ABSTRACT
BACKGROUND: The quality of care in labor and delivery is traditionally measured through the Hospital Consumer Assessment of Healthcare Providers and Systems but less is known about the experiences of care reported by patients and caregivers on online sites that are more easily accessed by the public. OBJECTIVE: The aim of this study was to generate insight into the labor and delivery experience using hospital reviews on Yelp. METHODS: We identified all Yelp reviews of US hospitals posted online from May 2005 to March 2017. We used a machine learning tool, latent Dirichlet allocation, to identify 100 topics or themes within these reviews and used Pearson r to identify statistically significant correlations between topics and high (5-star) and low (1-star) ratings. RESULTS: A total of 1569 hospitals listed in the American Hospital Association directory had at least one Yelp posting, contributing a total of 41,095 Yelp reviews. Among those hospitals, 919 (59%) had at least one Yelp rating for labor and delivery services (median of 9 reviews), contributing a total of 6523 labor and delivery reviews. Reviews concentrated among 5-star (n=2643, 41%) and 1-star reviews (n=1934, 30%). Themes strongly associated with favorable ratings included the following: top-notch care (r=0.45, P<.001), describing staff as comforting (r=0.52, P<.001), the delivery experience (r=0.46, P<.001), modern and clean facilities (r=0.44, P<.001), and hospital food (r=0.38, P<.001). Themes strongly correlated with 1-star labor and delivery reviews included complaints to management (r=0.30, P<.001), a lack of agency among patients (r=0.47, P<.001), and issues with discharging from the hospital (r=0.32, P<.001). CONCLUSIONS: Online review content about labor and delivery can provide meaningful information about patient satisfaction and experiences. Narratives from these reviews that are not otherwise captured in traditional surveys can direct efforts to improve the experience of obstetrical care.
ABSTRACT
STUDY OBJECTIVE: Individuals increasingly use online rating platforms to rate and review hospitals. We seek to describe and compare publicly available online review content and ratings of emergency departments (EDs) and urgent care centers. METHODS: We analyzed Yelp reviews of EDs and urgent care centers to identify topics most correlated with 1- and 5-star ratings. Latent Dirichlet Allocation, a method of identifying groups of co-occurring words in narrative text, was used to identify and label 25 topics across 1- and 5-star reviews of urgent care centers and EDs. Differential Language Analysis was then used to measure the correlation of these topics with 1- and 5-star reviews for urgent care centers and EDs. RESULTS: We analyzed 100,949 Yelp reviews, 16,447 from 1,566 EDs and 84,502 from 5,601 urgent care centers. There were significantly more 5-star urgent care center reviews (n=43,487; 51%) than 5-star ED reviews (n=4,437; 27%). Themes associated with 5-star reviews among EDs and urgent care centers were similar for comfort, professionalism, facilities, pediatric care, and staff interactions. Themes associated with 1-star reviews among EDs and urgent care centers were similar for communication, telephone experience, waiting, billing, pain management, and diagnostic testing. Themes unique to 5-star ED reviews included bedside manner, care for family members, and access. Themes unique to 5-star urgent care center reviews were based on recommendation and prescription refills. Themes unique to 1-star ED reviews were service and speed of care. Themes unique to 1-star urgent care center reviews were lack of confidence and reception experience. CONCLUSION: Understanding drivers for high and low online ratings and what patients value in their ED and urgent care center experiences offers insights for health systems and providers to improve acute care delivery. Patients' perspectives may become increasingly important as they seek care in the expanding urgent care markets.
