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MarkeTrak Topics . Demographic indices
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1. MarkeTrak V Hearing Aid Industry Market Tracking Survey Sergei Kochkin, Ph.D.
Knowles Electronics, Inc.
June 1999
2. MarkeTrak Topics Demographic indices & trends
Customer satisfaction revisited
Hearing aids in the drawer
Subjective benefit
3. Demographic Indices National family opinion panel
80,000 households
13,492 hearing-impaired households
Detailed questionnaire 2,720 hearing aid owners.
Response rate 83%
No new survey to non-owners in MarkeTrak V.
4. Hearing Aid Market Penetration
5. Hearing-impaired User & Non-user Population
6. Hearing Loss Population by Age Group Owners versus Non-owners
7. Clinton Announcement Spurred “Baby Boomer” Potential Market Growth Clinton news release 10/97.
Survey taken 11/97.
Age 45-54 hearing loss growth =23%
$60k growth =35%
Some college growth = 30%
8. Physician Screening for Hearing Loss During Physical Exam
9. Binaural Penetration Trend
10. Hearing Instrument Fittings by Perceived Profession
11. Hearing Instrument Fittings by Source of Distribution (1997)
12. Third-party Payment Trend
13. Average Retail Price to Consumer
14. Age of Hearing Instrument
15. First Time User Rate
16. Factors Influencing New First Time Users to Purchase Factors less than 10% mentions:
Free HA (7%)
Price (6%)
Ad-magazine (5%)
HL Literature (3%)
Boss/co-worker (3%)
Newspaper (2%)
Direct mail (2%)
Ad - TV (1.5%)
17. Physician Recommendation Trends 1989 - HIA advertising to physician.
Current initiatives:
Mfg. screening kit
BHI - physician handbook
BHI - Academy of Family Physicians
AAA Best Practice
Family doctor (Positive)
ENT (Negative)
18. Key Trends Negative trends
hearing aid penetration
Static trends
hearing screenings by physicians
distribution penetration
Binaural penetration
19. Key Trends Positive trends
third party payment
first time users
repeat purchase
retail price (??)
Clinton - motivation of “Baby Boomers”
1 million new potential customers
20. Customer Satisfaction Revisited
21. Topics Trends 1991-1997 (1-5 years old)
Segmentation (1-5 years old)
Publishing of new research norms (3-12 months old)
Hearing aids in the drawer (total)
22. Method MarkeTrak Survey
4 behavioral items (hours, repurchase)
1 Quality of life
Likert Satisfaction Scale
8 Product features
12 Performance/value
13 Listening situations
6 dispenser attributes
Modified APHAB (21 point scale = 5%)
23. Customer Satisfaction by Age of Hearing Instrument
24. Amount of Time Spent Counseling New Users of Hearing Instruments
25. Customer Satisfaction as a Function of Time Spent with New Users
26. Multiple Environmental Listening Utility (MELU) is Critical to Satisfying Consumers
27. Perceptions of Benefit as a Function of Multiple Environment Listening Utility (MELU)
28. Quantifiable Client Oriented Scale of Improvement (COSI) MarkeTrak measures satisfaction in 13 listening situations (5 point scale).
Very Satisfied (+2) to very dissatisfied (-2)
Also “Importance” of hearing in these 13 listening situations (0-3 point scale)
Not important (0) to very important (3)
Score = Satisfaction x importance
Total score = Sum (all situations x need)/Total possible score
29. Quantifiable COSI - Strong Predictor of Perception of Benefit
30. U.S. Customer Satisfaction Trends No significant differences (H.A. 1-5 years.)
31. U.S. Customer Satisfaction New Hearing Instruments (<1 year) Declines (+5%)
Battery life
Adjust. V.C.
