SHS Web of Conferences 76, 01028 (2020) https://doi.org/10.

1051/shsconf/20207601028
ICSH 2019

The Analysis Factor of Medical Tourism

in Singapore
Martin Lianto1, Widjojo Suprapto1*, and Maizirwan Mel2
1Department of Management, Faculty of Business and Economics, Petra Christian University,
Jl. Siwalankerto 121-131, Surabaya 60236 Indonesia
2Department of Biotechnology Engineering, Faculty of Engineering, International Islamic University

Malaysia, 50728 Kuala Lumpur, Malaysia

Abstract. Indonesian citizens have spent the USD 11.5 × 109 for medical
treatment services abroad. Singapore is one of the favorite countries in
medical tourism for Indonesian people. This research aims at analyzing the
attraction factors of medical tourism in Singapore. There are 100
respondents visited Singapore to do medical tourism. The retrieved data is
processed using the CFA (confirmatory analysis factor) method. The result
shows the five main factors that make Singapore attractive for medical
tourism, and the factors are the atmosphere and medical accuracy,
competency and price, facilities, customer satisfaction, and entertainment.

Keywords: Health tourism, tourist destination, destination attractiveness

1. Introduction
Traveling abroad for medical care to various international locations is common and not new
phenomena. Nowadays, medical tourism has become a big interest value in a new tourism
category [1]. Medical tourism has become a choice to do medical care and it grows rapidly.
These phenomena are a combination of medical activities and tourism that gives positive
influences for the investment of the economy and health in a country. It contributes to the
employment, foreign exchange earnings, infrastructure, health, and quality standard of the
destination country. Some countries all over the world start to promote medical tourism to
get benefits [2].
Sultana et al. add that medical tourism is a complex idea. This includes the good quality
of medical care services, and some other supporting facilities, such as a decent
accommodation, shopping center, and even recreation setting [1]. The phenomena are that
the people of the developed and developing countries visit the destination country for
medical purposes [3]. The medical tourism destination is not always in the western or
European countries. The main reason for this is the long waiting time to obtain a visa for
medical services in most western countries. At the same time, the expenses are expensive
and often not covered by insurance. The countries in Asia attracts more visitors than other
destinations because the price is lower than the United States or European countries [4].

*
Corresponding author: [email protected]

© The Authors, published by EDP Sciences. This is an open access article distributed under the terms of the Creative Commons
Attribution License 4.0 (http://creativecommons.org/licenses/by/4.0/).
SHS Web of Conferences 76, 01028 (2020) https://doi.org/10.1051/shsconf/20207601028
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Most of the Asian countries have lower labor costs. Medical travelers or international
customers can save 40 % to 60 % of their medical expenses.
Ganguli and Ebrahim explain that medical tourism refers to tourism practice to get a
health care facility. About 50 countries officially state that medical tourism is their national
industry [5]. Medical tourism helps to build world peace and better understanding between
developing countries because tourism is the best way to communicate [6]. Some college
student volunteers, researchers, and medical trainees from developed countries help to work
in third world countries.
The general procedures of medical tourism are, firstly, the individual who wants to do
medical care abroad contact the medical tourism service provider [7]. The provider will ask
for the details of the patient, such as medical reports, symptoms, medical records,
diagnosis, local doctor’s opinion and the other relevant information. If the review has been
done, the procedure will be continued by the doctor or certified medical consultant that
gives information to the patient about medical care. The finance determines the patient in
choosing the designated hospital and it also determines how long to stay. The patient who
signs the agreement will get a recommendation letter for a medical visa issued by the
related embassy. If the requirements and formality have been completed, it will be
continued by visiting the destination country. The hospital will take care of all the patient
needs from accommodation, treatment, or even post medical care. After the treatment, the
patient will go back to the home country. Regularly, the patient can go back to the
destination country for some post-treatment cares [8].
According to the Laws of Republic Indonesia number 36, the year 2009 about health, it
explains that health care consists of some types; preventive, curative and rehabilitative [9].
Preventive health care is an activity to prevent a problem or illness. These preventive action
examples are vaccines, consultation of lifestyle to reduce health risk, unlike curative health
that aims to treat illness. Curative health care is an activity and/or a series of treatment
activities that aim at healing, suffer reducing, disability controlling to make the quality of
life of the patient is optimally maintained. Medical check-up activity is categorized in both
depending on the purpose. If the patient wants to know the health profile, it is categorized
as preventive. If the patient wants to analyze the health profile for diagnostic
considerations, it is categorized as curative. In medical tourism, both treatments are
common. For rehabilitative care, it is also possible, for example, providing rehabilitative
care for such patients as drug addicts.
In the journal of Horowitz and Rosensweig , they state that medical tourism is a trend
growing rapidly where patients from industrial countries are looking for health care in
developed countries through the service offered by the community of the countries [7]. The
medical tourism definition sometimes is used in referencing all medical care, and it is
believed that these phenomena are different from traditional international medical traveling.
In the traditional model, the patient of developing countries country goes to the main
medical centers of developed countries for advanced medical care. This is encouraged by
some help of an organized treatment system and makes medical tourism rapidly growing
for patient medical care.
The rapid growth of the medical tourism industry is of the escalating demands of
lifestyle changes which cause various lifestyle-related illnesses [10]. Some countries like
Thailand, Singapore, and India have been the three leading countries of the medical tourism
industry, which they are predicted to control medical treatment industries in Asia about 80
% in the future [5]. The growth of medical tourism is reported by 20 % increases per year.
For European markets, medical tourism activity is dominated by Canada, England, and
Israel. The index shows that the number is not much different from Singapore and India,
which are the destinations for Asian countries [11]. Southeast Asia is the center of the
industry growth of Asia. Thailand records 1.28 × 106 foreign patients visiting hospitals to

