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Attitudes Toward Hospitals - US - January 2011

With more than 5,000 hospitals in the country, the hospital category is extremely diverse, ranging from large public hospitals in urban centers, to prestigious teaching institutions, to small rural facilities. The American public’s view of the category is just as diverse, showing the opportunity for targeted marketing that speaks to the needs of various demographics. Some of the topics covered in this expansive report include:

  • A detailed analysis of the hospital category, including short- and long-term trends affecting the well-being of hospitals
  • Respondents’ attitudes toward private, teaching and public hospitals, along with specific recommendations to capitalize on consumer wants and desires
  • How urgent care and in-store clinics are redefining the category and consumer expectations
  • How respondents gather information about hospitals, and what marketers can do to better reach consumers
  • What drives hospital selection, and how advertisers can position their institutions to be more appealing
  • Consumer attitudes toward hospital care, with suggestions for addressing brand dilution and leveraging social media

The hospital category is expansive and complex, but this report uncovers the most important issues and provides numerous suggestions for strategies and tactics. As a result, hospital marketers will be empowered to develop more effective campaigns and stronger brands.

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Table of contents

  1. Scope and Themes

    • What you need to know
      • Definition
        • Data sources
          • Consumer survey data
            • Advertising creative
              • Abbreviations and terms
                • Abbreviations
                  • Terms
                  • Executive Summary

                    • Snapshot of the hospital category
                      • Snapshot of the Emergency Department (ED)
                        • Financial struggles lead to a decline in the number of hospitals
                          • Urgent care and in-store clinics seize on hospitals’ troubles
                            • Attitudes toward private, teaching, and public hospitals
                              • Private hospitals
                                • Teaching hospitals
                                  • Public hospitals
                                    • Gathering information and reasons for hospital visit
                                      • Reasons for picking a hospital
                                        • Impressions of hospital care
                                        • Insights and Opportunities

                                          • Making the most of marketing
                                            • The doctor will see you now
                                              • You can trust us
                                                  • Figure 1: Positive feelings toward consumers’ hospital, by age, October 2010
                                                • The double-edged sword of medical errors
                                                • Inspire Insights

                                                    • Trend: Horizontal Communities
                                                      • Horizontal communities in hospitals
                                                        • The benefits of Horizontal Communities
                                                        • Hospital Statistics

                                                          • Key points
                                                            • The health of hospitals: a time of transition
                                                                • Figure 2: Number of hospitals, 1975-2007
                                                              • Snapshot of teaching hospitals
                                                                • Figure 3: Number and type of teaching hospitals, 2007
                                                                • Figure 4: Location of teaching hospital by top five states, 2007
                                                              • Most common reasons for hospital visits
                                                                • Older Americans disproportionately count for discharges
                                                                  • Childbirth drives hospital visits
                                                                    • Hospital stays
                                                                      • Figure 5: Most common reasons for hospital stays, by gender, 2008
                                                                      • Figure 6: Number of discharges, by age and gender, 2000, 2004, 2008 National statistics
                                                                    • Cost of hospital care and length of stay
                                                                        • Figure 7: Inflation-adjusted hospital costs, by principal diagnosis, 1997, 2002, and 2008
                                                                        • Figure 8: Mean costs for all discharges, by age and gender, 2000, 2004, 2008 national statistics
                                                                    • Emergency Room Statistics

                                                                      • Key points
                                                                        • The ED: Treating the poor and chronically ill
                                                                            • Figure 9: Overview of emergency department visits, adults 18+, U.S., 2008
                                                                            • Figure 10: ED visits for acute and/or chronic conditions, adults 18+, U.S., 2008
                                                                          • The government is the chief payer
                                                                            • Figure 11: Percentage of visits by expected payer, adults 18+, U.S., 2008
                                                                        • Hospital Attitudes and Preferences

                                                                          • Key points
                                                                            • Private hospitals have positive associations
                                                                                • Figure 12: Hospital preferences and attitudes, by hospital type, October 2010
                                                                            • Private Hospitals

