NRC Health 2022 Pediatric Consumer Trends Report


A note from NRC Health
Chief Growth Officer Helen Hrdy


We’ve often heard from you that serving pediatric patients is rewarding, is inspiring, and gives hope for a new generation. In a post-COVID world, this sentiment has more at stake than ever before. As 2022 begins, we have gathered insights about how parental needs have shifted and how healthcare trends have evolved, so you can maintain these meaningful relationships crucial to pediatric care.

As leaders in pediatric healthcare, you will find insights and data in the NRC Health 2022 Pediatric Consumer Trends Report, organized around the major trends impacting your work:

These topics, gleaned from our country’s premier pediatric healthcare-consumer database, are explored in depth in our report. Culled from millions of data points captured from hundreds of thousands of consumer households, these insights will provide you with unique knowledge of what this special population wants and needs from providers.

As you lead positive transformation for your organization in 2022 and beyond, we hope our report will enrich your work and the work of your peers, guiding you in deeper Human Understanding™ to serve our cherished pediatric patients and families.


Helen Hrdy,
Chief Growth Officer, NRC Health


Parents are delaying healthcare less and are
returning to healthcare in record numbers.

One of the most significant disruptions in healthcare delivery in modern history has come from patients deferring care during the pandemic. The promising news is, NRC Health data shows that healthcare deferment in pediatrics is decreasing, and parents are starting to resume services for their children. However, pediatric systems should be mindful that some pediatric patients who re-emerge could be sicker and costlier in 2022.

As of Q4 2021, 11.6% of parents stated that they had delayed pediatric care for a child in the household, compared to 12.3% in Q4 2020. Additionally, 42.6% of parents stated that concerns over COVID-19 very much impacted their decision to delay care.

Fortunately, the rate at which parents are resuming services has risen by 135% from 2020 to 2021 across all major service lines. The largest increases in volume among major service lines have come from:

A small but often overlooked percentage of parents don’t plan to return to healthcare or are unsure when they’ll do so. As of Q4 2021, 12.5% of parents say they are unsure when to resume healthcare activities, and 5.5% say they will not return to healthcare.

As pediatric healthcare organizations continue to manage the flux, the CDC urges pediatric providers to work with families to keep children up to date with all recommended vaccinations as much as possible. They should also identify children who have missed well-child visits, recommend vaccinations, and contact them to schedule in-person appointments, prioritizing infants, children younger than 24 months, and school-aged children.

Developmental surveillance and early childhood screenings, including developmental-disability and autism screening, should continue, along with referrals for early intervention services if concerns are identified.1


There is strong and consistent excitement around telehealth, but
pediatric healthcare systems should strategically determine which
services work best with the technology.

Telehealth excitement among parents has hovered around 63% throughout the pandemic, compared to the pre-pandemic average of 57.8% in Q1 2020. Additionally, parents are more excited about telehealth (63.1%) than consumers without any children in the household (52.3%).

Telehealth’s inherent ease of use, amount of time spent with providers, courtesy, respect received, and attentiveness have made the technology a winner—but only for specific groups of providers. Telehealth usage has grown within disciplines such as:

Outside of these areas, telehealth usage in pediatrics has decreased in almost every area, so it’s critical for pediatric healthcare systems to use telehealth strategically. A parent from California explains that they’re tired of telehealth serving as the default: “I don’t feel like the service for my son is as good as it would be in person. For some things it’s fine, but for others, I feel like it’s gone too far and hasn’t come back to what is best for the patient yet.”

Given that telehealth usage has more than doubled since 2020, pediatric healthcare systems should cultivate an effective and meaningful telehealth practice and consider digital health innovations. Pediatric healthcare systems should also prioritize provider time, attentiveness, and financial transparency in their telehealth offerings.


The pandemic’s toll on mental health has been staggering:
children’s mental-health hospitalizations alone have increased
163% from 2020 to 2021. Pediatric healthcare systems need
to act now to offer mental-health resources and preventative
mental-health resources to their communities.

Citing mounting evidence of ongoing harm, U.S. Surgeon General Vivek H. Murthy issued a publichealth advisory in December 2021 on the mental-health challenges confronting youth, a rare warning and a call to action to address what he called an emerging crisis exacerbated by pandemic hardships.

Before the pandemic, children from all backgrounds—especially immigrants, students with disabilities, and students of color from low-income families—faced serious mental-health challenges. At the same time, pandemic-related safety measures reduced in-person interactions among children, friends, social support, and professionals such as teachers, school counselors, pediatricians, and child welfare workers.2

NRC Health’s robust patient feedback data finds that mental-health hospitalizations of children have increased 163% from 2020 to 2021. In early 2021, emergency-department visits in the United States for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same time in early 2019.3

While parents have noticed an increase in advertising relating to preventative care and wellness—from 19.1% in Q1 2020 to 21.6% in Q4 2021—they have also experienced a delay in several types of care, and parents are now facing barriers to resuming care due to staffing/scheduling and COVID policies.

Because pediatric care was delayed, new data shows that parents report a decrease in child immunizations, an indicator of preventative care, from 25.5% in Q1 2020 to 21.0% in Q4 2021. Further, parents report slightly higher rates of their own worsened mental health (32.4%) than consumers without children in the household (29.9%) in Q4 2021.

Pediatric health systems should maximize communication in offering mental-health resources and preventative mental-health services to help decrease pediatric hospitalizations. The National Institute of Mental Health suggests sharing prevention hotlines, promoting different providers, and offering literature on community services, online therapists, Medicare, and options for those without insurance. Promoting online apps and phone resources also helps.4 In addition to highlighting their resources, pediatric health systems can highlight the National Alliance on Mental Health’s free 24/7 helpline to connect people to support by texting NAMI to 741741.