Value ($$/performance)
Gains (+5%)
Visibility
Localization
Outdoors
Place worship
Telephone
Post fitting service
32. Customer Satisfaction Trends MarkeTrak V significantly higher than:
MarkeTrak IV (1994) :
23 of 33 items (p<.01)
MarkeTrak III (1991):
4 of 33 items (p<.01)
33. Customer Satisfaction Trends Key improvements (1997 vs.1991 & 1994):
Outdoor enjoyment
Phone usage
Value
Explain care of hearing aids
Visibility ratings are lower than in 1991
34. The introduction of CICs Probably Caused Post-purchase Cognitive Dissonance with Visibility of Instrument
35. Satisfaction Segmentation by type of hearing loss
by style of hearing aid
Programmable/non-programmable
Telecoil
Hearing aids without volume controls
New user versus repeat user
Binaural versus monaural
36. Overall satisfaction by Style of Hearing Aid
37. Satisfaction by Style of Hearing Aid CIC rated superior on 15 attributes.
Visibility
Comfort with loud sounds
Listening situations (7 of 13)
Telephone, Outdoors, workplace, Groups, restaurant
CIC rated lower on battery life, V.C.
34% w/o a V.C. want one
38. Satisfaction by Style of Hearing Aid BTE rated significantly lower:
Ability to hear soft sounds
Difficult listening situations
Tell direction of sounds
BTE rated higher
Hours worn
Battery life
Are lower ratings due to degree of loss?
39. Customer Satisfaction by Perceived Level of Hearing Loss
40. Customer Satisfaction by Perceived Level of Hearing Loss Mild loss significantly lower on 13 attributes
Quality of life
Likelihood of repurchase/recommend HA
Wearing of aids
Perception of benefit
One-on-one communication
41. Customer Satisfaction by Perceived Level of Hearing Loss Profound lower on 15 attributes:
Perceived benefit
Fit and comfort
Ability to hear soft sounds
Localization
Whistling/feedback
Nearly all listening situations
Yet, they give the highest overall rating.
42. What about the volume control? 9% report they have none.
37% want one.
Big differences on satisfaction.
Should make sure consumer can live without a volume control.
43. The Binaural Advantage (Rated higher on 15 attributes)
44. The Telecoil Advantage (Rated higher on 8 attributes)
45. The Programmable Advantage (Rated higher on 37 attributes)
46. New Users More likely to be Dissatisfied with Their Experience 54% overall satisfaction new users
versus 63% for repeat users
New users rate 16 items lower
Quality of life (-21)
Recommend hearing aids (-12)
Repurchase , reliability (-10)
Battery life (-8)
New users rate 5 items higher
Able to hear soft sounds (+10), Large group (+7)
47. Key Findings Modest improvements since 1991
Major improvements since 1994
Strong advantage in favor of
Programmable
Telecoil
Binaural
CIC
Mild hearing loss & new users less satisfied
48. Key Findings CIC introduction - probable negative impact on larger instrument satisfaction.
Lack of a VC could depress satisfaction for some segments of users.
Importance of:
Counseling time spent with consumer
Multiple environmental listening utility (MELU)
Volume control to some users of CICs
49. Hearing Aids in the Drawer
50. Methodology Consumers who own a hearing aid but NEVER wear it = hearing aid in the drawer.
Hearing aids in drawer = 16.2% respondents.
Told to explain why non-use in MarkeTrak survey.
Received 348 letters.
Content coding yielded 567 comments.
51. Hearing Aids in the Drawer are Related to Age of the Instrument
52. 907,120 Customers do not Use Their Hearing Instruments
53. Reasons for Non-Use Poor benefit (30%) - 268,507
54. Reasons for Non-Use Poor Benefit “I threw it away it was worthless to me”
“I don’t see much difference with them. I feel I was sold one under false pretense. Don’t feel I really needed one”
“There is no improvement in my hearing with the aids. Where there is a slight improvement in my hearing, it is minimal.”
55. Reasons for Non-Use Poor Benefit “I don’t wear the aids at all. The problems appears to be clarity of words. Volume is OK but I can’t distinguish words”
“I have not been able to wear the H.A. since the day I received it. It was made wrong and the Company said there was nothing wrong with it.”
56. Reasons for Non-Use Poor Benefit “It is not worth the trouble or expense for the small difference in hearing. I wish I had my money back.”
“_____ aims at taking old people’s money for little value.”
