Healthcare facilities with higher Yelp ratings associated with lower mortality rates

Editor's note: The following is an edited excerpt from our sister publication, HealthLeaders.

U.S. counties with healthcare facilities with the greatest share of 1-star Yelp reviews had the highest death rates, and a difference of just one point—roughly one star—between counties’ average scores could indicate a mortality rate that is better or worse by dozens of lives, according to researchers at the Penn Medicine Center for Digital Health.

More than 95,000 facilities that provided some form of care recognized by the Affordable Care Act were included in the study, which was recently published in JAMA Network Open. Each facility included in the study had at least three reviews between 2015 and 2019 on Yelp. Each healthcare facility’s ratings were also coded to the specific U.S. county where it was located, resulting in more than 1,300 counties—roughly a third of the country—being represented in the study.

Overall, healthcare facilities achieved an average 2.9 score out of 5 stars, but reviews were weighted very heavily to either side of the scale: five-star reviews account for 52.9% of all reviews, while one-stars made up 33.3%. But when researchers looked at the county-level data of reviews, they found that five-star reviews within the group with the lowest death rates made up 55.6 percent of their total, while one-star reviews were at just 29.1 percent. In the group of counties with the highest death rates, five-star reviews made up only 42.9 percent of the total, compared to 38.8 percent one-stars.

The researchers then determined that if a county’s health facilities’ reviews were a star higher than their average—one point on the scale—models indicated that it translated to 18 fewer deaths per 100,000 residents. But when the study was refined to include counties with three or more healthcare facilities, the impact was greater, indicating a reduction in roughly 53 deaths per 100,000. Refined even further to counties with five healthcare facilities or more, the impact grew to about 60 preventable deaths.

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Leadership Insight, Quality