From Public to Social Reporting of Hospital Quality

Abstract

M ore than a quarter-century has passed since the Centers for Medicare and Medicaid Services (CMS) published their first Breport cards^on hospital mortality data. 1 While this initial attempt at public reporting suffered from methodological flaws and was ended in 1993, 2 it represented the beginning of a huge international experiment. This experiment is ongoing and is still pondering the question: BCan providing publicly available information about health care quality direct patient choice of health care providers and simultaneously drive health care organizations to improve? 1T he subsequent years have revealed that public reporting of quality data does seem to drive attempts on the part of physicians and hospitals to improve care. 3 Yet there is still scant evidence that these initiatives have had an impact on where patients choose to receive care. 4 It has been hypothesized that this is related to a lack of awareness of differences in health care quality, limited literacy and numeracy of patients, and poor design of publicly funded quality reporting websites. 5 CMS's Hospital Compare is an example of a site that includes a plethora of data, including information about processes of care (e.g., percentage of patients hospitalized for acute myocardial infarction treated with beta blockers); risk-adjusted outcomes, such as condition-specific mortality and readmission rates; results of surveys of patient experience of care; and measures of hospitalization costs and case volumes. However, despite the hope and expectation that rational patients would use this information to make informed choices, they rarely do. At the very least, the great experiment of public reporting has, thus far, failed to engage patients.In contrast, social media use is widespread and growing. In 2014, 58 % of US adults used the social networking site Facebook. 6 At the same time, 51 % of US hospitals are now on Twitter, and 99 % are covered by Yelp. 7 Patients are also looking for health care quality data online: in 2012, 65 % of Americans were aware of online ratings of physicians and hospitals, and 23 % reported using ratings to choose a physician. 8 Notably, these numbers appear to reflect patients' use of online reviews found on social media sites and commercial rating sites (e.g., Yelp) rather than patients' use of quality data found on government-funded websites.That so many consumers are getting health care quality information from social media and commercial sources raises the question of whether the information that patients get from these sites is of similar value to the information they could get from sites such as Hospital Compare. In this issue of JGIM, Glover et. al. examine whether hospitals' risk-adjusted readmission rates reported on Hospital Compare were associated with the average number of Bstars^patients gave hospitals as part of their Facebook reviews. 9 Most notably, the authors observed that hospitals with lower readmission rates (and thus a higher Bobjective^measure of quality) were more likely to have a higher st...

Facebook Reviews as a Supplemental Tool for Hospital Patient Satisfaction and Its Relationship with Hospital Accreditation in Malaysia

“…The discrepancy between the typical patient survey and other data sources demonstrates the need to use other data sources to ascertain public sentiment about healthcare services [ 17 ]. Therefore, the internet in general and social media in particular have been suggested as new tools for evaluating patient satisfaction and monitoring the quality of healthcare services [ 7 , 58 ].…”

“…Even though these surveys are conducted in a systematic manner and capable of capturing a significant number of patient responses in a given hospital, they are expensive to implement, time intensive, and suffer from poor response rates and other challenges [ 2 , 5 ]. Thus, the internet, and social media specifically, has been proposed as a method of complementing or replacing traditional methods of assessing patient satisfaction and monitoring the quality of healthcare services [ 6 , 7 ].…”

Content, Quality, and Assessment Tools of Physician-Rating Websites in 12 Countries: Quantitative Analysis

“…This has been evidenced in a German study that showed how doctors who read their negative reviews and also responded to them, make an effort to improve the aspects that were criticized in their work [ 47 ]. Hence, the need for the public to be involved in quality of care reporting is increasingly suggested [ 49 , 50 ]. Yet, the assurance of quality and content on PRWs asks for further research and knowledge translation into practice.…”

Assessing Patient-Perceived Hospital Service Quality and Sentiment in Malaysian Public Hospitals Using Machine Learning and Facebook Reviews

“…In Malaysia, Facebook is extensively utilized, and its market share continues to rise and in 2020, Facebook was the country’s most popular social networking site [ 20 ]. Facebook reviews is a technology that allows people to provide narrative reviews on organizations’ Facebook pages, and the feature offers insight into how the public perceives healthcare services [ 21 ]. Few studies have been conducted in the past to evaluate Facebook reviews of hospital services and nursing homes and found a low to moderate correlation between Facebook ratings and patient satisfaction metrics from systematic surveys [ 18 , 22 , 23 , 24 ].…”