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Public Reputation Of A Hospital And Its Healthcare

Hospitals exist to provide patients healthcare services. The appearance of the hospital can either make the patient want to come to the hospital or it can deter them from it. A good atmosphere helps to make people more comfortable, something that is important with hospitals that aim to provide “patient-centered care” (Frampton & Charmel, 2009). In addition, the hospital reputation is important because it is how people perceive a hospital based on their experiences. The study’s aim is to determine how people rank the outer appearance, the inner appearance, and the reputation of a hospital in terms of importance in choosing a hospital facility.

Research Questions

How do people rank the outer appearance of a hospital in terms of importance in choosing a healthcare facility?

How do people rank the inner appearance of a hospital in terms of importance in choosing a healthcare facility?

How do people rank the public reputation of a hospital in terms of importance in choosing a health care facility?

Purpose of the study

The study expects to establish a relationship between how people choose a certain healthcare facility and the factors involved in making that decision. The factors being analyzed are the inner appearance, outer appearance, and the reputation of a hospital. The study hopes to provide new and valuable information on how hospital chains can market to potential patients.


It is assumed the study participants will answer questions on the questionnaire and computer generated test honestly and to the best of their ability.

Definition of terms

Aesthetics. “The study of the mind and emotions in relation to the sense of beauty” (, 2010).

Community health fair. A fair provided for the community where healthcare businesses can provide free services for individuals and disseminate useful health information about various topics.

Differentiate. Marketing term used to describe a product or service strategy used to stand out from the competition.

Marketing. “The process of planning and executing the conception, pricing, promotion, and distribution of ideas, goods, and services to create exchanges that satisfy individual and organizational objectives” (Berkowitz, 2006, p.2).

Background and Significance

In the United States alone, there are over 6,000 hospitals, and these contribute to “30% of the total annual healthcare expenditures” (Nowicki, 2006, p. 2). Numerous hospitals out there face difficulties on how to market to potential patients. With increasing competition these days, it is hard for facilities to differentiate themselves from one another. According to Nowicki, “hospitals, facing increasing competition for patients, have found themselves in a price war.” Therefore, “greater attention has been given to marketing and public relations programs” (Nowicki, 2006, p. 5).

There have been studies related to hospital marketing in which aesthetics, or appearances, of hospitals resulted in better health care outcomes (Caspari, Eriksson, & Naden, 2006). There were also studies done previously on patient satisfaction. In addition, many studies have proven that hospital reputation is an important consideration point for customers when choosing a hospital. However, no studies have considered the factors of hospital appearances and reputation together, in choosing a facility. The study of this problem is significant, as it will help to ascertain whether hospitals should market to potential patients based on outer appearance, inner appearance, or reputations of a facility.

Literature Review

Healthcare marketing is a significant topic and requires extensive analysis and study.. Healthcare marketing might seem like a common concept these days, but it was not introduced to the industry until the 1970s. “In 1975, Evanston Hospital in Evanston, Illinois, was one of the first hospitals to establish a formal marketing staff position. Now, more than 30 years later, marketing has diffused throughout health care into hospitals, group practices, rehabilitation facilities, and other health care organizations” (Berkowitz. 2006, p.3). This field is rapidly developing, and these facilities need to know how to market to potential patients.

The existing literature revealed that studies of hospital aesthetics were taken into consideration in relation to the result of health and wellness outcomes (Caspari, Erikkson, & Naden, 2007). The study aimed to ascertain the role of aesthetics on the health and well-being of patients, and how these measures of aesthetics were handled by facilities. Aesthetics can influence how people feel about a certain facility, however, it cannot measure what factors people assess when choosing a facility.

Patient preference when choosing a healthcare facility can depend on different factors.. A study by Burge, Devlin, Appleby, Rohr, and Grant suggests, “Where the reputation of an alternative (shorter wait) hospital is either worse than the existing (longer wait) hospital or simply unknown, patients place a relatively high negative valuation on the choice (Burge et al., 2005, p.16). Negative reputation to a healthcare facility can make the people avoid that facility overall.

