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What Negative Online Reviews Reveal About Hospitals

Yelp is the go-to website when looking for customer reviews, whether it’s a restaurant, plumber, hair salon or physician. There are more than 140 million reviews on Yelp, with 8.4 million related to healthcare. Some reviews are positive and others negative. But a new study found that certain words were common to both positive and negative reviews.

What Did The Study Find?

For negative reviews, the word “told” appears in about 20 percent of the posts, and is generally used in conjunction with a person expressing frustration or anger with their experience. For example, they were never told about the cost of the procedure, or “the idiot doctor told me there was nothing they could do for me.”

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“Oftentimes, words such as ‘told’ hint at a breakdown in communication,” said study author Anish Agarwal, MD, a National Clinician Scholars fellow and emergency medicine physician at the University of Pennsylvania School of Medicine, in a news release. “I suspect that patients are not feeling listened to or heard and this could be driving poor experiences and low reviews.”

For positive reviews, the word “friendly” appeared in almost 11 percent, and the word “great” correlated the most with five-star reviews. These two words were often used in conjunction with descriptions of how they were treated by the staff. For example, “the entire staff was very friendly and made sure we were taken care of.”

Other words that frequently appeared in the negative online reviews include “worst,” “hours,” “rude,” “said,” “no” and “not.” For the positive reviews, “staff” and “very” were also often included.

“Patients value communication highly in their overall experience when they’re in the hospital,” Dr. Agarwal said. “As healthcare transitions to being more patient-centered, I think hospitals and providers need to continue to work on how we improve communication, how we listen and how we approach all patient interactions.”

In this study, Dr. Agarwal and colleagues, analyzed hospital reviews posted on Yelp using the machine learning tool Differential Language Analysis (DLA) and natural language processing. The reviews included in their analysis were all of specific facilities and included narrative text, date and star rating. The researchers hypothesized there would be common language that correlated with both negative and positive reviews.

Dr. Agarwal and his team had previously compared Yelp reviews of hospital emergency departments with those of urgent care centers, and found that those reviews generally fell on either extreme of the spectrum — either one star or five stars. About 47 percent of emergency departments and 30 percent of urgent care centers were rated as one star. Five-star reviews were similar for both types of facilities, and focused on comfort, cleanliness, pediatric care and professionalism. Conversely, one-star reviews typically addressed poor phone experiences, long wait times, billing difficulties and pain management, all of which were seen in both emergency departments and urgent care centers.

For their current analysis, they analyzed 51,376 reviews for 1,566 hospitals located in the United States. The word “told” appeared in 9,578 reviews, and when pooled together, the reviews averaged 1.78 stars. Conversely, the word “friendly” was found in 5,594 of the positive reviews.

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What Does This Mean For Healthcare Providers?

Hospitals and doctors need to take these online reviews seriously, as an increasing number of consumers use them to select and rate their care.

A survey conducted last year by the Binary Fountain, an online reputation management platform for enterprises, healthcare organizations and small- to medium-sized businesses, suggests how important these online reviews are becoming. Slightly over half (51 percent) reported that they share their personal healthcare experiences via social media, online ratings and review sites, which is an increase of 65 percent from their previous 2017 survey. About 70 percent of respondents said that online ratings and review sites have influenced their decision when selecting a physician. Even in cases when they were referred by another doctor, 41 percent said they still check online ratings and reviews.

Last updated on 9/30/19.

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