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receive medical treatment. Malaysia also records the number of foreign patients increasing
three times during 2001 to 2006. In Singapore, about 410 000 foreign visitors come to do
the treatment. Ormond and Sulianti explain that the phenomenon of Southeast Asia's rapid
growth in the medical tourism industry is because of the significant growth in infrastructure
and the high investment of the country [6]. The development of technology and
communication give access to health and logistics activity. The rapid growth in the medical
tourism industry has been a catalyst that increases global economic growth in Asia.
For Southeast Asia markets, Singapore and Malaysia have been the most popular
medical tourism destinations. Ganguli and Ebrahim state that Singapore's income from the
medical tourism industry is estimated at about USD 1.6 × 109 in 2016, 13.6 % from CAGR
[5]. The high-income streams from the Southeast Asia medical tourism industry Indonesia
contribute a lot to this. Indonesian patients spend the USD 11.5 × 109 for medical treatment
abroad. Kompas newspaper reported in 2018, 1.7 × 106 Indonesian patients do medical
treatment abroad. It is estimated that Indonesia accounted for foreign exchange of about
USD 100 × 1012 per year for the high number of Indonesian traveling to do medical tourism
abroad. Another finding, the number of Indonesian traveling to Penang for medical reasons
is 500 000 people per year and it will continue to grow [12].
Petriella also adds that World Bank data shows that Indonesian people choose to do
medical treatment abroad; it is twice more to Singapore than Malaysia [13]. They have a
tendency to choose Singapore because it has more attraction values, whether it is medical or
tourism. Singapore and Malaysia are the main destination at the moment for Indonesian
people to do their medical treatment and traveling abroad [14].
Ganguli and Ebrahim explain that the attractions of medical tourism in Singapore have
some factors. Service is one of the factors Indonesian travelers look for in Singapore [5].
Some simple procedures and special complicated surgery such as cardiac surgery, dental
surgery, joint replacement (knee/hip) the and cosmetic surgery are the next factors. Various
health care, including alternative treatment, psychiatric, recovery and even funeral service,
is also available. The government of Singapore sets some strategies to increase the
country’s foreign exchange from the medical tourism sector. One strategy is called seven
pillars that consists of seven main points as a drive to stimulate the sector. This strategy is
built to increase the attraction of medical tourism by increasing tourism locations and
supporting infrastructure.
Singapore is a city-country with a small population, so it is possible to determine the
implementing of the cost for individual and corporate medical treatment. The government
targets to invite one million medical tourists. In 2012, there are 850 000 medical tourists as
reported by Singapore Tourism Board and it has been evaluated critically by the medical
tourism organization [15]. IMTJ (International Medical Treatment Journal) argues that the
number includes the members of the family and local expats. Therefore, it’s only about
200 000 of the patients and 47 % is from Indonesia and 12 % is from Malaysia [7].
Singapore Department of Health builds Singapore Medicine, industrial partnerships
with the government in 2003. This purpose is to increase industrial, medical tourism and to
strengthen the image of the medical center of Asia [15]. The strategy of Singapore medical
tourism is built on high quality, trustworthy, and 21 accredited hospitals that have joined
JCI (Joint Commission International). Singapore puts the efforts to provide health systems
and facilities for its citizens, such as providing the most sophisticated high-end diagnostic
equipment available in the market.
Widely spoken English, clean and safe neighborhood, and a stable political situation
attract medical tourists to Singapore [15]. This condition gives benefits to international
patients, but the excessive dependency on foreign doctors will become a threat when the
doctors go back to the home country or move to another place because of social and
economic reasons [5].

