This study aims to determine the effect of work motivation, job stress, job satisfaction and self-efficacy significantly influence employee performance and to determine one among the four variables dominant influence on employee performance. The collection of data and population in this study are employees of Saras Husada Hospital purworejo. The sampling technique using the formula slovin with an error rate of 5%. Methods of data collection using questionnaires obtained 130 respondents. Data analysis tool used in this research is multiple linear regression with the help of data processing using SPSS software, and test instrument is a test of validity and reliability testing. As for testing the hypothesis includes the F test, and coefficient of determination. The results provide the conclusion that: 1) Motivation significant positive effect on employee performance. 2) Job satisfaction significant positive effect on employee performance. 3) significant negative effect of work stress on employee performance. 4) self-efficacy posifive significant influence on employee performance