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What Negative Online Reviews Reveal About Hospitals

There are 140 million+ Yelp reviews, with 8.4 million related to healthcare. Some are positive and others negative, but a new study found that certain words were common to both types of reviews.

Yelp is the go-to website for customer reviews, whether 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. However, a new study found that certain words were common in positive and negative reviews.

What Did The Study Find?

For negative reviews, the word “told” appears in about 20% 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.”

“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, “friendly” appeared in almost 11%, and “great” correlated the most with five-star reviews. These two words were often used in conjunction with descriptions of how the staff treated them. 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 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 had narrative text, date, and star rating. The researchers hypothesized there would be a 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. They found that those reviews generally fell on either extreme of the spectrum — either one star or five stars. About 47% of emergency departments and 30% of urgent care centers were rated one star. Five-star reviews were similar for both 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 seen in 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 positive reviews.

What Does This Mean For Healthcare Providers?

Hospitals and doctors must take these online reviews seriously, as many consumers use them to select and rate their care.

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