More on Quality and Safety

Yelp reviews prove a reliable tool for determining hospital quality, New York State Health Foundation study says

More consumers use those platforms and comment on them, creating a real-time feedback loop, Foundation says.

Jeff Lagasse, Associate Editor

As online tools like Yelp become increasingly popular with consumers looking for information about doctors and hospitals, a study sponsored by the New York State Health Foundation showed yelp ratings were a clear and reliable tool for determining hospital quality as defined by potentially preventable readmissions rates.

The news for hospitals is positive as well -- by pointing people to higher-quality doctors and hospitals, those institutions can attract market share, leading to more lives saved and more costs avoided for patients, taxpayers and employers.

The news comes as high-deductible health plans are gaining steam, covering nearly one in three Americans in 2016. The spread of these plans means consumers are paying for more and more of their care out of pocket, giving them a reason to seek out high-quality care at the lowest possible cost.

[Also: ACO tools have lukewarm effect on cost savings, improvement in care quality, Health Affairs study says]

The Medical Payment Advisory Commission estimated that as many as 20 percent of Medicare patients discharged from a hospital were readmitted within 30 days, and research has found that as many as 76 percent of these readmissions could be prevented by better hospital coordination and planning, something consumers should consider in making informed choices.

Insurers and other third parties, including federal and state governments, have developed tools that offer patients more information, including some measures of quality and cost. The downside, according to the study, is that they're not consumer friendly, offering too many choices and some dizzying complexity.

Without a simpler alternative such as Yelp, the authors wrote, New Yorkers in particular would continue to pay for low-quality care that leads to excess spending, poor health outcomes and possibly even needless deaths. High-quality providers without a well-known brand name would struggle to gain market share, compared with lower-quality or more expensive options.

[Also: Physicians doubt whether ACOs deliver cost-effective care, higher quality]

Examining a number of studies on the topic, the authors found that when patients and physicians had a choice about where to seek treatment, they transferred to a higher-quality hospital, suggesting an important role for consumer demand in driving market share to those higher-quality facilities. In fact, the trend toward those hospitals was responsible for as much as a 25 percent of the decline in heart attack mortality from 1996 to 2008. Heart failure and pneumonia also saw declines, though not as large.

One of the advantages of sites like Yelp, the study said, is that as more consumers use those platforms and comment on them, they create a real-time feedback loop that's likely to improve. Surveys suggest that about 75 percent of Americans with internet access searched for medical information online in 2012, while 16 percent have had online interactions with other patients who have the same health conditions. About 25 percent have read or watched someone else's experience regarding health issues.

The authors stressed that while there's a strong correlation between Yelp reviews and 30-day readmission rates, there's a lesser correlation when it comes to other quality measures, such as mortality.

They suggested that Yelp should be made more visible to consumers, perhaps through insurers' websites or those of health insurance exchanges; it also should be made more accessible to elderly, non-English-speaking, and low-income minority populations.

Twitter: @BethJSanborn