Abstract
BackgroundLittle is known about the usefulness of online ratings when searching for a hospital. We therefore assess the association between quantitative and qualitative online ratings for US hospitals and clinical quality of care measures.MethodsFirst, we collected a stratified random sample of 1000 quantitative and qualitative online ratings for hospitals from the website RateMDs. We used an integrated iterative approach to develop a categorization scheme to capture both the topics and sentiment in the narrative comments. Next, we matched the online ratings with hospital-level quality measures published by the Centers for Medicare and Medicaid Services. Regarding nominally scaled measures, we checked for differences in the distribution among the online rating categories. For metrically scaled measures, we applied the Spearman rank coefficient of correlation.ResultsThirteen of the twenty-nine quality of care measures were significantly associated with the quantitative online ratings (Spearman p = ±0.143, p < 0.05 for all). Thereof, eight associations indicated better clinical outcomes for better online ratings. Seven of the twenty-nine clinical measures were significantly associated with the sentiment of patient narratives (p = ±0.114, p < 0.05 for all), whereof four associations indicated worse clinical outcomes in more favorable narrative comments.ConclusionsThere seems to be some association between quantitative online ratings and clinical performance measures. However, the relatively weak strength and inconsistency of the direction of the association as well as the lack of association with several other clinical measures may not enable the drawing of strong conclusions. Narrative comments also seem to have limited potential to reflect the clinical quality of care in its current form. Thus, online ratings are of limited usefulness in guiding patients towards high-performing hospitals from a clinical point of view. Nevertheless, patients might prefer different aspects of care when choosing a hospital.
Highlights
Little is known about the usefulness of online ratings when searching for a hospital
The present study aims at adding further knowledge on whether both quantitative and qualitative patient satisfaction results displayed on United States of America (US) hospital rating websites demonstrate an association with clinical performance measures
We focused on non-disease specific clinical quality measures, since we expected the narrative comments to be non-disease related in most cases
Summary
Little is known about the usefulness of online ratings when searching for a hospital. (recent research from the Netherlands has demonstrated that information from social media which integrates the patient’s perspective can be important for health care inspectorates, especially for its enforcement by riskbased supervision of elderly care [20].) In this context, one study recently showed that the overrepresentation of positive comments in online reviews might enable ineffective treatments to maintain a good reputation [21]. Applying this finding to the health care provider rating context, it means that low-performing providers may be likely to have positive ratings, which could lead to suboptimal provider choices
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