Harris, McBride, Ross, and Curtis did a study that showed that various environmental factors can lead to higher satisfaction within people. Analysis indicated, “interior design, architecture, housekeeping, privacy, and the ambient environment were all perceived as sources of satisfaction (Harris et al., 2006, p.2). The environmental factors and the architecture of the hospital really affected the way people felt about the facility. People tend to be much more satisfied in a place where they can feel comfortable.

Patient satisfaction is an aspect that has been measured before but it is usually determined after the patient’s visit to a particular facility (Baalbaki, Ahmed, Pashtenko, & Makarem, 2008). This particular study, mentioned above, explored the patient/consumer satisfaction once they are discharged from emergency room settings of the healthcare setting. It also explored the reasons and patterns behind the consumer satisfaction or dissatisfaction after their discharge from the facility.

A study done by Cheng, Yang, and Chiang explored a different route in determining patient satisfaction after their visit to the hospital (Cheng, Yang, & Chiang, 2003). The procedure involved getting feedback from patients with four specific conditions after discharge via telephone survey. This study implied that the hospitals that received the highest level of recommendation did not necessarily have the highest percentage of customer satisfaction. Due to the implication in this study, we were able to delve more into our study of what factors the patients consider when choosing a particular facility.

“The design of the physical facility can differentiate a firm from its competitors and signal the market segment that the service is intended for,” (Bitner, Gremler, & Zeithaml, 2009, p. 323). Therefore, the outer and inner appearances of a building are important factors to consider because they can be used as marketing tools to differentiate themselves from the competition. Moreover, many studies have proven that the reputation of the hospital is one of the factors used by customers to choose a hospital facility (Pope, 2009). Considering the points listed above led to the factors of hospital appearances and reputation as determinants for hospital choice by potential patients.


The study takes place at a community health fair at the Crockett Special Events Center in Austin, Texas. The purpose for the study taking place at a setting like a community health fair is so that it is on a neutral ground, free of biases from any particular hospital chain. This in turn allows the study to be highly generalizable and benefit any community hospital chain that seeks information on appropriate methods of marketing to potential patients.

Sampling Design

The event is approximately five hours long and is expected to have an attendance of about 500 people. The demographics of the health fair represent a diverse population segment to take part in the study, therefore minimizing possibilities of bias that could occur. Moreover, this population is attending the fair because they have some kind of interest in healthcare, and therefore make up a suitable study sample. Since the study is easy to participate in, it is expected about half of those attending the health fair are taking part in the study. Therefore, the sample size consists of 250 individuals and of anyone who attends the health fair that wants to take part in the study. The sample is a captive audience because they consist of those already at the health fair.

In order to attract such a large number of individuals for the study, incentives are provided at the health fair. These incentives consist of gift cards given to each participant who takes part in the study. The gift cards are at twenty dollar value and are to the place of the participant’s choice. These are given to the participants once they have completed the study to ensure they complete all the steps. In addition to gift cards, a table of refreshments is provided at the site of the study. The money for these incentives is included in the overall budget of the study.

Research Instruments to be used

At the health fair, a station is set up where there are questionnaires and computer generated tests. First, participants are asked to fill out written questionnaires. Once those are completed, they are asked to take a computer generated test. Therefore, the same groups of people are tested in the duration of the study. Both of these tests are designed to see what individuals feel are important in choosing a hospital facility and allow them to rank the factors being assessed in terms of importance in choosing a facility.

The first part of the study involves questionnaires which will be quantified to see which factor is most important in deciding which facility to choose. The next part of the study consists of a computer generated test, which will also be quantified to see which factor is most important in choosing a facility. Then both of these sets of data will be compared to see whether the data is in accordance with one another. The written questionnaires consist of two parts. The first section of the questionnaire contains questions in which the responses are in Likert- like format. In the questionnaires, specific questions are asked regarding patients’ perceptions towards how important they ascertain hospital appearance and reputation are in regards to choosing a facility. For example, the questionnaire could ask a question such as “how important is outer appearance in choosing a hospital facility?” The answers to this question are in a Likert-like scale, ranging from not important to very important. A series of these types of questions are asked to measure the importance level of each factor being assessed according to the individuals who take the test. The second half of the questionnaire consists of questions comparing the different factors being assessed in terms of importance relative to one another. For instance, a question could be posed such as, “which is more important in choosing a hospital facility outer appearance, inner appearance or neither?” By asking questions that compare the two factors with another, the questionnaire can determine how important the different factors are relative to one another. Therefore, the first part of the questionnaire measures how important individuals feel the factors like inner appearance, outer appearance, and reputation are in general; while the second half measures how individuals rank the factors in terms of importance relative to one another.

