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Yelp Reviews Bolster Information on How Patients View Hospitals

PHILADELPHIA – If government surveys don’t give you enough information on how your hospital is viewed by patients, try going online.

A study published recently in the journal Health Affairs points out that Yelp reviews of hospitals cover topics not found in the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey.

Researchers from the University of Pennsylvania’s Perelman School of Medicine say that additional information, such as positive or negative reviews from Yelp contributors, not only influences patient decisions on where to seek hospital care but also can provide valuable feedback to hospital quality professionals and administrators.

The 33rd most visited website in the United States, with 142 million unique monthly visitors, Yelp publishes online crowd-sourced reviews about local businesses and services. Hospitals can be ranked from one to five stars, and reviewers often discuss features of a hospital experience most important to them.

For the recent study, researchers compared about 17,000 Yelp reviews to HCAHPS reviews of the same 1,352 hospitals.

"Nearly 75% of U.S. Internet users reported looking online for health information in 2012," said the study's senior author Raina M. Merchant, MD, MSHP. "Forty-two percent reported looking at social media for health-related consumer reviews. Meanwhile, only 6% of Americans had heard of the government website where the HCAHPS survey is reported, as of 2008. This divergence presents an opportunity for online consumer reviews to augment and even improve formal rating systems such as HCAHPS and increase their use in consumer decision-making."

Using natural language-processing techniques, researchers analyzed the text of Yelp narrative reviews of hospitals posted as of July 15, 2014, to categorize them; for example, a post that contained the terms "pain, doctor, nurse, told, medication, meds, gave," was labeled under the category "pain medications."

When possible, the categories were matched up with HCAHPS domains. The Yelp reviews ended up including information about seven of the 11 HCAHPS domains, but also covered 12 additional areas not included in the federal survey: cost of hospital visit, insurance and billing, ancillary testing, facilities, amenities, scheduling, compassion of staff, family member care, quality of nursing, quality of staff, quality of technical aspects of care, and specific type of medical care.

Interestingly, among the categories not covered by HCAHPS domains were four of the top five topics most strongly associated with positive Yelp review ratings: caring doctors, nurses, and staff; comforting; surgery/procedure and peri-operative care; and labor and delivery.

HCAHPS domains also didn’t encompass two of the top five Yelp categories most strongly associated with negative review ratings: insurance and billing, and cost of hospital visit.

"Yelp reviews are in real time and often written by patients for patients," Merchant said. "In addition, patients' perceptions of what matters most to them can change over time. HCAHPS may not be able to respond as agilely to these kinds of changes as social media."