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Health quality researchers: We could learn from Yelp

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Yelp hospital reviewers may do a better job of assessing hospital quality than the official U.S. hospital quality survey program does, because Yelp gives users room to talk about topics such as caring, compassion and staff manners, and the official survey program does not.

Dr. Benjamin Ranard, a researcher at the University of Pennsylvania medical school, and other researchers have come to that conclusion in a new paper published behind a paywall in Health Affairs, an academic journal that focuses on health care finance and delivery systems.

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In the paper, the researchers compare Yelp hospital reviews with U.S. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results.

The Centers for Medicare & Medicaid Services (CMS) requires all hospitals that receive Medicare payments to participate in the HCAHPS program. HCAHPS survey scores now affect 25 percent of the financial incentives that hospitals get through the Medicare value-based purchasing program, the researchers write.

The researchers created a database of the Yelp-recommended hospital reviews that were in the Yelp system on July 15, 2014. The researchers then developed a collection of the recommended hospital reviews for the hospitals that participate in the HCAHPS program. Using a standard language analysis technique, the researchers identified the topics included in the Yelp narrative reviews.

The researchers found that the Yelp topics that correlated the most with positive Yelp ratings were “caring doctors, nurses and staff”; “comforting”; and “clean, private, nice hospital rooms.” 

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The Yelp topics that correlated most with negative Yelp ratings were “horrible hospital,” “rude doctor/nurse communication,” and “pain control.”

When a hospital had at least three Yelp reviews, its average Yelp rating had a strong correlation with its overall HCAHPS rating. But Yelp reviews covered far more topics than the HCAHPS does, since their questionnaire leaves out many of the topics most strongly associated with positive or negative Yelp ratings, according to the researchers.

The researchers say the only HCAHPS item that has anything to do with caring, compassion or manners is, “How often did doctors [or nurses] communicate well with patients?”

The problem is that the hospital staff can show a lack of compassion and empathy even if they communicate well with patients, according to the researchers. They also cite an example in which a reviewer said her boyfriend “was on the floor crying and screaming in pain,” and nurses “walked by as if we didn’t exist!!!”

Health care quality survey teams could also get lessons from on how to present samplings of the most helpful positive and negative consumer reviews, the researchers stated.

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