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Using Yelp, VA Hospitals Rated Higher than Affiliated Non-VA Hospitals


BACKGROUND:
Hospital Compare – a website maintained by the Centers for Medicare & Medicaid Services (CMS) – allows comparisons of outcomes and processes of care for VA and non-VA hospitals; however, patient satisfaction is reported on Hospital Compare for non-VA hospitals only. Online patient ratings of hospitals (e.g., Yelp) have been shown to correlate strongly with more conventional measures of patient satisfaction, as well as patient outcomes. Therefore, this study compared online hospital ratings from Yelp between VA hospitals and their local affiliated hospitals. Investigators identified 39 VA hospitals and 39 non-VA-affiliated hospital with at least two online Yelp ratings [1 (worst) to 5 (best)] from March 2014 to June 2014. Ratings were excluded if they were specific to a department (e.g., cafeteria).

FINDINGS:

  • VA hospitals had significantly higher Yelp ratings than non-VA-affiliated hospitals, suggesting better patient satisfaction. This was not explained by bed size or teaching status of the hospital.
  • After weighting for the number of reviews, the mean patient ratings were slightly higher for both VA hospitals (3.70 +/- 0.74) and affiliated hospitals (3.19 +/- 0.54), although the difference remained similar and significant. This difference in online ratings persisted when the sample was limited to dyads of hospitals (VA and non-VA) with more than two reviews.

IMPLICATIONS:

  • Although Yelp reviews describe patient experience, they also may be a marker of patient outcome. This study was not powered to detect differences in outcome; however, a different study found that high Yelp ratings were significantly associated with lower 30-day all-cause mortality following an admission for myocardial infarction or pneumonia – and lower 30-day all-cause readmissions following a discharge for myocardial infarction, heart failure, or pneumonia.

LIMITATIONS:

  • This study is potentially limited by the comparison group, which included local university-affiliated hospitals that often share trainees and faculty with the VA hospital.
  • Differences in patients could explain the results. For example, investigators could not know if Veterans were more likely than non-Veterans to rate all hospitals highly.

AUTHOR/FUNDING INFORMATION:
This study was partly funded through HSR&D QUERI (CHF 04-236). Drs. Heidenreich and Sahay are part of HSR&D's MedSafe QUERI located in Palo Alto, CA.


Heidenreich P, Zapata A, Shieh L, Oliva N, and Sahay A. Patient Ratings of Veterans Affairs and Affiliated Hospitals. American Journal of Managed Care. June 2017;23(6):382-384.

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HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.