“All the aids do is amplify the sound that I can’t discriminate with an aid in the ear.”
57. Reasons for Non-Use Poor Benefit “When ______sold me the H.A., I was confident it would help me hear better. When I received it and wore it every day, it did not make my hearing any better. So, I don’t wear the HA and feel like I wasted my money. I tried to return it and the person did not seem to want to help me. I am quite dissatisfied with the whole experience.”
58. Reasons for Non-Use Poor Benefit “I can’t hear high pitch sounds with the behind the ear model.”
“H.A.s amplify everything but human voices which is what you need to hear.”
“____plugs are not worth the price.”
59. Reasons for Non-Use #1. Poor benefit (30%) - 268,507
60. Reasons for Non-Use Background Noise “I will not wear my H.A. because it increases background noise. And therefore, after a while I get a headache and get somewhat nervous.”
“It catches all the sound on the road, TV, etc at the same time.”
“Background noise is distracting.”
61. Reasons for Non-Use Background Noise “H.A.s don’t work when there is a lot of background noise. This is when you need them to work.”
“Background noise really drives him crazy.”
“My problem is with background noise. All my H.A.s do is amplify so they are of little help.”
62. Reasons for Non-Use Background Noise “I don’t wear my H.A. because I need it at a dance, restaurants, and large groups. All the H.A. does is increase all sound including background sounds. No help.”
“Sudden loud noise is a killer.”
“H.A. amplify other sounds so much that I actually feel pain.”
63. Reasons for Non-Use Background Noise “If someone drops a spoon on the table it is like a rifle going off.”
“Hate them. They don’t work for me. All sounds are amplified. Never knew there were so many. I can’t adjust the H.A. constantly to every noise.”
64. Reasons for Non-Use #1. Poor benefit (30%) - 268,507
#2. Background noise (25%) - 229,383
65. Reasons for Non-Use Fit & Comfort “My hearing aids are too big for my ears.”
“It is uncomfortable and my wife says I don’t listen to her anyway.”
“It hurts my ears.”
“I do not like the feel of it in my ear.”
66. Reasons for Non-Use Fit & Comfort “I don’t wear my H.A. because they plug up my ears and feel uncomfortable.”
“My H.A. has the tendency to fall out when I am working hard in hot weather.”
“It’s hard to keep it in my ear. I travel for business a lot and can’t risk it falling out of my ear.”
67. Reasons for Non-Use #1. Poor benefit (30%) - 268,507
#2. Background noise (25%) - 229,383
#3. Fit & Comfort (19%) - 169,431
68. Ears that hurt
Too much pressure in the ears
Blisters in ears
Rashes in ears
Itching ears
Dizzy
Nervous
Reasons for Non-Use Negative Side-effects
69. Ears that sweat
Builds up wax in inner ear
Headache
Hair gets caught in hearing aid
Infections in ear
Problems chewing or swallowing
Plugs up ears
Reasons for Non-Use Negative Side-effects
70. Reasons for Non-Use #1. Poor benefit (30%) - 268,507
#2. Background noise (25%) - 229,383
#3. Fit & Comfort (19%) - 169,431
#4. Negative side effects (11%) - 99,048
71. Reasons for Non-Use Price & Cost “I bought the H.A. when I was teaching. I had trouble hearing student’s questions. Since retiring I have stopped using them. They were costing too much for what good I was able to get from them.”
“Programmable H.A. would be desirable but they cost too much.”
72. Reasons for Non-Use Price & Cost “My current H.A. are broken & I am unable to afford the cost of a replacement. They are too old for service.”
The expense of owning and maintaining are too great.
HMO does not cover for HA. Price is high.
73. Reasons for Non-Use Price & Cost “I enjoyed my H.A., but they burned up in a house fire and I can’t afford another one.”
“I wish an aid would be developed to allow us to hear natural sound and an aid with a reasonable price.”
“If I could afford it, I would buy a different brand.”
74. Reasons for Non-Use Price & Cost “My H.A. was never dependable. Taking it in for an adjustment was only a headache as it never performed very long. Had to be looked at again. The last time I had trouble, the office wanted to send it to _____ at $200 & just to check it, plus another $200 to repair it.”
