What do we know about online patient feedback?

The first part of the INQUIRE project involved conducting a literature review to find out what kind of research has been done on online patient feedback and what can we learn from it.

We searched several databases to find any research that has been conducted on this topic across the world. Because we wanted to establish the state of current evidence, we excluded anything that wasn’t research, like opinion pieces and editorials. The search returned over 25,000 articles that we reviewed for relevance. We reduced these to 70 after applying a set of strict exclusion criteria.

So, what do we know now?

Firstly, the vast majority (n=41) of studies we found were conducted in the USA. The next most prolific country was the UK with nine studies.
Initial findings from a German study suggest that awareness of online feedback sites is lower than rating sites for consumer goods. Other German and American studies indicate that young people, women and people with higher levels of education are more likely to use healthcare rating and review sites to post reviews or ratings and/or to aid in choosing a health professional. Older people and those who have a well-established relationship with their doctors tend to leave positive feedback. In fact, the majority of online feedback is positive and, interestingly, longer comments were found to be more likely to contain negative feedback.
Analyses of the content of the feedback showed that it contained comments on doctors’ knowledge and competency, communication, personal character and professional conduct. It also contained information about the cleanliness of a hospital, how easy it is to schedule an appointment and the length of waiting times.

Studies about attitudes to online feedback indicate that professionals are concerned about its usefulness. But it’s worth noting that some studies in the Netherlands concluded that it could be useful to healthcare monitoring agencies (such as the Care Quality Commission here in England). Professionals may also be interested to learn that UK studies have shown a correlation between the number of patients willing to ‘recommend a hospital to a friend’ and overall National Inpatient Survey ratings. Positive online recommendations were correlated with hospital mortality ratios, and better ratings of hospital cleanliness were associated with lower rates of infections.
Through this review, we’ve begun to build up a picture about several aspects of online patient feedback, and it’s clear that we need to explore its potential to make a difference to the NHS. However, more research is needed to confirm how it can be harnessed to greatest effect. Through the range of methods applied and the various different groups of participants involved, the INQUIRE project is well-placed to begin to explore some previously unanswered questions.

Dr Anne-Marie Boylan & Dr Veronika Williams, Senior Researchers, INQUIRE

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