‘’Patients prioritise medical expertise above all other factors’’

What prompted BCG to undertake this study? What was the rationale behind initiating it?

Priyanka Aggarwal

BCG undertook this research last year in 2013 as a joint initiative of the Healthcare Practice and Center for Consumer and Customer Insight (CCCI ). There was a need felt to better understand insights from a patient lens. It has become imperative to understand how patients select a hospital for treatment and what drives their satisfaction once they are receiving an OPD or IPD treatment at a hospital.

This is the first-of-its-kind research in India. In our discussions with different hospital chains, they all received this very well and said it really added robustness and nuance to their understanding of drivers of patient satisfaction and will help inform their decisions on where to invest for improving patient experience.

You have identified four broad drivers of patient satisfaction: medical expertise, pricing and process efficiency, care and patient comfort, and facilities. Which of these scored more points with the patients, which factor did they give more precedence to and why?

From the results of the study, medical expertise drives a third (33 per cent) of the overall satisfaction, pricing and process efficiency drives another 30 per cent of the satisfaction, care and patient comfort drives 25 per cent of the satisfaction and facilities drives 12 per cent.

What are the key learnings from the study for hospital providers?

Implications for providers are clear :

1. They should focus on giving patients tangible experience on medical expertise through efforts like establishing clear metrics and sharing data on outcomes for different conditions
2. They should build uniform and consistent processes to provide smooth, hassle-free and predictable experience across processes along the patient value care (e.g., uniform expected waiting time, time taken to get admitted etc)
3. Finally they should enhance their organisational capability to provide good service experience to the patients (e.g., interaction with nurses, doctors, other staff)

How predictive were the results of the study? Any surprising outcomes?

We had six sets of insights that we have detailed out in the study:

• Medical expertise, more than patient satisfaction, drives hospital selection: When first selecting a hospital, patients prioritise medical expertise above all other factors. However in the absence of tangible metrics to measure medical quality, patients rely on proxies to judge hospitals on medical quality like quality of interaction with nurses, staff and non-medical processes like time taken to get admitted etc.
• Process excellence is essential: Over the course of care, many non-medical processes determine patient satisfaction significantly – e.g., efficiency of service (not having to wait too long), predictable processes and wait time for different tests that are done.
• Pricing transparency rivals price: Patients care about transparency in billing as much as actual price of the treatment. They do not like to be surprised – this can be a big source of dissatisfaction
• Focus on the basics: Luxuries have little impact on patient satisfaction, but they expect basic standards of service – hygiene, clean drinking water and food services.
• Institutional quality trumps the reputation of doctors: While doctor reputation is important in attracting first time patients, it is less critical in driving loyalty. Patients are more likely to come back to the hospital if they are satisfied with overall medical care and non-medical processes experienced during their treatment.
• Personal referrals reign, but the role of Internet is increasing: Referrals and word-of-mouth is the biggest source of information and influence on decision making, but significant proportion of patients (~20 per cent) now use Internet to research/ look for information.

The study covers respondents from cities, do you intend to scale it up in the recent future? Would these findings corroborate with the views of the patients in rural India?

The focus of the study is urban centres – 1000 patients were surveyed across 19 cities. The interviewees — men and women of all ages with diverse socioeconomic and other demographic profiles—received care from seven of the top private hospital chains.

The drivers of selection and satisfaction would perhaps be very different in rural India – that was not part of the scope of the study. We undertake research from time to time, to deepen our knowledge base or in response to specific client requirements.

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