Yelp ratings of medical facilities may reveal local health inequities

Counties with essential health care facilities that had lower ratings on Yelp also had higher mortality rates, data showed.

“Patient experience and satisfaction with health care are increasingly recognized as important measures of health care quality, but data on these factors are less widely collected,” Daniel Stokes, MD, a researcher with the Penn Medicine Center for Digital Health and an internal medicine resident at UCLA Health, and colleagues wrote. “Patient experience might also be associated with county-level mortality, but those associations have not yet been well explored.”

The researchers conducted a retrospective, population-based, cross-sectional study of Yelp performance reviews for 95,120 essential health care facilities in 1,301 U.S. counties from Jan. 1, 2015, to Dec. 31, 2019. Essential health care facilities were defined as those that offered services that Marketplace health insurance plans must cover: ambulatory patient services; emergency services; hospitalization; pregnancy, maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription medications; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and oral and vision care for children.

The findings, published in JAMA Network Open, indicated that at the county level, a one-point increase in a mean Yelp rating was linked to a mean age-adjusted decrease of 18.05 deaths for every 100,000 individuals (P < .001). The mean county-level rating of the analyzed facilities across the study period, with one being the worst and five being the best, was 2.9 stars.

The researchers also noted that words related to time, such as “minutes,” “hours,” “finally,” “waiting” and “schedules;” words to describe payment, including “money,” “insurance” and “pay;” and words related to interactions with other people, such as “rude,” “tell” or “told” appeared more frequently in one-star reviews in counties with high mortality. On the contrary, words such as “friendly,” “nice” and “staff” were used more frequently in five-star reviews in counties with high mortality.

In a press release, Stokes said the results show that “how patients feel about the care they are receiving has an impact on how they engage with health care and, in turn, their own health and well-being.”

“Ideally this democratization of information can help us to improve health care for all and reduce our blind spots,” Raina Merchant, MD, director of the Penn Medicine Center for Digital Health, said in the release.

References:

Healthcare.gov. What Marketplace health insurance plans cover. https://www.healthcare.gov/coverage/what-marketplace-plans-cover/. Accessed Nov. 15, 2021.

Stokes DC, et al. JAMA Netw Open. 2021;doi: 10.1001/jamanetworkopen.2021.27799.

Yelp star ratings on health care facilities may reveal county-level death rate disparities. https://penntoday.upenn.edu/news/yelp-star-ratings-may-reveal-county-level-death-rate-disparities. Published Oct. 19, 2021. Accessed Nov. 15, 2021.