                                                                              • Key points
                                                                                • Males more likely to report private hospitals as preferred type
                                                                                  • Figure 13: Private hospital preferences, by gender, October 2010
                                                                                • Parents like private hospitals
                                                                                  • Figure 14: Private hospital preferences, by presence of children in HH, October 2010
                                                                                • Affluent prefer private hospitals
                                                                                  • Figure 15: Private hospital preferences, by household income, October 2010
                                                                                • Positive attributes of private hospitals
                                                                                  • Short wait times, quality care, and cleanliness
                                                                                    • Figure 16: Positive attributes of private hospitals, by gender, October 2010
                                                                                  • Parents with children like everything about private hospitals
                                                                                    • Figure 17: Positive attributes of private hospitals, by presence of children in HH, October 2010
                                                                                  • Affluent think private hospitals excel at most things
                                                                                    • Figure 18: Positive attributes of private hospitals, by household income, October 2010
                                                                                  • Older respondents less skewed toward private hospitals
                                                                                    • Figure 19: Positive attributes of private hospitals, by age, October 2010
                                                                                  • Negative attributes of private hospitals
                                                                                    • Private hospitals less likely to be viewed negatively across demographics
                                                                                      • Figure 20: Negative attributes of private hospitals, by gender, October 2010
                                                                                      • Figure 21: Negative attributes of private hospitals, by age, October 2010
                                                                                  • Teaching Hospitals

                                                                                    • Key points
                                                                                      • Preference for teaching hospitals
                                                                                        • Preference low across the board, slightly higher among women
                                                                                          • Figure 22: Teaching hospital preferences, by gender, October 2010
                                                                                        • Older respondents more open to teaching hospitals
                                                                                          • Figure 23: Teaching hospital preferences, by age, October 2010
                                                                                        • Affluent prefer teaching hospitals
                                                                                          • Figure 24: Teaching hospital preferences, by household income, October 2010
                                                                                        • Positive attributes of teaching hospitals
                                                                                          • Modern equipment, best doctors, and updated facilities
                                                                                            • Figure 25: Positive attributes of teaching hospitals, by gender, October 2010
                                                                                          • Older respondents view teaching hospitals more favorably
                                                                                            • Figure 26: Positive attributes of teaching hospitals, by age, October 2010
                                                                                          • Higher-income respondents more likely to view teaching hospitals favorably
                                                                                            • Figure 27: Positive attributes of teaching hospitals, by household income, October 2010
                                                                                          • Negative attributes of teaching hospitals
                                                                                            • An inexperienced staff
                                                                                              • Figure 28: Negative attributes of teaching hospitals, by gender, October 2010
                                                                                          • Public Hospitals

                                                                                            • Key points
                                                                                              • Preference for public hospitals
                                                                                                • Men more likely than women to prefer public hospitals
                                                                                                  • Figure 29: Public hospital preferences, by gender, October 2010
                                                                                                • The less affluent prefer public hospitals
                                                                                                  • Figure 30: Public hospital preferences, by household income, October 2010
                                                                                                • Positive attributes of public hospitals
                                                                                                  • Public hospitals rate consistently low on positive attributes
                                                                                                    • Figure 31: Positive attributes of public hospitals, by gender, October 2010
                                                                                                  • The less affluent have more positive opinions of public hospitals
                                                                                                    • Figure 32: Positive attributes of public hospitals, by household income, October 2010
                                                                                                  • Negative attributes of public hospitals
                                                                                                    • Staff is inexperienced and overworked
                                                                                                      • Figure 33: Negative attributes of public hospitals, by gender, October 2010
                                                                                                      • Figure 34: Negative attributes of public hospitals, by age, October 2010
                                                                                                  • Market Drivers