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Sultana et al. describe that there are four main factors shaping medical tourism
attraction in Singapore [1]. The first factor is Destination Competitiveness, which includes
climate, environment, flora and fauna, health area and medical care, heritage or historical
attractions, events, transportation, government policy, the quality of actual management and
skill of workers. A good location is also considered as the Destination Competitiveness.
The second factor is Service Quality, which covers Reliability, Tangibility, Empathy,
Responsiveness, and Assurance [1]. The destination country is required to provide medical
tourists with a good quality of service and performance. Service quality is also proved to
become a strong competitive factor that attracts tourists, including medical care. The
quality of service organization is more than just the application of the mere management
quality to all the organizations.
The third factor is the Tourist Attitude that is the culture of the destination country,
manners, or social norms used by the destination country, and the language as the
consideration of the medical tourists. Income also influences the attraction of medical
tourism in Singapore [1].
The fourth factor is the Cost. Consumers are sensitive about product or service costs [1].
This condition is applicable to all customers especially the price-sensitive ones. The price
of each product or service is a key element to determine customer satisfaction. Medical
fees, accommodation cost, food cost and transportation cost is also in this fourth factor.
The number of Indonesian citizens doing medical tourism in Singapore is relatively
high as Singapore keeps on offering new development on general infrastructures and tourist
attractions [16]. The high number of medical tourism from overseas raises the topic of how
Singapore offers and develops medical tourism as a mainstream of foreign exchange
income. This is the main reason in this research to analyze the factors that attract medical
tourism in Singapore for Indonesian markets.

Fig. 1. Research framework

2 Research method
The type of this research is quantitative. This research uses quantitative analysis in
identifying the factors of consumer decision in choosing Singapore as a medical
destination. The population of this research is all Indonesian consumers that have done
medical tourism in Singapore. From the population, the sample is drawn with such criteria
as the age of 17 and above, visiting Singapore at least two times for medical purposes, and
intending to another medical and pleasure tourism in the near future. In this research,

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minimum samples are 96 respondents. The data are collected from the respondents using
some questionnaires which are constructed using Likert scales of five levels from strongly
disagree to strongly agree [17]. Then, the data are processed to obtain descriptive statistics.
Descriptive statistics is a statistic that has a function to describe or give descriptions to the
object of the research through sample data or population as it is, without analyzing and
concluding that applies to the public. Descriptive statistics used in this research are
minimum value, maximum value and average value. The data analysis method for this
research is the factor analysis [18].

