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October 27, 2021
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David Burda
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Consumerism Outcomes System Dynamics
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Healthcare Consumers Know Best

Consumers may struggle with health literacy, but they know a lousy provider when they experience one, and many are not afraid to let other consumers know about it.

That’s the scary takeaway for provider executives who are dismissive of consumer ratings from a new study in JAMA Network Open that links online provider reviews to county-level mortality rates. You can download the study here

Researchers from UCLA and the University of Pennsylvania wanted to know how astute patients were in evaluating the clinical performance of their local healthcare providers. So, they basically cross tabulated the online providers reviews that consumers posted on Yelp with resident mortality rates in the counties where those providers did business. 

The researchers included 95,120 healthcare facilities in the study because they provided one or more of 10 essential services covered by ACA health insurance plans. The facilities included hospitals, physician practices, other types of ambulatory-care sites, rehab facilities, pharmacies, behavioral health providers and clinical laboratories. The facilities were located in 1,301 counties across the U.S.

The facilities also had to have at least three online reviews of their performance posted on Yelp over the five-year study period from 2015 through 2019. On Yelp, consumers rated providers’ performance on a five-star scale, with one star being the lowest rating and five being the highest. The researchers then  compared those ratings with the mortality rates in those counties.

Lo and behold, the analysis found that the lower the rating, the higher the mortality rate. Or, if you’re a glass half-full kind of person, the higher the rating, the lower the mortality rate. In fact, every star higher equated to a drop in the county-level mortality rate of 18 people for every 100,000 residents.

“These findings suggest that online ratings and reviews may provide insight into unequal experience of essential health care,” the researchers concluded. Further, “Facilities in counties with higher mortality are more likely to provide worse care.”

That’s a polite way of saying that consumers actually may know what they’re talking about when they believe that the medical care that they got from a provider was either good or bad. 

That makes them smarter than health system executives, many of whom think that their system’s performance is better than it actually is, as we wrote in this post: “What Executives Think of Their Own Health System’s Performance.” 

That makes them smarter than hospital marketing departments, many of which inflate their hospital’s performance in their advertising campaigns, as we wrote in this post: “Should Consumers Trust Hospital Advertising?” 

That makes them adept at diagnosing and triaging their own medical symptoms online, as we wrote in this post: “Patient Search Thyself” 

They just need to be more aggressive and less passive in demanding safe and effective care and good service from providers and payers, as we wrote in this column: “The Secret to Being a Good Healthcare Consumer Is Food.”  

A good place to start is by looking at online reviews.

Thanks for reading. 

About the Authors

David Burda

Dave is 4sight Health’s biggest news junkie, resident journalist and healthcare historian. He began covering healthcare in 1983 and hasn’t stopped since. Dave writes his own column, “Burda on Health,” for us, contributes weekly blog posts, and manages our weekly e-newsletter and weekly podcast, 4sight Friday and 4sight Roundup.

Dave believes that healthcare is a business like any other business, and customers—patients—are king. If you do what’s right for patients, good business results will follow.

Dave’s personal experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 35 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 35 years and his three children, none of whom want to be journalists or lobster fishermen.

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