                                                                                                    • Key points
                                                                                                      • An aging America will go to the hospital more frequently
                                                                                                        • Figure 35: Population, by age, 2006-16
                                                                                                        • Figure 36: Top 10 states ranked by population and percent of U.S. population age 65 and older, 2005
                                                                                                      • Hospitals are inhospitable
                                                                                                        • The special needs of Hispanics
                                                                                                            • Figure 37: U.S. Hispanic population, by age, 2006-16
                                                                                                          • Diseases on the rise
                                                                                                            • Lack of health insurance hurts hospitals
                                                                                                                • Figure 38: Type of health insurance coverage for persons younger than 65, 1997-2009
                                                                                                                • Figure 39: Americans younger than 65 without health insurance coverage, by age group and race/Hispanic origin
                                                                                                              • The Patient Protection and Affordable Care Act should help hospitals
                                                                                                              • Competitive Context

                                                                                                                • All hospitals are created equal
                                                                                                                  • Who needs the ED when urgent care is in the strip mall?
                                                                                                                    • In-store clinics at pharmacies: quality, affordable care without the hassle
                                                                                                                      • In doctors we trust
                                                                                                                        • Figure 40: Whom/what consumers turn to for immediate health needs, by gender, October 2010
                                                                                                                    • Innovation and Innovators

                                                                                                                      • Overview
                                                                                                                        • Celebrity and high-profile partnerships at St. Jude Children’s Research Hospital
                                                                                                                          • Mobile initiatives
                                                                                                                            • Partnering with sports franchises
                                                                                                                              • Luxury hospital stays
                                                                                                                                • Other interesting initiatives
                                                                                                                                • Marketing Strategies

                                                                                                                                  • Overview of the brand landscape
                                                                                                                                    • Massachusetts General Hospital: a scholarly and sophisticated teaching hospital
                                                                                                                                      • High-profile partnerships
                                                                                                                                        • Healthy online marketing efforts
                                                                                                                                          • A busy special events calendar
                                                                                                                                              • Figure 41: Massachusetts General Hospital television ad, 2010
                                                                                                                                            • Brigham and Women’s Hospital: a private hospital with a caring face
                                                                                                                                              • Figure 42: Brigham & Women’s hospital television ad, 2010
                                                                                                                                              • Figure 43: Brigham & Women’s hospital television ad, 2010
                                                                                                                                            • The Mayo Clinic: a not-for-profit hospital sharing its expertise
                                                                                                                                              • Figure 44: Mayo Clinic television ad, 2010
                                                                                                                                            • Billboards are a popular tactic
                                                                                                                                            • Hospital Visits

                                                                                                                                              • Key points
                                                                                                                                                • Almost eight in 10 visited hospitals within past five years
                                                                                                                                                  • Figure 45: Last hospital visit, by gender, October 2010
                                                                                                                                                • Bumps, bruises, and breaks take parents to the hospital
                                                                                                                                                  • Figure 46: Last hospital visit, by children in household, October 2010
                                                                                                                                                • Least affluent least likely to go to the hospital
                                                                                                                                                  • Figure 47: Last hospital visit, by household income, October 2010
                                                                                                                                              • Reason for Hospital Visit

                                                                                                                                                • Key points
                                                                                                                                                  • Males more likely to go to the ED for injury
                                                                                                                                                    • Figure 48: Reason for last hospital visit, by gender, October 2010
                                                                                                                                                  • Parents going for childbirth and the ED
                                                                                                                                                    • Figure 49: Reason for last hospital visit, by children in household, October 2010
                                                                                                                                                  • Planned surgery for 55 and older
                                                                                                                                                    • Figure 50: Reason for last hospital visit, by age, October 2010
                                                                                                                                                  • Income affects reason for visit
                                                                                                                                                    • Figure 51: Reason for last hospital visit, by household income, October 2010
                                                                                                                                                • Factors Driving Hospital Selection

                                                                                                                                                  • Key points
                                                                                                                                                    • Doctor drives choice of hospital
                                                                                                                                                      • Figure 52: Selecting a primary doctor/hospital, by gender, October 2010
                                                                                                                                                    • Seven in 10 can pick a hospital
                                                                                                                                                      • Figure 53: Lack of choice in hospital selection, by household income, October 2010
                                                                                                                                                    • Over-45s pick hospitals and doctors together
                                                                                                                                                      • Figure 54: Selecting a primary doctor/hospital, by age, October 2010
                                                                                                                                                    • Affluent more likely to be able to choose a hospital
                                                                                                                                                      • Figure 55: Selecting a primary doctor/hospital, by household income, October 2010
                                                                                                                                                    • Unmarried and with limited choices in choosing a hospital
                                                                                                                                                      • Figure 56: Selecting a primary doctor/hospital, by marital status, October 2010
                                                                                                                                                  • Important Criteria in a Hospital