3 Analysis and discussion

3.1 Descriptive mean analysis
The descriptive mean analysis aims to describe or depict data in a frequency table. Table 1
shows the result of the motivation for conducting medical tourism in Singapore.
Table 1. The result of mean motivation (X1)
Factor Statement in my opinion Mean SD
F1 Access to the medical treatment area and tour area are easy 3.82 .80
F2 Public transportation is fast 3.90 .83
F3 The weather is the same, so no need to adapt 4.08 .72
F4 The medical treatment center is easy to find the address 4.04 .83
F5 The medical treatment area is close to various tour attractions 3.94 .88
Singapore provides many entertainment places around the medical treatment
F6 3.94 .87
location such as amusement park, food center, and mall
F7 Singapore offers many attractions such as festivals or performances 3.86 .89
F8 The medical treatment system gives accurate illness diagnostic 4.00 .86
F9 Medical treatment has a high success level 4.05 .74
F10 The medical tools and equipment are modern and comprehensive 4.17 .73
F11 The rooms and buildings are nicer 4.09 .75
Medical professionals in Singapore seriously listen to patient’s complaints
F12 4.14 .77
thoroughly
F13 Medical workers in Singapore have high skills 4.29 .75
F14 Singapore uses international language to make it easier for tourists 4.10 .70
F15 Singapore has the same cultural mannerism more or less 4.27 .73
F16 Consumers who do medical tourism to Singapore have a high income 4.15 .80
F17 Singapore provides optional payments with insurance 4.05 .82
F18 Medical treatment in Singapore is as good as the quality of the treatment received 3.93 .80
F19 There are some optional prices for the types of accommodation 4.12 .80
F20 Public transportation is as good as the quality of the transportation itself 4.12 .70
F21 The food price in Singapore is various 4.16 .70
Total 4.05 .42

The result of the analysis shows that, based on the Confirmatory Analysis Factor
method, there are five main factors recognized to form the attractions of medical tourism in
Singapore.

Table 2. Rotated component matrix

Number Component Matrix
Factor 1 2 3 4 5
F1 .460 .143 -.014 -.013 .598
F2 .526 -.040 .025 .157 .322
F3 .688 .024 .036 .284 .042
F4 .775 .138 .150 -.041 -.031
F5 787 .067 .026 .006 .233
F6 .808 -.014 .132 -.061 .039
F7 .322 .091 .226 .131 .689

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Number Component Matrix

Factor 1 2 3 4 5
F8 .538 .116 .280 .042 .390
F9 .231 .374 .490 .211 .087
F10 .332 .058 .123 .526 .307
F11 .125 .072 .906 .154 .145
F12 .061 .272 .195 .887 .088
F13 .060 .560 .241 .198 .414
F14 -.002 .360 .245 .073 .532
F15 .044 .477 .457 .218 .136
F16 .049 .593 .056 .212 .206
F17 -.044 .699 -.077 .051 .287
F18 .119 .783 .069 -.034 .015
F19 .060 .749 .161 .287 -.291
F20 .139 .024 .909 .101 .123
F21 -.030 .202 .156 .910 -.018

3.2 Discussion

The result from Table 2. is assembled into new groups, which can be seen in Table 3.
Table 3. New factor naming
Factor Element Factor Statement
1. In my opinion, public transportation is fast to visit a wanted place
2. In my opinion, the weather is the same, so no need to adapt
3. In my opinion, the medical treatment area is close to various tour
Atmosphere &
attractions
1 Medical
4. In my opinion, Singapore provides many entertainment places around the
Accuracy
medical treatment location such as amusement park, food center, and mall
5. In my opinion, the medical treatment system gives accurate illness
diagnostic
1. In my opinion, medical workers in Singapore have high skills
2. In my opinion, Singapore has the same cultural mannerism more or less
3. In my opinion, consumers who do medical tourism to Singapore have a
high income
Competency &
2 4. In my opinion, Singapore provides optional payments with insurance
Price
5. In my opinion, medical treatment in Singapore is as good as the quality of
the treatment received
6. In my opinion, there are some optional prices for the types of
accommodation
1. In my opinion, medical treatment has a high success level
2. In my opinion, the rooms and buildings are nicer
3 Facility
3. In my opinion, public transportation is as good as the quality of the
transportation itself (cheap, fast, safe and clean)
1. In my opinion, the medical tools and equipment are modern and
comprehensive
Customer
4 2. In my opinion, medical professionals in Singapore seriously listen to
satisfaction
patient’s complaints thoroughly
3. In my opinion, the food price in Singapore is various
1. In my opinion, access to the medical treatment area and tour area are easy
2. In my opinion, Singapore offers many attractions such as festivals or
5 Entertainment performances
3. In my opinion, Singapore uses international language to make it easier for
tourists

