENDATIONS
Dental polyclinic in a hospital is one of the services of dental and oral health service providers who are expected to provide income or profit because of patients visiting the hospital.From the external factors of the hospital it is known that the lack of public knowledge about dental and oral health is one of the reasons why the dental polyclinic is sometimes not as busy as other poly in the hospital.The notion that dental and oral diseases are not a serious illness that causes dental treatment is not the main choice when visiting a hospital.From the internal factors of the hospital it is known that the lack of dental and oral health promotion to the surrounding community also causes dental and oral health information not to be conveyed to the public.Currently the dental and oral polyclinic is a promising business opportunity in increasing the hospital' s own profits.Before marketing is carried out, it is expected that the hospital has carried out strategic planning, one of which is the SWOT analysis.From the results of the analysis, it can be seen that the target market and good marketing are in accordance with the capabilities of the surrounding community.Many efforts can be made in marketing the dental polyclinic at the hospital.The marketing effort that can be done is by doing social services to the community in various events.After standing and running a dental polyclinic at the hospital it is expected that patient visits will continue to increase.An increase in patient visits at the hospital dental clinic can be done with one of the 3.0 marketing approaches.The hospital dental polyclinic is also expected to have its own characteristics and it will be a branding image that is always remembered by patients so that they will be treated again.Marketing strategies can also be done by marketing mix twith the "4 P' s" key elements -pricing, product, place, and promotion.The marketing method can be done directly by sharing information in the form of brochures, leaflets and others, and utilizing internet-based smartphone technology that can be utilized by everyone.Legal aspects and ethical codes must also be considered in making marketing efforts so that they are expected not to violate the law. Figure1