75. Reasons for Non-Use #1. Poor benefit (30%) - 268,507
#2. Background noise (25%) - 229,383
#3. Fit & Comfort (19%) - 169,431
#4. Negative side effects (11%) - 99,048
#5. Price & cost (10%) - 93,839
76. “I work and live alone and do not need the aid most of the time.”
“I had an operation on my right ear and I can hear better again.”
“I don’t talk to anyone during the day.”
Reasons for Non-Use Don’t Need Help
77. Reasons for Non-Use Don’t Need Help “I can hear most everything without H.A.s”
I feel I was sold under false pretense. I don’t feel I really needed one.”
“Don’t wear very often since my hearing loss is only 35 degrees.”
78. Reasons for Non-Use #1. Poor benefit (30%) - 268,507
#2. Background noise (25%) - 229,383
#3. Fit & Comfort (19%) - 169,431
#4. Negative side effects (11%) - 99,048
#5. Price & cost (10%) - 93,839
#6. Don’t need help (8%) - 72,987
79. Reasons for Non-Use Broke or does not Work “After a year, the H.A. is down. I can’t afford to repair them.”
“Because it doesn’t work. ______ refused to do anything. The man that sold it to me has been fired.”
“It does not work right.”
80. Reasons for Non-Use Broke or does not Work
“I don’t wear it because after the warranty expired it got broken. It would cost $1,200 to replace it, so I quit wearing it.”
“The housing is currently broken and will have to be glued back together. This is the fourth time it has broken.”
81. Reasons for Non-Use Broke or does not Work “It seems as if the aids were in the shop for repair more than in my ear. They are still not adjusted correctly for my comfort level. The cost of the repairs were too much. It is easier to go without them and have everyone speak louder.”
“I have 2 H.A.s that don’t work. It costs $200 a piece cash to have them fixed.”
82. Reasons for Non-Use #8. Sound quality (6%) - 57,329
83. Reasons for Non-Use Sound Quality “Never got true sound clarity I wanted”
Uncomfortable sound
Sound of crickets
Unnatural
Distorted
Slight hiss
Tinny
Picks up wind
84. Reasons for Non-Use Sound Quality Chewing and swallowing noise
Poor fidelity
“Can’t stand sound of my voice”
Hollow sound
Aversiveness of sounds (running water, sharp sounds)
85. Reasons for Non-Use #8. Sound quality (6%) - 57,329
86. “I have trouble adjusting the sound.”
“Hard to adjust. Every time the phone rings I have to adjust the volume.”
“They need adjusting, because the background noises are annoying.” Reasons for Non-Use Volume Control Adjustments
87. Reasons for Non-Use Volume Control Adjustments
“They are a bother having to turn up & down too often.”
“The volume never stays at setting.”
“I can’t adjust H.A. constantly to every noise.”
88. Reasons for Non-Use #8. Sound quality (6%) - 57,329
#9. Won’t wear - unspecified (6%) - 57,556
#10. Volume control adjust. (5%) - 44,314
89. Reasons for Non-Use #15. Stigma of wearing (3%) - 26,037
#16. Profound hearing loss (3%) - 23,460
#17. Work in limited situations (3%)-23,460
#18. Uncomfortably loud (2%) - 27,114
#19. Battery life (2%) - 19,186
90. Reasons for Non-Use 1% or less of mentions Does not work on phone
Monaural aids inadequate
Expectations not met
Has Tinnitus
Manual dexterity
Forget to use Family pressure
Feels like ear plugs
Poor directivity
Low gain
Lost hearing aids
Ear wax problem
Rare social user
91. Key Findings 907k inactive hearing aid owners
Key reasons:
Poor benefit
Background noise
Fit and comfort
Cost
Negative side effects
Hearing aids broke
92. MarkeTrak V - Conclusions Significant opportunities for improvement.
Encouraging positive trends.
Huge opportunity still waiting to be tapped.
Need to find new marketing methods to reach “Baby Boomers”.
