Hospital ratings on social media appear to reflect quality of care

Social media has become an important way for institutions to communicate - both sending messages and receiving feedback - with clients and with the general public. Hospitals and other health care organizations use social media for a variety of purposes, but there has been little investigation of whether hospitals ratings that patients and other consumers submit via social media accurately reflect patient satisfaction or the quality of care delivered. A new study published online in the Journal of General Internal Medicine finds a correlation between how hospitals are rated on Facebook's five-star system and how well they performed on a widely-used measure of quality care.

"We found that the hospitals in which patients were less likely to have unplanned readmissions within the 30 days after discharge had higher Facebook ratings than were those with higher readmission rates," says lead author McKinley Glover, MD, MHS, a clinical fellow in the Massachusetts General Hospital (MGH) Department of Radiology. "Since user-generated social media feedback appears to be reflective of patient outcomes, hospitals and health care leaders should not underestimate social media's value in developing quality improvement programs."

A co-author of the study, Garry Choy, MD, MBA, an MGH radiologist who also is assistant chief medical information officer of advanced technologies at the Mass. General Physicians Organization, adds, "As we embrace data analytics to better drive how we deliver care at a systems level, this study shows there is opportunity and significant value in sentiment analysis - the use of social media data to track public opinion -as it pertains to health care."

While few studies have examined the relationship between social media and measures of health care quality, as the use of social media has grown, consumers' health care decisions may be influenced information posted to social media sites by patients and others, the authors note. Since few consumers are aware of established sources of information on hospitals' quality of care and outcomes, social media may be a valuable way for institutions both to assess and to share information about patient satisfaction and care quality. Late in 2013, Facebook began providing organizations the option of allowing users to post ratings ranging from one to five stars on their official Facebook pages, and the current study was designed to compare hospitals' 30-day readmission rates with their Facebook ratings.

The investigators began by analyzing data available from Hospital Compare - a website sponsored by the Center for Medicare and Medicaid Services - on 30-day readmission rates for 4,800 U.S. hospitals. While more 80 percent had rates within the expected national average range, 7 percent had significantly lower-than-average readmission rates - a measure that reflects above-average care - and 8 percent had rates that were significantly higher than average. There were no significant differences between the low- and high-readmission hospitals in terms of size, number of admissions, expenses and whether they were non-profit or for-profit, although major teaching hospitals were more likely to be high-readmission hospitals.

Low-readmission hospitals were more likely to have Facebook pages than were high-readmission hospitals - 93 percent versus 82 percent - and more than 80 percent of those in both groups with Facebook pages provided the five-star rating system. Comparison between the two groups revealed that each one-star increase in a hospital's Facebook rating was associated with a greater than five-fold increase in the likelihood that it would have a low, rather than a high readmission rate. Other data available on hospital Facebook pages - including the number of times users reported visiting the hospital, how long a hospital's Facebook page had been available, and the number of Facebook 'likes' - did not differ between the low- and high-readmission groups.

"While we can't say conclusively that social media ratings are fully representative of the actual quality of care, this research adds support to the idea that social media has quantitative value in assessing the areas of patient satisfaction - something we are hoping to study next - and other quality outcomes," says Glover. "Hospitals should be aware that social media ratings may influence patient perceptions of hospitals and potentially their health care choices. Hospitals and other healthcare organizations should also be aware of the potential message they send by not using social media. Members of the general public should be encouraged to provide accurate feedback on their health care experiences via social media, but should not rely solely on such ratings to make their health care decisions."

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In addition to Glover and Choy, co-authors of the Journal of General Internal Medicine are Omid Khalilzadeh, MD, MPH; Anand Prabhakar, MD; Pari Pandharipande, MD MPH; and Scott Gazelle, MD, MPH, PhD, all of the MGH Department of Radiology.

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $760 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, transplantation biology and photomedicine.

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