Boomers give health care failing grade

Get ready for baby boom invasion, study shows

(Editor's note: In 13 more years, the first of the baby boom generation will turn 65, becoming the heaviest users of the health care system. Do you know what the boomer patients will want? And are you ready to satisfy them? In this first part of a series on boomers and health care, we'll find out why boomers aren't happy about the current health care system.)

Baby boomers - that generation born between 1946 and 1964 - have changed everything they've touched. In addition to spurring rock 'n' roll, mutual funds, and suburbia, this generation of 77 million will also redefine health care, warns Mary Malone, MS, JD, CHE, executive director at Press, Ganey Associates Inc., a health care satisfaction measurement firm in South Bend, IN.

"As a whole, they are relatively more affluent, which means they have money to spend on alternative care, and more educated, which means they are more informed - and they lack patience," she explains. "And what things are health care providers known for? Their paternalistic approach to giving information and designing care around their needs without regard for convenience or desires of the patient."

The firm's recently released report, The Boomer Generation and Health Care, predicts the health care industry will be "forced to restructure to find better ways to serve and satisfy this generation that has been described as consumer-driven, extremely mobile, distrustful of institutions, and self-centered."

Not happy with the status quo

The study confirms that those under the age of 50 aren't happy with the status quo.

The analysis shows patients under the age of 50 are less satisfied with acute and home care experiences in particular when compared with those in the generation in front of it, Malone explains.

The study, which analyzed more than a million responses from inpatients, revealed baby boomers had a mean satisfaction score of 83.1, significantly lower than scores for generations born during World War II, the Depression, and before 1930. (See top chart, p. 58.)

Responses from more than 18,000 home care patients confirmed that boomers were less satisfied in that setting as well. For example, boomers had a mean satisfaction score of 86.98, which was lower than other generations. (See bottom chart, above.)

After determining that the boomers were less satisfied, the researchers looked to see what other differences existed by exploring these issues:

· Were older people more satisfied with the friendliness of nurses?

· Were younger people less satisfied with the way their visitors were treated?

· Are the issues that influence patient satisfaction different for older and younger patients?

"What we found was that older patients [those over 51 years of age] rated their care higher than younger patients [those under 50] on all 49 questions on our survey," Malone says.

For example, the quality of food, the issue with the greatest point spread, was rated more than five points higher by the older generations than the younger.

Yet Malone cautions that although there were generational differences in care ratings, the top five important issues ranked the same despite the age.

"No matter whether the patient is older or younger, the factors most closely associated with recommending the hospital to others were interpersonal issues, interactive skills, and caring behavior," she says.

For example, the No. 1 issue for those younger and older than 50 is the "staff sensitivity to the inconvenience that health problems and hospitalization can cause."

"No longer is simply treating the physical manifestation of the disease enough," she says. "Health care staff at all levels must respond to the entire range of socio-emotional issues that accompany the physical problem," she says.

For example, providing a truly patient-focused model of care for this up-and-coming generation will require a change in perception to the fact that people are more than their disease.

"Staff will need to see them not just as a sick patient in a body that needs repair but as a whole person who has roles outside of that of the patient," she explains. "And those roles don't go away just because you are sick."

How might facilities begin to improve on their perceptions? "First, realize that in many places, health care is still focused on our own internal turfdoms," she says. "We still have an us vs. them mentality that doesn't allow us to focus on the patient."

In addition, she says that most organizations fail to consider the fact that hospitalized employees make effective focus groups. "Tap into their experiences. Find out what your care delivery system is really like," she advises.

Health care systems that don't take up the baby boomer challenge to provide holistic, patient-focused care may find themselves falling behind competitors that do.

It is this lack of holistic approach that makes boomers unhappy with the current system, says Malone, citing the report's projections of their "demands."

Baby boomers, it says, will:

· seek "healthy" aging;

· pore over self-help books, videos, and databases - and constantly seek more information;

· demand convenience and excellent service;

· ask for evidence of quality and expertise;

· refuse to accept advice at face value;

· explore alternative therapies.

And they're likely to get it, she warns. "Remember baby boomers will have read the books on customer service and embraced the concepts of 'wowing the customer' in their own fields. This generation will raise the bar on customer satisfaction," she says. "And they're a generation accustomed to getting what they want. Remember Vietnam?"