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Factor 1 is shaped from a combination of factors that reflects the fast public
transportation to the destination, the same weather condition from the origin country that no
need to adapt, medical treatment center easy to find, medical treatment area located near to
various tourist attractions, many entertainment places around the medical treatment location
such as amusement park, food center, and mall, medical treatment system giving accurate
illness diagnostics. In this case, factor 1 describes the ease that the visitors feel to use public
facilities, the friendly weather, easy to find location, and location near to attractions. Factor
1 is related to the medical treatment description in general because it represents both
medical and tourism needs at the same time. Based on the explanation above, factor 1 is
named Atmosphere and Medical Accuracy.
Factor 2 is shaped from element factors that reflect the medical workers in Singapore
having higher skills, the same cultural mannerisms more or less, high income to afford the
treatment, insurance payment option for medical cost, the price as good as the quality, and
various accommodations with many prices ranges choices. The second factor is related to
the same mannerism in both countries and the readiness described in the income level or
insurance support. Based on the descriptions above, factor 2 is named Competency & Price.
Factor 3 reflects the respondents’ confidence about the high success rates of medical
treatment in Singapore, the nicer building, the good quality of the public transport (cheap,
fast, safe, and clean). Factor 3 is related to the attraction of medical treatment offered by the
Singapore government, where the success rates of the medical treatment are high by the
support of the government to provide good buildings and public transportation facilities.
From the descriptions, factor 3 is named the Facilities factor.
Factor 4 reflects the consumers’ view that the tools and the equipment available in
Singapore are sophisticated and comprehensive, the medical professionals listen to the
patient’s condition thoroughly, and the food prices in Singapore are various. Factor 4
reflects the professionalism of the workers and the equipment owned in Singapore. It is
clear that the respondents travel to Singapore for medical treatment in hoping the quality of
the better workers and equipment compared to Indonesia. Factor 4 is named Customer
Satisfaction.
Factor 5 is reflecting the merging factors related to the ease of access to medical
treatment and tourist attraction areas, entertaining festivals and performances, and the
international language that makes it easy for tourists to visit. Factor 5 reflects the general
factors that attract tourists to Singapore, on the medical side is determined from road
access. Eventually, factor 5 is named Entertainment.

4 Conclusion
This research concludes from the result of analysis and discussion as follows:
(i). From a total of 21 factors estimated to be the medical treatment attractions in
Singapore, all are reduced to five main factors: Atmosphere and Medical Accuracy,
Competency and Price, Facilities, Customer satisfaction, and Entertainment.
(ii). The Atmosphere and Medical Accuracy Factor is a combination of element statements
of public transportation, the weather, the medical treatment area, the entertainment
places, and the medical treatment accuracy.
(iii). The Competency and Price Factor is a combination element statements of high skillful
medical workers, the same cultural mannerism, the high-income consumers, the
optional payment with insurance, the quality medical treatment reflected in the price,
and the wide range hotel types.
(iv). The Facilities factor is a combination of element statements of highly successful
medical treatment, the facilities, the public transportation

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(v). Customer Satisfaction is a combination of element statement of modern and

comprehensive medical equipments, professional medical workers, and various food
prices.
(vi). The Entertainment factor is a combination element statement of accessibility to the
medical treatment area, many tourist attractions, and several international languages
spoken by the locals.

