Online Ratings of the Patient Experience: Emergency Departments Versus Urgent Care Centers

Anish K Agarwal; Kevin Mahoney; Amy L Lanza; Elissa V Klinger; David A Asch; Nick Fausti; Christopher Tufts; Lyle Ungar; Raina M Merchant

doi:10.1016/j.annemergmed.2018.09.029

Online Ratings of the Patient Experience: Emergency Departments Versus Urgent Care Centers

Ann Emerg Med. 2019 Jun;73(6):631-638. doi: 10.1016/j.annemergmed.2018.09.029. Epub 2018 Nov 2.

Authors

Anish K Agarwal¹, Kevin Mahoney², Amy L Lanza³, Elissa V Klinger³, David A Asch⁴, Nick Fausti³, Christopher Tufts⁵, Lyle Ungar⁶, Raina M Merchant⁷

Affiliations

¹ Penn Medicine Department of Emergency Medicine, Philadelphia, PA; Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA. Electronic address: anish.agarwal@uphs.upenn.edu.
² Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA; Penn Medicine Center for Healthcare Innovation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
³ Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA.
⁴ Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA; Penn Medicine Center for Healthcare Innovation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA.
⁵ Penn Medicine Center for Healthcare Innovation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
⁶ Computer and Information Science, University of Pennsylvania, Philadelphia, PA.
⁷ Penn Medicine Department of Emergency Medicine, Philadelphia, PA; Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA.

PMID: 30392737
DOI: 10.1016/j.annemergmed.2018.09.029

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.

Publication types

Comparative Study

MeSH terms

Ambulatory Care Facilities* / standards
Emergency Service, Hospital* / standards
Health Services Research
Humans
Pain Management
Patient Satisfaction / statistics & numerical data*
Quality of Health Care / standards*
Retrospective Studies