Analysis of the loyalty of hospitals' loyal patients

Objectives: To investigate the trend of loyalty change for hospitals’ loyal patients and the factors associated with the continuity of patients’ loyalty. Methods: We utilized NHRI’s LHID2005 dataset to define ‘hospital loyal patients’ who had at least 50% of their ambulatory care visits in one of medical centers and regional hospitals in 2005. Patient’s loyalty was measured by the percent of ‘loyal’ visits among their total visits. We classified patients into those who continued their loyalty to the same hospital from 2005 to 2008 and those who did not, and applied logistic regression to identify the factors associated with the continuity of patients’ loyalty. Results: Loyal patients account for 19.7% and 16.3% of patients who ever visited medical centers or regional hospitals respectively in 2005. Average loyalty was about 78.1% in 2005 for both type of hospitals, but decreased rapidly to 46.5% and 38% in 2008. Loyal patients who were more likely to continue their loyalty were male, older, and with higher scores in Charlson’s comorbidity index and more outpatient visits in 2005. Medical expenses kept increasing in the following years for continuous loyal patients, while medical expenses were decreasing for discontinuous loyal patients. Conclusion: Hospital loyal patients are unlikely to keep their loyalty to one hospital over time. Therefore, hospitals were not able to be held totally accountable for these patients’ health care and financial responsibility. Health policy should reconsider the appropriateness of hospital loyal patient model in capitation demonstration.