Yelp reviews reveal strengths and weaknesses of emergency departments and urgent care

November 9, 2018, Perelman School of Medicine at the University of Pennsylvania
Credit: CC0 Public Domain

Yelp reviews reveal that emergency departments are viewed as being higher quality but lacking in service as compared to urgent care centers, which patients rate the opposite, according to a new study from researchers in the Perelman School of Medicine at the University of Pennsylvania. The study results, published this month in the Annals of Emergency Medicine, provide a unique opportunity for researchers and clinicians to learn from online reviews, which provide a raw narrative from consumers.

"Today's world is very digital, and it's very common for consumers to rate a restaurant, hotel or service online, a practice that is spilling over into health care," said the study's lead author, Anish Agarwal, MD, a National Clinician Scholars fellow and Emergency Medicine physician at Penn Medicine. "As an physician, patients often tell me that the internet is the first place they go for information about medical conditions and to research providers. Health systems and clinicians can learn a lot about the communities they treat and how people experience the services they provide by looking to online ratings and reviews."

In this new study, researchers, with the help of an automated system, analyzed high (five-star) and low (one-star) Yelp reviews for both departments and , two venues that patients can select from when in need of acute care.

Researchers identified key themes in the five-star reviews of emergency departments, including bedside manner, treatment of family members, and access to care on nights and weekends. Urgent care centers were unique in receiving five-star reviews more often for factors including ease of refilling prescriptions and being positively recommended by others.

On the other side, emergency departments received negative remarks for speed of care, while urgent care centers received one-star reviews as a result of poor reception experiences and patients lacking confidence in the care received.

"We are seeing more and more that patients are sharing their experiences online, and they're looking to social media platforms and online communities to help inform their decision-making," said Kevin B. Mahoney, executive vice president and chief administrative officer of the University of Pennsylvania Health System. "Within these and rating websites lies a trove of decision-making data that we can and should be culling through to help inform how care is delivered, and what matters most to our patients in emergency situations."

Urgent care centers have proliferated widely across the country in the past 15 years. Between 2007 and 2016, visits increased by more than 1,700 percent. But while emergency departments have established surveys for patients and their families to report their experiences, there is not a clear equivalent for gathering direct feedback from patients who visit urgent care centers.

The study's senior author, Raina Merchant, MD, director of the Penn Medicine Center for Digital Health and an associate professor in Emergency Medicine, believes Yelp reviews could fill a knowledge gap.

"Online reviews provide a rapid way of taking the pulse of how this acute care market is emerging and what consumers look for in these settings" said Merchant. "These platforms can also help us identify new focus areas, in an effort to provide better, more efficient care to based on their expressed needs."

The researchers analyzed more than 100,000 Yelp reviews, posted between 2005 and 2017—in the midst of the urgent care boom—tied to 1,566 emergency departments and 5,601 from urgent care centers. During the study period, an average of one new review for an emergency department or an urgent care center appeared every hour of every day.

The reviews fell largely on one end of the spectrum or the other: five stars or one star. Roughly 47 percent of emergency department and 30 percent of urgent care center reviews fell in the one-star category. The disproportionate amount of negative reviews for acute care facilities, compared to other entities reviewed online, like hotels or restaurants, could be a result of what is at stake for the consumer.

"If a restaurant provides you with a quick meal exactly as advertised, they meet your expectations," Merchant said. "With healthcare, things are different. People are often critically ill, the outcomes are uncertain, and the wait can be long—which are all things that sometimes can't be controlled."

The research team found that each type of facility received similar five-star reviews for comfort, cleanliness of facilities, pediatric care, and professionalism. One-star reviews for poor phone experiences, long wait times, billing difficulties, and pain management were tied to both emergency departments and urgent care centers.

Moving forward, the researchers hope to find more nontraditional sources to provide clues about patient experiences and use them to enhance quality.

Explore further: Inappropriate prescribing of abx high in urgent care centers

More information: Anish K. Agarwal et al, Online Ratings of the Patient Experience: Emergency Departments Versus Urgent Care Centers, Annals of Emergency Medicine (2018). DOI: 10.1016/j.annemergmed.2018.09.029

Related Stories

Inappropriate prescribing of abx high in urgent care centers

July 16, 2018
(HealthDay)—There is considerable variability in the proportion of visits at which antibiotics are prescribed among traditional medical and retail clinic settings, according to a research letter published online July 16 ...

Urgent care visits increase as emergency room visits fall

September 4, 2018
Treatment for new health problems, or acute care visits, encompass over one-third of all ambulatory care delivered in the United States. Given the high costs of emergency departments, many insurance plans have created incentives ...

Updated guidelines released for emergency care of children

November 1, 2018
(HealthDay)—The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have released updated guidelines for emergency care of injured and critically ill children. The ...

When to go to the emergency room vs. urgent care

April 17, 2018
When injury or sickness strikes, it can be hard to know where to go for proper care and treatment and if the situation is urgent enough to call 911.

Learning by listening: Physicians say online reviews can improve health care

December 20, 2016
Online platforms that allow users to read and write reviews of businesses and services afford health care providers an opportunity to learn by listening, Penn Medicine physicians say in a new Viewpoint published today in ...

Ambient particulate matter linked to emergency asthma care

September 17, 2018
(HealthDay)—Ambient particulate matter concentrations are associated with emergency/urgent care visits among individuals with asthma, according to a study published in the Aug. 1 issue of the Annals of the American Thoracic ...

Recommended for you

Youth dating violence shaped by parents' conflict-handling views, study finds

November 16, 2018
Parents who talk to their children about nonviolent ways of resolving conflict may reduce children's likelihood of physically or psychologically abusing their dating partners later—even when parents give contradictory messages ...

A low-gluten, high-fiber diet may be healthier than gluten-free

November 16, 2018
When healthy people eat a low-gluten and fibre-rich diet compared with a high-gluten diet, they experience less intestinal discomfort including less bloating. Researchers at University of Copenhagen show that this is due ...

Why we shouldn't like coffee, but we do

November 15, 2018
Why do we like the bitter taste of coffee? Bitterness evolved as a natural warning system to protect the body from harmful substances. By evolutionary logic, we should want to spit it out.

Dietary fat is good? Dietary fat is bad? Coming to consensus

November 15, 2018
Which is better, a low-fat/high-carbohydrate diet or a high-fat/low-carbohydrate diet—or is it the type of fat that matters? In a new paper featured on the cover of Science magazine's special issue on nutrition, researchers ...

Colder, darker climates increase alcohol consumption and liver disease

November 14, 2018
Where you live could influence how much you drink. According to new research from the University of Pittsburgh Division of Gastroenterology, people living in colder regions with less sunlight drink more alcohol than their ...

Survey reveals how we use music as a possible sleep aid

November 14, 2018
Many individuals use music in the hope that it fights sleep difficulties, according to a study published November 14 in the open-access journal PLOS ONE by Tabitha Trahan of the University of Sheffield, UK, and colleagues. ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

LaPortaMA
not rated yet Nov 10, 2018
Meaningless except in its illogic.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.