An increase in consumers naming a healthcare system
shows that healthcare recall is rising in general, but pediatric
facilities have not stood out.

For health organizations that adults visit, marketing recall has increased 4.8% from its lowest point of 59.4% in 2020 to 66.3% in 2021. However, for pediatric facilities specifically, that percentage has remained stagnant (at 1.5%) in both 2020 and 2021.

Advertising for pediatric services among parents has only marginally improved, with 9.1% of parents recalling seeing advertising for pediatric services in 2021, compared to 8.1% in 2020.

Fortunately, consumers visiting a pediatric-hospital website have increased 5.3% from 2020 to 2021. An all-time high of 41.4% consumers report having visited a pediatric-hospital website as of Q4 2021, so the commitment within pediatric marketing-communications technology is important.

Parents report a 6.9% increase in hospital website visits from 28.5% in 2020 to 35.4% in 2021, which provided useful health information.

Pediatric providers can ensure that their marketing has a digital-first, mobile-ready strategy. Nearly two-thirds (65.8%) of parents say they will use a handheld mobile device to access information in the next 12 months. Social media (at 20.1%, up from 13.3% in 2020) is now the second-most recalled ad platform behind television (24.8%) among consumers with children in the household.

The lack of pediatric recall for consumers creates an opportunity to elevate brand campaigns in regional and national markets. Pediatric organizations should build their brands using an omnichannel approach to engage patients and personalization techniques to promote services, provide resources, and advertise personalized care to target active audiences.


Pediatric health systems must demonstrate an understanding
of patients’ unique needs and preferences to show Human
Understanding in action, which builds trust.

Consumers’ likelihood of recommending pediatric hospitals and health systems has increased while parents’ likelihood of recommending hospitals has decreased, which indicates that the care experience is not meeting expectations. Pediatric hospitals and health systems must meet people where they are to increase this critical metric.

Consumers’ likelihood of recommending pediatric hospitals and health systems (Net Promoter Score or NPS) has increased slightly (by 0.3 points) from 45.8 to 46.1 between 2020 and 2021. Although slight, consumer NPS for pediatric hospitals has not shown an upward trend in several years. Conversely, the pediatric patient experience peaked during the onset of the pandemic—with an NPS at 69 in April 2020 for hospital inpatients and emergency departments—but has been declining since, resulting in an NPS of 53 in December 2021.

The key to enhancing a patient’s care journey is understanding preferences in advance, which can be achieved through communication assessments. Pediatric healthcare systems should deliver a person-centered, equity-focused experience as a standard measure across care settings and treat each patient as unique while personalizing their experience.

During the past 15 years, covering the existence of the CAHPS program, NRC Health has seen the overall percentage of patients who recommend an organization barely increase—yet the industry is still spending billions of dollars a year to drive improvement against such measures.

What needs to happen is a new understanding that 99% of a patient’s life happens beyond the pediatric hospital care setting. When pediatric healthcare organizations begin to understand each person’s expectations in advance of their interaction or episode of care, they can personalize those interactions at the right moments and exceed patients’ expectations.

In NRC Health’s 2022 Healthcare Consumer Trends Report, we report that the number of consumers with no preference has plateaued, and pediatric services have shown a similar trend. However, pediatric hospitals and health systems have a vested interest in ensuring that their brand is preferred.

Consumers who had no preference among pediatric services have followed similar trends as those with no preference among adult services, with 35.7% of consumers indicating no preference for pediatric services in 2021, compared to 36.9% in 2020.

Consumers who had no preference among pediatric services have followed similar trends as those with no preference among adult services, with 35.7% of consumers indicating no preference for pediatric services in 2021, compared to 36.9% in 2020.

Further, consumers are reporting no change in preference for hospitals and health systems in terms of personalized care, indicating that hospitals and health systems are not going out of their way to meet patients where they are.

In 2021, the percentage of parents indicating “no preference” among hospitals that provide personalized care declined only 2.0%, from 26.5% in 2020 to 24.5% in 2021.

Ultimately, pediatric healthcare organizations must strive for seamless connectivity between service recovery and missed patient expectations, driving caregiver recognition and positive comments on social media to enhance reputation. Now is the time for pediatric organizations to use meaningful advertising and aim their messaging at patients in a personalized way that adds value to their life.


A more empathic future

The global pandemic of COVID-19 and its variants have quickly taught all healthcare organizations that transformational change is necessary to meet demand and move the industry forward. And while many pediatric hospitals and health systems have shown they can be flexible despite catastrophic losses, the pandemic has shined a light on how necessary consumer-driven improvements and a better patient experience are for continued survival and growth.

The pediatric-healthcare industry can use NRC Health’s six Human Understanding imperatives to strengthen their commitment to consumers:

When pediatric organizations lead with empathy and Human Understanding and engage patients to co-design the healthcare process, they will be more than ready to meet any future challenges.


1 Centers for Disease Control and Prevention. “Information for Pediatric Healthcare Providers.” (Updated December 30, 2020.) Accessed at

2 Blume H, Gomez M. “Surgeon General Warns of Emerging Youth Mental Health Crisis in Rare Public Advisory.” Los Angeles Times. (December 7, 2021.) Accessed at

3 Department of Health & Human Services. “Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory 2021.” (2021.) Accessed at

4 Leonard J. “What Mental Health Resources Are Available?” Medical News Today. (September 28, 2020.) Accessed at