Once the questionnaires have been completed, the participants take a computer generated test. The computer test has a set of detailed instructions explaining exactly how to take the test and the purpose behind it. Once the participant has read the instructions, there is a small 15 second example of how to answer a question with a brief explanation of what the answer implies for the purposes of the test. This test ensures that the participant fully understands how to use the test, therefore making it more accurate as well as reliable as a measuring tool.

The test consists of a series of a pair of pictures that are shown. Each time, the individual chooses the picture that relates to the factor he or she feels is most important in choosing a facility. In the test, images of the outside of a hospital represent outer appearance, while images of the inside of a hospital, such as the lobby or the hallways, represent inside appearance. In addition, images of a fake headline represent reputation. At the beginning of the test, the pictures start out all different. Throughout the test, different combinations of all of the pictures are tested in order to assess which factors are truly considered important. As one goes through the test, those pictures chosen as favorites in the test are tested against each other. Therefore, in the end of the test, the individual is left with one picture, which represents the factor that is most important to him or her in choosing a facility.

Study Design

This study is quantitative in nature. The data to be obtained from both methods mentioned above will be counted, thus resulting in frequency data. Furthermore, the study takes place within a day at a community health fair. The duration of the fair is approximately five hours, and therefore the study takes place in that amount of time. It is a cross-sectional study because the study looks at a specific point in time (Griffiths, 2009).


As previously mentioned, the first part of the study consists of participants filling out questionnaires. The responses that are filled out will be quantified to see which factor is most important in choosing a facility. The next part of the study consists of participants taking a computer generated test. The results of these tests will also be quantified in order to see which factor is most important in choosing a facility. The data that will be obtained from both the questionnaires and the computer generated tests will be frequency data.

Once the responses are all quantified, two separate analysis of variance (ANOVA) tests will be performed; one for the questionnaires and one for the computer generated tests. An ANOVA test would be most appropriate to use because there are three factors being assessed, and therefore three different groups of data are to be analyzed (Munroe, 2005). These tests will show how the different groups vary among each other, and then the two tests together can be compared to see if the data is in accordance. The p-value would be set at .05, with a confidence interval of 95. Because the data is all quantifiable, clear results of what factor is most important can be accessed from the study.


The study hopes to establish a relationship between how people choose their hospitals and the factors being assessed. It is hoped that the data sets obtained from each of the methods will be in accordance, thus providing hospitals with information on which of the three factors being measured are the most important to patients in choosing a facility. This information is critical to the health care industry in order for hospitals to market themselves to potential patients appropriately.


Although the study focuses on the appearance and reputation of a hospital, these factors are only a small portion of the thinking process that takes place when considering a facility. Other important factors are: the types of services provided by the hospital, the quality of instruments used, the clinical care provided, and better technology. In addition, the study uses fake headlines to represent the reputation of a facility. Depending on what the headline says, this could potentially cause responses to the computer test to be biased.


This study is designed in order to assess what is important to individuals in choosing a hospital facility. This is important so that hospitals can know how to differentiate themselves from the increasing competition in the industry. In this study, questionnaires and computer generated tests are used in order to find out what is most important in choosing a facility. From the data collected, the study hopes to find new and reliable information that will help with healthcare marketing. With a struggling economy, and the need to conserve resources from every angle possible, it is important that hospitals know how to market themselves to patients in an effective and efficient manner. This study hopes to provide information from the perspective of potential patients, which can be used by community hospital chains of all kinds looking to market to patients successfully.

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