References
1. S. Sultana, A. Haque, A. Momen, F. Yasmin, Iranian J Publ Health, 43,7:867–
876(2014). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401052/
2. S. Zuhri, I. Suhendrianto, P.D. Sentia, International Conference on Engineering and
Science for Research and Development, 1,2:167–175(2015).
https://www.researchgate.net/profile/Prima_Sentia/publication/317568299_The_Analy
sis_of_Relationships_Among_Variables_Toward_Medical_Tourism_to_Malaysia_by_
Employing_Structural_Equation_Modelling/links/59400ba745851554614a7749/The-
Analysis-of-Relationships-Among-Variables-Toward-Medical-Tourism-to-Malaysia-
by-Employing-Structural-Equation-Modelling.pdf
3. J. Connell, Tourism Management, 27,6:1093–1100(2006).
https://www.sciencedirect.com/science/article/pii/S0261517705001871
4. H.G. Singh, Journal of Service Science and Management, 4:315–324(2011).
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.860.2107&rep=rep1&type=p
df
5. S. Ganguli, A.H. Ebrahim, Tourism Management Perspectives, 21,1:74–48(2017).
https://www.sciencedirect.com/science/article/pii/S2211973616301155
6. M. Ormond, D. Sulianti, Current Issues in Tourism, 20,1:94–110(2014).
https://www.tandfonline.com/doi/abs/10.1080/13683500.2014.937324
7. M.D. Horowitz, J.A. Rosensweig, IMTJ International Medical Travel Journal, 1,2:1–
14(2008).
https://www.researchgate.net/publication/285032774_Medical_tourism_vs_traditional_
international_medical_travel_A_tale_of_two_models
8. S. Banerjee, S.S. Nath, N. Dey, H. Eto, New Business Opportunities In The Growing E-
Tourism Industry. Asia: IGI Global (2015).
https://books.google.co.id/books?id=woEfCgAAQBAJ&dq
9. DepkesRI. Undang-Undang No. 36 Tahun 2009 Tentang Kesehatan. [Law No. 36 of
2009 concerning Health]. [Legal document]. Jakarta: Sekretariat Negara (2009). [in
Bahasa Indonesia].
https://www.depkes.go.id/resources/download/general/UU%20Nomor%2036%20Tahu
n2%20009%20tentang%20Kesehatan.pdf
10. J. Kumar, K. Hussain, International Interdisciplinary Business-Economics
Advancement Journal, 1,1:1–10(2016).
https://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=1000&context=globe
11. K. M. Wong, P. Velasamy, T.N.T. Arshad, SHS Web of Conferences, 12,1:1–8(2014).
https://www.shs-
conferences.org/articles/shsconf/abs/2014/09/shsconf_4ictr2014_01037/shsconf_4ictr2
014_01037.html
12. L. Fathia, Tidak Hanya Aceh, Banyak Orang Indonesia Memilih Berobat ke Penang.
Berikut Alasannya, [Not Only Aceh, Many Indonesians Choose Treatment at Penang.
Here are the reasons], [Online] from https://liza-fathia.com/warga-indonesia-berobat-
ke-penang-malaysia/ (2018). [Accessed on May 2, 2019]. [in Bahasa Indonesia].

8
SHS Web of Conferences 76, 01028 (2020) https://doi.org/10.1051/shsconf/20207601028
ICSH 2019

13. Y. Patriella, Setiap Tahun, Rp100 Triliun Melayang karena Pasien RI Berobat di Luar
Negeri [Every Year, IDR100 Trillion Is Hovered Because RI Patients Are Treated
Overseasretreived], [Online] from
https://ekonomi.bisnis.com/read/20180703/12/812357/setiap-tahun-rp100-triliun-
melayang-karena-pasien-ri-berobat-di-luar-negeri (2018). [Accessed on May 2. 2019],
[in Bahasa Indonesia].
14. M.O. Sulianti, Current Issues in Tourism, 20,1:94–s110(2014).
https://www.tandfonline.com/doi/abs/10.1080/13683500.2014.937324
15. J.C.H. Yap, International Hospital Federation Reference Book 2006/2007, Switzerland:
IHF-FIH (2006). p. 25–28. https://www.ihf-
fih.org/download_doc_file.php?doc=469be46b07c5e91d7bce0897764b9d4b
16. L.K. Anna, Pasien Indonesia, Turis Medis Terbesar di Singapura [Indonesian Patient,
Largest Medical Tourist in Singapore]. [Online] from
https://lifestyle.kompas.com/read/2015/04/26/091700723/Pasien.Indonesia.Turis.Medis
.Terbesar.di.Singapura (2015). [Accessed on May 2. 2019], [in Bahasa Indonesia].
17. S. Lemeshow, D.W. Hosmer, J. Klar, Adequace of Sample Size in Health Studies, USA:
World Health Organization (1994).
https://apps.who.int/iris/bitstream/handle/10665/41607/0471925179_eng.pdf;sequence
=1
18. Sugiyono, Statistika untuk penelitian. [Statistics for research]. Bandung: Alfabeta
(2018). [in Bahasa Indonesia]. https://www.goodreads.com/book/show/29974706-
statistika-untuk-penelitian