Could Yelp Reviews Help Hospitals Improve Patient Satisfaction?

Hospital Yelp reviews provide complementary insight into admitted patients' experiences.

Hospital Yelp reviews provide complementary insight into admitted patients’ experiences.

New research published in Health Affairs found that Yelp offered 12 more quality domains than those measured in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), suggesting that the website’s crowd-sourced reviews could provide more ways to measure patient satisfaction. Analysis of Yelp reviews could also provide actionable feedback for hospitals, the study authors argued.

First author Benjamin L. Ranard, a junior fellow at the Penn Social Media and Health Innovation Lab and a combined MD/MS in health policy research student at the Perelman School of Medicine, told Pharmacy Times that the most surprising aspect of the study were the nuances of the hospital Yelp reviews.

When we think of online reviews, we tend to think of them as falling into 2 camps: extremely positive or extremely negative. However, Ranard said the Yelp reviews showed more complexity, as the average review was 170 words long and tackled 11 different topics.

“The same review might comment on the inappropriateness of receiving opiates for migraines, the kind nurse, the rude front desk staff, and a confusing physician,” he said. “The reviews contained a significant amount of information that may be helpful for other patients, as well as hospitals that are trying to improve care.”

While pharmacists were rarely mentioned in the reviews, patients did show interest in direct interactions with all members of the health care team, Ranard said.

“For example, often if there was a rude doctor but a helpful other member of the team, that helpful team member would also make it into the review,” he explained. “Patients in the hospital are looking for a kind, caring, competent health care team that communicates well and helps the patients to get better. Pharmacists certainly have a role in providing this kind of patient experience and care.”

HCAHPS surveys have some limitations, including the fact that they’re expensive, they don’t have great response rates, and there can be major delays between hospitalization and reporting. In addition, the development of the survey dates back to the early 2000s.

In contrast, social media reporting is free and constantly updated. It can also offer a clear, concise representation of what the problem or positive experience was exactly.

However, the researchers recognized that Yelp isn’t a random sampling of the US population, as its users tend to be younger and well educated. Hospitals may find it difficult to respond to specific criticisms, too.

Despite these limitations, Yelp proved to be a useful, popular tool for measuring patient satisfaction. It’s the 33rd most-visited site in the United States, and it’s the most popular free website for hospital ratings.

On Yelp, hospitals are given a score of 1 to 5, and patients can also comment on their positive or negative experiences. Around 31% of the Yelp reviewers gave 1 star, and 33% gave 5 stars. The median Yelp rating was 3.2.

The researchers sought to determine how Yelp review content compared with the domains covered in the HCAHPS survey, and then to correlate Yelp ratings with HCAHPS survey ratings. They examined June 2012 to June 2013 HCAHPS survey data and hospitals with Yelp reviews as of July 2014.

The researchers’ final cohort included 1352 hospitals, which had 16,862 Yelp reviews and a median of 4 reviews per hospital.

The Yelp domains that weren’t covered in HCAHPS were as follows:

1. Cost of hospital visit

2. Insurance and billing

3. Ancillary testing

4. Facilities

5. Amenities

6. Scheduling

7. Compassion of staff

8. Family member care

9. Quality of nursing

10. Quality of staff

11. Quality of technical aspects of care

12. Specific type of medical care

The researchers found that 80% of the topics most strongly linked to positive Yelp reviews weren’t covered by the HCAHPS domains.

Positive Yelp reviews mainly related to relationships among patients, physicians, nurses, and staff. Meanwhile, topics linked to negative reviews were often about insurance and billing and cost of hospital visits, which also weren’t covered in the HCAHPS domains.

This study was especially relevant considering that 72% of US Internet users go online to find health information, and 42% consult social media for health-related consumer reviews, the study authors noted.

“This discrepancy raises the possibility that there are important lessons from the information contained in online consumer reviews that can be used to improve current, more formal rating systems and increase their use in consumer decision making,” the researchers concluded.

They argued that current measurements for hospital quality are missing out on major drivers of patient satisfaction.