The likelihood of patients to return to the same hospital is a
key indicator of a hospital's future financial performance. Gallup
has conducted extensive research on how to measure and improve
patient loyalty. But how might the public's perceptions of the
healthcare industry overall affect patients' likelihood to be loyal
to a specific hospital? Can those more general attitudes tell us
anything about the future of patient loyalty in America?
Determinants of Patient Loyalty
A recent Gallup study of more than 2,800 recently treated
patients from 52 facilities in 12 metropolitan areas indicates that
the following three factors are key determinants in the likelihood
of a patient to return to a healthcare facility:
- The patient's overall satisfaction with the services
provided
- The patient's perception regarding whether or not the hospital
is one of the best at treating the medical condition for which he
or she was hospitalized
- The patient's trust of the hospital to always provide
high-quality care
If patients report satisfaction with the care they received at a
particular hospital, but feel that another hospital may be better
able to treat their specific medical condition, or if they do not
trust the facility for some reason, then they are significantly
less likely to return than a patient who gives high scores on all
three of these criteria.
Patient Trust
Patients obviously can't be loyal to a hospital they don't
trust. According to the 2001 Gallup Patient Loyalty Database, a
majority of patients trust the hospitals at which they received
care. More than half of past patients in each service area measured
(discharged six to eight weeks prior to the interview) strongly
agree (giving a score of "5" on a scale of 1 to 5) that they trust
the hospital they used to always provide quality care.
Trust of Healthcare Professionals
In a November 2001 Gallup Poll* on the honesty and ethics of 23
professions, healthcare professionals were well represented. Nurses
ranked No. 2 on the list behind firefighters, with 84% of
respondents rating their honesty and ethical standards as "high" or
"very high." Doctors, pharmacists and dentists also all scored in
the top 10, as they almost always do when Gallup conducts this poll
each year. These results indicate that the high esteem that
patients have for healthcare personnel could be successfully
leveraged to increase patient loyalty.
Image of the Healthcare Industry
On the other hand, an August 2002 Gallup Poll** sought public
opinion on the images of 24 major business and industry sectors.
The healthcare industry was rated negatively by about half (49%) of
all respondents. Thirty percent gave a thumbs-up, giving the
healthcare industry a net negative rating of -19%, (19% more
respondents rated the industry negatively than rated it
positively). This is the lowest net negative rating of any of the
24 industries measured, and it has declined five points since 2001.
Positive ratings of healthcare decreased from 37% in 2001 to 30% in
2002. This poor overall rating of the industry, at the same time
that health professionals are rated positively, may result from the
fact that managers of HMOs typically rank near the bottom of
Gallup's annual audit of honesty and ethics in professions.
Key Points
Decades of Gallup polling have shown that it is not uncommon for
people to rate specific people or organizations with which they
have had contact more highly than they rate an industry as a whole.
However, the differences are particularly acute in the healthcare
area. Frequent news coverage about patient safety issues, rising
healthcare costs and decreasing accessibility to basic services
seem to have taken their toll on Americans' perceptions of the
healthcare industry.
An August 2002 Gallup Poll story (see "Health Care, Lawyers,
Energy and Accounting Suffer in Public's Eye" in Related Items)
noted that the low ratings of the healthcare industry "suggest a
significantly pent-up anger on the part of the population toward
their health care and drug system that could have significant
political effects in the months and years to come." Despite
relatively high levels of patient trust in the hospitals they have
used, and the fact that the public holds healthcare professionals
in high esteem, the negative image of the healthcare industry
suggests that there could be tough times ahead for hospitals
seeking to build patient and community loyalty.
*Results are based on telephone interviews with 1,025 national
adults, aged 18 and older, conducted Nov. 26-27, 2001. For results
based on the total sample of national adults, one can say with 95%
confidence that the margin of sampling error is ±3%.
**The results reported here are based on telephone interviews
with a randomly selected national sample of 518 adults, aged 18 and
older, conducted Aug. 5-8, 2002. For results based on the total
sample of national adults, one can say with 95% confidence that the
margin of sampling error is ±5%.
