Little is known about how alternative online sources of patient and caregiver experiences of hospitals in the U.S. 10, 19 In England, the National Health Service (NHS) runs a website, NHS Choices, which allows structured patient reviews to be published 14, 15 however, no such government run site currently exists in the U.S.
hospitals but has not examined the content of the online reviews.
Previous work on online patient reviews of hospitals has focused on hospitals in the United Kingdom, 14– 16 South Korea, 17 and Germany, 18 or has studied U.S. 13 The narrative component of reviews often reflects the features of a hospital experience most important to patients, providing information that structured surveys cannot. 10 On the site, businesses are given a rating of one through five stars, which is displayed to the public. 13 To date, Yelp is the most widely used, freely available commercial website in the U.S. It is the 28 th most visited website in the U.S., the 129 th most viewed site globally, 12 and has 142 million unique monthly visitors. Yelp () is a website where users submit star ratings and narrative reviews of local businesses (e.g., restaurants, retail stores, hotels), which are then posted for the public to view. Yet, the testimonials on social media sites are free, continuously updated, 10, 11 and often reveal exactly what the problem or positive occurrence was that impacted the patient’s or family member’s experience. In contrast, reviews on social media sites are organic, largely unstructured, essentially uncurated, and both seemingly haphazard and subject to gaming. 1 However, they are expensive to deploy, 6 suffer from low response rates, 7 incur significant delay between hospitalization and public reporting of results 8 and, even if they can give an overall indication of patient satisfaction, rarely identify the source of perceived problems. Perhaps more importantly, 20 years ago patients were not spontaneously publishing their opinions about health care facilities on social media sites where those opinions reach a public increasingly comfortable using them to inform their own decisions.Įvaluations like HCAHPS are the products of years of measurement research, are fielded and interpreted systematically, 1, 2 and collect a large number of patient responses per hospital.
2 In the intervening 20 years, the indications for and experience of hospitalization have changed greatly. 5 Although HCAHPS is the current standard for patient experience of care data, 1 its origins derive from 1995. 3 Currently, HCAHPS scores drive 30% of the financial incentives in the Medicare value-based purchasing program, 4 which will eventually penalize hospitals with poor performance by up to 2% of their Medicare payments. 1, 2 HCAHPS survey results are publically reported on the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website, 1 which rates all United States (U.S.) hospitals that receive Medicare payments on a variety of quality measures. Since 2006, 1, 2 patient-reported experiences after hospitalization have been collected with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.
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