Abstract
BackgroundRegional population health management (PHM) initiatives need an understanding of regional patient experiences to improve their services. Websites that gather patient ratings have become common and could be a helpful tool in this effort. Therefore, this study explores whether unsolicited online ratings can provide insight into (differences in) patient’s experiences at a (regional) population level.MethodsUnsolicited online ratings from the Dutch website Zorgkaart Nederland (year = 2008–2017) were used. Patients rated their care providers on six dimensions from 1 to 10 and these ratings were geographically aggregated based on nine PHM regions. Distributions were explored between regions. Multilevel analyses per provider category, which produced Intraclass Correlation Coefficients (ICC), were performed to determine clustering of ratings of providers located within regions. If ratings were clustered, then this would indicate that differences found between regions could be attributed to regional characteristics (e.g. demographics or regional policy).ResultsIn the nine regions, 70,889 ratings covering 4100 care providers were available. Overall, average regional scores (range = 8.3–8.6) showed significant albeit small differences. Multilevel analyses indicated little clustering between unsolicited provider ratings within regions, as the regional level ICCs were low (ICC pioneer site < 0.01). At the provider level, all ICCs were above 0.11, which showed that ratings were clustered.ConclusionsUnsolicited online provider-based ratings are able to discern (small) differences between regions, similar to solicited data. However, these differences could not be attributed to the regional level, making unsolicited ratings not useful for overall regional policy evaluations. At the provider level, ratings can be used by regions to identify under-performing providers within their regions.
Highlights
Regional population health management (PHM) initiatives need an understanding of regional patient experiences to improve their services
Data sources Two data sources were used in this study; the primary focus were the unsolicited online patient ratings provided by the Dutch Patient Federation (DPF), while the solicited survey data provided by the National Monitor Population management (NMP) was used predominantly for comparative reasons
When further classified by category of care provider, it is shown that dental care, general physicians (GP) care, hospital care, nursing homes and physiotherapy had a substantial number of ratings available per pioneer site
Summary
Regional population health management (PHM) initiatives need an understanding of regional patient experiences to improve their services. Regional Population health Management (PHM) initiatives are challenged to evaluate regional patient experiences to improve their health and social services. These initiatives have been increasingly widening their focus from individuals to populations [1, 2] to deal with the changing care demand. Their intent is often to achieve the Triple Aim; i.e. simultaneously improve population health and the experienced quality of care, while reducing costs [3]. Patients can often rate their care experiences on general websites like Yelp or Facebook, as well as specialized websites such as RateMDs and HealthGrades
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