                                                                                                                                                    • Key points
                                                                                                                                                      • Location, location, location
                                                                                                                                                        • Figure 57: Most and least important reasons for selecting most recent hospital visited, October 2010
                                                                                                                                                      • Respondents aged 65+ value convenience, speed
                                                                                                                                                        • Figure 58: Most and least important reasons for selecting most recent hospital visited, by age, October 2010
                                                                                                                                                      • Parents less concerned with convenience
                                                                                                                                                        • Figure 59: Most and least important reasons for selecting most recent hospital visited, by children in household, October 2010
                                                                                                                                                    • Gathering Information

                                                                                                                                                      • Key points
                                                                                                                                                        • Women turn to doctors, the internet
                                                                                                                                                          • Figure 60: Sources turned to for information on hospitals, by gender, October 2010
                                                                                                                                                        • 18-34s turn to friends and go online to get information
                                                                                                                                                          • Figure 61: Sources turned to for information on hospitals, by age, October 2010
                                                                                                                                                        • More educated rely on the internet and newspapers
                                                                                                                                                            • Figure 62: Sources turned to for information on hospitals, by education, October 2010
                                                                                                                                                        • Impression of Hospitals and Quality of Care

                                                                                                                                                          • Key points
                                                                                                                                                            • You have to experience a hospital to really know it
                                                                                                                                                              • Figure 63: Quality of hospital care, by gender, October 2010
                                                                                                                                                            • Young consumers tend to see little difference between hospitals; those aged 65+ disagree
                                                                                                                                                              • Figure 64: Quality of hospital care, by age, October 2010
                                                                                                                                                            • Affluent respondents: All hospitals are not created equal
                                                                                                                                                              • Figure 65: Quality of hospital care, by household income, October 2010
                                                                                                                                                          • Impressions of Hospitals

                                                                                                                                                            • Key points
                                                                                                                                                              • The doctor and staff create impressions
                                                                                                                                                                • Figure 66: Hospital impressions and recommendations, by gender, October 2010
                                                                                                                                                              • Older respondents more likely to base impressions on how they are treated
                                                                                                                                                                • Figure 67: Hospital impressions and recommendations, by age, October 2010
                                                                                                                                                              • Those from higher-income households more likely to be worried about cleanliness
                                                                                                                                                              • Anticipated Hospital Selection Criteria

                                                                                                                                                                  • Key points
                                                                                                                                                                    • Haven’t been to hospitals in the past five years
                                                                                                                                                                        • Figure 69: Last hospital visit more than five years ago, by gender, age, and household income, October 2010
                                                                                                                                                                      • Cost and convenience most important criteria
                                                                                                                                                                        • Figure 70: Anticipated most and least important reasons for selecting a specific hospital, among those who have not been in to the hospital in the past five years, October 2010
                                                                                                                                                                      • Women like hospitals to be approachable
                                                                                                                                                                          • Figure 71: Anticipated most and least important reasons for selecting a specific hospital, among those who have not been in to the hospital in the past five years, by gender, October 2010
                                                                                                                                                                      • Race and Hispanic Origin

                                                                                                                                                                        • Key points
                                                                                                                                                                          • Hispanics and blacks more likely to have visited hospitals in the past year
                                                                                                                                                                              • Figure 72: Last hospital visit, by race/Hispanic origin, October 2010
                                                                                                                                                                            • Blacks going for unscheduled emergency illness care
                                                                                                                                                                              • Figure 73: Reason for last hospital visit, by race/Hispanic origin, October 2010
                                                                                                                                                                            • Asians think private hospitals provide quality care
                                                                                                                                                                              • Figure 74: Attributes of private hospitals and preferences, by race/Hispanic origin, October 2010
                                                                                                                                                                            • Blacks have favorable impressions of teaching hospitals
                                                                                                                                                                              • Figure 75: Attributes of teaching hospitals and preferences, by race/Hispanic origin, October 2010
                                                                                                                                                                            • Blacks, Hispanics think staff overworked at public hospitals
                                                                                                                                                                              • Figure 76: Attributes of public hospitals and preferences, by race/Hispanic origin, October 2010
                                                                                                                                                                          • Custom Consumer Groups

