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Patient Loyalty: What's Age Got to Do With It?

Patient Loyalty: What's Age Got to Do With It?

by Rick Blizzard

Age influences patients' perceptions of -- and consequently their satisfaction with -- hospital services. Gallup's 2003 patient database shows that younger patients are consistently less satisfied than older patients when it comes to emergency department, outpatient surgery, and outpatient test and treatment services (see "Do Patient Expectations Mellow With Age?" in Related Items).

But are satisfaction ratings adequate measures of success in healthcare patient tracking?

The answer is no. Consider the exchange I recently had with a friend over lunch at a restaurant. She ordered a dish she had never had before, and after the meal I asked her if she liked it. She said yes -- but when I asked if she would order the dish again, she said no. It's a question of intensity -- my friend liked the meal enough to say she was satisfied with it, but not enough to be loyal to it given all the other culinary options available to her.

The same difference applies to hospital ratings. Patients may say they're satisfied with the services they receive at a hospital, but that doesn't necessarily mean that they would return to that hospital again. So while Gallup's database shows that differences in average patient loyalty (as measured by their stated likelihood to return to the hospital) by age follow the same pattern as average patient satisfaction by age in many cases, there are some exceptions.

Emergency Department

In the emergency department, age seems to affect patient loyalty and patient satisfaction in similar ways. Younger patients (those between the ages of 18 and 45) tend to have loyalty levels that are below the overall mean, while older patients tend to average above the mean (46- to 55-year-old patients score right at the overall mean). Patients under the age of 18 (or at least the guardians or caretakers of these patients, who actually participate in the surveys) score below the mean on satisfaction, but above the mean on loyalty.

Outpatient Surgery

Patient loyalty to outpatient surgery services varies less by age than does loyalty in emergency department services. The only age group that differs substantially from the overall average patient loyalty score is the 18- to 25-year-old group, which tends to be less loyal. Patient satisfaction with outpatient surgery services follows a nearly identical pattern.

Outpatient Test and Treatment

In this department there is a clear difference: while there is an almost linear relationship between patient age and satisfaction with outpatient test and treatment (the younger the patient, the lower the satisfaction), age seems to have very little impact on patients' loyalty to outpatient test and treatment departments. Variation from the mean is relatively small among all age groups, but there is no clear pattern.

Inpatient

Inpatient loyalty scores also do not follow a linear pattern by age group. The youngest patients tend to be most loyal, while the older patients (with the exception of 65+ year-olds) are least loyal. Patient loyalty scores among patients in the middle age groups (those between the ages of 36 and 55) are even lower than the already low patient satisfaction scores for those groups.

Bottom Line

Gallup analysis has shown that overall, the strongest single predictor of patients' stated likelihood to return to a facility is patient satisfaction. Thus, it is not surprising that these two measures follow similar patterns by age in many cases.

How, then, do we explain the instances in which patient loyalty scores clearly show less variation by age than patient satisfaction, as in the outpatient test and treatment area? In some cases, the answer is simple: convenience of that facility's location trumps a patient's satisfaction with the services there. Younger patients may have been unhappy with an outpatient test and treatment facility, but that unhappiness might not be intense enough to overcome the fact that it's easily accessible, especially if follow-up visits are necessary.

When patients are very unhappy, however, convenience considerations may go out the window -- meaning low satisfaction scores will translate to low loyalty scores. In such cases, which seem to occur particularly frequently among 18- to 35-year-old emergency department patients and 36- to 55-year-old inpatients, dissatisfaction is clearly driving patients not to return to a facility.


Gallup https://news.gallup.com/poll/14005/Patient-Loyalty-Whats-Age-Got-It.aspx
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