                                                                                                                                                                            • Luring moms-to-be with amenities
                                                                                                                                                                                • Figure 77: Reason for last hospital visit, by gender and age, October 2010
                                                                                                                                                                              • Children drive hospital visits
                                                                                                                                                                                  • Figure 78: Last time visited a hospital, by marital status and children younger than 18 in household, October 2010
                                                                                                                                                                                • The different needs of younger women (18-34) and older men (55+)
                                                                                                                                                                                    • Figure 79: Reasons for choosing hospital for last visit, by gender and age, October 2010
                                                                                                                                                                                  • Money matters to less-affluent men when it comes to picking a hospital
                                                                                                                                                                                      • Figure 80: Reasons for choosing hospital in the future, by gender and income, October 2010
                                                                                                                                                                                  • Appendix—Other Useful Consumer Tables

                                                                                                                                                                                    • More affluent pick doctor first
                                                                                                                                                                                      • Figure 81: Selecting a primary doctor/hospital, by household income, October 2010
                                                                                                                                                                                    • Respondents living with a partner pick hospitals for convenience and finances
                                                                                                                                                                                      • Figure 82: Most and least important reasons for selecting most recent hospital visited, by marital status, October 2010
                                                                                                                                                                                    • More affluent respondents turn to doctors for information
                                                                                                                                                                                      • Figure 83: Sources turn to for information on hospitals, by household income, October 2010
                                                                                                                                                                                    • Separated/divorced/widowed more likely to think first-hand experience is key
                                                                                                                                                                                      • Figure 84: Quality of hospital care, by marital status, October 2010
                                                                                                                                                                                    • Suburbanites turn to their physician
                                                                                                                                                                                      • Figure 85: Sources turned to for information on hospitals, by area, October 2010
                                                                                                                                                                                    • Whites turn to doctor; blacks and Hispanics, the internet
                                                                                                                                                                                      • Figure 86: Sources turned to for information on hospitals, by race/Hispanic origin, October 2010
                                                                                                                                                                                  • Appendix: Trade Associations

                                                                                                                                                                                    Companies Covered

                                                                                                                                                                                    • ABC, Inc.
                                                                                                                                                                                    • American Heart Association, Inc.
                                                                                                                                                                                    • Brinker International Inc.
                                                                                                                                                                                    • Centers for Disease Control and Prevention
                                                                                                                                                                                    • Centers for Medicare & Medicaid Services
                                                                                                                                                                                    • Clorox Company , The
                                                                                                                                                                                    • CVS Caremark Corporation
                                                                                                                                                                                    • Facebook, Inc.
                                                                                                                                                                                    • FOX Broadcasting Company
                                                                                                                                                                                    • Gallup Organization, The
                                                                                                                                                                                    • Google UK
                                                                                                                                                                                    • Hershey Company, The
                                                                                                                                                                                    • Johns Hopkins Arthritis Center
                                                                                                                                                                                    • National Broadcasting Company, Inc. (NBC)
                                                                                                                                                                                    • Reuters Group PLC
                                                                                                                                                                                    • Target Corporation
                                                                                                                                                                                    • The New York Times Company
                                                                                                                                                                                    • Twitter, Inc.
                                                                                                                                                                                    • U.S. Bureau of Labor Statistics
                                                                                                                                                                                    • U.S. Bureau of the Census
                                                                                                                                                                                    • Walgreen Co
                                                                                                                                                                                    • Washington Post Company (The)
                                                                                                                                                                                    • YouTube, Inc.

                                                                                                                                                                                    Attitudes Toward Hospitals - US - January 2011

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